ABSTRACTAimTo investigate whether webcam access for parents of infants in neonatal intensive care units influences parental postpartum depression and stress experiences.MethodsParents whose infants had a birth weight below 1500 g and who were admitted to one of the four participating tertiary care hospitals were eligible to participate in the study. The study followed the structure of a multi‐centre cross‐over pragmatic randomised controlled trial. Depending on their assigned study group, participants gained access to a webcam either in Weeks 1–4 of the observation period and abstained from webcam use in Weeks 5–8 (First‐Half Access Group) or vice versa (Second‐Half Access Group). Outcomes were measured at four time points utilising the Edinburgh Postnatal Depression Scale and the Parental Stressor Scale: Neonatal Intensive Care Unit. Effects were estimated using linear mixed‐effects regression modelling.ResultsData from 229 mothers and 211 fathers/partners were analysed; neither group's webcam access had a significant effect on the level of symptoms related to postpartum depression or stress experienced.ConclusionBased on the present results, webcam access has neither negative nor positive effects on parental psychological strain. Further research is needed to understand how individual preferences and physical presence influence the impact of webcams.

Objectives: During the COVID-19 pandemic, dental appointments were cancelled or postponed by both patients and dentists. This study investigated the associations between German dentists' concerns on cross infection and their emotional burden due to personal economic impact on dentist -initiated appointment cancellations. Methods: Data were collected using an anonymous cross-sectional online survey of outpatient physicians in Germany from March through April 2020. Dental treatments were divided into 3 treatment categories (plannable treatments, acute treatments without COVID-19 -like symptoms, and acute treatments with COVID-19 -like symptoms). Descriptive analyses and multivariate logistic regression models were performed. Results: A sample of 269 self-employed dentists was considered. Cancellations of prophylaxis appointments were reported by 82% of dentists, whilst 49% reported cancellations of appointments for acute complaints with simultaneous patient -side COVID-19 -like symptoms. Further, 58% of respondents stated high or very high concerns about COVID-19 selfinfection; 81% stated to be emotionally burdened by the personal economic impact. Dentists' concern of infecting themselves significantly decreased the likelihood of maintaining appointments, with odds ratios of 0.635 (95% confidence interval [CI], 0.426 to 0.932) for plannable treatments and 0.587 (95% CI, 0.367 to 0.916) for treatments of patients with acute complaints and simultaneous COVID-19 -like symptoms. In addition, there was a significant negative association between dentists who reported emotional distress due to personal economic impact and the likelihood to maintain appointments, with odds ratios of 0.291 (95% CI, 0.123 to 0.695) for plannable treatments and 0.231 (95% CI, 0.053; 0.706) for treatments of patients without acute complaints and simultaneous COVID-19 -like symptoms. Conclusion: Dentists' fear of infecting themselves with COVID-19 played a role in terms of practice -related appointment cancellations. Dentists differentiated their appointment cancellations according to different treatment categories and patient needs. If dental care is to be maintained in pandemic times, physicians' personal factors such as concerns about infection and perceived pandemic -related personal economic impact need to be considered. (c) 2023 The Authors. Published by Elsevier Inc. on behalf of FDI World Dental Federation. This is an open access article under the CC BY -NC -ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

BACKGROUND:The challenging transition to parenthood affects both mothers and fathers; yet, the strain intensifies with a premature birth in the neonatal intensive care unit (NICU), underscoring the importance of acknowledging and addressing potential differences in parental roles. PURPOSE:This paper aimed to investigate how parental role conflicts among mothers and fathers of preterm-born infants hospitalized in German NICUs manifest and investigated potential parental resources. METHODS:Twenty-four participants, 17 mothers, and seven fathers of very low birth-weight infants were interviewed. A thematic content analysis was performed at a semantic level. RESULTS:Fathers feel pressured to fulfill the role expectations, often leading to the suppression of paternal feelings and needs. For mothers, deviating from societal expectations regarding their expressive roles can be distressing, as they worry that such deviation might hinder their infants from having a successful start in life. Consulting with healthcare professionals shows to ease challenges for both parental roles. IMPLICATIONS FOR PRACTICE AND RESEARCH:Maternal and paternal challenges are often rooted in expectations placed on their societal roles. Highlighting these challenges can be essential for increasing awareness and effectively addressing them. Tailored nursing practices may have the potential to facilitate individuals' navigation of uncertainties and fulfillment of caregiving roles.

