Virtues and vocation: An historical perspective on scientific integrity in the twenty-first century.

According to the Dutch chemist Gerrit Jan Mulder (1802-1880), the principal aim of university education was character building and moral edification. Professional training was of secondary importance. Mulder's ideas about the vocation and moral mission of the university professor can serve as a historical counterpart to later Weberian, Mertonian, and contemporary ideas on the ethos of science. I argue that a revaluation of the moral precepts that Mulder saw as defining the life of an academic is helpful in dealing with the problems of late modern science, such as the replication crisis and research misconduct. Addressing such problems must start in the university classrooms. To empower students to internalize the principles of responsible conduct of research, we need an updated version of Mulder's idea of the university professor as a moral agent.

Visions for planetary health: Results from open-ended questions of survey participants after a virtual planetary health lecture series.

INTRODUCTION: A profound transformation of all areas of human activities is urgently needed for planetary health. Developing a shared vision of the future that is grounded in values aligned with planetary health is indispensable in this regard. The Planetary Health Academy is the first open online lecture series in Germany aiming for transformative planetary health education. As part of a recent evaluation of the impact of the lecture series, participants' visions for planetary health were also examined. METHODS: As part of a retrospective, cross-sectional, self-administered online survey, participants were asked to respond to an open-ended question on their visions for planetary health. Results were analysed using summarising qualitative content analysis according to Mayring. Sociodemographic details of those participants who provided a valid answer (n = 197) were calculated. RESULTS: Eight main categories were developed to summarise participants' visions for planetary health. These were: Awareness for planetary health - Planetary health integrated in all types of education - Establishment and development of the concept - A different understanding of health (care) - A transformative movement and global community - Transforming human activities - Planetary health as a guiding principle - The future state of planetary health. DISCUSSION: Broadly, the participants' visions were about planetary health as a goal and the means necessary to achieve this goal. Our findings can only be seen as a first explorative step in eliciting aspects of a common vision for planetary health, as our study design did not include a mechanism of building consensus towards one common vision. Besides the field of planetary health, similar concepts and associated movements exist or are emerging. Facilitating dialogue and exchange across disciplines and narratives about the prevailing future visions will be key to achieving what we call planetary health and what others might call Ubuntu or buen vivir. CONCLUSION: The results of this study provide first insights into the planetary health visions of those whom we would consider members of a movement aligned behind the idea of planetary health. In future editions, the Planetary Health Academy could integrate more discursive elements with a particular focus on negotiating future visions to support the creation of a critical mass of change agents within the health community and beyond.

[Implementing systematically: To what extent can implementation science make an educational contribution to health care practice?] / Systematisch implementieren. Inwiefern kann die Implementierungswissenschaft einen Bildungsbeitrag für die Akteure im Gesundheitswesen leisten?

BACKGROUND: Implementation science is currently struggling with the challenge to translate its findings into implementation practice in health care. Therefore, it is of interest to explore to what extent advanced trainings are relevant for health care practice to support knowledge circulation, and what needs to be considered in their design. DESIGN OF EDUCATIONAL INITIATIVES AND TRAINING: Internationally, numerous initiatives have emerged in recent years to make implementation science more accessible to health care implementers. They focus, in particular, on the development of curricula for actors in health care practice and the widespread implementation of these qualification programs. In German-speaking countries, the interest in health services research is particularly evident at the level of Master's degree programs to make implementation science accessible to health care. However, these efforts need to be complemented by a participatory, needs-oriented and theory-based approach to advanced training for implementers in health care practice. This will enable the required competencies to be addressed on different levels of training and the further development of training formats. DISCUSSION: Recent literature shows that implementers in German-speaking countries can benefit from a training program tailored to their needs. International experience in the field of advanced training in implementation science for health care practice allows us to derive essential components for the development of advanced training for the German-speaking region.

Child-focused infant and early childhood mental health consultation: Shifting adult attributions to reduce the risk for preschool expulsion.

