Threat Perception and Attitudes of Adolescents towards Re-Introduced Wild Animals: A Qualitative Study of Young Learners from Affected Regions in Germany

ERIC Educational Resources Information Center

Hermann, Nadin; Menzel, Susanne

2013-01-01

Conservation efforts such as the restoration of European bison or the support of wolf immigration into Germany are often socio-scientifically controversial. In many cases, disputes are based on individuals' threat perception and attitudes towards the animal involved. The herewith reported study provides qualitative insights into German…

Epidemiology of cutaneous melanoma and non-melanoma skin cancer in Schleswig-Holstein, Germany: incidence, clinical subtypes, tumour stages and localization (epidemiology of skin cancer).

PubMed

Katalinic, A; Kunze, U; Schäfer, T

2003-12-01

Population-based figures on skin cancer are essential for a realistic assessment of the personal disease burden, prevention modes and the need for caring. The Robert Koch Institute in Germany estimates the incidence of melanoma skin cancer as seven cases in 100 000 persons (age-standardized by the European standard rate). Population-based studies presumably show higher incidence rates of 10-16 cases in 100 000 persons. Few data exist for non-melanoma skin cancer (NMSC) as this is not systematically registered in Germany. To present the first population-based results from the Schleswig-Holstein (Germany) Cancer Registry on incidence, stage distribution, clinical types and localization of skin cancer and to compare the results with other studies. The Cancer Registry of the Bundesland Schleswig-Holstein with 3500 registering institutions, 100 of which are dermatological institutions, investigates all notifiable incident cancer cases according to international standards. From the recorded data all melanoma and NMSC cases were identified and evaluated. Between 1998 and 2001, 1784 malignant melanoma (MM) and 12 956 NMSC cases underwent diagnostic and analytical evaluation. For MM, age-standardized incidence rates were 12.3 and 14.8 in 100 000 men and women, respectively, and the mean age of men was greater than that of women (56.6 vs. 54.9 years, P < 0.05). Superficial spreading melanoma was the most frequent clinical type (39.1%). The tumours were predominantly located on the trunk in men (46.8%) in contrast to leg and hip in women (39.5%). For NMSC, the age-standardized incidence rates were 100.2 and 72.6 in 100 000 men and women, respectively. More than 80% of all tumours were basal cell carcinoma. The first population-based data from Schleswig-Holstein on the characteristics (age, sex, histological subtypes, localization and stage) of skin tumours agree well with the existing literature and may thus be regarded as representative. However, markedly higher incidences for MM and NMSC in the north of Germany compared with other parts of the country were observed. As the incidence rates from the north of Germany fit well into the European geographical pattern, we assume no regional increase. Therefore, the official German estimates on cutaneous tumours may largely depend on regional factors and may not be regarded as representative for all regions in Germany.

DICOM Standard Conformance in Veterinary Medicine in Germany: a Survey of Imaging Studies in Referral Cases.

PubMed

Brühschwein, Andreas; Klever, Julius; Wilkinson, Tom; Meyer-Lindenberg, Andrea

2018-02-01

In 2016, the recommendations of the DICOM Standards Committee for the use of veterinary identification DICOM tags had its 10th anniversary. The goal of our study was to survey veterinary DICOM standard conformance in Germany regarding the specific identification tags veterinarians should use in veterinary diagnostic imaging. We hypothesized that most veterinarians in Germany do not follow the guidelines of the DICOM Standards Committee. We analyzed the metadata of 488 imaging studies of referral cases from 115 different veterinary institutions in Germany by computer-aided DICOM header readout. We found that 25 (5.1%) of the imaging studies fully complied with the "veterinary DICOM standard" in this survey. The results confirmed our hypothesis that the recommendations of the DICOM Standards Committee for the consistent and advantageous use of veterinary identification tags have found minimal acceptance amongst German veterinarians. DICOM does not only enable connectivity between machines, DICOM also improves communication between veterinarians by sharing correct and valuable metadata for better patient care. Therefore, we recommend that lecturers, universities, societies, authorities, vendors, and other stakeholders should increase their effort to improve the spread of the veterinary DICOM standard in the veterinary world.

Ongoing haemolytic uraemic syndrome (HUS) outbreak caused by sorbitol-fermenting (SF) Shiga toxin-producing Escherichia coli (STEC) O157, Germany, December 2016 to May 2017.

PubMed

Vygen-Bonnet, Sabine; Rosner, Bettina; Wilking, Hendrik; Fruth, Angelika; Prager, Rita; Kossow, Annelene; Lang, Christina; Simon, Sandra; Seidel, Juliane; Faber, Mirko; Schielke, Anika; Michaelis, Kai; Holzer, Alexandra; Kamphausen, Rolf; Kalhöfer, Daniela; Thole, Sebastian; Mellmann, Alexander; Flieger, Antje; Stark, Klaus

2017-05-25

We report an ongoing, protracted and geographically dispersed outbreak of haemolytic uraemic syndrome (HUS) and gastroenteritis in Germany, involving 30 cases since December 2016. The outbreak was caused by the sorbitol-fermenting immotile variant of Shiga toxin-producing (STEC) Escherichia coli O157. Molecular typing revealed close relatedness between isolates from 14 cases. One HUS patient died. Results of a case-control study suggest packaged minced meat as the most likely food vehicle. Food safety investigations are ongoing. This article is copyright of The Authors, 2017.

[Modelling of the costs of productivity losses due to smoking in Germany for the year 2005].

PubMed

Prenzler, A; Mittendorf, T; von der Schulenburg, J M

2007-11-01

The aim of this study was to estimate disease-related productivity costs attributable to smoking in the year 2005 in Germany. The calculation was based on the updated relative smoking-related disease risk found in the US Cancer Prevention Study II combined with data on smoking prevalence for Germany. With this, smoking-attributable cases resulting in premature mortality, invalidity, and temporal disability to work could be estimated. Neoplasms, diseases of the circulatory and the respiratory systems as well as health problems in children younger than one year were considered in the analysis. The human capital approach was applied to calculate years of potential work loss and productivity costs as a result of smoking. Various sensitivity analyses were conducted to test for robustness of the underlying model. Based on the assumptions within the model, 107,389 deaths, 14,112 invalidity cases, and 1.19 million cases of temporary disability to work were found to be due to smoking in 2005 in Germany, respectively. As a result, productivity costs of 9.6 billion were caused by smoking. The model showed that smoking has a high financial effect. Even so, further analyses are necessary to estimate an overall impact of smoking on the German society.

Large and ongoing outbreak of haemolytic uraemic syndrome, Germany, May 2011.

PubMed

Frank, C; Faber, M S; Askar, M; Bernard, H; Fruth, A; Gilsdorf, A; Hohle, M; Karch, H; Krause, G; Prager, R; Spode, A; Stark, K; Werber, D

2011-05-26

Since early May 2011, an increased incidence of haemolytic uraemic syndrome (HUS) and bloody diarrhoea related to infections with Shiga toxin-producing Escherichia coli (STEC) has been observed in Germany, with most cases in the north of the country. Cases reported from other European countries had travelled to this area. First results of a case–control study conducted in Hamburg suggest an association between the occurrence of disease and the consumption of raw tomatoes, cucumber and leaf salad.

Tularaemia in southwest Germany: Three cases of tick-borne transmission.

PubMed

Boone, I; Hassler, D; Nguyen, T; Splettstoesser, W D; Wagner-Wiening, C; Pfaff, G

2015-07-01

Tularaemia, caused by Francisella tularensis, is an endemic zoonosis frequently occurring in southwest Germany. Since 2005 there is an increase in the number of reported cases of tularaemia in Germany. We report on two cases of ulceroglandular tularaemia and one case of glandular tularaemia that occurred in the summer of 2012 and 2013 in two counties in the Federal State of Baden-Wuerttemberg. Bacteria were transmitted through tick bites, which to date has only rarely been reported in Germany. Inadequate treatment of the patients and an aggravation of clinical symptoms were caused by a delay between disease onset and the detection of the pathogen. Although contact to or consumption of infected hares are the most often reported transmission routes of tularaemia in Germany, tick-bites should also be taken into account. Health professionals should include Francisella tularensis in the differential diagnosis of patients with fever and/or ulcerative lymphadenopathy following a tick bite. Copyright © 2015 Elsevier GmbH. All rights reserved.

Description of the early stage of pandemic (H1N1) 2009 in Germany, 27 April-16 June 2009.

PubMed

2009-08-06

We report characteristics of the early stage of the pandemic (H1N1) 2009 in Germany. Until 16 June 2009, 198 confirmed cases were notified. Almost half of the cases (47%) were imported, mostly from Mexico and the United States. About two third of indigenous cases were outbreak-related (with two large school-associated outbreaks, n=74). According to our results Germany is still in the early stage of the pandemic with limited domestic transmission.

Enhanced Passive Bat Rabies Surveillance in Indigenous Bat Species from Germany - A Retrospective Study

PubMed Central

Auer, Ernst; Goharriz, Hooman; Harbusch, Christine; Johnson, Nicholas; Kaipf, Ingrid; Mettenleiter, Thomas Christoph; Mühldorfer, Kristin; Mühle, Ralf-Udo; Ohlendorf, Bernd; Pott-Dörfer, Bärbel; Prüger, Julia; Ali, Hanan Sheikh; Stiefel, Dagmar; Teubner, Jens; Ulrich, Rainer Günter; Wibbelt, Gudrun; Müller, Thomas

2014-01-01

In Germany, rabies in bats is a notifiable zoonotic disease, which is caused by European bat lyssaviruses type 1 and 2 (EBLV-1 and 2), and the recently discovered new lyssavirus species Bokeloh bat lyssavirus (BBLV). As the understanding of bat rabies in insectivorous bat species is limited, in addition to routine bat rabies diagnosis, an enhanced passive surveillance study, i.e. the retrospective investigation of dead bats that had not been tested for rabies, was initiated in 1998 to study the distribution, abundance and epidemiology of lyssavirus infections in bats from Germany. A total number of 5478 individuals representing 21 bat species within two families were included in this study. The Noctule bat (Nyctalus noctula) and the Common pipistrelle (Pipistrellus pipistrellus) represented the most specimens submitted. Of all investigated bats, 1.17% tested positive for lyssaviruses using the fluorescent antibody test (FAT). The vast majority of positive cases was identified as EBLV-1, predominately associated with the Serotine bat (Eptesicus serotinus). However, rabies cases in other species, i.e. Nathusius' pipistrelle bat (Pipistrellus nathusii), P. pipistrellus and Brown long-eared bat (Plecotus auritus) were also characterized as EBLV-1. In contrast, EBLV-2 was isolated from three Daubenton's bats (Myotis daubentonii). These three cases contribute significantly to the understanding of EBLV-2 infections in Germany as only one case had been reported prior to this study. This enhanced passive surveillance indicated that besides known reservoir species, further bat species are affected by lyssavirus infections. Given the increasing diversity of lyssaviruses and bats as reservoir host species worldwide, lyssavirus positive specimens, i.e. both bat and virus need to be confirmed by molecular techniques. PMID:24784117

Epidemiological investigation and case-control study: a Legionnaires' disease outbreak associated with cooling towers in Warstein, Germany, August-September 2013.

PubMed

Maisa, Anna; Brockmann, Ansgar; Renken, Frank; Lück, Christian; Pleischl, Stefan; Exner, Martin; Daniels-Haardt, Inka; Jurke, Annette

2015-01-01

Between 1 August and 6 September 2013, an outbreak of Legionnaires' disease (LD) with 159 suspected cases occurred in Warstein, North Rhine-Westphalia, Germany. The outbreak consisted of 78 laboratory-confirmed cases of LD, including one fatality, with a case fatality rate of 1%. Legionella pneumophila, serogroup 1, subtype Knoxville, sequence type 345, was identified as the epidemic strain. A case-control study was conducted to identify possible sources of infection. In univariable analysis, cases were almost five times more likely to smoke than controls (odds ratio (OR): 4.81; 95% confidence interval (CI): 2.33-9.93; p < 0.0001). Furthermore, cases were twice as likely to live within a 3 km distance from one identified infection source as controls (OR: 2.14; 95% CI: 1.09-4.20; p < 0.027). This is the largest outbreak of LD in Germany to date. Due to a series of uncommon events, this outbreak was most likely caused by multiple sources involving industrial cooling towers. Quick epidemiological assessment, source tracing and shutting down of potential sources as well as rapid laboratory testing and early treatment are necessary to reduce morbidity and mortality. Maintenance of cooling towers must be carried out according to specification to prevent similar LD outbreaks in the future.

Computer Science Education in North-Rhine Westphalia, Germany--A Case Study

ERIC Educational Resources Information Center

Knobelsdorf, Maria; Magenheim, Johannes; Brinda, Torsten; Engbring, Dieter; Humbert, Ludger; Pasternak, Arno; Schroeder, Ulrik; Thomas, Marco; Vahrenhold, Jan

2015-01-01

In North-Rhine Westphalia, the most populated state in Germany, Computer Science (CS) has been taught in secondary schools since the early 1970s. This article provides an overview of the past and current situation of CS education in North-Rhine Westphalia, including lessons learned through efforts to introduce and to maintain CS in secondary…

Governance in Adult and Further Education: Unified Germany as a Case Study

ERIC Educational Resources Information Center

Schrader, Josef

2010-01-01

There is little discussion in Germany on governance of further education. This is surprising for two reasons--first, that the process of German unification should have sparked such a debate, and second, because it was expected that the current international discussions about governance would also reach a scholarly debate on further education. A…

[A report on clinical PET activities in Germany].

PubMed

Tashiro, M; Kubota, K; Itoh, M; Sasaki, H; Moser, E

1999-09-01

Clinical diagnostic procedure using positron emission tomography (PET) requires high costs. To promote clinical use of PET, sociomedical evaluation is necessary. In this paper, sociomedical situations concerning clinical use of PET in Germany is reported. Some comparisons are made between Japan and this country putting emphases on several points such as 1) number of cyclotron and PET facilities, 2) social restriction to transportation of radioisotopes, 3) activities of satellite PET facilities, and 4) clinical indications for PET studies. Number of cyclotron was larger in Japan (29) than in Germany (17), but number of PET facilities was larger in Germany (47) than in Japan (29). The reason seems that in Germany transportation and buying of radioisotopes is less restricted. Hence, more than half of PET facilities in Germany are "satellite facilities" which do not have their own cyclotrons. Radioisotope distribution seems to serve as a backbone of "satellite concept." Additionally in Germany, list of clinical indications for PET study is almost completed and now is widely in applied to most cases. To promote clinical use of PET in Japan, the German system might serve as an important socioeconomic model in Europe instead of the United States.

Long-term Evaluation of Landuse Changes On Landscape Water Balance - A Case Study From North-east Germany

NASA Astrophysics Data System (ADS)

Wegehenkel, M.

In this paper, long-term effects of different afforestation scenarios on landscape wa- ter balance will be analyzed taking into account the results of a regional case study. This analysis is based on using a GIS-coupled simulation model for the the spatially distributed calculation of water balance.For this purpose, the modelling system THE- SEUS with a simple GIS-interface will be used. To take into account the special case of change in forest cover proportion, THESEUS was enhanced with a simple for- est growth model. In the regional case study, model runs will be performed using a detailed spatial data set from North-East Germany. This data set covers a mesoscale catchment located at the moraine landscape of North-East Germany. Based on this data set, the influence of the actual landuse and of different landuse change scenarios on water balance dynamics will be investigated taking into account the spatial distributed modelling results from THESEUS. The model was tested using different experimen- tal data sets from field plots as well as obsverded catchment discharge. Additionally to such convential validation techniques, remote sensing data were used to check the simulated regional distribution of water balance components like evapotranspiration in the catchment.

Care Management in Germany and the U.S.: An Expanded Laboratory

PubMed Central

Pittman, Patricia M.; Arnold, Sharon B.; Schlette, Sophia

2005-01-01

Germany and the U.S. share a keen interest in exploring the potential of care management programs for the chronically ill. Despite obvious health system differences, in both countries there has been a proliferation of disease management models, initiated by a variety of actors, paid for in different ways, targeting different types of population groups, and encompassing a broad menu of interventions and services. Comparison of three case studies from the U.S. and four from Germany reveals greater differences among models within countries than between them. PMID:17288074

Surveillance of recent HIV infections among newly diagnosed HIV cases in Germany between 2008 and 2014.

