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Background:
Childhood and adolescence are critical stages of life for mental health and well-being. Schools are a key setting for mental health promotion and illness prevention. One in five children and adolescents have a mental disorder, about half of mental disorders beginning before the age of 14. Beneficial and explainable artificial intelligence can replace current paper- based and online approaches to school mental health surveys. This can enhance data acquisition, interoperability, data driven analysis, trust and compliance. This paper presents a model for using chatbots for non-obtrusive data collection and supervised machine learning models for data analysis; and discusses ethical considerations pertaining to the use of these models.
Methods:
For data acquisition, the proposed model uses chatbots which interact with students. The conversation log acts as the source of raw data for the machine learning. Pre-processing of the data is automated by filtering for keywords and phrases.
Existing survey results, obtained through current paper-based data collection methods, are evaluated by domain experts (health professionals). These can be used to create a test dataset to validate the machine learning models. Supervised learning
can then be deployed to classify specific behaviour and mental health patterns.
Results:
We present a model that can be used to improve upon current paper-based data collection and manual data analysis methods. An open-source GitHub repository contains necessary tools and components of this model. Privacy is respected through
rigorous observance of confidentiality and data protection requirements. Critical reflection on these ethics and law aspects is included in the project.
Conclusions:
This model strengthens mental health surveillance in schools. The same tools and components could be applied to other public health data. Future extensions of this model could also incorporate unsupervised learning to find clusters and patterns
of unknown effects.
Two of a kind?
(2014)
School attacks are attracting increasing attention in aggression research. Recent systematic analyses provided new insights into offense and offender characteristics. Less is known about attacks in institutes of higher education (e.g., universities). It is therefore questionable whether the term “school attack” should be limited to institutions of general education or could be extended to institutions of higher education. Scientific literature is divided in distinguishing or unifying these two groups and reports similarities as well as differences. We researched 232 school attacks and 45 attacks in institutes of higher education throughout the world and conducted systematic comparisons between the two groups. The analyses yielded differences in offender (e.g., age, migration background) and offense characteristics (e.g., weapons, suicide rates), and some similarities (e.g., gender). Most differences can apparently be accounted for by offenders’ age and situational influences. We discuss the implications of our findings for future research and the development of preventative measures.
School attacks are attracting increasing attention in aggression research. Recent systematic analyses provided new insights into offense and offender characteristics. Less is known about attacks in institutes of higher education (e.g., universities). It is therefore questionable whether the term “school attack” should be limited to institutions of general education or could be extended to institutions of higher education. Scientific literature is divided in distinguishing or unifying these two groups and reports similarities as well as differences. We researched 232 school attacks and 45 attacks in institutes of higher education throughout the world and conducted systematic comparisons between the two groups. The analyses yielded differences in offender (e.g., age, migration background) and offense characteristics (e.g., weapons, suicide rates), and some similarities (e.g., gender). Most differences can apparently be accounted for by offenders’ age and situational influences. We discuss the implications of our findings for future research and the development of preventative measures.
Leaking comprises observable behavior or statements that signal intentions of committing a violent offense and is considered an important warning sign for school shootings. School staff who are confronted with leaking have to assess its seriousness and react appropriately - a difficult task, because knowledge about leaking is sparse. The present study, therefore, examined how frequently leaking occurs in schools and how teachers identify leaking and respond to it. To achieve this aim, we informed teachers from eight schools in Germany about the definition of leaking and other warning signs and risk factors for school shootings in a one-hour information session. Teachers were then asked to report cases of leaking over a six- to nine-month period and to answer a questionnaire on leaking and its treatment after the information session and six to nine months later. Our results suggest that leaking is a relevant problem in German schools. Teachers mostly rated the information session positively and benefited in several aspects (e.g. reported more perceived courses of action or improved knowledge about leaking), but also expressed a constant need for support. Our findings highlight teachers' needs for further support and training and may be used in the planning of prevention measures for school shootings.
Leaking comprises observable behavior or statements that signal intentions of committing a violent offense and is considered an important warning sign for school shootings. School staff who are confronted with leaking have to assess its seriousness and react appropriately - a difficult task, because knowledge about leaking is sparse. The present study, therefore, examined how frequently leaking occurs in schools and how teachers identify leaking and respond to it. To achieve this aim, we informed teachers from eight schools in Germany about the definition of leaking and other warning signs and risk factors for school shootings in a one-hour information session. Teachers were then asked to report cases of leaking over a six- to nine-month period and to answer a questionnaire on leaking and its treatment after the information session and six to nine months later. Our results suggest that leaking is a relevant problem in German schools. Teachers mostly rated the information session positively and benefited in several aspects (e.g. reported more perceived courses of action or improved knowledge about leaking), but also expressed a constant need for support. Our findings highlight teachers' needs for further support and training and may be used in the planning of prevention measures for school shootings.
