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Purpose: This paper presents the results of the first joint survey on the use of SPECT and PET myocardial perfusion imaging (MPI) and cardiac amyloidosis imaging in Austria, Germany, and Switzerland of the year 2021. Methods: A questionnaire was sent in 2022 to centres practicing nuclear medicine. Results: Data from 14 Austrian (10,710 SPECT), 218 German (133,047 SPECT), and 16 Swiss centres (11,601 MPI (6,879 SPECT, 4722 PET)) were analysed. In Austria and Germany, the PET MPI numbers were close to zero and not considered. Official MPS numbers from 2015 to 2021 from Austria and Germany revealed a decline in Austria by about 40% in the pandemic years 2020 to 2021, but an increase in Germany by 9%. Ambulatory care cardiologists represented the major referral group (56–71%). Mostly, stress tests were performed pharmacologically (58–92%). Contrary to Germany, a 1-day protocol was predominant (58–97%) in Austria and Switzerland. The leading camera systems were SPECT-CT in Austria and Switzerland (57–79%) and multi-head systems in Germany (58%). Switzerland had the highest proportion of SPECT MPI with attenuation correction (84%), followed by Austria (43%), and Germany (33%). Electrocardiogram-gated SPECT MPI showed an overall high penetration of 87–99%. Scoring was most frequently applied in Germany (72%), followed by Austria (64%), and Switzerland (60%). Related to the population, the number of cardiac amyloidosis imaging was highest in Austria, followed by Switzerland and Germany. Conclusions: This first joint survey of 2021 shows considerable differences among the countries. The Swiss situation is outstanding due to the wide use of PET MPI. In terms of camera equipment, Switzerland is also leading, followed by Austria and Germany. Despite the differences in procedural issues, the results reveal an overall high standard of MPI imaging. [ABSTRACT FROM AUTHOR]

This article investigates the vocabulary of textbooks and relates it to education policy, assessment methods and teaching methods. It considers the range of vocabulary covered by key stages 3 and 4 German foreign language textbooks for secondary schools from the beginning of the 1990s to 2006 and shows that there is an overall decrease in the vocabulary throughout this period, as well as an imbalance, which means that pupils acquire detailed knowledge of the vocabulary of certain semantic fields, while other essential vocabulary is neglected. This article proposes changes in the type of vocabulary that is covered by textbooks, and in teaching methods, in order to encourage and facilitate independent language use. (Contains 1 table.)

Conclusions reached in meta‐analyses of changes in insect communities may be influenced by method‐specific sampling biases, which may lead to inappropriate conservation measures.We argue that the contradictory conclusions regarding terrestrial insect biomass, abundance and richness patterns are, at least partly, due to methodological limitations that reflect taxon‐specific responses to environmental changes.In this study, light and Malaise traps were simultaneously deployed to sample insects at 52 plots in a temperate forest in Germany along gradients of elevation (>1000 m) and canopy openness (3%–100%). These gradients were used as predictors in models of total arthropod biomass according to the two trapping methods and in models of abundance and richness of three commonly targeted groups: nocturnal moths, sampled using light traps, and hoverflies and bees, collected with Malaise traps.A comparison of the total arthropod biomass obtained with the two methods revealed contrary results along the canopy openness gradient. Biomass in light traps showed a decreasing trend with increasing canopy openness while biomass in Malaise traps increased. The same opposing pattern was found for the abundance of selected taxa.The different patterns describing spatial variation of arthropod communities obtained using light and Malaise traps can be explained by differences in the taxa predominantly collected. Regarding the ongoing debate on insect decline, our results demonstrate that comparing different taxa from different taxon‐specific traps is inappropriate. Thus, we recommend that future meta‐analyses take into account the sampling methods and taxon‐specific responses to environmental changes. [ABSTRACT FROM AUTHOR]