Infant and early childhood mental health consultation (IECMHC) in early care and education (ECE) settings is a promising approach to support young children. Although research on the effects of IECMHC is encouraging, it is limited by the complexities of the systems in which IECMHC is implemented and the variability in IECMHC models. The current study aims to clearly articulate a statewide, child-focused, short-term IECMHC model, assess consultee satisfaction, examine the effects of consultation on children's functioning in the school and home settings, and evaluate changes in teacher perceptions associated with expulsion risk following consultation. In total, 268 children ages 1-5 (69% White, 75% male) and their family and school caregivers participated in consultation in a New England state, and 95 children and caregivers were included in an evaluation subsample. Of this subsample, teachers and ECE administrators, but not families, indicated significant improvement in children's functioning from referral to end of consultation. There was also a significant decrease in children's risk of expulsion, as measured by teachers' perceptions associated with expulsion decisions. This study contributes to the IECMHC literature by providing results specific to a child-focused model of consultation and highlighting the possible role of adult attributions for children in ECE.

La consulta de salud mental infantil y la temprana niñez (IECMHC) en los entornos de cuidados y educación tempranos (ECE) es un acercamiento prometedor para apoyar a los niños pequeños. A pesar de que la investigación sobre los efectos de IECMHC es alentadora, está limitada por las complejidades de los sistemas dentro de los cuales se implementa IECMHC y la variabilidad en los modelos de IECMHC. El presente estudio se propone articular claramente un modelo de IECMHC para todo el estado, con enfoque en el niño y a corto plazo, evaluar la satisfacción que quienes participan de la consulta, examinar los efectos de la consulta sobre el funcionamiento de los niños en la escuela y en el entorno del hogar, así como evaluar los cambios en las percepciones de los maestros asociadas con los riesgos de expulsión después de la consulta. En total, 268 niños de edad 1-5 (69% blancos, 75% varones) y sus familias y quienes les cuidaba en la escuela participaron en la consulta en un estado de Nueva Inglaterra, y se incluyó a 95 niños y sus cuidadores en una evaluación de un subgrupo muestra. De este subgrupo muestra, los maestros y los administradores de ECE, pero no las familias, indicaron significativas mejorías en el funcionamiento de los niños desde la referencia hasta el final de la consulta. Se dio también una significativa disminución en el riesgo de expulsión de los niños, tal como se midió por medio de las percepciones de los maestros asociadas con las decisiones de expulsión. Este estudio contribuye a la literatura informativa sobre IECMHC por medio de ofrecer resultados específicos al modelo de consulta enfocado en el niño y subrayar el posible papel de las atribuciones del adulto para los niños en ECE.

La consultation de santé mentale du nourrisson et de la petite enfance (Infant and early childhood mental health consultation abrégé en anglais IECMHC) dans des contextes éducatifs et de crèches (abrégé ici CEC selon le français) est une approche prometteuse pour le soutien aux jeunes enfants. Bien que les recherches sur les effets de l'IECMHC sont encourageantes, elles sont limitées par les complexités des systèmes dans lesquels l'IECMHC est mise en oeuvre et la variabilité des modèles de l'IECMHC. Cette étude s'est donné pour but de clairement articuler un modèle IECMHC au niveau de l'état, focalisé sur l'enfant et à court terme, d'évaluer la satisfaction de la personne consultée, d'examiner les effets de la consultation sur le fonctionnement des enfants à l'école et à la maison, et d'évaluer les changements dans les perceptions de l'enseignant liée au risque d'expulsion après la consultation. En tout 268 enfants âgés de 1-5 ans (69% blancs, 75% garçons) et leur famille et les personnes prenant soin d'eux à l'école ont participé à une consultation dans un état de nous Nouvelle Angleterre (aux Etats-Unis), et 95 enfants et personnes prenant soin d'eux ont été inclus dans un sous-échantillon d'évaluation. Dans ce sous-échantillon les enseignants et administrateurs CEC, mais pas les familles, ont fait état d'une amélioration important dans le fonctionnement des enfants du moment de la référence à la fin de la consultation. Il n'a pas de baisse importante du risque d'expulsion des enfants, mesurée par les perceptions des enseignants liées aux décisions d'expulsion. Cette étude contribue aux recherches sur l'IECMHC en offrant des résultats spécifiques à un modèle de consultation focalisé sur l'enfant et en mettant en lumière le rôle possible des attributions adultes pour les enfants dans les CEC.