PubMed

Hofmann, Alexandra; Hauser, Andrea; Zimmermann, Ruth; Santos-Hövener, Claudia; Bätzing-Feigenbaum, Jörg; Wildner, Stephan; Kücherer, Claudia; Bannert, Norbert; Hamouda, Osamah; Bremer, Viviane; Bartmeyer, Barbara

2017-07-11

The HIV surveillance system in Germany is based on mandatory, anonymous notification of newly diagnosed HIV cases by laboratories. Because the time between HIV infection and the diagnosis of HIV varies widely between persons, it is difficult to determine the number of cases of recent HIV infection among newly diagnosed cases of HIV. In Germany, the BED-capture-enzyme immunoassay (BED-CEIA) has been used to distinguish between recent and long-standing HIV infection. The aim of this analysis is to report the proportion of cases of recent HIV infection among newly diagnosed cases in Germany between 2008 and 2014 and to identify factors associated with recent infections. A sample of voluntary laboratories among all HIV diagnostic laboratories was recruited. Residual blood from HIV diagnostic tests was spotted on filter paper as dried serum or dried plasma spots and was sent along with the notification form of the HIV cases. The BED-CEIA test was performed. A case was defined as recent HIV infection with a BED-CEIA test result of less than 0.8 normalized optical density, with the exclusion of CDC stage C. The proportion of recent newly diagnosed HIV infections among different groups (such as transmission groups, gender or age groups) was calculated. We used logistic regression to identify factors associated with recent HIV infection and to identify subpopulations with high proportions of recent HIV infections. Approximately 10,257 newly diagnosed cases were tested for recency using the BED-CEIA. In total, 3084 (30.4%) of those were recently infected with HIV. The highest proportion of recent HIV infections was found among men who had sex with men (MSM) (35%) and persons between 18 and 25 years of age (43.0%). Logistic regression revealed that female German intravenous drug users with a recent HIV infection had a higher chance of being detected than German MSM (OR 2.27). Surveillance of recent HIV infection is a useful additional tool to monitor the HIV epidemic in Germany. We could observe ongoing HIV transmission in Germany in general and in different subgroups, and we could identify factors associated with recent HIV infection in Germany.

Access to healthcare for undocumented migrants with communicable diseases in Germany: a quantitative study.

PubMed

Mylius, Maren; Frewer, Andreas

2015-08-01

Migrants without residence permits are de facto excluded from access to healthcare in Germany. There is one exception in relevant legislation: in the case of sexually transmitted infections and tuberculosis, the legislator has instructed the local Public Health Authorities to offer free and anonymous counseling, testing and, if necessary, treatment in case of apparent need. Furthermore, recommended vaccinations may be carried out free of charge. This study intends to comprehensively capture the services for undocumented migrants at Public Health Authorities in Germany. An e-mail survey of all Local Public Health Authorities (n = 384) in Germany was carried out between January and March 2011 using a standardized questionnaire. One hundred thirty-nine of 384 targeted local Health Authorities completed the questionnaire (36.2%), of which approximately a quarter (n = 34) reported interaction with 'illegal' immigrants. Twenty-give authorities (18.4%) gave the indication to carry out treatment. This outpatient treatment option is mostly limited to patients afflicted with sexually transmitted infections with the distinct exception of human immunodeficiency virus/acquired immune deficiency syndrome. The study highlights the gap between legislation and the reality of restricted access to medical services for undocumented migrants in Germany. It underlines the need of increased financial and human resources in Public Health Authorities and, overall, the simplification of national legislation to assure the right to healthcare. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Teachers' Views on Organizational and Pedagogical Approaches to Early Bilingual Education: A Case Study of Bilingual Kindergartens in Germany and Israel

ERIC Educational Resources Information Center

Moin, Victor; Breitkopf, Anna; Schwartz, Mila

2011-01-01

The article focuses on bilingual kindergartens in Germany and Israel offering education in both host (German or Hebrew) and immigrant (Russian) languages. The main questions are how teachers of bilingual kindergartens understand and explain the organizational and pedagogical principles of the kindergartens and how they negotiate home and host…

The Impact of the Bologna Reform on Teacher Education in Germany: An Empirical Case Study on Policy Borrowing in Education

ERIC Educational Resources Information Center

Kuhlee, Dina

2017-01-01

This article investigates aspects of policy transfer and educational borrowing in German higher education in the wake of the Bologna reforms of higher education in Europe. It examines the origins and results of the Bologna reform process in Germany. Focussing on teacher education, it highlights inconsistencies between political legitimation,…

Fatal Balamuthia mandrillaris infection in a gorilla - first case of balamuthiasis in Germany.

PubMed

Mätz-Rensing, Kerstin; Kunze, Marius; Zöller, Martina; Roos, Christian; Kiderlen, Albrecht F; Ludwig, Carsten; Kaup, Franz-Josef

2011-12-01

A 12-year-old female western lowland gorilla died in a zoological garden in Germany after exhibiting general neurological signs. Balamuthia mandrillaris was identified as causative agent by indirect immunofluorescent staining of brain sections and confirmed by PCR and respective sequencing. The animal suffered from a chronic progressive necrotizing amebic meningoencephalitis. This is the first case of Balamuthia amebic encephalitis in Germany. © 2011 John Wiley & Sons A/S.

Evaluation of preventive technologies in Germany: case studies of mammography, prostate cancer screening, and fetal ultrasound.

PubMed

Perleth, M; Busse, R; Gibis, B; Brand, A

2001-01-01

In this article, three preventive strategies-mammography screening for breast cancer, PSA screening for prostate cancer, and routine ultrasound in normal pregnancy-are discussed in the context of German health care. Epidemiologic data and German studies evaluating different aspects of these preventive measures were identified and analyzed. Only a few studies could be identified that investigate these preventive measures. Despite sufficient evidence, in part derived from a German study, there is not yet a mammography screening program. In contrast, ultrasound in pregnancy is offered routinely, although there are controversies regarding the benefit of this practice. PSA screening is not offered as part of the screening program for prostate cancer. However, PSA tests as well as mammographies are done in large numbers in German ambulatory care-a practice that could be considered wild or opportunistic screening. These case studies show that preventive programs and practices in Germany are not sufficiently based on sound evidence. The paucity of evaluation activities related to prevention in Germany is probably due to the low threshold to introduce new preventive programs into the German healthcare system in the past.

The epidemiological impact of childhood influenza vaccination using live-attenuated influenza vaccine (LAIV) in Germany: predictions of a simulation study

PubMed Central

2014-01-01

Background Routine annual influenza vaccination is primarily recommended for all persons aged 60 and above and for people with underlying chronic conditions in Germany. Other countries have already adopted additional childhood influenza immunisation programmes. The objective of this study is to determine the potential epidemiological impact of implementing paediatric influenza vaccination using intranasally administered live-attenuated influenza vaccine (LAIV) in Germany. Methods A deterministic age-structured model is used to simulate the population-level impact of different vaccination strategies on the transmission dynamics of seasonal influenza in Germany. In our base-case analysis, we estimate the effects of adding a LAIV-based immunisation programme targeting children 2 to 17 years of age to the existing influenza vaccination policy. The data used in the model is based on published evidence complemented by expert opinion. Results In our model, additional vaccination of children 2 to 17 years of age with LAIV leads to the prevention of 23.9 million influenza infections and nearly 16 million symptomatic influenza cases within 10 years. This reduction in burden of disease is not restricted to children. About one third of all adult cases can indirectly be prevented by LAIV immunisation of children. Conclusions Our results demonstrate that vaccinating children 2–17 years of age is likely associated with a significant reduction in the burden of paediatric influenza. Furthermore, annual routine childhood vaccination against seasonal influenza is expected to decrease the incidence of influenza among adults and older people due to indirect effects of herd protection. In summary, our model provides data supporting the introduction of a paediatric influenza immunisation programme in Germany. PMID:24450996

Dental tourism from Switzerland to Germany.

PubMed

Gheorghe, Raluca; Zürcher, Andrea; Filippi, Andreas

In recent years the topic of dental tourism has increasingly come into focus of dentists and patients. In the present study an attempt was made to find out, why patients from a restricted region travel to Germany for dental care. In five German dental clinics located in the border area between Switzerland and Germany, 272 women and 236 men ranging in age from 5 to 94 years, who had undergone at least one dental treatment in Germany, were questioned concerning the reasons for their visits. The interviews took place within a period of 6 months and relied on a questionnaire to collect data regarding sociodemographic features and patient behavior. In comparison to residents of Germany, patients residing in Switzerland took on considerably longer travel distances for the dental visit, in some cases more than 50km (9.7%). For patients residing in Switzerland the technical equipment of the practice was more important (p<0.001), whereas for residents of Germany the cost-effective treatment was decisive (p<0.05). Almost all patients residing in Switzerland (95.6%) confirmed that dental treatments in Germany were cheaper and that additional family members also came to Germany for dental care (65.0%).

Quality Assurance in In-House Continuing Training. Case Studies from Europe.

ERIC Educational Resources Information Center

Severing, Eckart; Stahl, Thomas

Nine European Community Member States (Belgium, Germany, France, Greece, Ireland, Luxembourg, Portugal, Spain, and United Kingdom) conducted national studies that involved case studies of quality assurance in continuing education. Analysis of findings indicated that many firms regarded continuing training as a central instrument for achieving…

Epidemic profile of Shiga-toxin-producing Escherichia coli O104:H4 outbreak in Germany.

PubMed

Frank, Christina; Werber, Dirk; Cramer, Jakob P; Askar, Mona; Faber, Mirko; an der Heiden, Matthias; Bernard, Helen; Fruth, Angelika; Prager, Rita; Spode, Anke; Wadl, Maria; Zoufaly, Alexander; Jordan, Sabine; Kemper, Markus J; Follin, Per; Müller, Luise; King, Lisa A; Rosner, Bettina; Buchholz, Udo; Stark, Klaus; Krause, Gérard

2011-11-10

We describe an outbreak of gastroenteritis and the hemolytic-uremic syndrome caused by Shiga-toxin-producing Escherichia coli in Germany in May, June, and July, 2011. The consumption of sprouts was identified as the most likely vehicle of infection. We analyzed data from reports in Germany of Shiga-toxin-producing E. coli gastroenteritis and the hemolytic-uremic syndrome and clinical information on patients presenting to Hamburg University Medical Center (HUMC). An outbreak case was defined as a reported case of the hemolytic-uremic syndrome or of gastroenteritis in a patient infected by Shiga-toxin-producing E. coli, serogroup O104 or serogroup unknown, with an onset of disease during the period from May 1 through July 4, 2011, in Germany. A total of 3816 cases (including 54 deaths) were reported in Germany, 845 of which (22%) involved the hemolytic-uremic syndrome. The outbreak was centered in northern Germany and peaked around May 21 to 22. Most of the patients in whom the hemolytic-uremic syndrome developed were adults (88%; median age, 42 years), and women were overrepresented (68%). The estimated median incubation period was 8 days, with a median of 5 days from the onset of diarrhea to the development of the hemolytic-uremic syndrome. Among 59 patients prospectively followed at HUMC, the hemolytic-uremic syndrome developed in 12 (20%), with no significant differences according to sex or reported initial symptoms and signs. The outbreak strain was typed as an enteroaggregative Shiga-toxin-producing E. coli O104:H4, producing extended-spectrum beta-lactamase. In this outbreak, caused by an unusual E. coli strain, cases of the hemolytic-uremic syndrome occurred predominantly in adults, with a preponderance of cases occurring in women. The hemolytic-uremic syndrome developed in more than 20% of the identified cases.

Elimination of terrestrial rabies in Germany using oral vaccination of foxes.

PubMed

Müller, Thomas; Bätza, Hans-Joachim; Freuling, Conrad; Kliemt, Anke; Kliemt, Jeannette; Heuser, Rolf; Schlüter, Hartmut; Selhorst, Thomas; Vos, Adriaan; Mettenleiter, Thomas C

2012-01-01

Oral rabies vaccination (ORV) has become the method of choice in fox rabies control in Europe. During the past three decades fox-mediated rabies virtually disappeared from Western and Central Europe. Following Switzerland, Germany was the second European country to launch ORV field trials on its territory in 1983. This paper provides a historical overview on the emergence of fox rabies in Germany; describing the basic principles and milestones of the German rabies eradication programme and presenting results of two decades of efforts to control the disease in foxes. Also, setbacks as well as country-specific differences and particularities on Germany's long way to rabies elimination in comparison to other European countries are addressed. Since the first field trials in Germany the number of rabies cases steadily decreased from 10 484 in 1983 to three cases recorded in 2006. On February 3rd 2006 the last case of terrestrial rabies in Germany was detected in a fox near the town of Mainz, Rhineland-Palatinate. In 2008, ORV ceased after 25 years and Germany was officially declared as free from terrestrial rabies. The German rabies eradication programme did cost approximately 100 million euro of which 37 million euro were covered by the EU. For the future, efforts should focus on maintaining a rabies free status by implementing measures to prevent reintroduction of terrestrial rabies from endemic countries.

Birth prevalence and initial treatment of Robin sequence in Germany: a prospective epidemiologic study

PubMed Central

2014-01-01

Background We conducted a monthly epidemiological survey to determine the birth prevalence of Robin sequence (RS) and the use of various therapeutic approaches for it. Methods Between August 2011 and July 2012, every pediatric department in Germany was asked to report new admissions of infants with RS to the Surveillance Unit for Rare Pediatric Diseases in Germany. RS was defined as retro- or micrognathia and at least one of the following: clinically evident upper airway obstruction including recessions, snoring or hypoxemia; glossoptosis; feeding difficulties; failure to thrive; cleft palate or RS-associated syndrome. Hospitals reporting a case were asked to return an anonymized questionnaire and discharge letter. Results Of 96 cases reported, we received detailed information on 91. Of these, 82 were included; seven were duplicates and two erroneous reports. Given 662,712 live births in Germany in 2011, the birth prevalence was 12.4 per 100,000 live births. Therapeutic approaches applied included prone positioning in 50 infants, followed by functional therapy in 47. Conventional feeding plates were used in 34 infants and the preepiglottic baton plate (PEBP) in 19. Surgical therapy such as mandibular traction was applied in 2 infants, tracheotomy in 3. Conclusion Compared to other cohort studies on RS, surgical procedures were relatively rarely used as an initial therapy for RS in Germany. This may be due to differences in phenotype or an underrecognition of upper airway obstruction in these infants. PMID:24433508

The Balance of Payments: A Case Study Approach

ERIC Educational Resources Information Center

McCulloch, D. W.

1977-01-01

An economic case study is presented of the balance of payments in Italy, Canada, and West Germany during the 1940s through 1960s. The study examines the circular flow of income, price level fluctuations, supply and demand theory, and basic considerations of financial markets. For journal availability, see SO 505 703. (Author/AV)

Entities and frequency of neonatal diabetes: data from the diabetes documentation and quality management system (DPV).

PubMed

Grulich-Henn, J; Wagner, V; Thon, A; Schober, E; Marg, W; Kapellen, T M; Haberland, H; Raile, K; Ellard, S; Flanagan, S E; Hattersley, A T; Holl, R W

2010-06-01

The aim of this study was to elucidate the entities and the frequency of neonatal diabetes mellitus (NDM) in a large representative database for paediatric diabetes patients in Germany and Austria. Based on the continuous diabetes data acquisition system for prospective surveillance (DPV), which includes 51,587 patients with onset of diabetes before the age of 18 years from 299 centres in Germany and Austria, we searched for patients with onset of diabetes mellitus in the first 6 months of life. Ninety patients were identified, comprising 0.17% of all paediatric cases in the DPV registry. This represented an incidence of approximately one case in 89,000 live births in Germany. A monogenic basis for NDM was established in 30 subjects (seven UPD6, 10 KCNJ11, seven ABCC8, two FOXP3, two PDX1, one INS, one EIF2AK3). Pancreatic hypoplasia or agenesis was reported in 10 patients and seven subjects were classified as having Type 1 diabetes by their centres. Transient neonatal diabetes (TNDM) accounted for approximately 10% of all cases with NDM. No aetiology was defined in 41 subjects, which may reflect incomplete genetic testing or novel genetic aetiologies. Based on a large database, we identified a higher rate of NDM in Germany than has been reported previously. Full molecular genetic testing should be performed in all patients diagnosed before 6 months of age.

Relationships between Food Manufacturers and Retailers and Possible Implications for Training.

ERIC Educational Resources Information Center

King, Richard; Kruse, Wilfried

A pilot study examined the relationship between the retail sector and food and beverages industries and their implications for training. A range of case studies were undertaken in food manufacturing and retailing enterprises in the United Kingdom (UK) and Germany. The UK case studies examined the problems of manufacturers, both small and large,…

Follow-Up Study on Parenting with Intellectual Disability in Germany.

ERIC Educational Resources Information Center

Pixa-Kettner, Ursula

1999-01-01

Five cases of parenthood of persons with intellectual disability were reinvestigated about two years after a previous German study. Problem-centered interviews were conducted with mothers or fathers with an intellectual disability and with the caretakers. Results show developmental disability in two of six children and, in some cases,…

Outbreak of hepatitis A in two federal states of Germany: bakery products as vehicle of infection.

PubMed

Schenkel, K; Bremer, V; Grabe, C; Van Treeck, U; Schreier, E; Höhne, M; Ammon, A; Alpers, K

2006-12-01

In April 2004, increased numbers of hepatitis A were noted in six neighbouring districts in Germany. Exploratory interviews showed that patients had consumed bakery products from company X where two employees had been diagnosed with hepatitis A in February. A case-control study of consumption of products of company X was carried out through telephone interviews. Altogether, 64 cases were identified. Fifty-two cases and 112 controls aged >or=16 years were included in the case-control study. In total, 46/52 cases and 37/112 controls had consumed company X products [odds ratio (OR) 15.5, 95% confidence interval (CI) 6.1-39.7]. Of these, 36/46 cases and 16/37 controls had consumed pastries (OR 4.7, 95% CI 1.8-12.3), 25/46 cases and 12/37 controls had consumed filled doughnuts (OR 2.5, 95% CI 1.0-6.1). Sequence analysis of the VP1-2A junction region indicated 100% strain homology between cases and an infected employee of company X. We recommended reinforcement of hygiene precautions, and consideration of a prolongation of compulsory work absence after post-exposure vaccination.

