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Virtual reality (VR) is increasingly gaining importance as a valuable methodical tool for psychological research. The greatest benefit of using VR is generating rich, complex and vivid, but still highly controllable settings. As VR has been found to elicit lifelike psychophysiological and emotional responses, we examined by means of a height exposure whether VR resembles physical reality to the necessary degree to constitute a suitable framework for investigating real-life behavior in a controlled experimental context. As hypothesized, participants behaved in VR exactly as would be appropriate in a real environment: Being exposed to great height, participants walked significantly slower across a virtual steel girder construction protruding from a high-rise building as compared to participants who traversed the very same construction on the ground level. In the height condition, this realistic behavior could be predicted on basis of the participants' trait anxiety. Aligned with the behavioral responses, they showed realistic psychophysiological responses, i.e., an elevated heart rate when exposed to height. Interestingly, participants of the height condition reported a greater sense of presence, which indicates that emotions have an elevating effect on presence. As a conclusion, our findings provide further evidence that VR evokes lifelike responses at both behavioral and psychophysiological level and therefore increases ecological validity of psychological experiments.

In early 2020 the world was struck by the epidemic of novel SARS-CoV-2 virus. Like many others, German government has introduced severe contact restrictions to limit the spread of infection. This paper analyses effects of weather on the spread of the disease under the described circumstances. We demonstrate that regions reported lower growth rates of the number of the infection cases after days with higher temperatures, no rain and low humidity. We argue that this effect is channelled through human behaviour. The evidence suggests that "good" weather attracts individuals to outdoor (safer) environments, thus, deterring people from indoor (less safe) environments. Understanding this relationship is important for improving the measures aiming at combating the spread of the virus., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Using a hand collected data-set, this paper analyzes the investment behavior of over 15,100 investors and over 42,200 investments on one of Germany's largest equity crowdfunding portals. It shows that paramount contributions come from one subpopulation. Contributions of EUR 5000 and larger from the first 59 campaigns account for 50.6% of the raised capital while they make up a mere 3.2% of all investments. When these investments are linked to investor profiles, these individuals are found to invest less frequently, suggesting different investment behaviors among crowd-investors. This significantly advances the understanding of equity crowdfunding by showing that the crowd is not a homogenous community. Furthermore, it is found that for investors who make these investment sizes, men are not statistically more likely to be a part of this group. These findings provide numerous revelations for policy-makers, equity crowdfunding platforms, as well as entrepreneurs. [ABSTRACT FROM AUTHOR]

This paper investigates the spouses' perceived influence on household purchases. A questionnaire-based survey among 200 Romanian couples was conducted. The research sample included only couples in which women are involved in circular migration toward Austria and Germany. As a result of their financial empowerment, an increase of women's perceived influence on the couple's purchase decision-making has been expected. Yet the research shows that influence upon purchase of products and services is stronger correlated with the performance of household chores than spouses' income. After returning home, spouses tend to resume their traditional roles. Moreover, in many couples, there are major incongruences between the perceptions of spouses regarding both the influence upon the purchase decision-making process and the performance of household chores. Managerial and societal implications are discussed. [ABSTRACT FROM AUTHOR]

This paper examines the link between attitudes, the acceptance of violence and the performance of extremist acts. It is tested, if different ideologies of extremism develop commonalities in their positions, attitudes and structures. Data from a school survey of more than 6,700 9th grade students from Germany serves as the empirical basis. The results show among other things that different extremist ideologies (right-wing, left-wing, Islamism) covary on the level of attitudes, acceptance of violence and extremist behavior. In a further step of analysis, the theoretically based paths of initially extremist attitudes, then an additional approval of violence and finally the commission of extremist acts was examined approximately in a person-oriented approach. Except for one path, the analyses of radicalization patterns confirm a model that commences on the cognitive level, followed by the acceptance of deviant means to reach ideological goals and finally leading to extremist acts. [ABSTRACT FROM AUTHOR]

Over the past decades, plagiarism has been classified as a multi-layer phenomenon of dishonesty that occurs in higher education. A number of research papers have identified a host of factors such as gender, socialisation, efficiency gain, motivation for study, methodological uncertainties or easy access to electronic information via the Internet and new technologies, as reasons driving plagiarism. The paper at hand examines whether such factors are still effective and if there are any differences between German and Slovene students’ factors influencing plagiarism. A quantitative paper-and-pencil survey was carried out in Germany and Slovenia in 2017/2018 academic year, with a sample of 485 students from higher education institutions. The major findings of this research reveal that easy access to information-communication technologies and the Web is the main reason driving plagiarism. In that regard, there are no significant differences between German and Slovene students in terms of personal factors such as gender, motivation for study, and socialisation. In this sense, digitalisation and the Web outrank national borders. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic and the measures taken to combat it led to severe constraints for various areas of life, including mobility. To study the effects of this disruptive situation on the mobility behaviour of entire subgroups, and how they shape their mobility in reaction to the special circumstances, can help to better understand, how people react to external changes. Methodology: Aim of the study presented in this article was to investigate to what extent, how and in what areas mobility behaviour has changed during the outbreak of SARS-CoV-2 in Germany. In addition, a focus was put on the comparison of federal states with and without lockdown in order to investigate a possible contribution of this measure to changes in mobility. We asked respondents via an online survey about their trip purposes and trip frequency, their choice of transport mode and the reasons for choosing it in the context of the COVID-19 crisis. For the analyses presented in this paper, we used the data of 4157survey participants (2512 without lockdown, 1645 with lockdown). Results: The data confirmed a profound impact on the mobility behaviour with a shift away from public transport and increases in car usage, walking and cycling. Comparisons of federal states with and without lockdown revealed only isolated differences. It seems that, even if the lockdown had some minor effects, its role in the observed behavioural changes was minimal. [ABSTRACT FROM AUTHOR]

Background: The news media is a key source for health and medical information, and relies to a large degree on material from press releases (PR). Medical universities are key players in the dissemination of PRs. This study aims to 1) explore the relation between the quality of press releases (PRs) from medical universities and their corresponding news stories (NSs) and 2) to identify the likelihood that specific scientific and interest-raising measures appear or are omitted in PRs and NSs. Methods and findings: In this retrospective study using quantitative content analysis, PRs (n = 507) from 21 medical universities in Germany, the Netherlands, Sweden, the USA and the UK were retrieved. Of all PRs, 33% had media coverage, resulting in 496 NSs. With two codebooks, 18 scientific (e.g. reporting the study design of the study correctly) and 7 interest-raising measures (e.g. words like ‘ground-breaking’) were evaluated in the PRs and NSs. For all measures the percentage of presence in NSs and PRs was calculated, together with a Mean PR Influence Factor. Quality of PRs and NSs was defined as a score, based on 12 of the 18 scientific measures. Mean (SD) NS quality score was 6.5 (1.7) which was significantly lower than the PR score of 8.0 (1.5). The two quality scores were significantly correlated. Quality measures that were frequently omitted included reporting important study limitations (present in 21% of PRs, 21% of NSs), funding (59% of PRs, 7% of NSs) and conflicts of interest (16% of PRs, 3% of NSs). We did not evaluate the quality of the scientific papers (SPs), and can therefore not determine if the quality of PRs and NSs is associated with the quality of SPs. Conclusions: This large study of medical university press releases and corresponding news stories showed that important measures of a scientific study such as funding and study limitations were omitted to a very large extent. The lay public and health personnel as well as policy makers, politicians and other decision makers may be misled by incomplete and partly inaccurate representations of scientific studies which could negatively affect important health-related behaviours and decisions. [ABSTRACT FROM AUTHOR]

The majority of transgender and gender-nonconforming people (TGNC) report negative experiences with doctors in the healthcare system. As there is little knowledge about the communication behaviour of doctors towards TGNC, this survey aimed to assess the self-reported trans-inclusive communication of doctors and their willingness to communicate trans-inclusively, as well as their self-perceived barriers to it. A mixed-methods survey was applied for this. Firstly, we measured self-reported trans-inclusive communication behaviour based on the CommTrans questionnaire. Based on this, the overall willingness, as well as self-perceived barriers (qualitative) to communication, were assessed. In total, N = 57 doctors took part in the survey. Most participants reported not introducing themselves using pronouns (79.4%). Of these, 61.4% said that they would not be able to do this in the future either. Perceived barriers were classified into the following eight categories: necessity, sample-dependency, habit, structural barriers in practice, uncertainties in dealing with the topic, limits of patient-centredness, gender as a binary concept, and transphobia. In summary, doctors in Germany show different degrees of trans-inclusive communication. It is likely that this has a negative effect on TGNC, their health and access to the healthcare system. [ABSTRACT FROM AUTHOR]

