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Research on faculty emotions is scarce, despite their evident relevance for faculty well-being, higher education quality, and student outcomes. The present studies aimed to investigate six discrete emotions (enjoyment, pride, boredom, anxiety, anger, frustration) faculty may experience during grading. Study 1 compared faculty emotions for grading with emotions for research and teaching (US sample, N = 1226). Mean comparisons showed that grading generally elicited less positive and more negative emotions than research and teaching. Study 2 further examined faculty emotions for grading through the lens of control-value theory, by identifying emotion-specific appraisal patterns in two countries (US, n = 244 and Germany, n = 201). Multiple linear regressions revealed that the most consistent predictor for grading emotions across both samples was cost, in terms of the extent to which faculty perceived grading as a thankless task that kept them away from more meaningful tasks. Our findings further point to the important role of faculty-student relationships and faculty members' confidence in their grading ability for eliciting grading emotions. This study extends existing research on emotions in higher education by considering grading as a relevant emotion-inducing task, and by applying control-value theory to a new context in two countries, thereby contributing to the question of this theory's generalizability. Practical implications of our findings entail that universities should aim to improve the circumstances of grading and equip their faculty with the means to handle their grading duties well, to optimize their somewhat worrisome emotional experiences in this context.

Student ratings of instruction (SRI) are commonly used to evaluate courses and teaching in higher education. Much debate about their validity in evaluating teaching exists, which is due to concerns of bias by factors unrelated to teaching quality (Spooren et al., 2013). Our objective was to identify peer-reviewed original research published in English from January 1, 2012, to March 10, 2021, on potential sources of bias in SRIs. Our systematic review of 63 articles demonstrated strong support for the continued existence of gender bias, favoring male instructors and bias against faculty with minority ethnic and cultural backgrounds. These and other biases must be considered when implementing SRIs and reviewing results. Critical practices for reducing bias when using SRIs include implementing bias awareness training and avoiding use of SRIs as a singular measure of teaching quality when making decisions for teaching development or hiring and promotion.

This article provides an analysis of how military history museums in Germany, Britain, Belgium, Poland, and the United States exhibit and contextualize weapon technologies that were developed in the two world wars. The article focuses on technologies (gas warfare, the atomic bomb, tanks, and the V2 long-range rocket) that are directly connected to military success and innovation but also relate to dehumanization and destruction. By employing the analytical concepts of experientiality and of antagonistic, cosmopolitan, and entangled memory, this article demonstrates how museums can create open or closed narratives, steer the visitor toward particular interpretations, enhance or deconstruct the authentic aura of technological artifacts, and stage the symbolic potential of technologies. In addition, it shows how museums can educate visitors and allow them to experience the ambiguities, controversies, and complexities of these technologies.

• Feasibility of rapid epidemic panel involving population-based cohort. • Four protection levels against severe COVID-19 based on literature synthesis. • Protection levels based on vaccination, previous infection, and immunity status. • Model-based estimates on SARS-CoV-2 hospitalizations with varying scenarios. • Varying scenarios on transmissibility, variants, and boosters inform policymakers. Throughout the SARS-CoV-2 pandemic, Germany like other countries lacked adaptive population-based panels to monitor the spread of epidemic diseases. To fill a gap in population-based estimates needed for winter 2022/23 we resampled in the German SARS-CoV-2 cohort study MuSPAD in mid-2022, including characterization of systemic cellular and humoral immune responses by interferon-γ-release assay (IGRA) and CLIA/IVN assay. We were able to confirm categorization of our study population into four groups with differing protection levels against severe COVID-19 courses based on literature synthesis. Using these estimates, we assessed potential healthcare burden for winter 2022/23 in different scenarios with varying assumptions on transmissibility, pathogenicity, new variants, and vaccine booster campaigns in ordinary differential equation models. We included 9921 participants from eight German regions. While 85% of individuals were located in one of the two highest protection categories, hospitalization estimates from scenario modeling were highly dependent on viral variant characteristics ranging from 30-300% compared to the 02/2021 peak. Our results were openly communicated and published to an epidemic panel network and a newly established modeling network. We demonstrate feasibility of a rapid epidemic panel to provide complex immune protection levels for inclusion in dynamic disease burden modeling scenarios. [Display omitted] [ABSTRACT FROM AUTHOR]

Purpose: Despite the need to generate valid and reliable estimates of protection levels against SARS-CoV-2 infection and severe course of COVID-19 for the German population in summer 2022, there was a lack of systematically collected population-based data allowing for the assessment of the protection level in real time. Methods: In the IMMUNEBRIDGE project, we harmonised data and biosamples for nine population-/hospital-based studies (total number of participants n = 33,637) to provide estimates for protection levels against SARS-CoV-2 infection and severe COVID-19 between June and November 2022. Based on evidence synthesis, we formed a combined endpoint of protection levels based on the number of self-reported infections/vaccinations in combination with nucleocapsid/spike antibody responses ("confirmed exposures"). Four confirmed exposures represented the highest protection level, and no exposure represented the lowest. Results: Most participants were seropositive against the spike antigen; 37% of the participants ≥ 79 years had less than four confirmed exposures (highest level of protection) and 5% less than three. In the subgroup of participants with comorbidities, 46–56% had less than four confirmed exposures. We found major heterogeneity across federal states, with 4–28% of participants having less than three confirmed exposures. Conclusion: Using serological analyses, literature synthesis and infection dynamics during the survey period, we observed moderate to high levels of protection against severe COVID-19, whereas the protection against SARS-CoV-2 infection was low across all age groups. We found relevant protection gaps in the oldest age group and amongst individuals with comorbidities, indicating a need for additional protective measures in these groups. [ABSTRACT FROM AUTHOR]

Background: Recent case studies and media outlets have hypothesised an effect of SARS-CoV-2 infection and immunisation on the development or progression of neurodegenerative diseases such as Alzheimer's disease or sporadic Creutzfeldt-Jakob disease (sCJD). Objectives: This study aims to identify potential associations of SARS-CoV-2 infections and SARS-CoV-2 immunisation with sCJD incidence, disease duration, and age of onset. Method: We used data from a prospective sCJD surveillance study in Germany (2016–2022) and publicly available datasets of SARS-CoV-2 cases and vaccination numbers in Germany for the years 2020–2022. Associations of SARS-CoV-2 incidence and immunisation rates with sCJD incidence were assessed by comparing quarterly and annual cumulative sCJD incidences in the periods before (2016–2019) and during the pandemic (2020–2022). Results: We could not identify any time-related effect of SARS-CoV-2 incidence or immunisation rate on the sCJD incidence. Moreover, we did not find any sCJD incidence alterations before and during the SARS-CoV-2 pandemic on a federal or state level. The overall sCJD incidence was within expected ranges in the years 2020–2022. There were no changes in age of onset and clinical disease duration in these years. Conclusions: We found no evidence supporting a short-term effect of the pandemic on sCJD incidence. However, considering the extended pre-clinical phase of sCJD, continued surveillance is needed to identify potential future incidence alterations. [ABSTRACT FROM AUTHOR]

