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Individual perceptions of pay satisfaction and pay justice are closely related social indicators. Notwithstanding their apparent resemblance, there are essential theoretical differences between those two concepts. Yet, we know little if people merely consider pay satisfaction and pay justice as two sides of the same coin. This paper theorizes two situations in which people's perceptions of pay satisfaction and pay justice should differ in meaningful ways. First, their pay level should affect people's self-interest and thus have a stronger effect on their pay satisfaction than on pay justice. Second, pay inequality in the workplace should affect people morally and thus should have a stronger effect on their pay justice perception than on pay satisfaction. These hypotheses were tested with linked employer-employee data collected in Germany (N = 2.695). Results of regression analyses with multiple dependent variables show that people's pay satisfaction and pay justice perceptions increased with the level of their individual pay and decreased with the degree of workplace inequality. The pay effect was significantly stronger on pay satisfaction than on pay justice while the workplace inequality effects did not differ significantly. These results suggest that people under specific circumstances differentiate between pay satisfaction and pay justice. Consequently, researchers should consider that their results and conclusions might differ if they analyze pay satisfaction instead of pay justice and vice versa. [ABSTRACT FROM AUTHOR]

The paper reports the results of an exploratory online survey among German, Austrian, and Swiss hospital chaplains (n = 158, response rate 17%) to identify the ethical conflicts they encounter in their work. Respondents indicated that questions surrounding end-of-life care are predominant among the conflicts faced. Chaplains get involved with these conflicts most often through the patients themselves or through nursing staff. Most encounters occur during pastoral care visits rather than in structured forms of ethics consultation such as clinical ethics committees. The results add to the ongoing discussion of chaplains as agents in ethics consultation within healthcare systems as well as their specific role and contribution. [ABSTRACT FROM AUTHOR]

As digitalization in the agricultural sector has intensified, the number of studies addressing adoption and use of digital technologies in crop production and livestock farming has also increased. However, digitalization trends in the context of small-scale farming have mainly been excluded from such studies. The focus of this paper is on investigating the sequential adoption of precision agriculture (PA) and other digital technologies, and the use of multiple technologies in a small-scale agricultural region in southern Germany. An online survey of farmers yielded a total of 2,390 observations, of which 1,820 operate in field farming, and 1,376 were livestock farmers. A heuristic approach was deployed to identify adoption patterns. Probable multiple uses of 30 digital farming technologies and decision-support applications, as well as potential trends of sequential technology adoption were analyzed for four sequential points of adoption (entry technology, currently used technologies, and planned short-term and mid-term investments). Results show that Bavarian farmers cannot be described as exceedingly digitalized but show potential adoption rates of 15–20% within the next five years for technologies such as barn robotics, section control, variable-rate applications, and maps from satellite data. Established use of entry technologies (e.g., automatic milking systems, digital field records, automatic steering systems) increased the probability of adoption of additional technologies. Among the most used technologies, the current focus is on user-friendly automation solutions that reduce farmers' workload. Identifying current equipment and technology trends in small-scale agriculture is essential to strengthen policy efforts to promote digitalization. [ABSTRACT FROM AUTHOR]

Background: The paper examines whether the widespread assumption holds that younger birth cohorts (referred to as Millennials or Generation Y) act as pioneers of changing everyday mobility. Methodology: Based on the time-series dataset "Mobility in Germany" (Mobilität in Deutschland), cohort-specific changes in everyday bicycle and car use that have occurred between 2002 and 2017 are analyzed. The empirical analyses are differentiated by age-group and settlement type. Additionally, socio-structural factors are taken into account. Results: The results show a decline in the predominant everyday use of cars in metropolitan cities, especially among Generation Y. However, the Millennials do not emerge as pioneers of the trend toward predominant bicycle use. The results challenge the assumption that changes in everyday mobility are essentially driven by generational change. [ABSTRACT FROM AUTHOR]

During recent years, maintaining scientific and medical databases has turned out to be a major challenge in the medical sector. The medical data regarding the patients comprise diverse diagnostic medical reports and features for such disease need to be recorded carefully for providing high-quality treatments. Therefore, this paper proposes a hybrid deep convolutional neural network (HDCNN)-based COOT approach to predict the risk of diseases. Initially, an improved crossover-based levy flight optimization algorithm (ICLFDO) algorithm is employed in selecting and processing the unstructured textual data. Then later, the HDCNN-COOT approach predicts the diseases more accurately. In addition to this, the classifier predicts whether the patient is at risk of disease in the future or not. The efficiency of the proposed model is evaluated by using a dataset obtained from University Hospital of Ludwig Maximilian University of Munich, Germany. The data collected in the data center include 29,477,035 data items from 36,082 patients. The proposed model is capable of using structured data and uses textual data of the patients. Finally, the higher classification accuracy and improved performance of the classifiers can be viewed using the experimental results conducted on five different datasets. [ABSTRACT FROM AUTHOR]

