The multicultural conceptualisation of well-being : The role of culture and circumstance in operationalising well-being in South Africa: A mixed-methods approach.

BACKGROUND: Exploring and understanding indicators of better life outcomes have remained popular among social and health researchers. However, the subjective approach to measuring well-being has raised questions on the appropriateness of standard measures of well-being in multicultural settings. The current study examines generalised well-being and its dependence on the implicit understanding of individual culture and circumstances. METHODS: A mixed-method approach with a cross-sectional design and focus group discussions was adopted. Fifteen focus group discussions with 66 participants were conducted in four provinces of South Africa. Descriptive statistics, correlations, regression analysis and analysis of variance were computed for quantitative data. The focus group discussions were analysed using a content analysis approach. The recorded focus group discussions were transcribed using the intelligent verbatim technique. Data analysis was done stepwise using open, axial, and selective coding techniques. RESULTS: Quantitative analysis showed a strong and significant association between quality of life and income and a moderate association with educational attainment. The open coding technique for qualitative data confirmed 11 different subconstructs of well-being, mentioned 403 times during the 15 focus group discussions. Furthermore, well-being indicators varied based on participants' racial identity. CONCLUSIONS: The findings confirm personal circumstance and culture as significant for interpreting results from well-being research. Furthermore, it supports Maslow's Hierarchy of Needs, highlighting the movement from deficiency needs to growth needs after deficiency needs are met. Research must adopt a more sociological approach to improve the accuracy and implementibility of findings when using standardised measures of well-being.

The current state of international research on the effectiveness of school nurses in promoting the health of children and adolescents: An overview of reviews.

OBJECTIVE: School nurses are engaging worldwide to promote and protect children's health. Many researchers who examined the effectiveness of the school nurse criticized the inadequate methodology employed in many of the studies. We therefore carried out an evaluation on the effectiveness of school nurses based on a rigorous methodological approach. METHODS: In this overview of reviews we performed an electronic databank search and global research results on the effectiveness of school nurses were sought. We identified 1,494 records through database search. Abstracts and full texts were screened and summarized using the dual control principle. We summarized the aspects of quality criteria as well as the significance of the effectiveness of the school nurse. In the first step, k = 16 systematic reviews were summarized and evaluated following the AMSTAR-2 guidelines. In a second step, j = 357 primary studies included in these k = 16 reviews were summarized and assessed following the GRADE guidelines. RESULTS: Research results on the effectiveness of school nurses show that school nurses play a key role in improving the health of children with asthma (j = 6) and diabetes (j = 2), results on combating obesity are less certain (j = 6). The quality of identified reviews is mostly very low with only six studies of medium quality, of which one identified as a meta-analysis. A total of j = 289 primary studies were identified. Approximately 25% (j = 74) of identified primary studies were either randomized controlled trials (RCT) or observational studies, of which roughly 20% (j = 16) had a low risk of bias. Studies with physiological variables such as blood glucose or asthma labeling led to higher quality results. CONCLUSION: This paper represents an initial contribution and recommends further evaluation of the effectiveness of school nurses, particularly in the areas of mental health or children from low socioeconomic backgrounds. The general lack of quality standards in school nursing research should be integrated into the scientific discourse of school nursing researchers to provide robust evidence for policy planners and researchers.

School-Based Interventions for Child and Adolescent Victims of Interpersonal Violence.

BACKGROUND: Interpersonal violence against children and adolescents can affect their mental health and functioning in the long term. To reduce mental health problems in children and adolescents, school-based mental health interventions have been shown to be beneficial. A review of school-based interventions designed to mitigate posttraumatic symptoms after interpersonal violence is lacking to date. METHODS: We searched for original studies published in English or German until November 2019 in 6 electronic databases. Supplementary search strategies to reduce publication bias were implemented. Peer-reviewed original studies assessing school-based interventions for children and adolescents under the age of 21 after interpersonal violence were included. Relevant data was extracted, synthesised and assessed qualitatively. The methodological quality of included studies was assessed. RESULTS: Of 5,021 unduplicated publications, 15 studies met eligibility criteria. The included studies were almost exclusively conducted in the USA; over half utilised a randomised-controlled design. Studies mainly focussed on Posttraumatic Stress Disorder (PTSD) or depression. In all studies, implemented interventions partially or fully mitigated posttraumatic symptoms. Nine school-based interventions, five of which were based on cognitive behavioural therapy (CBT), were identified. School staff were often involved in intervention implementation besides mental health professionals. CONCLUSIONS: School-based interventions can be beneficial to reduce mental health problems in children and adolescents after interpersonal violence. Trained school staff aided by mental health professionals can implement trauma-informed practices at school. While school-based interventions may be a feasible way to provide children and adolescents with accessible mental health care, further research on school-based trauma interventions outside the USA is necessary.