Background: The media are an important source of information on mental health. They are often implicit in reinforcing negative stereotypes of people with mental health problems. There are no studies in German-speaking countries or Russia on media attitudes to mental health and mental health professionals' (MHP) attitudes to the media. Aims: This study explored journalists and MHPs attitudes to mental health media reporting in the German speaking countries of Switzerland, Germany, and Austria and in Russia. Methods: A cross-sectional online internet survey, of ten Likert scale statements to ascertain perceptions of stigma, role, and training needs following the STROBE guidance was conducted among journalists and MHPs via their professional organizations. A non-discriminatory exponential snowballing technique leading to non-probability sampling was used. Descriptive statistics, Kruskal-Wallis, and a post hoc Dunn's multiple comparisons test using Bonferroni adjustment were used to analyze data. Results: A total of 106 German-speaking and 78 Russian journalists, 109 German-speaking, and 82 Russian MHPs fully answered the survey. Journalists felt the media were more balanced about mental health than MHPs, and MHPs were wary of engagement with the media. Small minorities of journalists had engaged with mental health training, similarly few MHPs had engaged with media training, but both groups were interested in doing so in the future. Significant differences between German and Russian speaking respondents were found on a range of issues (e.g. stigmatization, image about psychotherapy, the media/MHPs, and their own role in engaging with the media/MHPs). Russians were more likely to know specialized (media/mental health awareness) training compared to German-speaking MHPs and journalists. Conclusion: There are potential opportunities to engage journalists and MHPs in training about each other's worlds and reducing stigma toward mental illness through engaging MHPs with the media. [ABSTRACT FROM AUTHOR]

Artificial tracers are often used for quantitative estimates of solute transport properties in rivers. However, single‐injection tracer tests give insights in transport characteristics limited to the ecohydrological conditions at the testing time. Series of time‐consuming and laborious tracer tests would be required to properly capture seasonal changes. The present study uses intrinsic diurnal fluctuations of electrical conductivity (EC) caused by discharge of treated wastewater as a tracer to evaluate solute transport processes along a 4.7‐km reach of the River Erpe, Germany. By reproducing the fluctuations recorded along the river using the solute transport model one‐dimensional transport with inflow and storage, this study investigated the long‐term dynamics in solute transport properties. Individual 48‐hr curves of EC were used in the steady state configuration of the model to gain 48‐hr‐integrated estimates of selected transport parameters. Using a sliding window approach in 1‐hr steps along the 2,270‐hr time series of EC the temporal variability of solute transport between April and June 2016 was assessed. To test the identifiability of parameters using the proposed method, sensitivity analyses and a breakthrough curve analysis of selected 48‐hr windows were implemented. With time advancing into the summer, a significant rising trend (Mann‐Kendall test p‐value < 0.05) of the cross sectional area of the channel was observed and attributed to the growth of macrophytes and a significant slightly decreasing trend for the storage rate was found. The presented method is of high value for river management, as promoting transient storage enhances biogeochemical cycling and benefits water quality. Key Points: Electrical conductivity fluctuations caused by discharge of treated wastewater into a river contain information about solute transportA solute transport model applied to recordings of solute fluctuations can be used to obtain long‐term time series of transport metricsDifferences in transport metrics in adjacent river sections were found; Mowing of macrophytes may increase the transient storage area [ABSTRACT FROM AUTHOR]

A central theme of approaches to new public management is the emulation of the market through state-induced competition. Basing state funding allocations on comparative performance is one way of setting an incentive for competitive practice amongst universities. Reforms in funding allocation have occurred in Germany at both state and university level. These have concentrated on indicator-based models, and an analysis of these procedures is the focus of this article. In general, it can be concluded that indicator-based models are used extensively at state and university level and that their general structure suggests a "tool box" of indicators, commonly used at both levels. In many cases, performance-based funding only determines a marginal part of total budget allocations and discretionary, incremental funding dominates. Besides being a question of allocation model construction, this has both to do with the continuing need to improve institutions' capability to compete with one another and--directly connected to this--the reluctance by many German states to complete the transition to "steering at a distance". The article concludes with an outlook for the future of models of performance-based funding in Germany. (Contains 4 figures and 3 notes.)

Simple Summary: Patients diagnosed with early-stage ovarian cancer (OC) are treated by surgery and, if appropriate, by adjuvant chemotherapy. However, in practice, there is disagreement about both the extent of surgical staging and the indication of adjuvant chemotherapy. Therefore, we sought to structurally assess clinically relevant parameters of treatment practice and aimed to identify individual patient factors that may influence decisions regarding the extent of treatment. This study confirmed that a relevant proportion (34.2%) of early-stage OC patients were not operated on in compliance with the current standard. This was independent of patient age and hospital healthcare level. The reasons for omitting complete surgical staging were balanced. Only a subset of cases underwent BRCA1/2 testing. Though mono-chemotherapy is recommended for early-stage OC, almost every second patient receives combination treatment. Our study underlines the high need for further prospective registries and educational programs to increase awareness for adequate clinical management of patients with early-stage OC. Background: Surgery is the backbone of early-stage ovarian cancer (OC) management. However, in practice, there is disagreement about the extent of surgical staging and whether additional adjuvant treatment should be provided. As omitting relevant diagnostic or therapeutic procedures might lead to undertreatment, we aimed to structurally investigate treatment practice in addition to prognostic factors in a multicentre series of patients (pts) diagnosed with early-stage OC. Patients: Within this retrospective, multicentre study, medical records of 379 pts who had undergone surgery for suspected early-stage OC between January 2014 and March 2020 were analysed. Results: Of the 379 patients, 292 had pT stage 1a-2a and had complete data on the extent of surgical staging. At least one surgical step was omitted in 100 pts (34.2%). Complete surgical staging (n = 192; (65.8%)) was more often performed in high-grade serous OC and was independent of the healthcare level of the hospital where the initial diagnosis was made. Missing to take peritoneal biopsies was associated with reduced relapse-free-survival in incompletely staged, pT1 cases (p = 0.03). About every second patient (46.7%) with a final stage lower than FIGO IIB and treated with adjuvant chemotherapy received combination chemotherapy. BRCA1 and BRCA2 testing was only performed in a subset of pts, and mutations were detected in 18% (14/79) and 9% (7/85) pts, respectively. Conclusions: This study helps to increase our understanding of early-stage OC treatment and prognosis. In addition to treating patients in compliance with current guidelines, the need for BRCA testing should also be considered for early-stage OC. [ABSTRACT FROM AUTHOR]

This paper presents the results of assessing the performance of Trimble Applanix PCDA™ SLAM-based technology to simultaneously optimize any mobile mapping system trajectory and LiDAR point cloud data in a GNSS-denied environment. The simultaneous use of inertially-aided GNSS data along with LiDAR point clouds to optimally correct shifts and/or drifts in the trajectory in GNSS-denied environments is addressed in detail in this paper. A number of Trimble MX50 Mobile Mapping System data sets were acquired in Germany particularly to assess the performance of PCDA™. The land mobile mapping data sets were acquired in deep urban canyons which were purposely acquired that way to reach the most challenging land mobile mapping data sets in a GNSS-denied environment. The PCDA™ technology assessment results are presented in detail. In summary, the results show how LiDAR data can successfully be used to correct the trajectory shifts and drifts due to GNSS outages by simultaneously optimizing both point cloud and trajectory data. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to characterize the distribution of energy and macronutrient intakes across eating occasions (EO) in European children from preschool to school age. Methods: Data from 3-day weighed food records were collected from children at ages 3, 4, 5, 6 and 8 years from Belgium, Germany, Italy, Poland and Spain. Food intakes were assigned to EO based on country-specific daytimes for breakfast, lunch, supper and snacks (morning, afternoon). The average energy and nutrient intakes were expressed as percentage of total energy intake (%E). Nutrients were additionally expressed as percentage per EO (%EEO). Foods were assigned to food groups; variation in intake was calculated via coefficient of variation (CV). We analyzed age trends in diurnal intake using mixed-effects beta regression. Results: The 740 healthy children included in the analysis consumed the largest proportion of daily energy at lunch (31%E ± 8, M ± SD) and supper (26%E ± 8), followed by breakfast (19%E ± 7) and snacks [afternoon (16%E ± 8); morning (8%E ± 7)], with the most variable intake at morning snack (CV = 0.9). The nutrient composition at lunch and supper was highest for fat (36 ± 9%ELunch; 39 ± 11%ESupper) and protein (18 ± 5%ELunch; 18 ± 6%ESupper) and at breakfast and snacks for carbohydrates (54 ± 12%EBreakfast; 62 ± 12%ESnacks). High-sugar content foods were consumed in relatively large proportions at breakfast and snacks. Food intakes varied significantly with age, with lower snack intakes at later ages (p < 0.001). Conclusion: Possibly unhealthy EOs with high-fat intakes and high-sugar-content foods were observed. Changes in nutrient composition of EOs may be beneficial for health. Trial registry: ClinicalTrials.gov: NCT00338689; 19/June/2006. [ABSTRACT FROM AUTHOR]

