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Corona Health
(2021)
Physical and mental well-being during the COVID-19 pandemic is typically assessed via surveys, which might make it difficult to conduct longitudinal studies and might lead to data suffering from recall bias. Ecological momentary assessment (EMA) driven smartphone apps can help alleviate such issues, allowing for in situ recordings. Implementing such an app is not trivial, necessitates strict regulatory and legal requirements, and requires short development cycles to appropriately react to abrupt changes in the pandemic. Based on an existing app framework, we developed Corona Health, an app that serves as a platform for deploying questionnaire-based studies in combination with recordings of mobile sensors. In this paper, we present the technical details of Corona Health and provide first insights into the collected data. Through collaborative efforts from experts from public health, medicine, psychology, and computer science, we released Corona Health publicly on Google Play and the Apple App Store (in July 2020) in eight languages and attracted 7290 installations so far. Currently, five studies related to physical and mental well-being are deployed and 17,241 questionnaires have been filled out. Corona Health proves to be a viable tool for conducting research related to the COVID-19 pandemic and can serve as a blueprint for future EMA-based studies. The data we collected will substantially improve our knowledge on mental and physical health states, traits and trajectories as well as its risk and protective factors over the course of the COVID-19 pandemic and its diverse prevention measures.
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Studies using transcranial magnetic stimulation with simultaneous electroencephalography (TMS-EEG) revealed an imbalance between cortical excitation and inhibition (E/I) in the dorsolateral prefrontal cortex (DLPFC) in depression. As adolescence is a developmental period with an increase in depression prevalence and profound neural changes, it is crucial to study the relationship between depression and cortical excitability in adolescence. We aimed to investigate the cortical excitability of the DLPFC in adolescents with depression and a dependency of the TMS-evoked potential N100 on the depression severity. 36 clinical patients (12–18 years of age; 21 females) with a major depressive episode were assessed twice in a longitudinal design: shortly after admission (T0) and after six weeks of intervention (T1). GABA-B-mediated cortical inhibition in the left and right DLPFC, as assessed by the N100, was recorded with EEG. Significantly higher depression scores were reported at T0 compared to T1 (p < 0.001). N100 amplitudes were significantly increased (i.e., more negative) at T0 compared to T1 (p = 0.03). No significant hemispheric difference was found in the N100 component. The correlation between the difference in depression severity and the difference in N100 amplitudes (T0–T1) obtained during stimulation of the left DLPFC did not remain significant after correction for testing in both hemispheres. Higher N100 amplitudes during a state of greater depression severity are suggestive of an E/I imbalance in the DLPFC in adolescents with an acute depressive episode. The N100 reduction potentially reflects a normalization of DLPFC over inhibition in association with decreased depressive symptomatology, indicating severity dependency.
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This work strives to develop a typological classification of the use of conscious and unconscious defense and coping mechanisms based on methodically and structurally collected data from a qualitative survey of 43 former soldiers in Germany. Seven coping and defense types were identified: the Fighter, the Comrade, the Corpsman, the Strategist, the Partisan, the Self-Protector and the Infantryman. The types identified differed with regard to the accumulation, combination, and use of their conscious and unconscious defense and coping mechanisms in the superordinate areas of behaviour, relationships, emotions, reflexivity and time focus. The typological classification could offer psychotherapeutic interventions tailored to individuals and their defense and coping mechanisms, which could lead to improved therapy use and compliance.