Previous macroecological studies have suggested that larger and darker insects are favored in cold environments and that the importance of body size and color for the absorption of solar radiation is not limited to diurnal insects. However, whether these effects hold true for local communities and are consistent across taxonomic groups and sampling years remains unexplored. This study examined the variations in body size and color lightness of the two major families of nocturnal moths, Geometridae and Noctuidae, along an elevational gradient of 700 m in Southern Germany. An assemblage‐based analysis was performed using community‐weighted means and a fourth‐corner analysis to test for variations in color and body size among communities as a function of elevation. This was followed by a species‐level analysis to test whether species occurrence and abundance along an elevation gradient were related to these traits, after controlling for host plant availability. In both 2007 and 2016, noctuid moth assemblages became larger and darker with increasing elevation, whereas geometrids showed an opposite trend in terms of color lightness and no clear trend in body size. In single species models, the abundance of geometrids, but not of noctuids, was driven by habitat availability. In turn, the abundance of dark‐colored noctuids, but not geometrids increased with elevation. While body size and color lightness affect insect physiology and the ability to cope with harsh conditions, divergent trait–environment relationships between both families underline that findings of coarse‐scale studies are not necessarily transferable to finer scales. Local abundance and occurrence of noctuids are shaped by morphological traits, whereas that of geometrids are rather shaped by local habitat availability, which can modify their trait–environment‐relationship. We discuss potential explanations such as taxon‐specific flight characteristics and the effect of microclimatic conditions. [ABSTRACT FROM AUTHOR]

The high diversity of insects has limited the volume of long‐term community data with a high taxonomic resolution and considerable geographic replications, especially in forests. Therefore, trends and causes of changes are poorly understood. Here we analyse trends in species richness, abundance and biomass of nocturnal macro moths in three quantitative data sets collected over four decades in forests in southern Germany. Two local data sets, one from coppiced oak forests and one from high oak forests included 125K and 48K specimens from 559 and 532 species, respectively. A third regional data set, representing all forest types in the temperate zone of central Europe comprised 735K specimens from 848 species. Generalized additive mixed models revealed temporal declines in species richness (−38%), abundance (−53%) and biomass (−57%) at the regional scale. These were more pronounced in plant host specialists and in dark coloured species. In contrast, the local coppiced oak forests showed an increase, in species richness (+62%), while the high oak forests showed no clear trends. Left and right censoring as well as cross validation confirmed the robustness of the analyses, which led to four conclusions. First, the decline in insects appears in hyper diverse insect groups in forests and affects species richness, abundance and biomass. Second, the pronounced decline in host specialists suggests habitat loss as an important driver of the observed decline. Third, the more severe decline in dark species might be an indication of global warming as a potential driver. Fourth, the trends in coppiced oak forests indicate that maintaining complex and diverse forest ecosystems through active management may be a promising conservation strategy in order to counteract negative trends in biodiversity, alongside rewilding approaches. [ABSTRACT FROM AUTHOR]

The article discusses the protection of registries and archives in the Second World War in the south west of Munsterland, Germany. It notes that all files were lost due to the effects of the war. It adds that the city administration of Borkens reported all files with the exception of the registration cards as losses to Munster, Germany.

Background Data on the value of digital breast tomosynthesis (DBT) for further assessment of screen-detected lesions are still limited. Purpose To compare screening mammography, single-view DBT and ultrasound-information (TS) vs. screening mammography, additional views and ultrasound-information (AV) for assessment of screen-detected abnormalities. Material and Methods The use of wide-angle DBT for screen-detected, soft-tissue abnormalities requiring additional views was investigated: 241 cases (206 benign and 35 malignant lesions), verified by histology or two-year follow-up, were read by ten readers as TS and as AV sets, yielding 2410 diagnoses for each set. Readings were randomly sequenced. Results The mean interval between readings was nine weeks (random sequence). Evaluation was breast-based. Overall, in terms of area under receiver operating characteristic (AUC; varying degree of suspicion cutoff), TS and AV readings showed similar performance: for TS, AUC was 0.889 (95% confidence interval [CI] = 0.871-0.907) and for AV, AUC was 0.903 (95% CI = 0.886-0.921). TS readings had slightly higher sensitivity than AV readings (96.9% vs. 95.4%) but lower specificity (50% vs. 58.1%) and more variations between reader performance; absolute false negatives (FN) were reduced in 8/16 readers, equal in 5/16, and increased in only 3/16. Conclusion This study broadly confirms previous data showing equivalence of DBT to AV. However, bias against TS may have occurred since the region of interest was not indicated in the TS set as compared to its obvious identification on the AV set by the selected spot views. A key finding is that reader experience with DBT may be more important than so far reported. [ABSTRACT FROM AUTHOR]