Exploring Fairness in Scholarly Development: Are We Creating Knowledge Storing Zombies or Curious, Creative and Critical Healthcare Professionals?

Scholarly doctors require research knowledge and skills (Ausbildung), as well as an academic mindset, which includes curiosity, creativity, and critical thinking (Bildung). However, in contrast to knowledge and skills, summative assessment of the development of an academic mindset is not so easy in an objective and so-called 'fair' way. As a result, in practice, assessing knowledge and skills tends to dominate in scholarly development. In this perspective, we explore the issues that arise when we give priority to objective assessment of knowledge and skills in scholarly development to safeguard fairness and, consequently, standardize educational procedures and learning pathways. We argue that eventually this approach may even result in hampered development of a true academic mindset and can be considered unfair rather than fair. To solve this, perhaps we should go back to the core business of the university and in the tradition of founder of the modern university Von Humboldt focus on shaping an academic mindset (Bildung). To rebalance Ausbildung and Bildung in academic education, we should go beyond the assumption that objectivity is a prerequisite for achieving fairness in assessment. Shifting the focus from pure objectivity to both objectivity and subjectivity in assessment as well as learning pathways can assist in protecting fairness and, as a result, bring back Bildung to medical education to ensure future doctors to be true scholars.

Advance Care Planning in Hong Kong.

Hong Kong is a well-developed city with outstanding healthcare services, leading to the highest life expectancy in the world. Paradoxically, the quality of end-of-life care in this city lagged behind that of many other high-income regions. Possibly, the advances in medicine contribute to the death denial culture, hindering communication about end-of-life care. This paper discusses challenges arisen due to poor public awareness and professional training and local initiatives to promote advance care planning in the community.

[School Children's COVID-Related Future Anxiety over the Course of 8Months of the Pandemic]. / Coronabezogene Zukunftsangst bei Grundschulkindern im Verlauf von 8 Monaten der Pandemie.

To explore the long-term effects of the COVID-19-pandemic on children, N = 140 8- to 10- year-olds were asked about their COVID-related future anxiety (CRFA) in their classrooms during months 6, 9, and 14 of the pandemic which started inMarch 2020 in Germany. Future anxiety was defined as a "state of apprehension, uncertainty, fear, worry, or anxiety about unfavorable changes in a more distant personal future" which was related to the effects of the COVID- 19-pandemic. In this survey, 13%to 19%of children reported experiencing CRFA "often" on at least one of the four items of the newly developed CRFA scale. Experiencing CRFA "often" was reported by 16% of the children at two and by 8 % of the children at three measurement points, among them more girls and more children from homes with poor educational backgrounds. Analyses uncovered large interindividual differences: For 45 % of the children CRFA decreased between months 6 and 9 of the pandemic, whereas for 43 % it increased. Children of parents with low educational backgrounds weremore likely to report frequent CRFA at all three measurement time points, even after controlling for gender and incidence of COVID-19-in Germany.This confirms predictions that contagion risk and controllability influence future anxiety. The descriptive results additionally support earlier findings that many children already experience future anxiety about macro-level events. The results on chronic CRFA underscore the urgency to examine the long-time effects of CRFA with greater care.This is of paramount importance considering the macro-level challenges of the future.

[La formation médicale continue en Suisse - un récit]. / Ärztliche Weiterbildung in der Schweiz ­ ein Narrativ.