Short-term eye movement desensitization and reprocessing (EMDR) therapy to treat children with posttraumatic stress symptoms after single trauma: A case series.

BACKGROUND: Traumatic experiences can lead to posttraumatic stress disorder (PTSD). For young children, even minor, inconspicuous looking events can lead to posttraumatic stress symptoms. Trauma-focused treatment with Eye Movement Desensitization and Reprocessing (EMDR) offers children an age-adapted intervention to help them successfully process traumatic experiences. So far, there has been a lack of well evaluated trauma-focused treatments for young children. METHODS: These case series examine the effectiveness of a short-term treatment with EMDR therapy for children showing PTSD symptoms after experiencing a single incident induced trauma. Five children between 5 and 10 years of age who developed PTSD after a single incident trauma received a manualized EMDR treatment for 6 weeks (mean number of sessions: seven including a mean number of EMDR sessions: 3.4). Posttraumatic stress symptoms were assessed prior to treatment, following treatment and at a 3-month follow-up with standardized instruments for caregivers and children. RESULTS: PTSD symptoms decreased for all children after completing the treatment from clinical to non-clinical level. Reductions in vegetative hyperarousal, fears and clinging behaviour were achieved. Furthermore, reductions in the parental stress levels, as well as a recovery of everyday routine and everyday stability were observed. CONCLUSION: Short-term EMDR treatment appears to be a promising treatment for single incident trauma in young children providing a potentially successful quick and safe psychological treatment for children. Results contribute to the knowledge of feasibility and acceptability of short-term, trauma-focused treatments of children with EMDR. Replication of the results of these case series in larger samples using a randomized controlled design is warranted.

Interpreting Microaggression as a Determinant of Wellbeing.

Despite the increasing interest in exploring microaggression in the humanitarian context, there remains uncertainty on its mechanism for affecting life outcomes. There is a lack of studies on ethnic and racial minorities in non-western countries. The current research explores dimensions and manifestations of microaggression and how they affect wellbeing in a multicultural setting. The study uses a qualitative approach with 15 focus group discussions (FGDs) and 66 participants conducted in 4 provinces of South Africa: Gauteng (k = 6), North-West (k = 3), KwaZulu-Natal (k = 3), and Western Cape (k = 3). The recorded FGDs were transcribed using the intelligent verbatim technique. The transcripts were then analysed using a phenomenological approach. Data analysis was done stepwise using the deductive coding technique. Results show that participants' perception of the dimensions of microaggression varies depending on the manifestation as verbal, behavioural, or systemic. Furthermore, variations in patterns and reactions to dimensions of microaggression were linked with participants' racial identity. It further confirms that experiencing discrimination is associated with poorer wellbeing. Connectedness to the ingroup provides stability and certainty in multi-group societies due to the group rivalry that pervades such societies.

[Discrimination Experience Among Children and Adolescents - Results of an Instrument Search and Cognitive Interviews with Pupils in Preschool, Elementary and Primary Schools]. / Diskriminierungserfahrungen von Kindern und Jugendlichen erfragen ­ Ergebnisse einer Instrumentenrecherche und kognitiver Interviews mit Schüler/innen in Vor-, Grund- und Sekundarschulen.

Although the experiences of discrimination have become part of everyday lives for many children and adolescents in Germany, there is a lack of empirical data to explore its consequences on the well-being and other aspects of life. The limited data can be attributed to the lack of age-appropriate survey methods and instruments. Thus, the authors focus on the possibilities and challenges for an age-appropriate, standardised assessment of discrimination experiences among children and adolescents in Germany. An electronic database search was conducted to identify published instruments worldwide. Three Englishlanguage questionnaires developed for children aged nine years and onwards in the USA were found.These instruments have been used to collect data in samples with a large proportion of minor African Americans. The authors tested for the comprehensibility of the Child Perceived Discrimination Questionnaire (CPDQ; LaFont et al., 2018) in a sample of n = 21 schoolchildren aged between 6 and 14 years using cognitive interviews.The results highlight age differences in the item comprehensibility and demonstrate the topic's relevance even for preschool children. The authors discuss the importance of findings on discrimination experiences of minors for therapeutic and pedagogical practice and illustrate starting points for closing the research gap identified.