From the transport economic literature, it is known that optimal pricing of (environmental) externalities improves the urban system. In contrast to theory-based optimal pricing strategies, real-world policy setting often follows so-called "backcasting" approaches where certain targets are set, and policy measures are implemented in order to reach those targets. An example for the latter approach is the EU goal to reduce global greenhouse gas emissions in the transport sector by 20% until 2020 with respect to 1990 levels. This article aims to (i) compare optimal pricing and backcasting approaches for a specific case study in a simulation environment by identifying the contribution of each approach in EU's 2020 emission reduction target, and (ii) to determine the costs required to reach the desired targets. For this purpose, an optimal emission pricing strategy is applied to a real-world scenario of the Munich metropolitan area in Germany. The highly differentiated tolls relate to individual exhaust emissions, i.e. they are calculated using damage cost estimates from the literature and vary over time of day, with traffic situation, and with vehicle type. The results indicate that the desired reduction in CO2 emissions is not reached for optimal pricing approach, and that the initial damage costs estimates need to be multiplied by a factor of 5 in order to reach the target, yielding a price of 350 CO2. When aiming at a decrease of the overall emission costs by 20% (CO2 and local pollutants), the initial cost estimates need to be multiplied by a factor of 10. Furthermore, it is shown that the major contribution to the overall emission reduction stems from behavioral changes of commuters and reverse commuters rather than from urban travelers; under some circumstances, urban travelers even increase their CO2 emission levels. Hence, the study rises awareness that conflicting trends for different types of pollutants and different types of individuals are very likely: an increase in non-methane hydrocarbon levels for urban travelers and freight depicts that pricing emissions does not necessarily result in a reduction of all pollutants or of the emissions levels of all travelers. It is shown how agent-based simulations can be used to provide valuable insights and decision support in such possibly counter-intuitive situations. [ABSTRACT FROM AUTHOR]

Background Ultraviolet (UV) exposure during outdoor work increases the risk of developing skin cancer. Therefore, the uptake of recommended sun protection behaviors is important to prevent UV-related skin damage in the population of outdoor workers. To develop targeted prevention campaigns, information on the use of sun protection behaviors in different industries is needed. Methods A total of 486 outdoor workers were surveyed on the use of several sun protection measures as part of the 7th wave of the National Cancer Aid Monitoring. Furthermore, details on job-related characteristics, sociodemographics, and skin type were assessed. Descriptive analyses stratified by sex were conducted. Results In general, use of sun protection was insufficient (e.g. 38.4% used sunscreen on the face). Sun protection behavior differed between female and male outdoor workers with females being more likely to use sunscreen and males being more likely to wear sun protective clothes and headgear. For male outdoor workers, we revealed several associations with job-related characteristics. For instance, those who were employed full time were more likely to wear sun protective clothes (e.g. shoulder-covering shirt: 87.1% versus 50.0%, P < 0.001). Discussion We identified deficits in sun protection behavior in outdoor workers and differences by sex- and job-related characteristics. These differences offer starting points for targeted prevention measures. In addition, the findings may inspire qualitative research. [ABSTRACT FROM AUTHOR]

• The inclusion of sixteen new items creates a timely commensurate BYNDS. • In particular, a broader picture of smartphone use is introduced. • The paper presents an innovative translation process easy to adopt. • Pitfalls for response errors are addressed, and semantics are improved. • The questionnaire was applied to a representative German sample of young drivers. In Germany, every year 66,000 road crashes lead to death or injury of young novice drivers. This makes them twice as likely to be involved in, or cause, vehicle crashes compared to their older and more experienced counterparts. This study aims to address this societal issue by developing a better understanding of the German young driver problem. For this purpose, we created an updated, 55-item strong version of the Behaviour of Young Novice Drivers Scale (BYNDS), originally developed by Scott-Parker et al. in 2010. To make the new version of the BYNDS understandable for German young novice drivers, this research used a new method of translation in combination with extensive pre-testing. As a result, we identified possible threats for response errors such as retrospective formulated questions or double negations. Due the adjustment of the possible sources of error the presented version of the BYNDS is semantically and conceptually different from the original. However, due to the application of the updated version of the BYNDS in a robust sample of 700 participants, this paper presents the first reliable and validated tool to measure novices risky driving behaviour in Germany. Moreover, it offers an updated and extended version of the BYNDS that allows practitioners but also researchers to broaden their understanding of young driver risk. [ABSTRACT FROM AUTHOR]

Integrated care is regarded as a key for care delivery to persons with chronic long-term conditions such as Parkinson's disease. For persons with Parkinson's disease, obtaining self-management support is a top priority in the context of integrated care. Self-management is regarded as a crucial competence in chronic diseases since the affected persons and their caregivers inevitably take up the main responsibility when it comes to day-to-day management. Formal self-management education programs with the focus on behavioral skills relevant to the induction and maintenance of behavioral change have been implemented as a standard in many chronic long-term conditions. However, besides the example of the Swedish National Parkinson School, the offers for persons with Parkinson's disease remain fragmented and limited in availability. Today, no such program is implemented as a nationwide standard in Germany. This paper provides (1) a systematic review on structured self-management education programs specifically designed or adopted for persons with Parkinson's disease, (2) presents the Swedish National Parkinson School as an example for a successfully implemented nationwide program and (3) presents a concept for the design, evaluation and long-term implementation of a future-orientated self-management education program for persons with Parkinson's disease in Germany. [ABSTRACT FROM AUTHOR]

Background: Adolescence is a phase of higher vulnerability for suicidal behavior. In Germany, almost 500 adolescents and young adults aged 15-25 years commit suicide each year. Youths in rural areas are characterized by a higher likelihood of poorer mental health. In rural areas, appropriate support for adolescents and young adults in mental health crises is difficult to access. The general acceptability of digital communication in youths can make the provision of an eHealth tool a promising strategy. Objective: The aim of this study was to explore the health needs regarding suicide prevention for adolescents and young adults in rural areas of Germany and Switzerland and to identify characteristics of suitable e-mental health interventions. Methods: This study reports on a qualitative secondary analysis of archived data, which had been collected through formative participatory research. Using 32 semistructured interviews (individually or in groups of 2) with 13 adolescents and young adults (aged 18-25 years) and 23 experts from relevant fields, we applied a deductive-inductive methodological approach and used qualitative content analyses according to Kuckartz (2016). Results: Experts as well as adolescents and young adults have reported health needs in digital suicide prevention. The health needs for rural adolescents and young adults in crises were characterized by several categories. First, the need for suicide prevention in general was highlighted. Additionally, the need for a peer concept and web-based suicide prevention were stressed. The factors influencing the acceptability of a peer-driven, web-based support were related to low-threshold access, lifelike intervention, anonymity, and trustworthiness. Conclusions: The results suggest a need for suicide prevention services for adolescents and young adults in this rural setting. Peer-driven and web-based suicide prevention services may add an important element of support during crises. By establishing such a service, an improvement in mental health support and well-being could be enabled. These services should be developed with the participation of the target group, taking anonymity, trustworthiness, and low-threshold access into account. [ABSTRACT FROM AUTHOR]

The high level of uncertainty brought about by the COVID‐19 pandemic has affected the general population's well‐being and capacity for adaptive responding. Studies indicate that flexibility, defined as the ability to choose and employ a variety of emotional, cognitive and behavioural strategies in accordance with changing contextual demands, may significantly contribute to adaptive responding to long‐term stressors such as COVID‐19. In the current study, we aimed to investigate which facets of flexibility predict different latent profiles of adaptive responding to the COVID‐19 pandemic in Israel and Germany. A total of 2330 Israelis and 743 Germans completed online questionnaires measuring cognitive and coping regulatory flexibility and cognitive, emotional and behavioural responding to the COVID‐19 pandemic. Analyses revealed three distinct response profiles in each country (high, medium and low). These profiles differed in both anxiety and depression symptoms with the non‐adaptive response group experiencing clinically relevant symptoms both in Israel and Germany. Additionally, cognitive flexibility and coping flexibility emerged as significant predictors of response profiles in both countries. Training cognitive and coping flexibility may thus help individuals respond more adaptively to psychosocial stressors such as COVID‐19. Such training could be selectively administered to less flexible subpopulations as well as adapted to the specific population characteristics. [ABSTRACT FROM AUTHOR]

