Bearing children in unstable times: psychological traits and early parenthood in a lowest-low fertility context, Rostock 1990 - 1995

In this paper, we analyze a unique longitudinal data set from Rostock in Eastern Germany. Data collection began in the communist era and has been followed up until today. Employing proportional-hazard models, we use psychological individual-level measures (such as personality traits, social and cognitive resources, coping styles, etc.) at age 20 as determinants of the subjects´ subsequent transition rate to parenthood. We find strong evidence to support the notion that psychological factors function as proximate determinants of differential fertility. We conclude that psychological individual-level data are important in understanding patterns, especially during times when society faces massive and incalculable upheavals.

Attitudes toward innovative mental health treatment approaches in Germany: E-mental health and home treatment

E-mental health and home treatment are treatment approaches that have proven to be effective, but are only slowly implemented in the German health care system. This paper explores the attitudes toward these innovative treatment approaches. Data was collected in two large, non-clinical samples representative of the German population in spring 2020 (N = 2,503) and winter 2020/2021 (N = 2,519). Statistical associations between variables were examined using two-tailed tests. Binary and multinomial logistic regressions were performed to predict attitudes toward online-based treatment concepts and home treatment approaches. Only few (<20%) people preferred online-based treatment approaches, while a larger proportion (~50%) could imagine being treated at home. Overall, younger subjects were more open to online-therapy approaches, while people with lower education preferred more often a traditional therapy setting. Acceptance of online-therapy did not raise significantly during the first months of the COVID-19 pandemic. When different online-based treatment options were available, the probability of accepting home treatment significantly increased with increasing levels of therapeutic support. Further promotion of acceptance for online-therapy and home treatment seems to be necessary. In the future, more information on innovative treatment approaches should be actively provided

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Knowledge hardly translates to reality—A randomized controlled trial on sexual abuse prevention for girls with intellectual disabilities

ObjectivePeople with intellectual disabilities (ID) are at higher risk of being sexually abused and developing psychiatric disorders in consequence. The effects of behavior prevention programs for children with ID have rarely been investigated. Previous studies suffer from methodical weaknesses, such as the lack of a control group, small sample size, or invalid outcome measures. This study aimed at demonstrating the efficacy of a prevention program by overcoming these flaws.MethodsA group prevention program was developed and evaluated. One hundred and six girls aged from 8 to 12 years with mild ID were enrolled in a randomized controlled study, comparing the training to a sham intervention. Effects were examined in a three-time follow-up design as individual changes in preventive knowledge (board game, verbal reports) and preventive behavior (role-play, in situ tests). Participants' behaviors were videotaped and rated by three blinded raters.ResultsGirls from the intervention group (n = 64) showed significant improvements in preventive knowledge compared with the control group (n = 39) but showed non-significant improvements for preventive behavior. In situ tests with realistic seduction situations revealed no improvement. The intervention proved to be safe, but several risks need to be considered.DiscussionThis is the first study that evaluates a behavioral prevention program on sexual abuse for children with ID on a high level of evidence. Group interventions empowering girls with ID to recognize abuse situations are suitable to enhance sexual preventive knowledge but are less suitable to enhance preventive behavior. Naturalistic settings are indispensable for providing evidence for preventive interventions in children with ID

A short note on the reliability of perceptual timing tasks as commonly used in research on developmental disorders.

OBJECTIVES: Perceptual timing tasks are frequently applied in research on developmental disorders, but information on their reliability is lacking in pediatric studies. We therefore aimed to assess the reliability of the four paradigms most frequently used, i.e., time discrimination, time estimation, time production, and time reproduction. METHODS: Based on the data from our recent longitudinal study by Marx et al. (Front Hum Neurosci 11:122, 2017), we estimated the internal consistency and test-retest reliability of these tasks in children with ADHD and typically developing children. Individual thresholds were used as dependent measures for the time discrimination task, whereas absolute error and accuracy coefficient scores were used for the other three tasks. RESULTS: Although less commonly used, the time estimation paradigm was the most robust measure of perceptual timing in terms of internal consistency and test-retest reliability in both ADHD and typically developing children, whereas the most frequently used paradigms showed poor internal consistency (time reproduction) and poor test-retest reliability (time discrimination). Compared to the absolute errors, accuracy coefficients showed almost exclusively higher internal consistency and test-retest reliability. CONCLUSIONS: Our findings call for more frequent use of the time estimation paradigm in studies of perceptual timing in ADHD. The time reproduction paradigm should be re-considered, avoiding pooling of a wide range of time intervals (2-48 s). The accuracy coefficient score is the more reliable and the more intuitive dependent variable and should be preferred in future timing research. To increase the reliability of the timing measurement, each experimental session should be performed twice, if possible

Use of outpatient medical care by headache patients in Germany: a population-based cross-sectional study