Background:The challenging transition to parenthood affects both mothers and fathers; yet, the strain intensifies with a premature birth in the neonatal intensive care unit (NICU), underscoring the importance of acknowledging and addressing potential differences in parental roles.Purpose:This paper aimed to investigate how parental role conflicts among mothers and fathers of preterm-born infants hospitalized in German NICUs manifest and investigated potential parental resources.Methods:Twenty-four participants, 17 mothers, and seven fathers of very low birth-weight infants were interviewed. A thematic content analysis was performed at a semantic level.Results:Fathers feel pressured to fulfill the role expectations, often leading to the suppression of paternal feelings and needs. For mothers, deviating from societal expectations regarding their expressive roles can be distressing, as they worry that such deviation might hinder their infants from having a successful start in life. Consulting with healthcare professionals shows to ease challenges for both parental roles.Implications for Practice and Research:Maternal and paternal challenges are often rooted in expectations placed on their societal roles. Highlighting these challenges can be essential for increasing awareness and effectively addressing them. Tailored nursing practices may have the potential to facilitate individuals' navigation of uncertainties and fulfillment of caregiving roles.

AIM:Strain on couple relationships is associated with a lower well-being. As premature birth is known to pose stress to parents, this study explores whether interparental relationship strain comes to pass within mothers and fathers during their infant's stay in a neonatal intensive care unit. METHODS:A retrospective cross-sectional survey was conducted with parents who experienced a preterm birth (September to December 2020). Linear regression was used to analyse associations between stress and relationship strain. RESULTS:The study included 437 mothers and 301 fathers. Fathers experienced lower relationship strain (M = 2.49, SD = 1.00) than mothers (M = 3.37, SD = 1.04). Overall, a significant association between relationship strain and stress due to the infant's behaviour and appearance was found for mothers (β = 0.16, p = 0.02) and fathers, with a significantly higher association for fathers (β = 0.27, p ≤ 0.002). With regard to parental role alterations, only mothers showed a significant association (β = 0.21, p ≤ 0.001). CONCLUSION:Although mothers showed higher levels of stress and relationship strain, stress may also have an impact on fathers. Therefore, research should focus on stress prevention measures to meet both maternal and paternal needs.

Hintergrund Die Nutzung von Webcams auf neonatologischen Intensivstationen soll kein Ersatz für persönliche Besuche der Eltern auf der Station sein. Trotzdem ruft sie häufig die Sorge vor einer Abnahme der elterlichen Anwesenheit beim Kind auf der Station hervor [1]. Die Studie Neo-CamCare evaluiert den Einsatz von Webcams auf neonatologischen Intensivstationen u. a. im Hinblick auf die elterlichen Besuchszeiten und die Webcamnutzung.

Background: COVID-19 vaccination is recognized as a key component in addressing the COVID-19 pan-demic. Physicians' attitudes toward vaccination are known to play a defining role in the management and dissemination of medical advice to patients. In Germany, outpatient practitioners are predominantly responsible for the dissemination of vaccines.Method: Using a cross-sectional online survey, 932 outpatient general practitioners, gynecologists, and pediatricians in Germany were asked in fall, 2021, about their attitude toward COVID-19 vaccination and - among others - their communication in vaccine discussions, their assessment of vaccine safety, and reporting of suspected adverse events. Physicians were divided into two groups along their attitudes toward COVID-19 vaccination. In addition, multivariate linear regression models were constructed to assess differences in communication strategies.Results: 92 % of physicians had a positive or very positive attitude toward COVID-19 vaccination. Own vaccination status, practice-based vaccination delivery, and estimated vaccination coverage among patients were significantly associated with the attitude toward vaccination. Confidence in vaccine safety was significantly lower among physicians with negative attitudes. There were no differences between the two groups in self-assessment of the ability to detect suspected adverse events, but there were differ-ences in the observing and reporting of adverse events. For the linear regression models, we found that a more negative attitude toward COVID-19 vaccination was significantly associated with increased accep-tance of patient refusal of COVID-19 vaccination and empathic behavior for patient concerns. In contrast, willingness to engage in a detailed persuasion consultation was significantly lower. Pediatricians showed significantly higher empathy for patient-side concerns compared to general practitioners, whereas gyne-cologists showed less empathy than general practitioners.Discussion: The physician's attitude toward COVID-19 vaccination influences the physician's practices as a vaccine provider. However, when providing medical advice and healthcare, the physician should focus on the actual needs of the patient.(c) 2022 Elsevier Ltd. All rights reserved.

