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To investigate determinants of willingness to adopt telerehabilitation, willingness of technology use, core affect regarding using telerehabilitation, and digital competencies in rehabilitation professionals in Austria and Germany before and during the COVID-19 pandemic. A cross-sectional paper-based and online survey was conducted before and during COVID-19, respectively, with three cohorts of rehabilitation professionals. Outcomes were the willingness to adopt telerehabilitation evaluated using the extended Unified Theory of Acceptance and Use of Technology; willingness of technology use using the short scale for assessing the willingness of technology use; digital competencies and core affect using the Digital Competence Framework and semantic differential, respectively. Multivariate ordinal regression analysis was performed to determine predictors. Included were 603 rehabilitation professionals. Analysis revealed differences between Austria and Germany and before and during the pandemic for most outcomes. German residency, the pandemic, and a higher educational level were most important predictors of higher willingness to adopt telerehabilitation, willingness of technology use, digital competencies, and positive core affect. The pandemic increased most aspects of willingness to adopt telerehabilitation, willingness of technology use, digital competencies, and positive core affect. Results confirm that rehabilitation professionals with higher degrees are more prone to adopt innovations in healthcare.Registration: German Clinical Trials Register (DRKS00021464) The willingness to adopt telerehabilitation is associated with external factors increasing the need for alternative rehabilitation delivery, such as COVID-19, and with financial facilitators, such as reimbursement. As the willingness to adopt telerehabilitation is higher among speech and language therapists and dietitians, efforts are necessary to enhance its use in physiotherapists and occupational therapists. As a higher willingness to adopt telerehabilitation was observed in younger rehabilitation professionals and those with higher education, increasing the importance of telerehabilitation in education curricula and further knowledge transfer into practice for those already working in the field seems necessary. [ABSTRACT FROM AUTHOR]

Based on research undertaken as part of the EU funded EPPIC project, this paper aims to update and elaborate on the relationship between drug use and offending behaviours by exploring variations within a cross-national sample of drug-experienced young people in touch with criminal justice systems. Adopting a trajectory-based approach, interviews were undertaken with 198 young people aged 15–25 in six European countries (Austria, Denmark, Germany, Italy, Poland, and UK). Data were analysed by applying the Bennett and Holloway categorization of the drugs-crime link, with a focus on the concept of social exclusion as developed by Seddon. Three main types of mechanisms (economic, pharmaceutical, and lifestyles) are used to interpret the data, showing how the relationship between drugs and offending can vary according to type of substances and over time. Furthermore, it can be associated with very different degrees of social exclusion and needs. The results suggest that while economic inequalities still play key roles in explaining drug use and offending, both behaviours can originate from a state of relative deprivation, resulting from the contradictions inherent in 'bulimic societies' that raise aspirations and desires while providing young people scarce opportunities for self-realisation and social recognition. [ABSTRACT FROM AUTHOR]

Objectives: This paper aimed to describe the burden experienced by informal caregivers supporting a person with dementia (PwD) who lives at home and utilizes a dementia care network (DCN), to investigate the factors that are associated with caregiver burden, and to identify possible differences in caregiver burden among different types of DCNs. Method: This study was part of a multi-center, interdisciplinary evaluation of DCNs in Germany (DemNet-D). Cross-sectional data were collected in face-to-face interviews with people with dementia (PwDs) and their caregivers, and 13 DCNs were represented. Standardized questionnaires were used to assess caregiver burden, challenging PwD behaviors, functional competence and caregiver health status. Based on qualitative data, four DCN governance types were used in a multivariate analysis of burden categories. Results:There were 560 PwD-caregiver dyads enrolled in the study. Informal caregivers (n= 536) reported a low-to-moderate burden associated with PwD characteristics (instrumental activities of daily living, challenging behaviors) and caregiver characteristics (gender) as well as the relationship between the caregivers and PwDs. Women felt more burdened but also showed higher levels of personal development. No differences were observed among the different DCN governance types. Conclusions:DCNs might contribute toward moderate to low caregiver burden. Indicators of positive caregiving aspects can be used by DCNs to advance support structures for informal caregivers drawing upon interventions already established for other community settings. Particular interest should be paid to female and spousal caregivers who might be in in need of greater and/or different kinds of support. [ABSTRACT FROM PUBLISHER]

Authenticity is an important concept in positive psychology and has been shown to be related to well-being, health, and leadership effectiveness. The present paper introduces employee authenticity as a predictor of relevant workplace behaviors, namely employee silence and prohibitive voice. Converging evidence across two studies using cross-sectional and longitudinal designs demonstrates that when responding to hypothetical problematic workplace events (Study 1) or actual workplace experiences (Study 2), individual differences in employees’ authenticity predicted more self-reported voice behaviors and less silence that emanated from various motivations. Furthermore, authenticity scores consistently yielded predictive utility over and above the contribution of a broad set of individual and organization-based characteristics. Finally, organizational identification moderated the relation between authenticity and silence, such that for employees with high levels of identification, the relation between authenticity and silence was stronger. [ABSTRACT FROM PUBLISHER]

Globalization, internationalization, and regionalization affect domestic social work. This paper explores how undergraduate students perceive international aspects of their social work education. A questionnaire was distributed to social work undergraduates in Stockholm, Sweden (n=97), and Darmstadt, Germany (n=43). Results showed that a majority of students in Sweden were prepared to work with immigrants and refugees. A majority of students in both countries wanted more education about refugee social work and social work in other countries. The amount of exchange activities was modest, but many students could consider working abroad. Students related most strongly to international aspects of domestic social work such as work with immigrants and refugees. [ABSTRACT FROM AUTHOR]

Automated vehicles (AVs) enable driver-passengers to perform non-driving related tasks (NDRTs). However, it remains unclear if and how they would engage with NDRTs. Therefore, we developed a questionnaire on NDRTs, the QNDRT, for SAE Level 3 (L3) and 5 (L5) driving automation. It comprises 24 items with a general NDRT Work subscale querying general aspects of working while driving in an AV (8 items; L3: 4 items, L5: 4) and a specific NDRT Communication subscale assessing different communication modalities (16 items; L3: 8, L5: 8). Hence, we carried out a cross-sectional questionnaire study and queried 725 participants (351 female, 374 male) from 18 to 96 years. We applied factor analyses and extracted a stable unidimensional factor structure for both NDRT subscales with good psychometric properties (e.g. high and clear factor loadings; satisfactory communalities, item discrimination, and internal consistency). The initial findings revealed that significantly smaller values were assigned to both subscale factors by participants older than 55 years in contrast to younger ones and by women when compared to men. The QNDRT can be used in future (quasi-)experimental L3 and L5 studies and in population surveys to obtain more insight into working and communicating while driving in an AV. [ABSTRACT FROM AUTHOR]

