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Measures implemented to contain the Covid 19 pandemic have led to systematic changes in familiar structures over the past 3 years, resulting in multiple psychosocial stresses among families. Psychosocial stress can have a harmful impact on children's health and development (1-3), with young children being particularly vulnerable (4). Psychosocial stress during the pandemic is reflected in an increase of parenting stress (5-7) and psychological problems among parents (8,9). Given the close association between parenting stress, parental mental health, and parenting behaviors (10-12), it is not surprising that parent-child relationships have also suffered in the course of the pandemic (13). In addition, children may have missed important educational and learning opportunities due to limited access to childcare facilities. These factors might have had an impact on children’s mental health during the pandemic. The Bavaria-wide CoronabaBY study - the first project in Germany to explicitly address psychosocial stress in families with infants and young children during the pandemic – has demonstrated clear signs of psychosocial stress in young families compared to pre-pandemic data (14). Even during periods of low incidences and associated "relaxations" (i.e., the summer months), stress parameters did not decrease. Rather, the number of psychosocially stressed families increased steadily during the course of the pandemic (15). Alongside the pandemic, other societal challenges, such as the onset of the economic crisis, the impact of the Ukraine war, and climate change have led to the experience of “multi-crisis times”, and can fuel fears and concerns about the future and place additional stress on young families. Systematic and reliable identification of families with psychosocial support needs is urgently indicated in order to prevent negative direct and indirect effects on child health. Burdened families could also find easier access to appropriate support services by communicating information in a needs-based manner (e.g., via smartphone app). Hence, we aim to examine (1) psychosocial stress factors in N = 5,000 families with children aged 0-6 years old (2) the effectiveness of an app-based information module on psychosocial support for young families (=intervention). We therefore perform a Bavaria-wide intervention study (JuFaBY) over a study period of 18 months in total with two measurement time points for each participant (at study entry and 6 months later). (1) Werner, E. E. (1993). Risk, resilience, and recovery: Perspectives from the Kauai Longitudinal Study. Development and Psychopathology, 5, 503-515. (2) Laucht, M., Esser, G. & Schmid, M. H. (1997). Developmental Outcome of Infants Born with Biological and Psychosocial Risks. Journal of Child Psychology and Psychiatry, 38(7), 843-854. (3) Laucht, M., Schmidt, M. H. & Esser, G. (2002). Motorische, kognitive und sozial-emotionale Entwicklung von 11-Jährigen mit frühkindlichen Risikobelastungen: späte Folgen. Zeitschrift für Kinder- und Jugendpsychiatrie, 30(1), 5-19. (4) Schlack, H. G. (2009). Sozialpädiatrie: Eine Standortbestimmung. In H. G. Schlack, R. von Kries & U. Thyen (Eds.), Sozialpädiatrie. Gesundheitswissenschaft und pädiatrischer Alltag (pp. 1-8). Berlin, Heidelberg: Springer. (5) Giannotti, M., Mazzoni, N., Bentenuto, A., Venuti, P. & de Falco, S (2021). Family adjustment to COVID-19 lockdown in Italy: Parental stress, coparenting, and child externalizing behavior. Fam Process, 1-19. (6) Spinelli, M., Lionetti, F., Setti, A. & Fasolo, M (2020). Parenting Stress During the COVID-19 Outbreak: Socioeconomic and Environmental Risk Factors and Implications for Children Emotion Regulation. Fam Process, 60(2):639-53. (7) Taubman-Ben-Ari, O., Ben-Yaakov, O. & Chasson, M (2021). Parenting stress among new parents before and during the COVID-19 pandemic. Child Abuse Negl, 117:105080. (8) Panda, P.K., Gupta, J., Chowdhury, S.R., Kumar, R., Meena, A.K., Madaan, P. et al. (2021). Psychological and Behavioral