Background In the early phase of the COVID-19 pandemic, many restrictions hit people in ways never seen before. Mental wellbeing was affected and burden was high, especially for high-risk groups such as parents. However, to our knowledge no research has yet examined whether being a parent was not only a risk for psychological burden but also a way to cope with the COVID-19 pandemic. Methods An online survey was used to collect data from 1,121 participants from April to June 2020. In addition to demographic variables, risk factors (financial burden, problems complying with COVID-19 restrictions, and pre-treatment due to mental health problems) and protective factors (emotion regulation, humor, and crisis self-efficacy) were collected. The dataset was divided into three groups: parents whose children lived at home ( n = 395), parents whose children did not (no longer) live at home ( n = 165), and people who were not parents ( n = 561). Results A linear mixed effect model showed that parents had no higher burden than non-parents, and even less when children did not live at home. Expected risk factors were generally less important, and there were no differences between parents and non-parents. In contrast, parents had advantages in protective factors. Conclusion In the early phase of the COVID-19 pandemic, it was shown that parents (with and without their children at home) were not necessarily at risk due to additional burden, but also had prospects of coping better with the situation than people without children.
The achievement motive refers to a preference for mastering challenges and competing with some standard of excellence. Along with affiliation and power motives, the achievement motive is typically considered to occur on the level of implicit versus explicit representations. Specifically, whereas implicit motives involve pictorial, emotional goal representations and facilitate corresponding action effortlessly, explicit motives involve propositional (“verbalized”) goal representations but need some effort to translate into action (McClelland et al., 1989). We used functional magnetic resonance imaging (fMRI) to investigate whether and to which degree the implicit and explicit achievement motives differentially predict blood-oxygen-level-dependent (BOLD) responses to pictures of individuals engaging in challenging activities. Whereas the implicit AM predicted activity in areas associated with emotion (orbitofrontal cortex) and visual processing (right dorsolateral prefrontal cortex, premotor and occipital cortices), the explicit AM predicted activity in areas associated with cognitive self-control or verbal goal processing (dorsal anterior cingulate cortex, left dorsolateral prefrontal cortex). The findings support the commonly assumed distinction between implicit and explicit motives with neuronal data. They also suggest that explicit motives require cognitive self-control to overcome potential lacks of motivation.
Objectives The phenomenon of doping is rarely researched in Paralympic sport, especially from the coach perspective. This study responds directly to this gap in research by exploring coaches' doping-related perceptions, knowledge, and opinions of the current anti-doping system in order to inform future interventions specific to disabled elite sport contexts. Method Eleven coaches from Germany (n = 6) and the UK (n = 5) working across physiological (n = 7) and skill-based (n = 4) sport disciplines at an elite level (Paralympic, n = 10 and World Championship, n = 1) took part in semi-structured interviews. Data were analysed using abductive reflexive thematic analysis (Braun & Clarke, 2019a). Findings Four themes were developed to capture the coaches’ perspectives. The first represents coaches’ perception that doping is an issue in Paralympic sport. The second theme shows that risk factors to dope are typically multiple and intertwined, stemming especially from financial incentives and pressure to win. Theme three captures coaches' opinion of differences in testing and education across countries due to budget, resource, or infrastructure issues. Finally, data showed that coaches prefer to refer responsibility for doping prevention to their national anti-doping organisation, rather than taking on personal responsibility for anti-doping efforts. Conclusions According to the interviewed coaches, doping has the potential to be a big issue in disabled elite sport. The main risk factors of money and pressure to win (earn prize money or funding/sponsorship) are knitted together and can be additionally impacted (negatively) by a nation’s sporting system. These factors should be addressed by thinking both on an individual level (e.g., support dual careers) and a structural/policy level (e.g., aim to have minimum standards to level the global inconsistent anti-doping systems, including anti-doping education/testing). Furthermore, coaches should take their role and be proactively made aware of their responsibility in doping prevention to coach clean and protect their athletes properly.
Children often perform worse than adults on tasks that require focused attention. While this is commonly regarded as a sign of incomplete cognitive development, a broader attentional focus could also endow children with the ability to find novel solutions to a given task. To test this idea, we investigated children’s ability to discover and use novel aspects of the environment that allowed them to improve their decision-making strategy. Participants were given a simple choice task in which the possibility of strategy improvement was neither mentioned by instructions nor encouraged by explicit error feedback. Among 47 children (8—10 years of age) who were instructed to perform the choice task across two experiments, 27.5% showed a full strategy change. This closely matched the proportion of adults who had the same insight (28.2% of n = 39). The amount of erroneous choices, working memory capacity and inhibitory control, in contrast, indicated substantial disadvantages of children in task execution and cognitive control. A task difficulty manipulation did not affect the results. The stark contrast between age-differences in different aspects of cognitive performance might offer a unique opportunity for educators in fostering learning in children.