The Impact of Perceived Discrimination on Cultural Identification, Psychological Stress, Emotion Regulation and Aggressive Tendencies in Individuals With Turkish Migration Background in Germany.

The following study considers correlates of the identification with the origin and host culture of German individuals with a Turkish migrant background. It examines how these two factors mediate the relationship between perceived discrimination, emotion regulation or psychological stress, and aggressive tendencies as the major dependent variable. For this purpose, the data of 229 people with Turkish migration background living in Germany was collected through an online survey. Findings depict that the identification with the Turkish (origin) and German (host) culture mediate the relationship between perceived discrimination and emotion regulation. The relationship between perceived discrimination and psychological stress is mediated by the identification with the German culture. The analysis shows that perceived discrimination is associated with a reduced identification with the German culture and with a high identification with the Turkish culture. Emotion regulation abilities are negatively related to perceived discrimination and identification with the Turkish culture. In contrary, the psychological stress level is positively related to perceived discrimination. The preparedness for aggressive behavior is also associated positively by psychological stress and negatively by emotion regulation abilities. The results are discussed against the background of the specific migration history and living conditions of Turkish immigrants in Germany.

Experiences of Discrimination and Everyday Racism Among Children and Adolescents With an Immigrant Background - Results of a Systematic Literature Review on the Impact of Discrimination on the Developmental Outcomes of Minors Worldwide.

Experiences of discrimination such as everyday racism can negatively affect the mental and physical health of children and adolescents with an immigrant background and impair their integration process in the host societies. Although experiences of racism are part of the everyday life of many minors affected by the process of "Othering" (e.g., those with an immigrant background), an overview of empirical findings is missing for this age group worldwide. A systematic review was conducted to identify and analyze international research on the impact of discrimination on the developmental outcomes and integration of immigrant children and adolescents. Three scientific databases were systematically searched up to June 11, 2021. A total of k = 4,769 identified publications were reviewed based on inclusion and exclusion criteria in terms of the PICOS format by independent reviewers. Thirty-four primary studies published between 1998 and 2021 met all inclusion criteria. The samples examined were mainly migrant youth (k = 30), with only k = 2 studies assessing refugee youth and k = 1 study assessing both migrant and refugee youth. The majority of included studies assessed perceived discrimination, with only k = 1 study directly assessing experiences of racism. The association between discrimination or racism and developmental outcomes was assessed by the included studies within the three main topics of (a) mental and physical health-related outcomes (k = 30, e.g., self-esteem, depressive symptoms), (b) school-related outcomes (k = 6, e.g., academic achievement), and (c) other developmental outcomes (k = 13, e.g., misconduct or delinquency). Data collection procedures were implemented, and findings on minors' developmental outcomes and integration process who experience discrimination and racism were summarized and discussed. The current review suggests experienced (racial) discrimination as a negative predictor of children and adolescents' (mental) health-related outcomes, while no clear results could be found for the association between discrimination and school-related outcomes. A need for more empirical research focusing on the path and (possibly) indirect link between discrimination and children and adolescents' school-related outcomes as well as resulting school recommendations and the chosen career path was derived. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=260291], identifier [CRD42021260291].

Prevalence of dental neglect and associated risk factors in children and adolescents-A systematic review.

BACKGROUND: Dental neglect (DN) is characterized within the wider framework of child neglect, though it is under-recognized by professionals. AIM: To get an overview of the prevalence of DN worldwide and highlight the possible risk factors associated with it. METHODS: A systematic review was conducted according to PRISMA guidelines. Studies on children and adolescents aged 0-19 years were included. Studies were identified by searching in the various scientific databases up to 14 January 2020. RESULTS: Ten primary studies were included in which DN or indicators of DN were examined. The prevalence estimate range of DN reported by seven of the included studies after removing the outliers is from 34% to 56%. The prevalence of untreated caries reported by three of the included studies ranged from 38.9% to 99%. The education level and SES of parents and parental attitudes towards dental health affect children's oral health. Moreover, looked-after children and children of refugees are at higher risk of DN. CONCLUSION: The study showed a high prevalence of DN and untreated caries. Due to the under-reporting of DN and a limited number of included studies, the results cannot be generalized worldwide. There is a need to make policies that include reporting of DN to higher authorities by dental professionals.