Purpose -- We aimed to determine the minimum 20-year survival rates of a cementless press-fit cup in young patients. Patients and methods -- This is a retrospective, single-center, multi-surgeon cohort study investigating the minimum 20-year clinical and radiological outcome of the first 121 consecutive total hip replacements (THRs) using a cementless, press-fit cup (Allofit, Zimmer, Warsaw, IN, USA) performed between 1999 and 2001. 28-mm metalon-metal (MoM) and ceramic-on-conventionally not highly crosslinked polyethylene (CoP) bearings were used in 71% and 28%, respectively. Median patient age at surgery was 52 (range 21-60) years. Kaplan-Meier survival analysis was conducted for different endpoints. Results -- The 22-year survival rate for the endpoint aseptic cup or inlay revision was 94% (95% confidence interval [CI] 87-96) and 99% (CI 94-100) for aseptic cup loosening. 20 patients (21 THRs; 17%) had died and 5 (5 THRs; 4%) were lost to follow-up. No THR showed evidence of radiographic cup loosening. Osteolysis was observed in 40% of THRs with MoM and 77% with CoP bearings. 88% of THRs with CoP bearings showed significant polyethylene wear. Conclusion -- The investigated cementless press-fit cup, which is still in clinical use today, showed excellent longterm survival rates in patients under the age of 60 years at surgery. However, osteolysis due to polyethylene and metal wear was frequently observed and is a matter of concern in the third decade after surgery. [ABSTRACT FROM AUTHOR]

Background: Although digital maternity records (DMRs) have been evaluated in the past, no previous work investigated usability or acceptance through an observational usability study. Objective: The primary objective was to assess the usability and perception of a DMR smartphone app for pregnant women. The secondary objective was to assess personal preferences and habits related to online information searching, wearable data presentation and interpretation, at-home examination, and sharing data for research purposes during pregnancy. Methods: A DMR smartphone app was developed. Key features such as wearable device integration, study functionalities (eg, questionnaires), and common pregnancy app functionalities (eg, mood tracker) were included. Women who had previously given birth were invited to participate. Participants completed 10 tasks while asked to think aloud. Sessions were conducted via Zoom. Video, audio, and the shared screen were recorded for analysis. Task completion times, task success, errors, and self-reported (free text) feedback were evaluated. Usability was measured through the System Usability Scale (SUS) and User Experience Questionnaire (UEQ). Semistructured interviews were conducted to explore the secondary objective. Results: A total of 11 participants (mean age 34.6, SD 2.2 years) were included in the study. A mean SUS score of 79.09 (SD 18.38) was achieved. The app was rated "above average" in 4 of 6 UEQ categories. Sixteen unique features were requested. We found that 5 of 11 participants would only use wearables during pregnancy if requested to by their physician, while 10 of 11 stated they would share their data for research purposes. Conclusions: Pregnant women rely on their medical caregivers for advice, including on the use of mobile and ubiquitous health technology. Clear benefits must be communicated if issuing wearable devices to pregnant women. Participants that experienced pregnancy complications in the past were overall more open toward the use of wearable devices in pregnancy. Pregnant women have different opinions regarding access to, interpretation of, and reactions to alerts based on wearable data. Future work should investigate personalized concepts covering these aspects. [ABSTRACT FROM AUTHOR]

Current estimates of pandemic SARS-CoV-2 spread in Germany using infectious disease models often do not use age-specific infection parameters and are not always based on age-specific contact matrices of the population. They also do usually not include setting- or pandemic phase-based information from epidemiological studies of reported cases and do not account for age-specific underdetection of reported cases. Here, we report likely pandemic spread using an age-structured model to understand the age- and setting-specific contribution of contacts to transmission during different phases of the COVID-19 pandemic in Germany. We developed a deterministic SEIRS model using a pre-pandemic contact matrix. The model was optimized to fit age-specific SARS-CoV-2 incidences reported by the German National Public Health Institute (Robert Koch Institute), includes information on setting-specific reported cases in schools and integrates age- and pandemic period-specific parameters for underdetection of reported cases deduced from a large population-based seroprevalence studies. Taking age-specific underreporting into account, younger adults and teenagers were identified in the modeling study as relevant contributors to infections during the first three pandemic waves in Germany. For the fifth wave, the Delta to Omicron transition, only age-specific parametrization reproduces the observed relative and absolute increase in pediatric hospitalizations in Germany. Taking into account age-specific underdetection did not change considerably how much contacts in schools contributed to the total burden of infection in the population (up to 12% with open schools under hygiene measures in the third wave). Accounting for the pandemic phase and age-specific underreporting is important to correctly identify those groups of the population in which quarantine, testing, vaccination, and contact-reduction measures are likely to be most effective and efficient. Age-specific parametrization is also highly relevant to generate informative age-specific output for decision makers and resource planers. [ABSTRACT FROM AUTHOR]

Purpose: Public debates and scholarly literature on football fandom are often characterised by generalisation and lacking differentiation. The changing ethnography of fans, affected by the rapid commercialisation and internationalisation of the game, reinforces the demand for contemporary classification criteria and fan typologies that take the complexity and heterogeneity of fans into account and draw a more differentiated picture of fans and sub-groups. Design/methodology/approach: Based on the grounded theory methodology and a systematic literature review on stakeholder theory, stakeholder classification criteria and football fandom, the authors conduct and analyse 14 semi-structured expert interviews with fan managers employed by German professional football clubs. Building on the analysis, the authors identify, present and discuss ten contemporary criteria and five corresponding typologies for the classification of football fans. Findings: The grounded theory analysis suggests that football fans can be characterised according to ten classification criteria. Building on the analysis, the authors derive five fan typologies that differ in their characteristics along the continua of the identified criteria. Typologies comprise (1) active fans, (2) consuming fans, (3) event fans, (4) corporate fans and (5) passive followers. Originality/value: The paper enlarges prior knowledge on the behavioural and attitudinal characteristics of fans as individuals and adds knowledge regarding relationships within fan groups, and regarding formal and non-formal relations between fans and clubs. The results provide scholars with a framework for further scientific investigation and practitioners with a concept for a more sophisticated and differentiated approach to managing fan relations. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to determine the proportion of people living with HIV with anti-SARS-CoV-2 IgG antibodies in a sample from a large single HIV center in Munich, Germany, after the first phase of the coronavirus pandemic and to infer the prevalence of SARS-CoV-2 co-infection in people living with HIV. Methods: Prospective sub-study of the ongoing ArcHIV cohort between May and July 2020. Anti-SARS-CoV-2 IgG antibodies were measured using the recomWell SARS-CoV-2 IgG ELISA (Mikrogen, Neuried, Germany); positive and borderline results were re-tested using the recomLine SARS-CoV-2 IgG immunoassay (Mikrogen, Neuried, Germany). Demographic and medical data were extracted from the electronic patient files. Results: Overall, 500 people living with HIV were included in the study (83% male, median age 51 years). Three participants had been diagnosed with COVID-19 prior to study inclusion. Of those, nine were confirmed positive for SARS-CoV-2 IgG antibodies, resulting in an estimated seroprevalence (accounting for sensitivity and specificity of the test) of 1.5% (CI 95%: 0.69; 3.13) for the entire study sample, and 2.2% (CI 95%: 1.1; 3.9) for the subset of the Munich citizens. There were no marked differences for people living with HIV with and without SARS-CoV-2 co-infection. Conclusion: The seroprevalence of SARS-CoV-2 co-infection in people living with HIV as found in our study does not seem to exceed previous reports from general populations of 'hot-sport' areas; comparative data from the Munich population can be expected to be published soon. Our data also highlight, once more, the need to do confirmatory testing on positive samples to minimize the impact of false-positive results. [ABSTRACT FROM AUTHOR]

