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Construct: In this study, we examine the differences in test performance between the paper-based and the computer-based version of the Berlin formative Progress Test. In this context it is the first study that allows controlling for students’ prior performance.Background: Computer-based tests make possible a more efficient examination procedure for test administration and review. Although university staff will benefit largely from computer-based tests, the question arises if computer-based tests influence students’ test performance.Approach: A total of 266 German students from the 9th and 10th semester of medicine (comparable with the 4th-year North American medical school schedule) participated in the study (paper = 132, computer = 134). The allocation of the test format was conducted as a randomized matched-pair design in which students were first sorted according to their prior test results. The organizational procedure, the examination conditions, the room, and seating arrangements, as well as the order of questions and answers, were identical in both groups.Results: The sociodemographic variables and pretest scores of both groups were comparable. The test results from the paper and computer versions did not differ. The groups remained within the allotted time, but students using the computer version (particularly the high performers) needed significantly less time to complete the test. In addition, we found significant differences in guessing behavior. Low performers using the computer version guess significantly more than low-performing students in the paper-pencil version.Conclusions: Participants in computer-based tests are not at a disadvantage in terms of their test results. The computer-based test required less processing time. The reason for the longer processing time when using the paper-pencil version might be due to the time needed to write the answer down, controlling for transferring the answer correctly. It is still not known why students using the computer version (particularly low-performing students) guess at a higher rate. Further studies are necessary to understand this finding. [ABSTRACT FROM AUTHOR]

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]

Assessing the impact of dysarthria on a patient's ability to communicate should be an integral part of patient management. However, due to the high demands on reliable quantification of communication limitations, hardly any formal clinical tests with approved psychometric properties have been developed so far. This study investigates a web-based assessment of communication impairment in dysarthria, named KommPaS. The test comprises measures of intelligibility, naturalness, perceived listener effort and communication efficiency, as well as a total score that integrates these parameters. The approach is characterized by a quasi-random access to a large inventory of test materials and to a large group of naïve listeners, recruited via crowdsourcing. As part of a larger research program to establish the clinical applicability of this new approach, the present paper focuses on two psychometric issues, namely specificity and sensitivity (study 1) and retest-reliability (study 2). Study 1: KommPaS was administered to 54 healthy adults and 100 adult persons with dysarthria (PWD). Non-parametric criterion-based norms (specificity: 0.95) were used to derive a standard metric for each of the four component variables, and corresponding sensitivity values for the presence of dysarthria were identified. Overall classification accuracy of the total score was determined using a ROC analysis. The resulting cutscores showed a high accuracy in the separation of PWD from healthy speakers for the naturalness and the total score. Study 2: A sub-group of 20 PWD enrolled in study 1 were administered a second KommPaS examination. ICC analyses revealed good to excellent retest reliabilities for all parameters. [ABSTRACT FROM AUTHOR]

Objectives Multimorbidity poses various challenges, and previous research has indicated a causal relation with depression. As multimorbidity is not curable, the underlying mechanisms are of great interest. Positive affect is a major resource for coping with chronic conditions and for the prevention of depression. Long-term multimorbidity, however, may deplete positive affect. The purpose of this paper is to investigate the role of positive affect in the association between multimorbidity and depressive symptoms. Method We used four consecutive waves (2008, 2011, 2014, 2017) of the nationally representative German Ageing Survey (DEAS) with a total of 1,558 older adults aged 40 and over. To account for time-varying confounding, exposure-induced mediator-outcome confounding, and reciprocities, we applied the mediational g-formula with inverse-probability weighting techniques. We also tested for exposure-mediator interaction to adjust for differences in mediation across the duration of multimorbidity. Results We confirmed a positive longitudinal relation between multimorbidity and depressive symptoms, both of which were negatively associated with while positive affect. The model without interaction indicated a share mediated of ca. 18.3% on the total effect of multimorbidity on depressive symptoms. Addition of interaction led to substantial differences for multimorbidity duration and levels of positive affect. Associations for long-term multimorbidity (at least two survey waves) were more substantial, and the share mediated doubled (>40%). Additionally, the direct effect of multimorbidity on depressive symptoms diminished for short-term multimorbidity. Conclusion Strengthening positive affect could reduce depressive symptoms in those facing multimorbidity. This study also discusses methodological challenges in performing longitudinal mediation analysis. We advise researchers to consider the mediational g-formula and exposure-mediator interaction. [ABSTRACT FROM AUTHOR]

Background Students' motivation to participate is one of the main challenges in formative assessment. The utility framework identifies potential points of intervention for improving the acceptance of formative assessment [Van Der Vleuten C. 1996. The assessment of professional competence: Developments, research and practical implications. Adv Health Sci Educ 1(1):41-67]. At the Medical Faculty of the University of Cologne, the paper-based version of the Berlin Progress Test has been transformed into computer-based version providing immediate feedback. Aim To investigate whether the introduction of computer-based assessment (CBA) enhances the acceptance of formative assessment relative to paper-based assessment (PBA). Methods In a retrospective cohort study (PBA: N == 2597, CBA: N == 2712), students' overall acceptance of the two forms of assessment was surveyed, their comments were analyzed, and we analyzed their test behavior and categorized students into 'serious' or 'non-serious' test takers. Results In the preclinical phase of medical education, no differences were found in overall acceptance of the two forms of assessment ( p > 0.05). In the clinical phase, differences in favor of CBA were found in overall acceptance ( p < 0.05), the proportion of positive comments ( p < 0.001), and the proportion of serious participants ( p < 0.001). Conclusions Introduction of immediate feedback via CBA can enhance the acceptance and therefore the utility of formative assessment. [ABSTRACT FROM AUTHOR]

