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Background: Allergic diseases are among the most common chronic diseases in childhood. Early childhood allergy prevention (ECAP) behaviors of those caring for the infant during pregnancy and the first months of life may influence the risk of allergy development over the life course. Motivation and intention to use appropriate primary ECAP measures are thus of critical importance., Aims: To characterize parental ECAP motivation, (a) valid indicators will be developed and (b) typical parental characteristics will be identified. (c) According to socio-cognitive models, the predictive value of parental risk perception, control belief and self-efficacy for parental ECAP motivation shall be determined., Method: A sample of N = 343 (expectant) mothers of infants completed a questionnaire on self-reported ECAP motivation, risk perception, control belief, and self-efficacy. The cross-sectional data were analyzed using latent class analysis and structural equation modelling including nominal regression models., Results: Four typical maternal response profiles (motivated to a customary degree, 70%; motivated to use primary preventive measures, 17.8%; reluctant towards new prevention measures, 6.4%; highly motivated to apply preventive measures in case of an existing allergy, 5.8%) could be identified for the items on ECAP motivation. After splitting the model variables "risk perception" (allergy vs. allergy-associated general health problems) and "self-efficacy" (trust vs. insecurity) a satisfactory model-fit was achieved (CFI = .939; RMSEA = .064). Particularly, increased "risk perception-allergy" (OR = 1.655) and "self-efficacy-insecurity" (OR = 2.013) as well as lower "risk perception-general health" (OR = 0.555) and "control belief" (OR = 0.217), respectively, are associated with higher ECAP motivation., Conclusion: The use of ECAP-measures by parents to protect their newborns from allergies is important, but there are deficiencies in their implementation. Based on a social cognitive model approach, predictive characteristics could be identified, which are associated with increased motivation to implement ECAP-measures. For public health our findings provide a promising basis for conception of behavioral and environmental ECAP prevention measures and their motivated implementation by parents., (© 2024. The Author(s).)

Introduction: Vaccination readiness refers to psychological motives and beliefs that decisively determine individual and collective vaccination prevention behavior. Readiness to be vaccinated depends on expected individual and social benefits and harms. Differences exist in the perception of the threat of potential influenza vs. COVID-19 infection and its significance for the social environment. The study aimed to compare the 7C components of vaccination readiness for influenza and COVID-19 vaccination in adulthood., Methods: A total of 317 adults answered the 7C vaccination readiness scale in two vaccination-specific versions (influenza vs. COVID-19) in an online survey from September 2022 to March 2023. Data were analyzed using repeated measures, including analysis of covariance, correlations, and multiple regression., Results: For COVID-19, there is a higher readiness to be vaccinated compared to influenza regarding complacency R ( η p  = 0.683), constraints R ( η p  = 0.684), collective responsibility ( η p  = 0.782), and compliance ( η p  = 0.365). However, confidence ( η p  = 0.161) and conspiracy R ( η p  = 0.256) indicate an enhanced readiness for influenza vaccination (interaction scales × vaccination type: η p  = 0.602). Individual influenza vaccination recommendations and age do not or only marginally moderate these effects (interaction vaccination type × recommendation: η p  = 155)., Discussion: The 7C subscales reveal a differentiated pattern of readiness for the two vaccination types. This emphasizes the relevance of the multidimensional structure of the construct of vaccination readiness as well as the relevance of moderating effects of the respective vaccination type on the underlying motives and beliefs. Vaccination attitudes are influenced by cultural and social conditions as well as medical standards of care. Comparing attitudes to different vaccinations in different countries thus represents an important research desideratum in order to understand the concept of vaccination readiness more comprehensively., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Schulz, Abt, von Oppen and Wirtz.)