People receiving hematopoietic stem cell transplantation (HSCT) endure long phases of therapy and immobility, which diminish their physical activity (PA) level leading to physical deconditioning. One of the reasons is a lack of clarity on the part of those who work in oncology clinical settings of their role in assessing, advising, and referring patients to exercise. Therefore, our study investigates reported physical activity counseling behavior of health care professionals (HCPs) and the patient perspective on this topic. Physicians (N = 52), nurses (N = 52) physical therapists (N = 26), and patients receiving HSCT (N = 62) participated in a nationwide cross-sectional online-survey. Patients' preferred source of information concerning PA was determined. We examined HCPs self-assessed PA counseling behavior and patients' PA recall by assessing the use of the 5As (Ask, Advice, Agree, Assist, Arrange). Analysis of survey responses was descriptive. Univariate multinomial logistic regression examined whether sociodemographic factors and patient characteristics influence the response behavior. Physicians and PA specialists were patients' preferred source of information regarding PA. A large discrepancy between HCPs' perception and the degree to which HSCT patients recall advice became apparent; profound counseling steps like making referrals were less often recalled in our patient sample. Inactive patients reported to receive less basic PA counseling by physicians. Future research should identify the requirements to increase patients' recall concerning PA counseling in the setting of HSCT. Important messages about PA need to be made more salient to those who are less active and less engaged. [ABSTRACT FROM AUTHOR]

Migration, displacement, and flight are major worldwide phenomena and typically pose challenges to mental health. Therefore, migrants' mental health, and the factors which may predict it, have become an important research subject. The present population-based cross-national comparison study explores symptoms of depression, anxiety, and somatization, as well as quality-of-life in samples of ex-Soviet Jewish migrants settling in three new countries: Germany, Austria and Israel, as well as in a sample of non-migrant ex-Soviet Jews in their country of origin, Russia. In the current study, we investigate the relationship of perceived xenophobiа and antisemitism, acculturation attitudes, ethnic and national identity, as well as affiliation with Jewish religion and culture to the psychological well-being of these migrants. Furthermore, we consider xenophobic and antisemitic attitudes as well as the acculturation orientation of the new countries' societies, assessed in the native control samples. Our data suggest that attitudes of the new country's society matter for the mental health of this migrant group. We conclude that the level of distress among ex-Soviet Jewish migrants seems to depend, among other factors, on the characteristics of the new country and/or specific interactions of the migrant population with the society they are settling in. [ABSTRACT FROM AUTHOR]

This study analyzed the conspiracy mentality of informal caregivers for older persons compared to non-caregivers and whether this association was dependent on age. The sample was collected randomly from a population-based online panel (forsa.omninet) and represents individuals aged ≥40 years from Germany. In total, 3022 participants were questioned about conspiracy mentality (Conspiracy Mentality Questionnaire), informal care provision (N = 489 informal caregivers of older adults), and sociodemographic background. Data assessment took place between 4th and 19th March 2021 and the questions referred to the time between December 2020 and March 2021. No significant differences were found between informal caregivers and non-caregivers. A significant interaction effect was found, indicating a decrease of conspiracy mentality among non-caregivers and an increase among informal caregivers with higher age. After stratifying by gender, this effect was found only among female informal caregivers. Middle-aged informal caregivers had a lower, and older-aged a higher, susceptibility to conspiracy theories during the COVID-19 pandemic compared to non-caregivers. The results indicate that providing care could be protective among middle-aged individuals, whereas older informal caregivers may benefit from interventions to reduce susceptibility to conspiracy theories and the associated risks for health and wellbeing. [ABSTRACT FROM AUTHOR]

Restrictions in mobility can lead to social and health-related issues. Assistive technologies and devices can help to sustain or regain mobility in affected persons. One of the most commonly used devices is the wheelchair. Many wheelchair users experience difficulties within the provision process and with the device itself. The presented study investigated the satisfaction with the wheelchair and the corresponding provision process. A comprehensive online survey was conducted. The questionnaire surveyed the quality of wheelchairs and the corresponding provision process among wheelchair users in Germany. Descriptive methods were used to analyse the results. Sub-groups were classified according to age, sex, waiting time for wheelchair, financing and type of wheelchair. After cleaning the data, 110 datasets remained for analysis. The predominant reasons for wheelchair acquisition were independence and the replacement for a defective wheelchair. Wheelchair quality aspects as well as the corresponding provision process were rated medium. Issues were found regarding waiting times, repair services and communication between service providers. The presented results reflect issues in the quality of wheelchairs and their provision process. Inequality between different sub groups is evident. Although some results should be considered with caution due to unequal group sizes, clear trends can be seen which confirm results from other studies throughout the literature. The presented cross-sectional study results give an important overview about the user satisfaction with the quality and provision process of wheelchairs. A longitudinal study accompanying users during the provision process is being recommended as a more in-depth study. Low durability and adaptability were identified as main issues regarding wheelchair quality. Waiting times for wheelchairs were perceived as too long by the users and make up the main factor for low satisfaction with the wheelchair provision process. Reduced waiting times for wheelchairs (especially for electric wheelchairs) can improve overall satisfaction with the assistive device. Waiting times could be reduced by a more efficient application and provision process. [ABSTRACT FROM AUTHOR]

In Germany, more than two-thirds of employees report mental health issues, while in Japan, more than half of the country's workforce are mentally distressed. Although both countries are socio-economically developed in similar ways, their cultures differ strongly. This article investigates mental health constructs among German and Japanese employees. A cross-sectional design was employed in which 257 German and 165 Japanese employees completed self-report scales regarding mental health problems, mental health shame, self-compassion and work motivation. T-tests, correlation and regression analyses were conducted. Results show that German employees have significantly higher levels of mental health problems, mental health shame, self-compassion and work motivation than Japanese employees. While many correlations were similar, mental health problems were associated with intrinsic motivation in Germans, but not in Japanese. Shame was associated with both intrinsic and extrinsic motivation in Japanese, but not in Germans. Self-compassion – defined as a complex of compassion, humanity, care and unconditional, compassionate love – was associated with gender and age in Japanese, but not in German employees. Lastly, regression analysis uncovered that self-compassion was the strongest predictor of mental health problems in Germans. In Japanese employees, mental health shame is the strongest predictor of mental health problems. Results can guide managers and psychologists in internationalised organisations to effectively approach employee mental health. [ABSTRACT FROM AUTHOR]

In the context of blue-collar work, digital technologies and robotic systems are introduced at a rapid speed. However, employees are not always motivated to adopt such new technologies. Thus, it is essential to understand the drivers of employees' attitudes towards new technology at work (e.g. their enthusiasm about new technology or their insecurity or resistance to change). The present study examines (actual and desired) work characteristics as a predictor of attitudes towards new technology in blue-collar work. Results from a correlational study among blue-collar workers (N = 127) showed that work characteristics among blue-collar workers could be divided into three dimensions, namely, work enrichment, work demands, and task identity. These correlated with attitudes towards a to-be-implemented new technology (here, robotic system): As expected, desired work demands correlated with greater technology enthusiasm, whereas a lack of actual work enrichment predicted technology-based job insecurity. Work characteristics were unrelated to user resistance to change. The findings suggest that how workers evaluate their current work, and how much they are (dis)satisfied with it, predicts attitudes towards new technology. This research adds to the knowledge about attitudes towards new technology in blue-collar work. Practical implications for the implementation of technologies in blue-collar work are discussed. [ABSTRACT FROM AUTHOR]