Aims: The main goal of the study was to apply and analyse a moderated participatory small‐group procedure with registered nurses, which aims at the development and implementation of measures to improve work organisation in hospital wards and nursing units. Background: Participation in job redesign is an essential prerequisite of the successful implementation of improvement measures in nursing. Methods: The study was carried out in a public hospital of maximum care in Germany. We selected 25 wards with the most critical reported exhaustion and general health and applied a series of moderated small‐group sessions in which the registered nurses jointly identified deficits in their work organisation, developed improvement measures, and then implemented and assessed them. Results: Registered nurses of 22 wards actively took part in the small‐group procedure. All nursing units jointly identified organisational deficits, developed possible improvement measures, and implemented them. The nursing teams then evaluated the implemented measures which were already assessable at the end of our research period; nearly all (99.0%) showed improvements, while 69.4% actually attained the desired goals. Conclusion: Participatory small‐group activities may be successfully applied in hospital nursing in order to improve work organisation. Implications for Nursing Management: Participatory assessment and redesign of nurses’ work organisation should be integrated into regular team meetings. The nursing management should actively support the implementation process. [ABSTRACT FROM AUTHOR]

We investigated how two types of care setting (home care and nursing home) and type of ownership (for‐profit vs. public/non‐profit) of geriatric care services interacted in influencing registered nurses’ intention to give up their profession. In prior research, employment in for‐profit‐organizations, high job demands, and low job control were important antecedents of nurses’ intent to leave. However, the impact of care setting on these associations was inconclusive. Therefore, we tested a mediated moderation model predicting that adverse work characteristics would drive professional leaving intentions, particularly in for‐profit services and in nursing homes. A representative German sample of 304 registered nurses working in 78 different teams participated in our cross‐sectional study. As predicted, lower job control and higher job demands were associated with higher professional leaving intentions, and nurses reported higher job demands in public/non‐profit care than in for‐profit care, and in nursing homes compared to home care. Overall, RNs in nursing homes and home care reported similar intent to leave, but in for‐profit settings only, nurses working in nursing homes reported higher professional leaving intentions than did nurses in home care, which was linked to lower job control in the for‐profit nursing home setting, supporting mediated moderation. Taken together, our results indicate that the interplay of care setting and type of ownership is important when explaining nurses’ intentions to give up their profession. © 2016 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Aims. To investigate the moderating effects of work overload and supervisor support on the emotional exhaustion-depressive state relationship. Background. Burnout and depression are prevalent in human service professionals and have a detrimental impact on clients. Work overload and supervisor support are two key job demands and job resources, whose role and interplay for the development and maintenance of burnout and depression are not fully understood yet. Design. Two consecutive cross-sectional surveys: survey 1 investigated 111 hospital nursing professionals and survey 2 examined 202 day care professionals. Data collection was completed in 2010. Results. After controlling for general well-being and sociodemographic characteristics, nurses' emotional exhaustion was associated with increased depressive state in both samples. We found a meaningful three-way interaction: our results show consistently that the relationship between emotional exhaustion and depressive state was strongest for nurses with high work overload and low supervisor support. Additionally, nurses with low work overload and low supervisor support were also found to have stronger associations between emotional exhaustion and depressive state. Conclusion. The findings indicate that nurses' reported supervisor support exerts its buffering effect on the burnout-depression link differentially and serves as an important resource for nurses dealing with high self-reported work stress. [ABSTRACT FROM AUTHOR]

