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In the future, learning will be essentially characterized by the ability to regulate the learning process and monitor success independently from a teacher. The technical possibilities offer better access to learning contents, precise and more individualized feedback, and learning phases adapted precisely to the needs of the learner in terms of scope and pace. In this study, we investigate an important aspect of the digitization of teaching/learning processes using the example of laboratory scripts for chemistry students at university. The focus is on looking up terms and concepts in preparation for the lab internships, firstly in a paper-based glossary and secondly in a digital glossary. During a two-day study, a total of 16 students prepared for experiments on two topics with completely identical materials. We then studied the influence of content knowledge, motivation, and cognitive load. While all students show significant learning achievements, there are no significant differences between the groups. Furthermore, results show that pure digitization of information has no effect, despite the theoretically assumed advantages.

Progress monitoring of academic achievement is an essential element to prevent learning disorders. A prominent approach is curriculum-based measurement (CBM). Various studies have documented positive effects of CBM on students' achievement. Nevertheless, the use of CBM is associated with additional work for teachers. The use of tablets may be of help here. Yet, although many advantages of computer- or tablet-based assessments are being discussed in the literature (e. g. innovative item formats, adaptive testing, automated scoring and feedback), there are still concerns regarding the comparability of different assessment modes (paper-pencil vs. tablet). In the study presented, we analyze the CBM data of 98 fourth graders. They processed the exact same computation items once with paper and pen and once in a tablet application. The analyses point to comparable results in the test modes, although some significant deviations can be found at item level. In addition, the children report perceived benefits when working with the tablet.

This essay explores the material imperatives of nineteenth-century statistical ambition, at a time when the nature of paper itself underwent rapid change. It expands the concept of paper technologies to include knowledge about the materials themselves, as well as the infrastructures, techniques, and agreements that made it possible for the right kind of paper to be made available for particular purposes. Taking the production of the forms for the Prussian census as a case in point, it argues that the enumeration effort of Prussian census statisticians went far beyond designing a form, collecting information, noting and compiling figures, or creating tables. Paper knowledge to define and control the material substance of the forms mattered as much as political impetus and statistical methods in getting the census right. [ABSTRACT FROM AUTHOR]

The Bündnis Junger Ärztinnen und Ärzte (BJÄ, Alliance of Young Physicians in Germany) has presented a position paper (PP) on Postgraduate Medical Education (PGME) against the background of an unfolding hospital reform in Germany, and they describe existing deficits of PGME in Germany. Based on this, demands were made of legislators, employers and medical associations which could result in a sweeping reformation of PGME. Hospital reforms can only be accomplished with well trained and motivated physicians. In this respect the BJÄ regards the reform of hospitals and the health-care system as a chance for a reform of PGME, which is long overdue. Legislative competence for PGME lies with the States of the Federal Republic of Germany and this warrants an adjustment of state medical association laws to accommodate the demands of the BJÄ. Generally PGME must be taken into consideration in all health-care legislation, in analogy to the meanwhile globally adopted principle of "Health in all Politics (HiAP)". The BJÄ has made every endeavour to produce this PP. The responsible stakeholders and actors in the health-care system would be well-advised to take the position paper seriously with a dwindling physician work force in hospitals and serious quality deficits in PGME. Hence, the BJÄ must be comprehensively supported. They need congenial partners to define the scientific foundation of all their demands, to test their application under real life conditions in hospital and outpatient care, to pursue research on the impact on patient care and on the intended transformation of the health-care system. This might best be accomplished by partnering with a scientific Association for Postgraduate Medical Education as has been the case in many countries for decades., Competing Interests: The author declares that he has no competing interests., (Copyright © 2024 Hahn.)

