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A growing interdisciplinary literature examines the role of hair textures and styles in Black and mixed‐race women's identity performances. Through an analysis of travel narratives, this paper extends and complements research on the context‐dependency of racialized identity performances. This paper presents an analysis of 24 qualitative interviews with Black and mixed‐race women in England and Germany. The question it seeks to answer is: 'How do changes in context alter Black and mixed‐race women's hairstyling practices as a performance of identity?' Navigating a novel context could lead the women to (1) conform to local standards of beauty and femininity, (2) resist external expectations, (3) try out novel performances and (4) negotiate the complex performance of belonging. All in all, this paper shows that Black and mixed‐race women dialogically re/negotiated and performatively re/created how they identify and how they are identified by others as they moved from one context to another. [ABSTRACT FROM AUTHOR]

The concept of biographical disruption has been used to explain the experience of a cancer diagnosis. Studies on cancer experience increasingly suggest that people diagnosed in older age may not have such disruptive experiences. Prostate cancer is diagnosed more often in older men and is often considered a disease of old age; furthermore, the signs of illness in prostate cancer and the signs of ageing might become convoluted. With this in mind, this paper aims to explore how 42 men with prostate cancer who participated in an interview study respond to and make sense of bodily changes. The sample was selected using a maximum variation strategy in order to describe a range of possible experiences with prostate cancer. Analysis was conducted thematically. The men's narratives tell of the constant process of dealing with ageing‐related and/or cancer‐related changes to both their bodies and their social interactions, and their struggle to disentangle the related effects of ageing and/or cancer on their bodies. We describe how men "muddle through" problems of urinary leakage, potency and loss of libido. We then identify how men attributed changes as part of ageing and/or cancer to (better) manage the experiences of loss. [ABSTRACT FROM AUTHOR]

Aim: To investigate nursing/midwifery students, Clinical Mentors, Link Teachers and Head Nurses experiences within "Dedicated Education Unit" model in 6 European clinical placements and analyse the necessary elements for a powerful clinical learning environment. Design: A multi‐country, phenomenological, qualitative study. Methods: Focus group interviews were performed to identify the personal and organizational factors of importance for students and nurses/midwives. Results: Data analysis produced 4 main themes (1) Clinical placement organization, (2) students' clinical knowledge and skill acquisition, (3) students, and nurses/midwives' experiences within the DEU model and (4) factors for creating an effective learning environment. Conclusions: A close educational‐service collaboration, a realistic clinical placement planning, a focus on student learning process and an investment in professionals' education and development among others, are elements to set up a powerful clinical learning environment. Implications for the profession: It is considered advisable and urgent to improve the working conditions of nurses/midwives and the learning environments of students as a strategy to alleviate the global shortage of nurses and respond to the increasingly demanding health needs of the population. Impact: Due to the close relationship between students' learning and features of the clinical environment nurse educators seek innovative models which allow students to manage patient care and their transition to professional practice. To implement new learning strategies, identifying students, nurses and midwives perceptions and suggestions is a powerful information to evaluate implementation process and outcomes. Public Contribution: Our findings could help academic and clinical managers to meet the human and organizational requirements to create a successful learning environment in every student placement. [ABSTRACT FROM AUTHOR]

Understanding the nature of science ( NOS) is a critical aspect of scientific reasoning, yet few studies have investigated its developmental beginnings and initial structure. One contributing reason is the lack of an adequate instrument. Two studies assessed NOS understanding among third graders using a multiple-select ( MS) paper-and-pencil test. Study 1 investigated the validity of the MS test by presenting the items to 68 third graders (9-year-olds) and subsequently interviewing them on their underlying NOS conception of the items. All items were significantly related between formats, indicating that the test was valid. Study 2 applied the same instrument to a larger sample of 243 third graders, and their performance was compared to a multiple-choice ( MC) version of the test. Although the MC format inflated the guessing probability, there was a significant relation between the two formats. In summary, the MS format was a valid method revealing third graders' NOS understanding, thereby representing an economical test instrument. A latent class analysis identified three groups of children with expertise in qualitatively different aspects of NOS, suggesting that there is not a single common starting point for the development of NOS understanding; instead, multiple developmental pathways may exist. [ABSTRACT FROM AUTHOR]

Aim This paper explores the experiences of older German Australians, with a focus on their support needs and preferences in later life. Methods Data were collected through qualitative semi-structured interviews. Data analysis incorporated a systematic concept matrix approach to content analysis. Results The findings of the study indicate that older German Australians have adapted well to the Australian way of life. Their high English language proficiency allowed them to source services without the barrier of language often reported in studies of older migrants. They did not show high interest in ethno-specific services. Conclusion Few studies have been conducted on older German Australians, and none focuses specifically on their experience of ageing in Australia. This study contributes to the body of knowledge on older migrants and, specifically, on those for whom language is not necessarily a major obstacle to obtaining aged care information or services. [ABSTRACT FROM AUTHOR]

Background: Most health systems are insufficiently prepared to promote the participation of chronically ill patients in their care. Strong primary health care (PHC) strengthens patients' resources and thus promotes their participation. The tasks of providing continuous care to people with chronic diseases and promoting self‐management are the responsibility of PHC nurses. Recent research assessing enablers of or barriers to nurses' efforts to support patients' participation has mostly not considered the special situation of patients with chronic diseases or focused on the PHC setting. Objective: To investigate enablers of and barriers to PHC nurses' efforts to promote the participation of chronically ill patients in their care. Methods: We interviewed 34 practicing PHC nurses and 23 key informants with advanced knowledge of PHC nursing practice in Brazil, Germany and Spain. The data was analyzed using thematic coding. Results: We identified four categories of barriers and enablers. (1) Establishing bonds with patients: Interviewees emphasized that understanding patients' views and behaviours is important for PHC nurses. (2) Cooperation with relatives and families: Good relationships with families are fundamental, however conflicts within families could challenge PHC nurses efforts to strengthen participation. (3) Communication and cooperation within PHC teams: PHC nurses see Cooperative team structures as a potential enabler, while the dominance of a 'biomedical' approach to patient care is seen as a barrier. (4) Work environment: Interviewees agreed that increased workload is a barrier to patient participation. Discussion and Conclusions: Supporting patient participation should be acknowledged as an important responsibility for nurses by general practitioners and PHC planners. PHC nurses should be trained in communicative competence when discussing participation with chronically ill patients. Interprofessional education could strengthen other professionals' understanding of patient participation as a nursing task. Patient or Public Contribution: This study is part of a research project associated with the research network 'forges: User‐oriented care: Promotion of health in the context of chronic diseases and care dependency'. The study's focus and provisional results were discussed continuously with partners in health and social care practice and presented to and discussed with the public at two conferences in which patient representatives, professionals and researchers participated. [ABSTRACT FROM AUTHOR]