Background In 2017, the agreement on an intermediate level of outpatient palliative care (BQKPMV) emerged. It is unclear what role BQKPMV plays in healthcare practice and what experiences family physicians have with the implementation. Methods In September 2021, all 5012 family physicians in Lower Saxony were invited to participate in an online or paper-based questionnaire survey on the implementation of BQKPMV. Data were analysed using descriptive statistics and frequency analyses. Results With 665 responses, a participation rate of 13 % was achieved. Data from 642 family physicians were included in the analysis. 13 % of the respondents (n = 84) are aware of BQKPMV. 71% of the participants with knowledge of BQKPMV (n = 58) have decided not to participate in the agreement. Thirty-eight of these family physicians justify this by saying that they consider the existing forms of outpatient palliative care to be sufficient. More than half of the participants see difficulties in the practical implementation. Conclusions The results of the survey of family physicians in Lower Saxony indicate that BQKPMV is rarely used in the clinical practice of the participants. Respondents see limitations in the feasibility of BQKPMV. Due to the rather low response rate and the regional connection, reliable nationwide conclusions about the reality of care can only be drawn to a limited extent. It is conceivable that, in addition to providing all family physicians with low-threshold information about BQKPMV, the framework conditions of BQKPMV need to be adjusted, e.g. in the areas of qualification requirements, remuneration and the distribution of tasks. Recommendations for optimising BQKPMV are developed in the overall project and enable a comprehensive evaluation of the implementation of this form of care. [ABSTRACT FROM AUTHOR]

Background This paper explores the role of providing structure for students within a new blended-learning family medicine curriculum at Saarland University. This study intends to clarify the role of different structural elements for different learning approaches (deep vs. structured vs. surface learning). Methods This study is based on a mixed-methods approach. Fifth year medical students' (n = 84) learning approaches, measured by a shortened version of the ASSIST questionnaire, were correlated with students' academic performance in state exams and the family medicine exam. Based on learning approaches and age, participants were purposefully sampled into two semi-structured group interviews with seven participants each. Results Although surface approach learning weakly correlated with lower performance in the first state exam (rho = 0.231), surface approach learning did not correlate with lower performance in the family medicine assessment. Based on qualitative results, the structural design of the curriculum seemed to have a high impact on students' satisfaction and motivation to learn. The reduction of extraneous cognitive load was identified as effective in motivating students to study. Deep-learning students highlighted the positive effects of curriculum activities that foster germane cognitive load through schema- based learning. Conclusions Especially for surface approach learners it may be important to provide structured guidance and provide a clear alignment of course content in a blended-learning curriculum, even in higher education. Deep and structured approach learners also benefit from a clear course structure that keeps extraneous cognitive load low and fosters schema acquisition. [ABSTRACT FROM AUTHOR]

This paper explores proculturative semiotic dynamics underlying self-construction in emigration that reveals various forms of the self's positioning through the processes of relating to the native and foreign socio-cultural environments. The self is conceptualised as the heterogeneous entirety of voices and self-related positions which are hierarchically organised. Hierarchical organisation implies the dominance of certain voices and I-positions at the expense of silencing others. Moreover, external societal voices promote hegemonic social representations which are represented as promoter I-positions/signs in the self-structures and have the power to regulate individuals' mental activity. Therefore, it is argued that selves' relations to the environment are not always symmetrically dialogical. The compelling power of hierarchically ordered external meaning systems that are conceptualised as "objective culture" is illustrated in the best manner when a person occurs in emigration where the native organisation of voices and I-positions is being semiotically ruptured due to the meeting with a foreign configuration of a hierarchy of external I-positions and gets "attacked" by alien promoter signs. External promoter voices and I-positions have the power to take the dominant position and establish asymmetric relations with other self-related elements. They can significantly influence intra-psychological negotiations by vocalising hegemonic social representations which exist in any community. The case study of a Georgian emigrant's living in Germany vividly reveals the wave of self-transformations which she undergoes after the liberation from the pressure of native promoter signs and engagement with the German ones. Specific microgenetic experiences leading to the transformations at the ontogenetic level are highlighted. Symmetric and asymmetric forms of communication are conceived as particular instances of relating. This paper vividly reveals the significance of the exploration of the forms of dynamic relations between various components of the self and socio-cultural environment and entailing intra-psychic and external negotiations for better understanding of the nature of humans' epigenetic development. [ABSTRACT FROM AUTHOR]