Shifting midwifery education to a university level is of great importance for healthcare systems worldwide by preparing graduates for current and future challenges. Some of them referring to management, research and teaching tasks as well as advanced practitioner roles, require competences that can only be acquired in a Master's program. The objectives of this narrative review are to outline the differences and commonalities of organizational aspects of Master's programs in selected OECD countries and to point out the competence goals and learning outcomes they are based on. Fifteen Master's programs in twelve OECD countries were identified and analyzed. Considering the organizational characteristics, differences are found in admission requirements and qualification levels, while similarities relate to the awarded title (MSc). All programs aim to develop abilities for research to advance midwifery practice. Leadership and management abilities are addressed through effective teamwork and communication. The programs' aims are to develop abilities for midwifery education tasks. Whereas competence goals mostly align across the programs, they are addressed differently through various learning outcomes. Development and enhancement of Master's programs in midwifery are needed by focusing on core elements, such as common competence goals. It is equally important to adapt them to national healthcare and educational systems., Competing Interests: The authors have each completed and submitted an ICMJE form for Disclosure of Potential Conflicts of Interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. M.A. Wirtz reports that he has received a grant from the German Research Foundation, he has participated on the Ethics Committee of the University of Freiburg, and he is a member of the German Association of Rehabilitation Sciences., (© 2024 Kranz A. et al.)

Introduction: The acquisition of academic competencies is one of the main outcomes of the academization of midwifery education. To analyze midwives' views on the key academic competencies of the recently reformed midwifery education in Germany, an existing assessment instrument was adapted to the German context of care and psychometrically analyzed. Furthermore, it was investigated whether the relevance assessments of academic and non-academic midwives differ from each other., Methods: The study design was cross-sectional. A total of 193 (prospective) midwives answered the items on the assessed relevance of midwifery competencies in academic education (59 items); 3 items were added (referring to evidence-based practice and digital literacy). Construct validity was tested using exploratory factor analysis. Item and reliability analysis as well as unpaired t-tests were performed., Results: Considering insufficient item-construct associations (20 items), a single factorial solution best fits the data (eigenvalue: 18.36; explained variance: 29.60%). Internal reliability was demonstrated to be very good with Cronbach's α=0.954. The assessed relevance of academic midwifery competencies from academic and non-academic midwives did not differ significantly from each other for students and trainee midwives (t=0.18; df=6.66; p=0.86), and for for midwives educated at vocational school and university (t= -0.035; df=106; p=0.97)., Conclusions: The adapted assessment tool can be used with minor modifications to reliably and validly measure the assessed relevance of academic competence from the midwives' perspective. Combined with data on the assessments of medical practitioners and laypersons, the assessment provides a substantial data basis for the development of a competence profile for academic midwifery education in Germany., Competing Interests: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. Markus A. Wirtz reports receiving grants from the German Research Foundation. He also reports participating on a Data Safety Monitoring Board of the Ethics Committee of the University of Freiburg and leadership role at the German Association of Rehabilitation Sciences., (© 2023 Kranz A. et al.)

Introduction: Interprofessional collaboration of physicians and midwives is essential for appropriate and safe care of pregnant and parturient women as well as their newborns. The complexity of woman-centered care settings requires the continuous exchange of information and the coordinated implementation of multi-and interprofessional care concepts. To analyze the midwives' perspective on the multi-and interprofessional care process during pregnancy, birth and postpartum period, we aimed to adapt and psychometrically evaluate the Interprofessional Collaboration Scale (ICS)., Methods: The ICS (13 items) was answered by 299 midwives for (i) prenatal and postpartum care as well as (ii) perinatal care. Three items on equitable communication (EC) identified in qualitative interviews with N  = 6 midwives were added as further aspects of quality in collaborative midwifery care. Confirmatory factor analysis was used to test competing theoretically hypothesized factorial model structures, including both care settings simultaneously, i.e., birth and prenatal/postpartum., Results: A two-dimensional structure assuming the 13 original ICS items and the 3 items on EC as psychometric distinct item groups accounts for the data best. After deleting 5 ICS items with insufficient indicator reliability, a very good-fitting model structure was obtained for both prenatal/postpartum as well as perinatal care: χ 2 df = 192  = 226.35, p  = 0.045, CFI = 0.991, RMSEA = 0.025 (90%CI: [0.004; 0.037]). Both the reduced ICS-R and the EC scale (standardized response mean = 0.579/1.401) indicate significantly higher interprofessional collaboration in the birth setting. Responsibility in consulting, attitudes toward obstetric care and frequency of collaboration with other professional groups proved to be associated with the ICS-R and EC scale as expected., Discussion: For the adapted ICS-R and the EC scale a good construct validity could be confirmed. Thus, the scales can be recommended as a promising assessment for recording the collaboration of midwives with physicians working in obstetric care from the perspective of midwives. The instrument provides a validated assessment basis in midwifery and obstetric care to identify potentially divergent perspectives within interprofessional care teams in woman's centered care., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Schulz and Wirtz.)

