After diagnosis of congenital heart disease (CHD) in the fetus, effective counseling is considered mandatory. We sought to investigate which factors, including parental social variables, significantly affect counseling outcome. A total of n = 226 parents were recruited prospectively from four national tertiary medical care centers. A validated questionnaire was used to measure counseling success and the effects of modifiers. Multiple linear regression was used to assess the data. Parental perception of interpersonal support by the physician (β = 0.616 ***, p = 0.000), counseling in easy-to-understand terms (β = 0.249 ***, p = 0.000), and a short period of time between suspicion of fetal CHD, seeing a specialist and subsequent counseling (β = 0.135 **, p = 0.006) significantly improve “overall counseling success”. Additional modifiers (e.g., parental native language and age) influence certain subdimensions of counseling such as “trust in medical staff” (language effect: β = 0.131 *, p = 0.011) or “perceived situational control” (age effect: β = 0.166 *, p = 0.010). This study identifies independent factors that significantly affect counseling outcome overall and its subdimensions. In combination with existing recommendations our findings may contribute to more effective parental counseling. We further conclude that implementing communication skills training for specialists should be considered essential.

The development of effective anti-corruption measures relies on a sound understanding of underlying country-specific cultural patterns of corruption. However, finding these patterns faces the problem of ecological fallacies when tracing back the results of comparative macro-studies to the national level or of using ex-post explanations for cultural variances in experimental research designs. Thus, we ask how cultural patterns can explain country differences in the propensity to act corrupt without neglecting the aforementioned problems. Based on institutional theory, we model path-dependent cultural patterns at the macro, meso and micro levels promoting propensity to act corrupt in Poland and Russia. The results of experimental data gathered from students in Poland and Russia show that the extent to which legal nihilism and ethical dualism are institutionalized at the macro level, as well as the micro factors of gender-specific socialization and studying law, has a significant effect on the propensity to act corrupt.

The COVID-19 pandemic impacts health care providers in multiple ways, even specialties that do not seem to be affected primarily, such as fetal cardiac services. We aimed to assess the effects on parental counseling for fetal congenital heart disease (CHD). In this multicenter study, we used a validated questionnaire. Parents were recruited from four national tertiary medical care centers (n = 226); n = 169 had been counseled before and n = 57 during the pandemic. Overall counseling success including its dimensions did not differ between the two groups (p = n.s.). However, by applying the sorrow scale, we could demonstrate that parents counseled during the pandemic were significantly more concerned (p = 0.025) and unsure (p = 0.044) about their child’s diagnosis, therapy and outcome. Furthermore, parents expressed a significantly increased need for written and/or online information on fetal heart disease (p = 0.034). Other modifiers did not affect counseling success (p = n.s.). We demonstrate that the COVID-19 pandemic impacts effectiveness of parental counseling for fetal CHD, possibly by altering parental perceptions. This needs to be taken into consideration when counseling. Implementing alternative and innovative approaches (e.g., online conference or virtual reality tools) may aid in facilitating high-quality services in critical times such as in the present pandemic.

Zusammenfassung: Die qualitative Untersuchung arbeitet die Funktion informeller Kommunikation in Gerichtsverfahren am Beispiel des deutschen Strafverfahrens heraus. Informelle Kommunikation ermöglicht in diesem Kontext Angeklagte auf die Übernahme einer geskripteten Verfahrensrolle einzustellen. Durch Lernen im sozialen System der juristischen Profession werden Quellen möglichen Protests gegen das Urteil neutralisiert. Diese Arbeit an der personalen Umwelt zur Bewältigung von Inklusionsproblemen findet maßgeblich in der Experten-Laien-Beziehung zwischen Mandant und Verteidiger statt. Dreh- und Angelpunkt der Arbeit an der personalen Umwelt ist ein dem Konditionalprogramm des Rechts gehorchender Fall, der kollegial auf der Hinterbühne mit dem Ziel einer zeitökonomisch effizienten Aufführung der mündlichen Verhandlung hergestellt wurde. Nach Lösung der Inklusionsprobleme können die Mechanismen von Legitimation durch Verfahren, die die Institutionalisierung von Protest nach enttäuschter Erwartung verunmöglichen, auf der Vorderbühne der mündlichen Verhandlung greifen.