Postgraduate Medical Education in Switzerland - A Narrative Abstract: Medical education has to respond to new challenges such as digitalisation, increase of chronic and complex diseases, economisation. The concept of Competency-Based Medical Education (CBME) has been implemented in undergraduate education in Switzerland. Postgraduate medical education has undergone a fundamental reformation, among other things with the development of Entrustable Professional Activities (EPAs), the adaptation of training programmes or "Teach the Teachers" classes. For the associated cultural change to be successful, the commitment of the professional societies, the training institutions, the hospitals is needed, but also the support of the health and education policy is of utmost importance.

[The Climate Change Challenge: How to get research into society through an online workshop]. / Herausforderung Klimawandel: Transfer von Wissenschaft in die Gesellschaft durch einen Online-Workshop.

BACKGROUND: According to the World Health Organisation, climate change poses the greatest health threat to humanity. At the same time, an environmentally friendly lifestyle has a positive impact on our health, such as a plant-based diet. In order to counter climate change, society needs to be informed about climate-friendly and health-promoting measures. Therefore, an online workshop was initiated at the Medical Faculty of Ulm. In an accompanying study, it was determined whether this leads to changes in environmental knowledge and awareness among the participants. METHODS: The online workshop consisted of four 2-hour sessions. Scientific basics on climate change and possible solutions were discussed. Other focuses were on health and the health system as well as environmental psychology and climate change denial. Participants could take part in an anonymous and voluntary online survey before (pretest) and after (posttest) the workshop. RESULTS: 86 participants took part in the workshop, of whom 24 attended all appointments and completed both surveys. While hardly any changes were observed in the subsection of environmental emotion, perception and behavior, there was a significant increase in environmental knowledge in the posttest. The workshop was evaluated very positively. Furthermore, many participants were motivated to make a personal contribution to climate protection after the workshop. CONCLUSION: The workshop serves as a good example of how medical scientific findings can be shared at a societal level. The participants already showed a high level of environmental awareness in the pretest, which is why the question remains open as to how people can be sensitized to the (health) threats posed by climate change who do not proactively sign up for such an offer themselves.

Updating the evidence: A systematic review of a decade of Infant and Early Childhood Mental Health Consultation (IECMHC) research.

Infant and Early Childhood Mental Health Consultation (IECMHC) is a preventative, capacity-building intervention in which mental health professionals partner with early childhood professionals to indirectly improve the environments and relationships that young children experience. Prior research has demonstrated that IECMHC is associated with positive outcomes for children, teachers, and classrooms. Over the past decade, IECMHC implementation and research have expanded, warranting an updated review. The current paper provides an update of the IECMHC evidence base. Included studies (n = 16) were systematically gathered, screened, and coded for context, intervention characteristics, methods and measures, outcomes across ecological levels, and alignment with the IDEAS Impact Framework's guiding questions. Our analysis replicates prior reviews, describing the positive impact of IECMHC on outcomes such as child externalizing behavior, teacher self-efficacy, and teacher-child interactions. Beyond updating prior reviews, this analysis describes emerging, nuanced findings regarding the mechanisms of change and the differential impact of IECMHC. We augment our review with descriptions of evaluations that did not meet our inclusion criteria (e.g., IECMHC in the home visiting context, unpublished evaluation reports) to provide context for our findings. Finally, we provide policy and practice implications and articulate an agenda for future research.

[Opportunities and challenges of active patient involvement in clinical research in Germany - from the perspectives of a patient representative, a clinical researcher and two staff members of research funding management]. / Chancen und Herausforderungen der aktiven Beteiligung von Patient*innen an klinischer Forschung in Deutschland ­ Eine Betrachtung aus den Perspektiven eines Patient*innenvertreters, einer klinischen Forscherin und zweier Mitarbeiterinnen des Forschungsfördermanagements.

