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Purpose: To investigate the prevalence and repeatability of high‐order aberrations (HOAs) from non‐cyclopleged eyes in 1515 children and adolescents 2.5–18 years of age. Methods: The Leipzig Research Centre for Civilization Diseases (LIFE)‐Child study is a population‐based, prospective, observational single‐centre study that investigates the development of children and adolescents in Germany. Wavefront measurements were repeated three times in each eye of 1515 healthy subjects. Results were described by 36 Zernike coefficients for a 5 mm reference pupil diameter. Short‐term repeatability is given for each coefficient. The impact on vision is described by the root mean squared (RMS) value of the HOA Zernike coefficients. Results: High‐order aberrations were dominated by five contributions. For 1004 right eyes: spherical aberration (c12 = 0.06 ± 0.07 μm), coma (c7 = 0.03 ± 0.09 μm, c8 = 0.03 ± 0.06 μm) and trefoil (c6 = −0.01 ± 0.07 μm, c9 = 0.008 ± 0.06 μm). The RMS value was 0.18 ± 0.06 μm. Modes higher than fourth order do not contribute clinically to the aberrations. HOAs show no clinically significant dependency with age. Instead, HOA values agree well with previous results on aberrations in adult eyes. Spherical aberration was highly correlated between the two eyes. Repeatability was worst for coma, 0.033 μm, due to variability in the alignment of the pupil centre. The left eye showed, on average, a 0.08 mm larger pupil diameter than the right eye (p < 0.02). Conclusions: Across the age span from 2.5 to 18 years, we see the same distribution of HOA as for adults. We established that only five Zernike coefficients, spherical aberration, coma and trefoil were of clinical significance in healthy eyes. A high correlation between the two eyes for spherical aberration suggests a common blueprint for each eye in any one subject. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate ocular biometry in a large paediatric population as a function of age and sex in children of European descent. Methods: Children were examined as part of the LIFE Child Study (Leipzig Research Centre for Civilization Disease), a population‐based study in Leipzig, Germany. Altogether, 1907 children, aged from 4 to 17 years, were examined with the Lenstar LS 900. Data from the right eye was analysed for axial length, central corneal thickness, flat and steep corneal radii, aqueous depth, lens thickness and vitreous depth. Wavefront‐based autorefraction was employed for analysis. Results: Axial length increased in girls from 21.6 mm (4 years) up to 23.4 mm (17 years); this increase (0.174 mm per year) was statistically significant up to age 14 (23.3 mm). Axial length increased in boys from 22.2 mm (4 years) up to 23.9 mm (17 years); this increase (0.178 mm per year) was statistically significant up to age 10 (23.3 mm). No change was observed for central corneal thickness (average: girls 550 µm; boys 554 µm). Corneal curvature in girls was somewhat flatter at age 4 (7.70 mm) compared to age 10 (7.78 mm), whereas it was constant in boys (7.89 mm). Aqueous depth at age 4 was 2.73 mm for girls and 2.86 mm for boys, with the same rate of increase per year (girls: 0.046 mm; boys: 0.047 mm) from age 4 to 10. At age 17, aqueous depth was 3.06 mm in girls and 3.20 mm in boys. Lens thickness was reduced from age 4 (3.75 mm) to age 10 (3.47 mm) in girls and from age 4 (3.73 mm) to age 10 (3.44 mm) in boys, with the same rate of decrease per year of 0.046 and 0.047 mm, respectively. At age 17, lens thickness was 3.52 mm in girls and 3.50 mm in boys. Vitreous depth at age 4 was 14.51 mm for girls and 15.08 mm for boys; with 0.156 mm (girls) or 0.140 mm (boys) increase per year until age 14 (girls: 16.08 mm; boys: 16.48 mm). At age 17, vitreous depth was 16.29 mm in girls and 16.62 mm in boys. Conclusions: Eye growth (axial length) in girls showed a lag of about four years compared to boys. Aqueous depth increase matches the lens thickness decrease from ages 4 to 10 years in girls and boys. Lens thickness minimum is reached at 11 years in girls and at 12 years in boys. All dimensions of the optical ocular components are closely correlated with axial length. These data may serve as normative values for the assessment of eye growth in central European children and will provide a basis for monitoring refractive error development. [ABSTRACT FROM AUTHOR]

