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Employees are a very important source of innovation and essential for the generation, dissemination and implementation of these ideas throughout the organization. This is especially relevant when considering innovation in services during service (co-) creation such as within the healthcare sector. However, perceived employee involvement in innovation (EII) and between stakeholder group interactions in hospitals has not yet been studied in detail. This paper addresses the following research questions: "How do different employee groups perceive their involvement in the innovation process in hospitals and how do their actual involvement levels differ?" and (2) "How do different employee groups perceive their interaction with other employee groups in the innovation process and how do their actual interactions differ?" We analyzed a single typical German research hospital and conducted episodic interviews with employees representing different staff groups. We revealed that while all groups of employees are involved in innovation activities, perception of their involvement in innovation activities differs widely. There is a gap between perception and actual involvement particularly for lower level employees such as nurses. Further, their interaction differs among employee groups and innovation takes place in-group, rather than through group interaction. With our paper, we add to the understanding of perceived EII in hospitals and discuss measures for hospital management to increase EII. [ABSTRACT FROM AUTHOR]

Medical guidelines recommend actively addressing patients' information needs regarding complementary and integrative healthcare (CIH). Within the CCC-Integrativ study, an interprofessional counseling program on CIH was developed and implemented at four comprehensive cancer centers (CCCs) in Germany. As part of the process evaluation, this study examines cancer patients' experiences with interprofessional CIH counseling sessions conducted by a physician and a nurse. Forty problem-centered interviews were conducted using a semi-structured interview guide. All interviews were audio-recorded, transcribed verbatim, and analyzed using deductive–inductive content analysis based on Kuckartz and Rädiker's approach. Findings revealed that most participants had prior experience with CIH approaches and were burdened by physiological and psychological symptoms. Counseling sessions focused on cancer- and treatment-related symptoms and appropriate CIH recommendations (e.g., herbal poultice against anxieties and acupressure against nausea). Participants appreciated the mutual exchange and integration of perspectives from different healthcare professions within the interprofessional approach. They noted that the counseling team comprehensively addressed their healthcare and CIH information needs. Suggestions for improvement included the specificity of the CIH recommendations. As the participants only received counseling and no CIH treatments, information about reputable CIH providers was particularly important to many seeking advice. Patients with cancer receiving tailored CIH counseling from two healthcare professionals experienced benefits in CIH counseling for symptom management. The interprofessional teams offered a comprehensive perspective on patients' needs, proposing personalized recommendations for symptom control. These insights may foster collaboration between healthcare professionals interested in CIH counseling, enabling them to expand and consolidate their counseling services. [ABSTRACT FROM AUTHOR]

Background: Caring for parents continuing pregnancy after learning about a severe life-limiting condition in their unborn is challenging. Most existing studies focus on affected families, whereas research on the subjective experience of care professionals is scarce. Aim: We aimed to (1) explore experiences and needs of involved care professionals, (2) obtain information about existing care structures, and (3) identify requirements for a structured perinatal palliative care program. Design: Grounded Theory study using theoretical sampling. Data was collected by semi-structured interviews and analyzed following the principles of grounded theory coding and situational analysis. Setting: A total of 18 professionals from 12 different services in Munich and surroundings participated in the study: 8 physicians, 3 midwives, 2 nurses, 1 each pregnancy counselor, grief counselor, chaplain, clinical psychologist, and undertaker. Results: Several organizations provide support for affected parents, but inter-institutional communication is scarce. Due to the lack of a dedicated perinatal palliative care program, professionals make immense and partly unpaid efforts to support concerned parents. Providers experience "collateral beauty" in their work despite all the suffering and grief. This includes the development of a humble attitude and feelings of gratitude toward life, the feeling of having a meaningful task and professional as well as personal growth. Requirements for a structured perinatal palliative care program include: fostering peer support, ensuring regular supervision, and enhancing interdisciplinary exchange. Conclusions: Perinatal palliative care demands a high level of personal engagement but is experienced as highly rewarding by care professionals. [ABSTRACT FROM AUTHOR]