This paper investigates the selection of third-party logistics providers (3PLs) based on the best prices offered by them. The focus is on outbound logistics where 3PLs must have their own distribution centres for storage and picking activities. They must also have suitable trucks for distribution to different small-scale customers. The motivation for this paper is a case study from Germany in which a furniture company with hundreds of small customers in ten zones is seeking one or more 3PLs to do the distribution. A mathematical programming model was built based on integer programming where demand per order can be expressed using exponential distribution in each customer zone. The main contribution of this paper is that it finds the best 3PLs based on the different pricing methods of the various providers; this means including the location problem indirectly using the new integer programming model. The model takes into consideration three different methods of pricing based on the offers of five 3PLs. These different methods make it difficult for the decision makers to choose the best solution, especially if specific trends in demand are expected in the future for some customer zones. The results show that future increases in demand in terms of the number of orders or order size could affect the optimal solution. The best pricing method with the lowest variability in cost over time is selected. [ABSTRACT FROM AUTHOR]

An accurate estimator of the real-time fatality rate is warranted to monitor the progress of ongoing epidemics, hence facilitating the policy-making process. However, most of the existing estimators fail to capture the time-varying nature of the fatality rate and are often biased in practice. A simple real-time fatality rate estimator with adjustment for reporting delays is proposed in this paper using the fused lasso technique. This approach is easy to use and can be broadly applied to public health practice as only basic epidemiological data are required. A large-scale simulation study suggests that the proposed estimator is a reliable benchmark for formulating public health policies during an epidemic with high accuracy and sensitivity in capturing the changes in the fatality rate over time, while the other two commonly-used case fatality rate estimators may convey delayed or even misleading signals of the true situation. The application to the COVID-19 data in Germany between January 2020 and January 2022 demonstrates the importance of the social restrictions in the early phase of the pandemic when vaccines were not available, and the beneficial effects of vaccination in suppressing the fatality rate to a low level since August 2021 irrespective of the rebound in infections driven by the more infectious Delta and Omicron variants during the fourth wave. [ABSTRACT FROM AUTHOR]

Purpose: Patients with polycythemia vera (PV) show an elevated incidence of thromboembolic complications and decreased survival when compared to age-matched healthy individuals. Hypercellularity as indicated by elevated hematocrit, pathophysiological changes induced by the JAK2 driver mutation and cardiovascular risk factors contribute to the increased incidence of thromboembolic events. Higher age and a history of thromboembolic events define a high-risk population of PV patients. Depending on the individual risk profile, phlebotomy or pharmacologic cytoreduction is recommended in combination with low-dose acetylsalicylic acid. Stringent cytoreduction is required for effective risk reduction. However, in recent reports, the rate of thromboembolic complications in PV patients under cytoreductive therapy appears still elevated compared to healthy individuals. This study reports on a chart review to assess for cytoreductive therapy of 1440 PV patients in real life. Methods: Forty-two eligible hematologists/oncologists in private practice treating patients with MPN were recruited to participate in a paper–pencil-based survey conducted between January 2019 and March 2020 in Germany. Physicians were asked to report primary documented data obtained from patient charts. Descriptive analyses were conducted to assess for patient characteristics, treatment modalities, risk factors and thromboembolic complications. Results: Data were collected from the patient charts of 1440 individuals diagnosed with PV. The patient population was older than those reported in multicenter trials with a median age of 72.2 years at the time of reporting and 63.5 years at diagnosis. Age was the main factor accounting for high-risk status with 84.7% of patients being above the age of 60 followed by thromboembolic complications reported in 21.3% of patients. The use of pharmacologic cytoreduction was highly variable between participating centers with an average of 60.7% and a range of 10.1–100%. Hydroxyurea was the most frequently used drug followed by ruxolitinib, while interferons were reported for a minority of patients. For 35.4% of patients a persistent need for phlebotomy in addition to cytoreductive treatment was reported. Although presence of high-risk criteria and insufficient disease control were reported as main triggers to initiate pharmacologic cytoreduction, 28.1% had elevated hematocrit values (> 45%) and 38.6% showed persistence of elevated leukocyte count (> 109/l) while on cytoreductive treatment. In contrast, physician-reported symptom burden was lower than published in clinical trials and patient-reported outcomes. The rate of patients experiencing thromboembolic complications was 32.2% at any time and 14.3% after diagnosis with most patients receiving acetylsalicylic acid and 10.8% remaining on oral anticoagulants or heparin. Conclusions: Cytoreductive treatment of high-risk PV in real life is highly variable regarding indication for cytoreduction and definition of therapy resistance. This study highlights the need for (i) improved risk stratification for thromboembolic events, (ii) consequent indication of pharmacologic cytoreduction in high-risk PV and (iii) attention to signs of therapy resistance that can trigger an earlier and stringent switch to second line agents. [ABSTRACT FROM AUTHOR]

