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Individuals in need of long-term care and their relatives prefer to receive and give care in their domestic environment for as long as possible. Residential long-term care is to be avoided for as long as possible. To achieve this goal, the care setting must be optimally oriented to the needs of the person in need of care. Moreover, relatives who provide care must be professionally supported. The Regional Care Competence Center (ReKo), launched on October 1, 2019, is a quasi-experimental study (two groups and pre-post design), funded by the Innovation Fund. As part of the ReKo project, people in need of care and their relatives are assisted by a case management (CM) system. An independent CM, supported by an IT network that includes the most important service providers, is to establish a comprehensive CM for people in need of care. Based on a literature review, this paper aimed to take a conceptual approach to the ReKo project by drawing on previous research and comparing the findings with the ReKo approach. The review considered CM projects that defined avoidance of hospitalization and/or delay in the transition of care recipients to long-term inpatient care as endpoints. Using PubMed and Google Scholar, the study screened 270 articles, abstracted and quality-assessed data, and included eight randomized clinical trials, two other studies, and seven reviews in the analysis. The review results and ReKo approaches are presented along the dimensions of clinical and medical benefits, community and public health benefits, economic benefits, and political and legislative benefits. CM organizations will continue to be established internationally in aging societies. The questions of improving quality of care, avoiding service costs, and the costs of establishing a CM must be raised, even if clear evidence is difficult to provide. [ABSTRACT FROM AUTHOR]

For a long time, Germany was regarded as a pioneer in climate policy. Recently, conflicts have intensified over the phase-out of coal from the energy sector. In 2020, the German Bundestag created the legal basis for a coal phase-out by 2038, subsequently revised to 2030 by the new coalition government of September 2021. This article analyzes the recent controversies from a political-economy perspective and shows the interrelationships and tensions between capitalism, democracy, and sustainability within Germany. In particular, the rise of right-wing populist attitudes opposing a coal phase-out, highlights the conflictual character and the social embeddedness of sustainability politics. The analysis of the conflicts surrounding the coal phase-out makes it possible to situate the future of energy supply in the overall societal context. [ABSTRACT FROM AUTHOR]

Postoperative junctional ectopic tachycardia (JET) is a frequent complication after pediatric cardiac surgery. Current recommendations on how and when to treat JET are inconsistent. We evaluated the management strategies of postoperative JET in German-speaking countries. We sent an online survey to 30 centers of pediatric cardiology that perform surgery for congenital heart defects in Germany (24), Austria (4), and Switzerland (2). The survey asked 18 questions about how and in what treatment sequence postoperative JET was managed. All 30 centers completed the survey (100% return rate). There was general agreement that the management of JET is based on administration of antiarrhythmic drugs, body surface cooling, and temporary pacing. Many centers presented treatment algorithms based on published literature, all centers named amiodarone as the first drug of choice. Significant disagreement was found concerning the timing and sequential order of additional therapeutic measures and particularly about the dosing of amiodarone and the role of R-wave synchronized atrial pacing.Conclusion: This survey reveals that from center to center, the treatment of postoperative JET may vary substantially. Future work should focus on those treatment modalities where a high rate of variation is found. Such studies may be of value to achieve commonly adopted treatment recommendations. What is known: • Treatment of postoperative junctional ectopic tachycardia is predominantly based on administration of antiarrhythmic drugs, therapeutic cooling, and temporary pacing. • Amiodarone is the antiarrhythmic drug of choice in this context. What is new: • Dosing and duration of administration of amiodarone differ relevantly from center to center. • The sequential order of drug administration, therapeutic cooling, and pacing is not consistent. [ABSTRACT FROM AUTHOR]

The article presents a study that evaluates the intrauterine course and the effects of tricuspid atresia detected in the fetus. The study is undertaken through a review of all tricuspid atresia cases identified prenatally between 1998 and 2006 in three referral centers in Germany. Results of the study show that tricuspid atresia were detected in 54 cases during the study period, 28 cases exhibit concordant ventriculoarterial connection of which 14 had aortic outflow obstruction.