With rising cancer incidence rates and numbers of long-term cancer survivors, diet increasingly comes into view of patients as well as healthcare providers. The aim was to analyze cancer patients' concepts of nutrition, changes in diet and reasons for these changes. This study is a cross-sectional single-center study. Data was collected 12/2017 − 01/2019 using a questionnaire. The study was set at an outpatient department at a German university hospital. 102 patients (male n = 47, female n = 54; age 34 to 86 years [mean = 62.3]) with cancer were included in the study. Statistical calculation was performed with Mann-Whitney-U-Test and Wilcoxon-signed-rank. p < 0.05 was considered significant. Patients were more concerned with diet after their diagnosis than before (p < 0.01). Seventy-one (70%) patients reported that they changed their diet or planned to do so. Some changes included an increased intake of vegetables or fruits. Patients who changed their diet more often were convinced that there was a positive influence of diet on the course of cancer (p < 0.05). Diet is an important topic for many cancer patients. Some patients seem to have a lack of information regarding the effect of diet on health. Physicians and dietitians should provide more education on healthy and safe diets for cancer patients. [ABSTRACT FROM AUTHOR]

To investigate general practitioners' (GPs') willingness to participate in long-term medical research and in research networks (RNs). Cross-sectional survey among German GPs around Halle-Wittenberg and Leipzig in 2020. Random sample of 905 GPs. Response rate 37%, 69% female. Overall, 57% were interested in participating in medical research, 34% in an active role in a RN. Interest in RN participation was positively associated with male sex, younger age, previous experiences in medical research, being involved in teaching undergraduates, and having qualification in a further specialty. Main motivators were improving patient care, giving a more realistic picture of GP care, and carrying out research on topics within their own interest areas and a reliable contact person at the leading institution. Most GPs were not afraid of reduced earnings; however, time investment was the main barrier for participation. GPs were willing to dedicate twice as much time to research when remuneration was offered. High rated topics were polypharmacy, chronic diseases, drug safety and adverse drug reactions. GPs are interested to participate in practice-based research. The study results providing useful and generalizable insights in barriers and motivators should be considered when building and running GP-RNs. There is a difference between general practitioners' (GPs') overall interest in clinical research and their job and socio-demographic related readiness to participate in research networks (RNs). GPs are interested in RNs when it is a resource of and leading to enhanced patient-oriented care. GPs are willing to dedicate twice as much time to research when remunerated. GPs need a reliable counterpart within the leading institution. [ABSTRACT FROM AUTHOR]

Interprofessional teamwork often suffers from the existence of negative stereotypes. To combat their prevalence, interprofessional education (IPE) activities are being implemented worldwide. The aim of this study is to inform IPE developers of the prevalence and content of interprofessional stereotypes in the workplace in Germany and similarly structured healthcare systems. We surveyed health professionals with several years of work experience as nurse, midwife, or therapist concerning their attitudes toward their own professions and those of doctors using an established trait rating measure and a qualitative approach. Stereotypes of respondents (N = 129) were mostly related to (1) academic, medical competence (being perceived as lower than that of doctors) and (2) the traditional role relationship (strict hierarchy, dependence on doctors) that guides a lot of behavior, such as the little participation of nurses, midwives and therapists. Despite profound structural differences in the education and healthcare systems, our analyses further revealed similar topics for further IPE activities as in international research, such as the general demand to convey knowledge about the roles, skills and responsibilities of the other professions. The demand to improve the teamwork skills of all health professionals and empower them to be full and equal members of the healthcare team was also evident. Thus, a more reflective approach to stereotypes and their impact on interprofessional teamwork is indicated, particularly in workplace-based interprofessional learning activities. More generally, to counteract stereotypes a more widespread adoption of IPE in pre and post licensure health professions education and continuing professional development in Germany is needed. [ABSTRACT FROM AUTHOR]

The aim of the study was to examine the mental well-being of audiologists in the midst of the COVID-19 pandemic. A cross-sectional online survey was conducted during the COVID-19 pandemic, between 23 June and 13 August 2020. A self-report survey included screening measures for psychological distress (PHQ-4: anxiety and depression) and loneliness (UCLA-3). 239 audiologists from around the world. The prevalence of psychological distress was 12.1% (subscales for anxiety 16.3% and depression 10.4%), and loneliness 32.2%. Depression and loneliness were higher in those participants self-reporting perceived job insecurity, with psychological distress (anxiety and depression) higher in those from South Africa. Accessibility to Employee Assistance Programs (EAPs) appears to be a protective factor. Well-being interventions, such as EAPS, are needed to support audiologists during challenging times like the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Physical activity promotion requires a multi-layered assessment that does not only assess body functions but which in particular also includes the measurement of personal factors (e.g. exercise self-efficacy). Objectives: The purpose was to review the utilisation of standardised measurements (SMs), admission interviews and interdisciplinary information sharing, and to analyse the content of these practices with respect to physical activity promotion. Design: Observational, cross-sectional national survey. Method: A Germany-wide, quantitative survey, collecting information from 713 exercise therapy departments, was conducted. Measurements were classified as standardised or non-standardised and assigned to the International Classification of Functioning (ICF). Admission interviews and information from other professionals were analysed using a qualitative content analysis. Results: In total, 1008 SMs included 9007 ICF concepts: 16% were classified as personal factors, but none were clearly related to physical activity promotion. Admission interviews contained several non-standardised assessments of personal factors: goals (40%), exercise experiences/activity bibliography (10%), activity level (5%), exercise preferences (2%). Information sharing does not contain relevant information for physical activity promotion. Discussion: Exercise therapists have scant information about the personal factors that influence clients' physical activity behaviour. An assessment for physical activity promotion that includes physical functioning and personal factors has, so far, barely been implemented in practice. [ABSTRACT FROM AUTHOR]

The aim of the study was to explore whether abstinent patients on recent opioid detoxification or on opioid maintenance treatment suffer from sleeping problems. 199 patients on opioid maintenance treatment (methadone, diacetylmorphine and buprenorphine) or recent opioid detoxification were included in this exploratory cross-sectional study. We used the Pittsburgh Sleep Quality Index (PSQI) and the Regensburger Insomnia Scale (RIS) in order to assess potential sleeping problems. There was a significant effect of the condition "opioid maintenance" or "recent opioid detoxification" on the total score of PSQI and RIS. All opioid maintenance drugs used by the study population were associated with more sleeping problems compared to the detoxification group when calculated with RIS values. Recently abstinent patients (opioid detoxification) displayed significantly fewer sleep disturbances than opioid-maintained patients. Since sleeping problems can seriously impair treatment success and quality of life, screening for sleep disturbances and their subsequent treatment is of pronounced relevance. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to provide insights into the impact of organizational family-centered care characteristics at German neonatal intensive care units (NICUs) on the satisfaction of parents of very low birthweight (VLBW) infants.Materials and methods: Using multilevel modeling, this study analyzed whether organizational characteristics of NICUs fostering parent-infant interaction (by way of the existence of a recreation room, possibility of rooming in, existence of unrestricted visiting hours for parents, existence of parental classes, and the connection to parent associations as well as the existence of standards on developmentally supportive care) increase the satisfaction of parents after the infants' high-intensive care phase within the NICU.Results: Nine hundred and twenty-three VLBW infants from 66 NICUs in Germany born between May and October 2013 were enrolled in this multicenter study. We retrieved 1493 questionnaires completed by 1277 parents. The existence of unrestricted visiting hours (adjusted odds ratio (AOR): 1.967; 95% CI [1.118, 3.459]) and standardized procedures for developmentally supportive care (AOR: 1.775; 95% CI [1.166, 2.704]) were positively associated with parental satisfaction.Conclusions: Fostering the parent-infant interaction through the provision of developmentally supportive care and unrestricted visiting hours for parents whose infants are hospitalized within an NICU significantly contributes to the satisfaction of parents. [ABSTRACT FROM AUTHOR]