Physical fitness is an important health resource. From 2003 onwards, the MoMo study, a part of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), has investigated physical fitness on the basis of nationally representative data. The objective of this paper was to analyse trends in physical fitness of three cohorts at the ages of 4–17 years. Changes within 10 test items of the MoMo-test profile are reported. The mean values of physical fitness and the relevant influencing factors were directly compared across cohorts (in the total group and in age-and sex-subgroups). Statistical significance of differences was examined by calculating the confidence intervals (95% CI) for complex samples; effect sizes were determined using Cohen's d. The results indicated that physical fitness levels of German children and adolescents initially slightly increased between MoMo baseline (2003–2006) and wave 1 (2009–2012). This could partly be attributed to increased physical activity in sports clubs and in extracurricular sports at school. Then, between MoMo wave 1 and MoMo wave 2 (2014–2017) the physical fitness of children and adolescents in Germany remained the same, as did all influencing factors with the exception of extracurricular sport. From a public health perspective, programmes and measures that can increase the chances for all children and adolescents to strive for greater physical fitness should be of the highest priority. [ABSTRACT FROM AUTHOR]

Stadium noise – created by spectators and fans – plays a critical part in the reality of professional sports. Due to a lack of research on the impact of these auditory cues and multimodal environments on motor performance, it is currently unclear how professional athletes experience and perceive stadium noise and how this potentially affects performance in practice. In order to explore the effect of stadium noise on athletes' performance, this paper presents an experimental design using the unique and standardised football training tool known as the "Footbonaut". Specifically, fifteen skilled German football players engaged in a standardised football-specific technical training programme while subjected to four different auditory training conditions; these included both "positive" and "negative" stadium noise conditions, a "baseline" condition providing auditory guidance, and a "no (auditory) cue" condition. Performance data for passing accuracy and passing time were measured for training in each auditory condition. A repeated measures MANOVA revealed a significant main effect for passing time. Specifically, participants showed faster passing times in the baseline compared to the negative and no auditory cue conditions. Findings are presented and discussed from a constraints-led perspective, allied to principles of ecological dynamics and nonlinear pedagogy. Particularly, the use of representative training experiences (including multimodal sensory and emotional information) appears to underline training to refine expert athletes' adaptive coordination of complex motor actions. [ABSTRACT FROM AUTHOR]

In this paper, we report on the development and refinement of a progressive physical exercise training and home modification intervention for older people with a risk of falling located in Germany by using the United Kingdom's Medical Research Council framework. The process was iterative and six phases of development emerged: (1) establishing an intervention development group, (2) identifying the evidence on interventions, (3) identifying a theory to underpin the intervention, (4) designing the intervention components, (5) drafting the intervention manual and training course, and (6) piloting and refining of intervention components. The result was an evidence-based, theory-informed, and user-endorsed intervention: FIT-at-Home. This intervention comprised nine individual sessions over 12 weeks and two follow-up booster sessions delivered by trained occupational therapists. A feasibility study demonstrated the acceptance and feasibility of intervention delivery. Users responses were generally favorable and included recommendations about the intervention manual, mode of delivery of the home hazard assessment, and producing a manual for older people. We developed a feasible home-based lifestyle-integrated physical exercise training and home modification intervention for older people with a risk of falling by using a systematic approach. Implications include how this intervention could enrich occupational therapy fall prevention strategy in older people living at home. Falls in older people represent a major public health concern and occupational therapists in rehabilitation practice are encouraged to apply evidence-based interventions that reduce the risk of falls in older people living in a community. Many physical and environmental fall risks are modifiable by lifestyle changes such as physical exercise training, home safety assessment, and home modification. We developed a home-based balance and strength exercise training and home modification intervention that aims to improve strength, balance, and home safety. This study indicates that older people, at risk of falling, with functional limitations, and limited mobility, who participated in the FIT-at-Home intervention, felt that exercising at home suited them best. [ABSTRACT FROM AUTHOR]

This paper primarily examines the perspectives of dying persons in Germany, in terms of if and when the dying feels lonely during their final weeks. The author contrasts emic perceptions with public discourses in regards to the non-dying ones possibly neglecting or tabooing the terminally ill. Secondly, the paper explores how and where the dying persons included in the study want to pass away. The dying individuals involved did not feel tabooed or ignored by non-dying persons. Dying at home did not necessarily remain the preferred option compared to dying at institutions. The author collected data between 2013 and 2015 in Western Germany, using long-term participant observation and interviews with individuals diagnosed as terminally ill. [ABSTRACT FROM AUTHOR]

Based on concepts from environmental gerontology and lifespan psychology, this study aims at comparing perceived housing and person-environment (p-e) fit across three age groups. Young (20-30 years old; n=125), young-old (55-65 years old; n=42) and old-old adults (80-90 years old; n=21) filled in an online or paper-pencil questionnaire on perceived housing and p-e fit. As expected, ANOVAs revealed significant differences in perceived housing between young and youngold adults and between young and old-old adults, but not between young-old and old-old adults. Social and comfort p-e fit contributed significantly to the prediction of perceived housing, while basic p-e fit did not. These findings show the relevance of differentiated assessments of housing processes to foster an age-group related understanding of housing needs and preferences in practice. [ABSTRACT FROM AUTHOR]

Reflecting team is a structured and guided method for peer collaborative reflection on critical incidents in teaching. The present evaluation study combining quantitative and qualitative data investigates the perceived usefulness and central insights associated with the participation in a reflecting team session. This method was implemented among three groups of teachers in Germany: student teachers, school teachers, and higher education teachers. All three groups reported high levels of perceived usefulness of the method and provided insights into their central experiences in connection with the reflecting team. Differences between the three groups in terms of perceived usefulness and central insights of peer reflection stem from participants' distinct organizational and educational contexts and show various ways of how teachers can derive benefits from the reflecting team method. [ABSTRACT FROM AUTHOR]