Background: Data from the core data set of the Hospice and Palliative Care Evaluation (HOPE) from 1999 to 2001 demonstrated considerable variance in the incidence of patients' symptoms and problems between participating services. This paper aims to investigate these differences more closely. Methods: During the evaluation period of HOPE in 2002 a telephone survey with a representative of each participating unit was performed. Telephone interviews assessed the professionals' definitions of selected symptoms and estimates of problem and symptom incidences. Content analysis was used to evaluate qualitative answers. Results: Staff members rated pain, weakness, nausea/emesis as the most frequent physical symptoms; anxiety, depression and amentia as most frequent psychological symptoms; wound treatment, mobilisation and weakness as nursing problems and organisation of care settings, loneliness, demands of relatives the most common social needs. Staff members used a wide range of definitions for cachexia, weakness and depression. Discussion: Standard definitions of symptoms and problems were lacking in the articulation of subjective staff members' perspectives. Meaningful evaluation of multicentre surveys would require training in symptom assessment and classification in order to produce a common basis for documentation. Even though definitions differed widely, underlying concepts seemed to be compatible. [ABSTRACT FROM AUTHOR]

The main object of this paper is to separate several strands in the relationship between the works of Marx and Max Weber. Max Weber has rightly been regarded as Marx's most profound intellectual critic. But there has been much confusion in subsequent literature over the nature and validity of Weber's critique of Marx. This perhaps stems, in part at least, from a failure to distinguish a number of different, although interrelated, themes in Weber's writings. Weber wrote not simply as a critic of Marx, but also in response to the writings and political involvements of the prominent Marxists of his day. Three partially separable aspects of Weber's views thus may be isolated: (a) His attitude towards Marxism in the shape of the main Marxist political agency in Germany, the Social Democratic Party. (b) His views upon the academic contributions of Marxist authors to history and sociology. (c) His views upon what he considered to be Man's own original ideas. These three aspects of Weber's thought may in turn be distinguished from the analytic problem of how far Weber's own understanding of Marx's theory of historical materialism was in fact a valid one. Some of Marx's posthumously published writings, unavailable to Weber, allow us to form a clear judgement on this question. The historical changes in the social and political structure of Germany from the middle to the latter part of the nineteenth century form an essential background to the whole of the paper: Weber's attitudes toward Marx and Marxism cannot be understood out of this context. Weber's work was written not solely in response to a wraith-like "ghost of Marx", but also in response to a force--Marxism--which played a vital political and intellectual role in Imperial Germany. [ABSTRACT FROM AUTHOR]

Identifying the underlying psychological and social factors of social distancing is crucial to foster preventive behavior during a pandemic effectively. We investigated the relative contribution of self-focused factors (fear of infection, fear of punishment) and other-focused factors (moral judgment, moral identity, empathy for unspecific others, empathy for loved ones) in an online study in Germany (N = 246) while COVID-19 was climaxing. Importantly, other-oriented factors were related to social distancing behavior beyond self-oriented factors. Moral judgment and empathy for loved ones remained the dominant factors while controlling for all aspects. These findings underline the relevance of interpersonal considerations when engaging in preventive behavior. [ABSTRACT FROM AUTHOR]

One of the strongest predictors of punitive attitudes is out-group prejudice. Two limitations of this literature are a relative lack of research examining (a) these relationships outside the United States and (b) the theoretical mechanisms involved. The current study tests the direct and moderating effects of group threat and economic insecurity on punitive attitudes among German citizens. Findings show the direct effect of group threat on punitive attitudes was significant and positive in three OLS regression models measuring different perceptions of threat by immigrants. The direct effect of economic insecurity on punitive attitudes was non-significant, but economic insecurity had a significant moderating effect on out-group prejudice and punitiveness in all three models. [ABSTRACT FROM AUTHOR]

In Germany and elsewhere, few hospital electronic patient record usability surveys are available. Moreover, there seems to be a complete lack of validated instruments in the respective literature. Hence, this study's purpose is to validate a scale for measuring the usability of hospital electronic patient record systems. The data used for the study's analyses (n = 949) were originally obtained during the German national initiative 'Hospital IT User Questionnaire'. In the course of the study, reliability and exploratory factor analyses were conducted and psychometric tests showed a reliable, valid and suitable instrument. Descriptive data analysis suggests a generally low user perception and variances hint at a high potential for future improvements. To our knowledge, this study shows that a general inventory (subscales from the IsoMetrics inventory) can be applied to measuring hospital electronic patient record usability as well. The validated instrument can be used to inform healthcare providers, decision makers and politicians of a given state of usability, discrepancies between different hospitals or systems providers, and serve as a basis for improvements. [ABSTRACT FROM AUTHOR]