In Northwestern Europe, Germany, France, the Netherlands, the UK and Belgium constitute the biggest five potato producers, with total potato crop production around 60% of EU-28 production before Brexit. Soil and climate conditions are highly favourable for potato growth in this region. Production is under driving forces of (i) the potato processing industry, particularly in Belgium; (ii) the innovation for fresh potato in the UK, France and Germany; (iii) the leadership of Germany and the Netherlands for starch potato; and (iv) the dominance of the Netherlands for seed production. Based on an industrial agri-food production system, the region has the highest potato yield levels worldwide and developed relevant trade networks for export of seed, fresh and processed potato products in and outside Europe. Conventional and intensive potato production is widespread over the region, whilst organic production started to develop in Germany and France. Whether the coming decades will be as successful as the last ones for sustainable potato production will depend on how the sector and stakeholders of the whole potato value-chain will overcome new issues and challenges. These are mainly soil quality and health conservation, consequences of climate change, increasing bans on the use of plant protection products, tightening environmental standards, food waste reduction and increasing trade tensions hampering the flow of potatoes around the world. After a detailed description of the potato production in the region, this paper contains a SWOT analysis aiming to identify potential solutions to overcome environmental, technical, economic, political and societal issues in the region for sustainable potato production in the coming years and decades. [ABSTRACT FROM AUTHOR]

Recent earthquakes as the 2012 Emilia earthquake sequence showed that recently built unreinforced masonry (URM) buildings behaved much better than expected and sustained, despite the maximum PGA values ranged between 0.20–0.30 g, either minor damage or structural damage that is deemed repairable. Especially low-rise residential and commercial masonry buildings with a code-conforming seismic design and detailing behaved in general very well without substantial damages. The low damage grades of modern masonry buildings that was observed during this earthquake series highlighted again that codified design procedures based on linear analysis can be rather conservative. Although advances in simulation tools make nonlinear calculation methods more readily accessible to designers, linear analyses will still be the standard design method for years to come. The present paper aims to improve the linear seismic design method by providing a proper definition of the q-factor of URM buildings. These q-factors are derived for low-rise URM buildings with rigid diaphragms which represent recent construction practise in low to moderate seismic areas of Italy and Germany. The behaviour factor components for deformation and energy dissipation capacity and for overstrength due to the redistribution of forces are derived by means of pushover analyses. Furthermore, considerations on the behaviour factor component due to other sources of overstrength in masonry buildings are presented. As a result of the investigations, rationally based values of the behaviour factor q to be used in linear analyses in the range of 2.0–3.0 are proposed. [ABSTRACT FROM AUTHOR]

Thirty years after reunification, East and West Germany are still characterized by a considerable difference in satisfaction with democracy (SWD). This paper proposes and tests a model which assumes SWD to be shaped by the interests (economic and cultural) and moral values individuals demand to see fostered by the democratic system. Empirical application of the model reveals substantial differences between the East and West German SWD function in that the satisfaction of economic interests is much more important in the East than the West whereas the opposite applies to moral concerns. Demands on redistribution and immigration policies—conceptualized as proximate drivers of SWD—also shape SWD differently in the East and the West, in addition to being shaped by interests and morals in different ways. East–West differences in the relationship between economic demands and SWD are more important than differences in the levels of demand. [ABSTRACT FROM AUTHOR]

This paper aims to provide a fresh historical perspective on the debates on vitalism and holism in Germany by analyzing the work of the zoologist Hans Spemann (1869–1941) in the interwar period. Following up previous historical studies, it takes the controversial question about Spemann's affinity to vitalistic approaches as a starting point. The focus is on Spemann's holistic research style, and on the shifting meanings of Spemann's concept of an organizer. It is argued that the organizer concept unfolded multiple layers of meanings (biological, philosophical, and popular) during the 1920s and early 1930s. A detailed analysis of the metaphorical dynamics in Spemann's writings sheds light on the subtle vitalistic connotations of his experimental work. How Spemann's work was received by contemporary scientists and philosophers is analyzed briefly, and Spemann's holism is explored in the broader historical context of the various issues about reductionism and holism and related methodological questions that were so prominently discussed not only in Germany in the 1920s. [ABSTRACT FROM AUTHOR]