The new characteristics and phenomena of hybrid AC/DC transmission grids challenge the conventional protection concepts. In hybrid AC/DC overhead line systems, AC and DC systems are located on the same support structure. As a result, electromagnetic and galvanic interactions between the AC- and the DC-line influence the AC-protection and the DC-control in a novel and complex way. This paper presents key findings and solutions from a current 400-kV-hybrid AC/DC overhead line project in Germany. The focus is on AC/DC intersystem faults, i.e. galvanic contact between DC and AC systems. Fault detection and fault response of the AC-protection and the DC-control as well as a proper AC/DC protection coordination are discussed. The paper illustrates the challenges of a secure and dependable fault clearing and indicates solution methods. The findings of this paper are based on EMT simulations with detailed PSCAD-models of the hybrid AC/DC overhead line and the VSC-converters. Laboratory protection tests have been conducted and confirmed the results. [ABSTRACT FROM AUTHOR]

Purpose: Adverse drug reactions (ADR) account for 5 to 7% of emergency department (ED) consultations. We aimed to assess medication risk profiles for ADRs leading to ED visits. Methods: We analysed medication intake and patient demographics in a prospective multi-centre observational study collecting ADR cases in four large EDs in Germany. Odds ratios (OR) were calculated to relate drug classes taken to those suspicious for an ADR after a causality assessment. Results: A total of 2215 cases of ED visits due to ADRs were collected. The median age of the cohort was 73 years; in median, six co-morbidities and an intake of seven drugs were documented. Antineoplastic/immunomodulating agents had the highest OR for being suspected for an ADR (OR 20.45, 95% CI 14.54–28.77), followed by antithrombotics (OR 2.94, 95% CI 2.49–3.47), antibiotics (OR 2.65, 95% CI 1.78–3.95), systemic glucocorticoids (OR 2.43, 95% CI 1.54–3.82) and drugs affecting the central nervous system (CNS), such as antipsychotics (OR 2.36, 95% CI 1.46–3.81), antidepressants (OR 2.10, 95% CI 1.57–2.83), antiparkinsonian medication (OR 2.11, 95% CI 1.15–3.84), opioids (OR 1.79, 95% CI 1.26–2.54) and non-opioid analgesics (OR 1.32, 95% CI 1.01–1.72). Conclusions: Patients experiencing ADRs leading to ED visits are commonly old, multi-morbid and multi-medicated. CNS drugs may be more relevant than prior expected. With calculating ORs, we could replicate involvement of antineoplastic agents, antithrombotics, antibiotics, systemic glucocorticoids and non-opioid analgesics as frequently suspected for ADRs in EDs. Trial registration: DRKS-ID: DRKS00008979. [ABSTRACT FROM AUTHOR]

Background: In Germany, 17--23% of the population suffers from chronic itching of the skin; in 5--10% of cases, the female genitalia are affected, specifically, the vulva. Vulvar pruritus is thus a common symptom that often markedly impairs the affected women's quality of life. Methods: This review is based on pertinent publications that were retrieved by a selective search in MEDLINE/PubMed for articles on the pathogenesis, diagnosis, and treatment of vulvar pruritus. The search terms were (in German and English) "vulvärer Juckreiz," "pruritus vulvae," and "genital itch," alone and in combination with "Behandlung," "Therapie," or "treatment." Results: The most common cause of vulvar pruritus is vulvovaginal candidiasis followed by chronic dermatoses, such as lichen sclerosus and vulvar eczema. Especially in refractory cases, an invasive or preinvasive lesion such as squamous epithelial dysplasia (VIN, vulvar intraepithelial neoplasia) should be borne in mind in the differential diagnosis. Rarer causes include infection, atrophy, and vulvodynia. The essential elements of treatment are topical/oral antimycotic drugs and high-potency glucocorticoids, along with consistently applied, basic moisturizing care and the avoidance of potential triggering factors. Conclusion: As vulvar pruritus has multiple causes, standardization of its diagnostic evaluation and treatment would be desirable, both to achieve optimal efficacy and to meet the diverse needs of women who suffer from this condition. INSET: 1. [ABSTRACT FROM AUTHOR]

Hyperparathyroidism has been described in people living with HIV undergoing tenofovir disoproxil fumarate (TDF)-containing antiretroviral therapy (ART), but differences in calcium levels have never been investigated in detail. We aimed to compare the prevalence of hypocalcemia between patients with and without TDF-containing ART. The patients and methods were a retrospective cohort study in HIV-infected adult patients receiving dolutegravir and either abacavir (ABC)/lamivudine (3TC) or TDF/emtricitabine in a single center in Munich, Germany. Of 172 patients, 126 (73.3%) were male and the median age was 48.5 years (interquartile range 42-54). Average calcium levels were 2.24 (2.21-2.29) mmol/l and 2.21 (2.16-2.26) mmol/l (P < 0.001) with a prevalence of at least one episode of total calcium <2.12 mmol/l of 16.2 and 34.4% in the groups treated with ABC/3TC and TDF/emtricitabine, respectively (P = 0.006). TDF use was independently associated with the occurrence of albumin-corrected calcium levels of <2.12 mmol/l (odds ratio: 6.7 [1.3-35.6]; P = 0.025). Hypocalcemia seems to occur more often in TDF-treated patients. Further research into hypocalcemia with TDF and potential cardiovascular effects may be of benefit based on these findings. [ABSTRACT FROM AUTHOR]