ABSTRACT This paper discusses the findings of a study that examined the processes of anchoring in the understanding of dementia caregiving using 29 interviews conducted in Germany with wives and daughters caring for a relative with dementia and 43 newspaper articles pertinent to the research objective. The concept of anchoring from Social Representations Theory was complemented by elements from cognitive linguistics to analyse the social representations (SRs) that served as source domains to determine what the target domain of dementia caregiving means, entails and requires. The analysis revealed three prevalent patterns of anchoring dementia care in SRs of child care and the good mother. The first pattern ascribed the role of the helpless clinging child needing his mother to the dementia patient, the second emphasised that the dementia caregivers' responsibility for caring, just like motherhood, should take precedence over all other interests and the third consisted of dementia caregivers deriving the perception of being the most suitable caregiver from the mother's natural aptitude for caring. The conclusions reached by the different patterns are argued to contribute to dementia caregivers overexerting themselves and not using support services. The clinical implications for targeting such adverse effects of the anchoring will be discussed. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This paper examines the role of the belief in a just world as a personal resource when people are faced with the adverse consequences of inflation and financial crises by presenting results from two longitudinal studies. The first study, based on responses from 262 German residents, found that participants with a strong personal belief in a just world perceived a lower economic impact in light of price increases following a tax increase. This effect remained stable after controlling for the socioeconomic variables of gender, age, household income, and education. The second study, based on a sample of 177 German residents, found that residents with a strong personal belief in a just world perceived a lower economic impact in light of the global subprime mortgage crisis. Again, this effect remained stable after controlling for the socioeconomic variables of gender, age, household income, and education. Furthermore, the personal belief in a just world influenced perceived economic impact over time and the relationship between personal belief in a just world and perceived economic impact was partially mediated by differences between life satisfaction in the future as measured in a first wave and current life satisfaction as measured in a second wave. [ABSTRACT FROM AUTHOR]

Recognizing the ageing of populations and expected increase in prevalence of dementia, the necessity of research involving persons with dementia is widely agreed upon. Autonomy is key to nursing home residents' well-being and quality of life, but this phenomenon has not been thoroughly assessed from the residents' perspective. The aim of this cross-sectional study was to investigate perceived autonomy of nursing home residents. Data on 560 randomly selected residents in 40 nursing homes in two German federal states were generated by face-to-face interviews, psychological and physical assessments, analysis of nursing records, and acquisition of institutional parameters. This paper reports on a subsample ( n = 179) that met screening requirements, including subjects with and without mild cognitive impairment ( Mini Mental Status Examination score 30-18), who completed the Hertz Perceived Enactment of Autonomy Scale ( HPEAS). The mean score of HPEAS was 101.1 ± 14.5 (range 54-122). In our population, Cronbach's alpha was 0.89. Scores in HPEAS were not related to demographical factors but positively associated with increasing self-efficacy and absence of pain. The novel findings contribute to an understanding of autonomy from the residents' perspective. [ABSTRACT FROM AUTHOR]

Applying social identity theory and the relational demography approach, this paper proposes that the effect of age diversity on individual team members' health is contingent on the individual age as well as on age stereotypes. We suggest that younger and older employees' health is negatively associated with age diversity, while middle-aged team members' health is not affected. We further postulate that age stereotypes strengthen the negative effect of age diversity for the younger age group, while they weaken the effect for older employees. For middle-aged team members, age stereotypes are expected not to determine the relationship between age diversity and health. We tested our hypotheses based on data from a representative sample of the German workforce ( n = 1,214). The results fully confirmed our hypotheses. Practitioner Points Organizations have to be aware that age diversity can undermine the health of older and younger team members., We found that younger team members' health is only affected by working in age-diverse teams if they hold negative stereotypical views about older team colleagues. In contrast, older team members' health is only affected if they do not hold negative stereotypical views about older employees., Accordingly, we advise taking steps to reduce the age stereotypes of younger team members in age-diverse teams. [ABSTRACT FROM AUTHOR]

Aim: To explore nurses' and nurse assistants' experiences of providing end‐of‐life care during the COVID‐19 pandemic in Austria, Germany and Northern Italy. Design: A qualitative explorative interview study. Method: Data were collected between August and December 2020 and analysed using content analysis. Healthcare professionals (nurses (n = 30), nurse coordinators (n = 6) and nurse assistants (n = 5)) from hospitals (n = 32) and long‐term care facilities (n = 9) in Austria, Germany and Northern Italy were interviewed for this study. Results: Five main categories were identified as follows: (i) end‐of‐life care involves love and duty, (ii) last wishes and dignity of the patient, (iii) communication with the family, (iv) organizational and religious aspects and (v) personal emotions. Results indicate that more training and guidelines are needed to prepare nurses and nurse assistants for end‐of‐life care during pandemics. Public contribution: This research can help prepare nurses and nurse assistants for end‐of‐life care in pandemics and will be of value for improving the institutional and government health policies. Furthermore, it can be of value in preparing training for healthcare professionals patient–relatives. [ABSTRACT FROM AUTHOR]

This paper analyzes question formats in a corpus of German market research focus groups. In particular, it identifies and studies the use of 'elaborate questions' (questions which include a range of reformulations and rewordings). The analysis highlights three functions of such questions in focus groups: (a) they are used to guide participants and head off trouble where the question type is 'non-mundane'; (b) they help secure participation by providing an array of alternative items to respond to; (c) they guide participants to produce a range of opinion relevant responses. More generally, they help manage a dilemma between the requirement that the talk should be both highly focused on predefined topics and issues, and at the same time spontaneous and conversational. The analysis provides a range of interactional evidence for the pragmatic role of these formats. [ABSTRACT FROM AUTHOR]

Today's business environment is becoming increasingly dynamic, and the concept of agility is gaining attention in the corporate world and in academia. The objective of our research is to explain how talent management (TM) can shape talents as key human resources, according to company‐specific agility needs, and thus contribute to gaining competitive advantage in dynamic firm environments. We approach this task by viewing it from the perspective of dynamic capabilities. A total of 24 semistructured interviews were conducted with senior TM professionals working in German companies differing in terms of size, age, structure, industry, and ownership. As a result, we identified three different types of dynamic TM capabilities promoting organizational agility to various extents. By rooting our qualitative study in the research fields of TM and agility in the under‐researched theoretical realm of dynamic capabilities, we contribute to the theoretical as well as the empirical discussion by addressing the specific challenges of an increasingly dynamic environment. As a result, we provide a contextualized viewpoint from which to explain the process inherent in dynamic TM capabilities that continuously shape talent and organizational agility. [ABSTRACT FROM AUTHOR]

Aim: To identify personal beliefs of Dutch nursing staff about encouraging psychogeriatric nursing home residents in daily activities. Design: Qualitative study following COREQ guidelines. Methods: Fifteen semi‐structured interviews with Dutch nursing staff of wards hosting psychogeriatric residents were conducted in Spring 2021. Data were systematically analysed through deductive coding analysis in NVivo. Results: Most nurses indicated to encourage residents frequently to perform activities independently, although many also indicated to take over tasks habitually. Nurses seemed to show sufficient awareness, reflected by adequate knowledge of what encouraging residents entailed and insight in the risks of not encouraging residents. Nurses' motivation to encourage residents seemed high, reflected by expressing multiple advantageous and few disadvantageous beliefs and a high willingness to encourage residents. Managerial support was perceived ambiguous. Self‐efficacy was perceived high, although little time, staffing shortages and resistance of residents reduced self‐efficacy. Nurses were often unable to anticipate such situations and expressed the need of skills, e.g. patience. [ABSTRACT FROM AUTHOR]

Although the leadership literature has emphasized the importance of leader identity for leader behaviors and leader effectiveness, little is known about whether and how professionals, who are experts in their field and hold a formal leader role, construe a leader identity. To expand our understanding of leader identity construal, we explored how professors in German research universities interpreted their formal leader role and whether and how they saw themselves as leaders. Based on findings from an inductive interview study, we contribute to the literature in three ways: First, our findings imply that patterns of professional identity and leader identity dimensions likely predict when a leader role is rejected, accommodated, incorporated, or emphasized. Second, we explain why professionals with a formal leader role see themselves primarily as specialists, mentors, managers, or shapers. Third, we extend previous notions of the leader identity concept by elaborating on its dimensions. Our findings have practical implications on an individual and organizational level, and may help design more effective leadership development programs. [ABSTRACT FROM AUTHOR]