Nudging users to keep them secure online has become a growing research field in cybersecurity. While existing approaches are mainly blackbox based, showing aggregated visualisations as one-size-fits-all nudges, personalisation turned out promising to enhance the efficacy of nudges within the high variance of users and contexts. This article presents a disaggregated whitebox-based visualisation of critical information as a novel nudge. By segmenting users according to their decision-making and information processing styles, we investigate if the novel nudge is more effective for specific users than a common black-box nudge. Based on existing literature about critical factors in password security, we designed a dynamic radar chart and parallel coordinates as disaggregated visualisations. We evaluated the short-term effectiveness and users' perception of the nudges in a think-aloud prestudy and a representative online evaluation (N=1.012). Our findings suggest that dynamic radar charts present a moderately effective nudge towards stronger passwords regarding short-term efficacy and are appreciated particularly by players of role-playing games. [ABSTRACT FROM AUTHOR]

To analyze which pandemic related changes of attitudes and behaviors were perceived by Seventh-day Adventists (SDA) and how these relate to wellbeing, a cross-sectional survey with standardized questionnaires was performed. Participants (n = 1,494) stated changes for Relationships, Digital media usage and Nature/Silence/Contemplation, but not for Spirituality or Reflection of life. Best predictors of psychological wellbeing (WHO-5) were Spiritual wellbeing, perceived Restrictions and Awe/Gratitude (R2 =.32). Mediation analyses (R2 = 0.51) revealed a mediation effect of Awe/Gratitude between spiritual to psychological wellbeing (β = 0.11, p < 0.0001). Perceived changes were less relevant to buffer the negative effects of the pandemic; instead, they were related to fears of future. More relevant to stabilize SDAs´ wellbeing was their spirituality. [ABSTRACT FROM AUTHOR]

Meeting lateness—that is, meetings starting past the pre-scheduled time—can be viewed as a disruption to the temporal pacing of work. Previous research in the United States indicates that late meetings produce less optimal outcomes, but empirical insights concerning the extent to which experiences of meeting lateness are similar or different across different cultures remain sparse. While prior work suggests differences in how individuals from different cultures experience time-related phenomena, globalization trends suggest increasing similarities in employees' work experiences, and potentially similar experiences of meeting lateness across different cultural settings. We explore this idea in a cross-cultural study of meeting lateness in China, Germany, Italy, the Netherlands, and the United States. We empirically establish the cross-cultural relevance of meeting lateness and their generally negative outcome. We show how meeting lateness relates to perceptions of impaired meeting processes, meeting outcomes, and group-related attitudes across cultures. We discuss these findings in light of extending meeting science to different cultures as well as contributions to the debate between cross-cultural differences versus globalization tendencies. [ABSTRACT FROM AUTHOR]

The usage of smartphones and apps to communicate, retrieve information, locate places, and entertain is a norm today. However, to this day, many users are unaware of, or indifferent to, how smartphones (and other mobile devices such as tablets, fitness trackers, or smartwatches) could possibly breach their mobile privacy. This case study investigates and compares mobile privacy behavior and attitude of library and information science students from the School of Communication and Information, Rutgers, the State University of New Jersey, U.S.A., with library and information science students from the Berlin School of Library and Information Science, Humboldt-Universität zu Berlin, Germany. Qualitative ethnographic research methods such as interviews, participant observation, and an experiment were conducted between 2017 and 2018 both in Germany and the U.S.A. The findings reveal that there are nearly no cultural differences in mobile privacy behavior and attitude between participants. In fact, this study discovers and discerns different mobile privacy typologies. These typologies, ranging from "mobile privacy objection" to "mobile privacy learned helplessness" reveal how they impact German and American students' privacy behavior and attitude in a similar fashion. The lack of significant differences between German and American library and information science students suggests that more could be done to raise privacy awareness, especially for mobile computing and emergent technologies such as facial recognition and A.I. [ABSTRACT FROM AUTHOR]

Background: As a reaction to the novel coronavirus disease (COVID-19), countries around the globe have implemented various measures to reduce the spread of the virus. The transportation sector is particularly affected by the pandemic situation. The current study aims to contribute to the empirical knowledge regarding the effects of the coronavirus situation on the mobility of people by (1) broadening the perspective to the mobility rural area's residents and (2) providing subjective data concerning the perceived changes of affected persons' mobility practices, as these two aspects have scarcely been considered in research so far. Methods: To address these research gaps, a mixed-methods study was conducted that integrates a qualitative telephone interview study (N = 15) and a quantitative household survey (N = 301). The rural district of Altmarkkreis Salzwedel in Northern Germany was chosen as a model region. Results: The results provide in-depth insights into the changing mobility practices of residents of a rural area during the legal restrictions to stem the spread of the virus. A high share of respondents (62.6%) experienced no changes in their mobility behavior due to the COVID-19 pandemic situation. However, nearly one third of trips were also cancelled overall. A modal shift was observed towards the reduction of trips by car and bus, and an increase of trips by bike. The share of trips by foot was unchanged. The majority of respondents did not predict strong long-term effects of the corona pandemic on their mobility behavior. [ABSTRACT FROM AUTHOR]

The augmented reality smartphone game Pokémon Go is one of the biggest commercial successes in the last years, posing the question concerning the factors contributing to the game's success. An apparent distinction to other games is the strong brand Pokémon. We derive a research model based on the established theory of technology acceptance, which includes an established construct for nostalgic feelings – childhood brand nostalgia – and theorise on how it is related to beliefs about technology characteristics and the intention to play the game. For this purpose, we adapt one of the most prominent technology acceptance models for the consumer context and for hedonic information systems, the UTAUT2 model. Based on our model, we conduct a study with 418 active German players aged between 18 and 35. Our results indicate that the effect of childhood brand nostalgia on behavioural intention is fully mediated by the belief constructs. Thus, nostalgic feelings about Pokémon influence the intention of users through altering beliefs concerning Pokémon. We include nostalgic feelings in a technology acceptance model for the first time, therefore contributing to the theoretical advance in the IS domain. The results can be used to enhance the technology acceptance of newly designed products. [ABSTRACT FROM AUTHOR]