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Background: The measures taken to contain the COVID-19 pandemic have led to significant changes in people’s daily lives. This paper examines changes in substance use during the first lockdown (March–July 2020) and investigates mental health burdens in substance users with increased consumption of alcohol, nicotine or tetrahydrocannabinol (THC) in Germany compared to users with unchanged or reduced consumption. Method: In a cross-sectional online survey, 2369 people were asked about their mental health and their substance use during the first lockdown in Germany. Results: Of the participants, 28.5% increased their alcohol use, 28.8% their use of tobacco products, and 20.6% their use of THC-containing products during the pandemic. The groups with increased alcohol, nicotine, and THC use during the first lockdown reported more depressive symptoms and anxiety. Individuals who reported increased consumption of alcohol or nicotine were also more likely to experience loneliness and have suicidal thoughts and were more often stressed due to social distancing. Conclusion: Alcohol, nicotine and THC increased in a subgroup of consumers who reported to have more mental health problems compared to individuals who did not increase their consumption. This increased substance use could, therefore, be understood as a dysfunctional strategy to cope with negative emotions during the lockdown.
Background
The ongoing Covid-19 pandemic not only threatens physical health, but also affects the mental health of people. Yet, health consequences of the pandemic do not affect all members of society equally. We therefore assessed the mental health burden of individuals who are at increased risk of severe illness from Covid-19 compared to individuals who are at low risk of severe illness during the first lockdown (March, 2020) in Germany. Furthermore, we investigated variables mediating the effect of being an individual at increased risk of serve illness on depression.
Methods
Adult German residents (n = 2.369) provided responses to a cross-sectional online survey about risk factors for of severe illness from Covid-19 and various aspects of mental health during the first lockdown in Germany. For data collection, standardized and validated self-report measures were used and for data analysis Mann-Whitney U-tests as well as regression and mediation analyses were performed.
Results
The results clearly show that the mental health burden is higher among individuals at increased risk of severe illness from Covid-19 compared to individuals at low risk of severe illness from Covid-19. Moreover, our findings indicate that the association between Covid-19 risk status and depressive symptoms is mediated by concerns about mental health, anxiety and loneliness in a causal effect chain.
Conclusions
Individuals at increased risk of severe illness from Covid-19 have an increased need for psychosocial support during times of lockdown. Future public health policies should pay special attention to these individuals and support them by targeted offers. More research, however, is needed on possible long-term consequences of social distancing on mental health.
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Objective: The current study explored the role of maternal depressive symptoms in the intergenerational transmission of childhood maltreatment and developmental psychopathology. Based on the sensitive window hypothesis, the effects of earlier versus later maternal depression symptoms on child development were analysed.
Method: Ninety-nine mother-child dyads, 65% of which had high-risk teenage mothers, participated in a longitudinal study with three assessments in the first 18 months of the child’s life (T1–T3) and a 4th reassessment (T4) at the child’s preschool age. Using serial mediation analyses, we tested whether the relationship between the mother’s own maltreatment history (Childhood Experience of Care and Abuse Questionnaire) and the child’s psychopathological outcome at preschool age was mediated in a causal effect chain by maternal depression in the first 2 years of life, by current maternal depression (Beck Depression Inventory-II) and by current maternal child abuse potential (Child Abuse Potential Inventory). The children’s emotional problems and externalizing symptoms were assessed at preschool age by parent or teacher Strengths and Difficulties Questionnaire ratings.
Results: The results indicated that especially later maternal depression mediated the relationship between maternal childhood maltreatment and negative developmental outcomes in the next generation. The effects of maltreatment type on maternal depression were rather nonspecific. However, mental abuse affected existing risk factors more directly over time compared to physical and sexual abuse. Additionally, the impact of early life maltreatment and maternal depression on child psychopathology varied by rater. The pathway to externalizing symptoms was significant only in teacher ratings and for the pathway to emotional problems only in maternal ratings.
Conclusions: The present findings suggest that early maternal depression followed by ongoing maternal depression plays a mediating role in the intergenerational cycle of maltreatment. Therefore, in the future, interventions should be offered at an early stage, but also extend well beyond the first 2 years of a child’s life, addressing maternal depression and trauma.