Paper-based visual analogue scale (VAS) items were developed 100 years ago. Although they gained great popularity in clinical and medical research for assessing pain, they have been scarcely applied in other areas of psychological research for several decades. However, since the beginning of digitization, VAS have attracted growing interest among researchers for carrying out computerized and paper-based data assessments. In the present study, we investigated the research question "Which different design characteristics of paper-based VAS items are preferred by women and men?" Based on a sample of 115 participants (68 female), our results revealed that the respondents preferred a paper-based VAS item with a horizontal, 8-cm long, 3 DTP ("desktop publishing point") wide, black line, with flat line endpoints, and the ascending numerical anchors "0" and "10", both for women and men. Although we did not identify any gender difference in these characteristics, our findings uncovered clear preferences on how to design paper-based VAS items.

Up to the publication of the results of Germany's first participation in the PISA study in 2001, there had been no national educational standards in Germany's 16 federal states. In the aftermath of the discussions about the disappointing outcomes, Germany's federal states decided to develop national standards, yet focusing on "core subjects" and leaving geography disregarded. Consequently, the DGfG, which is the governing body of all professional geography associations in Germany, agreed on solving the problem on its own and published its own Educational Standards in Geography in 2006. Even though there have been countless efforts to foster the implementation of these widely-accepted, yet without legislative validation, standards we do not know exactly to what extent they have been implemented in the particular German federal states. The study presented here addresses this research gap bifid: Firstly, a research tool designed to analyze the paper implementation (i.e., putting into place new policies and procedures with the adoption of an innovation as the rationale for the policies and procedures, Fixsen et al., 2005, p. 6) of standards in curricula is introduced. Secondly, the results of a thorough examination of all curricula valid for the grammar schools in Germany are presented and discussed. As it becomes obvious, the Educational Standards have become increasingly implemented within the past years despite a lack of support by the legislations of the 16 federal states. However, there are some gaps that remain to be closed in order to ensure a complete, entirely successful paper implementation, ranging from particular areas of competence within the curricula in some states that have not adopted standards based geography instruction.

The current situation in Germany is characterised by significant differences between the two types of higher education institutions offering bachelor's degree programmes in midwifery at both universities of applied sciences and universities. These differences are noticeable in admission procedures, resource allocation, content focus and competence assessment at the respective institutions, which in turn result in heterogeneous study experiences. This article highlights the challenges currently facing bachelor degree programmes and the academic qualification of midwives, and identifies future requirements for the development of degree programmes in theory and practice as well as theory-practice transfer, and assessment formats. Furthermore, this article covers the content-related and structural-organisational requirements to develop in-depth academic skills grounded in theory teaching, the facilitation of clinical placements at an academic level, the training of qualified practical instructors and the development of applicable competence-based assessment formats, especially for the state exam. The development of a standardised, high-quality academic education for midwives in Germany requires networking of the different academic sites/locations to exchange experiences in teaching/learning and assessment formats. Furthermore, it can facilitate the development of a standardised competence-oriented model and core curriculum as well as the definition of quality criteria and standards for study programmes of midwifery science. The Midwifery Science Committee (AHW) in the DACH Assoviation for Medical Education (GMA) offers an optimal platform for cooperation between the different universities. The existing challenges for the further professional development of midwives can only be overcome by collaboration and pooled expertise., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2024 Plappert et al.)

The objective of academic training is to prepare midwives as independent healthcare professionals to make a substantial contribution to the healthcare of women in their reproductive years as well as to the health of their children and families. This article therefore describes the professional and educational requirements derived from the legal midwifery competencies within the new midwifery act. Furthermore, it identifies the conditions that need to be established to enable midwives in Germany to practise to their full scope in compliance with statutory responsibilities. Educational science, academic efforts, policymaking and accompanying research should work in synergy. This in turn enables midwives to achieve the maximum scope of their skills, with the objective of promoting physiological pregnancies and births. Consequently, it can strengthen early parenthood in alignment with the national health objectives of "health around childbirth". The academisation of the midwifery profession presents a profound opportunity for professional development in Germany. It is essential that midwives receive training based on the principles of educational science and care structures that are yet to be developed. This can enable them to perform within the wide range of their professional tasks to the highest standards, thereby ensuring the optimal care of their clients. Moreover, there is a chance to implement sustainable improvements in healthcare provision for women and their families during the reproductive phase and the period of parenthood in Germany., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2024 Striebich et al.)