A simple and accurate method of determining foot strike angle (FSA) during running can simplify data collections and validations of wearable sensors. The purpose of this study was to determine the validity of two simplified methods for estimating FSA and foot angle (throughout the ground contact) from three-dimensional kinematics. Markers were placed on the heel and head of the second metatarsal (HEEL-TOE) or on the lateral side of the head of the fifth metatarsal (HEEL-MET5). When compared to the reference foot segment, the HEEL-TOE method performed similarly with a minimal mean difference (0.28° [0.19°,0.36°], p < 0.001), a high Pearson's r (r = 0.994; p < 0.001), and low bias (-0.20°±1.05°). Alternatively, the HEEL-MET5 method underestimated FSA: mean difference = 4.28° [4.07°,4.91°] (p < 0.001), Pearson's r = 0.968 (p < 0.001), and bias = -4.58°±2.61°. Throughout the contact phase, significant SPM cluster regions were identified, indicating that the HEEL-MET5 method underestimated the angle of the foot for all foot strike patterns in the first 23-34% of the stance (p < 0.025). This study supports the idea that the HEEL-TOE method can be used as a simplified method for determining FSA from 3D kinematics. Researchers should proceed with caution when employing the HEEL-MET5 method, as it is likely underestimating FSA due to foot inversion in the early stance phase.
The paper deals with the application of the non-destructive Vibration-Correlation Technique (VCT) to estimate the buckling load of thin-walled, unstiffened CFRP truncated cones. After validating the structural response, detailed attention was devoted to assessing the predictive capabilities of the VCT for two conical structures at different load levels. In addition, parametric studies were carried out considering changes in the nominal bottom radius, the semi-vertex angle and the length of the cone. Two FE models were defined in the numerical analyses that accurately and roughly model the boundary conditions during compression. The measured initial mid-surface and thickness imperfections were taken into account in the numerical models. The results of the conducted study showed a slightly higher sensitivity of the VCT to ply topology design and to the scheme of initial imperfections it generates than it can be seen only on the basis of the structural response. Parametric studies revealed considerable conservativeness of the predictions provided by the use of VCT (99.93% of considered cases). The influence of thickness imperfection was found to be insignificant. In general, an increase in the maximum load level under consideration correlated with an increase in the predictive capabilities of the VCT and a decrease in divergence from the nonlinear buckling load.
Introduction: Outreach interprofessional mental health services for nursing homes can increase the quality of care for residents experiencing mental health issues but research on how nurses in nursing homes experience such a service is lacking worldwide. Aim: To describe how nurses experience the involvement of an outreach interprofessional mental health team in the care for older people experiencing mental health issues in nursing homes and to identify barriers to and facilitators of interprofessional collaboration. Method: Qualitative descriptive analysis based on 13 semi-structured interviews. Framework analysis and complex adaptive systems theory were applied. Results: One core theme with two main categories: Nurses experienced relief from burden through inclusive support provided by the mental health team. Main categories were feeling accompanied and confident as a nurse and partnership-based collaboration. Discussion: Results showed for the first time that nurses felt supported by the mental health team and were encouraged to find new ways of coping with challenging situations. Implications for practice: To empower nurses, mental health teams should take into account nurses' perceptions in the treatment process, value and respect their role as nurses, transfer knowledge in both formal and informal settings, establish a steady and reliable contact person, and define processes and responsibilities.
The COVID-19 pandemic has severe consequences for physical as well as mental well-being. In times of restricted social contact, online self-help programs offer a low-threshold first aid to cope with the psychological burden. This current study evaluates the online self-help protocol “COVID Feel Good” in a German sample. The multicentric study was designed as a single cohort with a waiting list control condition. The convenience sample consisted of 38 German individuals who experienced at least two months of restrictions during the COVID-19 pandemic. The 7-day self-help protocol included the VR video “Secret Garden” as well as a social or cognitive exercise each day. General distress, depression, anxiety, stress, and hopelessness were assessed as primary outcomes. Social connectedness and fear of coronavirus were measured as secondary outcomes. Results showed a significant decrease in all primary outcomes except for hopelessness. Furthermore, the results indicated a significant improvement in social connectedness. Treatment effects on general distress, depression, stress, and anxiety persisted for two weeks after participation. The present study indicates that VR-based self-help protocols can mitigate the psychological burden associated with the pandemic, supporting recent findings.