1. Einleitung
2. Herausforderungen der (Gewalt-)Prävention
2.1 Prävention im kommunalen Raum
2.2 Herausforderung Vielfalt
3. Gewalt
3.1 Möglichkeiten einer Definition
3.2 Über Ursachen
4. Das Konzept Mea
4.1 Nutzung bereits evaluierter Programme
4.2 Organisationsentwicklung
5. Entwicklung von Präventionslandschaften
5.1 Von der Hierarchie zur Netzwerkarbeit
5.2 Räume einer gelingenden Sozialisation
5.2.1 Sozialräume
5.2.2 Soziale Netzwerke
6. Schlussbemerkungen
Literatur
Das Ziel der Doktorarbeit war die Entwicklung und Evaluation eines skillsbasierten primären Präventionsprogramms (Mainzer Schultraining zur Essstörungsprävention (MaiStep)) für partielle und manifeste Essstörungen. Dabei wurde die Wirksamkeit durch einen primären (Reduktion vorhandener Essstörungssymptome) und sekundären (assoziierte Psychopathologie) Zielparameter 3 und 12 Monate nach Durchführung des Trainings überprüft. Innerhalb der randomisiert kontrollierten Studie gab es zwei Interventionsgruppe und eine aktive Kontrollgruppe. 1.654 Jugendliche (weiblich/männlich: 781/873; mittleres Alter: 13.1±0.7; BMI: 20.0±3.5) konnten für die Studie, an zufällig ausgewählten Schulen in Rheinland-Pfalz, rekrutiert werden. Die Entwicklung des Präventionsprogramms basiert auf einem systematischen Literaturreview von 63 wissenschaftlichen Studien über die Prävention von Essstörungen im Kindes- und Jugendalter. Eine Interventionsgruppe wurde durch Psychologinnen/Psychologen und eine zweite durch Lehrkräfte angeleitet. Das in der aktiven Kontrollgruppe durchgeführte Sucht- bzw. Stresspräventionsprogramm wurde durch Lehrkräfte geleitet. MaiStep zeigte zur 3-Monatskatamnese keine signifikanten Effekte im Vergleich zur aktiven Kontrollgruppe. Allerdings zeigten sich nach 12 Monaten multiple signifikante Effekte zwischen den Interventions- und der aktiven Kontrollgruppe. Im Rahmen der Analyse des primären Parameters wurden in den Interventionsgruppen signifikant weniger Jugendliche mit einer partiellen Anorexia nervosa (CHI²(2) = 8.74, p = .01**) und/oder partiellen Bulimia nervosa (CHI²(2) = 7.25, p = .02*) gefunden. Im Rahmen der sekundären Zielparameter zeigten sich signifikante Veränderungen in Subskalen des Eating Disorder Inventory (EDI-2) Schlankheitsstreben (F (2, 355) = 3.94, p = .02*) und Perfektionismus (F (2, 355) = 4.19, p = .01**) sowie dem Body Image Avoidance Questionnaire (BIAQ) (F (2, 525) = 18.79, p = .01**) zwischen den Interventions- und der aktiven Kontrollgruppe. MaiStep kann somit als erfolgreiches Programm zur Reduktion von partiellen Essstörungen für die Altersgruppe der 13- 15-jährigen bezeichnet werden. Trotz unterschiedlicher Wirkmechanismen zeigten sich die Lehrkräfte im Vergleich zu den Psychologinnen/Psychologen ebenso erfolgreich in der Durchführung.
Trial registration MaiStep is registered at the German Clinical Trials Register (DRKS00005050).