Introduction: We report an investigation on collaboration practices in research papers published in the most prestigious English-medium astrophysics journals. Method: We propose an evaluation method based on three numerical indicators to study and compare, in absolute terms, three different types of collaboration (international, national and local) and authors' mobility on the basis of co-authorship. Analysis: We analysed 300 randomly selected research papers in three different time periods and used the student's t-test to determine whether the paired two-sample differences observed were statistically significant or not. Results: International collaboration is more common than national and local collaboration. International, national and local authors' mobility and intra-national collaboration do not seriously affect the indicators of the principal levels of collaboration. International collaboration and authors' mobility are more relevant for authors publishing in European journals, whereas national and intra-national collaboration and national mobility are more important for authors publishing in US journals. Conclusions: We explain the observed differences and patterns in terms of the specific scope of each journal and the socio-economic and political situation in both geographic contexts (Europe and the USA). Our study provides a global picture of collaboration practices in astrophysics and its possible application to many other sciences and fields would undoubtedly help bring into focus the really big issues for overall research management and policy.

In Nazi Germany (1933–45), reclaiming waste became an intrinsic component of the regime's economy as well as its ideological, racial, and expansionist ambitions. National Socialist interventions into waste streams began in 1934 with salvage campaigns. The state then brought urban waste policies and municipal waste services under its control, restructuring and 'Aryanising' the waste salvage trade. Moreover, both consumers and producers were prompted to collect and reprocess waste. Over time, the gradual expansion of the Nazi waste recovery policies and campaigns – here referred to as the 'Nazi waste exploitation regime' – brought forth a determined vision of a circular economy in which no waste whatsoever should escape its reclamation for the national community or Volksgemeinschaft. This article sketches the actors, structures, and objectives of this waste exploitation regime for the case of rags and paper and uncovers its entanglement with Nazi racist and genocidal ideology and expansionism. [ABSTRACT FROM AUTHOR]

Background and objectives: Waste paper recycling utilization has been increasing in Iran and world paper industries which offers many benefits to the environment and humans. Municipal waste is also reused after recycling processes. Cardboard recycling industry has great environmental and economic importance and helps overcone the lack of wood resources and high demand for paper products. It plays an important role in the development of paper-related industries. However, recycling can be associated with the reduction in the optical properties of the paper. The use of nanoparticles in the paper industry is also expanding gradually. Nanosilica is one of the most important nanoparticles which is used as a retention aid in the paper industry. In order to reduce the consumption of long fibers and obtain the desired optical properties, the use of nanosilica alone or in combination with other materials such as cationic starch and cationic polyacrylamide is investigated. The purpose of this research is to compare the effect of individual and combined use of nanosilica additives, cationic polyacrylamide, cationic starch and long fibers on the optical properties of white liner paper pulp. Methodology: In this study, white paper pulp with the brightness of at least 78% and the gloss of at least 45% was used to prepare handmade paper sheets. Long fiber kraft chemical pulp from coniferous wood imported from Russia with the brightness of 89% was used in the laboratory paper sheet making. Nanosilica powder (NanoSiO2) (Degussa), Germany, cationic polyacrylamide (Farinret K325 brand, Degussa, Germany), and cationic starch (LyckebyAmylex, Slovakia) were used. Independent treatments included the addition of 10% refined long fibers pulp, 6% nanosilica, 1.5% cationic starch and 0.15% cationic polyacrylamide and combined treatments included 6% nanosilica and 1.5% cationic starch and 6% nanosilica and 0.15% cationic polyacrylamide. Then 127 g.m-2 handmade papers were prepared and the optical and microscopic properties were evaluated. Results: The results showed that by adding 10% long fibers, the brightness decreased and by using 6% nanosilica, the maximum brightness was reached. Meanwhile, the whiteness of papers with 6% nanosilica was minimum and with the dosage of only 0.15% cationic polyacrylamide, the whiteness reached at the maximum value. Opacity showed its highest value with the combination of 6% nanosilica and 0.15% cationic polyacrylamide. Also, by increasing the amount of polyacrylamide and cationic starch, individually or in combination with nanosilica, the opacity increased. The light absorption coefficient was the lowest in papers with 6% nanosilica and the light scattering coefficient was the highest in papers containing 6% nanosilica and 0.15% cationic polyacrylamide. A colorimeter was used to measure the color components and the results showed that the additives had an effect on the brightness and whiteness of the papers. Also, changes in the color spectrum and the value of color change were also observed. Additives increased the darkness and changes in different colors. Conclusion: The use of nanosilica individually and in combination with starch and cationic polyacrylamide increases the brightness of papers. Also, the use of cationic polyacrylamide individually and in combination with nanosilica leads to an increase in the whiteness and opacity of papers. The brightness factor of the papers, which is representative of the L* component, decreased with the exception of the addition of 10% long fibers and 6% nanosilica. The amount of overall color change with ΔE* was the lowest in samples containing 1.5% cationic starch and the highest in samples containing 0.15% cationic polyacrylamide. The use of some treatments can lead to a decrease in the optical properties and a decrease in the printability quality of the white liner. To solve this problem, mechanical pulp that has been decolorized or coated on the surface of the paper can be used. The presence of nano-silica particles in the structure of the paper improves the surface structure and reduces the prosity, which results in the reduction of surface roughness and less light refraction, and increases the light reflection and brightness of the paper. [ABSTRACT FROM AUTHOR]