The LIFE Child study is a large population-based longitudinal childhood cohort study conducted in the city of Leipzig, Germany. As a part of LIFE, a research project conducted at the Leipzig Research Center for Civilization Diseases, it aims to monitor healthy child development from birth to adulthood and to understand the development of lifestyle diseases such as obesity. The study consists of three interrelated cohorts; the birth cohort, the health cohort, and the obesity cohort. Depending on age and cohort, the comprehensive study program comprises different medical, psychological, and sociodemographic assessments as well as the collection of biological samples. Optimal data acquisition, process management, and data analysis are guaranteed by a professional team of physicians, certified study assistants, quality managers, scientists and statisticians. Due to the high popularity of the study, more than 3000 children have already participated until the end of 2015, and two-thirds of them participate continuously. The large quantity of acquired data allows LIFE Child to gain profound knowledge on the development of children growing up in the twenty-first century. This article reports the number of available and analyzable data and demonstrates the high relevance and potential of the study. [ABSTRACT FROM AUTHOR]

Background: Cross-sectional survey of ocular biometry and visual function in healthy eyes across the life span of a German population aged 20 to 69 years (n = 218). Subject number in percent per age category reflected the percentage within the respective age band of the population of Leipzig, Germany. Methods: Measurements obtained: subjective and objective refraction, best-corrected visual acuity, accommodation, contrast sensitivity, topography and pachymetry with Scheimpflug camera, axial length with non-contact partial coherence interferometry, and spectral-domain optical coherence tomography of the retina. Pearson correlation coefficients with corresponding p-values were given to present interrelationships between stature, biometric and refractive parameters or their associations with age. Two-sample T-tests were used to calculate gender differences. The area under the logarithmic contrast sensitivity function (AULCSF) was calculated for the analysis of contrast sensitivity as a single figure across a range of spatial frequencies. Results: The results of axial length (AL), anterior chamber depth (ACD) and anterior chamber volume (ACV) differed as a function of the age of the participants (rho (p value): AL -0.19 (0.006), ACD -0.56 (< 0.001), ACV-0.52 (< 0.001)). Longer eyes had deeper ACD (AL:ACD 0.62 (< 0.001), greater ACV (AL:ACV 0.65 (< 0.001) and steeper corneal radii (AL:R1ant; R2ant; R1post; R2post 0.40; 0.35; 0.36; 0.36 (all with (< 0.001)). Spherical equivalent was associated with age (towards hyperopia: 0.34 (< 0.001)), AL (-0.66 (< 0.001)), ACD (-0.52 (< 0.001)) and ACV (-0.46 (< 0.001)). Accommodation was found lower for older subjects (negative association with age, r = -0.82 (< 0.001)) and contrast sensitivity presented with smaller values for older ages (AULCSF -0.38, (< 0.001)), no change of retinal thickness with age. 58 % of the study cohort presented with a change of refractive correction above ±0.50 D in one or both eyes (64 % of these were habitual spectacle wearers), need for improvement was present in the young age-group and for older subjects with increasing age. Conclusion: Biometrical data of healthy German eyes, stratified by age, gender and refractive status, enabled cross-comparison of all parameters, providing an important reference database for future patient-based research and specific in-depth investigations of biometric data in epidemiological research. Trial Registration: ClinicalTrials.gov # NCT01173614 July 28, 2010. [ABSTRACT FROM AUTHOR]

