Oliver Hirsch

In this study, we evaluate four German-language versions of the PSC (parent long: 35 items, short: 17 items, children and adolescents long: 35 items, short: 17 items). In two online surveys (COMPARE, ASK), we examined the psychometric quality criteria. The COMPARE data set included n = 388 parent–child dyads (age: parents M (SD) = 42.20 (7.37); age: children M (SD) = 10.90 (2.91)), and the ASK data set included n = 278 dyads (parents M (SD) = 43.00 (6.14); children M (SD) = 12.50 (2.11)). Data analysis revealed that all 35 items in the two versions fulfilled the quality criteria of classical test theory. The internal consistency for all four versions was acceptable to good. The three-factor structure was replicated and the discriminant and convergent validity compared to the CBCL and KIDSCREEN were satisfactory. Overall, the PSC is an economical, valid, and comprehensive screening instrument for mental health problems in children and adolescents.

Background: First-time diagnoses of attention-deficit/hyperactivity disorder (ADHD) in adults can be challenging due to diverse methodologies available for assessment, and the choices clinicians need to make about how to interpret diagnostic criteria. Network analysis is a statistical approach that has received growing attention in clinical research of recent years. It has the potential to aid visualization and illustrate the intricate relationships between the wide range of clinical measures. Aim: The goal of the present study is to examine the value of network analysis on a sample of N = 896 adults newly diagnosed with ADHD in an outpatient referral context. Method and Results: The network depicts the interrelationship of a comprehensive set of measures and test variables, including symptom self- and other-reports, cognitive tests, motor activity, as well as measures of symptom and performance validity. Conclusion: Our network analysis supports ADHD symptom clusters with distinct networks of motor activity and attention/impulsivity and reflects the mode of assessment, i.e., neuropsychological versus self- and observer-ratings. The network further depicts the dissociable role of symptom and performance validity measures, and the different nature of embedded and freestanding validity tests. We discuss the future application of network analysis in clinical research on ADHD.

Children account for a significant proportion of the world's population and are a particularly vulnerable subpopulation regarding environmental factors. In a scoping review of a total of 3130 articles compiled from relevant medical literature, including 107 publications, we provide an empirical overview of the literature on masks in connection with children, particularly with regard to its' expected effects on viruses during the pandemic 2020-2023 versus scientific reality and evidence, including the side effects. While masks lack ecological validity from a strictly empirical point of view (transferability of experimental results from laboratories and modelling to the real world, e.g. to situations or environments typical of everyday life) and high-quality studies are showing little evidence of their effectiveness in real-world scenarios, whereas the side effects appear to be clear. An individual risk-benefit analysis is necessary and also a consideration of the situations, in which the use of masks in children could be justified. This review including the literature found and analysed will be able to help when making decisions in this regard.

Nudging, a controversial technique for modifying people's behavior in a predictable way, is claimed to preserve freedom of choice while simultaneously influencing it. Nudging had been largely confined to situations such as promoting healthy eating choices but has been employed in the coronavirus disease 2019 (COVID-19) crisis in a shift towards measures that involve significantly less choice, such as shoves and behavioral prods. Shared decision making (SDM), a method for direct involvement and autonomy, is an alternative approach to communicate risk. Predominantly peer-reviewed scientific publications from standard literature databases like PubMed, PsycInfo, and Psyndex were evaluated in a narrative review. The so-called fear nudges, as well as the dissemination of strongly emotionalizing or moralizing messages can lead to intense psycho-physical stress. The use of these nudges by specialized units during the COVID-19 pandemic generated a societal atmosphere of fear that precipitated a deterioration of the mental and physical health of the population. Major recommendations of the German COVID-19 Snapshot Monitoring (COSMO) study, which are based on elements of nudging and coercive measures, do not comply with ethical principles, basic psychological principles, or evidence-based data. SDM was misused in the COVID-19 crisis, which helped to achieve one-sided goals of governments. The emphasis on utilitarian thinking is criticized and the unethical behavior of decision makers is explained by both using the concept of moral disengagement and the maturity level of coping strategies. There should be a return to an open-ended, democratic, and pluralistic scientific debate without using nudges. It is therefore necessary to return to the origins of SDM.

In this chapter, we briefly review foundational contributions to the study of propaganda along with examples of the use of propaganda techniques in medicine in the past. We then illustrate and discuss elements of propaganda found in communications from government, public health administration, and the mainstream media during the COVID-19 pandemic from 2020 to early 2022. The examples are drawn from Germany, Canada, and other countries in the Western World. They include elements of simplification and faulty analogies, emotional appeals and scapegoating, and manipulating numbers. We discuss the use of propaganda from an ethical perspective with particular attention to fear narratives, the weakness of the underlying evidence, and the use of moral appeals. We conclude that the use of propaganda techniques to support the COVID-19 pandemic response was unethical, since the broad scope and uniformity of the response measures were not sufficiently established by scientific evidence or by the facts on the ground.