Objective: Concordance-analysis and evaluation of existing algorithms detecting late-onset preeclampsia during first trimester screeningMethods: Retrospective cohort study investigating risk algorithms of late-onset preeclampsia during first trimester screening in a German prenatal center. Three previously developed algorithms including anamnestic factors (Apriori) and biophysical markers (BioM) were investigated by using detection rates (DR) with fixed FPR 10% and fixed cutoff >1:100. Furthermore, we set up a concordance-analysis of test results in late-onset preeclampsia cases to examine the effect of influencing factors and to detect potential weaknesses of the algorithms. Therefore, we modeled the probability of discordances as a function of the influencing factors based on a logistic regression, that was fitted using a Bayesian approach.Results: 6,113 pregnancies were considered, whereof 700 have been excluded and 5,413 pregnancies were analyzed. 98 (1.8%) patients developed preeclampsia (79 late-onsets, 19 early-onsets). The Apriori-algorithm reaches a DR of 34.2%, by adding BioM (MAP and UtA-PI) the DR improves to 57.0% (FPR of 10%). In concordance-analysis of Apriori algorithm and Apriori+BioM algorithms, influencing factor BMI<25 increases the chance of discordances sigificantly. Additional, in the subgroup of late-onset preeclampsias with BMI<25 the DR is higher in Apriori+BioM algorithms than in Apriori algorithm alone. If both compared algorithms include BioM, influencing factor MAP decreases the chance of discordances significantly. All other tested influencing factors do not have a statistically significant effect on discordancesConclusion: Normal-weight patients benefit more from the integration of MAP and UtA-PI compared to overweight/obese patients. [ABSTRACT FROM AUTHOR]

This study examined how quantity and quality of early childhood education and care (ECEC) are related to the socio-emotional adjustment of children born in Germany (30–48 months old, N = 395). Previous research focused on a small set of ECEC features, used broad measures, and yielded inconclusive results. We assessed ECEC quantity (age at entry, hours per week), process quality (CLASS Pre-K), structural quality (child-teacher ratio), and classroom composition (percentage of immigrant children). Controlling for child, family, and teacher characteristics, we tested main and interaction effects in regression analyses. Research Findings: More hours per week predicted lower adjustment only on specific indicators (hyperactivity, conduct problems) and only in classrooms with a high percentage of immigrant children or a high child-teacher ratio. In addition, a higher child-teacher ratio predicted more conduct problems, but only for children who entered ECEC at a very young age. Process quality did not predict adjustment. Practice or policy: In sum, this implies that German ECEC does not pose a major risk for children's socio-emotional adjustment, as only certain aspects of quantity and structural quality are linked to very specific socio-emotional outcomes under very specific circumstances. [ABSTRACT FROM AUTHOR]

Purpose: To quantify biomechanical change associated with autoimmune diseases using Corvis ST deformation data. Methods: Cross-sectional, observational, case control study of 76 patients with systemic autoimmune disease and 21 control subjects. All patients underwent detailed ophthalmic examination with Corvis-ST (Oculus Optikgerate Gmbh, Germany) measurements for biomechanical properties of the eye. Corneal deformation and also deformation caused by the extracorneal tissue were recorded. Using a mathematical formula, the three parameters, namely, corneal stiffness (kc), extracorneal tissue stiffness (kg), and extracorneal tissue viscosity (μg), were defined. Results: The biomechanical analysis showed that kc and μg were significantly lower in patients with systemic autoimmune disease with eye manifestations than control group. However statistically, it was significant in rheumatoid arthritis (RA) patients only. Conclusion: The new parameters, namely, kc, kg, and μg, can provide a sensitive marker of the ocular activity of the collagen vascular diseases. [ABSTRACT FROM AUTHOR]

Background: There are no validated assessment tools for evaluating quality of schoolwork task performance of children living in German-speaking Europe (GSE). Objective: To determine whether the international age-normative means of the School Version of the Assessment of Motor and Process Skills (School AMPS) are valid for use in GSE. Methods: The participants were 159 typically-developing children, 3-12 years, from GSE. We examined the proportions of School AMPS measures falling within ±2 standard deviation (SD) of the international age-normative means, and evaluated for significant group differences (p < 0.05) in mean School AMPS measures between the GSE sample and the international age-normative sample using one-sample Z tests. When significant mean differences were found, we evaluated if the differences were clinically meaningful. Results: At least 95% of the GSE School AMPS measures fell within ±2 SD of the international age-normative means for the School AMPS. The only significant mean differences were for 6- (p < 0.01) and 8-year-olds (p = 0.02), and only the 6-year-old school process mean difference was clinically meaningful. Conclusions: Because the only identified clinically meaningful difference was associated with likely scoring error of one rater, the international age-normative means of the School AMPS appear to be valid for use with children in GSE. [ABSTRACT FROM AUTHOR]

EHealth behaviour change interventions that help participants to adhere to professional physical activity recommendations can help to prevent future events of cardiovascular diseases (CVD). Therefore, identifying user groups of such interventions based on stages of health behaviour change is of great importance to provide tailored content to users instead of one-size-fits-all approaches. Our study used Latent Class Analysis (LCA) to identify underlying classes of users of an eHealth behaviour change intervention based on stages of change and associated variables. We compared participants' self-allocated stage with their latent class stage membership to display the correlation and mean differences between the two approaches. This was done by analysing baseline data of N = 310 people interested in reducing their CVD risk. LCA identified a three-class solution: (non-)intenders (19.4%), non-habituated actors (43.2%) and habituated actors (37.4%). The interrelation between self-allocated and latent class stage membership was moderate (ρ(308) = .49, p < .001). Significant mean differences for (non-)intenders and non-habituated actors were found in social-cognitive variables. Results showed that self-allocated stage outcomes represent a pseudo stage model − linear trends can be reported for stage-associated social-cognitive variables. The study provides information on the validity of stage measures, which can inform future interventions. [ABSTRACT FROM AUTHOR]