Impact of Lockdown and Quarantine Measures for COVID-19 Pandemic on Children, Adolescents and Caregivers: A Systematic Review and Meta-Analysis. J Trop Pediatr, 67(1). (9) Racine, N., Hetherington, E., McArthur, B.A., McDonald, S., Edwards, S., Tough, S. et al. (2021). Maternal depressive and anxiety symptoms before and during the COVID-19 pandemic in Canada: a longitudinal analysis. The Lancet Psychiatry, 8(5):405-15. (10) Farmer, A.Y. & Lee, S.K. (2011). The Effects of Parenting Stress, Perceived Mastery, and Maternal Depression on Parent-Child Interaction. Journal of Social Service Research, 37(5):516-25. (11) Thomason, E., Volling, B.L., Flynn, H.A., McDonough, S.C., Marcus, S.M., Lopez, J.F. & Vazquez, D.M (2014). Parenting stress and depressive symptoms in postpartum mothers: bidirectional or unidirectional effects? Infant Behavior and Development, 37(3): 406-415. (12) Vismara, L., Rollè, L., Agostini, F., Sechi, C., Fenaroli, V., Molgora S. et al. (2016). Perinatal Parenting Stress, Anxiety, and Depression Outcomes in First-Time Mothers and Fathers: A 3- to 6-Months Postpartum Follow-Up Study. Front Psychol, 7. (13) Russell, B.S., Hutchison, M., Tambling, R., Tomkunas, A.J. & Horton, A.L. (2020). Initial Challenges of Caregiving During COVID-19: Caregiver Burden, Mental Health, and the Parent-Child Relationship. Child Psychiatry Hum Dev, 51(5):671-82. (14) Buechel, C., Nehring, I., Seifert, C., Eber, S., Behrends, U., Mall, V., Friedmann, A. (2022). A cross-sectional investigation of psychosocial stress factors in German families with children aged 0-3 years during the COVID-19 pandemic: initial results of the CoronabaBY study. Child and Adolescent Psychiatry and Mental Health, 16, 37. (15) Buechel, C., Nehring, I., Seifert, C., Eber, S., Laub, O., Ewald, D., Behrends, U., Mall, V., Friedmann, A. (2022). Abnahme der Pandemiebeschränkungen = Abnahme der psychosozialen Belastungen bei Familien mit Kindern im Alter von 0-3 Jahren? Ein repetitiver Querschnitts-Vergleich in Bayern (CoronabaBY-Studie). Posterpräsentation. Kongress für Kinder- und Jugendmedizin 2022. Düsseldorf, 08.09.22.

Longitudinal studies of the last decades impressively demonstrate the potentially harmful influence of early psychosocial stress on children's physical and mental health (1,2,3). Within the first year of life, children are particularly vulnerable to health-relevant environmental factors, while at the same time their resilience is not yet very robust (4). Children between 1-3 years of age are also still highly dependent on the care provided by and the relationship with their parents. Overall, children aged 0-3 years are considered a special risk group for neglect and other forms of maltreatment (5). Currently, the restrictions caused by the Covid 19 pandemic and the worsening economic conditions lead to multiple psychosocial burdens for young families (parental stress, existential worries, etc.). It can be assumed that this is reflected in both the immediate parental stress and the children's behaviour (6). Early and systematic identification of the needs for psychosocial support in families with children between 0 and 3 years of age enables the prompt initiation of appropriate support services (e.g. early intervention services, so called “Frühe Hilfen”) and can contribute to preventing negative effects on child health. Due to the regular and early access to young families via the well-child visits (so called "U check-ups"), resident paediatricians are particularly suitable for this task (7). Currently, there is no universal standardised procedure in Germany that facilitates a reliable identification of psychosocially burdened families and referral to early intervention services. Within the framework of a Bavaria-wide study, it is to be examined whether the access rate to early prevention services can be positively influenced through a specific "early prevention module". Furthermore, the longitudinal course of psychosocial stress factors in families with children between 0 and 3 years of age during the Covid 19 pandemic