Screening for infectious diseases among asylum seekers newly arrived in Germany in 2015: a systematic single-centre analysis.

PubMed

Kortas, A Z; Polenz, J; von Hayek, J; Rüdiger, S; Rottbauer, W; Storr, U; Wibmer, T

2017-12-01

During the migrant crisis in 2015, Germany was the largest single recipient of new asylum seekers in Europe. The German asylum law requires a screening examination for certain infectious diseases in asylum seekers upon arrival. The aim of this work was to analyse the rate of certain infectious diseases among asylum seekers screened at a reception centre in Southern Germany. Retrospective medical record review. Medical records of 2602 asylum seekers screened by a local public health authority in Germany in 2015 were systematically analysed. The majority of screened subjects came from Afghanistan and Syria. The mean age was 22.1 (±12.0) years. The majority of subjects were male (75.4%). Most individuals were of normal weight or overweight, more subjects were obese than underweight. A total of 78 (3.9%) individuals were infected with hepatitis B and eight (0.4%) with HIV. In 31 cases, chest radiographs suggested active tuberculosis (1.6%), which was confirmed in four cases (0.2%). The physical examination uncovered 44 (1.7%) cases of scabies, nine (0.3%) cases of lice, eight (0.3%) of upper respiratory tract infections, two (0.1%) of varicella and 13 (0.5%) of other skin infections. In the majority of subjects none of the screened infectious diseases were found. No evidence was found that the overall prevalence of certain infectious diseases screened for in the present analysis was considerably higher than in previous migration studies. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Was molar incisor hypomineralisation (MIH) present in archaeological case series?

PubMed

Kühnisch, Jan; Lauenstein, Anne; Pitchika, Vinay; McGlynn, George; Staskiewicz, Anja; Hickel, Reinhard; Grupe, Gisela

2016-12-01

With respect to the unknown aetiology of molar incisor hypomineralisation (MIH), it is unclear whether this phenomenon was overlooked in the last century as a result of a high number of caries in children or if this developmental disorder was not present until then. Therefore, this study determined the presence of MIH in historical dentitions and teeth. Dental remains from late medieval (n = 191, twelfth-sixteenth century, Regensburg, Germany), post-medieval (n = 33, sixteenth-eighteenth century, Passau, Germany) and modern age archaeological skeletal series (n = 99, nineteenth-twentieth century, Altdorf, Germany) were examined for MIH. In addition, linear enamel hypoplasia (LEH), diffuse opacities, hypoplasia and Turner's teeth were documented. MIH-related demarcated opacities or enamel breakdowns were found in only 15 (0.4 %) of the 3891 examined permanent teeth. Ten cases (3.1 %) from a total of 323 dentitions were classified as having MIH. In contrast, 98 individuals (30.3 %) showed LEH. Other enamel disorders were recorded in 64 individuals (19.8 %). With respect to the low number of affected dentitions and teeth, MIH most likely did not exist or was at least rarely present in the investigated archaeological case series. This study supports the hypothesis that MIH may be linked to contemporary living conditions or other health-related factors.

In vitro efficacy of ByeMite and Mite-Stop on developmental stages of the red chicken mite Dermanyssus gallinae.

PubMed

Abdel-Ghaffar, Fathy; Semmler, Margit; Al-Rasheid, Khaled; Mehlhorn, Heinz

2009-10-01

The present in vitro study shows the efficacy of two antimite products (ByeMite = phoxim, Mite-Stop = neem seed extract) against all developing stages of the important red chicken mite Dermanyssus gallinae (obtained at two farms in France and Germany). While permanent contact with the active compound led to an efficacy of 100% in the case of Mite-Stop on mites in both farms, there was only a 96.2% killing effect of ByeMite on the mites of the French farm. Even short contacts of only 4 s killed 100% of mites in the case of Mite-Stop at the French farm and only 84.5% in the German farm. ByeMite, on the other hand, killed only 27.8% (Germany) and 30% (France) when mites got the chance to escape from the treated grounds to untreated ones. When using only the half doses of both products, Mite-Stop(R) still reached, after permanent contact, 100% activity on the German farm and 98.2% in France, while ByeMite killed 93.8% (Germany) and 90.6% (France). Short contact to half doses of course reduced the activity of both products (Mite-Stop = 59.3% in France, 22.1% in Germany; ByeMite = 28.8% in France, 18.8% in Germany). With respect to the fumigant activity of the products, the strains of D. gallinae reacted differently. While Mite-Stop(R) showed a clear fumigant activity in the case of the German mites, this product did not affect the French mites by air distribution, neither did ByeMite in both cases. Therefore, mites have to come in contact with both products. Against Mite-Stop, there was apparently no resistance and low doses have high efficacy after even short contacts, which regularly occur in a treated stable, where mites have the chance to leave treated places to untreated hidden spots.

Surveillance of vector-borne diseases in Germany: trends and challenges in the view of disease emergence and climate change.

PubMed

Jansen, Andreas; Frank, Christina; Koch, Judith; Stark, Klaus

2008-12-01

The changing epidemiology of vector-borne diseases represents a growing threat to human health. Contemporary surveillance systems have to adapt to these changes. We describe temporal trends and geographic origins of vector-borne diseases in Germany with regard to strengths of existing disease surveillance and to areas marked for improvement. We focused on hantavirus infection (endemic in Germany), chikungunya fever (recently emerging in Europe) and dengue fever (imported from tropical regions), representing important subgroups of vector-borne infections. Routine surveillance data on demographics, origin of infection and the date of reporting were analysed. From 2001 through 2007, 3,005 symptomatic hantavirus infections, and 85 cases of chikungunya fever were reported, similarly 1,048 cases of dengue fever in 2002 through 2007. The geographic origin of hantavirus infection was reported for 95.5% of all cases (dengue virus, 98.4%; chikungunya virus, 100%). Hantavirus infections were acquired in Germany in 97.6% of cases (n = 2800). In 2007, there was a marked increase of hantavirus cases, mainly in areas known to be endemic for hantavirus. In 2006, imported cases of chikungunya fever primarily returned from several islands of the Indian Ocean, while the majority of imported cases in 2007 came from India. The reported number of dengue fever cases have increased since 2004. Thailand contributed the largest proportion of cases (17-43% in individual years), followed by India, Brazil and Indonesia. Surveillance of notifiable vector-borne diseases in Germany is able to timely detect spatial and temporal changes of autochthonous an imported infections. Geographic and temporal data obtained by routine surveillance served as a basis for public health recommendations. In addition to surveillance of vector-borne infections in humans, nationwide monitoring programs and inventory techniques for emerging and reemerging vectors and for wildlife disease are warranted.

The Forces Shaping National Response(s) to Global Educational Regulatory Initiatives: The Case for Germany and Ontario

ERIC Educational Resources Information Center

Adam, Edmund G.

2017-01-01

This article argues that the stance toward global regulatory initiatives is influenced by the extent to which these regulatory initiatives threaten the comparative institutional advantages of the national economy. The cases through which this proposition is examined are the showpieces of Germany and Ontario: their system of vocational education…

Immigration Policies in Europe: Impact on Crime -- A Case Study of Germany

DTIC Science & Technology

2008-06-01

2180188,00.html? maca =en-bulletin- 433-html. Accessed 24 Feb 2008. 51 448,000 illegal immigrants up until September 2006 without EU assistance.168 The...asylum. 168 Your Link to Germany. http://www.dw-world.de/dw/article/0,,2180188,00.html? maca =en...for a European Response to Illegal Immigration" 21 September 2006. .http://www.dw- world.de/dw/article/0,,2180188,00.html? maca =en-bulletin-433-html

NATO NEC C2 Maturity Model

DTIC Science & Technology

2010-02-01

Academy of the United Kingdom Petra Eggenhofer Germany Universität der Bundeswehr München, Germany Fred van Ettinger Ne herlands C2 Centre of Excellence...C2 Centre of Excellence Jose Martins Portugal Military Academy, Portugal Jimmie McEver USA Evidence Based Research, Inc. Allen Murashige USA HQ USAF...integrating the results from the disparate case studies undertaken to validate the N2C2M2. Ms. Petra Eggenhofer from the Universität der Bundeswehr München

Learning Chemistry and beyond with a Lesson Plan on Potato Crisps, Which Follows a Socio-Critical and Problem-Oriented Approach to Chemistry Lessons--A Case Study

ERIC Educational Resources Information Center

Marks, Ralf; Bertram, Stefanie; Eilks, Ingo

2008-01-01

This paper discusses a chemistry lesson plan on potato crisps for 10th grade (age range 15-16) chemistry classes in Germany. The lesson plan focuses on the discussion about low-fat and low-carb diets as they are presented in everyday media such as TV or newspapers in Germany. The discussion follows a socio-critical and problem-oriented approach to…

Evolution of Security Identity of Domestic Antimilitarism and Roles of Political Parties: Case Studies of Japan and Germany

DTIC Science & Technology

2009-12-01

concerned. However, the political crisis engenered by the collapse of the Yugoslav Republic shaped conditions calling for revision of the German security...to produce atomic, biological, and chemical weapons. Second, Germany admitted the U.S. military presence and bore some of the direct costs of same...voice for removing nuclear, chemical and conventional weapons of mass destruction in line with the peace movement. Similarly, it demanded greatly

The Prussian Reform Movement: A Case Study in Defense Reform

DTIC Science & Technology

1989-09-01

H ., ed., The German Mind of the 19th Century , Continuum, 1981. Goerlitz, W., History of the German General Staff...set by technology and by the political and social conditions of Prussia in the eighteenth century ."E" ’Frederick H , Miariches Testament von 1768, pp... History of Germany Since 1789. pp. 34-35, Frederick A. Praeger, 1968. "𔃽Holbom, H ., A History of Modem Germany 1648-1840, p. 393, Yale Univ. Press,

Integrating Vocational and General Education: A Rudolf Steiner School. Case Study of the Hibernia School, Herne, Federal Republic of Germany. UIE Case Studies 1.

ERIC Educational Resources Information Center

Rist, Georg; Schneider, Peter

This study describes and analyzes the Hibernia School where the aim of curriculum articulation in its essential vertical and horizontal dimensions has been successfully converted into actual practice. (Curriculum articulation means the equal representation and integration of three major components--artistic, practical, and academic learning.)…

Development and evaluation of a case group concept for inpatients with mental disorders in Germany: using self-report and expert-rated instruments.

PubMed

Andreas, Sylke; Dirmaier, Jörg; Harfst, Timo; Kawski, Stephan; Koch, Uwe; Schulz, Holger

2009-03-01

The aim of this study was to evaluate a case-mix system to classify inpatients with mental disorders in Germany by means of self-report and expert-rated instruments. The use of case-mix systems enhances the transparency of performance and cost structure and can thus improve the quality of mental health care. We analysed a consecutive sample of 1677 inpatients with mental disorders from 11 hospitals using regression tree analysis. The model assigns patients to 17 groups, accounting for 17% of the variance for duration of stay. Patients with eating disorders had a longer duration of stay than patients with anxiety disorder, duration of mental illness of less than 3-5 years, lower levels of interpersonal problems and higher occupational position. The results showed that besides diagnosis, variables such as duration of illness and interpersonal problems are important for classifying inpatients with mental disorders. The results of the study should be critically reviewed regarding the empirical results of other studies and the appropriateness of case group concepts for inpatients with mental disorders.

Job Placement Regimes in Europe: Trends and Impacts of Changes. IAB Labour Market Research Topics.

ERIC Educational Resources Information Center

Konle-Seidl, Regina; Walwei, Ulrich

Trends in job placement in Europe and the effects of advances in information and communication technologies on job placement practices were examined through case studies of France, Germany, the Netherlands, and the United Kingdom. The case studies revealed that the market shares of public employment services (PES) are generally higher than those…

Remote sensing for site characterization

USGS Publications Warehouse

Kuehn, Friedrich; King, Trude V.; Hoerig, Bernhard; Peters, Douglas C.; Kuehn, Friedrich; King, Trude V.; Hoerig, Bernhard; Peters, Douglas C.

2000-01-01

This volume, Remote Sensing for Site Characterization, describes the feasibility of aircraft- and satellite-based methods of revealing environmental-geological problems. A balanced ratio between explanations of the methodological/technical side and presentations of case studies is maintained. The comparison of case studies from North America and Germany show how the respective territorial conditions lead to distinct methodological approaches.

Economic burden of multidrug-resistant bacteria in nursing homes in Germany: a cost analysis based on empirical data.

PubMed

Huebner, Claudia; Roggelin, Marcus; Flessa, Steffen

2016-02-23

Infections and colonisations with multidrug-resistant organisms (MDROs) increasingly affect different types of healthcare facilities worldwide. So far, little is known about additional costs attributable to MDROs outside hospitals. The aim of this study was to analysis the economic burden of multidrug-resistant bacteria in nursing homes in Germany. The cost analysis is performed from a microeconomic perspective of the healthcare facilities. Study took place in six long-term care facilities in north-eastern Germany. Data of 71 residents with a positive MDRO status were included. The study analysed MDRO surveillance data from 2011 to 2013. It was supplemented by an empirical analysis to determine the burden on staff capacity and materials consumption. 11,793 days with a positive multidrug-resistant pathogen diagnosis could be included in the analysis. On average, 11.8 (SD ± 6.3) MDRO cases occurred per nursing home. Mean duration per case was 163.3 days (SD ± 97.1). The annual MDRO-related costs varied in nursing homes between €2449.72 and €153,263.74 on an average €12,682.23 per case. Main cost drivers were staff capacity (€43.95 per day and €7177.04 per case) and isolation materials (€24.70 per day and €4033.51 per case). The importance of MDROs in nursing homes could be confirmed. MDRO-related cost data in this specific healthcare sector were collected for the first time. Knowledge about the burden of MDROs will enable to assess the efficiency of hygiene intervention measures in nursing homes in the future. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Challenges dealing with depleted uranium in Germany - Reuse or disposal

DOE Office of Scientific and Technical Information (OSTI.GOV)

Moeller, Kai D.

2007-07-01

During enrichment large amounts of depleted Uranium are produced. In Germany every year 2.800 tons of depleted uranium are generated. In Germany depleted uranium is not classified as radioactive waste but a resource for further enrichment. Therefore since 1996 depleted Uranium is sent to ROSATOM in Russia. However it still has to be dealt with the second generation of depleted Uranium. To evaluate the alternative actions in case a solution has to be found in Germany, several studies have been initiated by the Federal Ministry of the Environment. The work that has been carried out evaluated various possibilities to dealmore » with depleted uranium. The international studies on this field and the situation in Germany have been analyzed. In case no further enrichment is planned the depleted uranium has to be stored. In the enrichment process UF{sub 6} is generated. It is an international consensus that for storage it should be converted to U{sub 3}O{sub 8}. The necessary technique is well established. If the depleted Uranium would have to be characterized as radioactive waste, a final disposal would become necessary. For the planned Konrad repository - a repository for non heat generating radioactive waste - the amount of Uranium is limited by the licensing authority. The existing license would not allow the final disposal of large amounts of depleted Uranium in the Konrad repository. The potential effect on the safety case has not been roughly analyzed. As a result it may be necessary to think about alternatives. Several possibilities for the use of depleted uranium in the industry have been identified. Studies indicate that the properties of Uranium would make it useful in some industrial fields. Nevertheless many practical and legal questions are open. One further option may be the use as shielding e.g. in casks for transport or disposal. Possible techniques for using depleted Uranium as shielding are the use of the metallic Uranium as well as the inclusion in concrete. Another possibility could be the use of depleted uranium for the blending of High enriched Uranium (HEU) or with Plutonium to MOX-elements. (authors)« less

World Perspective Case Descriptions on Educational Programs for Adults: Federal Republic of Germany.

ERIC Educational Resources Information Center

Bugl, Helmut; And Others

This document contains the following case studies of West German adult education projects: (1) Counseling Courses in Agriculture (Bugl, Fehrenbach-Neumann); (2) The State Center for Political Education in Baden-Wurttemberg (Schiele); (3) Catholic Educational Organization Rottweil (Muller); (4) Adult Education Center--Herrenberg (Werner); (5)…

Influence of demographic changes on the impact of vaccination against varicella and herpes zoster in Germany - a mathematical modelling study.

PubMed

Horn, Johannes; Damm, Oliver; Greiner, Wolfgang; Hengel, Hartmut; Kretzschmar, Mirjam E; Siedler, Anette; Ultsch, Bernhard; Weidemann, Felix; Wichmann, Ole; Karch, André; Mikolajczyk, Rafael T

2018-01-09

Epidemiological studies suggest that reduced exposure to varicella might lead to an increased risk for herpes zoster (HZ). Reduction of exposure to varicella is a consequence of varicella vaccination but also of demographic changes. We analyzed how the combination of vaccination programs and demographic dynamics will affect the epidemiology of varicella and HZ in Germany over the next 50 years. We used a deterministic dynamic compartmental model to assess the impact of different varicella and HZ vaccination strategies on varicella and HZ epidemiology in three demographic scenarios, namely the projected population for Germany, the projected population additionally accounting for increased immigration as observed in 2015/2016, and a stationary population. Projected demographic changes alone result in an increase of annual HZ cases by 18.3% and a decrease of varicella cases by 45.7% between 1990 and 2060. Independently of the demographic scenario, varicella vaccination reduces the cumulative number of varicella cases until 2060 by approximately 70%, but also increases HZ cases by 10%. Unlike the currently licensed live attenuated HZ vaccine, the new subunit vaccine candidate might completely counteract this effect. Relative vaccine effects were consistent across all demographic scenarios. Demographic dynamics will be a major determinant of HZ epidemiology in the next 50 years. While stationary population models are appropriate for assessing vaccination impact, models incorporating realistic population structures allow a direct comparison to surveillance data and can thus provide additional input for immunization decision-making and resource planning.

