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BACKGROUND: Persons with intellectual disability (ID) often suffer from significant comorbidities. As data have been lacking until now, the present report is the first one containing outpatient data on the prevalence of ID in Germany, its comorbidities, and outpatient (drug) treatment. METHODS: This study is based on the nationwide outpatient billing data and drug prescription data of all SHI-insured adults (SHI, statutory health insurance) (age 18–109) who were seen at least once in an outpatient medical practice in 2018. Patients with at least two F70–F79 diagnoses in two quarters were included in the study group (SG) (n = 324 428). A random sample of patients without ID served as the control/comparison group (CG) (n = 648 856). The odds ratios (SG vs. CG) for comorbidities, prescriptions of selected classes of drugs, and involvement of medical specialties were each analyzed by multivariate logistic regression. RESULTS: The prevalence of ID was 0.55%. ID was found to be associated with a variety of comorbidities. The highest odds ratios [OR] were for infantile cerebral palsy (OR: 121.71; 95% confidence interval: [111.67; 132.67]), autism spectrum disorders (OR: 83.85 [75.54; 93.08]), and developmental disabilities (OR: 61.34 [58.86; 63.94]). The most frequently prescribed drug categories (as classified by the anatomic-therapeutic-chemical (ATC) convention) were psychoactive drugs (antipsychotic, anxiolytic, and hypnotic drugs and sedatives) and antiepileptic drugs (OR: 10.40 [10.27; 10.53] and 9.90 [9.75; 10.05], respectively). Both general practitioners (OR: 2.64 [2.59; 2.69]) and medical specialists were consulted by the SG more frequently than by the CG; the type of specialist most commonly consulted was in the neuropsychiatric field, i.e., a neurologist or psychiatrist (OR: 6.85 [6.77; 6.92]). CONCLUSION: A diagnosis of ID frequently appears in outpatient billing data. Future analyses should be devoted to the specific care of people with intellectual disability, who constitute an especially multimorbid and vulnerable patient group.

Der Markt für ökologische Produkte gewinnt zunehmend an Bedeutung. Es wurde daher die Entwicklung des Konsums ökologisch erzeugter Lebensmittel in Bayern anhand des Vergleichs von drei ähnlich angelegten Konsumentenerhebungen aus den Jahren 2004, 1998 und 1992 mit der Zielsetzung untersucht, die Änderungen in den Einstellungen und Verhaltensweisen der Verbraucher in einem Zeitraum von zwölf Jahren zu erkennen und zu bewerten. Es werden die Auswirkungen des Marktes für ökologische Lebensmittel in den letzten Jahren auf das Nachfrageverhalten der bayerischen Verbraucher aufgezeigt. The organic food market increasingly gains importance. As such was researched the development of the consumption of ecologically generated foods in Bavaria on the basis of the comparison of three similarly aimed consumer-inquiries from the years 2004, 1998 and 1992 with the objective to recognize and to assess the modifications of the consumer attitudes and behaviour of a time period of twelve years. In the study are shown the effects of the expansion of the organic food market on the demand-behaviour of the Bavarian consumers in the last years.

In der vorliegenden Arbeit wurde auf der Grundlage von genetischen Regulationselementen ein in vivo Assay und vergleichend hierzu ein in vitro Assay entwickelt. Ein rekombinanter E. coli Stamm wurde beim in vivo Reporterassay zur Detektion von 4-CBA verwendet, der bei Anwesenheit von 4-CBA Luziferase exprimiert. Durch Immobilisierung dieses Stammes konnte ein einfaches und spezifisches Testverfahren im Mikrotiterplattenformat entwickelt werden. Mit den optimierten Immobilisierungsbedingungen und der Verwendung einer Membranmutante von E. coli konnte ein Detektionslimit von 28 µM 4-CBA in 200 min erreicht werden. Zusätzlich wurde ein von den Eigenschaften der Zelle unabhängiges in vitro Assaysystem entwickelt. Da der Mechanismus der Tetrazyklinresistenz in Bakterien bekannt war, wurde Tetrazyklin als Analyt ausgewählt. Im neu zu entwickelnden Assay sollte der durch Tetrazyklin induzierte Abfall des Repressors von der Operator DNA zur quantitativen Bestimmung von Tetrazyklin benutzt werden. Dazu wurde der Tet Repressor mit N-terminal oder C-terminal fusioniertem Tag und nativ in E. coli überexprimiert. Die Funktionalität der Repressoren wurde im Gel-Mobility-Shift Assay untersucht. Nur der Repressor ohne Tag sowie der Repressor mit einem durch Proteaseverdau abgespaltenem Tag zeigten volle biologische Aktivität. Im Hinblick auf eine spätere Assay-Entwicklung wurde der Einfluß eines enzymatischen Markers auf die Repressor/Operator-DNA-Bindung mit derselben Methode getestet. Daraus folgte eine Versuchsdurchführung für den Mikrotiterplatten-Assay. Diese beeinhaltete die Immobilisierung des Repressors, die Bindung von Tetrazyklin an diesen und die Bindung POD markierter Operator-DNA an tetrazyklinfreie Repressoren. Die Bestimmung der POD Aktivität ließ Rückschlüsse auf die vorhandene Tetrazyklinkonzentration zu. Da dieses Assayformat mit sehr großen Standardabweichungen verbunden war, wurden markerfreie Oberflächenplasmonresonanzmessungen vorgenommen., The aim of this study was the development of in vivo and in vitro test systems using genetic regulatory elements. The in vivo reporter assay detected 4-CBA with recombinant E. coli strains. These strains express luciferase in the presence of 4-CBA, which can be quantified by its enzymatic reaction. Immobilization of the microorganism provided a handy and specific microtiter plate assay. The optimized system had a detection limit of 4-CBA of 28 µM within 200 min using a membrane mutant strain of E. coli. The second objective was the development of a cell independent in vitro system. The development was based on the mechanism responsible for the tetracycline resistance in microorganisms using it for the detection of tetracycline. Tetracycline induces by its binding to the Tet repressor dissociation of the repressor from the operator. The assay was to use the release of the repressor from the operator by tetracycline to quantify the analyte. The Tet repressor was overexpressed in E. coli either without any tag or as N-terminal or C-terminal fusion to Streptag(II). The activity of these repressors was checked in gel-mobility-shift assays. All three obtained repressors could bind to the operator, but only the repressor without tag and the repressor with protease digested tag showed dissociation from the DNA after tetracycline addition. In light of the later assay development the influence of an enzymatic label at the end of the operator DNA fragment onto the binding of the repressor was studied as well using a gel-mobility-shift assay. Based on these results a microtiter plate format assay was tested. After immobilization of the repressor binding studies on enzymatic labeled operator DNA were performed. Using POD activity estimation of the tetracycline concentration was possible. Due to the high standard deviations later surface plasmon resonance was used to measure the binding capability of the label free operator DNA fragments.