BACKGROUND: Active involvement of patients in clinical research is increasingly demanded in Germany. It has great potential to increase the quality and relevance of research and to contribute to patient empowerment. However, patients, researchers and research funders have experienced that the implementation of patient involvement is accompanied by cultural, practical and personal challenges. The aim of this article is to discuss the opportunities and challenges of patient involvement in Germany from the perspective of the stakeholders involved. METHOD: A patient representative, a clinical researcher and two staff members from research funding management were invited to discuss the opportunities and challenges of patient involvement. Their perspectives were recorded in two written open survey rounds. The answers were analyzed using qualitative content analysis. RESULT: In the opinion of the stakeholders involved, the increasing involvement of patients in clinical research is an opportunity to promote the practical relevance of research and the implementation of studies, to increase their acceptance by the target group and to improve the uptake of research results in practice. However, the implementation of patient involvement was also perceived as challenging. They described problems with regard to the acquisition and selection of patients, the training of the patients and the specifications and support structures for the implementation of patient involvement. DISCUSSION: While patient involvement in clinical research offers great potential, the development of appropriate structures and framework conditions for its implementation is still virtually unestablished in Germany. This needs to include, among other things, creating a broader awareness of the potential of patient involvement, developing training programs for patients and researchers, providing sufficient, mainly project-independent resources and ensuring regular evaluations.

A touchstone of Finnish curriculum thought and core curriculum for basic education: Reviewing the current situation and imagining the future.

Pandemics, like other global challenges, are unquestionably curricular issues. They are curriculum issues not only because of the disrupting consequences of Covid-19 and the economic and social crisis alike but also because people have, through their own activities, contributed to global catastrophes and perpetuated injustices. This article attempts to answer the question: How does Finnish curricular thought, including the role of the teacher and the core curriculum for basic education, respond to the various global crises? While reviewing the current situation, the article also imagines a post-Covid-19 curriculum. Reactivating what is still powerful in Bildung/Didaktik and emphasizing the importance of education's ethical dimension and the teacher's role as a curriculum theorist offer the means for dealing with the theme. In addition, understanding the structure of the National Core Curriculum document, the political dimension of the Finnish curriculum's design process, and the educative possibilities in subjects and multidisciplinary modules, the teacher is capable of creating opportunities for educational experiences that are (ethically) significant for students, proactively and in terms of crises.

Death and Dying Between Anthroposophy and Biomedicine / A morte e o morrer entre a antroposofia e a biomedicina

Abstract Death and dying constantly provoke debates regarding boundaries, rules and disputes for the legitimacy of different meanings regarding processes of finalizing life. This article places special emphasis on conflicts between the therapeutic system of anthroposophy and biomedicine in Brazil. The reflections contained in the text are based on ethnographic research, carried out in multiple locations between 2012 and 2015, investigating concepts of cure in anthroposophy in three different communities: two in Brazil, and one in Switzerland. Over the course of this journey, our experience as ethnographers led us to reflect on death and dying among the Widows of Demétria, one of the anthroposophical communities in which we conducted our research. Demétria is a rural neighborhood located in the city of Botucatu, in the interior of São Paulo state. The community was first organized during the 1970s, and it consists mostly of women - both Europeans and Brazilians - who live together, sharing a lifestyle that reimagines the ethos of death as a part of the aesthetic project of Bildung, which differs significantly from the conception of the death process in biomedicine.

Resumo A morte e o morrer suscitam continuamente o debate sobre as fronteiras, as regras e a disputa pela legitimidade dos distintos significados que envolvem os processos de finalização da vida. Este artigo busca abordar, especialmente, os conflitos que ocorrem entre o sistema terapêutico antroposófico e a biomedicina no Brasil. As reflexões se dão com base na etnografia multissituada realizada entre os anos 2012 e 2016 que se debruçou sobre a concepção de cura na antroposofia em três comunidades, duas no Brasil e uma na Suíça. Nesse percurso, fomos levados pela experiência etnográfica às elaborações sobre a morte e o morrer das viúvas da Demétria, uma das comunidades antroposóficas investigadas. Demétria é um bairro rural no interior do estado de São Paulo, na cidade de Botucatu, composto na sua maioria por mulheres, europeias e brasileiras, que convivem e partilham de um estilo de vida que reelabora o ethos da morte como um projeto estético de Bildung que difere da concepção do processo de morte na biomedicina.