Background: Running overuse injuries (ROIs) occur within a complex, partly injury-specific interplay between training loads and extrinsic and intrinsic risk factors. Biomechanical risk factors (BRFs) are related to the individual running style. While BRFs have been reviewed regarding general ROI risk, no systematic review has addressed BRFs for specific ROIs using a standardized methodology. Objective: To identify and evaluate the evidence for the most relevant BRFs for ROIs determined during running and to suggest future research directions. Design: Systematic review considering prospective and retrospective studies. (PROSPERO_ID: 236,832). Data Sources: PubMed. Connected Papers. The search was performed in February 2021. Eligibility Criteria: English language. Studies on participants whose primary sport is running addressing the risk for the seven most common ROIs and at least one kinematic, kinetic (including pressure measurements), or electromyographic BRF. A BRF needed to be identified in at least one prospective or two independent retrospective studies. BRFs needed to be determined during running. Results: Sixty-six articles fulfilled our eligibility criteria. Levels of evidence for specific ROIs ranged from conflicting to moderate evidence. Running populations and methods applied varied considerably between studies. While some BRFs appeared for several ROIs, most BRFs were specific for a particular ROI. Most BRFs derived from lower-extremity joint kinematics and kinetics were located in the frontal and transverse planes of motion. Further, plantar pressure, vertical ground reaction force loading rate and free moment-related parameters were identified as kinetic BRFs. Conclusion: This study offers a comprehensive overview of BRFs for the most common ROIs, which might serve as a starting point to develop ROI-specific risk profiles of individual runners. We identified limited evidence for most ROI-specific risk factors, highlighting the need for performing further high-quality studies in the future. However, consensus on data collection standards (including the quantification of workload and stress tolerance variables and the reporting of injuries) is warranted. [ABSTRACT FROM AUTHOR]

This paper analyzes how people's subjective well-being adapts to income poverty in Switzerland and Germany and presents two empirical findings. First, financial satisfaction (FS) does not adapt in either country. However, life satisfaction fully adapts in Switzerland but not in Germany. Second, people in income poverty have income lower than their reference income. In the long run, those who remain in income poverty are trapped in the situation of insufficient income. Therefore, FS has limited, if any, adaptation. [ABSTRACT FROM AUTHOR]

This paper discusses the 17 Nobel Prize nominations for the neurologist and neurosurgeon Otfrid Foerster (1873–1941). Drawing on files from the Stockholm Nobel Prize Archive, primary and secondary literature, it addresses the following questions: what were the reasons given by nominators for Foerster's nominations? What was the relationship between him and his nominators? Why was he ultimately not awarded the Nobel Prize? Most nominators of Foerster's highlighted as the main motive his Handbuch der Neurologie, which he had edited with Oswald Bumke. According to the nominators, this book together with Foerster's neurosurgical work had an enormous impact on contemporary neurology. Furthermore, his "honorable character" was underlined in the nomination letters; however, these reasons were not sufficient for the Nobel Committee: the members classified the handbook as not being original research. Despite this, Foerster's fame is reflected in the present, for example in the Otfrid Foerster Medal, which has been awarded to researchers by the German Society of Neurosurgery since 1953. [ABSTRACT FROM AUTHOR]

In order to slow the spread of the CoViD-19 pandemic, governments around the world have enacted a wide set of policies limiting the transmission of the disease. Initially, these focused on non-pharmaceutical interventions; more recently, vaccinations and large-scale rapid testing have started to play a major role. The objective of this study is to explain the quantitative effects of these policies on determining the course of the pandemic, allowing for factors like seasonality or virus strains with different transmission profiles. To do so, the study develops an agent-based simulation model, which explicitly takes into account test demand and behavioral changes following positive tests. The model is estimated using data for the second and the third wave of the CoViD-19 pandemic in Germany. The paper finds that during a period where vaccination rates rose from 5 to 40%, seasonality and rapid testing had the largest effect on reducing infection numbers. Frequent large-scale rapid testing should remain part of strategies to contain CoViD-19; it can substitute for many non-pharmaceutical interventions that come at a much larger cost to individuals, society, and the economy. [ABSTRACT FROM AUTHOR]