'Flight shame' describes an unease about the climate implications of air travel, and bears evidence of a change in social norms that have so far associated flying with social status. This paper discusses whether Fridays for Future demonstrations and ensuing flight shame have influenced social norms regarding the desirability of air travel, and whether this is measurable in a decline in air travel, or policy support for measures curbing emissions from aviation. These aspects are discussed on the basis of German flight statistics and an online panel survey (n = 1002) conducted in August 2019 in Germany. Results show that, against a background of falling domestic air transport demand, respondents do not report a significant change in travel behaviour. However, a two-third majority of respondents indicate support for market-based measures increasing the cost of flying, as well as policies forcing airlines to reduce emissions and legislation abolishing subsidies. These findings point at an ongoing change in social norms, which could be reinforced if policymakers took advantage of public support for ambitious climate policies. • Investigates flight shame debates' influence on social norms and policy support. • Finds strong evidence of a heightened awareness of air travel implications. • Suggests that social practice change is already visible in declining passenger numbers. • Affirms support for far-reaching climate policies to curb emissions from aviation. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, the Working Group "Prevention and Integrative Oncology" (PRIO) in the German Cancer Society has initiated flash interviews and surveys. One of these stated increasing rates of fears and mental stress of tumor patients. Now we aimed to analyze whether tumor patients did perceive changes in their attitudes and behaviors related to their relationships, awareness of nature and quietness, interest in spiritual issues, or feelings of worries and isolation. A further point of interest was how these perceived changes could be predicted, either by meaning in life, spirituality as a resource to cope, perceived fears and worries, or particularly by their wellbeing. Materials and Methods: Online survey with standardized questionnaires (i.e., WHO-Five Well-being Index (WHO5), Meaning in Life Questionnaire (MLQ), Spiritual and Religious Attitudes to cope with illness (SpREUK-15), Gratitude/Awe scale (GrAw-7)) among 292 tumor patients (72% men; mean age 66.7 ± 10.8 years; 25% < 60 years, 33% 60-70 years, 41% > 70 years) from Germany between May 6 to June 10, 2020. Results: Patients´ wellbeing (WHO5) scores were in the lower range (14.7 ± 6.0); 35% scored < 13, indicating depressive states. Wellbeing was significantly higher in older persons and lower in younger ones (F=11.1, p<.0001). Most were irritated by different statements about the danger and the course of the corona infection in the public media (60%), and 57% were worrying to be infected and to have a complicated course of disease. Because of the restrictions, patients noticed changes in their attitudes and behaviors (measured with the 12-item Perceptions of Change Scale): 1) Perception of nature and silence (Cronbach´s alpha =.82), 2) Worrying reflections and loneliness (Cronbach´s alpha =.80), 3) Interest in spirituality (Cronbach´s alpha =.91), 4) Intense relationships (Cronbach´s alpha =.64). These perceptions of change were similar in women and men, age groups and also with respect to tumor stages. Regression analyses revealed that the factor Perception of nature and silence was predicted best by patients´ ability to value and experience the 'wonder' of the present moment (in terms of wondering awe and gratitude) and by patients´ search for meaning in life. The factor Worrying reflections and loneliness was predicted best by their search for meaning in life and by feelings of being under pressure because of the Corona pandemic. Interest in spirituality was predicted best by search for an access to a spiritual source and by frequency of praying. Intense relationships were explained with weak predictive power by patients´ ability to reflect life concerns. Patients´ wellbeing during the Corona pandemic was predicted (R2 =.57) by a mix of disease and pandemic related stressor, and by available resources (meaning in life and religious trust). Conclusion: In this study among tumor patients from a secular society the topics meaning in life, having (religious) trust, stable relationships, mindful encounter with nature, and times of reflection were found to be of importance. To overcome tumor patients´ feelings of isolation, depressive states, and insecurity about future perspectives, further support is needed, particularly in their socio-spatial surrounding. These are the domains of psychotherapy and spiritual care. The planned integration of structured access to spiritual care seems to be important, not only for the field of cancer care. As the findings refer to patients´ self-perceptions, longitudinal studies are required to substantiate these perceived changes. [ABSTRACT FROM AUTHOR]

Objective: Telephone based health coaching (TBHC) seems to be a promising approach to foster self-management in patients with chronic conditions. The aim of this study was to evaluate the effectiveness of a TBHC on patient-reported outcomes and health behavior for people living with chronic conditions in Germany. Methods: Patients insured at a statutory health insurance were randomized to an intervention group (IG; TBHC) and a control group (CG; usual care), using a stratified random allocation before giving informed consent (Zelen's single-consent design). The TBHC was based on motivational interviewing, goal setting, and shared decision-making and carried out by trained nurses. All outcomes were assessed yearly for three years. We used mixed effects models utilizing all available data in a modified intention-to-treat sample for the main analysis. Participants and study centers were included as random effects. All models were adjusted for age, education and campaign affiliation. Results: Of the 10,815 invited patients, 4,283 returned their questionnaires at baseline. The mean age was 67.23 years (SD = 9.3); 55.5% were female. According to the model, TBHC was statistically significant superior to CG regarding 6 of 19 outcomes: physical activity in hours per week (p =.030) and in metabolic rate per week (p =.048), BMI (p =.009) (although mainly at baseline), measuring blood pressure (p<.001), patient activation (p<.001), and health literacy (p<.001). Regarding stages of change (p =.005), the IG group also showed statistically different results than the CG group, however the conclusion remains inconclusive. Within-group contrasts indicating changes from baseline to follow-ups and significant between-group comparisons regarding these changes supported the findings. Standardized effect sizes were small. TBHC did not show any effect on mental QoL, health status, alcohol, smoking, adherence, measuring blood sugar, foot monitoring, anxiety, depression and distress. Campaign-specific subgroup effects were detected for 'foot monitoring by a physician' and 'blood sugar measurement'. Conclusion: TBHC interventions might have small effects on some patient reported and behavioral outcomes. Practice implications: Future research should focus on analyzing which intervention components are effective and who profits most from TBHC interventions. Registration: German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS): DRKS00000584 [ABSTRACT FROM AUTHOR]

Though bank filtration diminishes the loads of many trace organic compounds (TOrCs) present in the source water, still there is a wide uncertainty on the influence of local environmental conditions on biodegradation processes. This research addresses the fate and transport behaviour of 37 trace organic compounds at a bank filtration site in Germany over a relatively long-time span of six years. Using two-dimensional heat and reactive transport modelling in FEFLOW, TOrCs are classified according to their occurrence in bank filtration wells with a residence time of up to 4 months. We identify 12 persistent compounds, 20 reactive compounds and 5 transformation products formed during aquifer passage. Estimates of first-order biodegradation rate constants are given for six reactive compounds. Minimum biodegradation rate constants (i.e. maximum half-lives) are approximated for eight compounds only present in the surface water. For some compounds, a simple first-order degradation model did not yield satisfactory results and the behaviour appears to be more complex. Processes like sorption, redox- and/or temperature-dependent biodegradation and temperature-dependent desorption are suspected but incorporating these into the model was beyond the scope of this paper that provides an overview for many compounds. Results highlight the ability of the sub-surface to improve the water quality during bank filtration, yet at the same time show the persistence of several compounds in the aquifer. Image 1 • Analysis of organic micropollutants in bank filtrate over 6 years at a field site. • Identification of 12 persistent compounds after 3–4 months of mean residence time. • Numerical characterization of half-lives for 20 reactive compounds. • On site production of 5 transformation products. • Evidence of seasonal temperature-redox-dependency for 6 biodegradable compounds. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess cancer patients' psychological burden during the COVID-19 pandemic by investigating distress (distress-thermometer), health status (EQ-5D-3L), general anxiety (GAD-7), COVID-19-related fear and associated behavioral changes and comparing these to matched healthy controls, using propensity score matching (PSM). Methods: During the first days of the COVID-19 pandemic in Germany, March 16 to 30, 2020, 150 actually treated cancer patients and 150 matched healthy controls participated in this study. Participants completed an anonymous online survey assessing health status, distress, general anxiety, COVID-19-related fear and behavioral changes (i.e., adherent safety behavior and dysfunctional safety behavior). Results: Cancer patients showed no elevated level of distress, U = 10,657.5, p = 0.428, general anxiety U = 10,015.5, p = 0.099, or COVID-19-related fear compared to healthy controls, U = 10,948, p = 0.680. Both groups showed elevated COVID-19-related fear. Cancer patients reported more adherent safety behavior, such as washing hands more often or avoiding public places, U = 8,285, p < 0.001, d = 0.468. They also reported more dysfunctional safety behavior such as buying larger quantities of basic food, compared to healthy controls U = 9,599, p = 0.029, d = 0.256. Adherent safety behavior could be significantly explained by cancer diagnosis, increased COVID-19-related fear and subjective level of information about COVID-19, R 2 = 0.215, F (3) = 27.026, p < 0.001. Conclusion: This suggests that cancer patients are more likely to utilize adherent safety behavior. Cancer patients reported comparable levels of distress and anxiety compared to healthy controls. Still, the COVID-19 pandemic is associated with elevated COVID-19-related fear. Therefore, specific interventions are needed to prevent anxiety and improve mental health during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: In Germany, evidence-based outpatient smoking cessation therapies are widely available. Long-term abstinence rates, however, are limited. Studies suggest that short-term residential therapy enables a higher level of environmental control, more intense contact and greater support among patients and from therapists, which could result in higher abstinence rates. The aim of the current START-study is to investigate the long-term efficacy of a short-term residential therapy exclusively for smoking cessation, conducted by a mobile team of expert therapists.Methods: A randomized controlled trial (RCT) is conducted to examine the efficacy of residential behavior therapeutic smoking cessation therapy compared to standard outpatient behavior therapeutic smoking cessation group therapy. Adult smokers consuming 10 or more cigarettes per day, who are willing to stop smoking, are randomized in a ratio of 1:1 between therapy groups. The primary endpoint is sustained abstinence for 6-month and 12-month periods. Secondary endpoints include smoking status after therapy, 7-day point abstinence after the 6-month and 12-month follow-ups, level of physical dependence, cost-effectiveness, use of nicotine replacement products, health-related quality of life, self-efficacy expectation for tobacco abstinence, motivational and volitional determinants of behavior change, self-reported depressive symptom severity, adverse events and possible side effects. Assessments will take place at baseline, post-therapy, and at 6-month and 12-month intervals after smoking cessation.Discussion: There is a high demand for long-term effective smoking cessation therapies. This study represents the first prospective RCT to examine the long-term efficacy of a residential smoking cessation therapy program compared to standard outpatient group therapy as an active control condition. The residential therapeutic concept may serve as a new model to substantially enhance future cessation therapies and improve the understanding of therapeutic impact factors on tobacco abstinence. Utilizing a mobile team, the model could be applied efficiently to medical centers that do not have permanent and trained personnel for smoking cessation at their disposal.Trial Registration: German Register for Clinical Trials (Deutsches Register für Klinische Studien), DRKS00013466. Retrospectively registered on 1 April 2019. https://www.drks.de/drks_web/navigate.do?navigationId=start. [ABSTRACT FROM AUTHOR]