Ultrasound practice is a longstanding tradition for radiology departments, being part of the family of imaging techniques. Ultrasound is widely practiced by non-radiologists but becoming less popular within radiology. The position of ultrasound in radiology is reviewed, and a possible long-term solution to manage radiologist expectations is proposed. An international group of experts in the practice of ultrasound was invited to describe the current organisation of ultrasound within the radiology departments in their own countries and comment on the interaction with non-radiologists and training arrangements. Issues related to regulation, non-medical practitioners, and training principles are detailed. A consensus view was sought from the experts regarding the position of ultrasound within radiology, with the vision of the best scenario for the continuing dominance of radiologists practising ultrasound. Comments were collated from nine different countries. Variable levels of training, practice, and interaction with non-radiologist were reported, with some countries relying on non-physician input to manage the service. All experts recognised there was a diminished desire to practice ultrasound by radiologists. Models varied from practising solely ultrasound and no other imaging techniques to radiology departments being central to the practice of ultrasound by radiologists and non-radiologist, housed within radiology. The consensus view was that the model favoured in select hospitals in Germany would be the most likely setup for ultrasound radiologist to develop and maintain practice. The vision for 20 years hence is for a central ultrasound section within radiology, headed by a trained expert radiologist, with non-radiologist using the facilities. Critical relevance statement The future of ultrasound within the radiology department should encompass all ultrasound users, with radiologists expert in ultrasound, managing the ultrasound section within the radiology department. The current radiology trainees must learn of the importance of ultrasound as a component of the 'holistic' imaging of the patient. Key points: 1. Ultrasound imaging within radiology departments precedes the introduction of CT and MR imaging and was first used over 50 years ago. 2. Non-radiology practitioners deploy ultrasound examinations to either 'problem solve' or perform a comprehensive ultrasound examination; radiologists provide comprehensive examinations or use ultrasound to direct interventional procedures. 3. Radiology does not 'own' ultrasound, but radiologists are best placed to offer a comprehensive patient-focused imaging assessment. 4. A vision of the future of ultrasound within the radiology department is encompassing all ultrasound users under radiologists who are experts in ultrasound, positioned within the radiology department. 5. The current radiology trainee must be aware of the importance of ultrasound as a component of the 'holistic' imaging of the patient. [ABSTRACT FROM AUTHOR]