[Various socioeconomic factors as predictors of internalizing and externalizing disorders in children and adolescents]. / Verschiedene sozioökonomische Faktoren als Prädiktoren für internalisierende und externalisierende Störungsbilder des Kindes- und Jugendalters.

Various socioeconomic factors as predictors of internalizing and externalizing disorders in children and adolescents Abstract. Objective: Socioeconomic status (SES) is an important risk factor for psychiatric disorders in children and adolescents. Various SES parameters are included in research efforts. This paper investigates the predictive value of different individual SES measures and the combination thereof regarding internalizing and externalizing disorders in children and adolescents. Method: We used data from N = 381 8- to 14-year-olds who had been recruited in child and adolescent psychiatric facilities and in the general population. Based on a diagnostic parent interview (K-SADS-PL), we divided the sample into internalizing and externalizing groups and a healthy control group. The SES data of both parents were collected. Education, occupational status, and income were integrated as single factors as well as combined factor to form the SES index. Additionally, we assessed unemployment. Results: Using multivariate analyses, we controlled for age and sex. All single factors turned out to be significant risk factors for internalizing and externalizing disorders. Occupational status was the most important single factor. The explained variance for the SES index was as high as for occupational status. Unemployment was not predictive when examined simultaneously with the SES index. Conclusion: Future studies should integrate the SES as risk factor and use the SES index or occupational status as single factor. The integration of unemployment is not necessarily needed.

DOUBLINGS BETWEEN BEWILDERMENT AND ENLIGHTENMENT: READING FREUD WITH HEINE ON THE TROUBLED IDENTITY OF HIRSCH-HYACINTH.

The present paper examines Freud's collapse of Heine's poignantly observed multi-cultural narratives in discerning the joke's mechanism of doubling as it progresses from initial bewilderment to momentary enlightenment. In so doing, Freud opens the door to examination of the complex Jewish cultural identity he and Heine share, as represented by the fictional character, "Hirsch-Hyacinth". Hirsch-Hyacinth is a caricature of the "marginal man" in his doubled orientation between and within conflicting aspects of self, a condition reflecting oscillation between idealization, derogation, awareness and dissociation, conditioned by internalization of societal prejudice and traumatization. Freud's tightly focused demonstration of psychoanalytic method upon the Heine joke sample proceeds toward two forms of revelation. The first illustrates the universal applicability of psychoanalytic method. The second signals the individual's ongoing reckoning with the particularities of subjective psychological experience as embedded in identification with large group assumptions of social reality.

Early childhood education and crime.

This article presents new evidence on the crime-reducing impacts of a high-quality, intensive early childhood program with long-term follow-up, evaluated by a randomized controlled trial. Proportionately, more women than men decrease their criminal activity after participating in the program. This gender difference arises because of the worse home environments for girls, with corresponding greater scope for improvement by the program. For both genders, treatment effects are larger for the least-advantaged children, as measured by their mother's education at baseline. The dollar value of the social cost of criminal activity averted is higher for men because they commit more costly violent crimes.

Increased Cancer Prevalence in Peripartum Cardiomyopathy.

