Background: Needle-stick injuries (NSIs) pose a safety risk for healthcare workers with great potential for serious infections. The aim was to determine numbers and causes of NSIs as well as the frequency with which medical students report NSIs in the final stages of study.Methods: An online questionnaire was developed and made available in January and February 2023 to all undergraduate medical students (n = 423) in the last 1.5 years of their degree course at Würzburg University, Germany.Results: The response rate was 19.6% (n = 84). Among respondents, 27.4% (n = 23) reported at least one NSI. Occurrence was particularly frequent in surgery, obstetrics and gynaecology, and internal medicine. Assisting with procedures, suturing, and blood sampling were considered high-risk activities. Lack of concentration, distraction, and time pressure played a role in incidents. Respondents did not report 18.8% of NSIs with the main reasons being fear of the consequences, self-assessment of the injury as minor, or the opinion of supervisors that reporting was unnecessary. Students with previous practice on simulators or patients were significantly more likely to suffer NSIs. Instructions from occupational health specialists beforehand correlated with fewer NSIs.Conclusion: We assume that trained students are more experienced in handling invasive procedures, leading to a greater adoption of corresponding activities and thus an increased risk of injuries in absolute numbers. This does not counter the need for didactic interventions prior to workplace-based training to raise awareness of NSI risks. Simultaneously, concepts must be developed and implemented to support reporting and alleviate fears regarding consequences.

Introduction: Sex-specific differences in psychopharmacological treatment have gained increasing attention in adults, with studies showing that women often have higher serum concentrations of psychotropic drugs due to biological differences. However, despite recognition of these differences in adults, reference ranges for therapeutic drug monitoring (TDM) in general, but even more sex-specific therapeutic windows for psychotropic drugs, are lacking in children and adolescents, who may metabolize and respond to medications differently. Aim: The study aimed to investigate sex-specific differences in antidepressant (AD) and antipsychotic (AP) -treatment outcomes, and pharmacokinetics in childhood/adolescence. In particular, we examined differences in AD and AP serum levels and clinical effects, including adverse drug effects (ADEs) and therapeutic effectiveness. Methods: This study is part of the multicenter “TDM-VIGIL” pharmacovigilance project, which prospectively followed patients aged 6–18 years treated with AD and AP across 18 child psychiatric centers in German-speaking countries from 2014 to 2018. Clinical data, including drug concentrations (AD: fluoxetine, mirtazapine, (es)citalopram, sertraline; AP: aripiprazole, quetiapine, olanzapine, risperidone), were collected using an internet-based registry, and treatment outcomes and ADEs were assessed during routine visits. Statistical analyses were performed to examine sex differences in pharmacokinetics and clinical responses, adjusting for age, weight, and other confounders. Results: A total of 705 patients (66.5% girls, 24.7% <14 years, mean age of 14.6 years) were included. Female patients were slightly older, had lower body weight, and were more often diagnosed with depression and anorexia nervosa, while boys were more frequently diagnosed with hyperkinetic disorders and atypical autism. We found no sex differences in the serum concentrations of investigated drugs when adjusted for age and weight. In fluoxetine treatment in patients diagnosed with mood (affective) disorders, female sex was associated with the probability for very good therapy response (p = 0.04), as well as with moderate treatment response (p = 0.02) compared to no treatment response. Discussion: Our findings suggest that sex may not affect serum levels of investigated AD and AP in children/adolescents. However, treatment outcome of fluoxetine was associated with sex, with higher probability for a better outcome in female patients diagnosed with mood (affective) disorders.

Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) presents significant challenges for affected children and adolescents, their social environment, and treating physicians, due to its profound impact on quality of life and the lack of causal therapeutic approaches. One crucial aspect of care that has been missing for these patients is comprehensive education for both them and their social circles. Objective: This study protocol aims to outline the goals, study design, execution, and evaluation of the subproject within the BAYNET FOR ME/CFS project. The focus is on developing online education programs for children and adolescents with ME/CFS, as well as for their parents, siblings, and school staff. These programs are designed to improve independent disease management, increase knowledge, and promote interaction with other affected individuals. Methods: In phase I, the group-based online education programs were developed by a multidisciplinary team based on the ModuS concept created by the Competence Network for Patient Education (KomPaS). These programs were then piloted and finalized. Phase II involved recruiting participants and implementing the finalized programs. Given the restricted physical and cognitive capacities of the affected individuals, the patient education programs were exclusively designed in a digital format to facilitate participation. In phase III, the programs will be evaluated for acceptance, completeness, and participant satisfaction. The qualitative assessment will focus on individual expectations and benefits derived from the training. Phase IV will further assess the programs in terms of improvements in disease knowledge, health-related quality of life, life satisfaction, and family burden. Results: The programs were developed, piloted, and finalized during phase I, which ran from December 2022 to May 2023. The pilot phase, from March to May 2023, led to adaptations in the program concept. In total, 8 patients and their parents, 5 siblings, and 59 school staff participated in the piloting. Adjustments were made to the format, content, duration, and schedule to better meet the needs of the affected individuals and their social circles. In phase II, participant recruitment for the patient education program took place from January to July 2023. The study successfully recruited 24 young patients with ME/CFS and their parents, along with 8 siblings and 51 school staff. Two program blocks for patients and parents and 2-3 blocks for siblings and school staff commenced in May 2023 and were completed within the same year. Phase III began after phase II and involves the evaluation of the programs, with the process expected to conclude by the end of 2024. Phase IV, planned for 2025-2026, will involve the rollout of the program to 150 children and their caretakers. This phase will focus on evaluating disease knowledge, health-related quality of life, life satisfaction, and family burden, as well as include longitudinal assessments. Conclusions: The data aim to support the development of a comprehensive, interprofessional care model for children and adolescents with ME/CFS. International Registered Report Identifier (IRRID): DERR1-10.2196/54679