Background: Traditionally, direct medical competences are taught in medical studies, whereas leadership and quality management competences are hardly taught, although graduates are already confronted with management tasks at the beginning of their clinical work. With the upcoming amendment of the Medical Licensing Regulations, this topic area will probably be addressed and must be adequately taught by the faculties. The learning objectives in the area of quality management listed in the current working version of the German National Catalogue of Learning Objectives in Medicine (NKLM) 2.0 have so far been formulated in rather general terms and need to be concretized., Aim: To develop a competence-based learning objectives catalog for the topic area of quality management in medical studies as a structured framework recommendation for the design of faculty teaching-learning programs and as a suggestion for further development of the NKLM., Methods: The competence-based learning objectives catalog was developed by an eight-member working group "Quality Management in Education, Training and Continuing Education" of the Gesellschaft für Qualitätsmanagement in der Gesundheitsversorgung e.V. (GQMG) within the framework of a critical synthesis of central publications. The members of the project group have many years of project experience in quality management in health care as well as in university didactics., Results: Six basic competence goals as well as 10 specific competence goals could be formulated and consented upon. These are each flanked by a list of essential basic concepts and examples. These focus on quality improvements, including patient safety and treatment success against the background of a physician leadership role in an interprofessional context., Discussion: A competency-based set of learning objectives has been compiled that encompasses the necessary concepts and basic knowledge of quality management required for those entering the profession to understand and actively participate in quality management after completing medical school. To the authors' knowledge, no comparable learning objectives catalog is currently available for medical studies, even internationally., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2023 Vogeser et al.)

(1) Background: The main basis for the public recognition of the merits of scientists has always been the system of scientific publications and citations. Our goal is to identify and analyze the most cited articles in the Public, Environmental & Occupational Health category. (2) Methods: We searched the Web of Science for all articles published in the "Public, Environmental & Occupational Health" category up to March 2022 and selected the 100 most cited articles. We recorded the number of citations, the journal, the year of publication, quartile, impact factor, institution, country, authors, topic, type of publication and collaborations. (3) Results: 926,665 documents were analyzed. The top 100 had 401,620 citations. The journal with the most articles was the Journal of Clinical Epidemiology and the one with the highest number of citations was Medical Care. The year with the highest number of articles in the top 100 was 1998. The country with the highest percentage of publications was the USA and the most productive institution was Harvard. The most frequent keywords were bias, quality, and extension. The largest collaboration node was between the USA, Canada, Germany, Spain, Australia, France, and Sweden. (4) Conclusions: This bibliometric study on Public, Environmental & Occupational Health provides valuable information not only to identify topics of interest in the analyzed category, but also to identify the differences in the topics they study.

Background: A large part of the population in Germany makes use of naturopathic, complementary and integrative medical treatments. There are now numerous scientific studies that provide evidence of efficacy for certain indications. At German medical faculties, selected procedures and their application are taught within the cross-sectoral unit called QB 12 and some elective courses, with a focus on specific aspects are offered. So far, however, there has been no structured curriculum that longitudinally anchors teaching across medical studies and enables all students to consider naturopathic and complementary medical options for patient care later on and to integrate them effectively into the diagnostic and treatment process., Objective: The aim of this position paper is to show the relevance of this topic for medical education, to clarify terminology and to present core competencies and possible implementation options for training., Method: The Integrative Medicine and Perspective Pluralism Committee of the German Association for Medical Education developed this position paper in a multi-stage consensual process, in cooperation with the Forum of University Work Groups on Naturopathic Treatment and Complementary Medicine., Results: First, different umbrella terms were discussed and an existing definition of integrative medicine and health was chosen for subsequent use. Building on this step, the status of education and its scientific foundation in Germany was considered in an international context. In the next step, a competency profile for medical training, consisting of seven areas of competency, was developed and described in detail with regard to naturopathic, complementary and integrative medicine. Implementation options were identified using possible starting points in the curriculum and using established examples of best practice., Conclusion: Despite different priorities at each faculty, it was possible to find an agreement on the development of competencies and anchoring them in medical education on the basis of a common definition of terms. Currently, the implementation in the mandatory and elective areas is very heterogeneous. As part of the current revision of the Medical Licensure Act, there are many possible starting points for the integration of naturopathic and complementary medical teaching content, especially in interprofessional and general practice courses. The implementation and accompanying research of targeted teaching settings should lay the foundations for a long-term and binding integration into medical education. Overall, it is clear that medical education in the field of naturopathy and complementary and integrative medicine has the potential to develop comprehensive core medical competencies., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2022 Homberg et al.)