[Locus of Control and the Psychological Quality of Life Among Migrants from Sub-Saharan Africa in Germany: Results of a Representative Survey]. / Kontrollüberzeugung und psychische Lebensqualität von Menschen mit afrikanischer Herkunft in Deutschland ­ Ergebnisse einer Repräsentativerhebung.

AIM OF THE STUDY: Many people with an African migration background in Europe are affected by discrimination and racism because of their skin color and culture and have a below-average socioeconomic status and quality of life (QoL). The aim of this study was to find starting points for improving the integration and QoL of people with a migration background from Sub-Saharan Africa (SSA) living in Germany. METHOD: For the first time, a sample of 518 people from SSA (19-56 years) living in Germany was interviewed via an online survey in three languages about the psychological QoL and their locus of control as an indicator of their adjustment performance. RESULTS AND CONCLUSION: The results of the nationwide survey pointed to a significant strong positive association between locus of control and psychological QoL among people from SSA in Germany (p<.010; r=.49). Here, age, length of residence in Germany, occupational group, and educational attainment were significantly related to locus of control beliefs and mental QoL. A multiple regression model showed that, among the socioeconomic and sociodemographic factors, educational attainment was a significant predictor for the relationship between psychological QoL and locus of control. About 24% of the variance in mental health was explained by locus of control beliefs and educational attainment. Education is a starting point for interventions to promote integration and mental health of migrants from SSA at different stages of life.

Trust, Sociability, and Quality of Life of Sub-Saharan African Migrants in Germany.

Poor social integration is associated with poor quality of life among minority groups. The current study hypothesized that trust and sociability may significantly explain the quality of life performance among Sub-Saharan African migrants in Germany. Data from 518 migrants were analyzed. Hierarchical multiple linear regression models were calculated to assess the predictive effect of trust and sociability on aggregate quality of life. Results show that general trust and sociability explained about 21% of the variance in quality of life score (adjusted R 2 = .206; p < .001) for the total sample. Socioeconomic and demographic features suggested an added predictive effect of about 8% for total sample (adjusted R 2 = .279; p < .001), 10% for male (adjusted R 2 = .322; p < .001) and 4% for female (adjusted R 2 = .211; p < .001). The results support trust and sociability as essential in connecting to a new environment and enhancing the quality of life.

[Paternal Risk and Protective Factors for Endangerment of Child Well-Being and their Consideration in the Risk Inventories Used Throughout Germany]. / Väterliche Risiko- und Schutzfaktoren für Kindeswohlgefährdung und ihre Berücksichtigung in den deutschlandweit eingesetzten Risikoinventaren.

Paternal Risk and Protective Factors for Endangerment of Child Well-Being and their Consideration in the Risk Inventories Used Throughout Germany In view of the current family and role models, paternal risk and protective factors can have a significant impact on the risk of violence within a family and should therefore - in addition to the factors on the part of the mother, the child and the closer or other family systems - be taken into consideration when estimating the endangerment of child well-being. In this article we explore which empirical findings on paternal risk and protective factors for abuse, neglect and sexual abuse (sexual violence) in childhood and adolescence were published in international research literature from 1980 to 2019. Seventeen risk factors and four protective factors could be identified, which in 33 quantitative original studies showed a risk-increasing or a buffering influence on violence experiences in families on the part of the father. In addition, the risk inventories used in practice in Germany were analyzed with regard to the paternal risk and protective factors, in order to be able to illustrate the application of the empirically identified factors in early intervention, youth welfare and health care. The article used results from a benchmark survey on risk inventories from 2009. These results were compared with current findings from 2018 as part of a research update. In 2009, 67 % of the instruments "often" contained items on the father, while this was found for 12 % of the instruments in 2018. At the same time, in 2018, 53 % of the risk inventories were "often" asked about custodians, parents or main caregivers. The article thus reflects developments in research and practice in risk assessment for child well-being, in which especially the fathers, who unlike the mothers are often not explicitly addressed during screenings and interventions for families with psychosocial problems, are taken into consideration. The knowledge about the influence of the fathers can feed into the preventive interventions in early interventions and complement them meaningfully.