Bladder dysfunction is physically and mentally stressful. Long‐term catheterization is indicated as conservative therapy for chronic urinary retention as well as urinary incontinence; although an indwelling, transurethral catheter still represents a risk factor for ascending urinary tract infection and urosepsis. The primary outcome of this study was the impact of the DFree ultrasonic sensor on the subjectively perceived quality of life and satisfaction of patients. The secondary outcomes evaluated were usefulness, ease of use (user‐friendliness), quality of care, and self‐reported degree of autonomy. In this pilot study, 18 urological patients with various kind of bladder dysfunction were treated with an ultrasonic sensor for at least 12 h a day over a 3‐month period. Assessment was conducted using the Kings Health Questionnaire (KHQ) and the German version of the Client Satisfaction Questionnaire (ZUF‐8) (quantitative data) and guided interviews (qualitative data). Eighteen participants were included in this study. Participants highly appreciated the ideas and concepts of the device. A change in KHQ after treatment could not be statistically confirmed; however, the average value in ZUF‐8 showed satisfaction with Dfree. However, no significant improvement was observed in the quantitative data. During the interviews at the end of the testing phase, the participants provided positive feedback with specific suggestions to improve device usability. The application was described as helpful and easy to use. Data triangulation illustrates that an improvement in technical implementation could increase device usefulness. This would imply higher patient satisfaction when using the device for bladder dysfunction. [ABSTRACT FROM AUTHOR]

Introduction: This mixed‐method study explores psychological needs, access and barriers in coronary heart disease (CHD) patients with and without mental health issues (MHI) within the German healthcare system. Methods: This study was conducted in three different healthcare settings: two hospitals, two rehabilitation clinics and three cardiology practices in Cologne, Germany. Patients were screened for angiographically documented CHD and other inclusion criteria. In total, 364 CHD patients took part in this study. It consisted of two parts: In the first part, participants filled in a newly developed questionnaire about their psychological needs, access and barriers within the healthcare system and their contact with their doctor in these matters. Then, patients were screened for MHIs with the help of the Hospital Anxiety and Depression Scale (HADS). When a score above seven was scored on the HADS, patients were additionally screened for specific MHIs using the Structured Clinical Interview for DSM‐IV Axis I Disorders. In the second part, 20 participants were subsequently interviewed in a semi‐structured interview to generate more in‐depth findings. Results: The interviews show that CHD patients with and without MHI experienced a cardiac event as life‐changing and had an urgent need to talk about CHD with their doctor, mostly the general practitioner (GP). When the GP spoke to the patient shortly after the cardiac event, patients experienced relief and were better able to cope with their illness. Only 9.1% reported being aided in their search for psychotherapeutic treatment or drug treatment (4.1%). Conclusion: The needs of CHD patients with and without MHI were not adequately satisfied within our sample. Psychological measures are necessary for sufficient improvement, such as training of doctors in doctor–patient communication (e.g., better support in coping with MHI/CHD), improvements in the procedure (more time for conversations during doctor contacts), and improvement of structural requirements (referring patients faster to psychotherapists). Patient or Public Contribution: We received input from patients during pretests and used the feedback to tailor our questionnaire and the interview guidelines. Afterwards, we disseminated the main results for the patient and public involvement (e.g., public lectures, leaflets for self‐help groups, etc.). [ABSTRACT FROM AUTHOR]

Diversity perspectives are philosophies of or approaches to diversity held by organizations, groups, or executives. They are important for organizations because they can determine the success or failure of diversity in the workforce. However, little is known about the predictors of diversity perspectives among executives. Using fuzzy set qualitative comparative analysis, we analyzed 50 interviews with top executives in Germany to identify individual and organizational characteristics that predict executives' adoption of a diversity perspective, in particular of a value‐in‐diversity perspective. Specifically, we analyzed gender, age, education level, vocational background, and tenure (individual characteristics), as well as size, sector of organization, and competitive environment (organizational characteristics), as potential predictors. We found single characteristics did not predict adoption, but configurations of characteristics did. Drawing on the person‐situation‐interactionist perspective, we developed specific profiles of executives likely to foster a value‐in‐diversity perspective and identified characteristics of their work environments that support such an approach. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

Against the backdrop of only a few empirical studies on the topic of up‐or‐out career models in professional service firms (PSFs), we highlight the importance of an explicit applicant perspective on the topic of up‐or‐out and develop a quantitative approach to analyze the perception and effects of up‐or‐out models in practice. Our empirical study is based on an online practitioner survey as well as on a two‐by‐two between‐subjects‐experiment with law and management students. The practitioner sample shows that the interviewed classic PSFs (law firms and accounting firms) have predominantly implemented alternative career positions in favor of up‐or‐out models while the interviewed Neo‐PSFs (management consulting firms) show a more balanced implementation of up‐or‐out models and extended career models. However, results of our experimental applicant study reveal that the potential employee groups have different preferences: Law students (and hence potential applicants of classic PSFs in the future) show a higher likelihood to apply in connection with the up‐or‐out‐model, whereas management students (and hence potential applicants of Neo‐PSFs in the future) show a higher likelihood to apply in connection with the alternative career model. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to explore patient preference for attributes of calcitonin gene‐related peptide (CGRP) inhibitors for the preventive treatment of migraine and to describe differences in treatment preferences between patients. Background: CGRP inhibitors are a novel class of migraine drugs specifically developed for the preventive treatment of migraine. Clinicians should understand patient preferences for CGRP inhibitors to inform and support prescribing choices. Methods: Patients with migraine in the US and Germany were recruited to participate in an online discrete choice experiment (DCE) survey, which presented hypothetical treatment choices using five attributes: mode of administration, side effects, migraine frequency, migraine severity, and consistency of treatment effectiveness. Attribute selection was informed by a literature review and semi‐structured patient interviews (n = 35), and evaluated using patient cognitive debriefing interviews (n = 5). Results: Of 680 who consented to participate, 506 participants completed the survey and were included in the study (US = 257; Germany = 249). Overall, participants placed highest importance (preference weight, beta = 1.65, p < 0.001) on the treatment's ability to reduce the severity of migraine (mild vs. unchanged severity), followed by consistent treatment effectiveness (beta = 1.13, p < 0.001), and higher chance of reduced migraine frequency (beta = 1.00, p < 0.001). Participants preferred an oral tablet every other day (beta = 1.00, p < 0.001) over quarterly infusion, quarterly injections (p = 0.019), or monthly injection (p < 0.001). Preference for all treatment attributes were heterogeneous, and the subgroup analyses found that participants naïve to CGRP monoclonal antibody treatments had a stronger preference for oral therapy compared to those with such experience (p = 0.006). Conclusion: In this DCE assessing CGRP inhibitors attributes, the main driver of patient choice was treatment effectiveness, specifically reduced migraine severity, and consistent treatment effectiveness. Further, patients exhibited an overall preference for an oral tablet every other day over injectables. Patients' experience with previous treatments informs the value they place on treatment characteristics. [ABSTRACT FROM AUTHOR]

