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Addressing the global challenges of climate change and biodiversity loss requires the widespread adoption of sustainable agricultural practices such as agroforestry. In many Sub-Saharan African countries, however, agroforestry adoption rates remain low among small-scale farmers, with insufficient knowledge about the benefits being a major barrier. To close this knowledge gap and increase farmers’ motivation to plant different tree species on their farms, this study applies a Role-playing game (RPG) as an awareness-raising tool. 72 small-scale farmers from Rwanda played the RPG and participated in pre- and post-game surveys. A comparison of responses before and after playing evidence that the RPG increased farmers’ knowledge and attitude towards most tree-related benefits. Moreover, playing the game significantly strengthened farmers' motivation to plant more tree species on their farms. The findings were supported by debriefing results, confirming that RPGs are an effective tool to raise farmers’ awareness and motivation on sustainable land use management.

Among developing countries, one can identify both proponents and opponents of extending the use of geographical indications (GIs) beyond wines and spirits. Such an extension is currently being discussed under the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) of the World Trade Organization. While labeling is mostly based on private initiatives, GIs are considered to be long-term public rights. Proponents therefore regard GIs as the stronger tools for protecting their national property rights and offering them new opportunities to develop their export markets. Opponents, however, consider GIs to be new barriers to trade that impede their export opportunities. This article clarifies these positions and pulls together some evidence on costs and benefits related to GIs versus labels. [ABSTRACT FROM AUTHOR]

Background: The new dental licensing regulations provide for a professional field internship to give students an initial, comprehensive insight into their later professional field. The location, implementation and assessment are not specified and can take place within university dentistry or in cooperation with dental practices. The Kiel Dental Clinic decided to develop a concept for a two-week course, including practical training in private practices, and to take greater account of aspects of medical interviewing. Based on a theoretical introduction and an e‑learning module, this is to be the introduction to a longitudinal communication curriculum. In the summer semester of 2021, a pilot project was carried out with the aim of developing the necessary course infrastructure and content and linking it with teaching content on communicative competences., Methods: A controlled intervention study (one measurement point) was conducted with 21 fourth-semester students (two groups with and without e‑learning module) and 20 dental practices. The students received documents on the organisation, procedure and documentation of various interview situations before the one-week internship. Students and practices were comprehensively evaluated after the end of the internship., Results: Students and practices were satisfied with the organisation, the documents provided and the process. The e‑learning module was well received. The format of the internship report proved to be impractical and was adapted., Discussion: The project goals were successfully achieved. The results will be incorporated into the concrete design and implementation of the new curricular course starting summer semester 2022., (© 2023. The Author(s).)

Natural resources are important in sustaining the livelihoods of rural households and the environment. However, over-exploitation is causing an alarming depletion of natural resources in many developing countries. At the same time, rapid economic growth has created non-farm employment opportunities for local people. In this context, examining the interrelationship between non-farm employment and natural resource extraction provides useful information for reducing resource extraction and improving rural households' welfare. In this study, we use a dataset of 1780 identical households from three survey waves undertaken in 2010, 2013, and 2016 in Vietnam to (i) identify the determinants of rural households' participation in non-farm activities, (ii) examine the interrelationship between non-farm employment and natural resource extraction, and (iii) investigate the impact of non-farm employment on rural households' welfare. The findings from pooled sample estimations reveal that (i) cable internet at home and rural road quality positively affect households' decisions to participate in non-farm employment; (ii) non-farm income and income from natural resource extraction have a negative association; and (iii) non-farm income significantly contributes to poverty reduction in both relative and absolute terms. Our findings suggest that improved provision of non-farm opportunities and increased investment in infrastructure and telecommunication are needed to improve rural households' welfare and consequently reduce their natural resource exploitation., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest in this research., (© The Author(s) 2022.)

The first case of coronavirus SARS-CoV‑2 infection in Germany was diagnosed on 27 January 2020. To describe the pandemic course in 2020, we regarded four epidemiologically different periods and used data on COVID-19 cases from the mandatory reporting system as well as hospitalized COVID-19 cases with severe acute respiratory infection from the syndromic hospital surveillance.Period 0 covers weeks 5 to 9 of 2020, where mainly sporadic cases of younger age were observed and few regional outbreaks emerged. In total, 167 cases with mostly mild outcomes were reported. Subsequently, the first COVID-19 wave occurred in period 1 (weeks 10 to 20 of 2020) with a total of 175,013 cases throughout Germany. Increasingly, outbreaks in hospitals and nursing homes were registered. Moreover, elderly cases and severe outcomes were observed more frequently. Period 2 (weeks 21 to 39 of 2020) was an interim period with more mild cases, where many cases were younger and often travel-associated. Additionally, larger trans-regional outbreaks in business settings were reported. Among the 111,790 cases, severe outcomes were less frequent than in period 1. In period 3 (week 40 of 2020 to week 8 of 2021), the second COVID-19 wave started and peaked at the end of 2020. With 2,158,013 reported cases and considerably more severe outcomes in all age groups, the second wave was substantially stronger than the first wave.Irrespective of the different periods, more elderly persons and more men were affected by severe outcomes., (© 2021. The Author(s).)