Prevention of Homicidal Violence in Schools in Germany: The Berlin Leaking Project and the Networks against School Shootings Project (NETWASS)

ERIC Educational Resources Information Center

Leuschner, Vincenz; Bondu, Rebecca; Schroer-Hippel, Miriam; Panno, Jennifer; Neumetzler, Katharina; Fisch, Sarah; Scholl, Johanna; Scheithauer, Herbert

2011-01-01

Since 1999, Germany has experienced at least twelve serious cases of targeted school violence. This article describes two projects designed to fill the gap between universal prevention and emergency response in preventing severe forms of school violence in Germany. The Berlin Leaking Project examined the viability of preventive efforts based on…

Working Women in Contemporary Germany. Roles, Attitudes, and a Handful of Success Stories.

ERIC Educational Resources Information Center

Stern, Susan

1997-01-01

In 1977, when women in West Germany (the Fedeal Republic of Germany) got the legal right to be employed outside the family against their husband's will, paragraph 1356 of the Civil Code, defining housework as the woman's duty, was abolished. Until then, heavy social pressure kept women close to home; in most cases, the choice of an outside…

The Impact of the Collapse of Communism and EU Accession on Language Education Policy and Practice in Central and Eastern Europe: Two Case-Studies Focussing on English and Russian as Foreign Languages in Hungary and Eastern Germany

ERIC Educational Resources Information Center

Bruen, Jennifer; Sheridan, Vera

2016-01-01

This paper considers the impact of geopolitical factors, and in particular the collapse of Communism and EU accession, on language education policy and practice in Central and Eastern Europe (CEE). CEE is understood here as referring to the former soviet-controlled, eastern bloc counties of Bulgaria, the Czech Republic, East Germany, Hungary,…

Market Perception of Consolidations in the European Defense Industry from 2001 to 2009 a Case of Event Studies

DTIC Science & Technology

2009-06-01

2000 by the merger of Daimler Chrysler Aerospace AG (DASA) of Germany, Aerospatiale-Matra of France and Construcciones Aeronauticas SA (CASA) of...Aerospace AG (DASA) of Germany, Aerospatiale-Matra of France and Construcciones Aeronauticas SA (CASA) of Spain. 4. History of Mergers and Merger Waves...Direction des Constructions Navales (DCN) took over the naval operations of Thales in a deal worth $714 million, while in the UK BAE Systems and Vosper

[First ciguatera outbreak in Germany in 2012].

PubMed

Friedemann, Miriam

2016-12-01

In November 2012, 23 cases of ciguatera with typical combinations of gastrointestinal and neurological symptoms occurred in Germany after consumption of imported tropical fish (Lutjanus spp.). A questionnaire was used to gather information on the disease course and fish consumption. All patients suffered from pathognomonic cold allodynia. Aside from two severe courses of illness, all other cases showed symptoms of moderate intensity. During a three-year follow-up, seven patients reported prolonged paresthesia for more than one year. Two of them reported further neuropathies over almost three years. This is the first time that long-term persistence of symptoms has been documented in detail. Outbreak cases were allocated to eight clusters in seven German cities. A further cluster was prevented by the successful recall of ciguatoxic fish. Three clusters were confirmed by the detection of ciguatoxin in samples of suspicious and recalled fish. An extrapolation on the basis of ciguatoxic samples revealed twenty prevented cases of ciguatera. Further officially unknown cases should be assumed. During the outbreak investigations, inadvertently falsely labelled fish species and fishing capture areas on import and retail level documents were observed. The ascertainment of cases and the outbreak investigations proved to be difficult due to inconsistent case reports to poisons centers, local health and veterinary authorities. In Germany, many physicians are unaware of the disease pattern of ciguatera and the risks caused by tropical fish. The occurrence of further outbreaks during the following years emphasizes the increasing significance of ciguatera in Germany.

[Bone sequestration in alpacas in Germany - A practice report with 12 cases].

PubMed

Kobera, Ralph; Wagner, Henrik

2018-04-01

Bone sequestration is relatively unknown in New-world camelids in Germany and is frequently wrongly addressed as neoplasia by veterinary practitioners. This clinical case report describes diagnosis and treatment for bone sequestration in alpacas based on 12 cases. The main symptom of the presented alpacas was moderate to severe lameness in one limb. Some of the patients had been treated with nonsteroidal anti-inflammatory drugs by the referring veterinarian. In eight alpacas, palpation of the swelling in the affected leg was painful and in five animals, exudation was observed. Radiographic imaging led to a correct diagnosis in all of the cases. Following surgical removal of the bone sequestrum, the lameness was already noticeably improved by the third postoperative day. In all patients, healing was achieved without any complications. These results show that bone sequestration in alpacas can be treated successfully by timely surgery. This is the first case report on this topic in alpacas in Germany. Schattauer GmbH.

Trends in surveillance data of human Lyme borreliosis from six federal states in eastern Germany, 2009-2012.

PubMed

Wilking, Hendrik; Stark, Klaus

2014-04-01

Lyme borreliosis (LB) is the most frequent vector-borne disease in Germany. For more than 10 years, data from mandatory notifications have been available from 6 federal states in the eastern part of Germany. A common case definition was applied. Clinical manifestations of erythema migrans, neuroborreliosis (radiculoneuritis, cranial neuritis, meningitis), and Lyme arthritis were notifiable. From 2009 to 2012, altogether 18,894 cases were notified. The overall incidence varied between 34.9 cases/100,000 inhabitants in 2009 and 19.54 cases/100,000 persons in 2012. LB in eastern Germany showed a pronounced seasonality with a peak in August. Decreasing as well as increasing trends were observed in different federal states. Females predominated among all cases (55.3%). The age distribution was bimodal with incidence peaks in children 5-9 years old (32.4 cases/100,000 persons in 2011) and in adults aged 60-69 years (56.7 cases/100,000 persons in 2011). Erythema migrans affected 95.4% of the patients and acute neuroborreliosis 3.3%. Among the latter, the most common manifestation was radiculoneuritis (n=316). Neuritis cranialis was more common in children than in adults (p<0.01). The same was true for meningitis (p<0.01). Altogether 2.0% of the LB cases developed Lyme arthritis. LB has a significant disease burden in the study area. Different levels of under-ascertainment in the surveillance system could explain parts of the differences in the incidence. Furthermore, there may be discrepancies in disease awareness among patients and physicians. Changes in time and differences among geographical regions could result from variations in risk factors related to human behaviour (e.g., outdoor activity). Additionally, vector-related risk factors may have varied (e.g., landscape, climate). Public health strategies with a particular focus on the high-incidence age groups should promote daily checks for ticks and prompt removal of ticks after exposure to avoid infection. Physicians should be able to recognize LB patients with early manifestations and promptly treat those appropriately. Copyright © 2014 Elsevier GmbH. All rights reserved.

Why Children Join and Stay in Sports Clubs: Case Studies in Australian, French and German Swimming Clubs

ERIC Educational Resources Information Center

Light, Richard L.; Harvey, Stephen; Memmert, Daniel

2013-01-01

This article builds upon research on youth sport clubs conducted from a socio-cultural perspective by reporting on a study that inquired into the reasons why children aged 9-12 joined swimming clubs in France, Germany and Australia. Comprising three case studies it employed a mixed method approach with results considered within the framework of…

One Child, Many Worlds: Early Learning in Multicultural Communities. Language and Literacy Series.

ERIC Educational Resources Information Center

Gregory, Eve, Ed.

By drawing on the experiences of children aged 3 to 8 attending schools in Britain, Germany, Iceland, Australia, and the United States, 11 case studies of young children provide insight into what it means for children to enter a new language and culture in school. The case studies are: "Learning through Difference: Cultural Practices in Early…

University ERP Implementation in Germany: Qualitative Exploratory Case Study of Administrative Staff Experiences

ERIC Educational Resources Information Center

Thelen, Anja

2015-01-01

Enterprise Resource Planning (ERP) implementations are expensive, time-consuming, and often do not lead to the expected outcome of integrated IT systems. Many German universities are implementing ERP systems as Campus Management Systems (CMS) and a solution to any problem, need, or requirement the organization has. This exploratory case study…

Exploring the effects of drastic institutional and socio-economic changes on land system dynamics in Germany between 1883 and 2007

PubMed Central

Niedertscheider, Maria; Kuemmerle, Tobias; Müller, Daniel; Erb, Karl-Heinz

2014-01-01

Long-term studies of land system change can help providing insights into the relative importance of underlying drivers of change. Here, we analyze land system change in Germany for the period 1883–2007 to trace the effect of drastic socio-economic and institutional changes on land system dynamics. Germany is an especially interesting case study due to fundamentally changing economic and institutional conditions: the two World Wars, the separation into East and West Germany, the accession to the European Union, and Germany's reunification. We employed the Human Appropriation of Net Primary Production (HANPP) framework to comprehensively study long-term land system dynamics in the context of these events. HANPP quantifies biomass harvests and land-use-related changes in ecosystem productivity. By comparing these flows to the potential productivity of ecosystems, HANPP allows to consistently assess land cover changes as well as changes in land use intensity. Our results show that biomass harvest steadily increased while productivity losses declined from 1883 to 2007, leading to a decline in HANPP from around 75%–65% of the potential productivity. At the same time, decreasing agricultural areas allowed for forest regrowth. Overall, land system change in Germany was surprisingly gradual, indicating high resilience to the drastic socio-economic and institutional shifts that occurred during the last 125 years. We found strikingly similar land system trajectories in East and West Germany during the time of separation (1945–1989), despite the contrasting institutional settings and economic paradigms. Conversely, the German reunification sparked a fundamental and rapid shift in former East Germany's land system, leading to altered levels of production, land use intensity and land use efficiency. Gradual and continuous land use intensification, a result of industrialization and economic optimization of land use, was the dominant trend throughout the observed period, apparently overruling socio-economic framework conditions and land use policies. PMID:25844027

Prevalence, Duration and Severity of Parkinson's Disease in Germany: A Combined Meta-Analysis from Literature Data and Outpatient Samples.

PubMed

Enders, Dirk; Balzer-Geldsetzer, Monika; Riedel, Oliver; Dodel, Richard; Wittchen, Hans-Ulrich; Sensken, Sven-Christian; Wolff, Björn; Reese, Jens-Peter

2017-01-01

Epidemiological data on the prevalence of Parkinson's disease (PD) in Germany are limited. The aims of this study were to estimate the age- and gender-specific prevalence of PD in Germany as well as the severity and illness duration. A systematic literature search was performed in 5 different databases. European studies were included if they reported age- and gender-specific numbers of prevalence rates of PD. Meta-analytic approaches were applied to derive age- and gender-specific pooled prevalence estimates. Data of 4 German outpatient samples were incorporated to calculate the proportion of patients with PD in Germany grouped by Hoehn and Yahr (HY) stages and disease duration. In the German population, 178,169 cases of PD were estimated (prevalence: 217.22/100,000). The estimated relative illness duration was 40% with less than 5 years, 31% with 5-9 years, and 29% with more than 9 years. The proportions for different HY stages were estimated at 13% (I), 30% (II), 35% (III), 17% (IV), and 4% (V), respectively. Key Message: We provide an up-to-date estimation of age- and gender-specific as well as severity-based prevalence figures for PD in Germany. Further community studies are needed to estimate population-based severity distributions and distributions of non-motor symptoms in PD. © 2017 S. Karger AG, Basel.

Lack of evidence for pre‐symptomatic transmission of pandemic influenza virus A(H1N1) 2009 in an outbreak among teenagers; Germany, 2009

PubMed Central

Hermes, Julia; Bernard, Helen; Buchholz, Udo; Spackova, Michaela; Löw, Johann; Loytved, Gunther; Suess, Thorsten; Hautmann, Wolfgang; Werber, Dirk

2011-01-01

Please cite this paper as: Hermes et al. (2011) Lack of evidence for pre‐symptomatic transmission of pandemic influenza virus A(H1N1) 2009 in an outbreak among teenagers; Germany, 2009. Influenza and Other Respiratory Viruses 5(6), e499–e503. Background  Observations on the role of pre‐symptomatic transmission in the spread of influenza virus are scanty. In June 2009, an outbreak of pandemic A(H1N1) 2009 infection occurred at a teenager’s party in Germany. The objective of this study was to identify risk factors for pandemic A(H1N1) 2009 infection. Methods  We performed a retrospective cohort study among party guests. A case was defined as pandemic A(H1N1) 2009 infection confirmed by rRT‐PCR who developed influenza‐like illness between 1 and 5 June 2009. Contact patterns among party guests were evaluated. Results  In eight (36%) of 27 party guests, the outcome was ascertained. A travel returnee from a country with endemic pandemic A(H1N1) 2009 who fell ill toward the end of the party was identified as the source case. Party guests with pandemic A(H1N1) 2009 infection had talked significantly longer to the source case than non‐infected persons (P‐value: 0·001). Importantly, none (0/9) of those who had left the party prior to the source case’s symptom onset became infected compared to 7 (41%) of 17 who stayed overnight (P = 0·06), and these persons all had transmission‐prone contacts to the source case. Conclusions  In this outbreak with one index case, there was no evidence to support pre‐symptomatic transmission of pandemic A(H1N1) 2009. Further evidence is required, ideally from larger studies with multiple index cases, to more accurately characterize the potential for pre‐symptomatic transmission of influenza virus. PMID:21668675

The landslide database for Germany: Closing the gap at national level

NASA Astrophysics Data System (ADS)

Damm, Bodo; Klose, Martin

2015-11-01

The Federal Republic of Germany has long been among the few European countries that lack a national landslide database. Systematic collection and inventory of landslide data still has a long research history in Germany, but one focussed on the development of databases with local or regional coverage. This has changed in recent years with the launch of a database initiative aimed at closing the data gap existing at national level. The present paper reports on this project that is based on a landslide database which evolved over the last 15 years to a database covering large parts of Germany. A strategy of systematic retrieval, extraction, and fusion of landslide data is at the heart of the methodology, providing the basis for a database with a broad potential of application. The database offers a data pool of more than 4,200 landslide data sets with over 13,000 single data files and dates back to the 12th century. All types of landslides are covered by the database, which stores not only core attributes, but also various complementary data, including data on landslide causes, impacts, and mitigation. The current database migration to PostgreSQL/PostGIS is focused on unlocking the full scientific potential of the database, while enabling data sharing and knowledge transfer via a web GIS platform. In this paper, the goals and the research strategy of the database project are highlighted at first, with a summary of best practices in database development providing perspective. Next, the focus is on key aspects of the methodology, which is followed by the results of three case studies in the German Central Uplands. The case study results exemplify database application in the analysis of landslide frequency and causes, impact statistics, and landslide susceptibility modeling. Using the example of these case studies, strengths and weaknesses of the database are discussed in detail. The paper concludes with a summary of the database project with regard to previous achievements and the strategic roadmap.

Public funding for medical research in relation to the burden of disease caused by cardiovascular diseases and neoplasms in Germany.

PubMed

Krone, Manuel; Dufner, Vera; Wagner, Martin; Gelbrich, Götz; Ertl, Georg; Heuschmann, Peter U

2018-04-13

Public funding for medical research in Germany is primarily provided by the German Research Foundation (DFG) and the Federal Ministry of Education and Research (BMBF). The aim of this study was to analyze the amount of national public funding for medical research on predominant causes of death in Germany, cardiovascular diseases and neoplasms, in relation to the burden of these diseases in Germany. Three evaluators categorized medical research projects funded by the DFG or BMBF between 2010 and 2012 into the categories "Diseases of the circulatory system" (with subgroups "Ischemic heart diseases", "Heart failure" and "Cerebrovascular diseases") and "Neoplasms". The total amount of public funding by the national agencies was analyzed in relation to the burden of disease for the respective disease condition. Information on national public funding for medical research of 2091 million euros was available; of those, 246.8 million euros (11.8%) were categorized being spent for research on "Neoplasms", 118.4 million euros (5.7%) for research on "Diseases of the circulatory system". This results in 362.08 euros per case of death, 16.58 euros per year of life lost (YLL) and 16.04 euros per disability-adjusted life year (DALY) for "Neoplasms" and in 113.44 euros per case of death, 8.05 euros per YLL and 7.17 euros per DALY for "Diseases of the circulatory system". In Germany, research on cardiovascular diseases receives a lower share of national public funding for medical research compared to oncological research. These results are comparable to other European countries.

