Cardiovascular Consequences of Unfair Pay

This paper investigates physiological responses to perceptions of unfair pay. In a simple principal agent experiment agents produce revenue by working on a tedious task. Principals decide how this revenue is allocated between themselves and their agents. In this environment unfairness can arise if an agent's reward expectation is not met. Throughout the experiment we record agents' heart rate variability. Our findings provide evidence of a link between perceived unfairness and heart rate variability. The latter is an indicator of stress-related impaired cardiac autonomic control, which has been shown to predict coronary heart diseases in the long run. Establishing a causal link between unfair pay and heart rate variability therefore uncovers a mechanism of how perceptions of unfairness can adversely affect cardiovascular health. We further test potential adverse health effects of unfair pay using data from a large representative data set. Complementary to our experimental findings we find a strong and highly significant association between health outcomes, in particular cardiovascular health, and fairness of pay.fairness, social preferences, inequality, heart rate variability, health, experiments, SOEP

Development and evaluation of a patient education programme for children, adolescents, and young adults with differences of sex development (DSD) and their parents: study protocol of Empower-DSD

Background: Differences in sexual development (DSD) are rare diseases, which affect the chromosomal, anatomical or gonadal sex differentiation. Although patient education is recommended as essential in a holistic care approach, standardised programmes are still lacking. The present protocol describes the aims, study design and methods of the Empower-DSD project, which developed an age-adapted multidisciplinary education programme to improve the diagnosis-specific knowledge, skills and empowerment of patients and their parents. Methods: The new patient education programme was developed for children, adolescents and young adults with congenital adrenal hyperplasia, Turner syndrome, Klinefelter syndrome or XX-/or XY-DSD and their parents. The quantitative and qualitative evaluation methods include standardised questionnaires, semi-structured interviews, and participatory observation. The main outcomes (assessed three and six months after the end of the programme) are health-related quality of life, disease burden, coping, and diagnosis-specific knowledge. The qualitative evaluation examines individual expectations and perceptions of the programme. The results of the quantitative and qualitative evaluation will be triangulated. Discussion: The study Empower-DSD was designed to reduce knowledge gaps regarding the feasibility, acceptance and effects of standardised patient education programmes for children and youth with DSD and their parents. A modular structured patient education programme with four generic and three diagnosis-specific modules based on the ModuS concept previously established for other chronic diseases was developed. The topics, learning objectives and recommended teaching methods are summarised in the structured curricula, one for each diagnosis and age group. At five study centres, 56 trainers were qualified for the implementation of the training programmes. A total of 336 subjects have been already enrolled in the study. The recruitment will go on until August 2022, the last follow-up survey is scheduled for February 2023. The results will help improve multidisciplinary and integrated care for children and youth with DSD and their families. Trial registration: German Clinical Trials Register, DRKS00023096. Registered 8 October 2020 - Retrospectively registered

A Short Form of the Child/Youth Health Care Questionnaire on Satisfaction, Utilization, and Needs in Children and Adolescents with a Chronic Condition (CHC-SUN-SF/YHC-SUN-SF)

We decided to develop a short-form of the CHC-SUN/YHC-SUN, a questionnaire aiming at assessing health care satisfaction of children and adolescents with chronic health conditions. Data analysis was based on samples from three different studies. Item selection involved statistical analysis and expert consensus. For independent validation purposes, we calculated descriptive statistics on single-item and composite-scale levels and applied classic test theory, confirmatory factor analyses, and correlation analysis to investigate the psychometric properties of the final short-form by different types of reliability and validity. Internal consistency (Cronbach’s Alpha) reached values of a = 0.89 (self-report) and a = 0.92 (parents report), split-half reliability values reached 0.85 (self-report) and 0.91 (parents report). Confirmatory factor analysis indicated no sufficient fit for the single factor solution, whereas the solution with three factors and one higher order factor indicated the best overall fit amongst three competing models. Validity of the short-form measure can be assumed, e.g., as indicated by its association with a single-item measure on general health care satisfaction. The short-form measures of the CHC-SUN for parents (CHC-SUN-SF) and the YHC-SUN self-report version for adolescents (YHC-SUN-SF) feature excellent psychometric performances, provide economical assessments, and are easy-to-administer questionnaires. They should be used whenever brief measures are needed for economic reasons

Transitionsorientierte Patientenschulung bei Adoleszenten und jungen Erwachsenen mit ADHS

Hintergrund: Der Übergang von der kind- zur erwachsenenzentrierten Behandlung birgt bei chronischen Erkrankungen zahlreiche Herausforderungen. Dies kann bei Aufmerksamkeitsdefizit-/Hyperaktivitätsstörungen (ADHS) durch krankheitsspezifische Charakteristika zusätzlich erschwert werden. Ziel dieser Sekundäranalyse war die Evaluation eines Transitionsworkshops bei Betroffenen mit ADHS. Methodik: Insgesamt wurden 56 Adoleszente und junge Erwachsene mit ADHS (Alter M = 17.3 Jahre, SD = 1.1, 17.9 % weiblich) und ihre Eltern quasirandomisiert einer Kontroll- (KG, n = 28) oder Interventionsgruppe (IG, n = 28) zugewiesen. Die KG erhielt die reguläre medizinische Versorgung, während die IG zusätzlich an einem eineinhalbtägigen Transitionsworkshop (ModuS-T) teilnahm. Vor Beginn sowie vier Wochen nach der Intervention wurden die Transitionskompetenz mit der 'Transitionskompetenzskala' (TKS), die Patientenaktivierung mit der 'Patient Activation Measure 13 for Adolescents' (PAM® 13) und die Versorgungszufriedenheit mit dem 'Fragebogen zur Patientenzufriedenheit' (ZUF-8) erfasst. Ergebnisse: Die IG wies eine signifikant verbesserte Transitionskompetenz (p <= .001) gegenüber der KG auf. Hinsichtlich der Patientenaktivierung zeigte sich kein bedeutsamer Interventionseffekt (p = .194). Insgesamt wies die IG eine hohe Zufriedenheit mit dem Workshop auf. Diskussion: Bislang wurden Transitionsworkshops überwiegend bei somatischen Erkrankungen evaluiert. Diese Sekundäranalyse deutet darauf hin, dass ein generisch konzipierter Workshop auch bei psychischen Erkrankungen mit einer verbesserten Transitionskompetenz und hohen Versorgungszufriedenheit assoziiert ist. Die Integration derartiger Angebote in den Versorgungsalltag ist zu diskutieren

Assessing empowerment as multidimensional outcome of a patient education program for adolescents with chronic conditions:A latent differences core model

ObjectivesThe current study aims to examine the construct of empowerment in the context of a transition education program. Patient education programs strive to empower adolescents with chronic conditions to take responsibility for their own health care to manage their transition from pediatric to adult medicine. Our study aimed to identify the core components of patient empowerment and examined whether its components are responsive to a patient education program.MethodsData was collected in two longitudinal studies involving N = 723 adolescents with chronic conditions. We used Latent Difference Score models (LDSm) of: 1) self-efficacy (GSE), 2) transition competence (TCS), and 3) patient activation (PAM) to quantify the latent variable of patient empowerment (PE). Additionally, the LDSm were extended to analyze the effects of group affiliation (intervention vs. control) and participants' age on empowerment.ResultsPE was identifiable by the three components. The intervention group developed significantly higher scores of PE compared to the control group. Age (13-21 years) did not moderate the relation between group affiliation and PE.ConclusionsWe quantified PE successfully using a psychometric modeling of change. Patient empowerment is measureable and utilizable in the specific context of transition of adolescents with chronic conditions