The use of renewable energy in Europe offers the possibility of reducing greenhouse gas emissions, and contributes to energy security and independence. With the reform of the Common Agricultural Policy (CAP) and a variety of recently introduced national directives supporting renewable energy sources in the European Union, the economic attractiveness of bioenergy production has distinctly increased. This article combines an economic evaluation of biomass production with site-related natural conditions of the Havelland region, situated in the north-east area of Germany. Two methods for evaluating site-specific potential biomass yields were compared. For three example biomass crops, evaluations of yield estimations at agricultural lots for site-optimized suitability (SOS) and conventional suitability (CS) were carried out. Both modelling approaches were compared. The results of the GIS modelling indicate that the financial support for increasing the use of renewable energy with the German feed-in system, called Erneuerbare-Energien-Gesetz (EEG), will possibly lead to an increased cultivation of crops with high biomass output. This monocultural orientation of farming practices and the negative effects on the ecosystem could act in opposition to other environmental initiatives of the EU. The outputs of the SOS analysis show that high biomass production could be integrated into environmental policy proposals. Therefore, new EU policy should take modified subsidies into consideration in order to avoid developing conflicts between small-scale changes in landscape ecosystems caused by large-scale transformations in energy policy. [ABSTRACT FROM AUTHOR]

This paper describes a broadband ISDN system based upon fibre-optic and advanced silicon technologies that has been realized by SEL. A laboratory model of this system called the BERKOM test network, is installed in Berlin. It is based on time division multiplex principles (TDM) and offers ISDN arid broadband services at the subscriber's premises. The broadband services are uttered through a universal broadband interlace type SB at the network termination. For services integration, transmission transmission and switching a universal TDM frame is used, being composed of the channel types D (16 kb/s). B (64 kb/s). H12 (2048 kb/s) and H4 (139.264 kb/s). For the ISDN services an S0-interface fully in line with the current ISDN standards is available. [ABSTRACT FROM AUTHOR]

Climate change mitigation triggers both spatial and moral complexities, as demonstrated by the contentious issue of phasing out coal power. The success of the Paris Agreement depends on, among other things, the acceptability of climate policy measures and thus, from a moral perspective, on the ability to organize transition processes in ways that do not damage the livelihoods of workers, communities, and entire regions. Spatially, the unequal distributions of burdens and advantages of both climate change and respective mitigation measures provoke struggles over their legitimacy in contexts ranging from local to global. Phasing out coal mining and the respective power generation capacity thus triggers processes of structural transformation that cut across geographic scales, vertical levels of policy and politics, as well as sectoral boundaries. In light of the urgency of the climate crisis, countries such as Canada and Germany have established stakeholder-driven commissions to develop proposals for just transition pathways for phasing out coal production and consumption. We argue that these commissions are arenas in which spatial, moral, and sectoral (re-)negotiations materialize. Comparing the Canadian and German stakeholder commissions through expert interviews with their members, the article traces how governments use commissions to legitimize their transition policies. Expectations at different levels and from different actors in turn place commission members under pressure to justify their involvement and the outputs of the commissions. We find that the Canadian task force showed greater commitment to collecting and reflecting the needs of communities in its coal regions, and to communicating these to the federal government. In the German coal commission, legitimation strategies focused mainly on a broad representation of interests, and on government spending for affected regions, workers, and industries. In that case, a compromise was reached that satisfied most, but not all, of the diverse requirements. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To examine the concordance of a questionnaire-based categorization as ‘at-risk for exercise dependence’ and an interview-based diagnosis of exercise dependence. Design: One hundred thirty four subjects answered the German version of the Exercise Dependence Scale-21 (EDS-G). They were also assessed with a structured clinical interview for exercise dependence. Method: The congruence between the questionnaire-based categorizations of ‘at-risk for exercise dependence’ and the diagnosis of exercise dependence based on the interview was examined using κ-coefficients. Result: The agreement between questionnaire-based and interview-based diagnoses was fair to moderate with more false positive categorization based on the EDS-G. Conclusion: Assuming that a structured clinical interview allows a more accurate diagnostic categorization, the EDS-G might overestimate the prevalence of exercise dependence. [Copyright &y& Elsevier]