Background: Interprofessional teams and peer support are being increasingly considered in informed shared decision‐making. In Germany, there appear to be deficits in the implementation of informed shared decision‐making in the choice of renal replacement therapy, such as the lack of collaboration in interprofessional teams and the absence of structured peer support programmes for patients with chronic kidney disease. Objective: To explore nephrologists' and nurses' perspectives regarding their involvement in shared decision‐making when choosing renal replacement therapy. Design: Guideline‐based, problem‐centred interviews were used. Participants: A total of 20 nephrologists and 15 nurses were recruited from 21 dialysis units all over Germany. Approach: Interviews were audio‐recorded and transcribed. They were analysed thematically using structuring and summary content analysis, supported by the qualitative data analysis software MAXQDA 12. Results: The most important findings were the late or missing participation of nurses in the informed shared decision‐making process and the unstructured peer support. Along with time and financial factors, these aspects were seen as barriers to shared decision‐making with patients who are often overwhelmed by the diagnosis. Furthermore, informed shared decision‐making has been insufficiently considered in professional education and training. Conclusion: Shared decision‐making in the choice of renal replacement therapy is particularly challenging due to the patients' high disease burden. The greater incorporation of informed shared decision‐making in education and training as well as the consistent involvement of nursing staff and structured peer counselling already in the predialysis phase with adequate reimbursement can address the identified hurdles. [ABSTRACT FROM AUTHOR]

Introduction: To effectively foster patient‐centeredness (PC), it is crucial to measure its implementation. So far, there is no German measure to assess PC comprehensively. The aim of this study is to develop and select items for the Experienced Patient‐Centeredness (EPAT) Questionnaire, a patient‐reported experience measure (PREM). The EPAT intends to assess PC from the perspective of adult patients treated for different chronic diseases in inpatient and outpatient settings in Germany. Furthermore, we aim at providing a best‐practice example for developing PREMs from qualitative data. Methods: The development process comprised a three‐phase mixed‐method design: (1) preparation, (2) item generation and (3) item selection and testing of content validity. We generated items using qualitative content analysis based on information from focus groups, key informant interviews and literature search. We selected items using relevance rating and cognitive interviews. Participants were patients from four chronic disease groups (cancer, cardiovascular disease, mental disorder, musculoskeletal disorder) and healthcare experts (e.g., clinicians, researchers, patient representatives). Results: We conducted six focus groups with a total of 40 patients, key informant interviews with 10 experts and identified 48 PREMs from international literature. After team discussion, we reached a preliminary pool of 152 items. We conducted a relevance rating with 32 experts and 34 cognitive interviews with 21 patients. We selected 125 items assessing 16 dimensions of PC and showed high relevance and comprehensibility. Conclusions: The EPAT questionnaire is currently undergoing psychometric testing. The transparent step‐by‐step report provides a best practice example that other researchers may consider for developing PREMs. Integrating literature and experts with a strong focus on patient feedback ensured good content validity. The EPAT questionnaire will be helpful in assessing PC in routine clinical practice in inpatient and outpatient settings for research and quality improvement. Patient or Public Contribution: Patients were not involved as active members of the research team. While developing the funding proposal, we informally reached out to several patient organizations who all gave us positive feedback on the study aims, thereby confirming their relevance. Those patient organizations endorsed the funding proposal with formal letters of support and supported recruitment by disseminating advertisements for study participation. [ABSTRACT FROM AUTHOR]

Introduction: Suicidal behaviour still cannot be sufficiently predicted. Exposure to suicidal behaviour in the personal social environment is assumed to moderate the individual's transition from suicidal ideation to suicidal behaviour within the integrated motivational–volitional model of suicidal behaviour (IMV model). This study aimed to investigate this moderating effect in a German high‐risk sample. Methods: We interviewed 308 psychiatric inpatients (53% female) aged 18 to 81 years (M = 36.9, SD = 14.30) admitted after attempted suicide (53%) or due to an acute suicidal crisis (47%) regarding exposure events in their social environment. Four types of exposure events were analysed using moderation analyses: familial suicides/suicide attempts and non‐familial suicides/suicide attempts. Additionally, the numbers of reported exposure events were compared between patients with and without a recent suicide attempt as well as between patients with lifetime suicide attempts and lifetime suicidal ideation. Results: Neither moderating effects of exposure events on the relationship between lifetime suicidal ideation and recent suicidal behaviour nor group differences between suicidal ideators and suicide attempters regarding the exposure events were found. Conclusions: Exposure events might have differential and possibly protective effects on suicidal behaviour—depending on type and quality (intensity, personal relevance and recency) of event—and on the outcome (suicide vs. suicide attempt). [ABSTRACT FROM AUTHOR]

Background: Medical rehabilitation plays an important role in the health care of chronically ill children and adolescents. During medical rehabilitation, supporting illness‐related self‐regulation is a central goal. Beliefs about illness and beliefs about treatment are core elements of patients' self‐regulation, and there is evidence that these beliefs are relevant predictors of different health‐ and treatment‐related outcomes such as adherence. However, little is known about adolescents' beliefs about rehabilitation. This study therefore explores adolescents' treatment beliefs in the context of inpatient medical rehabilitation. Methods: A qualitative study was conducted in a German rehabilitation clinic for children and adolescents. Using a purposive sampling method, 13 adolescents (12–16 years old) were recruited. Semi‐structured, audiotaped interviews were conducted and analysed using content analysis. Results: Results demonstrate that adolescents have differentiated rehabilitation‐related treatment beliefs. Twelve themes, with various subthemes, emerged, which include access to and knowledge about rehabilitation, the rehabilitation‐related individual position and normative aspects, expectations of oneself, as well as in respect of the social context (fellow patients, contact with family and friends), expectations of the structure, process and outcome of rehabilitation, concerns and barriers and emotional aspects. Conclusions: Our explorative study revealed a broad range of rehabilitation‐related treatment beliefs in adolescents, indicating parallels, but also differences, to research results with adults. Treatment beliefs are assumed to be an influencing factor for various health‐ and treatment‐related outcomes. Thus, implications of our findings for clinical practice and further research are discussed. [ABSTRACT FROM AUTHOR]

To ensure an adequate pain therapy with high patient adherence, it is necessary to know and consider patient preferences. A discrete choice experiment was used to obtain patients' preferences regarding treatment with systemic or topical pain medication. Patients with peripheral neuropathic pain (pNP) were recruited in two pain‐focused practices in Germany. To identify relevant attributes of topical or systemic pain medication, a literature review and face‐to‐face interviews with experts for pain treatment were conducted. The attributes used in the choice scenarios were noticeable onset of effect, time spent in medical office, risk of systemic and local side effects, and impairment of daily life with regard to sleep quality and sexuality. The model was estimated with a mixed multinomial logit regression model. The study included 153 participants suffering from moderate to severe pNP. Most important attributes from patient's perspective was noticeable onset of effect (odds ratio 2.141 [95% confidence interval 1.837 to 2.494]), followed by risk of systemic side effects (2.038 [1.731 to 2.400]) and risk of sexual dysfunction (1.839 [1.580 to 2.140]), while risk of local side effects regarding skin ranked fourth (1.612 [1.321 to 1.966]). The impairment of sleep quality was also significant but less important (1.556 [1.346 to 1.798]). Local side effects were more likely to be accepted than systemic side effects. The risk of sexual dysfunction as a side effect of treatment is very important for patients, although it has received little attention in the literature. [ABSTRACT FROM AUTHOR]