The Robert Koch Institute (RKI) plays a central role in Germany in the management of health hazards of biological origin. The RKI's crisis management aims to contribute to protecting the health of the population in Germany in significant epidemic situations and to maintain the RKI's working ability over a long period of time even under high load. This article illustrates the crisis management of the RKI in general as well as during the COVID-19 pandemic. The generic RKI crisis management structures and the setup of the RKI emergency operations centre (EOC), their operationalisation in the context of the COVID-19 pandemic and the resulting challenges as of 31 October 2020 are described in this paper. The exchange between the federal and state governments during the pandemic is also described.The COVID-19 pandemic has led to extraordinary circumstances. During the epidemic situation, good communication and coordination has been essential, both within the RKI and with other federal or state authorities and expert groups. Under great pressure, the RKI produces and regularly updates recommendations, statements and assessments on various topics. To provide operational support for all COVID-19 related activities, an EOC was activated at the RKI. During the COVID-19 pandemic, there are various challenges regarding personnel and structures. It became apparent that good preparation (e.g. existing task descriptions and premises) has an important positive impact on crisis management.

When the emerging novel SARS-CoV‑2 virus first appeared in December 2019, neither specific therapeutic options nor vaccinations were available. The role of nonpharmaceutical interventions (NPIs) became of central importance. At the Robert Koch Institute, a multilayer strategy consisting of population-based and individual preventive measures to control the pandemic was developed, which built upon existing influenza pandemic plans as well as generic plans. This paper explains the recommended NPIs and illustrates the pharmaceutical approaches developed in parallel.Among others, general contact bans, providing material for infection prevention and control, ban of events, closing educational institutions, and restricting travel are counted among population-based measures. Additional individual preventive measures are necessary, e.g., keeping a minimum distance, reducing contacts, and wearing a mouth-nose covering as well as quarantine and isolation. Measures within the health system are based on recommendations of the Commission on Hospital Hygiene and Infection Protection (Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO)) and specified and implemented by professional societies. Since November 2020, an antiviral therapy with remdesivir and treatment with the glucocorticoid dexamethasone have been available as pharmaceutical interventions. Monoclonal antibodies are at this time not approved. Therapeutic anticoagulation is recommended.Recommendations are constantly adapted to the increasing knowledge on the pathogen and its means of transmission. A challenge is to strengthen the trust of the population. Many measures have to be applied on an individual basis in order to work together.

In this paper we submit some thoughts on the possible implications of the COVID-19 pandemic for rural people in the countries of the Greater Mekong Subregion (GMS). We base our observations and conclusions on our long-term research experience in the region. The paper focuses on the economics of rural households during this crisis period and its aftermath. We conclude that country differences clearly exist due to their different stages of development. However, while rural households belong to the Corona risk groups, they are also resilient to such a shock. We submit that Governments in the GMS should strengthen policies that conserve the safety-net function of rural villages., Competing Interests: Conflict of interestThe authors declared that they have no conflict of interest., (© The Author(s) 2020.)

A scoping search and a systematic literature review were conducted to give an insight on entry and exit screening referring to travelers at points of entry, by analyzing published evidence on practices, guidelines, and experiences in the past 15 years worldwide. Grey literature, PubMed. and Scopus were searched using specific terms. Most of the available data identified through the systematic literature review concerned entry screening measures at airports. Little evidence is available about entry and exit screening measure implementation and effectiveness at ports and ground crossings. Exit screening was part of the World Health Organisation's (WHO) temporary recommendations for implementation in certain points of entry, for specific time periods. Exit screening measures for Ebola Virus Disease (EVD) in the three most affected West African countries did not identify any cases and showed zero sensitivity and very low specificity. The percentages of confirmed cases identified out of the total numbers of travelers that passed through entry screening measures in various countries worldwide for Influenza Pandemic (H1N1) and EVD in West Africa were zero or extremely low. Entry screening measures for Severe Acute Respiratory Syndrome (SARS) did not detect any confirmed SARS cases in Australia, Canada, and Singapore. Despite the ineffectiveness of entry and exit screening measures, authors reported several important concomitant positive effects that their impact is difficult to assess, including discouraging travel of ill persons, raising awareness, and educating the traveling public and maintaining operation of flights from/to the affected areas. Exit screening measures in affected areas are important and should be applied jointly with other measures including information strategies, epidemiological investigation, contact tracing, vaccination, and quarantine to achieve a comprehensive outbreak management response. Based on review results, an algorithm about decision-making for entry/exit screening was developed.