Background: Ensuring motivated and successful study participation is a key challenge in the design and conduct of health research studies. Previously, recruitment barriers and facilitators have been identified mainly from experience, and rarely based on theoretical approaches. We developed a framework of intentional and actional components of engaged participation in public health research studies (INTACT-RS), informed by psychological behavioral models. We aimed a) to identify precise indicators for each framework component and b) to better understand which components and decision processes are essential for study participants., Methods: Within a multicenter research network, we applied various approaches to recruit parents of newborns, pediatricians, and midwives. All recruitment processes were documented from the perspective of both participants and researchers. We used different qualitative and quantitative data material, which we applied in a multistage process according to the basic principles of qualitative content analysis., Results: INTACT-RS encompasses pre-intentional, intentional and actional phases with a total of n = 15 components covering all aspects of an individual's involvement with a research study. During intention formation, an understanding of efforts and benefits, why participation is valuable beyond contributing to research, and how others perceive the study, were particularly important to (potential) participants. Subsequently (intentional phase), participants consider how and when participation is compatible with their own resources, ability and availability, and hence seek for close communication with, and flexibility and support from the research team. During and after (initial) participation (actional phase), participants' assessment of whether expectations and interests have been met impact crucial further steps, especially the willingness to continue and to recommend participation to others. A strong topic-wise and or supportive participation interest as well as active, continuous exchange with the researchers appeared to be central determinants of study completion and data validity., Conclusions: A theoretical framework is now available to plan and conduct recruitment of different target groups, which accounts for essential motivational and volitional decision-making processes. Based on empirically specified constructs, possible barriers can be addressed even before the initial recruitment process. Therefore, recommendations for scientific practice have been formulated., (© 2023. The Author(s).)

Background: For quality-oriented evaluation of prenatal and obstetric care, it is important to systematically consider the perspective of the women receiving care in order to comprehensively assess and optimize quality in a woman-centered manner. Empathy and Shared Decision Making (SDM) are essential components of woman-centered midwifery care. The aim of the study was to analyze measurement invariance of the items of the Consultation and Relational Empathy (CARE) and Shared Decision Making-Questionnaire (SDM-Q-9) scales depending on the prenatal versus obstetric care setting., Methods: One hundred fifty women retrospectively assessed aspects of woman-centered midwifery care in both prenatal and obstetric care setting. The birth of the child was a maximum of 12 months ago. A structural equation modelling approach was adopted to separate true effects from response shift (RS) effects depending on care setting. The latter were analyzed in terms of recalibration (changing women's internal measurement standards), Reprioritization (changing associations of items and construct) as well as Reconceptualization (redefining the target construct)., Results: A response shift model was identified for both assessments (pregnancy/birth: CFI = .96/.96; SRMR = .046/.051). At birth, both scales indicated lower quality of care compared with prenatal care (SDM-Q-9-M/CARE-8-M:|d| = 0.190/0.392). Although no reconceptualization is required for the items of both scales, RS effects are evident for individual items. Due to recalibration and reprioritization effects, the true differences in the items are partly underestimated (SDM-Q-9-M/CARE-8-M: 3/2 items) or overestimated (4/2 items)., Conclusion: The structure of the constructs SDM and Empathy, indicating woman-centered midwifery care, are moderated by the care settings. To validly assess midwives' empathy and shared decision making from women's perspective, setting-dependent response shift effects have to be considered. The proven item-specific response effects contribute to a better understanding of construct characteristics in woman-centered care by midwives during pregnancy and childbirth., (© 2022. The Author(s).)