Epidemiological and Ecological Characterization of the EHEC O104:H4 Outbreak in Hamburg, Germany, 2011

PubMed Central

Tahden, Maike; Manitz, Juliane; Baumgardt, Klaus; Fell, Gerhard; Kneib, Thomas; Hegasy, Guido

2016-01-01

In 2011, a large outbreak of entero-hemorrhagic E. coli (EHEC) and hemolytic uremic syndrome (HUS) occurred in Germany. The City of Hamburg was the first focus of the epidemic and had the highest incidences among all 16 Federal States of Germany. In this article, we present epidemiological characteristics of the Hamburg notification data. Evaluating the epicurves retrospectively, we found that the first epidemiological signal of the outbreak, which was in form of a HUS case cluster, was received by local health authorities when already 99 EHEC and 48 HUS patients had experienced their first symptoms. However, only two EHEC and seven HUS patients had been notified. Middle-aged women had the highest risk for contracting the infection in Hamburg. Furthermore, we studied timeliness of case notification in the course of the outbreak. To analyze the spatial distribution of EHEC/HUS incidences in 100 districts of Hamburg, we mapped cases' residential addresses using geographic information software. We then conducted an ecological study in order to find a statistical model identifying associations between local socio-economic factors and EHEC/HUS incidences in the epidemic. We employed a Bayesian Poisson model with covariates characterizing the Hamburg districts as well as incorporating structured and unstructured spatial effects. The Deviance Information Criterion was used for stepwise variable selection. We applied different modeling approaches by using primary data, transformed data, and preselected subsets of transformed data in order to identify socio-economic factors characterizing districts where EHEC/HUS outbreak cases had their residence. PMID:27723830

Impact of HIV knowledge and stigma on the uptake of HIV testing – Results from a community-based participatory research survey among migrants from sub-Saharan Africa in Germany

PubMed Central

Koschollek, Carmen; Santos-Hövener, Claudia; Thorlie, Adama; Müllerschön, Johanna; Mputu Tshibadi, Christina; Mayamba, Pierre; Batemona-Abeke, Helene; Amoah, Stephen; Wangare Greiner, Virginia; Dela Bursi, Taty; Bremer, Viviane

2018-01-01

Background In 2015, 3,674 new HIV diagnoses were notified in Germany; 16% of those newly diagnosed cases originated from sub-Saharan Africa (sSA). One quarter of the newly diagnosed cases among migrants from sSA (MisSA) are notified as having acquired the HIV infection in Germany. In order to reach MisSA with HIV testing opportunities, we aimed to identify which determinants influence the uptake of HIV testing among MisSA in Germany. Methods To identify those determinants, we conducted a quantitative cross-sectional survey among MisSA in Germany. The survey was designed in a participatory process that included MisSA and other stakeholders in HIV-prevention. Peer researchers recruited participants to complete standardized questionnaires on HIV knowledge and testing. We conducted multivariable analyses (MVA) to identify determinants associated with ever having attended voluntary HIV testing; and another MVA to identify determinant associated with having had the last voluntary HIV test in Germany. Results Peer researchers recruited 2,782 participants eligible for inclusion in the MVA. Of these participants, 59.9% (1,667/2,782) previously had an HIV test. For each general statement about HIV that participants knew prior to participation in the study, the odds of having been tested increased by 19% (OR 1.19; 95%-CI: 1.11–1.27). Participants reporting that HIV is a topic that is discussed in their community had 92% higher odds of having been tested for HIV (OR 1.92; 95%-CI: 1.60–2.31). Migrants living in Germany for less than a year had the lowest odds of having had their last HIV test in Germany (OR 0.17; 95%-CI: 0.11–0.27). Additionally, MisSA 18 to 25 years (OR 0.55; 95%-CI: 0.42–0.73) and participants with varied sexual partners and inconsistent condom use (OR 0.75; 95%-CI: 0.44–0.97) had significantly lower odds of having had their last HIV test in Germany. Discussion Through participatory research, we were able to show that knowledge about HIV and discussing HIV in communities increased the odds of having attended HIV testing among MisSA. However, recent migrants and young sexually active people are among the least reached by testing offers in Germany. Community-based interventions may present opportunities to reach such migrants and improve knowledge and increase discussion about HIV. PMID:29641527

[Measles in Germany: An Epidemiological Analysis and First Measures for Containment].

PubMed

Matysiak-Klose, Dorothea; Wicker, Sabine

2017-11-01

Measles are one of the most contagious diseases of mankind. Measles incidence has declined worldwide since the introduction of vaccinations. Due to low numbers of measles cases in countries with high vaccination rates the population is not aware of possible complications of measles any more. Measles elimination is an important goal set by all regions of the World Health Organization. However, it remains a challenge for Germany and other European countries. Because of a high proportion of susceptibles in specific population and age groups outbreaks take place in Germany every year after importation of the virus. More than 50 % of measles cases are 20 years and older. However, the highest incidences have been seen in two-year-olds since several years. In addition to epidemiological findings such as case numbers and risk groups, genotyping permits e. g. an assessment of the endemic circulation of viruses. Suspicion of a measles case should result in immediate and consistent measures. © Georg Thieme Verlag KG Stuttgart · New York.

Epidemiology of subacute sclerosing panencephalitis (SSPE) in Germany from 2003 to 2009: a risk estimation.

PubMed

Schönberger, Katharina; Ludwig, Maria-Sabine; Wildner, Manfred; Weissbrich, Benedikt

2013-01-01

Subacute sclerosing panencephalitis (SSPE) is a fatal long-term complication of measles infection. We performed an estimation of the total number of SSPE cases in Germany for the period 2003 to 2009 and calculated the risk of SSPE after an acute measles infection. SSPE cases were collected from the Surveillance Unit for Rare Paediatric Diseases in Germany and the Institute of Virology and Immunobiology at the University of Würzburg. The total number of SSPE cases was estimated by capture-recapture analysis. For the period 2003 to 2009, 31 children with SSPE who were treated at German hospitals were identified. The capture-recapture estimate was 39 cases (95% confidence interval: 29.2-48.0). The risk of developing SSPE for children contracting measles infection below 5 years of age was calculated as 1∶1700 to 1∶3300. This risk is in the same order of magnitude as the risk of a fatal acute measles infection.

Epidemiology of Subacute Sclerosing Panencephalitis (SSPE) in Germany from 2003 to 2009: A Risk Estimation

PubMed Central

Schönberger, Katharina; Ludwig, Maria-Sabine; Wildner, Manfred; Weissbrich, Benedikt

2013-01-01

Subacute sclerosing panencephalitis (SSPE) is a fatal long-term complication of measles infection. We performed an estimation of the total number of SSPE cases in Germany for the period 2003 to 2009 and calculated the risk of SSPE after an acute measles infection. SSPE cases were collected from the Surveillance Unit for Rare Paediatric Diseases in Germany and the Institute of Virology and Immunobiology at the University of Würzburg. The total number of SSPE cases was estimated by capture-recapture analysis. For the period 2003 to 2009, 31 children with SSPE who were treated at German hospitals were identified. The capture-recapture estimate was 39 cases (95% confidence interval: 29.2–48.0). The risk of developing SSPE for children contracting measles infection below 5 years of age was calculated as 1∶1700 to 1∶3300. This risk is in the same order of magnitude as the risk of a fatal acute measles infection. PMID:23874807

The Politics of Evidence Use in Health Policy Making in Germany-the Case of Regulating Hospital Minimum Volumes.

PubMed

Ettelt, Stefanie

2017-06-01

This article examines the role of scientific evidence in informing health policy decisions in Germany, using minimum volumes policy as a case study. It argues that scientific evidence was used strategically at various stages of the policy process both by individual corporatist actors and by the Federal Joint Committee as the regulator. Minimum volumes regulation was inspired by scientific evidence suggesting a positive relationship between service volume and patient outcomes for complex surgical interventions. Federal legislation was introduced in 2002 to delegate the selection of services and the setting of volumes to corporatist decision makers. Yet, despite being represented in the Federal Joint Committee, hospitals affected by its decisions took the Committee to court to seek legal redress and prevent policy implementation. Evidence has been key to support, and challenge, decisions about minimum volumes, including in court. The analysis of the role of scientific evidence in minimum volumes regulation in Germany highlights the dynamic relationship between evidence use and the political and institutional context of health policy making, which in this case is characterized by the legislative nature of policy making, corporatism, and the role of the judiciary in reviewing policy decisions. Copyright © 2017 by Stefanie Ettelt.

The Case for the Development of a Theoretical Framework for Defence Acquisition

DTIC Science & Technology

2014-04-30

the preliminary results of a pan-European working party of defence academics based in Sweden, Germany , and the UK. This group sought to surface the...preliminary results of a pan-European working party of defence academics based in Sweden, Germany , and the UK. This group sought to surface the...it involved a series of on-going discussions over a six month period between European academics and practitioners (drawn from France, Germany

Utilisation of rheumatology care services in Germany: the case of physical therapy and self-help groups.

PubMed

Thieme, Holm; Borgetto, Bernhard

2012-01-01

Physical Therapy (PT) and self-help groups (SHG) are important components of health care in rheumatic diseases. The utilisation of PT and SHG by patients with rheumatic diseases may be influenced by several factors. The aim of this study is to summarize the evidence on PT and SHG utilisation of patients with rheumatic diseases in Germany. We systematically searched the MEDLINE-database for studies that evaluated the utilisation and factors that possibly influence the utilisation of PT and SHG. Eight studies were found for PT-utilisation and one for SHG-utilisation. Between 25 and 59 percent of patients with rheumatic diseases received PT services. Several individual and contextual factors that may influence the utilisation could be identified. In conclusion, evidence exists for wide variations in the utilisation of PT services and an underuse of such services among patients with rheumatic diseases in Germany. By contrast, little evidence exists on the utilisation of SHG.

Incidence of sudden cardiac death in Germany: results from an emergency medical service registry in Lower Saxony

PubMed Central

Martens, Eimo; Sinner, Moritz F.; Siebermair, Johannes; Raufhake, Carsten; Beckmann, Britt M.; Veith, Stefan; Düvel, Dieter; Steinbeck, Gerhard; Kääb, Stefan

2014-01-01

Aims Sudden cardiac death (SCD) is among the most common causes of death in western countries including Germany. Whereas risk stratification and primary prevention is still insufficient, we also lack accurate incidence estimates. Current estimates vary widely (18.6–128/100 000/year), but data on SCD incidence in Germany are missing. Depending on SCD definitions, death needs to occur between 1 and 24 h after the onset of symptoms. Methods and results In the district of Aurich (190 000 inhabitants, Lower Saxony, Germany), emergency medical service (EMS) is provided by a district government operated single carrier and two hospitals. To evaluate all EMS calls in this district from 2002 to 2009, we obtained EMS protocols, medical records, and death certificates for data analysis and adjudication of SCD. We defined SCD according to the definition of the World Health Organization, considering patients with cardiac arrest within ≤1 h after the onset of symptoms. We also required cardiopulmonary resuscitation being performed by EMS personnel. The overall mortality rate in the district of Aurich (1060/100 000/year) corresponded well with the average mortality rate in Germany (1030/100 000/year). During the observation period, we adjudicated 1212 SCD cases, equivalent to an annual rate of 151 SCD cases (81 cases/100 000/year). Rates remained remarkably stable over time, and affected a considerable number of individuals of working age (32/100 000/year). Conclusion Consistent with prior reports, the SCD incidence in a district of Germany is substantial. Despite an elaborate EMS system and advanced medical care, SCD rates remain stable and necessitate improved, individualized risk stratification. PMID:25061228

Incidence of sudden cardiac death in Germany: results from an emergency medical service registry in Lower Saxony.

PubMed

Martens, Eimo; Sinner, Moritz F; Siebermair, Johannes; Raufhake, Carsten; Beckmann, Britt M; Veith, Stefan; Düvel, Dieter; Steinbeck, Gerhard; Kääb, Stefan

2014-12-01

Sudden cardiac death (SCD) is among the most common causes of death in western countries including Germany. Whereas risk stratification and primary prevention is still insufficient, we also lack accurate incidence estimates. Current estimates vary widely (18.6-128/100,000/year), but data on SCD incidence in Germany are missing. Depending on SCD definitions, death needs to occur between 1 and 24 h after the onset of symptoms. In the district of Aurich (190,000 inhabitants, Lower Saxony, Germany), emergency medical service (EMS) is provided by a district government operated single carrier and two hospitals. To evaluate all EMS calls in this district from 2002 to 2009, we obtained EMS protocols, medical records, and death certificates for data analysis and adjudication of SCD. We defined SCD according to the definition of the World Health Organization, considering patients with cardiac arrest within ≤1 h after the onset of symptoms. We also required cardiopulmonary resuscitation being performed by EMS personnel. The overall mortality rate in the district of Aurich (1060/100,000/year) corresponded well with the average mortality rate in Germany (1030/100,000/year). During the observation period, we adjudicated 1212 SCD cases, equivalent to an annual rate of 151 SCD cases (81 cases/100,000/year). Rates remained remarkably stable over time, and affected a considerable number of individuals of working age (32/100,000/year). Consistent with prior reports, the SCD incidence in a district of Germany is substantial. Despite an elaborate EMS system and advanced medical care, SCD rates remain stable and necessitate improved, individualized risk stratification. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Cardiology.

Risk Factors for Sporadic Non-Pregnancy Associated Listeriosis in Germany-Immunocompromised Patients and Frequently Consumed Ready-To-Eat Products.

PubMed

Preußel, Karina; Milde-Busch, Astrid; Schmich, Patrick; Wetzstein, Matthias; Stark, Klaus; Werber, Dirk

2015-01-01

Non-pregnancy associated (N-PA) listeriosis, caused by Listeria monocytogenes, is a rare but severe disease, and is predominantly food-borne. Most cases appear sporadic and their infection vehicle remains unknown. Incidence has increased since 2008 in Germany. We aimed to identify underlying conditions and foods associated with sporadic N-PA listeriosis in Germany. We performed a nationwide case-control study from March 2012-December 2013. Cases were sporadic N-PA listeriosis patients notified to public health. Control subjects were age (40-65 years, 66-75 years, ≥ 76 years) frequency-matched persons from a nationwide random telephone sample. A structured questionnaire collected information on underlying diseases, therapies and >60 food items. We conducted multivariable logistic regression analysis, adjusting for host factors identified by causal diagram theory, and calculated population attributable fractions. We enrolled 109 cases and 1982 controls. Cases' median age was 69 years, 55% were male, 44% received immunosuppressive therapy within 3 months prior to illness onset; a further 28% had at least one immunocompromising disease. In multivariable analysis, immunosuppressive therapy (OR 8.8, 95%CI 4.9-15.6), immunocompromising disease (OR 2.7; 95%CI 1.4-5.2), gastric acid suppression (OR 3.0; 95%CI 1.4-6.3), the consumption of cold cooked sausages (OR 2.6; 95%CI 1.6-4.4), the preferred consumption of packaged cheese (OR 2.1; 95%CI 1.3-3.5) and pre-sliced cheese (OR 2.2; 95%CI 1.3-3.7) were significantly associated with N-PA listeriosis. These foods accounted for 59% of all cases. Typical high risk foods, e.g. cold seafood, certain types of cheeses, tended to be negatively associated with disease. In conclusion, immunosuppressive therapy and frequently consumed ready-to-eat foods are the main risk factors for sporadic N-PA listeriosis in Germany. To reduce their risk, immunocompromised persons should consume the identified foods well before the 'use-by' date. The microbiological criteria for Listeria monocytogenes in ready-to-eat foods may insufficiently protect persons who are markedly immunocompromised.

Lung cancer risk in male workers occupationally exposed to diesel motor emissions in Germany.

PubMed

Brüske-Hohlfeld, I; Möhner, M; Ahrens, W; Pohlabeln, H; Heinrich, J; Kreuzer, M; Jöckel, K H; Wichmann, H E

1999-10-01

Although in several epidemiological studies exposure to diesel motor emissions (DME) shows an elevated lung cancer risk, it is still controversial whether DME is a human carcinogen. In a pooled analysis of two case-control studies on lung cancer in Germany a total of 3498 male cases with histologically or cytologically ascertained lung cancer and 3541 male population controls were included. Information about lifelong occupational and smoking history was obtained by questionnaire. Drivers of lorries, buses, taxies, diesel locomotives and forklift trucks, bulldozers, graders, excavators, and tractors, were considered as exposed to DME and their cumulative exposure was estimated. All odds ratios were adjusted for smoking and asbestos exposure. The evaluation of lung cancer risk for all jobs with DME-exposure combined showed an odds ratio of OR=1.43 (95%-CI: 1.23-1.67). Most pronounced was the increase in lung cancer risk in heavy equipment operators (OR=2. 31 95%-CI: 1.44-3.70). The risk of tractor drivers increased with length of employment and reached statistical significance for exposures longer than 30 years (OR=6.81, 95%-CI: 1.17-39.51). The group of professional drivers (e.g., trucks, buses, and taxies), showed an increased risk only in West Germany (OR=1.44, 95%-CI: 1. 18-1.76), but not in East Germany (OR=0.83, 95%-CI: 0.60-1.14). DME-exposure in other traffic related jobs (e.g., diesel engine locomotive drivers, switchmen, forklift operators) was associated with an odds ratio of OR=1.53 (95%-CI: 1.04-2.24). The study provides further evidence that occupational exposure to diesel motor emissions is associated with an increased lung cancer risk. Copyright 1999 Wiley-Liss, Inc.

The definition and role of quality of life in Germany's early assessment of drug benefit: a qualitative approach.