This paper provides a detailed picture of the sources and types of informal support available to centenarians, depending on their housing and care arrangements. Participants were 112 centenarians and 96 primary contacts of centenarians enrolled in the population-based Second Heidelberg Centenarian Study. Findings indicate that children of centenarians were their primary source of support in daily life. Those without living children had overall less help. Most frequently reported was help with administrative tasks, regardless of centenarians' residence or living arrangement. All other types of help (e.g., with activities of daily living and housework) were reported by about one-third and were mostly provided by children; centenarians without children were more likely to have friends/neighbors involved in some of these tasks. The one category reported by a third of the centenarians regardless of residence, living arrangements, or presence of a child was help with socializing/companionship. Findings constitute an important step toward identifying and meeting the support needs of centenarians and their families. Policy implications are discussed. [ABSTRACT FROM AUTHOR]

This paper investigates neurophysiological correlates of prosodic prominence in German with two EEG experiments. Experiment 1 tested different degrees of prominence (three accent types: L+H*, H*, H+L* and deaccentuation) in the absence of context, making the acoustic signal the only source for attention orienting. Experiment 2 tested L+H* and H+L* accents in relation to contexts such as "Guess what happened today" triggering expectations as to how exciting the following utterance will be. Results reveal that prominence cues that attract attention, such as a signal-driven high level of prosodic prominence or a content-driven expression of excitement, engender positivities of varying latency. Furthermore, contextual expectations trigger prediction errors, e.g. deviations from an appropriate level of prosodic prominence result in a negative ERP deflection. Hence, the data suggest that the two core processes – attentional orientation and predictive processing – reflect discrete stages in the construction of a mental representation during real-time comprehension. [ABSTRACT FROM AUTHOR]

Background: The Heidelberger Drogenbogen (HDB) is a German language assessment of substance-specific knowledge and consumption patterns of the illicit psychoactive substances cannabis, MDMA (ecstasy), amphetamines, cocaine, and hallucinogens. The behavior modules for each of these five drugs/drug groups allow for a diagnostic evaluation of the extent of harmful consumption behavior. Each of the five modules represents a single standardized test. Objectives: This paper outlines several statistical parameters, Cronbach's alpha, retest reliabilities, as well as numerous validity and cut-off-criteria of the behavioral modules. Methods: Participants (N = 4,794) were recruited at schools, universities, in subcultural contexts, and in institutions of substance abuse treatment. Results: Internal consistencies range from =.68 to.79 while test–retest reliabilities between.87 and.94 were found. The behavior modules of the HDB can discriminate between populations with and without clinical levels of substance use. Furthermore, this measure has incremental validity and higher diagnostic accuracy over competing measures. Conclusions: The behavior modules of the HDB are reliable and valid measures of substance use and misuse. [ABSTRACT FROM AUTHOR]

The secular trend of reduced physical fitness (PF) leads to increased health risks. The aim of the present paper is to analyse various current factors that affect health behaviour with respect to the course of PF over 2 years. A path analysis combined with a latent growth curve analysis was based on a study that was conducted between June 2008 and June 2010 with 145 primary German school children (52.1% male, average age at baseline 7.95 years ± 0.95). PF was tested with the German Motor Test 6–18. For the mean PF and the course of PF, direct and indirect influences were shown over three levels, including migration background on the first level and physical activity (PA) on the second level. Body mass index (BMI) impacted the mean PF but not the course of PF. The influence of sedentary behaviour on the mean PF was diminished (compared to bivariate analysis) due to its common variance mainly with BMI. PA affected not only current PF in children but also the course of PF (aintercept =.28, P =.001; aslope =.27, P =.21). Consequently, preventive measures should focus on early adoption and maintenance of PA. [ABSTRACT FROM AUTHOR]

Trans and intersex individuals are often not considered in obstetric care—neither in practice nor in research. This quantitative study used an online survey to compare the experiences of pregnant trans men, non-binary individuals, and intersex people with those of endosex cisgender individuals who received care in obstetrics. Trans men and non-binary individuals reported discrimination during pregnancy and childbirth on the interactional, institutional, and structural level: for example, they reported more unsatisfactory encounters with health care personnel and more barriers in the structure of health care services and facilities. Trans and intersex individuals had less access to information relevant to them concerning pregnancy and birth compared to cisgender endosex individuals. Although it happened less frequently, cisgender endosex individuals also reported negative experiences, such as discrimination or violence during birth in a hospital. Our findings indicate a need for change concerning several aspects of the obstetric care spectrum—especially, but not exclusively, for trans, non-binary, and intersex people. Some suggestions for improvement include the following: On the hospital level, measures should be implemented to reduce structural discrimination and to ascertain one-on-one care during active labor. Inclusive information material should be developed and disseminated and health care institutions should raise awareness among their staff regarding care for their LGBTIQ patients. More studies on obstetric issues concerning queer, trans, and especially intersex people should be conducted and diversity and inclusion should be implemented as core topics in the training curricula for midwives, physicians, and nurses. [ABSTRACT FROM AUTHOR]

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]

This paper investigates the way the predictability of prosodic patterns in a particular language influences the processing of stress information by native speakers of that language. We extend previous findings where speakers of languages with predictable stress had difficulties to process and represent stress information when confronted with a language with distinctive stress and investigate how the co-existence of a predictable stress pattern and exceptions to that regularity within a single language influences prosodic processing. The stress system of Turkish constitutes an instructive test case since it employs predictable stress on the final syllable of a prosodic word (e.g.,mısır“corn”) and some exceptional nonfinal stress (e.g.,mısır“Egypt”). Results from an event-related potential (ERP) study on stress violations in Turkish trisyllabic words showed asymmetrical ERP responses for different stress violations: Stress violations with final stress produced an N400 effect whereas violations with nonfinal stress produced a P300 effect. The application of the predictable pattern to words with lexical stress led to lexical costs and the application of exceptional stress to words with default stress to effects reflecting the evaluation of this pattern. Although final stress constitutes no alternative pattern for words with exceptional stress, participants have difficulties to judge this pattern as incorrect. In contrast, exceptional stress patterns are detected easily when applied incorrectly to words that normally receive final stress. These findings demonstrate nicely the co-existence of two phonological processing routines in Turkish speakers. Furthermore, the variability of stress patterns does not affect prosodic processing in general but instead leads to differential effects in stress perception. We conclude that stress predictability does not homogenously result in the so-called “stress deafness” effects in stress processing, but that it rather emerges only for the default stress pattern. [ABSTRACT FROM PUBLISHER]