Background: Various determinants of nurses’ work motivation and turnover behavior have been examined in previous studies. In this research, we extend this work by investigating the impact of care setting (nursing homes vs. home care services) and the important role of rest break organization. Objectives: We aimed to identify direct and indirect linkages between geriatric care setting, rest break organization, and registered nurses’ turnover assessed over a period of one year. Design: We designed a multimethod cross-sectional study. Setting: 80 nursing units (n = 45 nursing homes, n = 35 home care) in 51 German geriatric care services employing 597 registered nurses. Methods: We gathered documentary, interview, and observational data about the organization of rest breaks, registered nurses’ turnover, and additional organizational characteristics (type of ownership, location, nursing staff, clients, and client-to-staff-ratio). Results: The findings show that the rest break system in geriatric nursing home units is more regularly as well as collectively organized and causes less unauthorized rest breaks than in home care units. Moreover, the feasibility of collective rest breaks was, as predicted, negatively associated with registered nurses’ turnover and affected indirectly the relation between care setting and registered nurses’ turnover. Care setting, however, had no direct impact on turnover. Furthermore, registered nurses’ turnover was higher in for-profit care units than in public or non-profit units. Conclusions: This study reveals significant differences in rest break organization as a function of geriatric care setting and highlights the role of collective rest breaks for nursing staff retention. Our study underlines the integration of organizational context variables and features of rest break organization for the analysis of nursing turnover. [ABSTRACT FROM AUTHOR]

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The quasi-experimental field study with 174 advanced engineering students analysed the possibilities to assist the requirement analysis when solving design problems. Technical check lists are in common practice for assisting the requirement analysis. We wondered if a generic question answering system (GQAS) aiming at the 'semantic relationships' would offer an additional benefit to the exhaustive identification of the requirements of a design task when a technical check list were offered at the same time. Therefore, the students were asked to develop a list of requirements for the design of a machine collecting windfall. Whereas one group was offered the technical check list together with the generic question answering system, the other group was only offered the technical check list in assisting their task. The entire number of identified applicable requirements is significantly higher for the group with the additional GQAS. The additional benefit of answering generic interrogative questions holds for the majority of the individual categories of technical requirements. The benefit is explained with the proven stimulation of meta-cognitive processes by means of systems of interrogative questions. Practically, the consideration of generic procedures of problem solving in engineering design education may be recommended. [ABSTRACT FROM AUTHOR]

Objective: The case of Ludwig II, King of Bavaria, had soon become synonymous with paranoia, after he had drowned at the age of 40 together with the neuropsychiatrist Gudden. Method: We were granted access to the Secret Archive of the House of Wittelsbach to study documents on Ludwig’s medical history. Results: The documents underlying Gudden’s expert opinion which led to Ludwig being deposed would be insufficient for a diagnosis of schizophrenia according to contemporary standards. The autopsy revealed prominent prefrontal brain atrophy. Conclusion: The evidence is compatible with a diagnosis of schizotypal personality and suspected frontotemporal degeneration. [ABSTRACT FROM AUTHOR]

Focuses on the life and works of German philosopher Stuart Hampshire. Education and career background; Common theme of the books written by the philosopher; Citations of prior intellectuals who made an influence of Hampshire's philosophy.

Neonates continue to be treated with off-label or unlicensed drugs while in hospital. However, some medications that have previously been used in adults underwent clinical testing and licensure for use with a different indication in the neonatal and pediatric population. Almost always, the marketing of these newly approved substances in a niche indication is accompanied by a steep increase in the price of the compound. We investigated the use of the approved formulation or the cheaper off-label alternative of Ibuprofen (Pedea®), Propanolol (Hemangiol®) and Caffeine Citrate (Peyona®) in neonatal clinical practice by conducting a National Survey of 214 Perinatal Centers in Germany. We also assessed price differences between on- and off-label alternatives and the extend of the clinical development program of the on-label medication in the neonatal population. On-label medication was more frequently used than the off-label alternative in all indications (PDA: on-label to off-label ratio 1:0.26, Apnea: 1:0.56, Hemangioma 1:0.76). All sponsors did conduct placebo-controlled Phase III trials with efficacy and safety endpoints in the target population and the number of participants in the target population varied between 82 and 497. Costs for the three drugs in their approved and marketed formulations increased in median 405-fold compared with the corresponding off-label alternative. Overall, about one out of three neonatologists prescribed an off-label or non-approved drug to patients despite an alternative medication that is approved for the indication in the target population being available. [ABSTRACT FROM AUTHOR]

The article presents a study on the use of positron emission tomography (PET) in monitoring inflammation in patients with atherosclerosis in Germany. It notes that the findings reveal that (PET) with fluorodeoxyglucose (FDG) can be a reliable method in quantifying plaque inflammation which is a risk factor for cardiovascular events. The study also found out that FDG PET or Computed Tomography (CT) is more effective in detecting treatment effects compared with other surrogate markers.