Background: Understanding peoples' evaluations of their health care is important to ensure appropriate health‐care services. Objectives: To understand what factors influence peoples' satisfaction with care and how interpersonal trust is established between doctors and cancer patients in Germany. Design: A narrative interview study that included women with a diagnosis of breast cancer and men with a diagnosis of prostate cancer. A question‐focused analysis was conducted. Setting and participants: Interviewees were sought across Germany through self‐help organizations, clinics, rehabilitation facilities, physicians and other health‐care professionals, in order to develop modules on experiencing cancer for the website krankheitserfahrungen.de (illness experiences.de). Results: Satisfaction was related to the perception of having a knowledgeable and trusted physician. Trust was developed through particular interactions in which 'medical expertise' and 'humaneness' were enacted by physicians. Humaneness represents the ability of physicians to personalize medical expertise and thereby to convey working in the individual's best interest and to treat the patient as an individual and unique human being. This was fostered through contextual and relational factors including among others setting, time, information transfer, respect, availability, profoundness, sensitivity and understanding. Conclusion: It was the ability to make oneself known to and know the patient in particular ways that allowed for satisfying care experiences by establishing interpersonal trust. This suggests the importance of conceptualizing the doctor‐patient relationship as a fundamentally reciprocal human interaction of caregiving and care‐receiving. At the core of the satisfying care experiences lies a doctor‐patient relationship with a profoundly humane quality. [ABSTRACT FROM AUTHOR]

Given the need for organs, public organizations use social marketing strategies to increase the number of donors. Their campaigns employ a variety of moral appeals. However, their effects on audiences are unclear. We identified 14 campaigns in Germany from over the last 20 years. Our approach combined a multimodal analysis of categorized posters with a qualitative analysis of responses, collected in interviews or focus groups, of 53 persons who were either skeptical or undecided about organ donation. The combined analyses revealed that the posters failed to motivate laypersons in general to donate, and were even less effective on skeptical or undecided individuals. We explain this in terms of the types of moral messages found on posters and the limits of such social marketing strategies. Furthermore, we discuss certain ethical aspects of organ donation campaigns pertaining to communicating norms and trust in public institutions. [ABSTRACT FROM AUTHOR]

This study aims to shed light on the implementation of HR practices as a key piece of the human resource management ( HRM)-performance puzzle. Although the literature suggests that discrepancies between the organization's intended and implemented HR practices are essential to understanding employees' perceptions of and reactions to HRM, little attention has been devoted to this issue. Drawing upon a multiple-case study of German health and social services organizations, we therefore explore the linkages (and potential gaps) between intended, implemented, and perceived HR practices. Our study provides new insights into the underlying mechanisms of this relationship, highlighting an organization's ability to leverage its resources as playing a crucial moderating role in implementing intended HR practices, while employees' expectations of HRM moderate the link between implemented and perceived HR practices. We advance a set of propositions that contributes to a more nuanced, multilevel understanding of the complex phenomenon of HRM implementation. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background: The resources used in treatment for sex offenders with intellectual disabilities have had much research attention, but less has been written about how participants are expected to respond (programme mechanisms). Methods: A realist evaluation of seven programmes from the UK, Canada, USA, Switzerland and Germany was conducted. In semi‐structured interviews, programme designers elucidated how they are intended to work. The data analysis was driven by the realist concern to expose programme mechanisms and intended outcomes. Results: Two main outcomes are increasing risk management capacities and cultivating prosocial identities. These are achieved through developing insights into a person's risks, work on (sexual) self‐regulation skills, sexual boundaries and personal values and by developing meaningful social roles and positive relationships. Conclusions: Over time, there have been changes to some of the treatment resources used. However, there were little differences in terms of the intended programme mechanisms and outcomes, which remained surprisingly consistent. [ABSTRACT FROM AUTHOR]

Recent discursive research has built on Michael Billig's theory of banal nationalism, arguing that minoritized individuals who explicitly claim adherence to a national group may be further marginalized from a perceived majority who view such acts as socially undesirable. In Germany, a master narrative of muted national pride precludes hot nationalism, while a narrative of integration calls for overt national allegiance from anyone perceived as Other. Integration is demanded not only of recent immigrants, but also of the second generation and beyond, bolstering a related narrative of unquestioned Germanness as ethnically based. We conducted narrative analysis of interviews with white and Turkish German young adults to explore these master narratives, examining national identity through the lens of banal and hot nationalism. We found it is not only hot nationalism that marginalized Turkish German participants, but also the unrealizable narrative of integration. Situated within research into exclusionary notions of German identity, we argue that the integration demand reiterates the narrative of Germany as ethnically homogenous while fostering a feedback loop of contested belonging. With the recent increase in refugees and other immigrants, this critical examination of identity and belonging in Germany offers a timely and underexamined perspective to an important discussion. [ABSTRACT FROM AUTHOR]

Background: Telephone surveys are intended to reduce attrition in longitudinal studies. For paediatric chronic pain patients, the comparability of pain-related information gathered using telephone interviews and postal surveys remain unknown. Furthermore, it remains unknown how social desirability may influence answers.Methods: To compare data from telephone interviews and postal surveys, a randomized cross-over design with two measure points 2 weeks apart and four conditions (combinations of telephone interviews (T) and postal surveys (P): P-T, T-P, P-P, T-T) was conducted in a sample of N = 323 paediatric chronic pain patients.Results: In the inter-group comparison, pain-related information did not differ between telephone interviews and postal surveys except for the information on pain location (back and extremities). Agreement measures of the intra-group comparisons suggest substantial to excellent agreements for all items and did not differ between the groups. The internal consistency of a disability scale was excellent for both assessment modes; the number of missing values did not differ. Participation rate was higher for telephone interviews compared to the postal surveys. Across both time points, attrition was lowest for the groups without a switch in assessment mode compared to the groups with a switch in assessment mode. Except for pain-related school absence, no effect of social desirability occurred.Conclusions: Telephone interviews are a useful method to achieve a high response rate. Pain locations should be asked for separately and not in an open question when interviewing children and adolescents on the telephone.Significance: Telephone interviews are a good method to achieve a high response rate and obtain valid data in studies with paediatric chronic pain patients. [ABSTRACT FROM AUTHOR]

Background Transmasculine people assigned female gender at birth but who do not identify with this classification have traditionally received little consideration in the voice literature. Existing analyses tend to be focused on evaluating speaker voice characteristics, whereas other factors that contribute to the production of vocal gender have remained underexplored. Most studies rely on researcher-centred perspectives, whereas very little is known about how transmasculine people themselves experience and make sense of their vocal situations. Aims To explore how participants described their subjective gender positionings; which gender attributions they wished to receive from others; which gender they self-attributed to their voices; which gender attributions they had received from others; and how far participants were satisfied with the gender-related aspects of their vocal situations. Methods & Procedures Transcripts of semi-structured interviews with 14 German-speaking transmasculine people served as the original data corpus. Sections in which participants described the gender-related aspects of their vocal situations and that were relevant to the current research objectives were selected and explored using qualitative content analysis. Outcomes & Results The analysis revealed diverse accounts pertaining to the factors that contribute to the production of vocal gender for individual participants and variable levels of satisfaction with vocal gender presentation and attribution. Conclusions & Implications Transmasculine people need to be regarded as a heterogeneous population and clinical practice needs to follow a client-centred, individualized approach. [ABSTRACT FROM AUTHOR]