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]

This study investigates assistant nurses' views on and needs for orientation to care robot use in three European countries. The use of care robots is gradually being incorporated into welfare services. Orientation to care robot use (in short, introduction to the use of the care robot technology) has thus become a key issue for care services. A survey was sent to assistant nurses in Finland, Germany, and Sweden, to which 302 participants responded (Finland n = 117; Germany n = 73; Sweden n = 112). Only 11.3% of assistant nurses had experience of giving orientation to care robot use to older adults or colleagues, but over 50% were willing to do so. Those with experience of using care robots should take part in orientation. Orientation to care robot use should be seen as part of care management and an issue that may affect the whole organisation. Management should, firstly, allow assistant nurses to get to know care robots by offering information, and secondly, consider with the assistant nurses the ways care robots can change their work and the implications of this change. Emphasising the social factors and practical orientation to care robot use extends the previous theories and perspectives of technology acceptance, adoption and diffusion. [ABSTRACT FROM AUTHOR]

We identify individuals who set daily intake budgets and examine if an intervention making people estimate their calorie intake up to a certain point in the day helps those setting daily budgets to regulate their calorie intake for the remainder of the day, after high prior consumption. We conducted an online experiment in five countries: Australia, China, Germany, India, and the UK (n = 3,032) using a 2 (setting calorie budget: yes vs. no, measured) x 2 (intervention: intake reminder vs. control, manipulated) between-subjects design, with the amount of prior consumption measured. Participants were contacted in the afternoon. Those in the intervention condition were asked to estimate their prior calorie intake on that day. We measured the individual characteristics of those who set daily calorie budgets and the intended calorie intake for the remainder of the day. Among people who set daily calorie budgets, the intervention reduced intended calorie intake for the remainder of the day by 176 calories if they had already consumed a high amount of calories that day. A timely intervention to estimate one's calorie intake can lower additional intended calorie intake among those who set daily calorie budget. [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]

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]

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]

This prospective one-year cohort study aimed to assess the feasibility and outcomes of a routine psychosocial screening at patients' admittance to specialist inpatient palliative care. Patients admitted to an academic palliative care ward were routinely screened for self-reported distress and psychological morbidity, psychosocial stress factors, and subjective need for help from psychosocial professions. Cognitive impairments were the most common patient barrier to screening. Screenings were completed in 138 of 428 patients (32%). Based on established cutoffs, distress was indicated in 89%, depression in 51%, and anxiety in 50% of these patients. The burden on next-of-kin emerged as the most prevalent stress factor (73%). One-half of the patients disclosed a subjective need for help (53%). Possible depression (p =.023), anxiety (p <.001), and subjective need for help (p <.001) correlated positively with a higher amount of time spent by psychologists and creative arts-based therapists with small to moderate effects. Patients who completed the screening were attributed with a higher amount of time by social workers than patients who did not (p =.004), but there were no relationships between screening results and social work. Results suggest the potential of screenings for the allocation of specialist psychosocial care during specialist palliative care; however, barriers to screening do exist. [ABSTRACT FROM AUTHOR]

The forward testing effect (FTE) refers to the finding that retrieval practice of previously studied material can facilitate recall of newly studied (critical) material. Such interim retrieval practice can also lead to a differential FTE, i.e., a more pronounced FTE for items at early than later serial positions in the critical material. The present study examined whether this differential FTE also holds with interim semantic generation of extra-list items, and whether it is influenced by study material. Consistent with prior work, the results of two experiments showed that both interim retrieval practice and interim semantic generation induce the general (list-level) FTE when unrelated study lists are applied, whereas retrieval practice only creates the effect with categorised study lists. Critically, however, the differential FTE was present in response to retrieval practice but absent in response to semantic generation. This pattern held regardless of which material was studied, thus experimentally dissociating the general (list-level) from the differential (item-level) FTE. The findings may suggest that retrieval practice, but not semantic generation, induces a reset of the encoding process which promotes attentional encoding such that a more pronounced FTE arises for early than middle and late serial positions in the critical list. [ABSTRACT FROM AUTHOR]

Non-word repetition tasks are widely used to assess phonological short-term memory (PSTM). Results of previous research on the performance of monolingual and bilingual children in PSTM tasks are inconclusive. Although in some studies bilinguals did outperform monolinguals in the repetition of non-words, most studies reported comparatively weak results of bilingual children, especially when they were tested in their L2. In this study, four-year-old monolingual and bilingual children acquiring German (N = 1,441) were tested with both German-based (GBNW) and quasi-universal non-words (QUNW). It was hypothesized that bilinguals would outperform monolinguals both in (a) GBNW under the condition of comparable German language skills and (b) QUNW without any preconditions because QUNW do not presuppose a good command of German. Bilinguals yielded significantly lower results in GBNW, but not in QUNW. After the exclusion of children with limited German language skills from both groups, bilinguals outperformed monolinguals in both tasks, especially in QUNW. It can be assumed that bilingualism puts higher demands on PSTM than monolingualism and thus contributes to its faster development. Unnecessary medical examinations and therapies that are sometimes prescribed to bilinguals due to a poor performance in German-based PSTM tasks can be avoided if QUNW are used instead of language-specific items. [ABSTRACT FROM AUTHOR]