Several psychological approaches concern explaining the dynamic psychological processes and mechanisms that render personality a coherent whole, a “well-sounding concert.” Building upon personality systems interactions (PSI) theory, which explains personality functioning on the basis of interactions among cognitive and affective-motivational personality systems, we demonstrate how diverse perspectives on personality coherence may functionally be integrated. To do so, we describe interactions among four cognitive personality systems considered to underlie and optimize two meta principles of personality functioning—self-growth (in terms of the integration of adverse experiences) and action control (in terms of goal pursuit). These meta principles establish different subtypes of personality coherence differentially focused by psychological perspectives. We highlight the interdisciplinary relevance and practical application of the present approach and conclude with implications for future research.
In stressful situations such as the COVID-19-pandemic, unpleasant emotions are expected to increase while pleasant emotions will likely decrease. Little is known about the role cognitive appraisals, information management, and upregulating pleasant emotions can play to support emotion regulation in a pandemic. In an online survey (N = 1682), we investigated predictors of changes in pleasant and unpleasant emotions in a German sample (aged 18–88 years) shortly after the first restrictions were imposed. Crisis self-efficacy and felt restriction were predictors of changes in unpleasant emotions and joy alike. The application of emotion up-regulation strategies was weakly associated with changes in joy. Among the different upregulation strategies, only “savouring the moment” predicted changes in joy. Our study informs future research perspectives assessing the role of upregulating pleasant emotions under challenging circumstances.
Anti-doping rule violations (ADRVs) can lead to sports-related and legal sanctions, thus, being knowledgeable is important. Research into this knowledge and how athletes and their support personnel (ASP) perceive the control mechanisms and the appropriateness of (legal) sanctions is still scarce. This explorative study aimed to examine the knowledge and perception of existing (legal) sanctions in Austria, by distributing a questionnaire to Austrian athletes and ASP covering the topics of knowledge related to legal and sports-related consequences associated with a specific ADRV presented in a case study, their trust and satisfaction with specific agencies (based on the European Social Survey (ESS)) and perceived efficiency and effectiveness of the doping control system. Data were analyzed descriptively. All respondents (N = 59) agreed on a ban from sport to be appropriate. Knowledge about legal consequences and the trust in the judiciary and the sport governing bodies was moderate (6.82 out of 10). Perceived appropriate consequences were on average higher than the likely sanctions to be faced. Future prevention should include trust building measures in the institutions and the control system, improvement in terms of access to law and education for the target group and critical reflection on the existence of social norms. Furthermore, the implementation of risk management aspects should be part of future approaches
Zusammenfassung Hintergrund und Ziel der Arbeit In dieser Studie wurden die Studierenden der Generationen Y und Z des Studiengangs Humanmedizin an der Georg-August-Universität Göttingen hinsichtlich ihrer Präferenzen am Arbeitsplatz und der Wahl eines Arbeitgebers befragt. Material und Methoden Die Befragung wurde 2016 über einen Onlinefragebogen über EvaSys an 2637 Studierende der Universitätsmedizin Göttingen versandt und wurde von 742 beantwortet (Rücklaufquote: 28,1 %). Ergebnisse Die Befragten fühlten sich unabhängig von der Generationszugehörigkeit mit 89,5 % überwiegend „gut“ und „nicht so gut“ auf den Übergang von der Universität ins Berufsleben vorbereitet. Die häufigsten Ängste waren viel Arbeit/wenig Freizeit, Zeitmangel bei der Patientenversorgung, mangelnde Erfahrung, Stress, fachliche Überforderung und schlechte Einarbeitung. Die Beschaffung von Informationen über zukünftige Arbeitgeber erfolgte in beiden Gruppen überwiegend mit knapp 60 % über die Homepage des Krankenhauses. Wichtig waren den Studierenden eine besonders gute Ausbildung und eine strukturierte Einarbeitung/ein strukturiertes Weiterbildungscurriculum. Diskussion Die Weiterentwicklung eines strukturierten Einarbeitungskonzepts für Berufseinsteiger, ein verbindliches, strukturiertes Weiterbildungscurriculum, die Etablierung bzw. Weiterentwicklung eines Mentoring-Programms, die Weiterentwicklung von Führungsqualitäten und die Gestaltung einer ansprechenden und aktualisierten Homepage sind wesentliche Voraussetzungen, um auf dem hart umkämpften Fachkräftemarkt zukünftig erfolgreich zu sein.