Vertical farming (alternatively, plant factories with artificial lighting) has the potential to contribute to sustainable food production and consumption and is relevant for several of the United Nation's Sustainable Development Goals. Already many consumers seem positive about vertical farming, but as fresh produce from vertical farming systems begin to become available to consumers, it is imperative that this positive attitude translates into purchase and consumption behaviour. In a multi-country study (USA, Australia, Germany and Singapore) where 2193 adult consumers (25–54 years old) took part in an online survey, the present quantitative research: i) investigated the aspects of vertical farming that are perceived positively and negatively by consumers, ii) measured stated intention to purchase lettuce from vertical farming, and iii) determined characteristics of vertical farming that are positive and negative drivers of intention to purchase. A largely positive attitude to vertical farming was confirmed, as well as the existence of smaller groups of people with negative and neutral/ambivalent attitudes. Cross-cultural differences in attitudes to vertical farming also existed but these were relatively minor. On average, participants from USA were most positive, while those from Germany were least positive. Stated intention to purchase lettuce from vertical farming was ∼70% ('probably will buy'), and again stated likelihood was highest in USA (74%) and lowest in Germany (65%). Based on the findings from the analysis that linked likelihood to purchase lettuce from vertical farming to attitude to specific characteristics of vertical farming, strategies to promote consumption of produce from vertical farming should stress the contribution of the technology to a more sustainable development, including health, environmental and social aspects. • Vertical farming (VF) contributes to sustainable food production and consumption. • Investigated consumer attitudes to VF and intention to purchase VF-grown lettuce. • Four countries were studied and compared: USA, Germany, Singapore, and Australia. • Most consumers were positive about VF with purchase intention ∼70% for lettuce. • Drivers of purchase intention were uncovered and linked to characteristics of VF. [ABSTRACT FROM AUTHOR]

The aim of this non-experimental follow-up study was to specify and quantify rhythmic attunement processes within free improvisations in the early phase of psychodynamic music therapy in order to investigate its predictive value for therapeutic change. Twenty-one in-patients diagnosed with psychosis (ICD-10F20, 23, 25) were included in the study. Participants received five sessions of individual music therapy as per usual. Improvisations were audio recorded. The initial and final improvisations were analysed with the Rhythmic Attunement Scale for Psychosis (RAS-P), which was specifically developed for the project. Clinical measures included external and self-report assessments (BPRS, Dührsen and Happach, TAS 20). Analysis of the audio recordings revealed early occurrence of rhythmic attunement on a stable and qualitatively high level. BPRS scores showed a post-treatment decline of 20%. There was no significant difference for the Dührsen and Happach and TAS 20 scores. Statistical analysis revealed that when initial rhythmic attunement occurred further into the first session, it was a predictor for the decline of psychotic symptoms. Evidence of carefully organised rhythmic attunement suggests beneficial effects on patients with psychosis through improvisational music therapy. Results are limited due to a small sample size and lack of a control comparison. [ABSTRACT FROM AUTHOR]

The article reports on the National Socialist German Workers' Party (NSDAP) and state authorities in Bad Sachsa on the southern Harz in Germany in 1931-32. After the NSDAP had risen in the parliamentary elections of September 14, 1930, in Bad Sachsa with 31.9% of the valid votes, began the rise of Bad Sachsa National Socialists, especially their dominant leader, Ortsgruppenfuhrer Heinrich Keizer.

Background: The antiepileptic drug pregabalin is one of the best-selling pharmaceutical products worldwide. There are increasing concerns about its potential for misuse and dependence especially among patients with former or current substance use disorders (SUDs).Objective: Our objective was to clarify the extent and pattern of pregabalin use as well as motives and predictors in this population.Methods: We conducted a cross-sectional study with patients on a detoxification ward for illicit drugs at the Center for Psychiatry, Südwürttemberg, Ravensburg in southern Germany from August 2012 until July 2013. We used an extensive questionnaire, part of the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition) Axis I Disorders (SCID-I) and urine samples.Results: Of the 253 participating patients, 56% had used pregabalin at least once. Of these, 92% had acquired it at least in part from illegal sources. The main motives for the use of pregabalin were the attenuation of opioid withdrawal symptoms, the augmentation of other psychotropic substances, and the psychotropic effects of pregabalin itself. Predictors for pregabalin use were opioid and sedative use as well as younger age. The criteria of dependency according to DSM-IV was met by 11% of pregabalin users and 13% of urine samples were positive for pregabalin.Conclusions: Use of pregabalin is common among users of illicit drugs in large parts of southern Germany, with motives for use, acquisition, and mode of use suggesting misuse. The mode of use, especially intake of high doses and concomitant use of other drugs, poses a serious risk to this population, including the development of dependency. [ABSTRACT FROM AUTHOR]

This paper attempts to benchmark the municipal solid waste (MSW) management performance of the NUTS 2-regions in the EU by constructing a composite indicator. In order to account for commensurability, weighting and aggregation issues of the performance indicators in regional waste and materials' management, this paper advocates a conditional directional distance version of the Benefit-of-the-Doubt weighting technique. In addition, the waste management hierarchy defined by the EU is strongly embedded in the construction of our composite indicator. The results reveal considerable differences in the aggregate performance of the regions, even within Member States. In general, waste sectors of the NUTS 2-regions in Austria, Belgium, and Germany generally do well in terms of MSW management. Our results also reveal that some differences in the operating environment of the regions, such as the number of tourist overnight stays, are related to the aggregate performance of the regions. However, the observation that other conditions are not significantly related to the performance on a regional level is interesting as many policy makers frequently argue that the level of performance in their regions cannot be compared to that in other regions precisely due to this difference in operating conditions. [ABSTRACT FROM AUTHOR]

Only limited efficacy and tolerability data on raltegravir (RAL) use are currently available. Study objectives were to describe the efficacy and tolerability profile of RAL-based antiretroviral therapy (ART) in routine clinical practice in Germany. The WIP study (WIP = "Wirksamkeit von Isentress unter Praxisbedingungen", Efficacy of Isentress under routine clinical conditions) was a prospective, multi-centre cohort study in Germany. Human immunodeficiency virus (HIV)-infected patients aged ≥ 18 years in whom combinational ART with RAL 400 mg BID was indicated were enrolled. The primary endpoint was virologic response (HIV-RNA <50 copies/mL; non-completion equals failure) after 48 weeks. Of 451 patients, 85.1% (n = 384) were still receiving RAL at week 48. At baseline (BL), the prevalence of concomitant diseases was higher in patients of the age group ≥50 years (94.2% vs. 75.7%) as well as concomitant medications (74.8 % vs. 55.4%). Virologic response at week 48 was 74.7% (overall), 75.0% (naïve at BL), 81.5% (suppressed at BL), 47.1% (interrupted previous treatment at BL) and 64.9% (failing at BL), without significant differences by age group. A significant correlation of achievement of HIV-RNA <50 copies/mL was seen with treatment status at BL (p = 0.004). In addition, 77.3 % of the patients with a CD4 cell count >200 cells/µL at BL achieved HIV-RNA <50 copies/mL (p = 0.029). RAL was well tolerated with 80 adverse events (AEs) in 49 patients (10.9%) and 8 serious AEs (SAEs) in 6 patients (1.3%) reported to be drug related. A total of 22 patients (4.9%) discontinued treatment due to AEs. The WIP study shows that the previously reported efficacy and safety profile of RAL can be achieved in a population with multiple comorbidities and comedications, with no major difference observed in ageing patients (≥50 years) vs. younger patients. RAL is therefore an attractive treatment option in routine medical care in Germany. [ABSTRACT FROM AUTHOR]