In recent years, multistatic specular meteor radars (SMRs) have been introduced to study the Mesosphere and Lower Thermosphere (MLT) dynamics with increasing spatial and temporal resolution. SMRs, compared to other ground-based observations, have the advantage of continuously measuring the region between 80 and 100 km independent of weather, season, or time of day. In this paper, frequency spectra of MLT horizontal winds are explored through observations from a campaign using the SIMONe (Spread-spectrum Interferometric Multistatic meteor radar Observing Network) approach conducted in northern Germany in 2018 (hereafter SIMONe 2018). The 7-day SIMONe 2018 comprised of fourteen multistatic SMR links and allows us to build a substantial database of specular meteor trail events, collecting more than one hundred thousand detections per day within a geographic area of ∼ 500 km × 500 km. We have implemented two methods to obtain the frequency spectra of the horizontal wind components: (1) Mean Wind Estimation (MWE) and (2) Wind field Correlation Function Inversion (WCFI), which utilizes the mean and the covariances of the line of sight velocities, respectively. Monte Carlo simulations of a gravity wave spectral model were implemented to validate and compare both methods. The simulation analyses suggest that the WCFI helps us to capture the energy of smaller scale wind fluctuations than those capture with MWE. Characterization of the spectral slope of the horizontal wind at different MLT altitudes has been conducted on the SIMONe 2018, and it provides evidence that gravity waves with periods smaller than 7 h and greater than 2 h dominate with horizontal structures significantly larger than 500 km. In the future, these analyses can be extended to understand the significance of small-scale fluctuations in the MLT, which were not possible with conventional MWE methods. [ABSTRACT FROM AUTHOR]

Relying on data collected by the Zurich Survey of Academics (ZSoA), a unique representative online survey among academics in Germany, Austria, and Switzerland (DACH region), this paper replicates Johann and Mayer's (Minerva 57(2):175–196, 2019) analysis of researchers' perceptions of scientific authorship and expands their scope. The primary goals of the study at hand are to learn more about (a) country differences in perceptions of scientific authorship, as well as (b) the influence of perceived publication pressure on authorship perceptions. The results indicate that academics in Switzerland interpret scientific authorship more leniently than their colleagues in Germany and Austria. The findings further indicate that, as perceived pressure to publish increases, researchers are more likely to belong to a group of academics who hold the view that any type of contribution/task justifies co-authorship, including even those contributions/tasks that do not justify co-authorship according to most authorship guidelines. In summary, the present study suggests that action is required to harmonize regulations for scientific authorship and to improve the research culture. [ABSTRACT FROM AUTHOR]

Purpose: Social service counseling (SSC) is an important instrument to support cancer patients, for example, regarding legal support, or rehabilitation. Several countries have established on-site SSC in routine care. Previous analyses have shown that SSC utilization varies across cancer centers. This analysis investigates patient and center-level predictors that explain variations in SSC utilization between centers. Methods: Logistic multilevel analysis was performed with data from 19,865 prostate cancer patients from 102 prostate cancer centers in Germany and Switzerland. Data was collected within an observational study between July 2016 and June 2020 using survey (online and paper) and tumor documentation. Results: The intraclass correlation coefficient for the null model implies that 51% of variance in SSC utilization is attributable to the center a patient is treated in. Patients aged 80 years and older, with higher education, private insurance, without comorbidities, localized intermediate risk, and undergoing androgen deprivation therapy before study inclusion were less likely to utilize SSC. Undergoing primary radiotherapy, active surveillance, or watchful waiting as compared to prostatectomy was associated with a lower likelihood of SSC utilization. Significant negative predictors at the center level were university hospital, center's location in Switzerland, and a short period of certification. Conclusion: The results show that patient and center characteristics contribute to explaining the variance in SSC utilization in prostate cancer centers to a large extent. The findings may indicate different organizational processes in the countries included and barriers in the sectoral structure of the healthcare system. In-depth analyses of processes within cancer centers may provide further insights into the reasons for variance in SSC utilization. [ABSTRACT FROM AUTHOR]

Although mathematical modeling plays an important role in many curricula worldwide, significant discrepancies persist in the importance of mathematical modeling in ordinary mathematics classrooms and teacher education. This paper compares pre-service mathematics teachers' professional mathematical modeling competencies in three different regions—Germany, Mainland China, and Hong Kong—where educational and cultural traditions differ, including the role of mathematical modeling. In total, 232 pre-service mathematics teachers from the three regions completed a modeling task covering mathematics content knowledge (MCK) of modeling and mathematical pedagogical content knowledge (MPCK) of modeling. The results show that pre-service teachers from Germany demonstrated the strongest MCK and MPCK of mathematical modeling; by contrast, pre-service mathematics teachers from Mainland China and Hong Kong demonstrated relatively weaker MCK and MPCK of mathematical modeling. MCK and MPCK of mathematical modeling were also found to be unevenly developed at different competence levels for the three regions. These differences may be attributed to the history of mathematical modeling in mathematics curricula, teacher education, and teaching culture in these three regions. [ABSTRACT FROM AUTHOR]

It is widely believed that civic associations are capable to produce social capital, here understood as an individual asset resulting from relations of mutual support and assistance. Although hardly anybody denies that socializing is widespread in many civic associations, it still remains to be shown that this socializing provides a genuine commitment to support. This paper explores the relationship between involvement in civic organizations and social support. The data analysed come from a nation-wide survey "Organized Sport and Social Capital—Revisited" (OSSCAR) representing the adult population in Germany. Findings show that participation in civic associations is associated with higher levels of social support. This effect is stronger for active participants and weaker for passive members. Path analyses further indicate that this effect is mediated by a person's sociability orientations as well as her commitment to prosocial values. These findings help providing a more nuanced understanding of mechanisms of social capital formation in civic associations. [ABSTRACT FROM AUTHOR]