Whether for identification and characterization of materials or for monitoring of the environment, space-based hyperspectral instruments are very useful. Hyperspectral instruments measure several dozens up to hundreds of spectral bands. These data help to reconstruct the spectral properties like reflectance or emission of Earth surface or the absorption of the atmosphere, and to identify constituents on land, water, and in the atmosphere. There are a lot of possible applications, from vegetation and water quality up to greenhouse gas monitoring. But the actual number of hyperspectral space-based missions or hyperspectral space-based data is limited. This will be changed in the next years by different missions. The German Aerospace Center (DLR) Earth Sensing Imaging Spectrometer (DESIS) is one of the new currently existing space-based hyperspectral instruments, launched in 2018 and ready to reduce the gap of space-born hyperspectral data. The instrument is operating onboard the International Space Station, using the Multi-User System for Earth Sensing (MUSES) platform. The instrument has 235 spectral bands in the wavelength range from visible (400 nm) to near-infrared (1000 nm), which results in a 2.5 nm spectral sampling distance and a ground sampling distance of 30 m from 400 km orbit of the International Space Station. In this article, the design of the instrument will be described.

Purpose  Refugees often live in confined housing conditions with shared kitchen and sanitary facilities, rendering susceptible to communicable diseases. We here describe the outbreak, spread and self-limiting nature of a norovirus outbreak in a German refugee camp in the winter of 2015. Methods  During a norovirus outbreak, data on clinical symptoms, nationality and living conditions was obtained in a refugee camp in northern Germany in the winter of 2015. Furthermore secondary data on norovirus outbreaks in 2015 was assessed. Results  Amongst n = 982 refugees, n = 36 patients (3.7 %) presented with acute norovirus gastroenteritis. The vast majority of cases were children, only the first patient was admitted to the hospital. Intensified hygiene measures were implemented on day 2 of the outbreak, but new cases peaked on day 21 and occurred until one month after the first case. Different cultural backgrounds, eating habits and hygiene standards amongst the refugees made it particularly challenging to implement stringent isolation and hygiene measures. Despite these predisposing factors, only minor norovirus outbreaks were reported in refugee camps in 2015. Conclusion  Adults refugees had a low attack rate of symptomatic norovirus infection, while small children are at high risk. Infection spreads despite hygiene measures and camp sites and staff should be prepared for the particular challenges of such situations with a particular focus on cultural-background specific implementation of hygiene measures., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: Current political crises in the Middle East and economic discrepancies led millions of people to leave their home countries and to flee to Western Europe. This development raises unexpected challenges for receiving health care systems. Although pan-European initiatives strive for updated and optimized vaccination strategies, little data on immunity against vaccine-preventable diseases in the current refugee population exist., Methods: We quantified serum IgG against tetanus and diphtheria (TD) in n = 678 refugees currently seeking shelter in six German refugee centers., Findings: Reflecting current migration statistics in Europe, the median age within the cohort was 26 years, with only 23.9 % of female subjects. Insufficient IgG levels without long-term protection against tetanus were found in 56.3 % of all refugees. 76.1 % of refugees had no long-term protection against diphtheria. 47.7 % of subjects needed immediate vaccination against tetanus, and 47.7 % against diphtheria. For both diseases, an age-dependent decline in protective immunity occurred., Interpretation: We observed a considerably low rate of tetanus-protected refugees, and the frequency of diphtheria-immune refugees was far from sufficient to provide herd immunity. These findings strongly support recent intentions to implement and enforce stringent guidelines for refugee vaccination in the current crisis.

Purpose: The current extent of migration poses emerging socio-economic and humanitarian challenges. Little is known on vaccination rates in migrants entering Europe, and the implementation of guidelines for serological testing and vaccination of refugees are pending., Methods: We conducted seroprevalence analyses for measles, mumps, rubella and varicella (MMRV) in 678 refugees coming to Germany during the current crisis., Results: The mean age of refugees was 28.8±11.4 years, and 76.1 % of subjects were male. Overall, IgG seronegativity was 7.4 % (95 % CI 5.5-9.6) for measles, 10.2 % (95 % CI 8.0-12.5) for mumps, 2.2 % (95 % CI 1.2-3.4) for rubella, and 3.3 % (95 % CI 1.9-4.9) for varicella. Seropositivity rates were age-dependent with considerably low values in children. For example, overall MMR immunity was 90.9 % (95 % CI 88.8-93.1), but only 73.1 % of minor aged refugees displayed complete seroprevalence against all three diseases, and only 68.9 % of children and adolescents were completely MMRV immune., Conclusion: Our initial data set suggests overall satisfactory MMRV immunity in adult migrants coming to Europe, but the observed low MMRV seroprevalences in refugee children support thorough and prompt vaccination of young migrants entering Europe. Taken together, our data set underlines the urgent need to implement and validate vaccination guidelines for refugee care in the current crisis.