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Reflexionskompetenz gilt als Schüsselqualifikation von Lehrkräften, insbesondere im inklusiven Unterricht, welcher durch Zielkonflikte geprägt ist und somit reflektierte Entscheidungen erfordert. Schon in der ersten Phase der Lehrkräftebildung sollte Inklusion deshalb als Querschnittsthema bearbeitet werden. Nicht nur Sonderpädagogik-, sondern alle Lehramtsstudierenden sollten die Möglichkeit erhalten, Reflexionskompetenz im Kontext inklusiver Bildung zu erwerben. Dieses Ziel verfolgt der Zertifikatskurs „Handlungswissen Inklusion“ an der Universität zu Köln. Es handelt sich hierbei um ein interdisziplinäres Kooperationsprojekt unterschiedlicher Fakultät­en und Arbeitsbereiche. Der Beitrag beschreibt die inhaltliche Konzeption des Zertifikatskurses und die Durchführung der Pilotierung (erste Kohorte im SoSe 2021) im Bachelorstudium der lehrkräfteausbildenden Fakultäten. Dabei nehmen die Studierenden während des gesamten Bachelorstudiums pro Semester an mehreren Zertifikatsworkshops teil. Zur Förderung der Reflexionskompetenz wird begleitend ein E-Portfolio bearbeitet. Themen des Zertifikats sind u. a. die Reflexion unterschiedlicher Inklusionsverständnisse, Spannungsfelder wie Kategorisier­ung vs. Dekategorisierung, Leistungsbewertung, Chancen und Herausforderungen im Kontext von Digitalisierung in inklusiven Settings und im Rahmen des Berufsfeldpraktikums eine erste Theorie-Praxis-Reflexion. Die Themen bieten Raum, das bisher erworbene Wissen über Inklusion zu erweitern, sich damit kritisch auseinanderzusetzen und eigene Überzeugungen zu hinterfragen, um den Erwerb professioneller Handlungskompetenzen zu fördern. Abstract Reflective competence is a key qualification particularly for teachers who teach inclusively, teaching that is marked by competing goals and one that requires reflected decisions. Starting with the first phase of teacher education, inclusion should be dealt with as a cross-cutting issue. All student teachers, not just special education students, should have the opportunity to acquire reflective competence in the context of inclusive education. The certificate course “Handlungswissen Inklusion” at the University of Cologne pursues this goal. This project is interdisciplinary, a product of cooperation between different faculties and (research) teams. This article describes the content and conceptualization of the certificate course and the implementation of its pilot cohort (summer 2021) for bachelor students in teacher education faculties. During the certificate course, students participated in several workshops per semester throughout their bachelor studies. An e-portfolio was worked on throughout the course to promote the students’ reflective competence. Certificate topics included: reflection on different conceptual understandings of inclusion, points of tension found, for example, in categorization and de-categorization, performance assessments, opportunities and challenges in the context of digitalization of inclusive settings and an initial theory-practice reflection in the context of the occupational field-related practical studies. The topics provide a space to expand previously acquired knowledge about inclusion, to critically engage with this knowledge, and to question one’s own beliefs in order to promote the acquisition of professional action competencies.

Abstract Awareness is vital for cancer prevention. US studies show a strong link between web searches and cancer incidence. In Europe, the relationship remains unclear. This study characterizes regional and temporal relationships between cancer incidence and web searches and investigates the content of searches related to breast, cervical, colorectal, lung, prostate, and testicular cancer, brain tumors, and melanoma in Germany (July 2018–December 2019). Aggregate data from Google Ads Keyword Planner and national cancer registry data were analyzed. Spearman’s correlation coefficient (r S ) examined associations between cancer incidence and web search, repeated measures correlation (r rm ) assessed time trends and searches were qualitatively categorized. The frequency of malignancy-related web searches correlated with cancer incidence (r S = 0.88, P = 0.007), e.g., breast cancer had more queries than the lower-incidence cervical cancer. Seasonally, incidence and searches followed similar patterns, peaking in spring and fall, except for melanoma. Correlations between entity incidence and searches (0.037 ≤ r rm ≤ 0.208) varied regionally. Keywords mainly focused on diagnosis, symptoms, and general information, with variations between entities. In Germany, web searches correlated with regional and seasonal incidence, revealing differences between North/East and South/West. These insights may help improve prevention strategies by identifying regional needs and assessing impact of awareness campaigns.