In this chapter, we briefly review foundational contributions to the study of propaganda along with examples of the use of propaganda techniques in medicine in the past. We then illustrate and discuss elements of propaganda found in communications from government, public health administration, and the mainstream media during the COVID-19 pandemic from 2020 to early 2022. The examples are drawn from Germany, Canada, and other countries in the Western World. They include elements of simplification and faulty analogies, emotional appeals and scapegoating, and manipulating numbers. We discuss the use of propaganda from an ethical perspective with particular attention to fear narratives, the weakness of the underlying evidence, and the use of moral appeals. We conclude that the use of propaganda techniques to support the COVID-19 pandemic response was unethical, since the broad scope and uniformity of the response measures were not sufficiently established by scientific evidence or by the facts on the ground.

From 2020 to 2023 many people around the world were forced to wear masks for large proportions of the day based on mandates and laws. We aimed to study the potential of face masks for the content and release of inanimate toxins. A scoping review of 1003 studies was performed (database search in PubMed/MEDLINE, qualitative and quantitative evaluation). Twenty-four studies were included (experimental time 17 min to 15 days) evaluating content and/or release in 631 masks (273 surgical, 228 textile and 130 N95 masks). Most studies (63%) showed alarming results with high micro- and nanoplastics (MPs and NPs) release and exceedances could also be evidenced for volatile organic compounds (VOCs), xylene, acrolein, per-/polyfluoroalkyl substances (PFAS), phthalates (including di(2-ethylhexyl)-phthalate, DEHP) and for Pb, Cd, Co, Cu, Sb and TiO₂. Of course, masks filter bacteria, dirt and plastic particles and fibers from the air we breathe and have specific indications, but according to our data they also carry risks. Depending on the application, a risk-benefit analysis is necessary. However, mask mandates during the SARS-CoV-2 pandemic have been generating an additional source of potentially harmful exposition to toxins at population level with almost zero distance to the airways.

Background: Burnout in the field of gastroenterology is an under-researched phenomenon. So far, only a few studies have dealt with this topic. There are large geographical variations in burnout rates with 16–20% of gastroenterologists in Mexico and Germany being at risk or having burnout, 30–40% in the United Kingdom, and 50–55% in South Korea, Canada, and the USA. The investigation of differential associations of burnout with important factors in gastroenterologists leading to tailored therapy recommendations is lacking. Therefore, we investigated the associations between work satisfaction and burnout in this specialization. Methods: We distributed an electronic survey to gastroenterologists organized mainly in the Federal Organization of Gastroenterology in Germany (the BVGD - Bundesverband Gastroenterologie Deutschland). The Maslach Burnout Inventory (MBI) and the Work Satisfaction Questionnaire (WSQ) were examined regarding their postulated internal structure in our sample of gastroenterologists. Canonical correlations were performed to examine the association between work satisfaction and burnout in endoscopy physicians. Results: An acceptable model fit was shown for both the MBI and the Work Satisfaction Questionnaire. The canonical correlation analysis resulted in two statistically significant canonical functions with correlations of .62 (p<.001) and .27 (p<.001). The full model across all functions was significant (χ2(18) = 386.26, p<.001). Burden, personal rewards, and global item regarding the job situation were good predictors for less exhaustion, while patient care and professional relations were good predictors for personal accomplishment. This supports the recognition of burnout as being a multidimensional construct which has to be thoroughly diagnosed. Conclusions: Specific interventions should be designed to improve symptoms of burnout in endoscopy physicians according to their individual complaints as burnout is a multidimensional construct. Differential interventions should be offered on the basis of our study results in order to alleviate the issue of work satisfaction and burnout in endoscopy physicians.

Background: Burnout in the field of gastroenterology is an under-researched phenomenon. So far, only a few studies have dealt with this topic. There are large geographical variations in burnout rates with 16–20% of gastroenterologists in Mexico and Germany being at risk or having burnout, 30–40% in the United Kingdom, and 50–55% in South Korea, Canada, and the USA. The investigation of differential associations of burnout with important factors in gastroenterologists leading to tailored therapy recommendations is lacking. Therefore, we investigated the associations between work satisfaction and burnout in this specialization. Methods: We distributed an electronic survey to gastroenterologists organized mainly in the Federal Organization of Gastroenterology in Germany (the BVGD - Bundesverband Gastroenterologie Deutschland). The Maslach Burnout Inventory (MBI) and the Work Satisfaction Questionnaire (WSQ) were examined regarding their postulated internal structure in our sample of gastroenterologists. Canonical correlations were performed to examine the association between work satisfaction and burnout in endoscopy physicians. Results: An acceptable model fit was shown for both the MBI and the Work Satisfaction Questionnaire. The canonical correlation analysis resulted in two statistically significant canonical functions with correlations of .62 (p<.001) and .27 (p<.001). The full model across all functions was significant (χ2(18) = 386.26, p<.001). Burden, personal rewards, and global item regarding the job situation were good predictors for less exhaustion, while patient care and professional relations were good predictors for personal accomplishment. This supports the recognition of burnout as being a multidimensional construct which has to be thoroughly diagnosed. Conclusions: Specific interventions should be designed to improve symptoms of burnout in endoscopy physicians according to their individual complaints as burnout is a multidimensional construct. Differential interventions should be offered on the basis of our study results in order to alleviate the issue of work satisfaction and burnout in endoscopy physicians.