will be investigated. A comparison with corresponding historical cohorts will be used to determine the extent to which the psychosocial stress of families with infants and young children has changed under the current crisis conditions, how the stress factors correlate and how effective support measures initiated by the paediatricians are. If psychosocial stress in families is detected at an early stage and support measures are initiated promptly, an escalation of the stressful circumstances (risk to children's well-being) and a chronification of the existing problems can be prevented. If the "early interventions module" proves to be effective, it should be considered to include it in the standard procedure of the paediatric U-check-ups. (1) Werner, E. E. (1993). Risk, resilience, and recovery: Perspectives from the Kauai Longitudinal Study. Development and Psychopathology, 5, 503-515. (2) Laucht, M., Esser, G. & Schmid, M. H. (1997). Developmental Outcome of Infants Born with Biological and Psychosocial Risks. Journal of Child Psychology and Psychiatry, 38(7), 843-854. (3) Laucht, M., Schmidt, M. H. & Esser, G. (2002). Motorische, kognitive und sozial-emotionale Entwicklung von 11-Jährigen mit frühkindlichen Risikobelastungen: späte Folgen. Zeitschrift für Kinder- und Jugendpsychiatrie, 30(1), 5-19. (4) Schlack, H. G. (2009). Sozialpädiatrie: Eine Standortbestimmung. In H. G. Schlack, R. von Kries & U. Thyen (Eds.), Sozialpädiatrie. Gesundheitswissenschaft und pädiatrischer Alltag (pp. 1-8). Berlin, Heidelberg: Springer. (5) Münder J, Mutke B, Schone R: Kindeswohl zwischen Jugendhilfe und Justiz. Münster: Votum-Verlag 2000. (6) Papoušek, M. (2004). Regulationsstörungen der frühen Kindheit: Klinische Evidenz für ein neues diagnostisches Konzept. In: M. Papoušek, M. Schieche, H. Wurmser (Hrsg.), Regulationsstörungen der frühen Kindheit, 77-110. Huber, Bern. (7) Hayutin, L. G., Reed-Knight, B., Blount, R. L., Lewis, J. & McCormick, M. L. (2009). Increasing Parent–Pediatrician Communication about Children’s Psychosocial Problems. Journal of Pediatric Psychology, 34 (10), 1155-1164.

Hintergrund und Ziele: Der Stellenwert der Lebensqualität ist heute in Hinblick auf das ständig erweiterte Therapiespektrum und die daraus resultierende verlängerte Überlebenszeit der Patienten durch effizientere Behandlungsmöglichkeiten so groß wie nie zuvor. Lebensqualität fließt als zentraler Punkt in die Bewertung von Therapien bei onkologischen Patienten mit ein. Hintergrund der Arbeit ist eine internationale Studie zur Aktualisierung des lungenkrebsspezifischen EORTC-Fragebogenmoduls QLQ-LC13, das bereits seit 20 Jahren der Erfassung der Lebensqualität von Lungenkrebspatienten dient. Nach dem EORTC Module Development Manual wird der Kernfragebogen EORTC QLQ-LC13 in einem 4-stufigen-Prozess dem aktuellen Stand in Diagnostik und Therapie angepasst. Bei dieser Arbeit handelt es sich um eine Teiluntersuchung der internationalen Phase 4 Studie zur Testung der psychometrischen Eigenschaften des neu zusammengestellten EORTC QLQ-LC29 Fragebogens. Hauptziel der vorliegenden Studie ist es, das Hornheider Screening-Instrument und die EORTC Fragebögen gleichzeitig einzusetzen und deren Gemeinsamkeiten und Unterschiede zu untersuchen. Methodik: In dieser Teilstudie der prospektiven klinischen Multicenterstudie wurden 81 Patienten mit histologisch gesichertem Bronchialkarzinom rekrutiert, welche sich in Behandlung am Universitätsklinikum Regensburg oder im Krankenhaus der Barmherzigen Brüder Regensburg befanden. Für die Befragung wurden dabei der Kernfragebogen EORTC QLQ-C30, das aktualisierte Modul QLQ-LC29 sowie das Hornheider Screening-Instrument verwendet. Die Lebensqualitätsfragebögen wurden anschließend ausgewertet und mit den Ergebnissen des Hornheider-Screening-Instruments verglichen. Die Studie wurde von der Ethikkommission der Universität Regensburg genehmigt (Bearbeitungsnummer 16-101-0059). Ergebnisse: 39 Patienten (48,1%) gelten laut HSI als betreuungsbedürftig bzw. als psychosozial belastet. Die höchste Korrelation der beiden