Early adopters (EAs) represent a crucial group of consumers in the diffusion of innovations. Therefore, reaching potential technological EAs for up-and-coming innovations is of vital importance. However, little is known as to how potential EAs for new technologies use the Internet. Our study examines the Internet usage of EAs in comparison to the general public and gives an overview of 15 different channels. Consequently, we classified EAs and analyzed a vast set of data containing 119 829 subjects. The results demonstrate significant differences between EAs and the remaining population and offer marketers new insights into EAs' Internet usage behavior. [ABSTRACT FROM AUTHOR]

Background: Tobacco smoking is one of the most important risk factors of coronary heart disease (CHD). Hence, smoking cessation is considered pivotal in the prevention of CHD. The current study aimed to evaluate smoking cessation patterns and determine factors associated with smoking cessation in patients with established CHD.Methods: The fourth European Survey of Cardiovascular Disease Prevention and Diabetes investigated quality of CHD care in 24 countries across Europe in 2012/13. In the German subset, smoking cessation patterns and clinical characteristics were repetitively assessed a) during index event due to CHD by medical record abstraction, b) as part of a face-to-face interview 6 to 36 months after the index event (i.e. baseline visit), and c) by telephone-based follow-up interview two years after the baseline visit. Logistic regression analysis was performed to search for factors determining smoking status at the time of the telephone interview.Results: Out of 469 participants available for follow-up, 104 (22.2%) had been classified as current smokers at the index event. Of those, 65 patients (62.5%) had quit smoking at the time of the telephone interview, i.e., after a median observation period of 3.5 years (quartiles 3.0, 4.1). Depressed mood at baseline visit and higher education level were less prevalent amongst quitters vs non-quitters (17.2% vs 35.9%, p = 0.03 and 15.4% vs 33.3%, p = 0.03), cardiac rehabilitation programs were more frequently attended by quitters (83.1% vs 48.7%, p < 0.001), and there was a trend for a higher prevalence of diabetes at baseline visit in quitters (37.5% vs 20.5%, p = 0.07). In the final multivariable model, cardiac rehabilitation was associated with smoking cessation (OR 5.19; 95%CI 1.87 to 14.46; p = 0.002).Discussion: Attending a cardiac rehabilitation program after a cardiovascular event was associated with smoking cessation supporting its use as a platform for smoking cessation counseling and relapse prevention. [ABSTRACT FROM AUTHOR]

Background: Among drug- or alcohol-addicted offenders under forensic treatment, therapy failure is a potent predictor of substance-related re-delinquency. Given this evidence, high drop-out rates pose a major problem in forensic addiction treatment in Germany. Legal preconditions for a premature discharge due to therapy failure are defined, and behavioral correlates are well described, but the precedent dynamics between patients and therapists have rarely been analyzed. The present study intended to shed light upon the subjective perception of the treatment course prior to therapy failure. Methods: Applying parallel questionnaires and structured interviews, patients' and therapists' perspectives on perceived reasons for therapy failure were retrospectively investigated and compared to each other on a dyadic level. Following this predominantly qualitative and explorative approach, the examination of 32 dyads could be realized; 13 patients with regular (i.e., successful) therapy termination served as controls. All patients had been treated within two specialized forensic addiction hospitals in the German federal state of Baden-Württemberg and were assessed shortly before discharge took place. Results: As expected, patients' and therapists' perspectives differed largely on perceived reasons for failure. In most cases, they appeared to have very different views on what happened during treatment and why therapy eventually failed. Patients mentioned psychological tension and aggressiveness, frequent quarrels with fellow patients, and a bad therapeutic environment as most important reasons for therapy failure. Therapists highlighted patients' unwillingness to make an effort or to change behavior. The analysis of patients' narratives regarding how to explain the negative treatment course confirmed pre-assumptions on predominantly negative feelings and attitudes towards the clinic. The precedent dynamics of therapy failure were shown to be highly individual. However, despite varying notably, a cluster analysis revealed that they seemed to follow "typical patterns" that could partially be linked to patients' characteristics. Conclusions: A better understanding of treatment dynamics during forensic addiction therapy is a prerequisite for the avoidance of therapy failure with negative effects on re-delinquency. It seems that the incapacity to establish a common frame of reference for assessing the therapy process could be one of the major reasons why treatment dynamics take on a life of their own towards a disruption of the therapeutic relationship, leading to therapy failure. The knowledge of "typical" risk patterns towards therapy failure could facilitate early therapeutic measures. [ABSTRACT FROM AUTHOR]

Germany is ethnically diverse and the social climate is more or less welcoming for different immigrant groups. The social climate can be described by stereotypes of members of the receiving society about immigrant groups, which in turn shape receiving-society members’ behavioral tendencies of support or discrimination. We investigated warmth and competence stereotypes about 17 immigrant groups in Germany. Results showed four clusters of immigrant groups in the two-dimensional space of warmth and competence. Groups who immigrated comparatively recently and from regions of conflict (e.g., the Balkans, Northern Africa) were stereotyped most negatively (moderate warmth, low competence). Across groups, path analysis investigated the socio-structural relations proposed by the stereotype content model and the BIAS map for immigrant groups in the German context. In a pre-registered model all hypothesized paths were significant but model fit was not good. Therefore, an exploratory model included additional paths as well as intercorrelations between exogenous variables and error terms. The modified model showed good fit and partly replicated the relations proposed by the BIAS map. Threat predicted warmth, whereas status predicted competence. Warmth predicted active behavioral tendencies and competence predicted passive behavioral tendencies. Additional paths from status to warmth, threat to competence, as well as from warmth to passive behavioral tendencies and competence to active behavioral tendencies were also significant. Thus, findings support receiving-society members’ active role in the process of integrating immigrant groups into German society. Based on the results, social-psychological approaches to foster immigrant integration are discussed. [ABSTRACT FROM AUTHOR]

Aim To assess the role of the TAND (tuberous sclerosis complex [TSC] associated neuropsychiatric disorders) checklist as a screening tool for neuropsychiatric pathology, to evaluate behavioral and psychiatric symptoms and related parental stress in children with TSC, and to analyze associations between parental stress, TAND findings, and TSC pathology. Method This is a prospective cohort study including 22 individuals from a national TSC surveillance study in Germany using demographic and clinical data, the TAND checklist, the Child Behavior Checklist (CBCL), and the Parenting Stress Index (PSI). Results Mean (standard deviation) age at follow-up was 4 years (3 years 9 months), and 13/22 of patients were male. Seventeen children had epilepsy (focal: 9; generalized: 4; infantile spasms: 4). Developmental delay was diagnosed in 12/22 patients. The most prevalent TAND items were anxiety and mood swings in 10/22 children. At least one TAND item was reported by 17/22 patients, internalizing symptoms by 10/22, and externalizing symptoms by 11/22. In contrast, only one patient had a clinically relevant score in the CBCL scales. Of 22 parents, 12 reported clinically relevant parental stress due to both child and parenting factors. Higher total parental stress was associated with a higher TAND externalizing score (r = 0.49; p = 0.028) and TAND total score (r = 0.51; p = 0.016), a higher CBCL total score (r = 0.59; p = 0.005), and the number of antiepileptic drugs (r = 0.50; p = 0.017). Developmental delay was correlated with child stress factors (r = 0.48; p = 0.023). Interpretation The TAND checklist appears to be a promising screening tool for neuropsychiatric problems in very young children with TSC. Parental stress in children with TSC is modified by TSC-related pathology, both neuropsychiatric and neurological. [ABSTRACT FROM AUTHOR]