Higher incidences of asthma during thunderstorms can pose a serious health risk. In this study, we estimate the thunderstorm asthma risk using statistical methods, with special focus on Bavaria, Southern Germany. In this approach, a dataset of asthma-related emergency cases for the study region is combined with meteorological variables and aeroallergen data to identify statistical relationships between the occurrence of asthma (predictand) and different environmental parameters (set of predictors). On the one hand, the results provide evidence for a weak but significant relationship between atmospheric stability indices and asthma emergencies in the region, but also show that currently thunderstorm asthma is not a major concern in Bavaria due to overall low incidences. As thunderstorm asthma can have severe consequences for allergic patients, the presented approach can be important for the development of emergency strategies in regions affected by thunderstorm asthma and under present and future climate change conditions. [ABSTRACT FROM AUTHOR]

To examine stroke inpatients' real-life wayfinding behaviour and how the built environment of rehabilitation clinics might influence their behaviour and experiences. Stroke inpatients in seven rehabilitation clinics were observed (n = 70), each over the course of 12 consecutive hours. Their paths through the clinic and the locations of encountered wayfinding-related events were mapped on the floor plans and described in the written notes. The observations were supplemented by a survey asking patients about their wayfinding experiences. For a third of observed patients, at least one wayfinding-related event was observed on the observation day, and 50% of patients reported getting lost in their clinic at least once. Most wayfinding-related events occurred between patient rooms and therapy rooms, and patients frequently relied on backtracking or the help of the staff to find their way. Clinics' layout organization was found to play a role in the wayfinding behaviour of patients. Wayfinding is a common challenge that stroke inpatients encounter in rehabilitation clinics. Avoiding multiple decision nodes on the paths between patient rooms and therapy rooms and creating distinct identities for corridor segments in the decision nodes and the areas in front of elevators would likely improve wayfinding performance. [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]

In Germany, vocational rehabilitation (VR) for young people with disabilities (YPWD) aims to counteract disadvantages on the training and labour markets. However, the school-to-work transitions (STWT) among YPWD are underexplored. This study investigates to what extent and for whom VR provides an institutional bridge into employment. Based on representative administrative data of the German Federal Employment Agency, young people in VR are observed for 6.5 years after completing lower or intermediate secondary education in 2008. Using optimal matching and cluster analysis, six typical STWT trajectories are identified. Most of the YPWD completed company-external vocational training, some undertook regular in-firm training. These forms of training often lead to regular employment, albeit with a delay for some. Other young people are guided from training in sheltered workshops into sheltered employment. Another group exhibits problematic STWTs in which recurring unemployment and (non-training) programmes fail to lead to training or employment. VR combined with in-firm or company-external vocational training can facilitate the STWTs of people with disabilities. However, individuals from poor families are less likely to benefit from VR. Similarly, restricted capabilities and problematic STWTs are observed when young people drop out of VR due to poor cooperation. Vocational training often is a prerequisite for labour market entry; however, if the structural conditions on the local labour market are unfavourable, young people with disabilities do not take up employment. Training within sheltered workshops often leads to highly institutionalised trajectories that should be reconsidered to permit greater permeability into the regular labour market. As young people with problematic STWT more often come from poor households, they should be targeted to a greater extent in the context of VR counselling. [ABSTRACT FROM AUTHOR]

Physiotherapists promote physical activity and exercise, yet patient adherence is often poor. To support patient adherence, behavior change techniques (BCTs) should be applied. These are insufficiently covered in physiotherapy curricula. The aim of this study was to evaluate a behavior change counseling training program for physiotherapists. The specific aims were to investigate: (1) physiotherapists' satisfaction with the training; (2) changes in physiotherapists' knowledge of BCTs and communication techniques immediately after the training and 6 weeks later; and (3) changes in physiotherapists' self-reported use of these techniques 6 weeks after the training. We conducted a single-group pre-post intervention study. Data of 56 physiotherapists (47 female, mean age 48.0 years) who participated in the training program "BeFo" (German: "Bewegungstherapie-Fortbildungen") were analyzed. Knowledge of BCTs and communication techniques, intention to apply these techniques, action and coping planning were assessed at baseline (t1), after the training (t2), and 6 weeks later (t3) using questionnaires. Participants' satisfaction was evaluated at t2, their use of BCTs and communication techniques at t1 and t3. Fifty-four participants (96.4%) were satisfied with BeFo. One-way repeated-measures ANOVAs and Friedman's ANOVA revealed increased knowledge (Chi2(2) = 28.12, p <.001) and improved action planning (F(2, 98) = 22.65; p <.001) and coping planning (F(2, 100) = 19.28, p <.001) at t2 and t3. Higher use of BCTs and communication techniques at t3 was identified when participants with high baseline values were excluded. BeFo could be successfully implemented for physiotherapists. Our results imply that BeFo is a promising approach to improve physiotherapists' behavior change counseling skills. [ABSTRACT FROM AUTHOR]

In patients with conductive (CHL) or mixed hearing loss (MHL), hearing rehabilitation with an implantable hearing system, active middle ear implant (AMEI) or a semi-implantable bone-conduction device (SIBCD), is an option when conventional hearing aids are insufficient, or patients are unable to wear them. Retrospective analysis of 20 consecutive patients (24 implants) with a comparison of demographic characteristics and audiometric results (air-bone gap = ABG, effective hearing gain = EHG, functional hearing gain = FHG, Freiburg Monosyllabic Test in quiet, Oldenburg Sentence Test in noise = OLSA). Patients, eligible for both devices, who received either AMEI or SIBCD due to CHL or MHL. Analysis showed no significant differences in post-operative functional hearing results between the group of AMEI vs. SIBCD (ABG-reduction: 31.6 ± 12.4 dB HL vs. 28.0 ± 11.8 dB HL; p = 0.702; EHG: −1.6 ± 7.7 dB HL vs. −1.2 ± 4.2 dB HL; p = 0.090; FHG: 33.4 ± 12.6 dB HL vs. 26.1 ± 11.7 dB HL; p = 0.192; Freiburg: 83.0 ± 15.6% vs. 83.6 ± 14.2%; Freiburg-improvement: 57.7 ± 26.8% vs. 68.2 ± 19.7%; p = 0.294; OLSA: −2.7 ± 3.0 SNR vs. −1.4 ± 3.6 SNR; OLSA-improvement: 2.6 ± 2.1 dB vs. 3.7 ± 2.8 dB; p = 0.323). Four patients had the AMEI explanted due to insufficient functioning and later received a SIBCD. Due to more challenging anatomical conditions, a surgical technique for the AMEI is more complex. However, functional results are comparable to the SIBCD. Therefore, proper patient counselling and cautious choice of the device are mandated before surgery. [ABSTRACT FROM AUTHOR]