Introduction: Controversy exists on optimal operative treatment of vertically unstable Neer IIB lateral clavicle fractures. Aim of this study was to analyse and compare clinical and radiological results and complications of locking plate osteosynthesis (LPO) versus hook plate osteosynthesis (HPO) with acromioclavicular joint (ACJ) stabilization. The hypothesis was, that HPO would recreate coracoclavicular stability more effectively and potentially lead to a superior outcome.Methods: This retrospective, observational cohort study included 32 patients (19 HPO, 13 LPO) with a mean age of 44.1 ± 14.2 years at surgery. The mean follow-up period was 54.2 months (range 25.2-111.4 months). Besides standard radiography, bilateral coracoclavicular distances were assessed by means of preoperative and follow-up stress radiographs after implant removal. Clinical outcome measures included the Constant score (CS), the Oxford shoulder score (OSS), the subjective shoulder value (SSV) and the Taft score (TS).Results: Bone union occurred in all but one patient and proved to occur delayed in five patients (15.6%). Radiographical healing required a mean of 4.2 ± 4.0 months irrespective of the type of osteosynthesis. At follow-up, mean coracoclavicular distance was increased by 34% (±36) without significant differences between both groups. HPO patients obtained a significantly lower TS (HPO: 9.5 ± 1.5 points, LPO: 11.1 ± 1.3 points; p = 0.005). Other mean score values did not differ (CS: 90.1 ± 7.4 points, OSS: 43.2 ± 9.2 points, SSV: 91.1 ± 14.7%). Sixteen patients (50.0%) experienced complications. Overall prevalence of complications was significantly higher in the HPO group (p = 0.014).Conclusions: Both HPO and LPO were equally effective in relation to restoration of vertical stability, overall functional outcome and fracture consolidation in treatment of Neer IIB fractures. Contrary to our hypothesis, HPO was not associated with superior recreation of the coracoclavicular distance. Considerable drawbacks of HPO were an inferior ACJ-specific outcome (Taft-Score) and a higher overall complication rate. Level of evidence IV. [ABSTRACT FROM AUTHOR]

Background: The BSI-18 contains the three six-item scales somatization, depression, and anxiety as well as the Global Severity Index (GSI), including all 18 items. The BSI-18 is the latest and shortest of the multidimensional versions of the Symptom-Checklist 90-R, but its psychometric properties have not been sufficiently clarified yet.Methods: Based on a representative sample of N = 2516 participants (aged 14-94 years), detailed psychometric analyses were carried out.Results: The internal consistency was good: Somatization α = .82, Depression α = .87, Anxiety α = .84 and GSI α = .93. Confirmatory factor analysis supported the three scales as second-order and GSI as first-order factors. The model fit based on RMSEA is good but that model fit based on CFI and TLI are too low.Conclusions: Therefore, it is a very short, reliable instrument for the assessment of psychological distress. The BSI-18 can be used to reliably assess psychological distress in the general population. However, further studies need to evaluate the usefulness of standardization in clinical samples. [ABSTRACT FROM AUTHOR]

• Explores consumer attitudes to vertical farming (VF) in Singapore and Germany. • Uncovers cognitive structures relating to VF based on means-end chains (MEC). • Implements a hybrid-hard laddering approach suitable for large online survey samples. • Consumer acceptance of VF is linked to altruistic and self-centred values. Through rapid advances, vertical farming (VF) systems are becoming an addition to conventional agricultural practices that under increasing climate stress can contribute to more sustainable food production. The present research advances extant consumer research on VF by exploring how consumers associate the different characteristics of VF with the technology's pros and cons, and how these link to their personal values. To this end, consumers' cognitive structures relating to VF were uncovered through means-end chains (MECs) and laddering methodology. While both soft and hard laddering approaches remain in use, innovation and methodological development are focused on hard laddering. The present research contributes to this expansion by trailing a hybrid-hard laddering approach that is suitable for online surveys and large sample sizes while incorporating some aspects of soft laddering. Participants lived in Singapore (SG) (n = 547) or Germany (DE) (n = 537) and completed the laddering task after reading an information text about VF. Data analysis resulted in hierarchical value maps (HVM) which were compared by country and groups of participants with different attitudes to VF. Both altruistic and self-centred motives were key to acceptance of VF while energy use emerged as a concern. For some consumers positive linkages were established to "pleasure and enjoyment" and this may be harnessed to enhance uptake. The hybrid-hard laddering approach was successful in so far as the results fitted expectations. However, room for improvement exists. [ABSTRACT FROM AUTHOR]

Tribocorrosion in taper junctions of retrieved anatomic shoulder arthroplasty implants was evaluated. A comparison of the tribocorrosion between cobalt-chromium and titanium alloy stems was conducted and the observations were correlated with the individual’s clinical data. Adverse effects caused by metal debris and subsequent elevated serum metal ion levels are frequently reported in total hip arthroplasty. In total shoulder arthroplasty, to date only a small number of retrieval analyses are available and even fewer address the issue of tribocorrosion at the taper junctions. A total of 36 retrieved hemiarthroplasties and total shoulder arthroplasties were assessed using the modified Goldberg score. The prevalence of fretting and corrosion was confirmed in this cohort. Titanium stems seem to be more susceptible to damage caused by tribocorrosion than cobalt-chromium stems. Furthermore, stemless designs offered less tribocorrosion at the taper junction than stemmed designs. A weak correlation between time to revision and increased levels of tribocorrosion was seen. Whether or not tribocorrosion can lead to adverse clinical reactions and causes failure of shoulder arthroplasties remains to be examined. [ABSTRACT FROM AUTHOR]

In the context of the control model of New Public Management, universities increasingly take over organisational action, controlling their development and therefore being in need of suitable instruments. In this field, much is expected of performance competition, and the partly wide distribution of comparative methods seems to prove its effectiveness. This article examines the strengths and weaknesses of several instruments regarding their supporting of control action at universities, and compares them. [ABSTRACT FROM AUTHOR]

1. Water used in a modern poultry processing line was tested from October 2005 to June 2006 to determine the level of bacteria in an abattoir in Germany. 2. A total of 420 water samples were taken from 14 processing sites (PSs), at 10 times, and from three different hours of the working shift at three sampling hours (SHs) at 5:00 a.m. (SH 1), 9:00 a.m. (SH 2) and 12:00 a.m. (SH 3). Each sample was assessed for the aerobic plate count (APC) and the prevalence ofSalmonella, Campylobacter, ListeriaandYersiniaover 30 sampling weeks. The APC numbers of each PS from three SHs were compared, and the prevalence ofSalmonella, Campylobacter, ListeriaandYersiniafrom each PS of three SHs was determined as well as change from the initial PS to the end of the processing line. 3. A total of 46 water samples were positive forSalmonella, 120 positive forCampylobacterand 4 positive forListeria. None of the water samples was found to be positive forYersinia. During the course of the day, the APC increased.Salmonellawas mostly found during SH 1 (5 a.m.) in water from all PSs. A high number ofCampylobacterwere observed at SH 2 (9 a.m.) and SH 3 (12 a.m.) from all PSs. 4. The results show that water, which is still used in substantial amounts in present poultry processing technology, can serve as a carrier forSalmonellaandCampylobacter. 5. The findings indicate that birds might progressively contaminate the equipment and become contaminated via the same equipment, that water at every processing position of the line constitutes a risk and that more attention should be paid to effective water management in the processing plan. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to examine the efficacy of two psycho-oncological interventions in anxiety, depression, and self-perceived as well as physiological stress in inpatients with gynaecological cancer. Methods: Forty-five women were included in the trial. Thirty-five were categorized as being at high risk of anxiety and depression, and were randomized to either a single psycho-oncological therapy session or a single-session relaxation intervention. Results: A significant decrease in anxiety [mean (t0) = 12, mean (t1) = 7.47, p = 0.001] and depression [mean (t0) = 9.71, mean (t1) = 6.35, p < 0.001] was observed in the psycho-oncological intervention group. In the relaxation group, anxiety also significantly decreased [mean (t0) = 11.67, mean (t1) = 8.22, p = 0.003], whereas depression did not. A comparative analysis of both interventions showed a trend in favour of psycho-oncological therapy for the treatment of depression (F = 3.3, p = 0.078). However, self-reported stress (p = 0.031) and different objective stress parameters only significantly decreased in the relaxation group. Conclusions: Psycho-oncological interventions should represent an essential part of interdisciplinary care for gynaecological cancer patients. Both types of intervention may reduce anxiety. However, the single psycho-oncological therapy session might be slightly more effective in treating depression, whereas the single-session relaxation intervention seems to have a stronger effect on physiological stress parameters. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports within the issue on topics including the German War experiences in the second decade of the Twenty-first century, the Second World War and its narratives, and Second World War scenarios.