We live in an aging society. The change in demographic structures poses a number of challenges, including an increase in age-associated diseases. Delirium, dementia, and depression are considered to be of particular interest in the field of aging and mental health. A common theory regarding healthy aging and mental health is that the highest satisfaction and best performance is achieved when a person's abilities match the demands of their environment. In this context, the person's environment includes both the physical and the social environment. Based on this assumption, this dissertation focuses on the investigation of non-pharmacological interventions that modify environmental factors in order to facilitate the prevention and treatment of mental disorders in older patients and their caregivers. The first part of this dissertation consists of two publications and deals with the prevention of postoperative delirium in elderly patients. The PAWEL study investigated the use of a multimodal, non-pharmacological intervention in the routine care of patients aged 70 years or older undergoing elective surgery. The intervention included an interdepartmental delirium prevention team, daily use of seven manualized “best practice” procedures, structured staff training on delirium, and the adaptation of the hospital environment to the patients’ needs. The second part of the dissertation used a meta-analysis to investigate whether technology-based interventions are a suitable form of support for informal caregivers of people with dementia. Subgroup analyses were conducted to examine the effect of different types of technology on caregiver burden and depressive symptoms. The following main results were found: The PAWEL study showed that the use of a multimodal, non-pharmacological intervention resulted in a significantly lower incidence rate of postoperative delirium and reduced days with delirium in the intervention group compared to the control group. However, this difference could not be observed in the group of patients undergoing elective cardiac surgery. The results of the meta-analysis showed that technology-based interventions offer a promising alternative to traditional “face-to-face” services. Significant effect sizes could be found in relation to both the burden and the depressive symptoms of caregiving relatives. These results provide further important information on the significant impact of non-pharmacological interventions that modify environmental factors on mental health, and support the consideration of such interventions in the prevention and treatment of mental disorders in both older patients and their caregivers.
Background: In physical activity (PA) counseling, primary care physicians (PCPs) play a key role because they are in regular contact with large sections of the population and are important contact people in all health-related issues. However, little is known about their attitudes, knowledge, and perceived success, as well as about factors associated with the implementation of PA counseling. Methods: We collected data from 4074 PCPs including information on physician and practice characteristics, attitudes toward cardiovascular disease (CVD) prevention, and measures used during routine practice to prevent CVD. Here, we followed widely the established 5 A's strategy (Assess, Advise, Agree, Assist, Arrange). Results: The majority (87.2%) of PCPs rated their own level of competence in PA counseling as 'high,' while 52.3% rated their own capability to motivate patients to increase PA as 'not good.' Nine of ten PCPs routinely provided at least 1 measure of the modified 5 A's strategy, while 9.5% routinely used all 5 intervention strategies. Conclusions: The positive attitude toward PA counseling among PCPs should be supported by other stakeholders in the field of prevention and health promotion. An example would be the reimbursement of health counseling services by compulsory health insurance, which would enable PCPs to invest more time in individualized health promotion.
Präventiver Kinderschutz
(2014)
Die "Grüne Liste Prävention"
(2014)
1. Notwendigkeit nachhaltiger Kriminalprävention
2. Das 1. Jugendgerichtsgesetz (JGGÄndG) 1990
3. Das 2. JGGÄndG 2008
4. Nationale Entwicklungen
5. Internationale Entwicklungen
5.1 Prävention in Europa
5.2 Jugendkriminalprävention im europäischen Vergleich
5.2.1 European Crime Prevention Network (EUCPN)
5.2.2 WHO-Bericht zur Jugendgewaltprävention in Europa (2010)
5.3 Jugendkriminalprävention USA
5.4 Reformbestrebungen, Präventionskoordination und -initiativen in den USA
6. Implementationswissenschaft: Effekte durch Einführung nachgewiesen wirksamer Programme
7. Ausblick
Literatur
Objective: This study assesses the short-term and intermediate effects of preschool training stimulating phonological awareness and letter-sound correspondence for children at risk of developing dyslexia. Moreover, we examined whether training reduced the frequency of subsequent dyslexic problems. Method: 25 children at risk of developing dyslexia were trained with Horen, Lauschen, Lernen 1 und 2 (Kuspert & Schneider, 2008; Plume & Schneider, 2004) by their kindergarten teachers and were compared with 60 untrained at-risk children. Results:The training revealed a significant short-term effect: The phonological awareness of trained at-risk children increased significantly over that of untrained at-risk children. However, there were no differences in phonological awareness, spelling, and reading ability between the first-graders in the training and control group. Furthermore, reading problems were reduced in the training group. Conclusions: In the future, phonological awareness as well as additional predictors should be included when identifying children vulnerable to developing dyslexia. Moreover, in order to prevent dyslexia, additional prerequisite deficits need to be identified, alleviated, and their effects evaluated.
A new evidence-based diet score to capture associations of food consumption and chronic disease risk
(2022)
Previously, the attempt to compile German dietary guidelines into a diet score was predominantly not successful with regards to preventing chronic diseases in the EPIC-Potsdam study. Current guidelines were supplemented by the latest evidence from systematic reviews and expert papers published between 2010 and 2020 on the prevention potential of food groups on chronic diseases such as type 2 diabetes, cardiovascular diseases and cancer. A diet score was developed by scoring the food groups according to a recommended low, moderate or high intake. The relative validity and reliability of the diet score, assessed by a food frequency questionnaire, was investigated. The consideration of current evidence resulted in 10 key food groups being preventive of the chronic diseases of interest. They served as components in the diet score and were scored from 0 to 1 point, depending on their recommended intake, resulting in a maximum of 10 points. Both the reliability (r = 0.53) and relative validity (r = 0.43) were deemed sufficient to consider the diet score as a stable construct in future investigations. This new diet score can be a promising tool to investigate dietary intake in etiological research by concentrating on 10 key dietary determinants with evidence-based prevention potential for chronic diseases.