Objectives: Data on cognitive testing in migrants in Germany are scarce. We aimed to evaluate the Montreal Cognitive Assessment (MoCA) in Turkish migrants in Berlin and its association with demographics and health-related variables. Method: For this cross-sectional study, a random sample of persons with Turkish names was drawn from the registration-office. Cognitive function was assessed using the MoCA; 0 = worst, 30 = best total score. Multivariable linear regression models were calculated to determine associated factors with the total MoCA-score. Results: In our analyses we included 282 participants (50% female), mean age 42.3 ± 11.9 years (mean ± standard deviation (SD)). The mean ± SD MoCA score was 23.3 ± 4.3. In the multivariable analysis, higher education (ß = 2.68; p < 0.001), and chosing the German version of the MoCA (ß = -1.13; p = 0.026), were associated with higher MoCA-scores, whereas higher age (ß = -0.08; p = 0.002) was associated with lower MoCA scores. Conclusion: In our study, a higher educational level, lower age, and German as the preferred test language (as compared to Turkish) were positively associated with the cognitive performance of Berliners with Turkish roots. To examine neurocognitive health of migrants, longitudinal population-based and clinical cohort studies that specifically compare migrants and their descendants with the original population of their home countries are required. [ABSTRACT FROM AUTHOR]

Background: Although young adult men are at an elevated risk for gambling problems (GP), compared to adolescents and adults in general this group is still largely unresearched. The current study investigates whether family functioning, which is associated with reduced risk for GP in adolescence, also affects gambling in young adults, who are more independent than minors. It analyses the relationship between GP and two core components of family functioning, the effectiveness of problem-solving in the family and perceived concordance of values. Methods: Data came from the baseline, 12- and 24-month follow-up assessments of Munich Leisure-time Study (MLS), a longitudinal online study in young male gamblers. Young men were recruited via the Munich citizens’ registry (n = 2,693) and Facebook invites (n = 105). In total, n = 173 individuals positively screened for frequent and/or regular gambling participated in the study. The hypothesised relations between problem-solving, concordance of values and GP were investigated with a path model controlling for non-planning impulsiveness and psychological distress. Results: Higher concordance of family values was significantly related to less GP in cross-sectional and longitudinal analyses. It mediated the relation between the effectiveness of problem-solving and GP. Conclusions: While previous studies indicated good family functioning as a factor preventive of GP, the current results indicate that this association is mediated by the perceived concordance of family values. In families with effective problem-solving, common family values might facilitate recognition of and reaction to first signs of problems. Perceived discordance may lead to feelings of shame and concealment of GP. [ABSTRACT FROM AUTHOR]

In this study the authors examined the issue of permanent infertility in two diagnoses of the diverse sex developments (DSD) spectrum: Complete Androgen Insensitivity Syndrome (CAIS) and Mayer-Rokitansky-KÏster-Hauser Syndrome (MRKHS). The participants with CAIS (n = 12) was older, showed a lower wish for a child and was less distressed about their infertility compared to participants with MRKHS (n = 49). Our data indicated an "indifferent" attitude toward motherhood in CAIS and an "ambivalent" attitude in MRKHS. Depression was frequent in both. Infertility is a source of distress. However, the two groups seem to cope in different ways. Comprehensive medical information and psychological support should be provided. [ABSTRACT FROM AUTHOR]

This study reports on the developmental patterns of /ʃC/ clusters in 145 normally developing monolingual German-speaking children between 2;00 and 2;11. All children completed a picture naming task to allow a systematic qualitative analysis of the production patterns. Children's reductions of target /ʃC/clusters are examined and are evaluated with respect to two models, 'factorial typology' and 'headedness', to account for them. The results reveal expected patterns of C2 retention for '/ʃ/+[-continuant]' (e.g. '/ʃ/+stop' and '/ʃ/ +nasal') targets, and a rather indeterminate pattern for /ʃl/ and /ʃʁ/. The results for /ʃv/, a clear-cut preference of C2 retention, were rather unexpected, as the C2 is a [+continuant]. The explanation offered for the retention of /v/ is related to a place constraint. The study also examines the data from children who reached an advanced stage of cluster formation with differential targets. More specifically, in several children, one target, /ʃv/, is found to have stayed behind in the reduction phase while all others have advanced to the 'cluster stage'. Neither the type nor the token frequencies seem satisfactory in accounting for the specific behaviour of /ʃv/. The explanation offered for the uniqueness of this target may be its non-abidence to the Sonority Sequencing Principle (SSP) because of its flat sonority and the Obligatory Contour Principle (OCP) [continuant], because of the unchanging 'continuance' which is demanded by the OCP. Theoretical and clinical implications are discussed. [ABSTRACT FROM AUTHOR]

Background: Traumatic experiences and posttraumatic stress disorder (PTSD) are prevalent in patients with alcohol use disorders (AUDs) and affect its course and outcome. Prior prevalence reports are limited by the inclusion of individuals with additional substance use disorders (SUDs), a focus on childhood events only and the use of self-ratings only. Objectives: To examine the prevalence of traumatic experiences, revictimization and PTSD in inpatients treated for alcohol dependence without other SUD, emphasizing interpersonal violence across the whole lifespan. Methods: For this cross-sectional study alcohol-dependent patients without additional SUD (N = 230, 73% male, mean age 43 years) were recruited in an inpatient detoxification unit and were administered the Structured Trauma Interview, the Posttraumatic Diagnostic Scale, and the Structured Clinical Interview for DSM-IV. Data analysis comprised descriptive statistics and appropriate significance tests. Results: 36.2% reported severe childhood physical or sexual abuse and 45.6% reported at least one of these types of abuse in adulthood. The lifetime rate of interpersonal violence was 61.1%. The prevalence of current PTSD was 13.2%. Women with a history of childhood abuse were about seven times as likely to be victimized in adulthood as women without these experiences, while in men revictimization was not significant. Conclusions: Even in patients with alcohol dependence without additional SUD experiences of interpersonal violence and PTSD are frequent. In order to adequately respond to the needs of this population, trauma and PTSD should routinely be assessed in alcohol-dependence treatment and considered in treatment planning if necessary. [ABSTRACT FROM AUTHOR]

Background: Transgender adolescents who apply for treatment often experience a marked increase in body-related distress when entering puberty, accompanied by internalizing problems and poor peer relations. Although adolescence is a time of considerable psychosocial and physical change, generally associated with a decline in health-related quality of life (HRQoL), research on HRQoL in transgender youth and possible predictors is sparse. This study thus aims to explore the predictive value of body image factors and emotional and behavioral problems for HRQoL. Methods: This cross-sectional one-group observational study was carried out at the Child and Adolescent psychiatric department (Gender Identity Service) in Hamburg, Germany. A sample of n = 126 (103 trans male and 23 trans female) adolescents, who were referred for counseling and/or treatment completed different standardized instruments before undergoing any sort of treatment. Firstly, five dimensions of HRQoL were explored in transgender adolescents and secondly, a linear regression model was applied to assess the impact of body image and emotional and behavioral problems on overall HRQoL. Results: HRQoL was generally impaired in transgender adolescents compared to norm scores, especially with regard to aspects of psychological and physical well-being. Linear regression analysis revealed that greater internalizing problems and less body satisfaction significantly predicted lower HRQoL outcomes. Conclusions: Impaired HRQoL may be explained by high degrees of internalizing problems and low body satisfaction. Thus, one important aim of mental health professionals working with youth should be to provide appropriate treatment and counseling options that may contribute to overall well-being in the long-term. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to explore cluster acquisition in typically developing German-speaking 2-year-olds. Method: Data from four cross-sectional studies (n = 145, aged 2;00–2;11) and one eight-month longitudinal study were analysed (n = 6, aged 2;01–2;04). Two different percentages of consonant clusters correct were calculated to allow a more detailed analysis. Result: Findings showed that the majority of children produced clusters, although they could not be considered to be fully acquired. Correct production significantly correlated with age. Only /gl/ and /kl/ were shown to be phonetically and phonemically acquired (75% criterion) in the older age group. Three-element clusters were acquired at the same time as 2-element clusters and /∫/-clusters were acquired to the same or larger extent as non-/∫/ clusters when fronting/backing of /∫/ was accepted. Younger children produced more reductions than simplifications but this effect was less strong for the /∫/-clusters. Developmental realisation patterns varied depending on cluster type. Inter- and intra-individual developmental patterns could be observed which changed depending on the time of testing. Conclusion: Findings on cluster acquisition in 2-year-old German-speaking children revealed language-specific differences but also similarities in comparison with results from other languages. All but two children produced clusters. However, individual variation between children was high. [ABSTRACT FROM PUBLISHER]