Background: Headache sufferers in need of professional health care often do not utilize the care available, and factors influencing headache-specific physician consultation are not yet understood. Objectives of this study are (1) to assess self-reported headache-specific physician consultations and (2) to identify headache-related and sociodemographic predictors. Methods: Data of a random sample of the general population in Germany aged ≥14 years were analyzed (N = 2461). A multivariate binary logistic regression was conducted to identify a parsimonious model to predict physician consultation. Results: 50.7% of the participants with headache reported at least one headache-specific physician consultation during lifetime. Of these, 53.6% had seen one, 26.1% two, and 20.3% more than two physicians because of their headaches. The odds of physician consultation increased with the number of headache days per month (HDM) (reference HDM 1) HDM 1–3 (OR = 2.29), HDM 4–14 (OR = 2.41), and HDM ≥15 (OR = 4.83) and increasing Headache Impact Test score (HIT-6) (reference “no or little impact”) moderate impact (OR = 1.74), substantial impact (OR = 3.01), and severe impact (OR = 5.08). Middle-aged participants were more likely to have consulted than younger and older ones (reference 14–34 years) 35–54 years (OR = 1.90), 55–74 years (OR = 1.96), ≥75 years (OR = 1.02). The odds of physician consultation among self-employed subjects were lower than among employed manual workers (OR = 0.48). The living environment (rural versus urban) did not have an influence on the consultation frequency. Conclusion: The results indicate that apart from burden-related factors (headache frequency; headache impact), health care utilization patterns are also influenced by patients’ occupational status and age. Further research is needed to analyze whether the lower consultation rate means that the self-employed have a higher risk of chronification or that they have more effective self-management strategies regarding headache

Clinical decision support for ExtraCorporeal Membrane Oxygenation:Will we fly by wire?

Prognostic modelling techniques have rapidly evolved over the past decade and may greatly benefit patients supported with ExtraCorporeal Membrane Oxygenation (ECMO). Epidemiological and computational physiological approaches aim to provide more accurate predictive assessments of ECMO-related risks and benefits. Implementation of these approaches may produce predictive tools that can improve complex clinical decisions surrounding ECMO allocation and management. This Review describes current applications of prognostic models and elaborates on upcoming directions for their clinical applicability in decision support tools directed at improved allocation and management of ECMO patients. The discussion of these new developments in the field will culminate in a futuristic perspective leaving ourselves and the readers wondering whether we may “fly ECMO by wire” someday.</p

Sexuality and Affection among Elderly German Men and Women in Long-Term Relationships: Results of a Prospective Population-Based Study

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.The study was funded by the German Federal Ministry for Families, Senior Citizens, Women and Youth (AZ 314-1722-102/16; AZ 301-1720-295/2), the Ministry for Science, Research and Art Baden-Württemberg, and the University of Rostock (FORUN 989020; 889048)

Achtsamkeitsorientierte Ansätze der Suchtprävention und -therapie bei Kindern und Jugendlichen

Hintergrund: Das Jugendalter gilt als vulnerable Phase für die Entwicklung von Suchtstörungen und der Anteil von jungen Menschen, die davon betroffen sind, ist hoch. Für die Entstehung und Aufrechterhaltung abhängigen Verhaltens sind Probleme in der exekutiven Kontrolle und Regulation von Gefühlen, Gedanken und Verhalten zentral. Das Thema Achtsamkeit ist in der Öffentlichkeit sehr präsent. Zahlreiche Studien belegen den Nutzen achtsamkeitsbasierter Interventionsansätze zur Stärkung exekutiver Regulation von Stress und Verhaltensimpulsen bei Suchtstörungen sowie deren komorbider psychischer Begleitsymptomatik. Methoden: Selektive Literaturrecherche zu Achtsamkeit und substanzbezogenen Störungen bei Kindern und Jugendlichen. Ergebnisse: Bisherige Studien beziehen sich weitestgehend auf Erwachsene. Empirische Evidenz zur Einschätzung des suchtpräventiven und -therapeutischen Nutzens von Achtsamkeitsprogrammen bei Kindern und Jugendlichen fehlt bislang. Im Rahmen des laufenden Forschungsverbunds „IMAC-Mind: Verbesserung der psychischen Gesundheit und Verringerung von Suchtgefahr im Kindes- und Jugendalter durch Achtsamkeit: Mechanismen, Prävention und Behandlung“ werden multifaktorielle Risikoprofile für Suchterkrankungen untersucht und in achtsamkeitsorientierte Interventionsmodelle überführt. Schlussfolgerung: Der Beitrag leitet Forschungsbedarfe zu Suchterkrankungen und Achtsamkeit aus einer kinder- und jugendspezifischen Perspektive ab und informiert über die Teilprojekte

Clinical decision support for ExtraCorporeal Membrane Oxygenation: Will we fly by wire?

Prognostic modelling techniques have rapidly evolved over the past decade and may greatly benefit patients supported with ExtraCorporeal Membrane Oxygenation (ECMO). Epidemiological and computational physiological approaches aim to provide more accurate predictive assessments of ECMO-related risks and benefits. Implementation of these approaches may produce predictive tools that can improve complex clinical decisions surrounding ECMO allocation and management. This Review describes current applications of prognostic models and elaborates on upcoming directions for their clinical applicability in decision support tools directed at improved allocation and management of ECMO patients. The discussion of these new developments in the field will culminate in a futuristic perspective leaving ourselves and the readers wondering whether we may " fly ECMO by wire" someday