Background Maternal depression has been associated with excessive infant crying, feeding and sleeping problems, but the specificity of maternal depression, as compared with maternal anxiety remains unclear and manifest disorders prior to pregnancy have been widely neglected. In this prospective longitudinal study, the specific associations of maternal anxiety and depressive disorders prior to, during and after pregnancy and infants' crying, feeding and sleeping problems were investigated in the context of maternal parity. Methods In the Maternal Anxiety in Relation to Infant Development (MARI) Study, n = 306 primiparous and multiparous women were repeatedly interviewed from early pregnancy until 16 months post partum with the Composite International Diagnostic Interview for Women (CIDI-V) to assess DSM-IV anxiety and depressive disorders. Information on excessive infant crying, feeding and sleeping problems was obtained from n = 286 mothers during postpartum period via questionnaire and interview (Baby-DIPS). Results Findings from this study revealed syndrome-specific risk constellations for maternal anxiety and depressive disorders as early as prior to pregnancy: Excessive infant crying (10.1%) was specifically associated with maternal anxiety disorders, especially in infants of younger and lower educated first-time mothers. Feeding problems (36.4%) were predicted by maternal anxiety (and comorbid depressive) disorders in primiparous mothers and infants with lower birth weight. Infant sleeping problems (12.2%) were related to maternal depressive (and comorbid anxiety) disorders irrespective of maternal parity. Conclusions Primiparous mothers with anxiety disorders may be more prone to anxious misinterpretations of crying and feeding situations leading to an escalation of mother-infant interactions. The relation between maternal depressive and infant sleeping problems may be better explained by a transmission of unsettled maternal sleep to the fetus during pregnancy or a lack of daily structure and bedtime routine with the infant. Maternal disorders prior to pregnancy require more attention in research and clinical practice. [ABSTRACT FROM AUTHOR]

Background People with aphasia experience a pronounced decrease in quality of life (QoL). Beyond that identity negotiation is hindered, which is crucial for QoL. Biographic-narrative approaches use life story telling to support identity (re)development after disruptive events like stroke. Because of the language deficits inherent in aphasia such 'talk-based' approaches have to be modified for an optimal use. Aims To evaluate an adapted interdisciplinary biographic-narrative intervention using quantitative measures of health-related quality of life (HRQL) and mood. Additionally, semi-structured interviews were conducted to gain a deeper understanding of identity development processes in people with aphasia. Methods & Procedures Twenty-seven participants with various types of chronic aphasia were enrolled. The biographic narrative intervention consisted of five face-to-face in-depth interviews and seven group sessions conducted over 10 weeks in a mixed-method design with pre- and post-tests and a follow-up assessment 3 months post-intervention. For quantitative evaluation the Aachen Life Quality Inventory (ALQI), the Satisfaction with Life Scale (SWLS) and the Visual Analog Mood Scales (VAMS) were used. Semi-structured interviews were conducted post-treatment, including questions concerning the participants' experiences with the intervention and identity change. Results were analysed using interpretative principles from Grounded Theory. Outcomes & Results For all 27 participants, we found significant and stable growth in HRQL. Self-reported states of mood also improved. As expected, overall cognitively based life satisfaction did not change. The interviews revealed two main categories: 'evaluation of the face-to-face interviews' and 'evaluation of the group sessions'. Further analysis found four overlapping main themes which were identified as identity issues: agency, control, disease concept and doing things. Conclusions & Implications Our quantitative and qualitative results demonstrated the benefits associated with the biographic-narrative intervention. The participants' sense of self changed through the approach. The findings provide foundations for future work using biographic narrative interventions to influence QoL and identity renegotiation in people with aphasia. [ABSTRACT FROM AUTHOR]

Objective The aim of the article is to report on the psychometric properties of a newly developed self-rating scale (Munich Eating and Feeding Disorder Questionnaire) for the detailed assessment of eating and feeding disorders on the basis of the DSM-5 criteria. The questionnaire aims at developing a comprehensive assessment of eating disorder symptoms suitable for severity ratings with regard to total scale and subscales, for deriving eating disorder diagnoses according to DSM-5 and ICD-10 and for measuring (intervention induced) changes over time. Methods Items were formulated by clinical experts and entered into factor analysis in two separate samples of eating-disordered inpatients. Additionally, 47 clinical and 547 community control participants were assessed. Internal consistency and sensitivity to change over time are also reported. Results Three subscales were identified covering 'preoccupation with figure and weight', 'bingeing and vomiting' and 'inappropriate compensatory behaviour' for current and past state. Test-retest reliability for the three subscales ranged between .95 and .98 (current status). A high sensitivity to change during inpatient treatment from admission to discharge was expressed in high effect sizes; for the total score (current status) for all eating disorders, the effect size was 1.70. Effect sizes for anorexia nervosa were mostly lower than those for bulimia nervosa. Clinical and community controls obtained significantly lower scores compared with eating-disordered patients. Conclusion This new DSM-5 questionnaire shows satisfying psychometric properties and is well suited for the rating of eating disorder severity in clinical practice and research. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Diaries written for patients in the Intensive Care Unit ( ICU) have been used in many European countries since the early 1990s to support patients and their relatives in their understanding of the ICU experience. ICU diaries have been introduced in Germany since 2008 via the internet, newsletters, newspapers, lectures and publications in German nursing journals. Aim The aim of the study was to update our knowledge of the extent and application of ICU diaries in Germany in 2014. Design The study had a prospective mixed methods multicenter design. Method All 152 ICUs in the two German federal states of Baden-Württemberg and Schleswig-Holstein were surveyed to identify units that had implemented ICU diaries. An additional 69 ICUs from other parts of Germany were included in the survey. We excluded diaries used in neonatal ICUs. Out of 43 units using diaries 14 were selected for semi-structured key-informant telephone-interviews on the application of ICU diaries. Results According to the survey, 8 out of 152 ICUs in the two federal states of Baden-Württemberg and Schleswig-Holstein had implemented ICU diaries and another six were planning implementation. Another 35 ICUs in other areas of Germany had implemented diaries and three units were planning to do so. Interviews were conducted with nurses at 14 selected ICUs. Informants reported successful adaption of the diary concept to their culture, but variability in application. No units were identified where all nursing staff participated in keeping ICU diaries. Conclusion Six years after the introduction of ICU diaries, ICU nurses in Germany are becoming familiar with the concept. Nursing shortage and bureaucratic challenges have impeded the process of implementation, but the adaption of ICU diaries to German conditions appears to be successful and is still in progress. Relevance to Clinical Practice Implementation of ICU diaries is feasible after adjusting for cultural and legal issues. [ABSTRACT FROM AUTHOR]

The misinterpretation of bodily symptoms as an indicator of a serious illness is a key feature of the criteria and the cognitive-behavioural models of hypochondriasis. Previous research suggests that individuals suffering from health anxiety endorse attributions of physical disease, whereas persons with elevated general anxiety have the tendency to attribute psychological causes to their symptoms. However, whether a somatic attribution style is specific to patients with hypochondriasis, as opposed to those with anxiety disorders, has not yet been investigated and is therefore part of the present study. Fifty patients with hypochondriasis, 50 patients with a primary anxiety disorder and 50 healthy participants were presented with nine common bodily sensations and had to spontaneously attribute possible causes to the symptoms. Patients with hypochondriasis differed from patients with anxiety disorders and healthy controls in giving significantly fewer normalizing explanations, but attributing more often in terms of moderate or serious diseases. Patients with anxiety disorders also made significantly fewer normalizing attributions and more somatic attributions to a severe illness than healthy controls. There were no differences between the groups in the frequency of psychological attributions and somatic attributions concerning mild diseases. The present study demonstrates that hypochondriasis is associated with a disorder-specific attribution style connecting somatic symptoms primarily with moderate and serious diseases. By contrast, normalizing attributions are largely omitted from consideration by patients with hypochondriasis. The findings conform with the cognitive conception of hypochondriasis and support the strategy of modifying symptom attributions, as practiced in cognitive-behavioural therapy. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Message Patients with hypochondriasis show a disorder-specific attribution style, which is biased towards moderate and serious diseases., This finding stresses the importance of therapeutic interventions challenging dysfunctional symptom attributions., In addition to attributions in terms of moderate and serious diseases, patients with hypochondriasis also produce constructive attributions (normalizing, psychological or in terms of mild illnesses)., Therefore, particular emphasis should be placed on a comprehensive exploration of all existing symptom attributions. By identifying beneficial attributions already in existence, the patient's resources are brought into focus and form the basis for reattribution training. [ABSTRACT FROM AUTHOR]