The measures taken to contain the COVID-19 pandemic had a major impact on society, affecting medical care as well as the utilization of medical services. We aimed to identify pandemic-related changes in gynaecologic/obstetric care through the personal experience of practitioners in the outpatient sector in Germany. Three consecutive anonymous online surveys of practising gynaecologists were conducted during the pandemic (07–09/2020, 11–12/2020 and 09–11/2021). Appointment management, medical supply and patients’ demand as well as concomitant circumstances were queried. Data from 860 (393, 262 and 205 from the first, second and third surveys, respectively) respondents were analysed. At the peak of the first COVID-19 wave, more than 50% of the gynaecologists surveyed had cancelled cancer screening appointments. There was a significant association between fear of self-infection and cancellation of cancer screening appointments (p = 0.006). An increase in domestic violence was reported by 13%, an increase in obesity by 67% and more advanced tumours due to delayed screening by 24% of respondents. Primary gynaecological oncological prevention was reduced in supply and demand during the COVID-19 pandemic, and this shortfall should be addressed in future similar situations. Prenatal care has been offered continuously since the start of the pandemic in Germany.

Hintergrund Die Milch der eigenen Mutter ist die beste Ernährung für frühgeborene Kinder. Als kritischer Schwellenwert gilt dabei eine abgepumpte Muttermilchmenge von 500 ml/24h am Tag 14 post partum (p.p.) [1]. Für die erfolgreiche Initiierung der Laktation essentiell ist regelmäßiges Abpumpen, wobei mindesten 8 Abpumpvorgänge pro Tag durchgeführt werden sollten [2]. Empfohlen wird vor dem Kind abzupumpen, oder wenn dies nicht möglich ist ein Bild oder ein Video des Kindes beim Abpumpen anzusehen, um die Produktion von Oxytocin anzuregen. Fragestellung: Untersucht wurde anhand von Real-Life Daten das Abpumpverhalten, wie auch die Milchmenge in Abhängigkeit der Rahmenbedingungen des Abpumpens (vor dem Kind, mit Foto und vor einem Live-Stream des Kindes, ohne).

Hintergrund Die Neo-CamCare Studie untersuchte über einen Zeitraum von drei Jahren den Einsatz von Webcams auf neonatologischen Intensivstationen (NICUs) in Deutschland. Die Webcams ermöglichen es Eltern von frühgeborenen Kindern, ihr Kind auch dann zu sehen, wenn sie selbst nicht auf der Intensivstation anwesend sein können. Der Einsatz dieser Webcams hat jedoch nicht nur Auswirkungen auf die Eltern, sondern auch auf das ärztliche und pflegerische Personal der NICU. Ihre Einstellung zu den Webcams wurde im Verlauf der Studie prospektiv erhoben.

Hintergrund Webcams werden bereits auf einzelnen neonatologischen Intensivstationen (NICUs) in Deutschland und international eingesetzt. Die Webcams ermöglichen es Eltern von Frühgeborenen, ihr Kind auch dann sehen zu können, wenn sie selbst nicht im Krankenhaus sein können. Die Neo-CamCare Studie evaluierte über einen Zeitraum von drei Jahren multiperspektivisch den Einsatz von Webcams auf NICUs. Ein Ziel der Studie war es, herauszufinden, wie sich die Nutzung der Webcams auf das Wohlbefinden der Eltern auswirkt.

Background: In Germany, general practitioners (GPs) provide basic and primary care in the ambulatory sector and refer patients to other specialists when necessary. Often, GPs present the first point of contact for patients in the German healthcare system. During the COVID-19 pandemic, GPs and other medical specialists in the ambulatory setting suddenly were confronted with unprecedented challenges. Objective: To answer the following research questions: How did COVID-19-related challenges affect the work climate? Do physicians with deteriorated work climate simultaneously report a worsened provision of patient care? Which challenges were the most burdening? Methods: In the course of the project COVID-GAMS more than 18 000 physicians of various specialties had been invited to a quantitative cross-sectional online survey (in Summer 2020). Analyses were conducted separately for the groups of GPs and other medical specialists. Group differences were analysed statistically and burdening factors were identified. Results: 1703 participants were included in the analysis. 22.2% of GPs (other medical specialists: 19.9%) stated, their work climate had deteriorated. Physicians with a deteriorated work climate showed a tendency towards poorer personal provision of patient care (M = 3.75, SD = 0.98 versus M = 3.93, SD = 0.99) compared to unchanged or improved work climate. The lack of protective material in March/April 2020, changes in practice management and possible economic impacts on the practice were the most burdening factors reported by GPs. Conclusion: GPs who reported a negative impact on the work climate in the course of the first pandemic lockdown also tend to see own deficits in the provision of patient care.