This paper takes up ongoing discussions on the inequality of educational opportunities and formulates a conceptual model to link separate lines of research. Our particular focus is on combining motivational and structural approaches into a mediation model that explains differences in academic achievement. In the literature, four main mechanisms of social reproduction are discussed. Two main pathways refer to (1) parents’ expectations regarding their children’s academic success and (2) replicating cultural capital through intra‐familial cultural practices. (3) Parents’ perception of children’s abilities depends on social position and is influential for expectations of success. (4) For all three pathways, we expect effects on students’ motivational characteristics, which in turn influence academic achievement. We test our conceptual model by structural equation modelling using longitudinal data from primary school students in Germany. Empirical evidence is in line with the assumptions in the model. Cultural reproduction and expectations of success can be seen as the key components of the model. However, both chains of reproduction are related to each other by parents’ perception of child’s ability, and their effects are mediated by child’s motivational characteristics.
This paper takes up ongoing discussions on the inequality of educational opportunities and formulates a conceptual model to link separate lines of research. Our particular focus is on combining motivational and structural approaches into a mediation model that explains differences in academic achievement. In the literature, four main mechanisms of social reproduction are discussed. Two main pathways refer to (1) parents’ expectations regarding their children’s academic success and (2) replicating cultural capital through intra‐familial cultural practices. (3) Parents’ perception of children’s abilities depends on social position and is influential for expectations of success. (4) For all three pathways, we expect effects on students’ motivational characteristics, which in turn influence academic achievement. We test our conceptual model by structural equation modelling using longitudinal data from primary school students in Germany. Empirical evidence is in line with the assumptions in the model. Cultural reproduction and expectations of success can be seen as the key components of the model. However, both chains of reproduction are related to each other by parents’ perception of child’s ability, and their effects are mediated by child’s motivational characteristics.
Employees of the public employment services (PES) are street-level bureaucrats who shape activation policy on the ground. This paper examines how PES staff use enhanced discretion in an innovation project carried out by the German Federal Employment Agency. Applying a bottom-up perspective, we reconstruct PES employees’ logic of action and the dilemmas they face in improving counselling and placement services. According to our findings, placement staff use enhanced discretion to promote more individualised support and an adequate matching of jobseekers and employers. The use of discretion is framed by organisational norms and reward mechanisms and by the current labour market situation. Our analyses are based on qualitative interviews and group discussions with placement staff.
Employees of the public employment services (PES) are street-level bureaucrats who shape activation policy on the ground. This paper examines how PES staff use enhanced discretion in an innovation project carried out by the German Federal Employment Agency. Applying a bottom-up perspective, we reconstruct PES employees’ logic of action and the dilemmas they face in improving counselling and placement services. According to our findings, placement staff use enhanced discretion to promote more individualised support and an adequate matching of jobseekers and employers. The use of discretion is framed by organisational norms and reward mechanisms and by the current labour market situation. Our analyses are based on qualitative interviews and group discussions with placement staff.
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Introduction
1. Blumenberg's Critique of Anselm's Ontological Argument
1.1 The Ontological Argument as a Proof of the Existence of God
1.2 Two Incompatible "Definitions" of God
1.3 Other Objections Against Anselm's Ontological Argument
2. Blumenberg's Critique of Anselm's Theological Anthropology
2.1 Hans Blumenberg's Anselm: Humanity as Ersatz
2.2 The Historical Anselm: Humanity as an End in Itself
2.3 Rational Theology
Childhood adversity has been suggested to affect the vulnerability for developmental psychopathology, including both externalizing and internalizing symptoms. This study examines spontaneous attention biases for negative and positive emotional facial expressions as potential intermediate phenotypes. In detail, typically developing boys (6–13 years) underwent an eye-tracking paradigm displaying happy, angry, sad and fearful faces. An approach bias towards positive emotional facial expressions with increasing childhood adversity levels was found. In addition, an attention bias away from negative facial expressions was observed with increasing childhood adversity levels, especially for sad facial expressions. The results might be interpreted in terms of emotional regulation strategies in boys at risk for reactive aggression and depressive behaviour.