Objective: The authors assessed whether an intervention using motivational signs designed in a participatory manner to promote stair use resulted in changes to the proportion of stair to elevator use. Participants: Students of a German university were observed in three different academic buildings. Methods: The study design consisted of direct observations during a pre-intervention period, an intervention phase introducing motivational signs promoting stair use at points of decision and a post-intervention period. Results: The proportion of students who took the stairs on average differed significantly between baseline and intervention phase I (χ2(1) = 12.2; p =.001; Phi = 0.078), baseline and intervention phase II (χ2(1) = 17.3; p =.001; Phi = 0.093), and baseline and post-intervention (χ2(1) = 9.9; p =.002; Phi = 0.074). Conclusions: Simple and cost-effective interventions can increase stair use of university students. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated how COVID-19-related media exposure during the COVID-19 crisis was related to same-day and next-day COVID-19-related worries. Design: A 21-day diary study was conducted between late March and late April 2020 in Germany. Main Outcome Measures: Hypotheses were tested in a sample of 561 participants (Mage = 42.79, SDage = 6.12). Every evening, participants indicated their exposure to COVID-19-related media (e.g., TV, print, online) and their COVID-19-related worries. Results: Same-day analyses showed that participants reported more COVID-19-related worries on days with higher exposure to COVID-19-related media. Dynamical structural equation models provided evidence for a reciprocal cycle across days: Higher media exposure at one day predicted higher worries the next day, and higher worries at one day also predicted higher media exposure the next day. Individuals with high trait anxiety reported an enhanced general level of media exposure during the 21 days of assessment, and individuals high in neuroticism and anxiety reported an enhanced level of worries. Conclusion: These findings suggest a self-reinforcing cycle whereby consuming crisis-related media and worrying reciprocally influence each other across days, possibly amplifying adverse effects of the COVID-19 crisis and other crises alike on mental and physical health. [ABSTRACT FROM AUTHOR]

Dance therapy and dance theatre are innovative interventions for patients with a chronic disease such as cancer. In this pilot study we investigate both how dance theatre as a supportive intervention may influence the mental health and quality of life of male cancer survivors and how participants experience this type of intervention. We used a pre-post design with two points of measurement based on a mixed-methods approach including quantitative and qualitative data. The sample (N = 16) included male cancer survivors and men indirectly affected by cancer. The results show that the level of distress and depressive symptoms slightly improved during the project. Anxiety symptoms showed a significant reduction. The results of the interviews revealed positive effects of the dance project in terms of coping with late effects, physical strengthening, emotional disclosure and developing personal empowerment and increased self-esteem. The results are preliminary and encourage validation in future studies. [ABSTRACT FROM AUTHOR]

This study investigated the relationships between different types of post-separation families (physical custody arrangements x stepfamily status) and parents' and children's well-being. Using data from waves 3–12 of the German Family Panel, random- and fixed-effects regression models were estimated for two analytical samples of 1,199 resident parents and 1,129 children aged 7–17. No statistically significant relationships between physical custody arrangements and parents' depressiveness and life satisfaction were found, but living with a partner was shown to be positively related to parental life satisfaction. Neither physical custody arrangements nor stepfamily status were related to children's mental and physical health. [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 how disability affects the levels of loneliness reported by people living in Germany. In particular, we are interested in analysing the transitions into and out of loneliness but incorporating a dynamic approach of disability (i.e., disability trajectories). Drawing data from the German Socio-Economic Panel for the years 2013 and 2017 and using a three-item version of the UCLA Loneliness Scale, we construct a balance panel of individuals and estimate linear regression models on loneliness, and probit models to predict the likelihood to become lonely or exit from loneliness. We find a positive association between disability and loneliness (especially for those people who are severely limited). The frequency of contacts with family, friends, etc., the number of close friends and the participation in volunteering, sports, cultural and religious events reduce loneliness. Furthermore, we find that those individuals making the transition into a moderate/severe disability and also those recovering totally from a severe disability are more likely to become lonely in 2017. From a public health policy perspective, it is necessary to undertake the design and implementation of instrumental, emotional and social support for people with disabilities. A higher engagement in social activities (e.g., social gatherings, cultural and leisure activities) and the elimination of barriers (e.g., structural and environmental) may become key elements to preventing loneliness. Loneliness has become an important social problem in most countries with a significant impact on individuals' health status (mental and physical). Loneliness strongly affects individuals who experience important levels of discrimination and social exclusion (e.g., people with disabilities). Transitions of disabilities and loneliness must be taken into account to investigate the relative position of people with disabilities (especially those with severe disabilities). People with severe disabilities report the highest levels of loneliness, especially if this disability status remains over time. Rehabilitation professionals must promote social relations and support among people with disabilities and help them exit from permanent loneliness. [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]