Abstract Background The use of webcam technology in neonatal intensive care units (NICUs) enables parents to see their child when the parents cannot be present at the NICU. The webcam’s use has been gaining increasing attention. Lead physicians and lead nursing staff play a key role in the decision of whether to implement webcams. This study investigates factors that are associated with the readiness for the implementation of a webcam system among lead NICU staff. Methods A postal survey was conducted among all lead physicians and lead nursing staff in all German NICUs between December 2020 and April 2021 (total N = 416, one lead physician and one lead nursing staff per NICU, N = 208). On the basis of normalization process theory, personal (technology acceptance) and organizational (innovation climate) attributes were chosen to determine their association with the readiness for the implementation of a webcam system. The association of these factors was determined using multiple linear regression models for both lead physicians and lead nurses. Results Overall, a response rate of 66.59% (n = 277) was achieved. Technology acceptance proved to be a significant factor associated with the readiness for the implementation of a webcam system among lead physicians. Furthermore, staff already working with webcams in their NICUs indicated a significantly higher level of technology acceptance than staff without webcam experience and without any desire to use a webcam in the future. No significant association was found between innovation climate and the readiness for the implementation of a webcam system. Conclusions Technology acceptance was identified as a factor associated with the readiness for the implementation of a webcam system. The insights from this study can be used to manage potential barriers regarding the readiness for implementation of webcams in NICUs. Trial registration The Neo-CamCare study is registered at the German Clinical Trials Register. DRKS-ID: DRKS00017755. Date of Registration in DRKS: 25-09-2019.

BACKGROUND:In the wake of the coronavirus disease 2019 (COVID-19) pandemic, administrative barriers to the use of telemedicine have been reduced in Germany. The study focused on the analysis of use and assessment of telemedicine by physicians working in the outpatient sector, considering the perspective of different disciplines during the COVID-19 pandemic in Germany.METHODS:The anonymous cross-sectional online survey within the study COVID-GAMS was conducted from 16 November 2020 to 1 January 2021. General practitioners; cardiologists; gastroenterologists; paediatricians; gynaecologists; ear, nose, and throat (ENT) specialists were randomly selected and invited to participate in the survey. At the same time, open recruitment to the online survey was conducted via the professional societies. Descriptive and regression analyses were performed based on the data of 1521 outpatient responding physicians.RESULTS:The use of telephone and video consultation increased during the pandemic. Regarding the frequency of use, physicians already using telephone/video consultations in March/April 2020 report an increase in such services. General medicine was associated with an increased use of telephone and video consultations than cardiology, gynaecology or ENT, and in the case of telephone consultations also compared to paediatrics. General practitioners assessed the subjective usefulness higher than gynaecology and ENT. And the self-reported proportion of patients receiving telemedical care was higher correlated with general medicine than all other disciplines. The location of the practice (rural vs. urban), type of practice (individual vs. group) and gender (male vs. female) were also shown to be significant influencing factors on the variables mentioned above. Barriers reported by physicians not using telemedicine were the lack of equivalence to face-to-face contact and perceived low demand from patients.CONCLUSION:The COVID-19 pandemic has led to a significant increase in the use of telemedicine, to varying degrees in the different specialities. Individual and structural factors lead to a reduced use of telemedicine and there are physician's and patient's barriers that have prevented telephone and video consultations from gaining acceptance by physicians. All these factors must be addressed if telemedicine procedures are to be implemented widely.