In the wake of local initiatives and developmental funding programs, interprofessionality is now included in national curricula in the German-speaking countries. Based on the 3P model (presage, process, product), this position paper presents the development of interprofessional education in recent years in Germany, Austria and Switzerland and places it in an international context. Core aspects as legal frameworks, including amendments to occupational regulations as well as the formation of networks and faculty development are basic requirements for interprofessional education. New topics and educational settings take shape in the process of interprofessional education: patient perspectives and teaching formats, such as online courses, become more important or are newly established. The influence of the COVID-19 pandemic on interprofessional education is explored as well. Among many new interprofessional courses, particularly the implementation of interprofessional training wards in Germany and Switzerland are positive examples of successful interprofessional education. The objective of interprofessional education continues to be the acquisition of interprofessional competencies. The main focus is now centered on evaluating this educational format and testing for the corresponding competencies. In the future, more capacities will be required for interprofessional continuing education and post-graduate education. Structured research programs are essential to ascertain the effects of interprofessional education in the German-speaking countries. In this position paper the GMA committee on interprofessional education encourages further advancement of this topic and expresses the aim to continue cooperating with other networks to strengthen and intensify interprofessional education and collaboration in healthcare. [ABSTRACT FROM AUTHOR]

Since the implementation of the Excellence Initiative and the Excellence Strategy, German higher education institutions have been restructuring university governance, especially those selected as Universities of Excellence. This study uses a holistic and mission-related integrated governance approach to conduct a qualitative analysis of the governance transformation of German Universities of Excellence, aiming to provoke discussion on transforming governance to optimize organizational effectiveness and sustainable development of German higher education institutions. Transforming governance of German Universities of Excellence involves mission statements, strategic goals, institutional strategies, research, teaching, the third mission, internationalization, global engagement, governance relationships and structures, institutional leadership, funding, autonomy, innovation, digital transformation, quality assurance, and sustainable development, aiming to enhance accountability, performativity, transparency, openness and organizational effectiveness with efficient administrative management in alignment with institutional missions, vision, core values, and strategic goals.

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Veterinarians have to face many communicative challenges in their professional capacity. Successful professional communication increases satisfaction among pet owners, staff members and colleagues, and ultimately also the veterinarians' own satisfaction. On the other hand, unsuccessful communication can easily lead to rejection, distrust and dissatisfaction. However, communicative skills are not explicitly taught as part of the compulsory courses in veterinary medicine in Germany. The position paper of the GMA Veterinary Medicine Committee and the DVG work group Didactics and Communication Competence describes the importance of successful communication for working veterinarians as well as the training situation in Germany and addresses topics that are often discussed in connection with the implementation. The authors come to the conclusion that there is both a necessity and a possibility for the introduction of communicative training contentand provide recommendations thatare intended to support the sustainable introduction of courses and exams to develop the communicative skills of veterinary students. [ABSTRACT FROM AUTHOR]