[Interpreter-Aided Psychotherapy for Deaf and Hearing-Impaired Patients - a Systematic Review of Research and Recommendations for Psychotherapists with Normal Hearing and Sign Language Interpreters]. / Psychotherapie für taube Patienten durch hörende Psychotherapeuten mittels Gebärdensprachdolmetscher ­ ein Systematisches Literaturreview zu Forschungsbefunden und Empfehlungen.

In Germany, deaf patients undergoing psychotherapy have the right to have the costs of a sign language interpreter covered by the insurance since 2001. The effectiveness of interpreter-aided psychotherapy worldwide is disputed. A systematic literature review was conducted on sign language interpreter-aided psychotherapy. Six scientific databases were searched. Two independent raters conducted a 2-step rating process. Out of 1,184 identified publications, 10 studies in German and English language were included. These 10 studies examined between 1 and 85 deaf patients (7-60 years) in different psychotherapeutic settings (8 ambulatory, 4 family therapy). Nine studies reported therapy success. Relevant knowledge (e. g. about culture of deaf people), attitudes (e. g. openness), abilities (e. g. sign language) and general conditions (e. g. declaration for professional secrecy, light conditions) were recommended for psychotherapists with normal hearing and sign language interpreters. Empirical data on psychotherapy with sign language interpreters is low and methodologically limited. The present study can be considered as a starting point for further research.

Reducing barriers to trauma inquiry in substance use disorder treatment - a cluster-randomized controlled trial.

BACKGROUND: Despite the high rate of traumatic events in clients with substance use disorders, trauma exposure often remains undetected in a majority of treatment-seeking clients. Improving health professionals' knowledge and skills in the inquiry of traumatic events is therefore of utmost importance for appropriately addressing trauma-related treatment needs. However, professionals in substance use disorder treatment settings frequently report barriers to the inquiry about traumatic events, e.g., the fear of offending or harming the client. Such barriers should be addressed by trainings that aim to improve the systematic inquiry of traumatic events. METHODS: Using a cluster-randomized trial, we examined whether a one-day training in trauma inquiry ('Learning How to Ask') would reduce professionals' perceived barriers to trauma inquiry. One hundred forty-eight professionals working in outpatient substance use disorder treatment centers were randomized to an intervention (n = 72) or a control group (n = 76). The professionals in the intervention group received a one-day training plus a refresher session 3 months later, the professionals in the control group received no training. At baseline, and at 3-month and 6-month follow-up, professionals rated on a four-point Likert scale regarding how strongly they agreed with statements about six common barriers to trauma inquiry, namely 'Feeling uncomfortable when asking about traumatic events', 'Fear of offending the client', 'Fear of retraumatizing the client', 'Fear that client may terminate treatment', 'Unsure whether authorities have to be informed when perpetrator is known', and 'No trauma-specific treatment available in my local area'. RESULTS: The trained group experienced significant greater decreases in five of the six perceived barriers to the inquiry of traumatic events from baseline to 6-month follow-up than the control group ('Feeling uncomfortable when asking about traumatic events': b = - 0.32, 95% CI [- 0.52, - 0.12]; 'Fear of offending the client': b = - 0.33, 95% CI [- 0.56, - 0.09]); 'Fear of retraumatizing the client': b = - 0.45, 95% CI [- 0.69, - 0.22]; 'Fear that client may terminate treatment': b = - 0.28, 95% CI [- 0.49, 0.07]; 'No trauma-specific treatment available in my local area': b = - 0.25, 95% CI [- 0.51, - 0.01]). CONCLUSIONS: Our findings provide first evidence that a one-day training in trauma inquiry is effective in reducing common barriers to trauma inquiry, which may in turn improve detection of traumatic events.

[Developmental trauma disorder (DTD) in children and adolescents - results from a patient population at the special consultation hour for traumatized children and adolescents]. / Entwicklungstraumastörung (ETS) bei Kindern und Jugendlichen ­ Ergebnisse einer Patientenpopulation der kinder- und jugend-psychiatrischen Spezialsprechstunde "Gewalt und Trauma".