As use of complementary medicine (CM) is increasing, health professionals may require proper training in CM to offer evidence-based advice to their patients. The aim of this study was to explore interprofessional collaboration (IPC) in CM in order to gain a comprehensive overview of determinants and to facilitate the definition of objectives for an undergraduate interprofessional educational module. Pursuant to a sequential mixed-methods approach, focus groups and individual interviews with health professionals, who actively use CM in patient care, were conducted. All hospital employees at the University Hospital Lübeck, Germany, were asked to complete an online questionnaire that was based on the previously obtained qualitative results. The interviews with 20 participants revealed four main themes: profession-specific aspects, communication, health care system-associated factors, and the influence of CM on interprofessional dynamics. An analysis of the 157 responses in the online questionnaire showed that team meetings (n = 124, 79%) were most frequently stated as promoting IPC. In binary regression analyses, nursing (OR = 6.17 [2.02–18.84]) and medical professions (OR = 3.77 [1.27–11.18]) predicted evidence-based care as enabler for IPC. Hence, teaching professional competencies and an equal understanding of evidence-based medicine seems necessary to promote IPC within CM. [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]

The aim was to create and validate an audiovisual version of the German matrix sentence test (MST), which uses the existing audio-only speech material. Video recordings were recorded and dubbed with the audio of the existing German MST. The current study evaluates the MST in conditions including audio and visual modalities, speech in quiet and noise, and open and closed-set response formats. One female talker recorded repetitions of the German MST sentences. Twenty-eight young normal-hearing participants completed the evaluation study. The audiovisual benefit in quiet was 7.0 dB in sound pressure level (SPL). In noise, the audiovisual benefit was 4.9 dB in signal-to-noise ratio (SNR). Speechreading scores ranged from 0% to 84% speech reception in visual-only sentences (mean = 50%). Audiovisual speech reception thresholds (SRTs) had a larger standard deviation than audio-only SRTs. Audiovisual SRTs improved successively with increasing number of lists performed. The final video recordings are openly available. The video material achieved similar results as the literature in terms of gross speech intelligibility, despite the inherent asynchronies of dubbing. Due to ceiling effects, adaptive procedures targeting 80% intelligibility should be used. At least one or two training lists should be performed. [ABSTRACT FROM AUTHOR]

Previous research has shown that the way people spend their money is as important to happiness as how much money people earn. Specifically, it has been shown that spending money on others contributes more to an individual’s happiness than spending money on oneself. In the present study, we investigated this effect and examined the role of the money’s origin. Students were randomly assigned either to spend a small amount of money on themselves or to spend the money on others. Moreover, half of the participants received the money as a wage, whereas the other half received the money as a windfall. The results replicated previous research indicating that prosocial spenders report greater happiness than do selfish spenders. However, the happiness effect was unaffected by the source of the money (i.e. wage vs. windfall). Implications for well-being and happiness are discussed. [ABSTRACT FROM PUBLISHER]

To investigate the association between total leisure noise exposure and intermittent tinnitus among young adults. Data were obtained from the Ohrkan study, an ongoing prospective cohort study conducted in South Germany since 2009. Information about exposure to impulse and leisure noise, tinnitus occurrences, sociodemographic variables, and self-rated hearing ability were analysed at four time points over a period of seven and a half years. Participants of the Ohrkan cohort study, who provided data about the occurrence of tinnitus for all surveys (n = 1028). Intermittent tinnitus was reported in the majority of the sample (60%). The risk for intermittent tinnitus increased with higher sound pressure levels from exposure to leisure noise (full model (Odds Ratio, 95%CI): 80–<85dB(A): 1.41 [1.13–1.78], 85–<90dB(A): 1.73 [1.38–2.16], >90dB(A): 2.04 [1.59–2.61]). Visiting nightclubs was a major contributor to this relationship. Of the considered covariables, self-rated hearing as "poor", and growing up in a single-parent household were significantly associated with intermittent tinnitus. Intermittent tinnitus is very frequent among young adults and is associated with high levels of leisure noise exposure. To prevent intermittent tinnitus, reduced sound pressure levels and the use of hearing protection are necessary. [ABSTRACT FROM AUTHOR]

Diagnostics in bilingual children is challenging, due to an overlap of production patterns in typically developing (TD) bilingual children and monolingual children with specific language impairment (SLI). To screen bilingual children effectively, the Language Impairment Testing in Multilingual Settings (LITMUS) tools were developed in an international project. The present study tests three of these tools for their suitability and diagnostic accuracy for early second language learners (eL2) of German, aged six to eight years. The study focuses on the timing in first language (L1) TD acquisition, investigating early and late acquisition phenomena of the morphosyntactic domain (subject-verb agreement [SVA], and case marking), combined with a non-word repetition (NWR) task targeting phonological complexity. The study aims at evaluating these three LITMUS-tools regarding their diagnostic accuracy, compared to a standardised assessment tool (LiSe-DaZ). To this end, forty-two children were tested using the LITMUS-tools, namely, contrastive case marking (CCM), supplemented by an elicitation task for the prepositional case, SVA and NWR. Four groups of children participated: eL2 children with SLI (mean age 7;6, mean age of onset 3;1), eL2 children with TD (mean age 7;10, mean age of onset 2;11), L1 TD children (mean age 7;3) and L1 SLI children (mean age 7;2). Results show NWR and SVA as suitable markers and the LITMUS-tools as suitable screenings. Conversely, CCM does not disentangle SLI from TD in the investigated bilingual population by this age. [ABSTRACT FROM AUTHOR]

Germany has an ambitious global health strategy, yet its universities provide few opportunities for global child health researchers. Improved understanding of the reasons and the academic role of global child health is needed. The objective of this study is to offer insights into Germany's academic global child health landscape by describing the actors and their priorities in research and education and by analysing perceived barriers and opportunities. We used a sequential exploratory mixed-method design. Participants were selected purposively to represent German global child health academics. Information was gathered first from a 33-item online survey and from interviews conducted four to six months post-survey. Surveys were analysed descriptively. A joint thematic approach using content analysis was used to analyse interview transcripts. Four categories emerged: training and professional orientation; professional realities; representation and advocacy, and barriers. Of the 20 survey participants (median [IQR] age 55 years [17], five female), seven agreed to be interviewed. Research experiences abroad shaped individuals' career choices in global child health. They engaged in global child health education, primary health care and access to health services, frequently in clinical and humanitarian settings, but spent little time on global child health-related activities. Participants were active and valued in international networks and keen to extend their activities. Yet they felt under-represented academically and reported multiple structural and individual barriers in Germany. They perceived a lack of leadership positions, career paths, funding opportunities, and institutional and project support which limits academic advancement. Germany's global child health experts are motivated to engage with global child health-related topics but face difficulties in advancing academically. Academic actors may need to intensify research and training efforts in order to expand global child health's scientific base in Germany. [ABSTRACT FROM AUTHOR]