In Germany, Douglas fir (Pseudotsuga menziesii Franco) is seen as a valuable species for future cultivation in times of climate change. Local seed production in seed stands and seed orchards may secure that local adaptation is transferred to the next generation, but small population sizes could lower genetic diversity and thus future adaptability. Here we analyse the transfer of genetic diversity from parent to offspring generation in four older German seed orchards. We detected low pollen contamination rates due to high levels of spatial isolation. Even with a relatively low number of 40 clones, seed orchard design with randomized and repeated planting of clones led to low selfing rates, and despite uneven parental contributions, the number of successful parents and the level of genetic intermixture were high enough to allow the transfer of an adequate part of the genetic diversity to the next generation. Larger numbers, however, might be needed to reliably conserve the entire genetic diversity over succeeding generations. Conclusions on the establishment of future seed orchards and regarding areas requiring further research are drawn at the end of the paper. [ABSTRACT FROM AUTHOR]

Since 2011, the Industry 4.0 initiative is a key research and development direction towards flexible production systems in Germany. The objective of the initiative is to deal with the challenge of an increased production complexity caused by various factors such as increasing global competition between companies, product variety, and individualization to meet customer needs. For this, Industry 4.0 envisions an overarching connection of information technologies with the production process, enabling smart manufacturing. Bringing current production systems to this objective will be a long transformation process, which requires a coherent migration path. The aim of this paper is to represent an exemplary production development way towards Industry 4.0 using eminent formalization approaches and standardized automation technologies. [ABSTRACT FROM AUTHOR]

Egg freezing has led to heated debates in healthcare policy and bioethics. A crucial issue in this context concerns the distinction between "medical" and "social" egg freezing (MEF and SEF)—contrasting objections to bio-medicalization with claims for oversimplification. Yet such categorization remains a criterion for regulation. This paper aims to explore the "regulatory boundary-work" around the "medical"–"social" distinction in different egg freezing regulations. Based on systematic documents' analysis we present a cross-national comparison of the way the "medical"–"social" differentiation finds expression in regulatory frameworks in Austria, Germany, Israel, and the Netherlands. Findings are organized along two emerging themes: (1) the definition of MEF and its distinctiveness—highlighting regulatory differences in the clarity of the definition and in the medical indications used for creating it (less clear in Austria and Germany, detailed in Israel and the Netherlands); and (2) hierarchy of medical over social motivations reflected in usage and funding regulations. Blurred demarcation lines between "medical" and "social" are further discussed as representing a paradoxical inclusion of SEF while offering new insights into the complexity and normativity of this distinction. Finally, we draw conclusions for policymaking and the bioethical debate, also concerning the related cryopolitical aspects. [ABSTRACT FROM AUTHOR]

Background: Health care costs of migraine constitute a major issue in health economics. Several publications analyzed health care costs for adult migraine patients, based on questionnaires or secondary (health insurance) data. Although migraine often starts already in primary school age, data on migraine related costs in children is scarce. In this paper we aimed to assess the migraine-related health care costs in 6 to 11 year old children in Germany. Methods: Using claims data of a large German health insurer (BARMER), overall annual health care costs of 6 to 11 year old children with a diagnosis of migraine in 2017 (n = 2597) were compared to a control group of 6 to 11 year old children without a headache diagnosis between 2013 and 2017 (n = 306,926). The association of migraine and costs was modeled by generalized linear regression (Gamma regression) with adjustment for sex, age and comorbidities. Results: Children with migraine caused considerably higher annual per capita health care costs than children without a headache diagnosis (migraine group: € 1018, control group: € 618). Excess costs directly related to migraine amounted to € 115. The remaining excess costs were related to comorbidities, which were more frequent in the migraine group. Mental and behavioural disorders constituted the most expensive comorbidity, accounting for € 105 of the € 400 annual excess costs in the migraine group. Conclusion: 6 to 11 year old children with a migraine diagnosis cause significant direct and comorbidity related excess costs in the German health care system. [ABSTRACT FROM AUTHOR]