BackgroundPsoriasis is a chronic skin disorder with a high burden of disease. People affected with psoriasis increasingly use the internet for health-related reasons, especially those with younger age, higher education, and higher disease severity. Despite advantages such as enhancing the individuals’ knowledge with the use of digital media for health-related issues, disadvantages were also present such as quality control, and variability in the individuals’ health information literacy. While patients with psoriasis within medical settings generally trust physicians over digital media, they commonly withhold their web-based research findings from health care providers. ObjectiveThe study aims to (1) identify further factors associated with regular psoriasis-related internet use, (2) rank specific digital media platforms used, and (3) examine digital media within the physician-patient relationship among individuals with and without dermatological treatment. MethodsA cross-sectional, questionnaire-based study was conducted among individuals with self-reported psoriasis in Germany between September 2021 and February 2022. Participants were recruited via digital media platforms and in person at a University Hospital Department of Dermatology in southern Germany. The questionnaire asked about demographic and medical information, individual psoriasis-related digital media use, and the impact of digital media on the physician-patient relationship. Data were analyzed descriptively, and logistic regression models were performed to assess the factors associated with regular psoriasis-related internet use. ResultsAmong 321 individuals with a median age of 53 (IQR 41-61) years (nonnormally distributed; females: 195/321), female sex, shorter disease duration, moderate mental burden of disease, and good self-assessed psoriasis-related knowledge were associated with regular psoriasis-related internet use. Of the 188 participants with a mean age of 51.2 (SD 13.9) years (normally distributed) who used digital media 106 (56.4%) usually searched for information on psoriasis-based websites and 98 (52.1%) on search engines, primarily for obtaining information about the disease and therapy options, while social media were less frequently used (49/188, 26.1%). Nearly two-thirds of internet users (125/188) claimed that their physicians did not recommend digital media platforms. About 44% (82/188) of the individuals reported to seek for additional information due to the insufficient information provided by their physician. ConclusionsThis study revealed the importance of digital media in the context of psoriasis, especially among women, individuals with shorter disease duration, and moderate mental disease severity. The lack of physicians’ digital media recommendations despite their patients’ desire to receive such and being more involved in health-related decisions seems to be a shortcoming within the physician-patient relationships. Physicians should guide their patients on digital media by recommending platforms with evidence-based information, thereby potentially creating an adequate framework for shared decision-making. Future research should focus on strategies to prevent the spread of false information on digital media and address the needs of patients and physicians to enhance health-related digital media offerings.

Abstract Several conventional cross-sectional studies have investigated the impact of the coronavirus disease (COVID-19) pandemic on patients with axial spondyloarthritis (axSpA) and reached contrary results regarding health and well-being. As analysis of web search data already provided insights into public interest and unmet needs, this study aimed to examine axSpA-related web searches before and during COVID-19 pandemic to gain a different perspective on the impact of COVID-19 on this disease. The Google Ads Keyword Planner was used to generate axSpA-related keywords and their monthly number of searches between June 2018 and November 2021 in Germany. These keywords were qualitatively classified into seven categories. A total of 538 axSpA-related keywords were used for the analysis. The number of axSpA-related searches increased during COVID-19 pandemic (before: n = 1,525,010 vs. during: n = 1,848,300), particularly searches for symptoms, disease outcomes, and causes, while interest in disease management and diagnosis decreased. This study demonstrated a shift in public interest in axSpA during COVID-19 in Germany and highlights an urgent expansion of telemedicine to be prepared for exceptional situations such as a pandemic.