1. Einleitung: … Prozesse nachhaltig gestalten?
2. Konzeptioneller Ansatz: Positive Entwicklung junger Menschen fördern
3. Impulse des DFK zur Weiterentwicklung der Gewaltprävention in Deutschland im Zeitraum 2001 bis 2011
3.1 Projekt „Primäre Prävention von Gewalt gegen Gruppenangehörige“ (2001–2006)
3.2 Unterrichtung der Ministerpräsidentenkonferenz über den Stand der Gewaltprävention sowie über zentrale Handlungserfordernisse zu ihrer nachhaltigen Gestaltung (2003–2006)
3.3 Bericht des Deutschen Jugendinstituts (DJI): Strategien der Gewaltprävention im Kindes und Jugendalter – Eine Zwischenbilanz in sechs Handlungsfeldern (2007)
3.4 Expertise „Gelingensbedingungen für die Prävention von interpersonaler Gewalt im Kindes- und Jugendalter“ (2008)
3.5 Förderung der Evaluation gewaltpräventiver Programme (seit 2009)
3.6 Kooperationsprojekt von Deutscher Bahn AG (DB), DFK und FU Berlin zur Verbreitung entwicklungsorientierter Programme (seit 2010)
3.7 Wissensmanagement zu Entwicklungsförderung und Gewaltprävention (seit 2008)
4. DFK-Projekt „Entwicklungsförderung und Gewaltprävention für jungen Menschen (E & G)“ (seit 2011)
4.1 DFK Sachverständigenrat und Leitfaden „Entwicklungsförderung und Gewaltprävention für junge Menschen“ (2012/2013)
4.2 Weitführenden Perspektiven: Memorandum „Qualität, Struktur und Kooperation fördern“ (2013)
4.3 Projektfortsetzung und Webportal „wegweiser prävention“ (2014)
5. Fazit: … und am Ende nachhaltige Prozesse?
Literatur
"Tolerantes Brandenburg"
(2014)
1. Einleitung
2. Kriminalitätsprävention und Rechtsextremismusprävention
3. Ausgewählte Strukturelemente des Kooperationsverbundes TBB
3.1 Aufgabendefinition zwischen Rechtsextremismusbekämpfung und Demokratieförderung
3.2 Status der landesweiten Zentralstelle
3.3 Ressortübergreifende Aufgaben im Verhältnis zu den Fachressorts
3.4 Vernetzung und Hierarchie
3.5 Verhältnis zur Zivilgesellschaft
3.6 Evaluation
4. Fazit
1. Einleitung
2. Präventionspraxis und -forschung
3. Qualitätskriterien für die Beschaffenheit von Präventionsarbeit bzw. gezielter Präventionsprojekte
4. Selbstevaluation des Projekts „Eltern-Medien-Beratung“ der Aktion Kinder- und Jugendschutz Brandenburg e. V. (AKJS)
4.1 Problemanalyse und Zielbestimmung
4.2 Zielgruppen und Methodenwahl
4.3 Ausgewählte Ergebnisse der Selbstevaluation zur Zufriedenheit der Beteiligten mit den Veranstaltungen sowie zur Wirksamkeit
5. Anforderungen an die Evaluation von Präventionsprojekten und deren Realisierung im Praxisalltag
Literatur
Although effective treatments exist, obsessive-compulsive disorder (OCD) is, according to the views of patients and experts, still associated with chronicity, a term with no clear and consistent definition. To improve patient care and to foster research, a clear distinction between the various concepts of chronicity cited in the literature is crucial. The aim was thus to explicate central concepts related to courses and trajectories in OCD based on an explorative, scoping search of the existing literature. Our review revealed a considerable lack in content validity, as the concepts were operationalized inconsistently. Concepts related to symptom improvement were (complete) recovery, partial/full remission and partial/full response. Terms used in relation with symptom stability or worsening were chronic/continuous, intermittent and episodic course, waxing and waning, relapse, recurrence, deterioration and treatment-refractoriness. All concepts are explained and visualized as a result of the review. Further, based on authors' remarks, we present recommendations on how to enhance care for chronic OCD patients, namely training psychotherapists to apply CBT as intended, managing patient beliefs about disease and treatment, and adapting psychotherapy to OCD subtypes. Finally, we then propose a literature-based definition of treatment-refractory OCD.