Background: Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood worldwide, and causes significant impairments in overall functioning. In order to develop effective prevention and intervention programs, knowledge of the determinants that have an impact on the onset and development of ADHD symptoms is essential. So far, little is known about factors affecting ADHD symptoms in children and adolescents over time. Therefore, this study investigates potential psychosocial risk and protective factors for ADHD symptoms based on cross-sectional and longitudinal data of a German population-based study. Methods: Data on children and adolescents (n = 1,384 aged 11 to 17 years) were collected at three measurement points (baseline, 1-year and 2-year follow-ups) covering a period of two years. We used latent growth modelling to investigate effects of parental mental health problems (risk factor) and self-efficacy, family climate and social support (protective factors) on symptoms of ADHD based on cross-sectional as well as longitudinal data. Sociodemographic factors, pre- and postnatal factors, and comorbid symptoms of internalizing and externalizing mental health problems were considered as covariates. Results: At baseline, male gender, younger age, stronger aggressive behavior, and stronger parental mental health problems were related to more ADHD symptoms. Longitudinal analyses showed that female gender, migration status, increasing symptoms of generalized anxiety, increasing aggressive behavior and increasing parental mental health problems were associated with stronger increase of ADHD symptoms over time. However, improving family climate was related to decreasing ADHD symptoms over time. We further found moderator effects for social support. Conclusion: The findings of the study provide important information concerning risk and protective factors in the context of ADHD. Hence, the results may be integrated into the planning and implementation of future prevention and early intervention strategies that target affected children and adolescents. [ABSTRACT FROM AUTHOR]

Background: Large proportions of the populations in many European countries, including Germany, are migrants. Migrant children and adolescents tend to be less physically active than their non-migrant peers. However, current research is limited as it does not sufficiently consider different domains of physical activity. Using a representative dataset, the present study examines the patterns of sports participation and other domains of physical activity among migrant and non-migrant children and adolescents residing in Germany. Methods: Nationwide data from the Motorik-Modul (MoMo) Study is used. Five different domains of physical activity participation (sports clubs, outside of sports clubs, extra-curricular physical activity, physical activity, outdoor play and active commuting to school) were compared between children and adolescents with no, one-sided and two-sided migration background using logistic regression adjusted for demographic factors. Interaction terms were included in order to examine whether difference between the three groups differ by age and gender. Results: Information on n = 3,323 children and adolescents was available. As compared to non-migrants, children and adolescents with a two-sided migration background had a 40% (adjusted odds ratio [aOR] = 0.60, 95%-CI: 0.44–0.81), those with a one-sided migration background a 26% (aOR = 0.74, 95%-CI: 0.55-<1.00) lower chance of participating in sport club activities. In contrast, children and adolescents with a two-sided migration background were at 65% higher chance of participating in extra-curricular physical activity than non-migrants (OR = 1.65, 95%-CI: 1.15–2.36). Conclusion: The study shows that differences in levels of physical activity between migrant and non-migrant children and adolescents are less pronounced than previous research has suggested. In particular, it reveals that migrants are only disadvantaged regarding participation in sports clubs whereas they fare better with respect to extra-curricular physical activity. Interventions should therefore address barriers migrant children and adolescents encounter in the access to sport clubs while maintaining their high level of extra-curricular physical activity. [ABSTRACT FROM AUTHOR]

Building change capabilities into public organizations is a challenge for strategic management. This study focuses on the micro‐level of extra‐role behaviours that contribute to continuous improvements in working procedures at the front‐end of organizations (i.e., taking charge behaviour; TCB). More particularly, we examine public service motivation (PSM) as a key variable mediating between perceived practices and TCB of street‐level bureaucrats. The analyses are based on survey data from a state police force in Germany (N = 1,165). Results confirm the role of PSM as full mediator, but this mediation is limited to the relationship between leadership behaviours and TCB, while perceived organizational characteristics—except for red tape—have direct positive impact on TCB. [ABSTRACT FROM AUTHOR]

Though many European Upper Palaeolithic sites document early examples of symbolic material expressions (e.g., cave art, personal ornaments, figurines), there exist few reports on the use of earth pigments outside of cave art–and occasionally Neanderthal–contexts. Here, we present the first in-depth study of the diachronic changes in ochre use throughout an entire Upper Palaeolithic sequence at Hohle Fels cave, Germany, spanning from ca. 44,000–14,500 cal. yr. BP. A reassessment of the assemblage has yielded 869 individual ochre artefacts, of which 27 show traces of anthropogenic modification. The ochre artefacts are from all Upper Palaeolithic layers, stemming from the earliest Aurignacian horizons to the Holocene. This wide temporal spread demonstrates the long-term presence and continuity of ochre use in a part of Europe where it has not been systematically reported before. The anthropogenic modifications present on the ochre artefacts from the Gravettian and Magdalenian are consistent with pigment powder production, whereas the only modified piece from the Aurignacian displays a possible engraved motif. The non-modified artefacts show that more hematite-rich specular ochres as well as fine-grained deep red iron oxide clays were preferred during the Gravettian and Magdalenian, while the Aurignacian layers contain a broader array of colours and textures. Furthermore, numerous other artefacts such as faunal elements, personal ornaments, shells, and an ochre grindstone further strengthen the conclusion that ochre behaviours were well established during the onset of the Aurignacian and subsequently flourished throughout the Upper Palaeolithic at Hohle Fels cave. [ABSTRACT FROM AUTHOR]

Background: Monitoring the reasons why a considerable number of people do not receive recommended vaccinations allows identification of important trends over time, and designing and evaluating strategies to address vaccine hesitancy and increase vaccine uptake. Existing validated measures assessing vaccine hesitancy focus primarily on confidence in vaccines and the system that delivers them. However, empirical and theoretical work has stated that complacency (not perceiving diseases as high risk), constraints (structural and psychological barriers), calculation (engagement in extensive information searching), and aspects pertaining to collective responsibility (willingness to protect others) also play a role in explaining vaccination behavior. The objective was therefore to develop a validated measure of these 5C psychological antecedents of vaccination. Methods and findings: Three cross-sectional studies were conducted. Study 1 uses factor analysis to develop an initial scale and assesses the sub-scales’ convergent, discriminant, and concurrent validity (N = 1,445, two German convenience-samples). In Study 2, a sample representative regarding age and gender for the German population (N = 1,003) completed the measure for vaccination in general and for specific vaccinations to assess the potential need for a vaccine-specific wording of items. Study 3 compared the novel scale’s performance with six existing measures of vaccine hesitancy (N = 350, US convenience-sample). As an outcome, a long (15-item) and short (5-item) 5C scale were developed as reliable and valid indicators of confidence, complacency, constraints, calculation, and collective responsibility. The 5C sub-scales correlated with relevant psychological concepts, such as attitude (confidence), perceived personal health status and invulnerability (complacency), self-control (constraints), preference for deliberation (calculation), and communal orientation (collective responsibility), among others. The new scale provided similar results when formulated in a general vs. vaccine-specific way (). In a comparison of seven measures the 5C scale was constantly among the scales that explained the highest amounts of variance in analyses predicting single vaccinations (between 20% and 40%; ). The present studies are limited to the concurrent validity of the scales. Conclusions: The 5C scale provides a novel tool to monitor psychological antecedents of vaccination and facilitates diagnosis, intervention design and evaluation. Its short version is suitable for field settings and regular global monitoring of relevant antecedents of vaccination. [ABSTRACT FROM AUTHOR]

Change recipients are not just negative and passive, but positive and active shapers of organizational change; we draw on job crafting to reflect positive and proactive behaviors individuals display in their changing work environment. Drawing on job crafting and organizational change theory, this study proposes a conceptual framework that links change-specific context factors to job crafting as a form of change proactivity. These factors provide the impetus for change recipients to engage in job crafting, a relationship that is moderated by individual differences and situational factors. Job crafting is also related to organizational and individual outcomes. We test these relationships using data collected from teachers shortly after a major policy change was announced in Germany’s public education sector. This study provides new insights into the antecedents and outcomes of job crafting, while offering a positive framing of change recipients as positive and active shapers during organizational change. [ABSTRACT FROM AUTHOR]