Objectives: The aims of this study were to estimate the expenditure for HIV-care in Germany and to identify variables associated with resource use. Design/setting: We performed an 18-month prospective multi-center study in an HIV specialized ambulatory care setting from 2006 to 2009. Subjects, participants: Patients were eligible for study participation if they (1) were HIV-positive, (2) were ≥18 years of age, (3) provided written consent and (4) were not enrolled in another clinical study; 518 patients from 17 centers were included. Main outcome measures: Health care costs were estimated following a micro-costing approach from two perspectives: (1) costs incurred to society in general, and (2) costs incurred to statutory health insurance. Data were obtained using questionnaires. Several empirical models for identifying the relationship between health care costs and independent variables, including age, gender, route of transmission and CD4 cell count at baseline, were developed. Results: Average annual health care costs were €23,298 per patient from the societal perspective and €19,103 from the statutory health insurance perspective. Most expenses are caused by antiretroviral medication (80 % of the total and 89 % of direct costs), while hospital costs represented 7 % of total expenditure. A statistically significant association was found between health care costs and clinical variables, with higher CD4 count and female gender generating lower costs, while increased antiretroviral experience and injection drug use led to higher expenditures ( P < 0.05). Conclusions: Expenditures for HIV-infection are driven mainly by drug costs. We identified several clinical variables influencing the costs of HIV-treatment. This information could assist policymakers when allocating limited health care resources to HIV care. [ABSTRACT FROM AUTHOR]

An important insight from the recent publication of Foucault's governmentality lectures for International Relations (IR) is that international manifestations of governmentalities such as police and liberalism, rather than constituting mere domestic analogies, have inherently international dimensions. Police and liberalism are both constituted by and constitutive of the international contexts in which they emerge: historically, the European balance of power and a 'globalisation' of markets, respectively. However, Foucault's account of German and American neoliberalism in the twentieth century omits references to the international context. This article first reconstructs the 'domestic-international nexus' in Foucault's account of police and liberalism, and then recovers aspects of the missing international dimension of his analysis of German neoliberalism with recourse to Wilhelm Röpke's writing on IR. The upshot of this recovery effort is threefold. First, the international remains pivotal to (mid-) twentieth-century neoliberal governmentality. Second, (German) neoliberalism's association with multiple 'international' governmentalities, including liberal and non-liberal ones, exposes neoliberalism as a 'promiscuous' mode of governance. Third, German neoliberalism's promiscuity is underwritten by (though not reducible to) a conservative ethos of moderation. More broadly, this article contributes to efforts to theorise the relationship between domestic and international politics, and to understand neoliberalism as a 'variegated' phenomenon. [ABSTRACT FROM AUTHOR]

Executive Summary. Manufacturing companies increasingly offer services related to their products. Although delivering services to customers entails many benefits, service provision is also a great challenge for manufacturers. These companies are traditionally focused on products and often regard services only as an add-on. Although developing new services has proven to be more complex in manufacturing than in service companies, service development is often carried out unsystematically in both types of firms. Following on a comprehensive literature review of service innovations in manufacturing companies, large-scale survey data from German manufacturing is analyzed with a view to shedding light on service development in manufacturing firms. [ABSTRACT FROM AUTHOR]

Background: Local corticosteroid injections can have serious septic and aseptic complications. Methods: From 2005 to 2009, medical expert committees and mediation boards reviewed 1528 cases of alleged treatment errors relating to injections. Results: 278 cases were identified in which complications arose after local glucocorticosteroid injections. The injections were intra-articular, paravertebral, intramuscular, and at other sites. In 39.6% of cases, treatment errors or patient information errors of the following types were found: aseptic technique was not maintained, injections were performed in the absence of an indication, time intervals between injections were too short, excessive doses were administered, infections were not diagnosed, erroneous injections were performed, patients were not informed of the risks, and there were errors of organization and documentation. Conclusions: Injections of glucocorticosteroids must be performed in strict adherence to the manufacturer's instructions with respect to the composition of the solution to be injected, the quantity per injection, and the intervals between injections. Repeated injections with too little time between them raise the risk of infection. Physicians should pay more attention to this fact, particularly when deciding on the indication for paravertebral injections. Aseptic technique should be strictly maintained. The indication for the injection should be clearly documented. When glucocorticosteroids are injected into small joints and tendon spaces, the introduction of crystals into the subcutaneous tissue and adipose tissue should be avoided. The intramuscular administration of depot glucocorticosteroids should be avoided. Patients should be informed of the risk of infection and/or tissue atrophy, as well as of alternative forms of treatment. INSETS: Prima facie evidence;KEY MESSAGES. [ABSTRACT FROM AUTHOR]

Objective: Joint crisis plans in psychiatry are consensus-oriented instruments for patients to state their will in case of a crisis. The aim of this survey is to determine the prevalence, practice and barriers for implementation of joint crisis plans in Germany. Methods: In spring 2009, 366 psychiatric hospitals in Germany were asked to complete a questionnaire. Results: The return rate was 46.4%; 68% of the participating hospitals offered joint crisis plans. The number of completed joint crisis plans was low (median 2.7/year per clinic). The demand did not increase according to a majority of the hospitals. The main reason for hospitals to abstain from joint crisis plans was low demand. Hospitals providing the option of joint crisis plans reported positive experiences. Conclusions: A theoretical offer of joint crisis plans is widespread in German psychiatric hospitals. Despite positive experiences, patients do not ask for them frequently. [ABSTRACT FROM AUTHOR]

Background: Anatomic reconstruction of the coracoclavicular ligaments for the treatment of acromioclavicular joint separations provides superior biomechanical stability compared with other procedures. Clavicular and coracoidal footprints of the conoid ligament (CL) and the trapezoid ligament (TL) are well described. So far, little is known about their kinematics and the changes of the coracoclavicular distance during shoulder abduction.Hypothesis: The coracoclavicular distance along the coracoclavicular ligaments changes significantly with shoulder abduction and weightbearing.Study Design: Descriptive laboratory study.Methods: With use of an open magnetic resonance imaging scanner, the shoulders of 13 healthy volunteers were examined in supine and sitting positions. Three-dimensional magnetic resonance images of the shoulders were obtained in 30° increments of abduction (0°-120°). A manual segmentation of the scapula, the clavicle, and the coracoclavicular ligaments was performed. The insertion points of the coracoclavicular ligaments were identified, and automated measures along the ligamentous course were carried out.Results: During transfer from the lying to sitting position, the coracoclavicular distance showed significant lengthening of 3 mm along the center of the CL, which significantly increased another 3 mm during shoulder abduction to a total lengthening of 6 mm. In the supine position, the coracoclavicular distance along the TL did not elongate significantly. In the sitting position, the distance along the medial portion of the TL shortened significantly, whereas the distance along the center portion did not elongate significantly during shoulder abduction.Conclusion: The distances between the coracoclavicular insertion points depend on both patient and shoulder positioning. To prevent overconstraining of the graft, the CL should be fixated during 90° to 120° of shoulder abduction in a sitting position. Isometric reconstruction of the TL can be achieved if precise fixation of the graft at the centers of the conoidal and clavicular footprints is performed. [ABSTRACT FROM PUBLISHER]