Objective: The menopausal syndrome is described as a series of various physical and nonphysical symptoms attributed to perimenopausal changes in hormone levels. However, evidence is biased by focusing research on the target group of middle aged women only. To overcome this bias, we examined the occurrence of menopausal symptoms during the entire life span in both women and men.Methods: Therefore, we studied the occurrence of menopausal symptoms with the widely used Menopause Rating Scale (MRS) across the entire life span in both women and men. To this end, we performed a nationwide cross-sectional survey study in Germany in which we examined a representative sample of 2527 persons aged from 14 to 95 years. Additionally, sociodemographic factors and self-efficacy were surveyed.Results: Although the overall MRS score was generally higher for women compared to men, there was no specific peak for the time of menopause. Instead the score increased linearly with age for both sexes. Furthermore, it was stronger associated with sociodemographic variables and self-efficacy than with the sex of the participants. Among all assessed symptoms, only hot flushes and sweating, but none of the others, emerged as specific for the menopausal episode.Conclusions: Our data indicate that among symptoms commonly classified as menopausal only hot flushes and sweating appear to be specific for the perimenopausal episode. Other symptoms may be caused by a multifactorial etiopathogenesis including physical, sociodemographic, cultural and psychological factors that, in turn, might benefit from multimodal treatment regimes. [ABSTRACT FROM AUTHOR]

This study examined contributions of different types of sport activities to the development of elite youth soccer performance. Match-play performance of 44 German male players was assessed by expert coaches twice, 24 months apart (age 11.1–13.1 years), based on videotaped 5v5 matches. Player pairs were matched by identical age and initial performance at t1. Each player was assigned to a group of either "Strong" or "Weak Responders" based on a higher or lower subsequent performance improvement at t2 within each pair (mean Δperformance 29% vs. 7%). A questionnaire recorded current and earlier amounts of organised practice/training and non-organised sporting play, in soccer and other sports, respectively. Group comparison revealed that "Strong Responders" accumulated more non-organised soccer play and organised practice/training in other sports, but not more organised soccer practice/training. Subsequent multivariate analyses (multiple linear regression analyses (MLR)) highlighted that higher resultant match-play performance at t2 was accounted for R2adj = 0.65 by performance at t1, together with more non-organised soccer play and organised engagement in other sports, respectively, and greater current, but less earlier volume of organised soccer. The findings suggest that variable early sporting experience facilitates subsequent soccer performance development in German elite youth footballers. [ABSTRACT FROM AUTHOR]

Background: Three different conceptualizations of occupational prestige were contrasted by applying social stratification to four exemplarily selected psychoactive substances. Although these conceptualizations partly measure the same construct, it is hypothesized that the gradient of occupational inequality differs depending on the type of conceptualization.Method: Data were taken from the 2012 German Epidemiological Survey of Substance Abuse. The study sample comprisedn = 9084 individuals of the general population aged 18–64 years. Use and heavy use of cigarettes, alcohol, cannabis and analgesics were stratified by (a) employment status (six groups: employed, marginally employed, apprenticeship, unemployed, retired and other), (b) occupational status (five groups: low to high) and (c) occupational social class (two groups: blue-collar and white-collar). Absolute and relative differences between occupational groups were calculated. All analyses were stratified by gender.Results: Risk for smoking was increased amongst unemployed males and blue-collar workers. Retired persons, people with low occupational status and female blue-collar workers had a diminished risk for alcohol consumption; apprentices had an increased risk. Amongst males, low occupational status and blue-collar work was associated with episodic heavy drinking. Unemployment and blue-collar work was related to cannabis use. Risk for heavy analgesics use was increased amongst unemployed women, men with low occupational status and male blue-collar workers, respectively.Conclusions: The results suggest that occupational inequality differs depending on the applied conceptualizations of occupational prestige. Consequently, they should not be used interchangeably. [ABSTRACT FROM AUTHOR]

The trickle-down effect assumes that sporting success at the elite sport level descends down to the amateur sport level in the sense that people are inspired by sporting success to participate themselves. Previous research failed to find convincing evidence for this relationship, mostly because the data used and the methods applied (e.g. cross-sectional data, primary data, correlations) were not adequate. This study addresses these shortcomings and examines the effect of national sporting success on amateur sport participation in German football using longitudinal data from 1950 to 2014. Since an individual’s decision to participate in sport also depends on other factors, the regression models also control for working hours, real wages etc. The results show that only World Cup title wins of the men’s national team have a positive and statistically significant impact on the number of and percentage changes in individual club memberships, clubs and teams. The coefficients of European Championship titles and title wins of the women’s national team turn out to be mostly insignificant. Future research should examine the reasons as to why only title wins by the men’s team have a measurable inspirational effect on amateur sport participation in football. [ABSTRACT FROM PUBLISHER]

Objective: To establish the status of hearing in adults in Germany and the effects of screening for noise, tinnitus, ear diseases, and general health on the distribution of hearing threshold levels (HTL)Design: A cross-sectional epidemiological study conducted between 2010 and 2012 in two middle-sized cities.Study sample: A total of 1903 adults aged 18 to 97 years from a randomized sample drawn from the local registration offices and stratified for age and gender.Results: Dispersion and distribution of HTL data observed in the population-based sample are well in line with international results. However, median HTL tend to be better than in most recent international studies. Screening for “otological normality” improves the median HTL overall by 3 dB in males and 1 dB in females. This effect is strongly age-dependent in males and far less pronounced in females. While by and large HTL medians of females in the screened sample meet the values expected by ISO 7029:2000, HTL medians of males in middle and higher age cohorts are better than expected, especially in the frequencies above 2 kHz.Conclusions: This study supports international findings that in males, the age-related decrease in hearing sensitivity at high frequencies is smaller than described by ISO 7029:2000. [ABSTRACT FROM PUBLISHER]