Background: Migrants in many European countries including Germany tend to utilize preventive measures less frequently than the majority population. Little is known about the dental health of migrants as well as about their oral health behaviour, particularly in the adult population. The aim of this study was to examine differences in the uptake of annual dental check-ups in adult migrants and non-migrants in Germany. Methods: We used data from the cross-sectional survey 'German Health Update 2010' conducted by the Robert Koch Institute (n = 22,050). Data from 21,741 German-speaking respondents with information on the use of dental check-ups was available, of which 3404 (15.7%) were migrants. Multiple logistic regression models were applied to adjust for demographic and socioeconomic confounders, including the place of residence as well as type of health insurance. Results: Migrants were generally younger, had a lower socioeconomic status and showed a lower utilization of dental check-ups. The unadjusted odds ratio (OR) for utilization was 0.67 (95%-CI = 0.61--0.73). After adjusting for demographic and socioeconomic confounders the chance only increased slightly (adjusted OR = 0.71; 95%-CI = 0.65--0.77). Conclusions: The analysis shows that migration status is associated with a reduced chance of attending dental checkups, independently of demographic and socioeconomic factors. The influence of other factors, such as type of health insurance and place of residence had also no influence on the association. Migrants are exposed to different barriers in the health care system, comprising the patient, provider and system level. Further studies need to examine the relevant barriers for the uptake of preventive dental services in order to devise appropriate migrant- sensitive measures of dental prevention. [ABSTRACT FROM AUTHOR]

Although international research is increasing in volume and importance, there remains a dearth of knowledge on similarities and differences in “national human research ethics” (NHREs), that is, national ethical guidelines (NEGs), Institutional Review Boards (IRBs), and research stakeholder’ ethical attitudes and behaviors (EABs). We begin to address this situation by reporting upon our experiences in conducting a multinational study into the mental health of children who had a parent/carer in prison. The study was conducted in 4 countries: Germany, Great Britain, Romania, and Sweden. Data on NHREs were gathered via a questionnaire survey, two ethics-related seminars, and ongoing contact between members of the research consortium. There was correspondence but even more so divergence between countries in the availability of NEGs and IRBs and in researcher’ EABs. Differences in NHREs have implications particularly in terms of harmonization but also for ethical philosophy and practice and for research integrity. [ABSTRACT FROM AUTHOR]

Skrjabingylus nasicola (Leuckart, 1842) are geographically widespread nematodes that parasitize the nasal and frontal sinus cavities of smaller mustelids. As most prior work was solely based on the analysis of bone injuries of museum skull, little is known about the determinants and effects of infestation in the host species. Working on fresh skulls, we aimed to analyze infestation patterns in American mink ( Neovison vison Schreber, 1777) from nine study areas in northern Germany and to identify factors that explained infestation prevalence and intensity in the host species. The prevalence (46.7-62.9 %) and infestation intensity values (4.5-10.89 nematodes) reported here were relatively large, especially compared to other American mink populations in Europe. Considering mink diet, our study sites probably harbored a larger number of infested paratenic hosts and climate did not have a substantial negative influence on survival of S. nasicola larvae. We did not observe any significant sex-age differences in either prevalence or intensity of S. nasicola infestation. We did not find a negative impact of an infestation on the host animals' body weight, confirming prior results that the parasite is not a significant mortality factor in mustelids. Our study suggests that this holds even outside the native distributional range where the host's defenses might not be optimally adapted to an autochthonous parasite. [ABSTRACT FROM AUTHOR]

Stepping to the podium for the last medal ceremony on August 2, 1936, day one of athletics competition at the 1936 Berlin Olympics, were the three Americans that swept the men's long jump: Cornelius Johnson (gold), David Albritton (silver) and Delos Thurber (bronze). Johnson and Albritton were black. That ceremony formed a watershed for those Games: Hitler had personally congratulated all of the earlier winners on August 2, 1936; but, he left before that medal ceremony and ceased to congratulate winners starting on day two, rather than congratulate all future winners. Hitler was told to congratulate all winners or no winners by the IOC President after his non-attendance at the men's long jump medal ceremony. It was on day two that Jesse Owens won the 100-meter run and was not congratulated. Public attention then shifted to Owens, removing attention from the actual snub of Johnson, Albritton, and Thurber that had led to action by the IOC President. This paper interprets two photos of the three Americans saluting in unison, but with two different postures: an American military salute and a straight-armed salute with palms turned upward. To understand their salute, three contexts were studied: salutes performed at the Games, activities leading up to that moment on August 2, 1936 and the American flag-saluting practice of that era. Johnson, Albritton, and Thurber were arguably making an elegant yet forceful statement of solidarity and defiance in performing the Bellamy or Flag Salute, a unique-at-those-Games act of patriotism little known in the present but, none-the-less an act deserving of recognition. [ABSTRACT FROM AUTHOR]

The study aimed at evaluating the psychometric properties of the German version of the Self- Harm Inventory (SHI) and examining the lifetime prevalence and correlates of self-harm in a representative German population sample (N = 2,507; age mean = 48.79, SD = 18.11; range 14 to 94 years; 55.5% women) using the SHI. All participants answered the German SHI, the short form of the Barratt Impulsiveness Scale (BIS-15), the ultra-brief Patient Health Questionnaire for Depression and Anxiety (PHQ-4), and provided sociodemographic information. The one-factorial structure of the SHI was replicated using a confirmatory factor analysis. Internal consistency coefficients were sufficient and in line with previous studies. Almost half of the sample (49%) acknowledged at least one self-harming behavior over the life-span, most frequently indirect forms of self-harm. The rate of participants who engaged in at least one SHI behavior was higher among men than women (51.6% vs. 46.9%, respectively, χ2 = 5.38, p = 0.020). Higher SHI scores were related to younger age, male gender, living alone, more symptoms of anxiety and depression (PHQ-4), higher impulsivity scores (BIS-15), and suffering from obesity grade 2. Women engaged more often in discreet forms of self-harm than men, e.g., preventing wounds from healing, exercising an injury, starving, and abusing laxatives. In terms of other indirect self-harming behaviors, men admitted more often driving recklessly, being promiscuous and losing a job on purpose, while women reported more frequently engaging in emotionally abusive relationships. With respect to direct self-harm, women were more likely to endorse suicide attempts and cutting, while men admitted more often head-banging. The findings suggest that self-harm constitutes a common problem. Future longitudinal studies are required to examine the natural course, sociodemographic and psychopathological risk factors, as well as possible time-trends of self-harming behaviors in more depth. [ABSTRACT FROM AUTHOR]

Objective: Type 2 diabetes mellitus (T2D) shows regional differences in Germany. The purpose of the project was to compare the prevalence of prediabetes and undiagnosed T2D in two regions in Germany, the Northeast and the South, and to evaluate their associations with regional variations in lifestyle factors and hypertension. Methods: Data from the KORA-F4 study (South Germany, 2006–2008) and the SHIP-TREND study (Northeast Germany, 2008–2012) were used. Participants aged 35–79 years without T2D with an overnight fasting of more than 8 hours and an oral glucose tolerance test were included: KORA-F4: n = 2,616 and SHIP-TREND: n = 1,968. Results: The prevalence of prediabetes/newly diagnosed T2D was especially high in men (about 60%) and women (about 50%) in the Northeast, followed by men (about 50%) and women (about 30%) in the South. Lifestyle factors associated with T2D varied between the regions: more participants in the Northeast were active smokers and the percentages of people with overweight or obesity were greater than in their southern counterparts. However, these differences could not explain the striking disparity in prediabetes/newly diagnosed T2D. The frequency of hypertension was also distinctly higher in the Northeast than in the South and clearly associated with prediabetes/newly diagnosed T2D. Especially in men living in the Northeast, screening individuals with blood pressure ≥ 140/90mmHg might reveal up to 70% of those with prediabetes/newly diagnosed T2D. Conclusions: Knowledge about regional variability in T2D and related risk factors is important for the planning of diabetes prevention programs. In our analyses, common lifestyle factors did not nearly explain these variations between the northern SHIP-TREND and the southern KORA-F4 studies. Further examinations of regional socioeconomic, political, environmental and other aspects are needed. Meanwhile, targeted diabetes prevention strategies with a special focus on men living in the northern parts of Germany are reasonable. [ABSTRACT FROM AUTHOR]