Background: The retina is part of the central nervous system. Layers of the retina can be investigated non‐invasively by optical coherence tomography (OCT). Previously, associations of retinal nerve fibre layer thickness (RNFLT) with cognitive function were established in population‐based studies. Clinical relevance constitutes the improvement of early detection of dementia precursors. Objectives: Investigate the relationship of RNFLT to cognitive function based on different neurocognitive testing procedures in a large population‐based sample. Methods: Within the population‐based LIFE‐Adult study (Leipzig Research Center for Civilization Diseases; Germany), circumpapillary RNFLT was measured by spectral domain OCT (Heidelberg Engineering, Heidelberg). RNFLT was evaluated for subjects with reliable measurements (≥50 B‐scan repetitions, quality ≥20 dB, ≤5% missing A‐scans) and without clinical ocular pathology. The relationship between cognitive function and RNFLT was investigated for six sectors: temporal (T), temporal superior (TS), temporal inferior (TI), nasal (N), nasal superior (NS), nasal inferior (NS) and global mean (G). Neuropsychological questionnaires included single tests from the German version of the CERAD Neuropsychological Test Battery (Consortium to Establish a Registry for Alzheimer's Disease), Trail Making Test, Stroop‐Test, Reading the Mind in the Eyes‐Test and Multiple Choice Vocabulary Intelligence Test‐B. Cognitive function was additionally examined using the CERAD Boston Naming Test and CERAD Phonematic Fluid in people over 60 years of age. Results: 5646 eyes of 5646 subjects were evaluated. After correction for multiple comparisons, statistically significant correlation with RNFLT was found for the CERAD test battery, Verbal Fluid Animals (T,TS), Word List Retrieval (G,T,TS,TI), and Word List Learning (G,T,TS,TI,NS). Furthermore, there was a correlation of RNFLT with the trail making test TMT‐A and TMT‐B (G,T,TS,TI). The Stroop‐neutral and Stroop‐incongruent condition (G,T,TS,TI,NS) and the vocabulary test (T,N,NS,NI) also showed a statistically significant association with RNFLT. The Reading the Mind in the Eyes test and some CERAD categories (Mini Mental Status Test (MMSE), Boston Naming Test, Figure Drawing, Figure Recall, Phonematic Fluid, Word List Recognition) did not correlate. Regression, after adjustment for age and refraction, presented with the following associations: TMT‐A (G,TS,TI), TMT‐B (G), Stroop incongruent condition (NS), vocabulary test (T). Discussion: For LIFE‐Adult, cognitive function was correlated with RNFLT using CERAD word list learning, trail making test, Stroop test and vocabulary test. In comparison, subjects of the Rotterdam study with a thinner RNFLT showed an increased risk of developing dementia within a few years; furthermore, a correlation between RNFLT to MMSE and Stroop test was established. The Erasmus Rucphen Family study found an association of thicker RNFL with better cognitive function especially in subjects under 40 years of age; RNFLT correlated with TMT‐B. In the Three‐City‐Alienor study, it was shown that thicker RNFLT was associated with better cognitive function in the Free and Cued Selective Reminding Test; this was particularly true for temporal, superotemporal and inferotemporal segments. Conclusions: Individual neurocognitive tests correlate with thickness differences in RNFLT. We found a thicker RNFLT associated with better cognitive function, while deficits in cognitive function were associated with a significantly thinner RNFLT. [ABSTRACT FROM AUTHOR]

The EU is very good at negative integration, removing barriers to cross-border activity. But does that automatically mean the creation of a common market? We investigate the extent to which EU health care policies, which undeniably are negative integration, are creating any kind of markets in health care. Using elite interviews in the UK and Germany, we find almost no behaviour by states or stakeholders that is both competitive and attributable to EU policy. There are multiple barriers to entry and weak incentives for patients, providers or governments to respond to EU health policy with competition or entry into new markets. So there is very little response to EU law, and what there is is driven by domestic political agendas. [ABSTRACT FROM AUTHOR]

European Union (EU) patient mobility law creates destabilization rights: rights for citizens that would, if consistently applied, destabilize law, administration and finance for healthcare systems across the EU. This article focuses on the responses of the destabilized organizations and their efforts to restabilize their legal situation. We argue that it takes place through two decisions: a decision about whether or not to change procedures in response to the new right; and a decision about whether or not to lobby to circumscribe the new right. Our qualitative research in Germany and the UK found some differences in responses, but across the board the incumbent organizations and governments opted for very limited compliance and considerable engagement in EU politics as their preferred strategy for responding to the new destabilization rights. [ABSTRACT FROM AUTHOR]

The article investigates the question of the extent to which the 1648 Peace of Westphalia signed in Osnabrück, Germany, ending the Thirty Years War, led to changed financial and political circumstances in the Old German Reich. The efforts to raise taxes for the benefit of the emperor and specifically for the appeasing of his military forces are discussed as less than successful at raising income but important for establishing political relations among the imperial court, the estates, and the knightly classes.

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The article questions whether the German social civil code (SGB) requires completion and codification, particularly in view of extended delay in legal output from the drafting commission. The author discusses the understandability of the SGB and finds it wanting, but he insists that a unified and systematic set of social statues is needed.

Objective: To investigate the clinical effectiveness of "Home Treatment" (HT) in comparison to the usual inpatient treatment in patients with acute psychiatric illness., Methods: In a prospective observational study we compared 60 of our HT patients to 18 patients receiving inpatient treatment as usual (TAU) with regard to psychopathological symptoms (PANSS, HAM-D 21), global functioning (GAF), symptom severity (HoNOS-D) and sociodemographic parameters at admission and discharge., Results: HT was a feasible alternative in patients with several different psychiatric diagnoses and appeared to be similar to TAU in view of clinical effectiveness., Conclusions: In potentially suitable patients fulfilling criteria of hospital admission, the alternative of HT can be actively considered., (© Georg Thieme Verlag KG Stuttgart · New York.)