Pediatric emergencies present significant risks, and medical students often have limited exposure to these situations, hindering the development of clinical skills. Virtual reality (VR) simulation offer a solution by providing high-fidelity experiences for practicing clinical reasoning and procedures. This study aimed to assess knowledge gain and gather student perspectives following a seminar based on a pediatric emergency VR simulation. A 45-min VR case scenario involving a newborn with late-onset sepsis was developed and implemented as part of a seminar during their pediatric clinical rotation for medical students. The learning experience in the seminar was further enhanced by feedback from peers and an expert clinician. Students’ knowledge was assessed before and after the seminar using open-ended questions. Additionally, a post-seminar questionnaire was employed to gather feedback on estimated learning success in individual clinical competencies, the effectiveness of VR simulation as a learning tool, and the didactic concept. Of the 116 students who attended the seminar, pre- and post-tests assessing objective knowledge were completed by 109. Average knowledge scores increased from 7.80 ± 2.1 points before the seminar to 10.90 ± 1.2 points after (out of a maximum of 12 points) ( p < .001). Knowledge of 5 out of 6 individual diagnostic and therapeutic measures showed a significant increase. Regarding learning success, participants reported a significantly increased competence level in all four assessed categories (on average from 2.68 ± 1.07 to 4.15 ± 0.70 on a 5-point Likert scale, p < .001). The VR software used for learning the pediatric emergency and its integration into the didactic concept of the seminar were also positively evaluated retrospectively. VR simulations for pediatric emergencies offer a practical means for students to link theoretical knowledge with practical skills. They prove to be a motivating educational tool that leads to an enhancement in students’ knowledge. In addition to its positive impact on learning outcomes, the present study also illustrates another potential approach for integrating VR simulation into a curricular seminar format.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) poses challenges for affected children and young people (CYP) and their parents. There is often a lack of knowledge about the illness. Education programs can help address this by providing knowledge and supporting the independent management of the condition. For this reason, two online education programs—one for affected CYP and one for their parents—were developed, implemented, and evaluated in terms of acceptance, format, and benefits. A total of 24 CYP with ME/CFS, aged of up to 20 years, and their parents were recruited for this study. Of these 22 CYP with ME/CFS and 20 parents participated in the online education program. After development and conduct of the programs, six affected CYP were interviewed using written questions, which were answered via an audio device. Furthermore, six semi-structured interviews were obtained with parents. All parents also received an online questionnaire to evaluate the program. Data were analyzed using both quantitative and qualitative methods. Both CYP and their parents expressed overall satisfaction with the program, highlighting aspects such as knowledge acquisition or reinforcement and, importantly, the opportunity to connect with other affected CYP or their parents. The online format was also perceived very positively. The online education program met the expectations and needs of both affected CYP and parents regarding content and format. It facilitated exchange and provided practical knowledge. In this format, the online program appears to be a valuable component of care for those affected.

Zusammenfassung: Hintergrund: Die Versorgung von Kindern und Jugendlichen mit Myalgischer Enzephalitis/Chronic Fatigue-Syndrom (ME/CFS) gestaltet sich aufgrund fehlender Anlaufstellen, einer notwendigen interdisziplinären Betreuung sowie einer eingeschränkten Mobilität der Betroffenen als schwierig. Ziel war es, ein Versorgungsmodell an einem sozialpädiatrischen Zentrum (SPZ) mit Behandlungsoptionen wie Videosprechstunde sowie online durchgeführten Gruppenschulungen zu entwickeln und den Betreuungsaufwand zu ermitteln. Material und Methoden: Patient:innen mit ME/CFS < 21 Jahre konnten sich für eine mindestens 3‑monatige Weiterbehandlung in einem SPZ entscheiden. Dort erfolgte eine interdisziplinäre Betreuung mittels Online-Sprechstunden. Zudem wurden Online-Gruppenschulungen für Betroffene, ihre Angehörigen sowie schulisches Personal entwickelt und durchgeführt. Während des Projektes wurde der Aufwand in Form aller direkten Patient:innenkontakte sowie der Organisation, Fallbesprechungen und Verwaltung dokumentiert und ausgewertet. Ergebnisse: Insgesamt nahmen 24 Patient:innen teil. Der Aufwand pro Patient:in der Studie betrug 240 min im direkten Patient:innenkontakt und 262 min für die Organisation, Fallbesprechungen sowie administrative Verwaltung innerhalb des 3‑monatigen Versorgungszeitraums im SPZ. Dabei konnten im Aufwand keine Unterschiede zwischen Patient:innen bis und älter als 18 Jahre festgestellt werden. Von den zusätzlichen angebotenen Gruppenschulungen für Betroffene und für Eltern wurden durchschnittlich 64 % der Module in Anspruch genommen. Diskussion: Ein interdisziplinäres Versorgungsmodell für Kinder- und Jugendliche mit ME/CFS unter Einbindung eines SPZ ist möglich. Die Online-Schulungen zeigten eine hohe Akzeptanz und könnten zu einem geringeren Betreuungsaufwand aufgrund des dort erworbenen Wissens führen.