Background
Reduced birthweight is associated with adverse physical and mental health outcomes later in life. Children of adolescent mothers are at higher risk for reduced birthweight. The current study aimed to identify the key risk factors affecting birthweight in a well-characterized sample of adolescent mothers to inform preventive public health efforts.
Methods
Sixty-four adolescent mothers (≤ 21 years of age) provided detailed data on pregnancy, birth and psychosocial risk. Separate regression analyses with (1) birthweight and (2) low birthweight (LBW) as outcomes, and pregnancy complications, prenatal care, maternal age, substance abuse during pregnancy, socioeconomic risk, stressful life events and the child’s sex as independent variables were conducted. Exploratively, a receiver operating characteristic (ROC) analysis was performed to investigate the quality of the discriminatory power of the risk factors.
Results
The following variables explained variance in birthweight significantly: prenatal care attendance (p = .006), pregnancy complications (p = .006), and maternal substance abuse during pregnancy (p = .044). Prenatal care attendance (p = .023) and complications during pregnancy (p = .027) were identified as significant contributors to LBW. Substance abuse (p = .013), pregnancy complications (p = .022), and prenatal care attendance (p = .044) showed reasonable accuracy in predicting low birthweight in the ROC analysis.
Conclusions
Among high-risk adolescent mothers, both biological factors, such as pregnancy complications, and behavioural factors amenable to intervention, such as substance abuse and insufficient prenatal care, seem to contribute to reduced birthweight in their children, a predisposing factor for poorer health outcomes later in life. More tailored intervention programmes targeting the specific needs of this high-risk group are needed.
Der Beitrag berichtet von einer Studie unter 107 Englischstudierenden in Österreich, die in der ersten Phase des COVID-19 Lockdowns von März bis Juni 2020 durchgeführt wurde. Zur Untersuchung wurden vier Arten von Online Interaktion (learner-self, learner-interfact, learner-content und learner-support) herangezogen (Ally, 2011; Boling, Hough, Krinsky, Saleem, & Stevens, 2012; Zheng, Lin, & Kwon, 2020). In einem Mixed-methods Untersuchungsdesign wurden geschlossene Fragebogenitems mithilfe quantitativer Methoden auf Verteilung und Homogenität der verwendeten Skalen untersucht, während offene Fragestellungen mittels Inhaltsanalyse verarbeitet wurden. Diese parallel durchgeführten Analysen mündeten in eine Triangulation der Daten, welche die folgenden Ergebnisse brachte: Studierende erleben regelmäßige Unterstützung durch die Lehrenden, welche ihre Lehrmaterialien in Lernmaterialien umwandeln, als ihrem Lernerfolg zuträglich. Wichtig erscheint der Einbezug von Aufgaben, welche kognitiv anspruchsvolle Denkprozesse initiieren. Darüber hinaus wurden positive Lernerlebnisse in Bezug auf Unterstützung durch die Lehrpersonen beschrieben, jedoch ein Defizit in Bezug auf kooperative und kollaborative Lernformen unter Studierenden. Der Artikel endet mit Empfehlungen betreffend die Weiterentwicklung von Online Lehre und weiterführenden Forschungsideen.
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Effervescence in Q Studies
(2005)
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The aim of this study was to investigate the impact of different coping styles on situational coping in everyday life situations and gender differences. An ecological momentary assessment study with the mobile health app TrackYourStress was conducted with 113 participants. The coping styles Positive Thinking, Active Stress Coping, Social Support, Support in Faith, and Alcohol and Cigarette Consumption of the Stress and Coping Inventory were measured at baseline. Situational coping was assessed by the question “How well can you cope with your momentary stress level” over 4 weeks. Multilevel models were conducted to test the effects of the coping styles on situational coping. Additionally, gender differences were evaluated. Positive Thinking (p = 0.03) and Active Stress Coping (p = 0.04) had significant positive impacts on situational coping in the total sample. For women, Social Support had a significant positive effect on situational coping (p = 0.046). For men, Active Stress Coping had a significant positive effect on situational coping (p = 0.001). Women had higher scores on the SCI scale Social Support than men (p = 0.007). These results suggest that different coping styles could be more effective in daily life for women than for men. Taking this into account, interventions tailored to users’ coping styles might lead to better coping outcomes than generalized interventions.