Background: There are a variety of possible contraceptives available. While medical advice is an important resource for selecting the individual contraceptive, previous research has shown that the Internet has become an increasingly important source of health care information. Objectives: This study aims to identify key trends in contraception-related web searches in Germany and thus allows conclusions about preferences and unmet needs with regard to pregnancy prevention. Design: Longitudinal retrospective study. Methods: Google Ads Keyword Planner was used to identify contraception-related keywords and their search volume in Germany and all federal states between 2018 and 2021. The keywords were categorized based on gender, hormonal/non-hormonal, and different contraceptive methods. Search volume and categories were analyzed for temporal trends, regional differences, and underlying socioeconomic variables. Results: The 1481 contraception-related keywords corresponded to 15,081,760 searches. In total, a 56% increase in searches/100,000 inhabitants was observed. Highest mean search volume was observed in categories “woman,” “woman/non-hormonal” and “woman/non-hormonal/barrier,” respectively, and in the federal state Hamburg, while the lowest was seen in North Rhine-Westphalia. Conclusion: The increase in search volume reflects a high interest in contraception, particularly in non-hormonal female methods. This stands in contrast to the limited number of effective non-hormonal contraceptives available and points to an unmet need. In addition, the low search volume for male contraceptives demonstrates gender-specific responsibilities regarding family planning in German society.

Abstract Background Herpes zoster (HZ) and its complication postherpetic neuralgia (PHN), whose incidence are both expected to increase with an ageing population, have demonstrated high costs on healthcare systems and burden on individual quality of life. Previous studies have shown the possibility of assessing public interest in a disease and factors that influence search behaviour using internet search data. The aim of this study was to analyze internet search data for HZ in Germany to evaluate public interest in the disease and relevant influential temporal and geographic factors that modify search behavior. Methods Google Ads Keyword Planner was used to generate a list of HZ-related keywords including their search volume for Germany as a whole and its sixteen federal states from October 2016 to September 2020. All keywords were qualitatively categorized, and changes over time and correlations with population density, physician density, and vaccination rates were assessed using Welch’s ANOVA, Bonferroni correction for post-hoc analyses, and Pearson’s correlation. Results A total of 1,651 relevant keywords with a search volume of 20,816,210 searches were identified. Overall, national search volume increased each year of the study period with a peak in August 2020. More than half of the total search volume related to general queries (55.1%). The highest average monthly search volumes were observed in the states of Hamburg, Saarland, and Bremen. Average monthly search volume showed strong positive correlations with population density (r = .512, p = .043) and a strong negative correlation with the number of inhabitants per working physician (r = -.689, p = .003). Conclusions The study demonstrated that evaluating internet search data is a viable method for assessing public interest in HZ, thereby identifying areas of unmet need to support targeted public health campaigns.

Abstract Background Atopic dermatitis (AD) is a common chronic skin disease causing substantial individual and overall socioeconomic burden. Objectives The aim of this study was to gain information on the healthcare of patients with AD from dermatologists' perspectives. Methods For this cross‐sectional study, office‐based dermatologists in Southern Germany were contacted by mail in June 2021, who received a questionnaire that assessed, for example, individual data, annual number of patients, treatment satisfaction, and awareness of patients' online searches. Results The 98 participating dermatologists (mean age 53.2 ± 10.3 years, 53.1% male) reported treating a median of 300 patients with AD yearly, of those 11.0% had a severe form. Two‐thirds of physicians were consulted at least six times a year by severely affected patients. Many physicians were contacted by several patients who were pretreated by other physicians. Topical corticosteroids were the most frequently used therapy. The median proportion of patients receiving a biological was 2.0%. While nearly all dermatologists (89.8%) were satisfied with the effectiveness of available therapies, only 37.7% were satisfied with their costs. Concerning perceived treatment satisfaction among patients, 65.3% of patients with severe AD seemed satisfied. Patient use of the internet for health information was indicated to be beneficial for the awareness of AD by 74.5% of physicians, whereas most found it obstructive to patients' claims (69.1%) and therapy decisions (48.4%). Nearly the same proportion mentioned that online searches were an obstacle for (37.9%) or had no effect on (38.9%) the physician–patient relationship. Conclusions The results indicated that care of AD, especially in severely affected people, can still be improved. Additionally, from the dermatologists' perspectives, online searches mostly have a negative effect on several healthcare‐related aspects.