Background Some neonatal intensive care units offer parents webcam systems for times when they cannot be in the ward. Leaving an infant in the ward can be challenging for parents, and trust in the neonatal healthcare professionals mitigates parents’ worries of not knowing how their infant is doing while they are away. If parents lack trust in the neonatal healthcare professionals, they may attempt to compensate by using webcams. In this work, we examine whether an association exists between the parental preference to use a webcam and low trust in physicians and nursing staff. Methods In a nationwide, retrospective cross-sectional study, parents of infants with a birth weight below 1500 g were surveyed six to 18 months after their infant’s birth. Parents who were not offered a webcam system in the ward were asked whether they would have opted for it. Trust was measured by the Trust in Physician and Trust in Nursing Staff scales. Results Of the parents who were not offered a webcam, 69% would have chosen to use a webcam if they had been granted the opportunity. The decision for or against a webcam was not significantly associated with either trust in physicians (OR = 0.654, 95% CI = 0.456, 0.937, p = .124) or trust in nursing staff (OR = 1.064, 95% CI = 0.783, 1.446, p = .932). Conclusions While the majority of parents surveyed would opt for webcam usage, this preference should not be interpreted as an indicator of lacking trust in neonatal healthcare professionals.

Acta PaediatricaEarly View READER’S FORUM Response to the letter concerning our publication on parental trust and stress experience Laura Mause, Corresponding Author Laura Mause laura.mause@uk-koeln.de orcid.org/0000-0002-7124-7882 Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany Correspondence Laura Mause, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany. Email: laura.mause@uk-koeln.deSearch for more papers by this authorJan Hoffmann, Jan Hoffmann Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, GermanySearch for more papers by this authorAlinda Reimer, Alinda Reimer Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, GermanySearch for more papers by this authorTill Dresbach, Till Dresbach Department of Pediatrics, University Hospital Bonn, Bonn, GermanySearch for more papers by this authorDirk Horenkamp-Sonntag, Dirk Horenkamp-Sonntag Techniker Krankenkasse, Healthcare Management, Hamburg, GermanySearch for more papers by this authorMelanie Klein, Melanie Klein DAK Gesundheit, Hamburg, GermanySearch for more papers by this authorNadine Scholten, Nadine Scholten orcid.org/0000-0002-7793-7745 Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, GermanySearch for more papers by this author Laura Mause, Corresponding Author Laura Mause laura.mause@uk-koeln.de orcid.org/0000-0002-7124-7882 Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany Correspondence Laura Mause, Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, Germany. Email: laura.mause@uk-koeln.deSearch for more papers by this authorJan Hoffmann, Jan Hoffmann Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, GermanySearch for more papers by this authorAlinda Reimer, Alinda Reimer Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, GermanySearch for more papers by this authorTill Dresbach, Till Dresbach Department of Pediatrics, University Hospital Bonn, Bonn, GermanySearch for more papers by this authorDirk Horenkamp-Sonntag, Dirk Horenkamp-Sonntag Techniker Krankenkasse, Healthcare Management, Hamburg, GermanySearch for more papers by this authorMelanie Klein, Melanie Klein DAK Gesundheit, Hamburg, GermanySearch for more papers by this authorNadine Scholten, Nadine Scholten orcid.org/0000-0002-7793-7745 Institute of Medical Sociology, Health Services Research and Rehabilitation Science, Faculty of Human Sciences and Faculty of Medicine, University of Cologne and University Hospital Cologne, Cologne, GermanySearch for more papers by this author First published: 10 February 2022 https://doi.org/10.1111/apa.16286Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Early ViewOnline Version of Record before inclusion in an issue RelatedInformation

AIM:To examine parents' perceptions of stress and their trust in physicians and nursing staff and to investigate whether trust influences the parental perceptions of potential stressors resulting from their infant's hospitalisation in a neonatal intensive care unit. METHODS:Parents of very and extremely low birth weight infants were surveyed in a nationwide retrospective cross-sectional study 6-18 months after their child's birth. Parental stress was measured utilising the PSS:NICU_German/2-scales, and trust was measured by the scales Trust in Physicians and Trust in Nursing Staff. In addition to descriptive analyses, multiple linear regression models were conducted. RESULTS:The change in parents' anticipated roles was assessed as more stressful than their infant's appearance and behaviour. Trust in nursing staff significantly influenced the parental stress level. Although the level of trust in physicians was rated higher than trust in nursing staff, trust in physicians did not yield a significant effect on the parental stress experience. CONCLUSION:Efforts to foster parental trust in nursing staff may reduce the parental stress level and hence enable parents to better cope with the situation. The parental resources unleashed in this way can be employed to enhance parenting.