Background: While substantial progress has been made in the development of disease-modifying medications for multiple sclerosis (MS), a high percentage of treated patients still show progression and persistent inflammatory activity. Autologous haematopoietic stem cell transplantation (AHSCT) aims at eliminating a pathogenic immune repertoire through intense short-term immunosuppression that enables subsequent regeneration of a new and healthy immune system to re-establish immune tolerance for a long period of time. A number of mostly open-label, uncontrolled studies conducted over the past 20 years collected about 4000 cases. They uniformly reported high efficacy of AHSCT in controlling MS inflammatory disease activity, more markedly beneficial in relapsing-remitting MS. Immunological studies provided evidence for qualitative immune resetting following AHSCT. These data and improved safety profiles of transplantation procedures spurred interest in using AHSCT as a treatment option for MS. Objective: To develop expert consensus recommendations on AHSCT in Germany and outline a registry study project. Methods: An open call among MS neurologists as well as among experts in stem cell transplantation in Germany started in December 2021 to join a series of virtual meetings. Results: We provide a consensus-based opinion paper authored by 25 experts on the up-to-date optimal use of AHSCT in managing MS based on the Swiss criteria. Current data indicate that patients who are most likely to benefit from AHSCT have relapsing-remitting MS and are young, ambulatory and have high disease activity. Treatment data with AHSCT will be collected within the German REgistry Cohort of autologous haematopoietic stem CeLl trAnsplantation In MS (RECLAIM). Conclusion: Further clinical trials, including registry-based analyses, are urgently needed to better define the patient characteristics, efficacy and safety profile of AHSCT compared with other high-efficacy therapies and to optimally position it as a treatment option in different MS disease stages. Plain language summary: Autologous haematopoietic stem cell transplantation for multiple sclerosis Substantial progress has been made in the development of disease-modifying medications for multiple sclerosis (MS) during the last 20 years. However, in a relevant percentage of patients, the disease cannot completely be contained. Autologous haematopoietic stem cell transplantation (AHSCT) enables rebuilding of a new and healthy immune system and to potentially stop the autoimmune disease process for a long time. A number of studies documenting 4000 cases cumulatively over the past 20 years reported high efficacy of AHSCT in controlling MS inflammatory disease activity. These data and improved safety profiles of the treatment procedures spurred interest in using AHSCT as a treatment option for MS. An open call among MS neurologists as well as among experts in stem cell transplantation in Germany started in December 2021 to join a series of video calls to develop recommendations and outline a registry study project. We provide a consensus-based opinion paper authored by 25 experts on the up-to-date optimal use of AHSCT in managing MS. Current data indicate that patients are most likely to benefit from AHSCT if they are young, ambulatory, with high disease activity, that is, relapses or new magnetic resonance imaging (MRI) lesions. Treatment data with AHSCT will be collected within the German REgistry Cohort of autoLogous haematopoietic stem cell transplantation MS (RECLAIM). Further clinical trials including registry-based analyses and systematic follow-up are urgently needed to better define the optimal patient characteristics as well as the efficacy and safety profile of AHSCT compared with other high-efficacy therapies. These will help to position AHSCT as a treatment option in different MS disease stages. [ABSTRACT FROM AUTHOR]

Competing Interests: AM and SA are authors of the work disputed by Gandjour. Previous work related to the letter of Gandjour was financed by Gilead. Further study grants in the last five years were received from Abbvie, Janssen Cilag and Johnson & Johnson.

Introduction: Medical quality indicators (QI) are important tools in the evaluation of medical quality. Their development is subject to specific methodological requirements, which include practical applicability. This is especially true for intensive care medicine with its complex processes and their interactions. This methods paper presents the status quo and shows necessary methodological developments for intensive care QI. For this purpose, a cooperation with the Association of the Scientific Medical Societies' Institute for Medical Knowledge Management (AWMF-IMWi) was established. Methodology: Review of published German manuals for QI development from guidelines and narrative review of quality indicators with a focus on evidence and consensus-based guideline recommendations. Future methodological adaptations of indicator development for improved operationalization, measurability and pilot testing are presented, and a development process is proposed. Results: The development of intensive care quality indicators in Germany is based on an established process. In the future, additional evaluation criteria (QUALIFY criteria) will be applied to assess the evidence base. In addition, a continuous exchange between the national steering committee of the DIVI responsible for QI development and guideline development groups involved in intensive care medicine is planned. Conclusion: Intensive care quality indicators will have to meet improved methodological requirements in the future by means of an improved development process. Future QI development is intended to improve the structure of the development process, with a focus on scientific evidence and a link to guideline projects. This is intended to achieve the goal of a broad application of QI and to further evaluate its relevance for patient outcome and performance of institutions., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2020 Kumpf et al.)