The aim of this longitudinal study was to examine whether the onset and the end of obesity was associated with loneliness. Nationally representative longitudinal data from Germany were taken from the Survey of Health, Ageing and Retirement in Europe (wave 5 to wave 7; n = 10,446 observations in the analytical sample). Using the three item loneliness scale (UCLA), loneliness was measured. According to the WHO thresholds, obesity was defined as BMI ≥ 30 kg/m2. Asymmetric fixed effects (FE) regressions were used. Conventional FE regression analysis revealed that changes in obesity status were associated with changes in loneliness (men: β = −.19, p <.05; women: β =.19, p <.05). Asymmetric FE regressions showed that in men the onset of obesity was associated with a decrease in loneliness (β = –.31, p <.05), whereas the end of obesity was not associated with loneliness. Asymmetric FE regressions showed that in women, the onset of obesity was associated with an increase in loneliness (β =.33, p <.01), whereas the end of obesity was not associated with loneliness. Findings showed that the onset of obesity has different consequences in terms of loneliness for older women and men in Germany, whereas the end of obesity was not associated with changes in loneliness scores. We recommend that future studies should distinguish between the onset and the end of obesity – which comes along with important practical implications. When older women report transitions to obesity, efforts to prevent loneliness may be of importance. [ABSTRACT FROM AUTHOR]

To examine the possible contributions of capability, opportunity, and motivation for explaining long-term physical activity among people with multiple sclerosis and to report the results of a German survey study. The questionnaire, which was based on an expert interview study and behavior change theory, was structured and detailed applying the Theoretical Domains Framework. A total of 1027 people with multiple sclerosis provided data on sociodemographics, disease-related characteristics, and a set of constructs possibly related to long-term adherence. Participants were assigned to three groups: not regularly active, currently regularly active, and long-term regularly active. Eta squared was calculated to assess the magnitude of differences between groups using ANOVA. Moderate or large differences between groups were identified for many domains within capability, opportunity, and motivation. For the following theoretical domains, large differences (η2 ≥0.140) were observed: Intention, Behavioural Regulation, Beliefs about Capabilities and Goals. Our results suggest that capability, opportunity, and motivation should be targeted simultaneously when designing future interventions. Inactive people with multiple sclerosis might benefit most from interventions increasing action self-efficacy and intention. Boosting autonomous motivation, goal setting, action planning as well as maintenance and recovery self-efficacy could have a positive effect on long-term adherence. This study applied the COM-B model and Theoretical Domains Framework to identify a set of constructs for explaining long-term physical activity among people with MS. Behaviour change and maintenance interventions for people with MS should include techniques that foster intention, perceived self-efficacy and self-regulatory skills, and promote goal setting and autonomy of motivation for regular physical activity. Although barriers of the physical and social environmental context did not seem to be that important in our sample, scientists should consider addressing them in interventions for inactive and more disabled people with MS. Information about the benefits of physical activity should be regularly provided in MS rehabilitation, while further research should explore the relevance of information provision and knowledge for behaviour change in different groups of people with MS. [ABSTRACT FROM AUTHOR]

To identify sick leave days (SLD) predictors after starting antidepressant (AD) treatment in patients affected by major depressive disorder (MDD), managed by general practitioners, with a focus on different AD therapeutic approaches. Retrospective study on German IQVIA® Disease Analyser database. 19–64 year old MDD patients initiating AD treatment between July-2016 and June-2018 were grouped by therapeutic approach (AD monotherapy versus combination/switch/add-on). Data were analysed descriptively by AD therapeutic approach, while a zero-inflated Poisson (ZIP) multiple regression model was run to evaluate SLD predictors. 8,891 patients met inclusion criteria (monotherapy: 66%; combination/switch/add-on: 34%). All covariates had an influence on SLD after AD treatment initiation. Focussing on variables that physicians may more easily intervene to improve outcomes, it was found that the expected SLD number of combination/switch/add-on patients was 1.6 times that of monotherapy patients, and the expected SLD number of patients diagnosed with MDD before the decision to start AD treatment was 1.2 times that of patients not diagnosed with MDD. A patient tailored approach in the selection of AD treatment at the time of MDD diagnosis may improve functional recovery and help to reduce the socio-economic burden of the disease. Few studies previously investigated the effect of antidepressant treatment approaches on sick leave days in major depressive disorder. To the authors' knowledge, this is the first study evaluating the effect of different antidepressant treatment approaches on sick leave days in major depressive disorder in German patients. Patients receiving antidepressant monotherapy treatment seemed to lose fewer working days than patients receiving antidepressants combination/switch/add-on therapy, both before and after starting treatment, even if differences were more pronounced after treatment has started. The use of antidepressant monotherapy or combination/switch/add-on therapy was the strongest predictor of sick leave days after starting antidepressant treatment: the expected number of sick leave days for the combination/switch/add-on group was 1.6 times that of the monotherapy group. Among factors associated with increased sick leave days, antidepressant therapeutic approach and the promptness of starting the antidepressant treatment when major depressive disorder is diagnosed, are those on which physicians may more easily intervene to improve outcomes. Findings from the present study suggest that a patient tailored approach may improve functional recovery and help reducing the socio-economic burden of the disease. [ABSTRACT FROM AUTHOR]