Background: Physical activity (PA) is a well-known and underused protective factor for numerous health outcomes, and interventions are hampered by lack of objective data. We combined accelerometers with diaries to estimate the contributions to total activity from different domains throughout the day and week in adolescents. Methods: Accelerometric and diary data from 1403 adolescents (45% male, mean age 15.6 ± 0.5 years) were combined to evaluate daily levels and domains of sedentary, light, and moderate-to-vigorous activity (MVPA) during a typical week. Freedson’s cutoff points were applied to determine levels of activity. Total activity was broken down into school physical education (PE), school outside PE, transportation to school, sport, and other time. Results: About 2/3 of adolescents’ time was spent sedentary, 1/3 in light activity, and about 5% in MVPA. Boys and girls averaged 46 (SD 22) and 38 (23) minutes MVPA per day. Adolescents were most active during leisure sport, spending about 30% of it in MVPA, followed by PE (about 20%) transport to school (14%) and either school class time or other time (3%). PE provided 5% of total MVPA, while leisure sport provided 16% and transportation to school 8%. School was the most sedentary part of the day with over 75% of time outside PE spent sedentary. Conclusions: These German adolescents were typical of Europeans in showing low levels of physical activity, with significant contributions from leisure sport, transportation and school PE. Leisure sport was the most active part of the day, and participation did not vary significantly by sex, study center (region of Germany) or BMI. Transportation to school was frequent and thus accounted for a significant fraction of total MVPA. This indicates that even in a population with good access to dedicated sporting activities, frequent active transportation can add significantly to total MVPA. [ABSTRACT FROM AUTHOR]

Unintentional injuries cause much of the global mortality burden, with the workplace being a common accident setting. Even in high-income economies, occupational injury figures remain remarkably high. Because risk factors for occupational injuries are prone to confounding, the present research takes a comprehensive approach. To better understand the occurrence of occupational injuries, sociodemographic factors and work- and health-related factors are tested simultaneously. Thus, the present analysis aims to develop a comprehensive epidemiological model that facilitates the explanation of varying injury rates in the workplace. The representative phone survey German Health Update 2010 provides information on medically treated occupational injuries sustained in the year prior to the interview. Data were collected on sociodemographics, occupation, working conditions, health-related behaviors, and chronic diseases. For the economically active population (18–70 years, n = 14,041), the 12-month prevalence of occupational injuries was calculated with a 95% confidence interval (CI). Blockwise multiple logistic regression was applied to successively include different groups of variables. Overall, 2.8% (95% CI 2.4–3.2) of the gainfully employed population report at least one occupational injury (women: 0.9%; 95% CI 0.7–1.2; men: 4.3%; 95% CI 3.7–5.0). In the fully adjusted model, male gender (OR 3.16) and age 18–29 (OR 1.54), as well as agricultural (OR 5.40), technical (OR 3.41), skilled service (OR 4.24) or manual (OR 5.12), and unskilled service (OR 3.13) or manual (OR 4.97) occupations are associated with higher chances of occupational injuries. The same holds for frequent stressors such as heavy carrying (OR 1.78), working in awkward postures (OR 1.46), environmental stress (OR 1.48), and working under pressure (OR 1.41). Among health-related variables, physical inactivity (OR 1.47) and obesity (OR 1.73) present a significantly higher chance of occupational injuries. While the odds for most work-related factors were as expected, the associations for health-related factors such as smoking, drinking, and chronic diseases were rather weak. In part, this may be due to context-specific factors such as safety and workplace regulations in high-income countries like Germany. This assumption could guide further research, taking a multi-level approach to international comparisons. [ABSTRACT FROM AUTHOR]

Young children understand pedagogical demonstrations as conveying generic, kind‐relevant information. But, in some contexts, they also see almost any confident, intentional action on a novel artefact as normative and thus generic, regardless of whether this action was pedagogically demonstrated for them. Thus, although pedagogy may not be necessary for inferences to the generic, it may nevertheless be sufficient to produce inductive inferences on which the child relies more strongly. This study addresses this tension by bridging the literature on normative reasoning with that on social learning and inductive inference. Three‐year‐old children learned about a novel artefact from either a pedagogical or non‐pedagogical demonstration, and then, a series of new actors acted on that artefact in novel ways. Although children protested normatively in both conditions (e.g., ‘No, not like that’), they persisted longer in enforcing the learned norms in the face of repeated non‐conformity by the new actors. This finding suggests that not all generic, normative inferences are created equal, but rather they depend – at least for their strength – on the nature of the acquisition process. [ABSTRACT FROM AUTHOR]

This article analyzes the impact of marital status and spousal employment on the timing of retirement in Germany and Spain. Retirement behavior is examined by means of event–history models, with a competing risks framework being used to distinguish between voluntary and involuntary work-exit transitions. To take account of the role of social policies, we adopt a comparative approach. Data are drawn from a 2006 special retirement module implemented analogously in national labor force surveys. The results show that spousal labor market participation plays a large role in work-exit transitions, even when retirement is involuntary. This finding questions the widespread belief that coretirement is exclusively due to preference for joint retirement shared among spouses. Moreover, widows and widowers tend to retire prematurely in Germany, whereas no such effect could be found in Spain. This finding is explained by reference to specific economic incentives arising from national pension legislation. [ABSTRACT FROM PUBLISHER]

Background. Although the Occupational Stress and Coping Inventory (AVEM) questionnaire is used to assess work behaviour during occupation-related oncological rehabilitation, little is known about its psychometric characteristics in cancer patients. Therefore, we analysed the psychometric properties of the AVEM in this group. Material and methods. The AVEM was administered to 477 cancer patients at the beginning of rehabilitation. The AVEM consists of 11 subscales that categorise patients into one of four types of work behaviour. We obtained data from several subgroups and analysed reliability using Cronbach's α. We performed a confirmatory factor analysis (CFA) of the dimensional structure proposed by the authors of the AVEM. In addition, we analysed the AVEM's predictive validity by examining work-related outcomes one year after the end of rehabilitation (N = 336). Results. Similar to a population-based reference sample, half of the patients exhibited work behaviours that might be problematic in stressful working situations. The AVEM proved to be a reliable instrument, and the CFA supported the factor structure of the AVEM. The analyses of predictive validity suggest that work behaviour and mental health characteristics, that involve the tendency to feel overwhelmed and less motivated at work, might lead to an increased level of occupational stress one year post-rehabilitation. Discussion. The AVEM can be used during rehabilitation to assess the extent to which patients report work behaviours associated with occupational stress and dissatisfaction. Patients who exhibit the tendency to feel overwhelmed and helpless in stressful work situations should be identified early so they can be offered support. [ABSTRACT FROM AUTHOR]

Background More conservative techniques for managing dental caries including 'partial' and 'no caries removal' have been increasingly of interest. Aim To compare children's behaviour and pain perception, also technique acceptability (parents and dentists), when approximal dentinal lesions ( ICDAS 3-5) in primary molars (3-8-year-olds) were managed with three treatment strategies; conventional restorations ( CR), hall technique ( HT), and non-restorative caries treatment ( NRCT). Design Secondary care-based, three-arm parallel-group, randomised controlled trial, with 169 participants treated by 12 dentists. Outcome measures: child's pain perception (Visual Analogue Scale of Faces); behaviour (Frankl scale); and parents' and dentists' treatment opinions (5-point Likert scales). Results Children showed more negative behaviour in the CR group (37%) compared to NRCT (21%) and HT (13%) ( P = 0.047, CI = 0.41 to 0.52). Pain intensity was rated 'very low' or 'low' in 88% NRCT, 81% HT, and 72% CR ( P = 0.11, CI = 0.10 to 0.12). NRCT and HT were 'very easy' or 'easy' to perform for >77% of dentists, compared to 50% in CR group ( P < 0.000). There were no statistically significant differences in parents' rating of their child's level of comfort ( P = 0.46, CI = 0.45 to 0.48). Conclusions Dentists reported more negative behaviour in CR group. For all techniques, children's pain perception and dentist/parent acceptability were similar. [ABSTRACT FROM AUTHOR]