PubMed

Lohrberg, David; Augustin, Matthias; Blome, Christine

2016-02-01

In 2011, Germany introduced a new form of drug benefit assessment, linking reimbursement prices to drug benefit and making quality of life (QoL) one of the main benefit criteria. Thus, QoL outcomes co-determine drug prices in Germany. QoL has, however, not been defined in the regulations. This study analyzed the definition and role of QoL in Germany's drug benefit assessment. It serves as a case study on the complexity of QoL as a parameter of health technology and drug assessments, which have become mandatory in almost all industrialized countries. In a qualitative analysis, the publicly available dossiers (summaries), dossier evaluations, protocols of the oral hearings, the final resolutions of the Federal Joint Committee (G-BA) and its rationale of all benefit assessments completed by 2013 (n = 66) were processed. Additionally, quantitative data on the decision outcomes were collected. Only two decisions drew on QoL outcomes as "main justifications" for additional benefit. It was due to a lack of valid and statistically significant QoL results, a deficient presentation of QoL data, or differing understandings of QoL, that QoL benefit was not demonstrated in more than two cases. While manufacturers applied wider definitions of QoL, the assessment institutions questioned evidence if it was not reported with the help of validated QoL questionnaires or deviated from their definition of QoL. The German experience with QoL as a drug benefit criterion highlights the importance of a clear QoL definition and according methodological regulations.

International Federation of Library Associations Annual Conference. Papers of the Special Libraries Division: Geographical and Map, Science and Technology and Social Science Libraries Sections (47th, Leipzig, East Germany, August 17-22, 1981).

ERIC Educational Resources Information Center

Sprudzs, Adolf; And Others

This set of eight papers includes papers presented by participants from the United States, France, East Germany, the United Kingdom, West Germany, and the USSR: "Problems with Sources of Information in International Law and Relations: The Case of the World-Wide Treaty Jungle," by Adolf Sprudzs; "French Map Libraries and National and…

Hantavirus cardiopulmonary syndrome due to Puumala virus in Germany.

PubMed

Vollmar, Patrick; Lubnow, Matthias; Simon, Michaela; Müller, Thomas; Bergler, Tobias; Alois, Philipp; Thoma, Bryan R; Essbauer, Sandra

2016-11-01

In Germany Puumala virus (PUUV), known to cause mild forms of hemorrhagic fever with renal syndrome (HFRS), is the predominating endemic hantavirus. We herein describe an unusually severe case of a PUUV infection that occurred in summer 2015 in South Eastern Germany in a region known to be endemic for PUUV since over ten years. A 54-year-old female gardener was admitted to hospital with fever, cough and dyspnea. Within 48hours the patient developed a rapid progressive adult respiratory distress syndrome (ARDS) with circulatory failure and required ECMO (extracorporeal membrane oxygenation) treatment. Serological and molecular biological examinations of serum samples confirmed an infection with PUUV. Partial sequences of the S- and M-segment clustered to a strain previously described in South Eastern Germany. Our reported case highlights, that in rare incidents PUUV can cause hantavirus cardiopulmonary syndrome, a syndrome that is usually found after infections with New World hantaviruses, and neurological symptoms. Copyright © 2016 Elsevier B.V. All rights reserved.

Estimation of the incidence of genital warts and the cost of illness in Germany: A cross-sectional study

PubMed Central

Hillemanns, Peter; Breugelmans, J Gabrielle; Gieseking, Friederike; Bénard, Stève; Lamure, Emilie; Littlewood, Kavi J; Petry, Karl U

2008-01-01

Background Human papillomavirus (HPV) is a necessary cause of cervical cancer. HPV is also responsible for benign condylomata acuminata, also known as genital warts. We assessed the incidence of genital warts in Germany and collected information on their management to estimate the annual cost of disease. Methods This was a multi-centre observational (cross-sectional) study of genital warts in Germany. Data were collected from gynecologists, dermatologists, and urologists seeing patients with genital warts between February and April 2005. The number of patients with new and recurrent genital warts was used to estimate the incidence in Germany. We assessed resource use for patients with genital warts seen during a two-month period as well as retrospective resource use twelve months prior to the inclusion visit through a chart review. The mean costs of treatment of patients with genital warts from third-party payer and societal perspectives were estimated, and the total annual cost of genital warts was then calculated. Results For the incidence calculation 217 specialists provided information on 848 patients and 214 specialists provided resource use data for 617 patients to assess resource consumption. The incidence of new and recurrent cases of genital warts was 113.7 and 34.7 per 100 000, respectively, for women aged 14–65 years consulting gynecologists. The highest incidence was observed in women aged 14–25 years (171.0 per 100 000) for new cases and in women aged 26–45 years (53.1 per 100 000) for recurrent cases. The sample size for males was too small to allow a meaningful estimate of the incidence. The mean direct cost per patient with new genital warts was estimated at 378 euros (95% CI: 310.8–444.9); for recurrent genital warts at 603 euros (95% CI: 436.5–814.5), and for resistant genital warts at 1,142 euros (95% CI: 639.6–1752.3). The overall cost to third-party payers was estimated at 49.0 million euros, and the total societal cost at 54.1 million euros, corresponding to an average cost per patient of 550 euros and 607 euros, respectively. Conclusion The societal burden and costs of managing and treating genital warts in Germany are considerable. A vaccination programme using the quadrivalent human papillomavirus vaccine could provide a substantial health benefit and reduce the costs associated with genital warts in Germany. PMID:18518976

[Travel times of patients to ambulatory care physicians in Germany].

PubMed

Schang, Laura; Kopetsch, Thomas; Sundmacher, Leonie

2017-12-01

The time needed by patients to get to a doctor's office represents an important indicator of realised access to care. In Germany, findings on travel times are only available from surveys or for some regions. For the first time, this study examines nationwide and physician group-specific travel times in the ambulatory care sector in Germany and describes demographic, supply-side and spatial determinants of variations. Using a full review of patient consultations in the statutory health insurance system from 2009/2010 for 14 physician groups (approximately 518 million cases), case-related travel times by car between patients' places of residence and physician's practices were estimated at the municipal level. Physicians were reached in less than 30 min in 90.8% of cases for primary care physicians and up to 63% of cases for radiologists. Patients between 18 and under 30 years of age travel longer to get to the doctor than other age groups. The average travel time at the county level systematically differs between urban and rural planning areas. In the case of gynecologists, dermatologists and ophthalmologists, the average journey time decreases with increasing physician density at the county level, but remains approximately constant from a recognisable point of inflection. There is no association between primary care physician density and travel time at the district level. Spatial analyses show physician group-specific patterns of regional concentrations with an increased proportion of cases with very long travel times. Patients' travel times are influenced by supply- and demand-side determinants. Interactions between influential determinants should be analysed in depth to examine the extent to which the time travelled is an expression of regional under- or over-supply rather than an expression of patient preferences.

Risk of Guillain–Barré syndrome following pandemic influenza A(H1N1) 2009 vaccination in Germany†

PubMed Central

Prestel, Jürgen; Volkers, Peter; Mentzer, Dirk; Lehmann, Helmar C; Hartung, Hans-Peter; Keller-Stanislawski, Brigitte

2014-01-01

Purpose A prospective, epidemiologic study was conducted to assess whether the 2009 pandemic influenza A(H1N1) vaccination in Germany almost exclusively using an AS03-adjuvanted vaccine (Pandemrix) impacts the risk of Guillain–Barré syndrome (GBS) and its variant Fisher syndrome (FS). Methods Potential cases of GBS/FS were reported by 351 participating hospitals throughout Germany. The self-controlled case series methodology was applied to all GBS/FS cases fulfilling the Brighton Collaboration (BC) case definition (levels 1–3 of diagnostic certainty) with symptom onset between 1 November 2009 and 30 September 2010 reported until end of December 2010. Results Out of 676 GBS/FS reports, in 30 cases, GBS/FS (BC levels 1–3) occurred within 150 days following influenza A(H1N1) vaccination. The relative incidence of GBS/FS within the primary risk period (days 5–42 post-vaccination) compared with the control period (days 43–150 post-vaccination) was 4.65 (95%CI [2.17, 9.98]). Similar results were found when stratifying for infections within 3 weeks prior to onset of GBS/FS and when excluding cases with additional seasonal influenza vaccination. The overall result of temporally adjusted analyses supported the primary finding of an increased relative incidence of GBS/FS following influenza A(H1N1) vaccination. Conclusions The results indicate an increased risk of GBS/FS in temporal association with pandemic influenza A(H1N1) vaccination in Germany. © 2014 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons, Ltd. PMID:24817531

Influenza A(H1N1)v in Germany: the first 10,000 cases.

PubMed

Gilsdorf, Andreas; Poggensee, Gabriele

2009-08-27

The analysis of the first 10,000 cases of influenza A(H1N1)v in Germany confirms findings from other sources that the virus is currently mainly causing mild diseases, affecting mostly adolescents and young adults. Overall hospitalisation rate for influenza A(H1N1)v was low (7%). Only 3% of the cases had underlying conditions and pneumonia was rare (0.4%). Both reporting and testing requirements have been adapted recently, taking into consideration the additional information available on influenza A(H1N1)v infections.

Comparison of Expert-Based and Empirical Evaluation Methodologies in the Case of a CBL Environment: The ''Orestis'' Experience

ERIC Educational Resources Information Center

Karoulis, Athanasis; Demetriadis, Stavros; Pombortsis, Andreas

2006-01-01

This paper compares several interface evaluation methods applied in the case of a computer based learning (CBL) environment, during a longitudinal study performed in three European countries, Greece, Germany, and Holland, and within the framework of an EC funded Leonardo da Vinci program. The paper firstly considers the particularities of the CBL…

Cancer patterns among children of Turkish descent in Germany: A study at the German Childhood Cancer Registry

PubMed Central

Spallek, Jacob; Spix, Claudia; Zeeb, Hajo; Kaatsch, Peter; Razum, Oliver

2008-01-01

Background Cancer risks of migrants might differ from risks of the indigenous population due to differences in socioeconomic status, life style, or genetic factors. The aim of this study was to investigate cancer patterns among children of Turkish descent in Germany. Methods We identified cases with Turkish names (as a proxy of Turkish descent) among the 37,259 cases of childhood cancer registered in the German Childhood Cancer Registry (GCCR) during 1980–2005. As it is not possible to obtain reference population data for children of Turkish descent, the distribution of cancer diagnoses was compared between cases of Turkish descent and all remaining (mainly German) cases in the registry, using proportional cancer incidence ratios (PCIRs). Results The overall distribution of cancer diagnoses was similar in the two groups. The PCIRs in three diagnosis groups were increased for cases of Turkish descent: acute non-lymphocytic leukaemia (PCIR 1.23; CI (95%) 1.02–1.47), Hodgkin's disease (1.34; 1.13–1.59) and Non-Hodgkin/Burkitt lymphoma (1.19; 1.02–1.39). Age, sex, and period of diagnosis showed no influence on the distribution of diagnoses. Conclusion No major differences were found in cancer patterns among cases of Turkish descent compared to all other cases in the GCCR. Slightly higher proportions of systemic malignant diseases indicate that analytical studies involving migrants may help investigating the causes of such cancers. PMID:18462495

Strategies for Adult Education. Practices in Western Europe.

ERIC Educational Resources Information Center

Titmus, Colin

European case studies on strategies for adult education are presented as representative or exemplary approaches to universal access. Each is described within a historical and social context: the British Community Colleges and the Open University; the Swedish Study Circles; the Evening Folk High School in Germany; the social-cultural animation…

[Medico-legal autopsies in Berlin from 1999 to 2003].

PubMed

Schmeling, Andreas; Geserick, Gunther; Wirth, Ingo

2009-01-01

This paper presents statistical data on medico-legal autopsies at the three Berlin institutes from 1999 to 2003. With an autopsy frequency of 6.5% in 1999, Berlin was ranking at the top in Germany. The relatively high autopsy rate--compared to other German institutes--led to a higher share of women, a higher mean age of the examined bodies and a higher percentage of cases of natural death. In accordance with studies from other major cities, there were more cases with an unknown cause of death and a higher number of drug victims than in rural areas. The negative consequences of a far too low autopsy rate in Germany regarding legal certainty, the quality of medical care and the validity of the statistics of causes of death are discussed in connection with possible measures to increase the frequency of autopsies.

A Blend of Romanism and Germanism: Experimental Science Instruction in Belgian State Secondary Education, 1880-1914

NASA Astrophysics Data System (ADS)

Onghena, Sofie

2013-04-01

A case study of secondary experimental science instruction in Belgium demonstrates the importance of cross-national communication in the study of science education. Belgian secondary science education in the years 1880-1914 had a clear internationalist dimension. French and German influences turn out to have been essential, stimulated by the fact that Belgium, as a result of its geographical position, considered itself as the centre of scientific relations between France and Germany, and as actually strengthened by its linguistic and cultural dualism in this regard. This pursuit of internationalist nationalism also affected the configuration of chemistry and physics as experimental courses at Belgian Royal State Schools, although the years preceding WWI are usually characterized as a period of rising nationalism in science, with countries such as Germany and France as prominent actors. To what extent did France and Germany influence Belgian debates on science education, science teachers' training, the use of textbooks, and the instalment of school laboratories and teaching collections?

Incidence of invasive pneumococcal disease in 5-15 year old children with and without comorbidities in Germany after the introduction of PCV13: Implications for vaccinating children with comorbidities.

PubMed

Weinberger, Raphael; Falkenhorst, Gerhard; Bogdan, Christian; van der Linden, Mark; Imöhl, Matthias; von Kries, Rüdiger

2015-11-27

To describe the burden of suffering from IPD in children aged 5-15 years with and without comorbidities up to 5 years after the introduction of PCV13 in Germany and to identify the potential benefit for PCV13 and PPV23 vaccination. The surveillance of IPD for children <16 years was based on two independently reporting sources: active surveillance in pediatric hospitals and a laboratory-based sentinel surveillance system. IPD with cultural detection of pneumococci at a physiologically sterile site in children from 2010 to 2014 in Germany. Incidence was estimated by capture-recapture analysis with stratification by absence/presence of comorbidities. Coverage of the observed serotypes by different vaccines was assessed. 142 (Capture recapture-corrected: 437) cases were reported: 72.5% were healthy children and 27.5% had a comorbidity. The incidence of IPD related to children with comorbidities was 0.2 per 100,000. One third of these cases had serotypes not included in either vaccine. The remaining cases might benefit from pneumococcal vaccination but one third of all cases was not vaccinated. The additional potential benefit of PPV23 compared to PCV13 with respect to coverage was 10%. The incidence of IPD in children with comorbidities in Germany is low. Pneumococcal vaccination uptake in children with comorbidities should be increased, although only about two-thirds of the cases might be preventable by presently available vaccines. Copyright © 2015 Elsevier Ltd. All rights reserved.

Epidemiology of trichinellosis in Germany, 1996-2006.

PubMed

Jansen, Andreas; Schöneberg, Irene; Stark, Klaus; Nöckler, Karsten

2008-04-01

The epidemiology of trichinellosis in Germany was investigated by analyzing national surveillance data from 1996-2006. During this period, 95 laboratory-confirmed infections and 12 outbreaks were reported. The highest mean annual incidence was found in immigrants from southeast European countries (0.3 cases/100,000 vs. 0.01 cases/100,000 in the German population) with an incidence rate ratio of 26.0 (95% confidence interval 11.6-51.8). The predominant clinical symptom was muscle pain in 79 patients (83%). Mean diagnostic delay was 49 days. Among patients with reported source of infection (85%; n = 81), the consumption of pork (mostly originating from endemic countries) represented the most frequent exposure (93%; n = 75). In addition, trichinellosis cases were associated with both indigenous (n = 1) and imported (n = 5) wild boar meat. Although domestic pigs in Germany are practically free from Trichinella spp., the parasite was found in German wild animals such as wild boars, foxes, and racoon dogs. We conclude that trichinellosis still remains a public health issue in Germany, especially among individuals with a migrational background. Immigrants from endemic countries need to be educated about the risks of consuming raw or inadequately cooked pork and wild boar products from their homeland. In addition, German healthcare providers need to be aware of trichinellosis, especially in areas with a large immigrant population.

Outbreak of Salmonella Goldcoast infections linked to consumption of fermented sausage, Germany 2001.

PubMed Central

Bremer, V.; Leitmeyer, K.; Jensen, E.; Metzel, U.; Meczulat, H.; Weise, E.; Werber, D.; Tschaepe, H.; Kreienbrock, L.; Glaser, S.; Ammon, A.

2004-01-01

Salmonella Goldcoast (SGC), an uncommon serotype in Germany, was identified in 25 isolates between 1 April and 7 May 2001. To determine the cause of the outbreak, we conducted a matched case-control study including 24 cases and 51 controls. In a multivariable regression model, only consumption of a raw fermented sausage manufactured by a local company remained significant (adjusted odds ratio 20.0, 95 % confidence interval 2.7-302.5). SGC isolated from case-patients shared an indistinguishable pulsed-field gel electrophoresis pattern. A part of the produced raw fermented sausage was sold after only 4 days of fermentation. Samples from the premises and products of the company were negative for SGC. However, short-time raw fermented sausage is more likely to contain pathogens. Irradiation of raw ingredients is not accepted by German consumers, thus strict adherence to good manufacturing practices, the use of HACCP programmes as well as on-farm programmes remain crucial to reduce Salmonella. PMID:15473151

Outbreak of Salmonella Goldcoast infections linked to consumption of fermented sausage, Germany 2001.