Abstract Background Little is known about what people are interested in when they search the web for psoriasis. The monitoring of online search behaviour allows the assessment of interest in a disease on a more representative level by including people outside of medical settings. Objectives This study aims to reveal relevant aspects regarding psoriasis for people consulting the web. Methods Google Ads Keyword Planner was used to select and evaluate relevant German keywords for ‘psoriasis' in the study period from September 2016 to August 2020 on German territory. All keywords were qualitatively reviewed and descriptively analysed in 11 categories. One‐way analysis of variance, Welch test and Pearson's correlation coefficient were used to assess differences within Germany, annual search volumes and seasons. Results Overall, 11,170,740 German language Google searches on the topic of psoriasis were made. In the general category, the most commonly searched disease aspect was related to the possible contagiousness of psoriasis (n = 122,040). ‘Head’ (51.1%), followed by ‘nails’ (15.9%), ‘hands’ (8.8%), ‘feet’ (7.8%), and ‘genital/anal area’ (6.1%), was the most frequently searched for localization. Pustular forms of psoriasis were overrepresented in the search volume. Almost half of the search terms for therapy were represented by keywords related to alternative care and phytotherapy, while less than 1% related to biologics. Differences between the federal states for search volume on treatment options (p

Background: Asthma is a chronic inflammatory disorder of the airways and one of the most important non-communicable diseases worldwide. Analyzing crowdsourced data can help understand public interest and unmet needs as well as potential factors influencing search behavior. Objective: The study aimed to investigate asthma-related web search data in Europe to identify possible regional and seasonal variations and to assess public interest. Methods: Google Ads Keyword Planner was used to measure search volume for search terms related to asthma, allergic asthma, and bronchial asthma in 21 European countries between January 2018 and December 2021. The top 10 keywords of each country were categorized qualitatively. Search volume per 100 000 inhabitants was descriptively assessed in terms of regional and seasonal trends. Spearman correlations between search volume and pollen concentration as well as coronavirus disease (COVID-19) cases were investigated. Results: The median search volume per 100 000 inhabitants for asthma and allergic asthma was highest in Northern and Western Europe, while the highest search volume for bronchial asthma was observed in Western and Eastern regions. A seasonal trend was identified for all search terms and in all regions. Correlations were found between search frequency and pollen load and search behavior and COVID-19 cases. Overall, Europeans were most interested in the diseases in general, their treatment options, and symptoms. Conclusion: These results highlighted the need for reliable and region-specific information about the disease and for public campaigns to improve asthma control. The study also emphasizes the importance of using crowdsourced data for a more encompassing overview beyond conventional healthcare data.

Positive health approaches, such as happiness, are largely unexplored in medicine, including dermatology. Taking into consideration the various happiness measures, the aims of this cross-sectional study were to assess this concept using a 1-item heuristic happiness question and its related dimensions (Satisfaction with Life, Positive and Negative Affect, Quality of Life, and Compound Psychological Capital) in outpatients with different skin diseases between December 2019 and June 2020, and to examine the link between these dimensions. Overall, 414 dermatological patients were included: 67 with psoriasis, 84 atopic eczema, 10 mastocytosis, 19 nummular eczema, 84 malignant melanoma and 150 keratinocyte carcinoma. Comparing the skin diseases, differences were observed for heuristic happiness, Positive Affect, and some domains of Quality of Life and Compound Psychological Capital. Analysing the relationship between heuristic happiness and other happiness measures, the data revealed moderate to strong correlations (r = 0.30–0.46, p