Secondary transfer effects ( STEs) of intergroup contact refer to the generalization of contact effects from a primary encountered outgroup to attitudes towards secondary outgroups (Pettigrew, 2009). Using two large, cross-sectional data sets from Germany ( N = 1,381) and Northern Ireland ( N = 1,948), this article examined the extent to which STEs of intergroup contact on attitudes towards a range of secondary outgroups occur via a previously unexplored psychological construct, social identity complexity (operationalized as similarity complexity and overlap complexity). Study 1 found primary outgroup contact to be associated with greater similarity complexity, but no indirect effects on secondary outgroup attitudes via complexity emerged. Study 2, however, revealed indirect positive relationships between primary outgroup contact and secondary outgroup attitudes via increased similarity complexity and overlap complexity. These relationships were obtained while controlling for two previously tested mediating mechanisms, attitude generalization (operationalized as primary outgroup attitude) and deprovincialization (operationalized as ingroup attitude and identification). We discuss the theoretical implications of these findings and the contribution of social identity complexity to understanding processes underlying STEs of contact. [ABSTRACT FROM AUTHOR]

Objectives To determine (1) the frequency and course of anxiety disorders in patients with implantable cardioverter defibrillators (ICDs), (2) the predictors of anxiety, (3) the treatment situation and patients' requests for therapy. Methods Quantitative and qualitative methods in a prospective design. At baseline, 327 ICD outpatients completed validated self-report questionnaires (participation rate = 77%). Five months later, a predefined subsample of patients (n = 108, participation rate = 81%) consisting of all patients with (n = 58) and a randomly selected subsample of patients without (n = 50) elevated symptoms of anxiety at baseline, was reassessed using a structured diagnostic interview, the baseline questionnaires, and open-ended questions. Results At baseline, 19.2% of patients suffered from at least some form of clinically relevant anxiety with an overall remission rate of 56.5% at follow-up. Predictive for anxiety at follow-up were higher levels of stress (odds ratio [OR], 1.52, P < 0.001), depression (OR, 1.26, P < 0.001), somatic symptom severity (OR, 1.25, P < 0.001), more perceived ICD-related constraints (OR, 2.4, P = 0.007), lower quality of life (physical health: OR, 0.91, P = 0.004; mental health: OR, 0.87, P = 0.001), and a higher New York Heart Association class (OR, 7.99, P = 0.002) at baseline. Only 35.3% of patients received an evidenced-based treatment for their anxiety disorder. A supervised ICD patient group was the most preferred treatment (51.1%). Conclusions Most patients seemed to adapt well to ICD therapy. Patients suffering from additional psychological strains and reporting more negative ICD-related attitudes were at risk for developing an anxiety disorder. Special tailored interventions, such as a supervised ICD patient group, could reduce the gap between treatment needs and the treatment situation. [ABSTRACT FROM AUTHOR]

Background Although the promotion of social inclusion through sports has received increased attention with other disadvantaged groups, this is not the case for children and adults with intellectual disability who experience marked social isolation. The study evaluated the outcomes from one sports programme with particular reference to the processes that were perceived to enhance social inclusion. Method The Youth Unified Sports programme of Special Olympics combines players with intellectual disabilities (called athletes) and those without intellectual disabilities (called partners) of similar skill level in the same sports teams for training and competition. Alongside the development of sporting skills, the programme offers athletes a platform to socialise with peers and to take part in the life of their community. Unified football and basketball teams from five countries - Germany, Hungary, Poland, Serbia and Ukraine - participated. Individual and group interviews were held with athletes, partners, coaches, parents and community leaders: totalling around 40 informants per country. Results Qualitative data analysis identified four thematic processes that were perceived by informants across all countries and the two sports to facilitate social inclusion of athletes. These were: (1) the personal development of athletes and partners; (2) the creation of inclusive and equal bonds; (3) the promotion of positive perceptions of athletes; and (4) building alliances within local communities. Conclusions Unified Sports does provide a vehicle for promoting the social inclusion of people with intellectual disabilities that is theoretically credible in terms of social capital scholarship and which contains lessons for advancing social inclusion in other contexts. Nonetheless, certain limitations are identified that require further consideration to enhance athletes' social inclusion in the wider community. [ABSTRACT FROM AUTHOR]

Prejudice is more prevalent among members of the working class than among members of the middle or upper class. It is still a matter of discussion whether education works to suppress prejudice among upper class members or, on the contrary, to enhance genuinely tolerant attitudes. We propose that (i) two indicators of social class-income and education-independently predict prejudice toward multiple targets as follows: lower levels of income and education are associated with higher levels of prejudice. (ii) The connection between social class and prejudice is explained by the endorsement of system-legitimating ideological attitudes, namely right-wing authoritarianism (RWA) and social dominance orientation (SDO). We tested these hypotheses in four studies using cross-sectional surveys in Europe (Studies 1 and 2, Ns = 11 330 and 2640) and longitudinal data from Germany and Chile (Studies 3 and 4, Ns = 343 and 388). Results show that education and income exert independent negative effects on prejudice. The effect of education is stronger than the effect of income, which is not stable across countries. The relationships between income and prejudice and education and prejudice are mediated by RWA and SDO. We conclude that people of the working class generally endorse an ideological configuration that is well suited for legitimating the social system. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background The study assessed the criterion validity of the 15-item version of the Center for Epidemiological Studies Depression Scale ( CES-D-15) as a screening instrument in paediatric care. Method A total of 327 patients (13-16 years) completed the CES-D-15 and a diagnostic interview serving as gold standard diagnosis for validation. Results Receiver operating characteristics yielded an overall accuracy of area under the curve ( AUC) = .90 (95% CI [.85, .95]) for the detection of any depressive disorder. At the optimal cut-off point of 14, sensitivity (.85) and specificity (.84) were good. Conclusions The CES-D-15 is a promising tool for paediatricians to enhance the recognition rate of juvenile depression. [ABSTRACT FROM AUTHOR]

International Journal of Paediatric Dentistry 2013; 23: 110-115 Background. Rubber dam is recommended for isolating the working field during adhesive dentistry procedures; however, dentists often omit rubber dam, particularly in paediatric dentistry, supposing that it would stress the patient. Aim. The aim of this study was to evaluate stress parameters during a standardized dental treatment procedure performed with or without rubber dam. The treatment time was measured as a secondary outcome variable. Design. This study was designed as a randomized, controlled, clinical study with 72 patients (6-16 years; mean age, 11.1). During standardized fissure sealing procedures, objective parameters of stress (e.g., skin resistance, breath rate) were recorded. The operator's stress level was measured by pulse rate. Subjective pain (patients) and stress perception (operator) were evaluated by an interview. Results. The breath rate was significantly ( P < 0.05) lower and the skin resistance level was significantly higher during treatment with rubber dam compared to the control group. Subjective pain perception was significantly lower for the test group. The treatment time needed for the fissure sealing procedure was 12.4% less in the test group. Conclusion. Isolation with rubber dam caused less stress in children and adolescents compared to relative isolation with cotton rolls if applied by an experienced dentist. [ABSTRACT FROM AUTHOR]