PubMed

Bremer, V; Leitmeyer, K; Jensen, E; Metzel, U; Meczulat, H; Weise, E; Werber, D; Tschaepe, H; Kreienbrock, L; Glaser, S; Ammon, A

2004-10-01

Salmonella Goldcoast (SGC), an uncommon serotype in Germany, was identified in 25 isolates between 1 April and 7 May 2001. To determine the cause of the outbreak, we conducted a matched case-control study including 24 cases and 51 controls. In a multivariable regression model, only consumption of a raw fermented sausage manufactured by a local company remained significant (adjusted odds ratio 20.0, 95 % confidence interval 2.7-302.5). SGC isolated from case-patients shared an indistinguishable pulsed-field gel electrophoresis pattern. A part of the produced raw fermented sausage was sold after only 4 days of fermentation. Samples from the premises and products of the company were negative for SGC. However, short-time raw fermented sausage is more likely to contain pathogens. Irradiation of raw ingredients is not accepted by German consumers, thus strict adherence to good manufacturing practices, the use of HACCP programmes as well as on-farm programmes remain crucial to reduce Salmonella.

Efficacy and safety of the remOVE System for OTSC® and FTRD® clip removal: data from a PMCF analysis.

PubMed

Caputo, Antonio; Schmidt, Arthur; Caca, Karel; Bauerfeind, Peter; Schostek, Sebastian; Ho, Chi-Nghia; Gottwald, Thomas; Schurr, Marc O

2018-06-01

The remOVE System (Ovesco Endoscopy AG, Tuebingen, Germany) is a medical device for the endoscopic removal of OTSC or FTRD clips (Ovesco Endoscopy AG, Tuebingen, Germany). The aim of this paper is to assess the efficacy and safety of this system. A total of 74 patients underwent clip extraction. The standard removal procedure comprises fragmenting the clip by applying an electrical direct current pulse at two opposing sides of the clip. Clip fragmentation was successful in 72 of 74 patients (97.3%). In two cases (2.7%) clip fragmentation was not possible. In nine cases (12.2%) a clip fragment could not be removed and was left in place. Complications occurred in three cases (4.1%): two minor bleedings near the clip removal site (2.7%), and one superficial mucosal tear resulting from clip fragment extraction (1.4%). Based on this study, the use of the remOVE System for OTSC or FTRD clip removal can be considered safe and effective.

[Integrated delivery systems in California--success and failure determining factors for the first 10 years and impetus for Germany].

PubMed

Janus, K; Amelung, V E

2004-10-01

Since the coming into effect of the Health Care Modernization Act (Gesundheitsmodernisierungsgesetz) the conditions for integrated health care delivery are favourable in Germany. However, comprehensive approaches are a long time in coming. In contrast, integrated health care delivery as an integral part of the spreading of managed care entered a further stage of development, which enables health care decision makers to draw conclusions regarding the further development of integrated health care delivery in Germany. Based on case studies integrated delivery systems in the San Francisco Bay Area have been analyzed with the objective to evaluate pitfalls and successful strategies for integrated health care delivery. The major pitfalls refer to an insufficient local focus, a lack of actual integration and the application of per capita reimbursement (which is a key subject on the political agenda in Germany as well) within integrated delivery systems. On the contrary, successful strategies include achieving a dynamic tension between centralized and decentralized coordination, internal and external relationship management, well organised human resource management including a well-defined corporate policy and a comprehensive implementation of information technology. Based on US experiences with integrated delivery systems implications for the design of integrated health care delivery in Germany are discussed.

Doctors in Court, Honour, and Professional Ethics: Two Scandals in Imperial Germany*

PubMed Central

Maehle, Andreas-Holger

2013-01-01

Summary Comparing two public medical affairs which involved disciplinary proceedings and libel actions, one from Bavaria and one from Prussia, this article analyzes the dynamics behind legal conflicts over doctors’ professional ethics in Imperial Germany. In both the case of Dr Maurice Hutzler, who committed suicide after conflicts with senior colleagues at the Gisela Children’s Hospital and a sentence of the court of honour of the Munich Medical District Society, and the Berlin ‘patient trade’ affair, in which the medical professors Ernst von Leyden, Hermann Senator, Karl Anton Ewald and Carl Posner were accused of having made payments to middlemen for bringing them lucrative private patients, notions of personal and professional honour played a central role. The Munich case highlighted shortcomings of the Bavarian medical court of honour system, which was less developed than its Prussian counterpart. The analysis of the two cases suggests that the ethics of medical practice in early twentieth-century Germany should be viewed as part of a culture of honour. PMID:22303773

Persistence with Antihypertensive Drugs in Patients with Hypertension and Dementia in Germany.

PubMed

Jacob, Louis; Adam-Schnepf, Leonie; Kostev, Karel

2017-01-01

Hypertension, a chronic disease resulting from aging and its related physiopathological dysregulations, is often associated with dementia. The goal was to analyze the persistence with antihypertensive drugs in patients affected by both hypertension and dementia in Germany. This study included hypertension patients who were initially treated with antihypertensive drugs in 1,262 general practices in Germany between January 2013 and December 2015 (index date). Patients with hypertension and comorbid dementia were matched (1 : 1) to patients without dementia by age, gender, type of residence (nursing home versus home-care setting), physician, and initial antihypertensive therapy, using a propensity score method. The primary outcome was the rate of patients without treatment discontinuation with antihypertensive drugs in cases and controls in the 12 months following the index date. Cox regressions were used to determine the impact of dementia on persistence with antihypertensive treatment. This study included 2,191 patients with hypertension and comorbid dementia and 2,191 patients with hypertension but without dementia. The mean age was 79.3 years (SD = 10.3 years) in both groups. Twelve months after initiation of antihypertensive therapy, 73.5% of cases and 69.5% of controls were persistent (p < 0.001). Dementia was associated with a significant decrease in the risk of non-persistence with antihypertensive drugs in the entire population (HR = 0.86, 95% CI: 0.79-0.93). This finding was corroborated in five different subgroups (age ≤60 years, age 61-70 years, men, women, and patients living in home-care settings). Dementia was found to be a protective factor for persistence with antihypertensive drugs in Germany.

Analysis of Landslide Hazard Impact Using the Landslide Database for Germany

NASA Astrophysics Data System (ADS)

Klose, M.; Damm, B.

2014-12-01

The Federal Republic of Germany has long been among the few European countries that lack a national landslide database. Systematic collection and inventory of landslide data still shows a comprehensive research history in Germany, but only one focused on development of databases with local or regional coverage. This has changed in recent years with the launch of a database initiative aimed at closing the data gap existing at national level. The present contribution reports on this project that is based on a landslide database which evolved over the last 15 years to a database covering large parts of Germany. A strategy of systematic retrieval, extraction, and fusion of landslide data is at the heart of the methodology, providing the basis for a database with a broad potential of application. The database offers a data pool of more than 4,200 landslide data sets with over 13,000 single data files and dates back to 12th century. All types of landslides are covered by the database, which stores not only core attributes, but also various complementary data, including data on landslide causes, impacts, and mitigation. The current database migration to PostgreSQL/PostGIS is focused on unlocking the full scientific potential of the database, while enabling data sharing and knowledge transfer via a web GIS platform. In this contribution, the goals and the research strategy of the database project are highlighted at first, with a summary of best practices in database development providing perspective. Next, the focus is on key aspects of the methodology, which is followed by the results of different case studies in the German Central Uplands. The case study results exemplify database application in analysis of vulnerability to landslides, impact statistics, and hazard or cost modeling.

[Pathology of South American Camelids: a retrospective study of necropsies at the Institute of Veterinary Pathology, University of Leipzig, Germany].

PubMed

Theuß, T; Goerigk, D; Rasenberger, S; Starke, A; Schoon, H-A

2014-01-01

The number of South American Camelids (New World Camelids) housed in Germany has increased in the recent years. While these species were formerly kept solely in zoological gardens, ever more private and commercial livestock is being established. Compared to indigenous livestock animals, they bear some distinctive differences, particularly in terms of digestive tract anatomy and physiology. Therefore, it is of considerable interest for veterinarians working with South American Camelids to obtain knowledge about the distinguishing features of these animals and the typical diseases affecting them in Germany. For this purpose, the necropsy reports, including the anamnestic data, and their diagnostic usefulness, from 1995 to 2012 were studied retrospectively. Du- ring this period, a total of 233 New World Camelids were examined (195 alpacas and 38 llamas). Anamnestic data of diagnostic usefulness regarding the cause of disease were only submitted in a limited number of cases, because most of the animals died without specific symptoms. The following were the most frequent pathological findings: enteritis (n = 91), gastritis (n = 76), cachexia (n = 73), pneumonia (n = 30), stomatitis (n = 27), azotaemia (n = 22) and anaemia (n = 9). An endoparasitosis occurred in 107 cases and was considered the predominant cause of enteritis. As with indigenous ruminants, llamas and alpacas primarily suffered from diseases of the digestive and respiratory tracts. Other organ systems were affected to a lesser extent. Even in cases with severe alterations in the affected organs, South American Camelids do not show or show too late diagnostically indicative clinical symptoms. Therefore, a detailed clinical examination of these animals is important.

Continuing Medical Education and Professional Revalidation in Europe: Five Case Examples

ERIC Educational Resources Information Center

Maisonneuve, Herve; Matillon, Yves; Negri, Alfonso; Pallares, Luis; Vigneri, Ricardo; Young, Howard L.

2009-01-01

Introduction: Since reliable information is scarce to describe continuing medical education (CME) and revalidation in Europe, we carried out a survey in 5 selected countries (France, Germany, Italy, Spain, and the United Kingdom). Methods: A tested questionnaire was sent to 2 experts per country (except in Germany), during August-September 2004.…

Green energy products in the United Kingdom, Germany and Finland

NASA Astrophysics Data System (ADS)

Hast, Aira; McDermott, Liisa; Järvelä, Marja; Syri, Sanna

2014-12-01

In liberalized electricity markets, suppliers are offering several kinds of voluntary green electricity products marketed as environmentally friendly. This paper focuses on the development of these voluntary markets at household level in the UK, Germany and Finland. Since there are already existing renewable energy policies regulating and encouraging the use of renewable energy, it is important to consider whether voluntary products offer real additional benefits above these policies. Problems such as double counting or re-marketing hydropower produced in existing plants are identified. According to our study, the demand varies between countries: in Germany the number of green electricity customers has increased and is also higher than in the UK or Finland. Typically the average additional cost to consumer from buying green electricity product instead of standard electricity product is in the range of 0-5% in all studied countries, although the level of price premium depends on several factors like electricity consumption. Case study of Finland and literature show that the impacts of green energy are not solely environmental. Renewable energy can benefit local public policy.

School Enterprises: Combining Vocational Learning with Production. International Project on Technical and Vocational Education (UNEVOC).

ERIC Educational Resources Information Center

Singh, Madhu

Trends in combining learning and production were examined through case studies of school enterprises in 11 countries: China, India, Indonesia, Papua New Guinea, Germany, Botswana, Kenya, Ghana, Algeria, Cuba, and Costa Rica. The study focused on the following: types and structures of school enterprises; organization of learning; competency…

Six Weeks in the Eifel: A Case for Culture Learning during Short-Term Study Abroad

ERIC Educational Resources Information Center

Brubaker, Cate

2007-01-01

Based on findings from a recent study investigating how a group of undergraduate students defined, experienced, and perceived self-identified cultural encounters during a five-week stay in Mayen, Germany, this article suggests that short-term language and culture study abroad programs are fertile venues for exploring culture learning. After…

Immigration and the modern welfare state: the case of USA and Germany.

PubMed

Wenzel, U; Bos, M

1997-10-01

"This article presents a comparison of the inclusion of migrants into welfare programmes in the USA and in Germany. In the first part of the article a brief overview is provided of immigration categories in both countries in order to demonstrate the relevance of these administrative regulations for the opportunities of individual migrants to participate in the welfare system. In the second part we elaborate in more detail on how welfare programmes have developed as basic mechanisms to include or exclude migrants. Our findings illustrate an increasing differentiation of membership statuses parallel to the expansion of modern welfare systems. In both the USA and Germany, the territorial principle and participation in the labour market are of prime importance to the access to social rights. In both cases all migrants may profit from contributory programmes." excerpt

Find and treat or find and lose? Tuberculosis treatment outcomes among screened newly arrived asylum seekers in Germany 2002 to 2014.

PubMed

Kuehne, Anna; Hauer, Barbara; Brodhun, Bonita; Haas, Walter; Fiebig, Lena

2018-03-01

BackgroundGermany has a low tuberculosis (TB) incidence. A relevant and increasing proportion of TB cases is diagnosed among asylum seekers upon screening. Aim: We aimed to assess whether cases identified by screening asylum seekers had equally successful and completely reported treatment outcomes as cases diagnosed by passive case finding and contact tracing in the general population. Methods: We analysed characteristics and treatment outcomes of pulmonary TB cases notified in Germany between 2002 and 2014, stratified by mode of case finding. We performed three multivariable analyses with different dependent variables: Model A: successful vs all other outcomes, Model B: successful vs documented non-successful clinical outcome and Model C: known outcome vs lost to follow-up. Results: TB treatment success was highest among cases identified by contact tracing (87%; 3,139/3,591), followed by passive case finding (74%; 28,804/39,019) and by screening asylum seekers (60%; 884/1,474). Cases identified by screening asylum seekers had 2.4 times higher odds of not having a successful treatment outcome as opposed to all other outcomes (A), 1.4 times higher odds of not having a successful treatment outcome as opposed to known non-successful outcomes (B) and 2.3 times higher odds of loss to follow-up (C) than cases identified by passive case finding. Conclusion: Screened asylum seekers had poorer treatment outcomes and were more often lost to follow-up. Linking patients to treatment facilities and investigating potential barriers to treatment completion are needed to secure screening benefits for asylum seekers and communities.

Detection of European bat lyssavirus 2 (EBLV-2) in a Daubenton's bat (Myotis daubentonii) from Magdeburg, Germany.

PubMed

Freuling, Conrad M; Kliemt, Jeannette; Schares, Susann; Heidecke, Dietrich; Driechciarz, René; Schatz, Juliane; Müller, Thomas

2012-01-01

In Europe bat rabies in Daubenton's bats (Myotisdaubentonii) and in Pond bats (Myotis dasycneme) caused by the European bat lyssavirus 2 (EBLV-2) has been confirmed in less than 20 cases to date. Here we report the second encounter of this virus species in Germany. A Daubenton's bat found grounded in the zoological garden in Magdeburg died shortly after. In the frame of a retrospective study the bat carcass was eventually transferred to the national reference laboratory for rabies at the Friedrich-Loeffler-Institute for rabies diagnosis. Lyssavirus was isolated and characterized as EBLV-2.

Risk of second primary cancers after testicular cancer in East and West Germany: A focus on contralateral testicular cancers

PubMed Central

Rusner, Carsten; Streller, Brigitte; Stegmaier, Christa; Trocchi, Pietro; Kuss, Oliver; McGlynn, Katherine A; Trabert, Britton; Stang, Andreas

2014-01-01

Testicular cancer survival rates improved dramatically after cisplatin-based therapy was introduced in the 1970s. However, chemotherapy and radiation therapy are potentially carcinogenic. The purpose of this study was to estimate the risk of developing second primary cancers including the risk associated with primary histologic type (seminoma and non-seminoma) among testicular cancer survivors in Germany. We identified 16 990 and 1401 cases of testicular cancer in population-based cancer registries of East Germany (1961–1989 and 1996–2008) and Saarland (a federal state in West Germany; 1970–2008), respectively. We estimated the risk of a second primary cancer using standardized incidence ratios (SIRs) with 95% confidence intervals (95% CIs). To determine trends, we plotted model-based estimated annual SIRs. In East Germany, a total of 301 second primary cancers of any location were observed between 1961 and 1989 (SIR: 1.9; 95% CI: 1.7–2.1), and 159 cancers (any location) were observed between 1996 and 2008 (SIR: 1.7; 95% CI: 1.4–2.0). The SIRs for contralateral testicular cancer were increased in the registries with a range from 6.0 in Saarland to 13.9 in East Germany. The SIR for seminoma, in particular, was higher in East Germany compared to the other registries. We observed constant trends in the model-based SIRs for contralateral testicular cancers. The majority of reported SIRs of other cancer sites including histology-specific risks showed low precisions of estimated effects, likely due to small sample sizes. Testicular cancer patients are at increased risk especially for cancers of the contralateral testis and should receive intensive follow-ups. PMID:24407180

Knowledge Growth, Academic Beliefs and Motivation of Students in Business and Economics--A Longitudinal German Case Study

ERIC Educational Resources Information Center

Biewen, Martin; Happ, Roland; Schmidt, Susanne; Zlatkin-Troitschanskaia, Olga

2018-01-01

In this study we examine the determinants of and the relationship among economic knowledge, epistemological beliefs, and extrinsic and intrinsic motivation over the course of undergraduate studies in a sample of students of business and economics at a university in Germany. We found economic knowledge increased over the course of studies,…

[Community-acquired Legionella pneumonia : data from the CAPNETZ study].