Dieser Artikel erforscht, wie ein Forschender Lernansatz auf mehreren Ebenen als Prozess von partizipativer Aktionsforschung in der Schulentwicklung genutzt werden kann. Der Lernprozess findet im Klassenzimmer mit Schülerinnen und Schülern statt, aber auch bei den Lehrkräften selbst sowie, nicht zuletzt, beim unterstützenden außerschulischen Forschungsteam. Bei diesem Prozess sollen auf all diesen Ebenen gewisse Kriterien zur Entfaltung gebracht werden, die für forschende, partizipative Lernarrangements typisch sind. Das Ziel der Studie ist es, jene Parameter zu finden, die forschendes, partizipatives Lernen begünstigen, sowie spezifische Methoden zu identifizieren, die Lehrkräfte in ihren Unterrichtsstunden dafür tatsächlich einsetzen. Dies wird einerseits durch die quantitative Analyse von Daten untersucht, die die Lehrkräfte in ihren Klassen bei ihren Schülerinnen und Schülern sammelten, und andererseits durch die qualitative Analyse von Leitfadeninterviews des unterstützenden Forschungsteams mit acht Lehrkräften. Die Analysen der Daten zeigen, dass eine fundierte Kenntnis der Theorie zum Forschenden Lernen, die Unterstützung des Forschungsteams, die Teilnahme der Lehrkräfte an schulinternen Lerngemeinschaften und vor allem auch das Vertrauen, das Lehrkräfte in die Fähigkeiten ihrer Schülerinnen und Schüler haben, eine zentrale Rolle bei der Effektivität des forschenden, partizipativen Unterrichtsansatzes spielen. Es zeigt sich, dass professionelle Refexion und Analyse der Aktivitäten im Unterricht schließlich neue, vertiefende Zyklen von Aktionsforschung auslösen, den Prozess der partizipativen Aktionsforschung dadurch vorantreiben und letztlich in einen Schulentwicklungsprozess münden.
A longitudinal pilot study on stress-levels in the crowdsensing mHealth platform TrackYourStress
(2019)
Background: The mobile phone app, TrackYourStress (TYS), is a new crowdsensing mobile health platform for ecological momentary assessments of perceived stress levels.
Objective: In this pilot study, we aimed to investigate the time trend of stress levels while using TYS for the entire population being studied and whether the individuals’ perceived stress reactivity moderates stress level changes while using TYS.
Methods: Using TYS, stress levels were measured repeatedly with the 4-item version of the Perceived Stress Scale (PSS-4), and perceived stress reactivity was measured once with the Perceived Stress Reactivity Scale (PSRS). A total of 78 nonclinical participants, who provided 1 PSRS assessment and at least 4 repeated PSS-4 measurements, were included in this pilot study. Linear multilevel models were used to analyze the time trend of stress levels and interactions with perceived stress reactivity.
Results: Across the whole sample, stress levels did not change while using TYS (P=.83). Except for one subscale of the PSRS, interindividual differences in perceived stress reactivity did not influence the trajectories of stress levels. However, participants with higher scores on the PSRS subscale reactivity to failure showed a stronger increase of stress levels while using TYS than participants with lower scores (P=.04).
Conclusions: TYS tracks the stress levels in daily life, and most of the results showed that stress levels do not change while using TYS. Controlled trials are necessary to evaluate whether it is specifically TYS or any other influence that worsens the stress levels of participants with higher reactivity to failure.