Background To bridge the physical distance between parents and children during a neonatal intensive care unit (NICU) stay, webcams are used in few German NICUs. They allow parents to view their infant even when they cannot be present on the ward. The aim of the study was to explore the factors for and against webcam use that parents with or without webcam use encountered. Methods Guideline-based, semi-structured qualitative interviews were conducted in the period from September 2019 to August 2020. Interview transcripts were analysed using a category-based content analysis. The categories were generated in a combined deductive–inductive procedure. Results We interviewed 33 mothers and seven fathers. Parents with webcam experience emphasised positive aspects concerning their webcam use. Factors that increased webcam acceptance included feeling certain about the child’s well-being and an increased sense of proximity. Only a few critical voices emerged from parents who had webcam experience, e.g. regarding privacy concerns. Parents who had no experience with webcam use showed ambivalence. On the one hand, they expressed a positive attitude towards the webcam system and acknowledged that webcam use could result in feelings of control. On the other hand, reservations emerged concerning an increase of mental stress or a negative influence on parental visitation behaviour. Conclusion In addition to the parents’ positive experiences with webcam use, results show a need within parents who lacked webcam experience. Despite some criticism, it was evident that webcam use was primarily seen as an opportunity to counteract the negative consequences of separation in the postnatal phase. Trial registration The Neo-CamCare study is registered at the German Clinical Trials Register. DRKS-ID: DRKS00017755 . Date of Registration in DRKS: 25-09-2019.

Background The separation of parents and their prematurely born children during care in a neonatal intensive care unit (NICU) can have far-reaching consequences for the well-being of the parents and also of the children. The aim of this study is to evaluate the use of webcams on NICUs and to conduct a systematic assessment of their possible effects on parents and clinical staff. In addition, it aims at determining the need for webcams in German NICUs and to identify possible barriers and moderators. The development and evaluation of practical guidance for the use of webcams will enable the comprehensive education of clinical staff and parents and, as a result, is intended to mitigate any potential undesirable consequences. Methods The study will be based on a mixed methods approach including all groups concerned in the care. Qualitative data will be collected in interviews and focus groups and evaluated using content analysis. The collection of quantitative data will be based on written questionnaires and will aim to assess the status quo as regards the use of webcams on German NICUs and the effects on parents, physicians, and nursing staff. These effects will be assessed in a randomised cross-over design. Four NICUs will be involved in the study and, in total, the parents of 730 premature babies will be invited to take part in the study. The effects on the nursing staff, such as additional workload and interruptions in workflows, will be evaluated on the basis of observation data. Discussion This study will be the largest multicentre study known to us that systematically evaluates the use of webcams in neonatal intensive care units. The effects of the implementation of webcams on both parents and care providers will be considered. The results provide evidence to decide whether to promote the use of webcams on NICUs or not and what to consider when implementing them. Trial registration The trial has been registered at the German Clinical Trial Register (DRKS). Number of registration: DRKS00017755 , date of registration: 25.09.2019,

Background The COVID-19 pandemic significantly changed the work of general practitioners (GPs). At the onset of the pandemic in March 2020, German outpatient practices had to adapt quickly. Pandemic preparedness (PP) of GPs may play a vital role in their management of a pandemic. Objectives The study aimed to examine the association in the stock of seven personal protective equipment (PPE) items and knowledge of pandemic plans on perceived PP among GPs. Methods Three multivariable linear regression models were developed based on an online cross-sectional survey for the period March–April 2020 (the onset of the pandemic in Germany). Data were collected using self-developed items on self-assessed PP and knowledge of a pandemic plan and its utility. The stock of seven PPE items was queried. For PPE items, three different PPE scores were compared. Control variables for all models were gender and age. Results In total, 508 GPs were included in the study; 65.16% believed that they were very poorly or poorly prepared. Furthermore, 13.83% of GPs were aware of a pandemic plan; 40% rated those plans as beneficial. The stock of FFP-2/3 masks, protective suits, face shields, safety glasses, and medical face masks were mostly considered completely insufficient or insufficient, whereas disposable gloves and disinfectants were considered sufficient or completely sufficient. The stock of PPE was significantly positively associated with PP and had the largest effect on PP; the association of the knowledge of a pandemic plan was significant but small. PPE scores did not vary considerably in their explanatory power. The assessment of a pandemic plan as beneficial did not significantly affect PP. Conclusion The stock of PPE seems to be the determining factor for PP among German GPs; for COVID-19, sufficient masks are the determining factor. Knowledge of a pandemic plans play a secondary role in PP.