The article presents the program and the table of contents of the International Symposium on Xenotransplantation which was conducted from June 5-6, 2008 at the Robert Koch Institute in Berlin, Germany. Among the topics discussed are the "Correction of diabetes in primates by macroencapsulated pig islets," by Pierre Gianello, "Cardiac regeneration by intramyocardial stem cell therapy: clinical development," by Gustav Steinhoff, and the "Impact of the German tissue act on xenotransplantation."

Precision cancer medicine (PCM) holds great promises to offer more effective therapies to patients based on molecular profiling of their individual tumours. Although the PCM approach seems intuitive, multiple conceptional and structural challenges interfere with the broad implementation of PCM into clinical practice. Accordingly, concerted national and international efforts are needed to guide the further development and broad adoption of PCM in Germany. With support of the 'German Cancer Aid' (Deutsche Krebshilfe [DKH]) a task force ' Molecular Diagnostics and Therapy' was implemented. In two workshops supported by the DKH, delegates from the fourteen comprehensive cancer centresidentified key topics essential to implement quality-guided, harmonized and adaptable PCM. Based on an online questionnaire and using a modified Delphi approach, nine statements were drafted and evaluated within the group. These statements could serve as a basis to define a collaborative strategy for PCM in the future with the aim to sustain and further improve its quality. • This consenus statement originated from collaborative efforts of all fourteen Comprehensive Cancer Centres in the German Cancer Aid network. • The consensus statement is based on all centres' consent due to implementation of a modified Delphi process. • This consensus statement will serve as a framework to establish sustainable structures for precision cancer medicine in Germany. [ABSTRACT FROM AUTHOR]

Objectives: To assess the psychometric properties of the German self-reported version of the Kiddy-KINDL that measures Health Related Quality of Life (HRQoL) in 3 to 5 year old kindergarten children. Study design: The population of the study comprised baseline data of a longitudinal study whose main aim is to investigate self-reported health outcomes in young children (N = 317). Methods: Missing values, the distribution of data, internal consistency (Cronbach's alpha and Guttman's lambda), and reliability (split half and two weeks test-retest) were analysed. To assess discriminant validity, mean differences were tested splitting the sample regarding socio-emotional competences (VBV 3-6), age and gender. Structural validity was investigated with Confirmatory Factor Analysis (CFA). Results: Mean HRQoL was 69.79 (SD 16.84). Overall missing values were 8.1%, overall Cronbach's alpha was 0.75 and overall Guttman's lambda was 0.77; for the whole scale Spearman-Brown test for split half reliability resulted in 0.80 and ICC for test-retest in 0.83. Discriminant validity investigation differentiated groups with high and low socioemotional competence and those children who were 4.5 years or older, compared to the younger ones. Differences between boys and girls were also found. CFA suggested two main dimensions: physical and socio-emotional. Conclusion: This preliminary validation of the Kiddy-KINDL in very young children shows satisfactory psychometric properties. However, results of the Cronbach's alpha, Guttman's lambda and the CFA depicted problems, mainly in the psychological dimension. Due to these we recommend to use the Kiddy-KINDL as an instrument with only two dimensions. Further studies in general population samples are needed. [ABSTRACT FROM AUTHOR]

Chronic cerebrospinal venous insufficiency (CCSVI) has been postulated as a cause for multiple sclerosis (MS). Venous pressure assessments have not been made. Intracranial venous pressure was assessed using ophthalmodynamometry in 29 MS patients and compared with 28 healthy controls and 19 cases with elevated intracranial pressure (ICP). MS and control subjects had normal venous pressures (mean 15.5 resp. 15.1 cmHg). Only cases with intracranial pressure pathology had elevated venous pressures (mean 28.8 cmHg). There is no evidence of an increased intracranial venous pressure in MS patients.