Individual preferences for same-ethnic friends contribute to persistent segregation of adolescents' friendship networks. Yet, we know surprisingly little about the mechanisms behind ethnic homophily. Prior research suggests that ethnic homophily is ubiquitous, but a social identity perspective indicates that strong ingroup identification drives ingroup favoritism. Combining a social identity perspective with a relational approach, we ask whether the presumed increased homophily of high identifiers extends to all ingroup members, or whether it is conditional on the strength of same-ethnics' identification. We propose that the strength of ethnic identification affects not only how much individuals desire same-ethnic friends, but also how attractive they are as potential friends to others. Fitting stochastic actor-oriented models to German adolescent school-based network panel data, we find that ethnic homophily is driven by an interplay of peers' ethnic identification: high identifiers befriend same-ethnic peers who share their strong ethnic identification, while excluding same-ethnic low identifiers. Low identifiers, in turn, tend to avoid befriending inter-ethnic high identifiers. Our relational approach reveals that ethnic homophily is hardly ubiquitous but requires strong identification of both parties of a (potential) friendship. [ABSTRACT FROM AUTHOR]

Background: Early integration of palliative care can improve outcomes for people with cancer and non-cancer diagnoses. However, prediction of survival for individuals is challenging, in particular in patients with haematological malignancies who are known to have limited access to palliative care. The 'Surprise'-Question can be used to facilitate referral to palliative care. Aim: To explore experiences, views and perceptions of haemato-oncologists on the use of the 'Surprise'-Question in the haemato-oncology outpatients clinics of a university hospital in Germany. Design: A qualitative study using individual semi-structured interviews transcribed verbatim and analysed thematically based on the framework approach. Setting/participants: The study took place at the haemato-oncology outpatient clinic and the bone marrow transplantation outpatient clinic of a university hospital. Nine haemato-oncologists participated in qualitative interviews. Results: Thematic analysis identified 4 themes and 11 subthemes: (1) meaning and relevance of the 'Surprise'-Question; (2) feasibility; (3) the concept of 'surprise' and (4) personal aspects of prognostication. A key function of the 'Surprise'-Question was to stimulate intuition and promote patient-centred goals of care by initiating a process of pause → reflection → change of perspective. It was easy and quick to use, but required time and communication skills to act on. Participants' training in palliative care enhanced their willingness to use the 'Surprise'-Question. Conclusion: Irrespective of its use in prognostication, the 'Surprise'-Question is a valuable tool to facilitate consideration of patient-centred goals and promote holistic care in haemato-oncology. However, prognostic uncertainty, lack of time and communication skills are barriers for integration into daily practice. Further research should involve haematology patients to integrate their needs and preferences. [ABSTRACT FROM AUTHOR]

This article is concerned with the role of perceived policy objectives in German citizens' attitude formation toward military action in Afghanistan. While some scholars have claimed that public opinion is prudent because citizens assess the effectiveness of a mission on the basis of these perceptions, micro-level tests of this kind of prudence remain scare. Drawing on two cross-sectional surveys of the German population conducted in 2008 and 2009, we use responses to open-ended questions about the German government's policy goals in Afghanistan to analyze whether such perceptions influenced support and whether any such influence was mediated via the perceived effectiveness of the mission. The results indicate that, irrespective of the level of political awareness, it was virtually irrelevant what German citizens perceived the military mission's objectives to be. In contrast, value-based attitude formation emerges as more important, with the foreign policy predispositions antimilitarism and Atlanticism exhibiting especially large effects. [ABSTRACT FROM AUTHOR]

An extensive body of literature discusses the disaffection of citizens with representative democracy and highlights increasing citizens' preferences for political decision-makers beyond elected politicians. But so far, little research has been conducted to analyse the relations between citizens' respective preferences and their political behaviour. To address this void in the literature, our article investigates the extent to which citizens' preferences for certain political decisionmakers (politicians, citizens or expert) have an impact on their retrospective and prospective political participation. Our analysis draws on data from a survey conducted in autumn of 2014 on a probability representative sample in Germany. Results indicate that respondents favouring politicians as decision-makers focus mainly on voting. Those who favour citizens as decisionmakers are more willing to get involved in participatory procedures, while those inclined towards expert decision-making show mixed participation. [ABSTRACT FROM AUTHOR]