Objective:To investigate total leisure noise exposure among adolescents and to assess its association with hearing.Design:Based on self-reported time spent on 19 leisure activities and associated mean sound pressure levels reported in the literature, total leisure noise exposure was evaluated and compared to noise at work limits (> 85 dB(A) = hazardous) in a cross-sectional survey. Tympanometry and pure-tone audiometry was performed in sound isolated rooms.Study sample:The study sample consists of 2143 pupils attending grade nine in any school in a German city 2009–2011 (mean age: 15.4 years; range: 13–19 years). Audiometric data were available for 1837 (85.8%) pupils (53.9% girls).Results:41.9% of the 2143 adolescents who had provided self-reported data on leisure activities associated with noise exposure were estimated to be hazardously exposed to leisure time noise. The interaction of gender with total leisure time noise exposure was not significant. No association between leisure time noise exposure and audiometric notches could be detected.Conclusion:While hearing loss seems seldom in this age group, a high proportion of adolescents aged 15–16 years are exposed to noise levels during leisure time bearing long-term risks of hearing loss. [ABSTRACT FROM PUBLISHER]

Residential self-selection is supposed to bias the relation between residential environments and physical activity, but empirical analyses are still rare. This study examines the association while simultaneously considering the effect of residential self-selection criteria. One thousand two hundred and forty-five German students were asked to report their physical activity, their perceived environment, and their reasons for choosing their neighbourhood. Structural equation modelling was employed. Reasons for choosing a neighbourhood were related to actual environmental characteristics. Utilitarian reasons were related to less physical activity, hedonic reasons were related to higher physical activity. The street network was related to higher physical activity independent of residential self-selection. Our results support the weight of both individual preferences and the street network on physical activity. The residential environment has an impact on people’s amount of physical activity regardless of their reasons for choosing a neighbourhood and should therefore be considered a resource in health prevention and promotion. [ABSTRACT FROM AUTHOR]

In a qualitative elicitation study with 61 cancer patients, a broad range of attitudes toward physical activity could be obtained, especially negative attitudes among insufficiently active patients. Based on these results, a second quantitative study was conducted; 64 patients [40 men; 42% insufficiently active (<150 minutes/week)] completed a Theory of Planned Behavior (TPB) questionnaire. Regression analyses revealed that different variables of the TPB are relevant for explaining the intention to exercise for physically active (subjective norm) and insufficiently active (attitudes) cancer patients. Health professionals should adapt their support to the special needs of insufficiently active and active cancer patients. [ABSTRACT FROM PUBLISHER]

Objectives. The analyses address the following research questions: (1) Do Turkish diabetics in Germany and Turkey differ in terms of quality of life? (2) If yes, can these differences (in part) be explained by social factors (age, gender, education, household size), functional limitations and availability of support? (3) Are social factors, functional limitations and availability of support differently associated with quality of life among Turkish diabetics in Germany and Turkey? Design. For this comparative cross-sectional study, 111 patients with type 2 diabetes were personally interviewed in Istanbul (Turkey) and 294 Turkish patients in Hamburg (Germany). For quality of life measurement we have used the Turkish version of the WHOQOL-Bref-26. Sociodemographics included age, sex, education and household-size. Health related functional limitations were assessed on the basis of an index of (instrumental) activities of daily living including the availability of help. Statistical analyses were conducted on group comparisons with Chi-square- andT-tests as well as linear regressions. Results. There are no significant differences between Turkish diabetics in Germany and Turkey in the physical and the psychological dimensions of the WHOQOL-Bref. However, in the WHOQOL-domains ‘social QoL’ and ‘environmental QoL’ Turkish diabetics living in Hamburg have a significantly better quality of life than their counterparts in Istanbul. These differences cannot be explained by individual sociodemographic factors, functional limitations and availability of support. Furthermore, we found much stronger positive associations between education and quality of life in Istanbul than in Hamburg. Conclusion. Beyond strong similarities between the two samples in sociodemographics, physical and mental health the social and environmental quality of life was significantly assessed better by the Turkish diabetics living in Hamburg. This is most likely an effect of public investment in social security, infrastructure and health care which is also influencing the decision as to where to spend life in retirement. [ABSTRACT FROM PUBLISHER]

Objectives: The present study aimed to assess long-term health-related quality-of-life (HRQoL) and potential predictors as well as burden in caregivers of patients with acquired brain injury (ABI). Furthermore, depressive symptoms, well-being, HRQoL and happiness were evaluated in caregivers and patients who had regained communication skills. Research design: Prospective cross-sectional survey. Methods: Data of 104 caregivers and 30 patients were analysed. A multiple linear regression model was calculated to identify independent predictors for HRQoL in caregivers. Additionally, correlation analysis was conducted to evaluate associations between patient questionnaire results and caregiver HRQoL. Results: After a mean time post-injury of 18 years, HRQoL and perceived health status in caregivers remained below normative scores of age-matched controls. Although HRQoL and perceived health status were lower in patients than in caregivers, there was no difference in happiness, perceived QoL or enjoyment of life. Reduced perception in well-being (WHO-5 score < 13) was found in 52% of the caregivers and 36% of the patients. HRQoL in caregivers was predicted by well-being, caregiver strain, depressive symptoms and caregiver age. Furthermore, HRQoL of caregivers was correlated with depressive symptoms and happiness in patients. Conclusion: This study under-scores the importance of long-term support for caregivers. [ABSTRACT FROM AUTHOR]

Conclusions: The Hearing Implant Sound Quality Index (HISQUI19) seems to be a valid tool for quantifying the self-perceived level of auditory benefit that cochlear implant (CI) users experience in everyday listening situations. Additional research is, however, required. Objectives: To develop and validate a user-friendly instrument for quantifying the self-perceived level of auditory benefit that CI users experience in everyday listening situations. Methods: This was an explorative, uncontrolled, single-group, cross-sectional study. Items for the HISQUI19 were decided upon using user input and verified by professionals. The HISQUI19 was assessed on 75 CI users from hearing implant centres in Germany and Austria to determine the questions. Results: The HISQUI19, consisting of 19 items scored on a 7-point Likert scale, was validated. Subjects older than 60 years at time of implantation did not have significantly higher mean values than subjects younger than 60 years. Gender and whether subjects are unilateral or bilateral implant CI users did not influence self-perceived functioning. Subjects with ≤20 years of hearing loss reported no significantly higher functioning than those with >20 years of hearing loss. [ABSTRACT FROM AUTHOR]

For successful communication of risk-related disease and treatment modalities, sufficient competence in risk literacy is important. Medical students who will soon be in the responsible role of physicians need to comprehend numeric estimates of probability in order to explain them understandably to patients. Therefore, we have examined the risk literacy among German medical students in a cross-sectional study with 600 participants from the first to the sixth year. Four hundred thirty-four complete datasets (72.35%) could be retrieved. The measuring instrument was the Berlin Numeracy Test, in which a maximum of 4 points could be obtained. Participants achieved an average score of 2.03 points, which is significantly higher than the score defined by the Berlin Numeracy Test (1.6 points). A slight increase from the first (2.00 points) to the sixth academic year (2.38) was detected, which was not significant. In addition, participants who made notes achieved significantly higher test results (2.45) than students who did mental arithmetic (1.77). Male participants showed a significantly higher performance (2.36) than their female colleagues (1.72). Medical students possess a good basis in their risk literacy skills; however, more exercise in dealing with practical case studies is needed. [ABSTRACT FROM AUTHOR]