Developmental trauma disorder (DTD) in children and adolescents - results from a patient population at the special consultation hour for traumatized children and adolescents Abstract. Objective: Children and adolescents who have experienced interpersonal Type-II-trauma often develop symptoms going far beyond the Post-Traumatic Stress Disorder (PTSD). Van der Kolk (2009) suggested the Developmental Trauma Disorder (DTD) to define the extensive symptomatology; however, research on DTD is limited. Method: Frequency and group differences of DTD were examined based on physicians' letters of n = 161 patients between one and 18 years (61 % female) from an out-patient unit for traumatized patients at a paediatric and adolescent psychiatry. Physicians' letters were rated and analysed using an adapted DTD algorithm. Results: In total, 77 % of the patients experienced interpersonal Type-II-trauma, 6 % met the criteria for the adapted DTD diagnosis. DTD criteria were found more frequently in interpersonal Type-II-trauma victims than in patients with accidental or Type-I-trauma, but group differences only reached statistical significance for the DTD criteria B (affective and physiological dysregulation) and G (impairments) at the adjusted 0,2 % significance level. No statistically significant differences for age or gender were found. The posttraumatic symptoms of children younger than seven years were analysed descriptively. Conclusions: The results show that, although many children and adolescents have developed symptoms beyond the PTSD, only a small proportion have met the DTD diagnosis. In view of the partially unspecific and contradictory findings, further studies on DTD considering larger samples, the complete DTD criteria, and diagnosis-specific instruments seem to be reasonable and necessary.

[Complex Trauma-related Disorders in Research and Practice]. / Komplexe Traumafolgestörungen bei Kindern und Jugendlichen in Forschung und Praxis.

Complex Trauma-related Disorders in Research and Practice Frequent traumata in childhood and adolescence are long-term or repeated interpersonal traumata caused by perpetrators in the close environment of the minors. For the description of the extensive symptoms after interpersonal Type II traumata, the complex trauma-related disorders Complex Posttraumatic Stress Disorder (CPTSD) or Disorder of Extreme Stress Not Otherwise Specified (DESNOS) and the Developmental Trauma Disorder (DTD) are being discussed for inclusion in the classification systems for mental disorders. Scientific knowledge and practical experiences regarding CPTSD, DESNOS and DTD in children and adolescents up to 18 years were examined by 1) a Systematic Review of 1,070 publications identified by database research and additional search strategies, and 2) a nationwide online survey of 374 psychotherapists and psychiatrists for children and adolescents in Germany. Of 13 included empirical studies (8 CPTSD or DESNOS, 5 DTD), 9 were conducted in the USA, 4 based on file coding and 3 on secondary data analysis and only 7 reported diagnosis rates (range: 0-78 %). Of the interviewed therapists, 100 % considered the CPTSD as being met with at least one patient with interpersonal traumata up to 18 years of age in 2014 and 99 % gave this estimate for the DTD. Two thirds of therapists rated the diagnostic option CPTSD and DTD as "very often" or "often" helpful for their therapeutic work with children and adolescents. While empirical data available is to be considered insufficient and characterized by methodological limitations, the relevance of complex trauma-related disorders is perceived as high by practitioners.

[Effects of written educational material on parental health knowledge depending on socioeconomic status : A randomized controlled trial]. / Steigerung von elterlichem Gesundheitswissen durch schriftliches Informationsmaterial unter Berücksichtigung des familiären sozioökonomischen Status : Eine randomisiert-kontrollierte Studie.

BACKGROUND: The nationwide prevention program "Parent Guide - Growing up Healthy" aims to improve parental health knowledge in Germany. At the birth of their first child, parents of any socioeconomic status (SES) are provided with written educational material that includes relevant health knowledge as well as basic information about routine health checkups for children. OBJECTIVES: This study aimed at evaluating the program regarding 1) the effects on parental health knowledge and parental satisfaction with routine child health checkups, 2) the sensitivity of the effects on SES, and 3) parental acceptance of the written educational material. MATERIALS AND METHODS: A longitudinal randomized controlled trial (RCT) was carried out with 1318 young parents recruited from 14 hospitals with maternity clinics in Germany. Parents of the intervention group received educational material whereas controls didn't receive material. Respondents completed interviews at the child's birth (T0) and first birthday (T1). RESULTS: Parental health knowledge at T1 was significantly higher (p = 0.005; partial eta2 = 0.006) in the intervention group but with a small effect size. The influence of the educational material was not moderated by SES (p = 0.456). Satisfaction with routine child health checkups did not differ significantly between the groups (p = 0.606). Parents showed high acceptance of the parent guide regardless of SES. CONCLUSIONS: Written educational material is an effective approach in increasing parental health knowledge and has the potential to reach all parents regardless of SES. A higher satisfaction with routine child health checkups could not be achieved by educational material.