OBJECTIVES: This study was designed to analyze the prevalence and potential genetic basis of cancer and heart failure in peripartum cardiomyopathy (PPCM). BACKGROUND: PPCM manifests as heart failure late in pregnancy or postpartum in women without previous heart disease. METHODS: Clinical history and cancer prevalence were evaluated in a cohort of 236 PPCM patients from Germany and Sweden. Exome sequencing assessed variants in 133 genes associated with cancer predisposition syndromes (CPS) and in 115 genes associated with dilated/hypertrophic cardiomyopathy (DCM/HCM) in 14 PPCM patients with a history of cancer, and in 6 PPCM patients without a history of cancer. RESULTS: The prevalence of cancer was 16-fold higher (8.9%, 21 of 236 patients) in PPCM patients compared to age-matched women (German cancer registry, Robert-Koch-Institute: 0.59%; p < 0.001). Cancer before PPCM occurred in 12 of 21 patients of whom 11 obtained cardiotoxic cancer therapies. Of those, 17% fully recovered cardiac function by 7 ± 2 months of follow-up compared to 55% of PPCM patients without cancer (p = 0.015). Cancer occurred after PPCM in 10 of 21 patients; 80% had left ventricular ejection fraction of ≥50% after cancer therapy. Whole-exome sequencing in 14 PPCM patients with cancer revealed that 43% (6 of 14 patients) carried likely pathogenic (Class IV) or pathogenic (Class V) gene variants associated with DCM/HCM in CPT2, DSP, MYH7, TTN, and/or with CPS in ATM, ERCC5, NBN, RECQL4, and SLX4. All CPS variants affected DNA damage response genes. CONCLUSIONS: Cardiotoxic cancer therapy before PPCM is associated with delayed full recovery. The high cancer prevalence in PPCM is linked to likely pathogenic/pathogenic gene variants associated with DCM/HCM and/or CPS/DNA damage response-related cancer risk. This may warrant genetic testing and screening for heart failure in pregnant women with a cancer history and screening for cancer in PPCM patients.

[Psychosocial Risk Factors and Negative Emotionality in Early Childhood: Mothers' Perspective]. / Psychosoziale Belastungsfaktoren und negative Emotionalität in der frühen Kindheit: die Perspektive der Mütter.

Psychosocial Risk Factors and Negative Emotionality in Early Childhood: Mothers' Perspective Based on a nationally representative study of parents, this study examines risk factors for mothers' perceptions of young children's negative emotionality, focusing the role of mothers' educational resources and related psychosocial risk factors. Participants were 7,311 mothers with children below age 48 month. Mothers' perception of child emotionality was assessed through two factors, irritability and defiance. Findings from regression analyses showed a stable negative relationship between maternal education and perceived defiance of the child. Although this effect was partly mediated by further psychosocial risk factors, lower education was consistently related with higher perceived defiance. Perceived irritability, in contrast, was not affected by mother's education. Further analyses showed age-specific effects (stronger effects for younger children) as well as a predictive value of mothers' perceptions regarding the occurrence of child abuse or neglect. The results are discussed in the context of early prevention programs in Germany, emphasizing the relevance of identifying risk-groups and offering early and multidimensional prevention.

[Midwives and Nurses in Early Childhood Intervention: The Benefit of Additional Qualification]. / Gesundheitsfachkräfte in den Frühen Hilfen: Wie nützlich ist die Zusatzqualifikation? Eine quantitative Studie.

Midwives and Nurses in Early Childhood Intervention: The Benefit of Additional Qualification Abstract. BACKGROUND: Early childhood interventions are locally and regionally organized support services for families from pregnancy until the end of the third year of life. The interventions promote diverse measures to enhance parental skills in order to improve developmental and living circumstances. Midwives and nurses with additional qualification support burdened families in early childhood intervention. METHOD: Within a retrospective survey (standardized interviews, CAPI) mothers' (N = 298) perspective of the benefit of the home visiting support is assessed. Data from two groups were compared: (1) mothers in the care of a midwife or nurse with additional qualification (GruppeGFK + Quali) and (2) mothers cared for by a midwife or nurse without additional qualification (GruppeGFK). RESULTS: (1) Families with weighted levels of psychosocial burdens reported an enhanced need for help. (2) Midwives and nurses with additional qualification support more frequently families with high levels of psychosocial burdens. (3) Mothers with care of midwives and nurses with additional qualification reported this support as more useful in relation to every day demands than mothers with regular care after birth (questionnaire for evaluation of the received support: GruppeGFK + Quali: mean = 2.57; GruppeGFK : mean = 1.97; t (121) = 2.799, p = .003). CONCLUSION: The study complements results of national and international studies showing that families with high levels of psychosocial burdens accept home visiting support. Furthermore, this support seems to be useful. An increase of the offer and the additional qualification is recommended for improving the developmental and living conditions of families with psychosocial burdens.