Social norm interventions hold the potential to change people's behavior. Five field experiments (N = 1,163) examined the effects of a simple and easily realizable social norm nudge based on the social media format "Be like Bill." The nudge consisted of a stick figure named Toni that communicated descriptive and injunctive norms regarding pro-environmental or pro-social behaviors. Nudge conditions were compared to no-intervention control conditions. Experiment 1 (N = 179) focused on paper towel consumption in a women's restroom at a German university. The nudge condition used less paper towels than the control condition, d = 0.48. Experiment 2 (N = 183) replicated this result (d = 0.32) in a more diverse setting of a women's restroom at a German Christmas market. Experiment 3 (N = 250) examined differences in the effects of prescriptive (i.e., 'do-norm') versus proscriptive (i.e., 'do not-norm') social norms on paper towel consumption again in a university women's restroom. The effectiveness of both social norm nudge conditions was shown in comparison to the control condition (d = 0.46; d = 0.40), while the prescriptive and proscriptive social norm manipulations did not differ. Experiment 4 (N = 206) applied the nudging approach to the use of plastic lids in a coffee shop, where no effect was found. Finally, Experiment 5 (N = 345) focused on the pro-social behavior of mask wearing in a bakery toward the end of the Covid-19 pandemic restrictions in Germany. In the nudge condition, more visitors put on face masks compared to the control group, d = 0.39. Limitations and contextual factors regarding the applicability of our social norm nudge are discussed. [ABSTRACT FROM AUTHOR]

Having teaching staff with didactic qualifications in university teaching leads to a measurable improvement in academic skills among students. Previous recommendations on the type and scope of medical didactic qualification measures primarily apply to teaching staff at university and in-patient settings. The situation of primary care medicine, which often employs external lecturers and whose teaching takes place to a considerable extent in decentralized training facilities (teaching practices) is not adequately addressed. Taking into account a survey on the status quo at higher education institutions for General Practice in Germany, recommendations for minimum standards are made, based on national and international recommendations on the content and scope of medical didactic qualification measures. These recommendations include preliminary work by the Personnel and Organizational Development in Teaching (POiL) Committee of the Society for Medical Education (GMA), the MedicalTeachingNetwork (MDN), the Society of University Teaching Staff in General Medicine (GHA) as well as the experiences of the committee members, who hail from the field of general medicine, internal medicine and pediatrics amongst others., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2020 Böhme et al.)

Purpose: Current trials on adjunctive treatment with antiseizure drugs often do not reveal results which are relevant for clinical practice., Method: Therefore, an interdisciplinary group of German experts discussed a new framework for future antiseizure drug (ASD) trials in adults. This group included members of the executive board of the German Society of Epileptology, of the German institutes for health technology assessment (HTA), of patient organizations and of drug manufacturers. Agreement was reached by consensus decision making after intensive discussion of the findings of a narrative review of the current literature., Results: The group jointly recommends that ASD trials in adults should be based on and include relevant patient groups, e.g. elderly patients and patients with relevant co-morbidities, should adopt a study duration of at least 12 months, should avoid placebo arms, should include active comparators of clinical relevance, may be designed as open label trials with blinded outcome measurements, should focus on patient relevant outcomes that reflect the impact of benefits and harms of treatments on daily living, such as seizure freedom and seizure severity as well as retention rate, functional outcomes and quality of life as compound measures, and should avoid arbitrary and non-sensitive primary endpoints such as dichotomized changes in seizure frequency., Conclusions: This paper focused on improved head-to-head trials on adjunctive treatment with antiseizure drugs. The group welcomes any further work and discussion to enhance future studies which can be applied to the entire spectrum of potentially meaningful study populations and outcomes., (Copyright © 2020 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.)