Objective: To test the efficacy of calcium dobesilate (CaD) in chronic venous insufficiency (CVI). Method: Double-blind, parallel groups, placebo-controlled, multicentre trial in adult patients with symptomatic CVI and pitting oedema. Wearing of compression stockings Class II was admitted. During treatment period of eight weeks, the patients received CaD 3 x 500 mg/day or placebo. The leg volume calculation was based on a truncated cone model. Results: A total of 256 patients was randomized to treatment (dobesilate: n = 132, placebo: n = 124); the demographic and anamnestic data at admission were comparable in the two therapeutic groups. The volume of the lower calf diminished in the dobesilate group at the end of the active treatment period by -64.72 ± 111.93 cm³ (mean ± SD), independent of the concomitant usage of compression stockings versus placebo +0.8 ± 152.98 cm³ (P = 0.0002). The symptoms of pain, discomfort, heavy legs, tired legs, tingling, itching and cramps, as well as the global assessments by investigators and patients, also improved significantly (P < 0.05) better in the dobesilate group at the end of the treatment. The observed adverse events correspond to the known profile. Conclusion: Dobesilate reduces leg oedema and improves the symptoms of objectively diagnosed CVI, independent of the concomitant usage of compression stockings. [ABSTRACT FROM AUTHOR]

The article discusses the influence of the bombardment in Dresden, Germany during the World War II. It mentions that two documentary films were released to mark the 60th anniversary of the bombing at Dresden, which includes "Das Drama von Dresden," directed by Sebastian Dehnhardt, and "Dresden," by production firm teamWorx. It reflects on the sufferings of the German during the bombing campaign, and the banishment of ethnic Germans in some parts of Europe.

Hardly anyone living in the Kaiserreich had personally visited the German colonies. Any knowledge that Kaiserreich citizens had of the colonies was gained via the media. Around, and mainly after, the year 1900, there was a noticeable increase in unremarkable photographs of colonial landscapes, architecture and natural phenomena in the media of the time. In these photographs, the aesthetic tone is significant. In schools, both Heimatkunde and the art of photography were taught, and images of the colonies were presented as consumer items that encouraged viewers to acknowledge the colonies as Heimat, or at least as potential Heimat. This representation of the colonies was given emphasis in educational curricula, both the content of the images, and the medium used, which was mainly photography. This process facilitated the promotion of the idea that the colonies were an integral part of the imperial nation, the Kaiserreich. [ABSTRACT FROM PUBLISHER]

The emission from industries and the mobility sector is under strong legal regulations in many countries worldwide. In Germany, the amendment to the 17th BlmSchV (Federal pollution control ordinance), which has been in force for waste incineration plants since 2013, has given rise to a new limit for nitrogen oxides of 150 mg/m3 as the daily mean level from 2019 on. A similar focus is on biomass-fired plants. According to the MCP (medium combustion plant) guideline of the EU, as a consequence, existing plants are required to either increase their consumption of ammonia water for nitrogen oxide reduction (SNCR process) or back fit SCR catalysts as secondary measures, which is a costly procedure. This paper presents a novel two-stage process in which an oscillating supply of secondary air allows nitrogen oxides to be reduced by approx. 50% at a good burnout level, which may obviate the need for secondary measures. Besides experimental investigations in a fixed bed reactor, CFD simulations confirm a high potential for reduction of nitrogen oxides. Together with the company POLZENITH, this process is under development for scale-up in a biomass incineration plant as a next step. [ABSTRACT FROM AUTHOR]

The article focuses on the influence of left and right political orientations on people's attitudes about welfare states. The discussion includes: causal analysis that uses instrumental, explanatory, and dependent variables; cross-sectional data for Sweden, Germany, and Norway that was taken from the European Social Survey; the political socialization theory and socioeconomic factors; an explanation of equations in the probit model that evaluates support for redistribution; and the artificial time dimension in this cross-sectional analysis.

Abstract  In August 2006, Bluetongue virus disease (BTD) was detected for the first time in the Netherlands, Belgium, Germany and Northern France. Serological tests as well as reverse transcriptase polymerase chain reaction (RT-PCR) proved the occurrence of Bluetongue virus (BTV) in diseased sheep and cattle, and the virus was identified as serotype 8. Therefore, the search for possible vectors was immediately initiated in the outbreak region in Germany. Traps with automatically regulated ultraviolet light lamps were placed at two different farms with sero-positive cattle, and insect monitoring was done from August 2006 until January 2007. The caught arthropods were weekly determined, and it could be observed that midges of the dipteran family Ceratopogonidae occurred in large numbers, sometimes representing up to 40% of all individuals. The microscopical analysis of the wing morphology showed that the species (complex) Culicoides obsoletus was most abundant covering about 97% of the analysed midges. On the second place ranged C. pulicaris, while C. nubeculosus and C. festivipennis were found only as single individuals. Fed and unfed females were separated, sent to the National Reference Laboratory for Bluetongue disease (Friedrich-Loeffler-Institut, Isle of Riems, Germany) and investigated with a BTV-8-specific real-time RT-PCR. It could be demonstrated that at both farms both fed and unfed C. obsoletus were tested positive for BTV-8 genomes, while none of the other species scored positive. This finding strongly supports that the BTD-epidemic, which reached in the meantime wide regions of North Rhine–Westphalia in Germany and of the neighbouring countries with several hundreds of affected farms, is initiated by virus transmission during the blood meal of midges of the C. obsoletus complex. Since they were captured still at the 21st of December close to cattle with clinical signs, it must be feared that BTV-8 is now established in Central Europe, where it had been absent until now. [ABSTRACT FROM AUTHOR]

Landscape fragmentation is increasingly considered an important environmental indicator in the fields of sustainable land use and biodiversity. To set goals for future development and to plan appropriate measures, suitable empirical data on the degree of landscape fragmentation are needed to identify trends and compare different regions. However, there is still a significant lack of data on landscape fragmentation as an indicator, despite the substantial scientific literature on this topic, likely because of confusion over the definition of ‘fragmentation,’ questions associated with scale and data issues, and lack of general agreement on a fragmentation measure. This study presents a state-wide quantitative analysis of landscape fragmentation in Baden-Württemberg, Germany, by means of the ‘ective mesh size’ (meff), which characterizes the anthropogenic penetration of landscapes from a geometric point of view and is based on the probability that two randomly chosen points in a landscape are connected, i.e., not separated by barriers such as roads, railroads, or urban areas. Baden-Württemberg is fragmented to a far greater extent than indicated by previous studies. The meff has decreased by 40% since 1930. This development is strongly related to the growing number of inhabitants, the increased use of motorized vehicles, and the hierarchical regional planning system based on the central place theory. To illustrate the suitability of the meff method for environmental monitoring, as a planning instrument and as an assessment instrument for impact assessment studies, we explored several variations of applying the method with regard to choice of fragmenting elements, consideration of noise bands, spatial differentiation (e.g., administrative districts vs. ecoregions), and way of dealing with patches at the boundaries of the reporting units. Depending on the objectives of the investigation (e.g., recreational quality vs. suitability for wildlife habitat), different variations may be most appropriate. The insights and quantitative results from Baden-Württemberg provide a yardstick for analyzing and assessing landscape fragmentation in other countries. [ABSTRACT FROM AUTHOR]