Messinstrumente ergibt sich zwischen HSI und der EORTC-Skala „emotionale Funktion“, r=-0,591, p, Background: Although, overall survival is the ultimate criterion for an oncological therapy, quality of life becomes a more and more important issue in the treatment of lung cancer. The current report is based on a satellite project within a prospective, international, cross-cultural, multicenter study to validate the EORTC QLQ-LC29, a new designed module to assess the quality of life of lung cancer patients. The goal of the present project was to administer the Hornheide Screening Instrument (HSI) and the EORTC QLQ-C30/-LC29 in a sample of lung cancer patients in order to analyze agreements and possible differences between the instruments. Method: The study recruitment for this satellite project took place from April 2016 to April 2017 and 81 patients with diagnosed lung cancer were recruited in the University Hospital Regensburg and the hospital Barmherzige Brüder in Regensburg. Patients were asked to fill in the EORTC QLQ-C30 questionnaire, the recently updated lung cancer module QLQ-LC29 and the Hornheide Screening Instrument. The instruments were analyzed and compared to each other. Approval from the Ethical Committee of the University Regensburg was obtained (reference number 16-101-0059). Results: According to the HSI, 39 patients (48,1%) needed psychosocial support. The most prominent correlation between the EORTC and the Hornheide Screening Instrument was found in “emotional function” (r=0,591, p

Lietuvoje stebimas didėjantis vaikų sergamumas onkologinėmis ligomis. Vaiko mirties patirtis ypač skaudi tėvams, kai jiems tenka išgyventi baimės, nerimo, liūdesio, nevilties ar pykčio emocijas, trukdančias toliau tęsti visavertį gyvenimą. Tėvams, išgyvenantiems netektį, reikalinga pagalba, kuri atlieptų jų viltis ir poreikius, padėtų įveikti socialinės atskirties jausmą, parodytų, kad pagalba yra čia pat ir galima ją gauti. Tyrimas atskleidė, kad žinios apie ligą priėmimas ir prisitaikymas prie naujų aplinkybių priklauso nuo tėvų pirminio kontakto su gydančiuoju gydytoju. Gydytojo dėmesys, aiškus ligos apibūdinimas, gydymo aptarimas, nuolatinis abipusis komunikavimas švelnina prisitaikymo etapą. Tyrimas atskleidė ir laiku teikiamos kompleksinės (gydytojo, psichologo, socialinio darbuotojo) pagalbos poreikį, kuris svarbus visą gydymosi laikotarpį. Po vaiko netekties tėvams ypač ryškus socialinio darbuotojo pagalbos poreikis. Tyrimo metu išaiškėjo tarpinstitucinio bendradarbiavimo būtinumas, siekiant padėti šeimai išgyventi netektį, suteikti būtiną psichosocialinę pagalbą, stebėti, analizuoti pokyčius visą gedėjimo laikotarpį, o dažnai ir ilgiau. Death of a child leaves an extremely deep and painful wound in the heart of the parents. There is an increase in the incidence of oncological diseases in Lithuania. It is not easy to reconcile, accept the fact, not be angry at life and destiny, and try to get back to everyday life. In order to help parents to survive the loss they require support that responds to their hopes and needs and would help them not to feel socially excluded, would show that the help is available and can be obtained. Therefore, it is necessary to find out what psychosocial help would be the most helpful for parents who have lost their child due to oncological disease.The study revealed that acceptance and reconciliation with the current situation depends particularly on the initial contact with the treating physician. His attention, clear description of the illness, discussion of the treatment, constant bilateral communication facilitates the stage of reconciliation with the disease. The need and importance of timely complex (including physician, psychologist, social worker) assistance throughout the treatment period and especially after the child‘s loss was noted. The study also revealed the need for interinstitutional cooperation to help the family survive the loss, provide the necessary psychosocial assistance, monitor, analyze changes throughout the mourning and in many cases even longer.