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Zusammenfassung Hintergrund Es gibt Anhaltspunkte dafür, dass die Gefahr von Kindesmisshandlung, sexuellem Kindesmissbrauch und Vernachlässigung während der strengen Kontaktbeschränkungen im pandemiebedingten Lockdown zugenommen hat, während der Wegfall der gewohnten Mechanismen zur sozialen Kontrolle mutmaßlich zu einer Zunahme des Dunkelfelds geführt hat. Ziel der Arbeit Anhand der Kinderschutzfallzahlen und -qualitäten deutscher Kinderkliniken und Kinderschutzambulanzen sollen Aussagen über Häufigkeit und Schwere vermuteter Kindeswohlgefährdung während des pandemiebedingten Lockdowns getroffen werden. Methoden Im Mai 2020 erfolgte eine Onlinebefragung mit Items a) zur Beschreibung der Institution, b) zur nach Alter, Gewaltform und Schweregrad differenzierten Anzahl von Kinderschutzfällen in März/April 2019 und 2020 sowie c) zu Besonderheiten und Ideen für den Kinderschutz während der Pandemie. Ergebnisse In einer Vollerhebung wurden 343 Kinderkliniken und medizinische Kinderschutzambulanzen zur Onlinebefragung eingeladen; die Teilnahmequote lag bei 46 %. Es gaben 81 Einrichtungen Gesamtfallzahlen für März/April 2019 und März/April 2020 an. Bei den Ambulanzen konnte ein Rückgang von 454 auf 387 Fälle (−15 %) verzeichnet werden, bei den Kinderschutzgruppen von 307 auf 246 (−20 %). Hinsichtlich der Altersgruppen und der Formen der Gefährdung fanden sich keine signifikanten Unterschiede. Schlussfolgerung Die Untersuchung beschreibt einen Rückgang der absoluten Fallzahlen im medizinischen Kinderschutz während des Lockdowns im März und im April 2020. Dieses Ergebnis stützt die Vermutung, dass das Dunkelfeld gefährdeter Kinder weiter gestiegen sein könnte. Weitere Datenerhebungen nach dem Lockdown werden die längerfristigen Auswirkungen besser bewerten können.

The Patient-Reported Outcome Measurement Information System (PROMIS®) is a National Institutes of Health (NIH)-funded initiative to develop reliable, valid, and normed item banks to measure health. We describe the first large-scale translation and cross-cultural adaptation effort to German and Spanish of eight pediatric PROMIS item banks: Physical activity (PAC), subjective well-being (SWB), experiences of stress (EOS), and family relations (FAM). We utilized methods outlined in the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) PRO Translation Task Force recommendations. Ten professional translators performed a translatability assessment and generated forward translations. Forward Translations were compared within a country and cross-culturally to identify problems and to produce a consensus-derived version, which was then back translated, evaluated, and revised where necessary. Reconciled versions were evaluated in cognitive interviews with 126 children before finalization. Eight resulting pediatric PROMIS® item banks were translated: Two PAC banks (22 total items), three SWB banks (125 total items), two EOS banks (45 total items), and one FAM bank (47 total items). Up to 92% of all items raised no or only minor translation difficulties, 0–5.6% were difficult to translate. Up to 20% item revisions were necessary to ensure conceptual equivalence and comprehensibility. Cognitive interviews indicated that 91–94% of the final items were appropriate for children (8–17 years). German and Spanish translations of eight PROMIS Pediatric item banks were created for clinical trials and routine pediatric health care. Initial translatability assessment and rigorous translation methodology helped to ensure conceptual equivalence and comprehensibility. Next steps include cross-cultural validation and adaptation studies.

It has been proposed that the P3b component of event-related potentials (ERPs) reflects linking of responses to target stimuli. This proposal was tested by disconnecting the temporal link between target stimuli and responses, and by applying residue iteration decomposition (RIDE) for separating the ERP components into stimulus-locked, response-locked, and "intermediate" clusters. Left or right keys had to be pressed in response to frequent (80%) and rare (20%) target letters, but responses had to wait for "go" signals (appearing in 90% of trials). Between blocks, stimulus-onset asynchronies (SOAs) from targets to go-signals varied from 0 ms to 800 ms. Rare targets with their rare responses were expected to evoke large P3bs ("oddball effect"). If related to stimulus processing only, this effect will be equally large across all SOAs and will be modeled by RIDE's stimulus-cluster. If related to response initiation only, the oddball effect will be evoked by go-signals rather than by targets and will be modeled by RIDE's response-cluster. If indicating integration of rare stimuli with their rare responses, the oddball effect will be evoked by targets but will be reduced and stretched in time across SOAs and will be modeled by RIDE's intermediate cluster. RIDE analysis confirmed this latter view, for the most part. SOA effects matched best, though not perfectly, predictions made by the stimulus-response-link view. These results call for a refined account of the oddball effect on P3b in terms of stimulus-response coupling.

Representatives of the statutory health insurance (n=46) and policy makers at the local, federal and state level (n=136) were interviewed in 2 nationwide online surveys about the significance and degree of implementation of prevention. The group comparison between the decision-makers shows significant differences in terms of attitudes towards health prevention. The political leaders are demanding an improvement of the GKV-benefit package and the obstacles require the cooperation of urgent attention.