A distinction between guilt and regret in reactions to in-group atrocities is proposed. Four studies (total N = 1249) support the notion that guilt and regret are distinct emotional reactions. Whereas guilt is a self-focused, aversive emotional reaction following from appraisals of responsibility and associated with the intention to make amends, regret follows from an empathic victim perspective, is less aversive, and is more strongly associated with positive attitudes towards the victim groups and the intention to engage in intergroup contact. These findings suggest that less aversive emotions like regret are more likely to improve intergroup attitudes after a common history of conflict, but the aversive experience of guilt might be more potent in motivating reparations. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Range of electric vehicles (EVs) has long been considered a major barrier in acceptance of electric mobility. We examined the nature of how range is experienced in an EV and whether variables from other adaptation contexts, notably stress, have explanatory power for inter-individual differences in what we term comfortable range. Forty EVs were leased to a sample of users for a 6-month field study. Qualitative and quantitative analyses of range experiences were performed, including regression analyses to examine the role of stress-buffering personality traits and coping skills in comfortable range. Users appraised range as a resource to which they could successfully adapt and that satisfied most of their daily mobility needs. However, indicators were found that suggested suboptimal range utilisation. Stress-buffering personality traits (control beliefs, ambiguity tolerance) and coping skills (subjective range competence, daily range practice) were found to play a substantial role in comfortable range. Hence, it may be possible to overcome perceived range barriers with the assistance of psychological interventions such as information, training, and interface design. Providing drivers with a reliable usable range may be more important than enhancing maximal range in an electric mobility system. [ABSTRACT FROM AUTHOR]

Objectives To determine the long-term effects of three strength and balance exercise interventions on physical performance, fall-related psychological outcomes, and falls in older people. Design A single-blinded, four-group, randomized controlled trial. Setting Community, Germany. Participants Community-dwelling adults aged 70 to 90 who had fallen in the past 6 months or reported fear of falling. Intervention After baseline assessment, 280 participants were randomly assigned to the control group ( CG; no intervention; n = 80) or one of three strength and balance exercise interventions (the strength and balance group ( SBG; strength and balance only; n = 63), the fitness group ( FG; strength and balance plus endurance training; n = 64), or the multifaceted group ( MG; strength and balance plus fall risk education; n = 73). The interventions consisted of 32 one-hour group sessions in 16 weeks. Measurements Data on physical performance, fall-related psychological outcomes, and falls were collected for 24 months. Results Mixed-effects regression analyses showed improved short- and long-term (12 and 24 months, respectively) physical performance for the SBG and FG, particularly regarding mobility, balance, and walking speed ( P < .05). The improvements in physical performance outcomes were most prominent in the FG. Fall-related psychological outcomes, number of falls, and injurious falls were not significantly different from in the control group. Conclusion Training focusing on strength, balance, and endurance can enhance physical performance for up to 24 months in community-dwelling older adults. These findings did not translate to improved fall-related psychological outcomes or reduced incidence of falls. This demonstrates the need for a different approach (e.g., regarding intervention dose and components) to gain intervention benefits in the multiple domains that contribute to independence and well-being in older adults. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims To test age differences in the prevalence of DSM-IV alcohol dependence (AD) diagnostic criteria in the adult general population while controlling for drinking behaviour. Design and setting Cross-sectional data from the 2006 German Epidemiological Survey of Substance Abuse (ESA) were used, applying a two-stage probability sampling design. The survey used self-administered questionnaires and telephone interviews (mixed-mode design; 45% response rate). Participants The analytical sample consisted of n = 6984 individuals aged 18-64 years reporting alcohol consumption within the previous year. Measurements Age effects on individual AD criteria were estimated using logistic regression models, adjusting for eight mutually exclusive drinking groups (defined in terms of average daily alcohol intake and episodic heavy drinking) and socio-economic variables. Findings When controlling for drinking behaviour, 18-24-year-olds were more likely to meet the criteria 'tolerance', 'larger/longer' and 'time spent' relative to older age groups. In contrast, the likelihood of experiencing 'withdrawal' symptoms increased with age. There was no significant age effect on the diagnosis of AD. Conclusions Age differences in the prevalence of specific alcohol dependence diagnostic criteria such as 'tolerance', 'drinking larger amount or for longer than intended' and 'time spent recovering' cannot be fully explained by differences in drinking behaviour. [ABSTRACT FROM AUTHOR]

Medical Education 2012: 46: 228-233 Context Bedside teaching encounters on hospital wards offer medical students opportunities to learn key medical and interpersonal skills. Although many aspects of bedside teaching have been studied, not much is known about the selection process used by medical teachers to find patients for these encounters. Patient selection could have a substantial impact on medical students' clinical experiences. Therefore, we studied the ways in which medical teachers select patients for bedside teaching and tried to determine the factors that affect patient selection. Methods Using a qualitative research approach, we interviewed 15 teachers from three departments within the Medical Faculty at Hamburg University on how they choose patients for bedside teaching encounters. We extracted selection criteria from the transcripts of the audio-recorded interviews and identified other factors that influenced selection. Results One main category and two minor categories of factors relevant to patient selection were identified: educational; bio-psycho-social, and structural. Medical teachers look primarily for patients who have diseases that fit their conceptions of the learning objectives of the lessons in question. The two minor categories influence their choice of patients in different ways. By finding a balance between these categories, they decide which patients are eligible for participation. As a result of these selection criteria, some patients are more likely to become involved in clinical teaching, whereas others may be omitted. Conclusions Patient selection for bedside teaching is based on several criteria. Non-representative patient selection may narrow the learning experiences of medical students. Curriculum planners need to be aware that specific aspects of medical care may be neglected as a result of the exclusion of some patients. Teacher training and additional teaching formats should be provided to ensure that these are covered. [ABSTRACT FROM AUTHOR]

Objectives To compare the accuracy of commonly used tasks with that of the Visual Association Test ( VAT), a conceptually different test involving cued recall of pictorial stimuli, in the recognition of dementia within primary care. Design A cross-sectional diagnostic study of concurrent validity. Setting Twenty-nine German primary care practices. Participants Four hundred twenty-three individuals in primary care participating in a longitudinal cohort study. Measurements Participants underwent a comprehensive neuropsychological interview. The validated clinical dementia diagnosis was used as reference standard. Index tests comprised the VAT, Mini-Cog, clock drawing, verbal fluency, episodic memory, and subjective complaints. Validity parameters were calculated; possible confounders of test performance (age, sex, education, comorbidity, depression, language) were evaluated. Results Twenty-one participants (5%) had dementia according to the reference standard. The VAT distinguished dementia from nondementia with a sensitivity of 95.2% (95% confidence interval ( CI) = 86.1-100.0), a specificity of 96.0% (95% CI = 94.1-97.9), a positive predictive value ( PPV) of 55.6% (95% CI = 39.3-71.8), and a negative predictive value ( NPV) of 99.7% (95% CI = 99.2-100.0). The next-most-accurate tasks were the Mini-Cog and immediate and delayed recall. Their sensitivity and NPV are similar to those of the VAT, but their PPV and specificity were significantly lower than those of the VAT. Age and depression affected all test scores. Conclusion The VAT (cued recall of pictorial material) is superior to other tasks for the recognition of dementia in terms of higher specificity and PPV. Age-specific cutoff scores may improve the validity of all tests. [ABSTRACT FROM AUTHOR]