Aims: This study investigated past month patterns and risk factors of alcohol, tobacco and cannabis use by level of intensity in the German general population. Methods: Data from the 2006 German Epidemiological Survey of Substance Abuse (ESA) were used. The cross-sectional random sample consisted of N = 7912 adults aged 18-64 years. The response rate was 45%. Intensive use of each substance was measured applying substance-specific cut-off points: alcohol: >20/30 g pure ethanol daily for women/men; tobacco: ≥20 cigarettes daily; cannabis: on ≥6 occasions monthly. Findings: The majority of substance users reported no intensive use of any of the three substances (77.5%) and 19.4% had used one of the three substances intensively. A total of 3.1% engaged in intensive use of multiple substances with alcohol and tobacco (2.3%) as the most prevalent pattern. A higher risk for intensive use of multiple substances was found among males, older individuals and those with a substance use disorder. Conclusions: Results of this study call for an integrated view on substance use and related disorders in prevention and treatment, taking diverse use patterns and specific needs of substance abusers into account. [ABSTRACT FROM AUTHOR]

Objective: Both dispositional optimism and illness representations are related to psychological health in chronic patients. In a group of chronic tinnitus sufferers, the interplay between these two variables was examined. Specifically, it was tested to what extent the relationship between dispositional optimism and depression is mediated by more positive illness representations. Method: The study had a cross-sectional design. One hundred and eighteen patients diagnosed with chronic tinnitus completed questionnaires assessing optimism (Life Orientation Test-Revised [LOT-R]), illness representations (Illness Perceptions Questionnaire-Revised [IPQ-R]) and depression (Hospital Anxiety and Depression Scale [HADS]). Results: Correlation analysis showed that optimism was associated with more positive illness representations and lower levels of depression. Simple mediation analyses revealed that the relationship between optimism and depression was partially mediated by the illness representation dimensions consequences, treatment control, coherence, emotional representations and internal causes. A multiple mediation analysis indicated that the total mediation effect of illness representations is particularly due to the dimension consequences. Conclusion: Optimism influences depression in tinnitus patients both directly and indirectly. The indirect effect indicates that optimism is associated with more positive tinnitus-specific illness representations which, in turn, are related to less depression. These findings contribute to a better understanding of the interplay between generalised expectancies, illness-specific perceptions and psychological adjustment to medical conditions. [ABSTRACT FROM PUBLISHER]

This study explores the relationship between a ruminative response style and symptom reports in children and adolescents of grades 5, 7 and 9 from German secondary schools. Questionnaires were used to assess rumination and symptom reports. A group of children and adolescents (N = 140) were asked to think first about the items before responding to them (increased attention condition), while a second group (N = 260) served as control group (standard condition). The assumption was that rumination and also additional attention to the symptoms by instruction would increase the reported frequency of experiencing somatic and psychological symptoms. The results showed significant relations between symptom reports and rumination, which increased with grade. There were sex differences for somatic symptom reports with increased symptom frequencies in girls, which were mediated by rumination. Moreover, instructing participants to think first about the items led to an increase in reported symptoms. It is concluded that an increased attention to symptoms of distress increases symptom reports, which may be induced momentarily by instruction and also more generally by a ruminative response style. Conclusions regarding prevention and concerning instructions in symptom report questionnaires are outlined. [ABSTRACT FROM PUBLISHER]

Educational effectiveness research often appeals tovalue-added models (VAM)to gauge the impact of schooling on student learningnetof the effect of student background variables. A huge amount of cross-sectional studies do not, however, meet VAM's requirement for longitudinal data.Contextualised attainment models (CAM)measure the influence of schools on student outcomes controlling for family background characteristics in cross-sectional studies. It is argued that the latter are adequate substitutes for student prior attainment. Drawing on data from a 3-point longitudinal study in the city of Berlin, Germany (n = 3,074), reading and mathematics achievement of primary students are investigated to assess effectiveness measures of schools. Estimates are compared for a 3-level growth curve analysis (VAM), a hierarchical linear model controlling for background characteristics (CAM), and one additionally controlling for prior achievement scores (prior attainment model). The article contributes to the enhancement of a feedback culture for cross-sectional study results. [ABSTRACT FROM PUBLISHER]

For implementation of patient-centered treatment in interprofessional health care units, such as rehabilitation teams, external participation (interaction between patient and health care professionals) and internal participation (communication, coordination and cooperation in the interprofessional team) need to be considered. The aim of this study is to identify the preferences of patients and health care professionals concerning internal and external participation in rehabilitation clinics, in order to develop an interprofessional shared decision-making (SDM) training program for health care professionals to enhance both types of participation. Therefore, a cross-sectional mixed-methods study was implemented in four rehabilitation clinics. The study consists of two parts: focus groups with patients and a survey of experts (senior health care professionals from medicine, psychotherapy, physical therapy and nursing). More time, more respect from the health care professionals and the desire for more participation in decision-making processes were mentioned most frequently by patients ( n = 36) in the focus groups. The health care professionals ( n = 32) saw most deficits in internal participation, e.g. management of feedback, talking with difficult team members and moderate conflict discussion. The results of both assessments have been used to develop an interprofessional SDM training program for implementing internal and external participation in interprofessional teams in medical rehabilitation. [ABSTRACT FROM AUTHOR]

Effective coordination among all members of hospital staff has been shown to be associated with better quality of care. The literature indicates that social capital, a form of organizational resource, may facilitate the task of coordination. However, to the best of our knowledge, no study has yet examined this link within a healthcare setting. Thus, the objective of this study was to analyze the relationship between social capital and coordination among hospital staff, as perceived by the medical director being a key informant of the hospital. In 2008, we surveyed the medical directors of 1224 German hospitals by the use of a standardized questionnaire. We conducted stepwise multivariate linear regression and controlled for hospital size, ownership and teaching status. In total, 551 medical directors (45%) responded to the survey. We found social capital to be a significant predictor of coordination (β = 0.444, p < 0.001). The regression model explained 28% of the variance in coordination. Higher levels of social capital can be associated with better coordination among members of hospital staff, as perceived by the medical director. Therefore, investment in social capital may facilitate better organization of work processes in hospitals and may therefore help to improve patient outcomes. However, longitudinal studies are needed in order to explain the causal relationship between social capital and coordination among hospital staff. [ABSTRACT FROM AUTHOR]

Although many studies have reported on internalising and externalising problems related to cyberbullying roles, there is a lack of longitudinal research in this area. This study reports (1) cross-sectional data from 412 German middle-school students to examine differences between cyberbullies, cybervictims and cyberbully–victims compared to non-involved students in regard to internalising (depressiveness and loneliness) and externalising (instrumental and reactive aggression) problems; and (2) longitudinal data from 223 students about links of cyberbullying and cybervictimisation with internalising and externalising problems across two measurement occasions, analysed using path analysis (separately by gender). Self-report measures were used. The results revealed no significant differences between groups in internalising problems, but all three cyberbullying groups differed significantly from the non-involved group in externalising problems. Female victims showed increases in externalising problems while male victims did not show changes across time in either internalising or externalising problems. Male bullies reported decreases in internalising problems across time. For boys, scoring high in both cyberbullying and cybervictimisation led to increases in loneliness, while for girls this predicted decreases in reactive aggression. [ABSTRACT FROM AUTHOR]