In recent years, several international-comparative studies have analyzed the relationship between migration and native populations’ decreasing support for redistributive policies. However, these studies use cross-sectional designs and aggregate the number of foreign-born residents at the national level. Both aspects are theoretically and methodologically problematic. We address these shortcomings by investigating cross-sectional as well as longitudinal effects in the case of Germany, using a combination of individual- and regional-level data for several time points from 1994 to 2010. Our results suggest that native-born populations become more reluctant to support welfare programs when the proportion of foreigners at the regional level increases. This effect is particularly strong in the initial phase of immigration, and it is further moderated by the economic context: the higher the unemployment rate, the more negative is the effect of foreigners on natives’ attitude toward providing welfare. [ABSTRACT FROM AUTHOR]

The article presents a study conducted to assess end-of-life care and communication from the perspective of intensive care unit staff. It also discusses psychological symptoms of relatives of patients receiving end-of-life care in the intensive care unit. Topics discussed include details of the study and its results, which reveal that communication need be improved within the intensive care unit caregiver team to strengthen the involvement of nurses in end-of-life care.

Introduction: The study reported here assessed the exploration of identity and commitment to an identity in German adolescents with and without visual impairments. Methods: In total, 178 adolescents with visual impairments (blindness or low vision) and 526 sighted adolescents completed the Ego Identity Process Questionnaire. Results: The levels of identity exploration and making commitments, as well as the distribution of identity statuses, did not differ between the two groups. However, adolescents with congenital visual impairments showed lower levels of identity exploration than their peers with acquired visual impairments. In addition, more severe disability was associated with less exploration of identity. Furthermore, levels of identity exploration and commitment varied by age, parental education, levels of social support, and levels of problem behavior. Discussion: The findings indicate that adolescents with visual impairments do not fall behind sighted adolescents in developing a sense of identity. Implications for practitioners: Adolescents who are congenitally blind or have a high level of disability may need support in exploring and accessing information on future opportunities. [ABSTRACT FROM AUTHOR]

The article reports a study which was conducted to examine paramedics’ attitudes towards advance directives and end-of-life care. The results demonstrate that more dialogue is needed in emergency medical and palliative care issues. The paramedics indicated that improved guidelines on end-of-life decisions and the termination of cardiopulmonary resuscitation in palliative care patients may be essential. Paramedics do not feel adequately trained in end-of-life care and advance directives.

Demographic change and the call for active ageing impose new demands on older individuals. Using data on German adults aged 56 to 75 (N = 1,468), the authors investigated perceived level of activation demands (e.g., increased expectations that the young-old will contribute to the public good) and appraisal of them as threatening or challenging by individuals with different health status and socioeconomic backgrounds. Overall, perceived level of demands was moderately high, and they were seen rather as a challenge. East Germans, those with better subjective health, and those unemployed reported a higher level of activation demands, whereas retired and widowed individuals reported a lower level. Moreover, East Germans, individuals with lower educational attainment, and those reporting health problems (but not physically handicapped individuals) experienced these demands more as a threat and less as a challenge. The authors argue that more targeted policy strategies are needed to promote active ageing in disadvantaged groups. [ABSTRACT FROM PUBLISHER]

This article argues that a sense of local belonging and emotional attitudes to one’s neighbourhood are inherently interconnected. It explores immigrant children’s emotional experiences of their neighbourhoods in Paris and Berlin through subjective maps drawn by the children. The article highlights the social and spatial nature of immigrant children’s belongings, and how their different emotional geographies are connected to differential access to material resources, extra-curricular education and their migration histories. [ABSTRACT FROM AUTHOR]

Young people create differentiated models of belonging. Their strategies reflect contexualized competences – the capacity to understand and negotiate the influence of national frameworks in specific situations. Theories that understand belonging as processual and intersectional offer useful frameworks with which to analyse this. This article uses data from empirical research with young people in a German secondary school and a Canadian junior high school to highlight young people’s situated competences and their critique of the respective frameworks of belonging. [ABSTRACT FROM AUTHOR]