The Münster dissertation was accepted by Bruno Schüller (1925-2007) in 1984. The author, Lucius Iwejuru Ugorji, was appointed Archbishop of Owerri in 2022. He is the president of the Nigerian Bishops' Conference. He published several works on moral theology since receiving his doctorate. Ugorji's doctoral thesis has received extraordinarily positive reviews from international experts. Nevertheless, a close reading reveals several problems concerning scientific ethics. This essay uses seven tables to document Ugorji's unacknowledged use of texts by other authors. Several passages are identical to popular reference works. Ugorji's book also contains numerous unacknowledged passages that can be found verbatim in an American dissertation published in 1935. In view of these facts, the research value of the Münster dissertation is open to discussion, as are the academic qualifications of its author.
The Work of Fr. Raymond Flanagan, OCSO, Author of Historical Novels, Devotional Books, and Pamphlets
(2021)
Father Mary Raymond Flanagan (1903–1990), a monk of Gethsemani Abbey, was the widely- read author of dozens of books and pamphlets particularly popular in the 1940s, 1950s, and early 1960s. Numbering in the dozens, his publications were characterized by a hard-hitting, vigorous Catholic piety that accentuated American family values, fidelity to Catholic traditions, the beauty of religious vocations, anti-Communism, and the athletic asceticism he associated with the first Cistercians. His works lost their appeal to a wide audience during the cultural shift of the late 1960s and later, but several of his writings have been reissued in recent years.
This essay includes a short biography and a bibliography of Flanagan's books and pamphlets.
Although he was a major figure in the early development of the Cistercian movement, liturgical veneration for St. Stephen Harding (†1134) seldom took place in the Middle Ages. Legends rarely discuss him. But in the Early Modern Period, he was "discovered" and credited more and more with being the sole author of the Carta Caritatis, although there were certainly other authors. This article shows how Stephen's personality was assessed differently from one era to the next.
Background: An ever-increasing number of patients seek health information via the internet. However, there is an overabundance of differing, often low-quality information available, while a lack of health literacy makes it difficult for patients to understand and assess the quality and trustworthiness of the information at hand. The web portal tala-med was thus conceived as an evidence-based, up-to-date, and trustworthy information resource for lower back pain (LBP), which could be used by primary care physicians (PCPs) and patients during and following consultations for LBP. The current evidence demonstrates that patients with LBP could benefit from web portals. However, the use of such portals by patients remains low, thus limiting their effectiveness. Therefore, it is important to explore the factors that promote or hinder the use of web portals and investigate how patients perceive their usability and utility.
Objective: In this study, we investigated the acceptance, usability, and utility of the web portal tala-med from the patient perspective.
Methods: This qualitative study was based on telephone interviews with patients who had access to the web portal tala-med from their PCP. We used a semistructured interview guide that consisted of questions about the consultation in which patients were introduced to tala-med, in addition to questions regarding patient perceptions, experiences, and utilization of tala-med. The interviews were recorded, transcribed, and analyzed through framework analysis.
Results: A total of 32 half-hour interviews were conducted with 16 female and 16 male patients with LBP. We identified 5 themes of interest: the use of tala-med by PCPs during the consultation, the use of tala-med by patients, its usability, added values derived from its use, and the resultant effects of using tala-med. PCPs used tala-med as an additional information resource for their patients and recommended the exercises. The patients appreciated these exercises and were willing to use tala-med at home. We also identified factors that promoted or hindered the use of tala-med by patients. Most patients rated tala-med positively and considered it a clear, comprehensible, trustworthy, and practical resource. In particular, the trustworthiness of tala-med was seen as an advantage over other information resources. The possibilities offered by tala-med to recap and reflect on the contents of consultations in a time-flexible and independent manner was perceived as an added value to the PCP consultation.
Conclusions: Tala-med was well accepted by patients and appeared to be well suited to being used as an add-on to PCP consultations. Patient perception also supports its usability and utility. Tala-med may therefore enrich consultations and assist patients who would otherwise be unable to find good-quality web-based health information on LBP. In addition, our findings support the future development of digital health platforms and their successful use as a supplement to PCP consultations.