"Learning how to ask": Effectiveness of a training for trauma inquiry and response in substance use disorder healthcare professionals.

CONTEXT: Exposure to traumatic events should be systematically assessed in health care services so that trauma-related treatment can be offered when appropriate. However, professionals often lack expertise in trauma inquiry and response, and therefore require training in this field. OBJECTIVE: We aimed to determine whether the "Learning how to ask" training for trauma inquiry and response (Read, Hammersley, & Rudegeair, 2007) is effective in increasing health care professionals' trauma inquiry behavior. METHOD: 148 professionals working in outpatient substance use disorder (SUD) services were cluster-randomized into an intervention or a waiting control group. The intervention group received a 1-day training and a refresher session 3 months later, while the control group received no training. The primary outcome was the change from baseline in the frequency of asking clients about traumatic events. Secondary outcomes were professionals' evaluation of the training, knowledge, attitudes toward and confidence in trauma inquiry and response. RESULTS: Change from baseline in the frequency of asking clients about traumatic events was significantly greater at 3-month and 6-month follow-up in the intervention group compared with the control group (b = 0.43, 95% CI [0.27, 0.59], p < .001). The training was positively evaluated by the participants. Knowledge, positive attitudes toward and confidence in trauma inquiry and response all showed significantly greater increases in the intervention group than in the control group. CONCLUSIONS: These findings suggest that health care professionals can acquire skills in trauma inquiry and response from short trainings, which may enhance systematic assessment of traumatic events. (PsycINFO Database Record

[Healthcare situation for children, adolescent and adult victims of sexual violence in Germany : A critical overview]. / Versorgungssituation von Kindern, Jugendlichen und Erwachsenen mit sexuellen Gewalterfahrungen in Deutschland : Ein kritischer Überblick.

In Germany, since 2010 the debate regarding sexual assault victims, additionally due to extensive activities of the independent commissioner for questions regarding sexual abuse of children (Unabhängiger Beauftragter für Fragen des sexuellen Kindesmissbrauchs, UBSKM), has received increased attention from the public and the healthcare system. Sexual violence is a burdening experience regardless of age and can have a lasting impact on the physical, psychological and/or social life of victims. Empirically, it has been found that more than half of the adult population suffering from mental disorders have experienced sexual abuse in childhood and adolescence. In some of the affected the impact of the trauma experienced, which is often accompanied by neglect and physical violence, can negatively influence the course of disease. Early counseling and therapeutic support for affected children and adolescents should be taken more into account and focus on optimizing treatment for this patient group. This article discusses the prevalence of sexual violence, possible health and social consequences and the treatment situation of affected children, adolescents and adults in various areas of the help/aid system. In doing so, a discrepancy between scientific findings, recommendations from statutory health insurance companies (GKV), the current healthcare situation and the real needs of the affected are made clear.

Protective mental health factors in children of parents with alcohol and drug use disorders: A systematic review.

Children of parents with drug and alcohol use disorders often grow up under severe stress and are at greater risk of developing psychological and social problems. However, a substantial proportion of affected children adapt to their distressing life conditions and show positive development in terms of their mental health. These children are described as resilient. One difference between resilient and maladapted children is the presence of protective factors. The aim of this systematic review is to provide an overview of the current state of the research concerning protective mental health factors in children of parents with alcohol or drug use disorders (COPAD). For that purpose, the PsychInfo, PubMed, CINAHL and ISI Web of Science databases were searched through January 2017. All the identified publications were screened using previously developed inclusion criteria. The search yielded 3,402 articles. Eleven of these publications (2003-2013) met the criteria for inclusion in the present review. Information on the studies was extracted using an extraction form. A narrative analysis was performed, and the methodological quality was examined using a checklist based on the Mixed Methods Appraisal Tool. The research identified familial, parental, child-related and biological factors that influenced mental health outcomes in affected children (N = 1,376, age range = 1-20 years). Overall, protective mental health factors are understudied in this target group. Most of the included studies were conducted in the United States and employed a cross-sectional design. A comparison of the included cross-sectional and longitudinal studies indicated consistent results related to a secure parent-child attachment. Based on the current state of the research, no causal conclusions with regard to the effectiveness of protective factors can be drawn. To develop effective prevention programs, further longitudinal studies and studies assessing the interactions between risk and protective factors are needed.