OCCUPATIONAL APPLICATIONSGlobalization and eCommerce continue to fuel unprecedented growth in the logistics and warehousing markets. Simultaneously, the biggest bottleneck for these industries is their human capital. Where automation and robotic solutions fail to deliver a return on investment, humans frequently take over handling tasks that place harmful loads and strains on the body. Occupational exoskeletons can reduce fatigue and strain by supporting the lower spine and are designed to prevent work-related musculoskeletal disorders and other injuries. They are a mid- to long-term investment for industries to improve ergonomic conditions in workplaces, with the potential for reducing absences from work, sick days logged, and workers compensation claims. To examine the effectiveness of the newly introduced Paexo Back exoskeleton, a study was completed with 10 participants who completed manual load handling tasks with and without the exoskeleton. Key findings include significant reductions in metabolic effort and low back loading when the exoskeleton is worn.
Emotional experience can influence cognitive estimates such as perceived psychological distance and time judgements. These estimators are crucial in threatening situations like the COVID-19 pandemic because the subjective perception of the closeness of a potential infection might influence behaviour. However, to date it remains unclear how fear affects these estimates. We report on data from N = 183 participants collected in Germany during the summer of 2020, when a “second wave” of COVID-19 infections was still only on the horizon of public awareness. We induced COVID-19-related fear in members of one group and compared their estimates of psychological distance and time judgements to those of a neutral group. Fear induction influenced these conjoint estimates in the way that an increase in infection rates appeared farther away and of shorter duration. Mediation analysis revealed inverse effects of changes in valence and ratings of Fear of COVID-19 on psychological distance. Possible explanations for these effects are discussed.
Background Increased tibial slope (TS) is believed to be a risk factor for anterior cruciate ligament (ACL) tears. Increased TS may also promote graft insufficiency after ACL reconstruction. Purpose To delineate the relationship between TS and single as well as multiple graft insufficiencies after ACL reconstruction. Study Design Cohort study; Level of evidence 3. Methods We retrospectively identified 519 patients who had sustained ACL graft insufficiency after primary or revision ACL reconstruction (1 graft insufficiency, group A; 2 graft insufficiencies, group B; and ≥3 graft insufficiencies, group C). In addition, a subgroup analysis was conducted in 63 patients who received all surgical interventions by 2 specialized high-volume, single-center ACL surgeons. TS was measured by an observer with >10 years of training using lateral knee radiographs, and intrarater reliability was performed. Multiple logistic and univariate Cox regression was used to assess the contribution of covariates (TS, age, sex, and bilateral ACL injury) on repeated graft insufficiency and graft survival. Results The study included 347 patients, 119 female and 228 male, who were 24 ± 9 years of age at their first surgery (group A, n = 260; group B, n = 62; group C, n = 25). Mean TS was 9.8°± 2.7° (range, 3°-18°). TS produced the highest adjusted odds ratio (1.73) of all covariates for repeated graft insufficiency. A significant correlation was found between TS and the number of graft insufficiencies ( r = 0.48; P < .0001). TS was significantly lower in group A (9.0°± 2.3°) compared with group B (12.1°± 2.5°; P < .0001) and group C (12.0°± 2.6°; P < .0001). A significant correlation was seen between the TS and age at index ACL tear ( r = −0.12; P = .02) as well as time to graft insufficiency ( r = −0.12; P = .02). A TS ≥12° had an odds ratio of 11.6 for repeated ACL graft insufficiency. Conclusion The current results indicate that patients with a markedly increased TS were at risk of early and repeated graft insufficiency after ACL reconstruction. Because the TS is rarely accounted for in primary and revision ACLR, isolated soft tissue procedures only incompletely address recurrent graft insufficiency in this subset of patients.
Education is a fundamental pillar of anti-doping. With the International Standard for Education (ISE) coming into effect in 2021, understanding the status quo of anti-doping education is paramount. This study aimed to evaluate young elite athletes’ perceptions of the anti-doping education they receive. A total of 2,232 athletes, participating at any of four Youth Olympic events between 2018 and 2020 (representing 49 sport disciplines and 124 countries) were surveyed using an online questionnaire, including questions about the anti-doping education received, athletes’ views about its usefulness and trust in its content. Additionally, anti-doping education programmes of the countries’ National Anti-Doping Organisations (NADOs) were assessed in terms of scope and extent, and categorised as ‘comprehensive’, ‘selective’, ‘limited’ or ‘information-only’. Perceived usefulness and trust were compared between these groups. Three-quarters (73.3%) of the athletes received anti-doping education, its usefulness and trust were rated as ‘good’ (> 4 out of 5). Based on NADO's anti-doping education, athletes in the ‘information-only’ category had significantly lower values for usefulness and trust, while those in the ‘selective’ category had the highest values. Results confirm the importance of a multifaceted education, recommending the implementation of at least one educational approach above information provision as they were perceived to be more useful and trusted, and could facilitate Code compliance via developing skills as well as knowledge for informed decision making.