Oxygen and carbon isotope measurements were carried out on tests of planktic foraminilers N. pachyderma (sin.) from eight sediment cores taken from the eastem Arctic Ocean, the Fram Strait, and the Iceland Sea, in order to reconstruct Arctic Ocean and Norwegian-Greenland Sea circulation patterns and ice covers during the last 130,000 years. ln addition, the influence of ice, temperature and salinity effects on the isotopic signal was quantified. Isotope measurements on foraminifers from sediment surface samples were used to elucidate the ecology of N. pachyderma (sin.). Changes in the oxygen and carbon isotope composition of N. pachyderma (sin.) from sediment surface samples document the horizontal and vertical changes of water mass boundaries controlled by watertemperature and salinity, because N. pachyderma (sin.) shows drastic changes in depth habitats, depending on the water mass properties. It was able to be shown that in the investigated areas a regional and spatial apparent increase of the ice effect occurred. This happened especially du ring the termination 1 by direct advection of meltwaters from nearby continents or during the termination and in interglacials by supply of isotopically light water from rivers. A northwardly proceeding overprint of the "global" ice effect, increasing from the Norwegian-Greenland Sea to the Arctic Ocean, was not able to be demonstrated. By means of a model the influence of temperature and salinity on the global ice volume signal during the last 130.000 years was recorded. In combination with the results of this study, the model was the basis for a reconstruction of the paleoceanographic development of the Arctic Ocean and the Norwegian-Greenland Sea during this time interval. The conception of a relatively thick and permanent sea ice cover in the Nordic Seas during glacial times should be replaced by the model of a seasonally and regionally highly variable ice cover. Only during isotope stage 5e may there have been a local deep water formation in the Fram Strait.

Oxygen and carbon isotope measurements were carried out on tests of planktic foraminifers N. pachyderma (sin.) from eight sediment cores taken from the eastern Arctic Ocean, the Fram Strait, and the leeland Sea, in order to reconstruct Arctic Ocean and Norwegian-Greenland Sea circulation patterns and ice covers during the last 130,000 years. In addition, the influence of ice, temperature and salinity effects on the isotopic signal was quantified. Isotope measurements on foraminifers from sediment surface sampies were used to elucidate the ecology of N. pachyderma (sin.). Changes in the oxygen and carbon isotope composition of N. pachyderma (sin.) from sediment surface sampies document the horizontal and vertical changes of water mass boundaries controlled by water temperature and salinity, because N. pachyderma (sin.) shows drastic changes in depth habitats, depending on the water mass properties. It was able to be shown that in the investigated areas a regional and spatial apparent increase of the ice effect occurred. This happened especially during the termination I by direct advection of meltwaters from nearby continents or during the termination and in interglacials by supply of isotopically light water from rivers. A northwardly proceeding overprint of the "global" ice effect, increasing from the Norwegian-Greenland Sea to the Arctic Ocean, was not able to be demonstrated. By means of a model the influence of temperature and salinity on the global ice volume signal during the last 130.000 years was recorded. In combination with the results of this study, the model was the basis for a reconstruction of the paleoceanographic development of the Arctic Ocean and the Norwegian-Greenland Sea during this time interval. The conception of a relatively thick and permanent sea ice cover in the Nordic Seas during glacial times should be replaced by the model of a seasonally and regionally highly variable ice cover. Only during isotope stage 5e may there have been a local deep water formation in the Fram Strait.