Alopecia areata is a common skin disease which is associated with psychosocial and financial burden. No curative therapy exists and, hence, affected persons resort to self-financed cosmetic solutions. However, studies on the economic impact of alopecia areata on individuals are limited. To estimate annual individual out-of-pocket costs in persons with alopecia areata, a cross-sectional study using a standardized online questionnaire was performed in Germany, Austria and Switzerland. A total of 346 individuals (95.1% women, mean age: 38.5 ± 11.6 years) with alopecia areata participated between April and August 2020. Mean additional spending on everyday necessities was 1,248€ per person per year, which was significantly influenced by the duration of the illness, the treatment provider, and disease severity. Hair replacement products and cosmetics accounted for the highest monthly costs, followed by costs for physician visits, hospital treatments, and medication. Most participants (n = 255, 73.7%) were currently not undergoing treatment, due to lack of efficacy, side-effects, costs and acceptance of the disease. Sex differences in expenses were observed, with women having higher expenditures. Alopecia areata-related out-of-pocket costs place a considerable financial burden on affected individuals, are higher compared with those of other chronic diseases, and should be considered in economic assessments of the impact of this disease.

The COVID-19 pandemic forced a rapid shift to digital strategies including e-exams in medical schools. However, there are significant concerns, predominately from student perspectives, and further data is required to successfully establish e-assessment in the medical curricula. The objective of the study was to examine medical students’ perceptions, concerns, and needs regarding e-assessment to establish a comprehensive e-exam based on these and previous findings and to evaluate its effectiveness in terms of examinee perceptions and further needs. During the 2021 summer term, a cross-sectional study using qualitative and quantitative methods was conducted among all 1077 students at the School of Medicine, Technical University of Munich. They were asked to provide information regarding their characteristics, preferred exam format, e-assessment perception, concerns, and needs in an online questionnaire. Based on these findings, a pilot e-exam including an e-exam preparation for the students were established and subsequently evaluated among 125 pilot e-exam examinees under study consideration via an online-questionnaire. Of the 317 pre-exam participants (73.2% female), 70.3% preferred in-person exams and showed concerns about the technological framework, privacy, and examination requirements. Qualitative analysis showed that these concerns lead to additional exam stress and fear of failure. The 34 (79.4% female) participants who participated in the evaluation survey showed a significantly more positive e-exam perception. The fairness of the platform, the independence from an internet connection, the organization including the e-exam preparation, and the consideration of participant needs were discussed as particularly positive in the open-ended comments. In both surveys, participants requested uniform platforms and processes for all subjects. This study provides evidence for a positive, complementary role of student participation in a successful e-exam implementation. Furthermore, when establishing an e-exam format in the medical curricula, e-exam training, equal accessibility, availability offline, and all-round fairness should be considered.

As atopic eczema is triggered by environmental factors, such as temperature, differences in disease burden between and within countries are possible. One method to study this phenomenon is to perform web-search analysis, since the internet is commonly used to retrieve health-related information. This study, investigating the Google search volume regarding eczema in Swedish counties between April 2017 and March 2021, revealed a continuous increase in number of searches and that the search volume was higher in Northern than Southern Sweden. Gotland had the most searches per 100,000 inhabitants. In general, there was a negative correlation between search volume and temperature (r=–0.315, p

[This corrects the article DOI: 10.1371/journal.pone.0251194.].

Computational reproducibility is a corner stone for sound and credible research. Especially in complex statistical analyses-such as the analysis of longitudinal data-reproducing results is far from simple, especially if no source code is available. In this work we aimed to reproduce analyses of longitudinal data of 11 articles published in PLOS ONE. Inclusion criteria were the availability of data and author consent. We investigated the types of methods and software used and whether we were able to reproduce the data analysis using open source software. Most articles provided overview tables and simple visualisations. Generalised Estimating Equations (GEEs) were the most popular statistical models among the selected articles. Only one article used open source software and only one published part of the analysis code. Replication was difficult in most cases and required reverse engineering of results or contacting the authors. For three articles we were not able to reproduce the results, for another two only parts of them. For all but two articles we had to contact the authors to be able to reproduce the results. Our main learning is that reproducing papers is difficult if no code is supplied and leads to a high burden for those conducting the reproductions. Open data policies in journals are good, but to truly boost reproducibility we suggest adding open code policies.