Objective: Development and psychometric evaluation of a multidimensional model and assessment scales measuring core aspects of the quality of woman-centred midwifery care processes in Germany., Design & Participants: 201 women, who received midwifery care during their pregnancy in 2018, were enrolled 6 to 18 months after birth. Data were assessed in a retrospective cross-sectional survey in Germany., Measurements: Established scales that are used in health care were adapted to the context of woman-centred midwifery care: Shared Decision-Making (SDM-Q-9-M), Empathy (CARE-M), Internal Team Participation (TEAM-M) and Professional Competence (PC-M). Confirmatory factor analyses were adapted to prove (a) the homogeneity of the single scales and (b) the multidimensional structure of the entire item pool., Findings: Appropriate to good model fit was confirmed for both the single assessments (CFI ≥ .96; SRMR ≤ .032) and the multidimensional model (CFI=.96; SRMR=.049). Minor model modifications reflecting local item dependencies had to be considered for the scales SDM-Q-9-M, TEAM-M, and PC-M. For the CARE-M scale, Participatory Communication proved to be a separate, second structural component., Conclusions: Shared Decision-Making, Empathy, Internal Team Participation, and Professional Competence constitute core components of woman-centred midwifery care processes. A multi-dimensional assessment is now available measuring women's experiences with midwifery care. The assessment provides an essential component to master the complex challenge of measuring the quality of midwifery care inside and outside the hospital by means of a standardised and validated assessment., (Copyright © 2021. Published by Elsevier GmbH.)

MET gene alterations are known to be involved in acquired resistance to epidermal growth factor receptor inhibition. MET amplifications present a potential therapeutic target in non-small cell lung cancer. Although next-generation sequencing (NGS) and fluorescence in situ hybridization (FISH) are conventionally used to assess MET amplifications, there are currently no clinically defined cut-off values for NGS, with FISH still being the gold standard. A collective of 20 formalin-fixed paraffin-embedded lung cancer tissue samples (mean age 64 years) were selected based on increased MET gene copy number (CNV) status or the presence of mutations detected by NGS (GeneReader, QIAGEN) and were further assessed by FISH ( MET /CEN7, Zytomed). Of these, 17 tumor samples were MET -amplified and one patient was found to have a MET rearrangement by NGS, while two samples had no MET gene alteration. In contrast to the NGS result, FISH analysis showed only one highly amplified sample and 19 negative samples. The single highly amplified case detected by FISH was also positive by NGS with a fold change (FC) of 3.18 and a mean copy number (CN MV 10-100% ) of 20.5. Therefore, for the assessment of MET amplifications using the QIAGEN NGS workflow, we suggest detecting amplified cases with an FC value of ≥ 3.0 and a CN MV 10-100% value of ≥ 20.0 by FISH. In summary, NGS allows for DNA- and RNA-based analysis of specific MET gene amplifications, point mutations or rearrangements., Competing Interests: CONFLICTS OF INTEREST Peter J. Wild: Advisory role and honoraria (institutional or personal): AstraZeneca, Janssen, Roche, Astellas, Bayer, Bristol-Myers Squibb, Janssen, Novartis, Thermo Fisher Scientific, MSD, QIAGEN, Molecular Health, Sophia Genetics. Melanie Demes: Advisory role and honoraria (institutional or personal): Amgen, AstraZeneca, Bayer, Diaceutics, Biocartis, Sophia Genetics., (Copyright: © 2021 Schmitt et al.)

The effect of nitrogen and carbon status on the regulation of glutamine synthetase (GS) and glutamate synthase (GOGAT) were investigated in Corynebacterium glutamicum 13032. Under carbon-sufficient, nitrogen-limiting conditions, GS and GOGAT activities were five- and seven-fold higher, respectively, and transcription of the corresponding genes (glnA and gltBD) was similarly induced. GS activity was also induced in complete medium with added glucose, while GOGAT activity was unaffected. Under carbon-limiting, nitrogen-limiting conditions, the level of GS induction was reduced approximately three-fold, whereas GOGAT activity did not respond. Disruption of the hkm gene, encoding a putative histidine kinase upstream of gltBD, reduced the levels of GOGAT activity two-fold under both nitrogen-rich and nitrogen-limiting conditions. Promoter studies using a hkm-chloramphenicol acetylase fusion plasmid revealed that transcription of hkm is moderately induced (ca. 1.5-fold) by nitrogen starvation, indicating that the Hkm protein may play a role in signal transduction of the nutritional status of the growth medium.