The world is currently facing an unprecedented pandemic crisis. The highly contagious coronavirus, or COVID-19, first occurred in Wuhan (China) in December 2019. The outbreak of the virus quickly spread all over the world, reaching Europe in January 2020. The first case in Germany was reported to be diagnosed on January 27. This study focuses on assessing the mental health consequences of the German public during COVID-19 outbreak. Psychological discomfort, generalized anxiety disorder, sleep disturbances, depressive symptoms and threat perception are especially investigated with respect to demographics, security importance and negative affectivity. The psychological vulnerabilities that go along with the pandemic are evaluated in detail. The cross-sectional online survey conducted in Germany reveals a prevalence of depressive symptoms, psychological discomfort, threat perception, generalized anxiety disorder and sleep disturbances associated with the pandemic crisis. The results also indicate a relationship between mental health issues and negative affectivity as well as the perception of threat. This paper gives an outlook on long-term consequences and what could be the strategies to mitigate the negative mental health outcomes of the crisis. [ABSTRACT FROM AUTHOR]

Nature-based solutions (NBS) find increasing attention as actions to address societal challenges through harnessing ecological processes, yet knowledge gaps exist regarding approaches to landscape planning with NBS. This paper aims to provide suggestions of how planning NBS can be conceptualized and applied in practice. We develop a framework for planning NBS by merging insights from literature and a case study in the Lahn river landscape, Germany. Our framework relates to three key criteria that define NBS, and consists of six steps of planning: Co-define setting, Understand challenges, Create visions and scenarios, Assess potential impacts, Develop solution strategies, and Realize and monitor. Its implementation is guided by five principles, namely Place-specificity, Evidence base, Integration, Equity, and Transdisciplinarity. Drawing on the empirical insights from the case study, we suggest suitable methods and a checklist of supportive procedures for applying the framework in practice. Taken together, our framework can facilitate planning NBS and provides further steps towards mainstreaming. [ABSTRACT FROM AUTHOR]

Nature-based solutions (NBS) for mitigating climate change are gaining popularity. The number of NBS is increasing, but research gaps still exist at the governance level. The objectives of this paper are (i) to give an overview of the implemented NBS for flood risk management and mitigation in Germany, (ii) to identify governance models that are applied, and (iii) to explore the differences between these models. The results of a hierarchical clustering procedure and a qualitative analysis show that while no one-size-fits-all governance model exists, polycentricism is an important commonality between the projects. The study concludes by highlighting the need for further research on traditional governance model reconversion and paradigm changes. We expect the findings to identify what has worked in the past, as well as what is important for the implementation of NBS for flood risk management in future projects. [ABSTRACT FROM AUTHOR]

Fire protection measures are taken to prevent fires or to keep the resulting damage as low as possible. The statistical effectiveness of fire protection measures can be derived from a large number of fires that have already occurred. With the research paper presented here, such proof of effectiveness is rendered for certain specific fire protection measures, such as installed fire detection and fire alarm systems, fire extinguishing systems, smoke and heat exhaust systems, as well as according to the type of fire service. The investigation is based on a systematically collected database of 5,016 building fire interventions with 1,216 real fires by 29 fire services across Germany. The results can be used by applying engineering methods for quantitative risk analyses, within the scope of the risk-based performance level oriented planning of object-specific protection strategies. In this way, the performance level can be achieved effectively, flexibly and economically. [ABSTRACT FROM AUTHOR]

Objective: Studies examining what renders workplace interventions to sustain and promote work ability of older workers successful have largely neglected older workers´ perspective. This paper outlines the results of a study with regard to older workers´ experiences and expectations of a workplace intervention. Based on these findings, some reflections on how to improve the design and the implementation of workplace interventions for older workers are provided. Methods: Semi-structured interviews were conducted with older workers (N = 8) participating in a workplace intervention undertaken at one production site of a large manufacturing company in Baden-Wurttemberg/Germany. The interview guide included questions on participants´ experiences with and expectations of the intervention. The interviews were recorded, transcribed verbatim and analyzed using qualitative content analysis according to Mayring (2014). Results: Older workers´ reported some challenges they face due to their participation in the workplace intervention. These resulted from the work environment (physical challenges), the work process design (new long work cycle), the work organization (tight time allowances, little job rotation, change of teams, age stereotypes) and the management of the workplace intervention (bad information, feeling of occupational insecurity and lack of being valued). Conclusions: The study shows that challenges arising for older workers from their participation in the workplace intervention may have counteracted the promotion of work ability. As findings suggest, some of these challenges might have been avoided either by considering workers´ perspective during design and implementation of an intervention or by referring to evidence on aging and work ability. [ABSTRACT FROM AUTHOR]

A correction to this paper has been published: https://doi.org/10.1007/s00334-021-00835-0 [ABSTRACT FROM AUTHOR]

A Correction to this paper has been published: https://doi.org/10.1007/s00784-021-03963-z [ABSTRACT FROM AUTHOR]