Individuals sometimes mistake others' expectations or imposed duties for self-chosen goals, even though they are not congruent with their emotional preferences or integrated values—a phenomenon coined as self-infiltration. Previous studies demonstrated that self-infiltration is more likely to occur in individuals with reduced self-regulation abilities. Here, we investigated in a sample of 250 students whether this association may be mediated by trait emotional awareness, the ability to recognize and understand one's emotions. This mediation hypothesis could be confirmed. We discuss our findings with respect to their potential relevance for research on motivated goal pursuit and health and practical applications.
Rhythmic eye movements performed during eye movement desensitization and reprocessing (EMDR) therapy have been shown to evoke a physiological de-arousal pattern. Objectives: Here, we examined whether the efficacy of a virtual reality exposure therapy (VRET) paradigm for phobic patients could be improved by adding rhythmic eye movements. Design: Spider-phobic patients (N = 53) were randomly assigned to either a group performing rhythmic eye movements or a control group undergoing exposure without such eye movements. Methods: During the VRET session, heart rate, electrodermal activity, eye movements, and subjective fear ratings were recorded. Participants underwent behavioural avoidance tests before and after treatment as well as a follow-up 10-14 days later. Questionnaire data were assessed before exposure and at follow-up. Results: There were clear treatment effects in both groups with almost no group differences (i.e., the subjective fear ratings and the skin conductance response). Conclusions: Contrary to our expectation, the implementation of rhythmic eye movements during virtual exposure did not enhance the effectiveness of the treatment. However, the eye movement group did show a significantly lower heart rate during exposure compared with the control group which might indicate a less stressful treatment. Practitioner points: One-session Virtual Reality Exposure Therapy reduced fear of spiders effectively. Performing rhythmic eye movements during exposure did not enhance therapy effects. Rhythmic eye movements during exposure resulted in lower heart rate than standard exposure.
Cognitive behavioral therapy (CBT) is the first choice of treatment of obsessive–compulsive disorder (OCD) in children and adolescents. However, there is often a lack of access to appropriate treatment close to the home of the patients. An internet-based CBT via videoconferencing could facilitate access to state-of-the-art treatment even in remote areas. The aim of this study was to investigate feasibility and acceptability of this telemedical approach. A total of nine children received 14 sessions of CBT. The first session took place face-to-face, the remaining 13 sessions via videoconference. OCD symptoms were recorded with a smartphone app and therapy materials were made accessible in a data cloud. We assessed diagnostic data before and after treatment and obtained measures to feasibility, treatment satisfaction and acceptability. Outcomes showed high acceptance and satisfaction on the part of patients with online treatment (89%) and that face-to-face therapy was not preferred over an internet-based approach (67%). The majority of patients and their parents classified the quality of treatment as high. They emphasized the usefulness of exposures with response prevention (E/RP) in triggering situations at home. The app itself was rated as easy to operate and useful. In addition to feasibility, a significant decrease in obsessive–compulsive symptoms was also achieved. Internet-based CBT for pediatric OCD is feasible and well received by the patients and their parents. Furthermore, obsessive–compulsive symptomatology decreased in all patients. The results of this study are encouraging and suggest the significance of further research regarding this technology-supported approach, with a specific focus on efficacy. Trial registration number: Clinical trials AZ53-5400.1-004/44.
After the first COVID-19 case was diagnosed in Germany, various measures limiting contact between people were introduced across the country. The implementation of these measures varied between jurisdictions and potentially had a negative impact on the psychological well-being of many people. However, the prevalence, severity, and type of symptoms of psychological burden has not been documented in detail. In the current study, we analysed various self-reported symptoms of psychological burden in a German sample. The dataset was collected between April 8th and June 1st, 2020, through an online survey measuring psychological burden using the ICD-10-symptom rating scale. More than 2,000 individuals responded to the survey, with a total of 1,459 complete datasets. Data was then sampled to compare (1) the new data to an existing demographically comparable reference dataset including a total of 2,512 participants who did not undergo any kind of contact restrictions or other pandemic measurements, and (2) psychological burden in two different German states. In line with recent observations from Germany, Italy, China, Austria and Turkey, we found a high prevalence of depressive symptoms in comparison to the reference sample. Furthermore, we found a high prevalence of eating disorder and compulsion symptoms. Especially younger adults and women reported a higher symptom severity compared to other groups during our measurement period. However, no difference between the two states in psychological burden was found.
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