PubMed

von Baum, H; Lück, C

2011-06-01

Legionella are present in the environment as well as in biofilms of water installation systems. Most Legionella live in amoebae. More than 51 different species of Legionella have been identified; however, most pneumonias are caused by Legionella pneumophila serogroup 1. Legionnaire's disease has an incidence of about 4% in Germany. Most cases of Legionnaire's disease are sporadic. Microbiological identification of Legionella can be achieved by cultivation of Legionella spp. on specific media, performing of Legionella-specific PCR from respiratory samples, or Legionella urinary antigen testing. Patients with severe underlying diseases, patients receiving immunosuppression, and patients who are heavy smokers have a predisposition to Legionnaire's disease. Men are significantly more often affected. Whereas outpatients show a mild clinical course, mortality for hospitalized patients is 11.2%. It can be assumed that only a minority of cases of Legionnaire's disease is recognized and reported in Germany.

Merkel cell polyomavirus detection in Merkel cell cancer tumors in Northern Germany using PCR and protein expression.

PubMed

Leitz, Miriam; Stieler, Kristin; Grundhoff, Adam; Moll, Ingrid; Brandner, Johanna M; Fischer, Nicole

2014-10-01

Merkel cell carcinoma is a highly malignant skin cancer which predominantly occurs in elderly and immunocompromised persons. The identification of the Merkel cell polyomavirus (MCPyV) has inaugurated a new understanding of Merkel cell carcinoma pathogenesis. The frequent detection of the virus in Merkel cell carcinoma tissue (70-90%), its monoclonal integration in the tumor cells and the expression of viral oncogenes highly suggest that MCPyV is causally linked to the pathogenesis of the majority of Merkel cell cancer (MCC) cases. Using qualitative and quantitative PCR together with immunohistochemical staining this study aimed at characterizing the presence of MCPyV sequences and viral early gene expression in a cohort of MCC cases (n = 32) selected in Northern Germany. 40-57% of the cases were identified as MCPyV positive with 40.6% of the cases positive by immunohistochemical staining and 51.6-57.6% positive by PCR. Interestingly, in the majority (64%) of LT-Antigen positive tumors only 25-50% of tumor cells express LT-Antigen. These data are in accord with published studies describing heterogeneity in MCPyV viral loads and suggest that detection of MCPyV in Merkel cell carcinoma by PCR should be undertaken using multiple primer pairs. © 2013 Wiley Periodicals, Inc.

The first wave of pandemic influenza (H1N1) 2009 in Germany: from initiation to acceleration.

PubMed

Poggensee, Gabriele; Gilsdorf, Andreas; Buda, Silke; Eckmanns, Tim; Claus, Hermann; Altmann, Doris; Krause, Gérard; Haas, Walter

2010-06-07

The first imported case of pandemic influenza (H1N1) 2009 in Germany was confirmed in April 2009. However, the first wave with measurable burden of disease started only in October 2009. The basic epidemiological and clinical characteristics of the pandemic were analysed in order to understand the course of the pandemic in Germany. The analysis was based on data from the case-based, mandatory German surveillance system for infectious diseases. Cases notified between 27 April and 11 November 2009 and fulfilling the case definition were included in the study. Two time periods with distinct epidemiologic characteristics could be determined: 23,789 cases (44.1%) occurred during the initiation period (IP, week 18 to 41), and 30,179 (55.9%) during the acceleration period (AP, week 42 to 45). During IP, coinciding with school summer holidays, 61.1% of cases were travel-related and one death occurred. Strict containment efforts were performed until week 32. During AP the majority of cases (94.3%) was autochthonous, 12 deaths were reported. The main affected age group shifted from 15 to 19 years in IP to 10 to 14 years in AP (median age 19 versus 15 years; p < 0.001). The proportion of cases with underlying medical conditions increased from 4.7% to 6.9% (p < 0.001). Irrespective of the period, these cases were more likely to be hospitalised (OR = 3.6 [95% CI: 3.1; 4.3]) and to develop pneumonia (OR = 8.1 [95% CI: 6.1; 10.7]). Furthermore, young children (0 to 2 years) (OR = 2.8 [95% CI: 1.5; 5.2]) and persons with influenza-like illness (ILI, OR = 1.4 [95% CI: 1.0; 2.1]) had a higher risk to develop pneumonia compared to other age groups and individuals without ILI. The epidemiological differences we could show between summer and autumn 2009 might have been influenced by the school summer holidays and containment efforts. The spread of disease did not result in change of risk groups or severity. Our results show that analyses of case-based information can advise future public health measures.

The first wave of pandemic influenza (H1N1) 2009 in Germany: From initiation to acceleration

PubMed Central

2010-01-01

Background The first imported case of pandemic influenza (H1N1) 2009 in Germany was confirmed in April 2009. However, the first wave with measurable burden of disease started only in October 2009. The basic epidemiological and clinical characteristics of the pandemic were analysed in order to understand the course of the pandemic in Germany. Methods The analysis was based on data from the case-based, mandatory German surveillance system for infectious diseases. Cases notified between 27 April and 11 November 2009 and fulfilling the case definition were included in the study. Results Two time periods with distinct epidemiologic characteristics could be determined: 23,789 cases (44.1%) occurred during the initiation period (IP, week 18 to 41), and 30,179 (55.9%) during the acceleration period (AP, week 42 to 45). During IP, coinciding with school summer holidays, 61.1% of cases were travel-related and one death occurred. Strict containment efforts were performed until week 32. During AP the majority of cases (94.3%) was autochthonous, 12 deaths were reported. The main affected age group shifted from 15 to 19 years in IP to 10 to 14 years in AP (median age 19 versus 15 years; p < 0.001). The proportion of cases with underlying medical conditions increased from 4.7% to 6.9% (p < 0.001). Irrespective of the period, these cases were more likely to be hospitalised (OR = 3.6 [95% CI: 3.1; 4.3]) and to develop pneumonia (OR = 8.1 [95% CI: 6.1; 10.7]). Furthermore, young children (0 to 2 years) (OR = 2.8 [95% CI: 1.5; 5.2]) and persons with influenza-like illness (ILI, OR = 1.4 [95% CI: 1.0; 2.1]) had a higher risk to develop pneumonia compared to other age groups and individuals without ILI. Conclusion The epidemiological differences we could show between summer and autumn 2009 might have been influenced by the school summer holidays and containment efforts. The spread of disease did not result in change of risk groups or severity. Our results show that analyses of case-based information can advise future public health measures. PMID:20525408

Global Perspectives on Multilingualism: Unity in Diversity

ERIC Educational Resources Information Center

Torres-Guzman, Maria E., Ed.; Gomez, Joel, Ed.

2009-01-01

In this timely volume, international scholars examine how multilingual schooling is handled in schools across the world with a series of case studies from South Africa, Nigeria, Germany, Colombia, Slovakia, New Zealand, and Taiwan. Presenting new contributions arising from the varied contexts of multilingualism today, this collection urges…

Prevalence of Nontuberculous Mycobacterial Pulmonary Disease, Germany, 2009–2014

PubMed Central

Wagner, Dirk; de Roux, Andrés; Diel, Roland; Hohmann, David; Hickstein, Lennart; Welte, Tobias; Rademacher, Jessica

2016-01-01

We analyzed routine statutory health insurance claim data to determine prevalence of nontuberculous mycobacterial pulmonary disease in Germany. Documented prevalence rates of this nonnotifiable disease increased from 2.3 to 3.3 cases/100,000 population from 2009 to 2014. Prevalence showed a strong association with advanced age and chronic obstructive pulmonary disease. PMID:27191473

Why Comparing? Some Insights from a Comparison of Publications in Educational Journals in England and Germany

ERIC Educational Resources Information Center

Ertl, Hubert; Zierer, Klaus

2017-01-01

This paper discusses rationales for comparative work in education and draws on two projects on analysing publications in educational journals internationally. It uses the cases of Germany and England to illustrate the points made. The paper outlines some of the major developments in education in these two countries and identifies their…

Team- and Case-Based Learning to Activate Participants and Enhance Knowledge: An Evaluation of Seminars in Germany

ERIC Educational Resources Information Center

Kuhne-Eversmann, Lisa; Eversmann, Thomas; Fischer, Martin R.

2008-01-01

Introduction: There is a strong need for high-quality continuing medical education (CME) in Germany. To maintain a medical license, physicians are required to participate in regular training. Although evidence suggests that compared to lectures interactive methods can impart sustainable knowledge and a high degree of satisfaction, few interactive…

Teaching Chemistry about "Stevia"--A Case of Cooperative Curriculum Innovation within PROFILES in Germany

ERIC Educational Resources Information Center

Stuckey, Marc; Lippel, Marianne; Eilks, Ingo

2014-01-01

PROFILES is a project of teacher education and curriculum innovation funded by the FP7-programme of the European Union. The aim of PROFILES is implementing innovative science teaching practices incorporating a societal perspective and compassing inquiry-based science learning. The University of Bremen, Germany, as one of the partners, combines…

From Equivalence to Transparency of Vocational Diplomas: The Case of France and Germany.

ERIC Educational Resources Information Center

Mobus, Martine

2000-01-01

The decision to establish equivalencies between vocational training diplomas in France and Germany is a legal act subject to publication in the official gazettes of both countries. The procedure for establishing the equivalence and forms of implementation is defined in arrangements adopted by the committee of Franco-German experts in application…

Host-Associated Absence of Human Puumala Virus Infections in Northern and Eastern Germany

PubMed Central

Drewes, Stephan; Ali, Hanan Sheikh; Saxenhofer, Moritz; Rosenfeld, Ulrike M.; Binder, Florian; Cuypers, Fabian; Schlegel, Mathias; Röhrs, Susanne; Heckel, Gerald

2017-01-01

Human hantavirus disease cases, caused by Puumala virus (PUUV), are mainly recorded in western and southern areas of Germany. This bank vole reservoir survey confirmed PUUV presence in these regions but its absence in northern and eastern regions. PUUV occurrence is associated with the presence of the Western bank vole phylogroup. PMID:27983499

Tradition for Development: Indigenous Structures and Folk Media in Non-Formal Education. Report and Papers from the International Seminar on The Use of Indigenous Social Structures and Traditional Media in Non-Formal Education and Development (Berlin, West Germany. November 5-12, 1980).

ERIC Educational Resources Information Center

Kidd, Ross, Ed.; Colletta, Nat, Ed.

Case studies and seminar reports are provided that were presented at an international seminar to examine field experiences in using a culture-based approach to nonformal education. Part I, containing an introductory paper and nine case studies, focuses on indigenous institutions and processes in health, family planning, agriculture, basic…

Network Centric Warfare Case Study. U.S. V Corps and 3rd Infantry Division (Mechanized) During Operation Iraq Freedom Combat Operations (Mar-Apr 2003). Volume 1: Operations

DTIC Science & Technology

2003-11-01

Command Historian , and the personnel from the Center for Army Lessons Learned (CALL) for their assistance in gaining access to the many documents that...after the Network Centric Warfare Case Study operations. The Center for Army Lessons Learned (CALL), the V Corps Command Historian , and other... Historian , Dr. Charles Kirkpatrick, in Heidelberg, Germany, assisted in this effort. Nu- merous documents were collected, both unclassified and classified

Acceptance of routine or case-based inquiry for intimate partner violence: a mixed method study.

PubMed

Stöckl, Heidi; Hertlein, Linda; Himsl, Isabelle; Ditsch, Nina; Blume, Carolin; Hasbargen, Uwe; Friese, Klaus; Stöckl, Doris

2013-03-26

The prevalence and detrimental health effects of intimate partner violence have resulted in international discussions and recommendations that health care professionals should screen women for intimate partner violence during general and antenatal health care visits. Due to the lack of discussion on routine or case-based inquiry for intimate partner violence during antenatal care in Germany, this study seeks to explore its acceptability among pregnant German women. A mixed methods approach was used, utilizing a self-administered survey on the acceptability of routine or case-based inquiry for intimate partner violence in a university hospital's maternity ward in Munich and in-depth interviews with seven women who experienced violence during pregnancy. Of the 401 women who participated in the survey, 92 percent were in favor of routine or case-based inquiry for intimate partner violence during antenatal care. Acceptance of routine or case-based inquiry for intimate partner violence during antenatal care was significantly associated with women's experiences of child sexual abuse, being young, less educated, single or divorced and smoking during pregnancy. Open-ended survey questions and in-depth interviews stressed adequate training for screening, sufficient time and provision of referral information as important conditions for routine or case-based inquiry for intimate partner violence. Women in this study showed an overwhelming support for routine or case-based screening for intimate partner violence in antenatal care in Germany. Until adequate training is in place to allow providers to inquire for intimate partner violence in a professional manner, this study recommends that health care providers are made aware of the prevalence and health consequences of violence during pregnancy.

Acceptance of routine or case-based inquiry for intimate partner violence: a mixed method study

PubMed Central

2013-01-01

Background The prevalence and detrimental health effects of intimate partner violence have resulted in international discussions and recommendations that health care professionals should screen women for intimate partner violence during general and antenatal health care visits. Due to the lack of discussion on routine or case-based inquiry for intimate partner violence during antenatal care in Germany, this study seeks to explore its acceptability among pregnant German women. Methods A mixed methods approach was used, utilizing a self-administered survey on the acceptability of routine or case-based inquiry for intimate partner violence in a university hospital’s maternity ward in Munich and in-depth interviews with seven women who experienced violence during pregnancy. Results Of the 401 women who participated in the survey, 92 percent were in favor of routine or case-based inquiry for intimate partner violence during antenatal care. Acceptance of routine or case-based inquiry for intimate partner violence during antenatal care was significantly associated with women’s experiences of child sexual abuse, being young, less educated, single or divorced and smoking during pregnancy. Open-ended survey questions and in-depth interviews stressed adequate training for screening, sufficient time and provision of referral information as important conditions for routine or case-based inquiry for intimate partner violence. Conclusions Women in this study showed an overwhelming support for routine or case-based screening for intimate partner violence in antenatal care in Germany. Until adequate training is in place to allow providers to inquire for intimate partner violence in a professional manner, this study recommends that health care providers are made aware of the prevalence and health consequences of violence during pregnancy. PMID:23531127

The Pericles Space Case: Preserving Earth Observation Data for the Future

NASA Astrophysics Data System (ADS)

Muller, C.; Pandey, P.; Pericles Consortium

2016-08-01

PERICLES (Promoting and Enhancing the Reuse of Information throughout the Content Lifecycle exploiting Evolving Semantics) is an FP7 project started on February 2013. It aims at preserving by design large and complex data sets. PERICLES is coordinated by King's College London, UK and its partners are University of Borås (Sweden), CERT (Greece), DotSoft(Greece), GeorgAugustUniversität, Göttingen (Germany), University of Liverpool (UK), Space Application Services (Belgium), XEROX France and University of Edinburgh (UK). Two additional partners provide the case studies: Tate Gallery (UK) brings the digital art and media case study and B.USOC (Belgian Users Support and Operations Centre) brings the space science case study.

Mapping a sustainable future: Community learning in dialogue at the science-society interface

NASA Astrophysics Data System (ADS)

Barth, Matthias; Lang, Daniel J.; Luthardt, Philip; Vilsmaier, Ulli

2017-12-01

In 2015, the German Federal Ministry of Education and Research (BMBF) announced that the Science Year 2015 would focus on the "City of the Future". It called for innovative projects from cities and communities in Germany dedicated to exploring future options and scenarios for sustainable development. Among the successful respondents was the city of Lüneburg, located in the north of Germany, which was awarded funding to establish a community learning project to envision a sustainable future ("City of the Future Lüneburg 2030+"). What made Lüneburg's approach unique was that the city itself initiated the project and invited a broad range of stakeholders to participate in a community learning process for sustainable development. The authors of this article use the project as a blueprint for sustainable city development. Presenting a reflexive case study, they report on the process and outcomes of the project and investigate community learning processes amongst different stakeholders as an opportunity for transformative social learning. They discuss outputs and outcomes (intended as well as unintended) in relation to the specific starting points of the project to provide a context-sensitive yet rich narrative of the case and to overcome typical criticisms of case studies in the field.

Highly Pathogenic Avian Influenza H5N8 Clade 2.3.4.4b in Germany in 2016/2017.

PubMed

Globig, Anja; Staubach, Christoph; Sauter-Louis, Carola; Dietze, Klaas; Homeier-Bachmann, Timo; Probst, Carolina; Gethmann, Jörn; Depner, Klaus R; Grund, Christian; Harder, Timm C; Starick, Elke; Pohlmann, Anne; Höper, Dirk; Beer, Martin; Mettenleiter, Thomas C; Conraths, Franz J

2017-01-01

Here, we report on the occurrence of highly pathogenic avian influenza (HPAI) H5Nx clade 2.3.4.4b in Germany. Between November 8, 2016, and September 30, 2017, more than 1,150 cases of HPAI H5Nx clade 2.3.4.4b in wild birds and 107 outbreaks in birds kept in captivity (92 poultry holdings and 15 zoos/animal parks) were reported in Germany. This HPAI epidemic is the most severe recorded in Germany so far. The viruses were apparently introduced by migratory birds, sparking an epidemic among wild birds across Germany with occasional incursions into poultry holdings, zoos and animal parks, which were usually rapidly detected and controlled by stamping out. HPAI viruses (mainly subtype H5N8, in a few cases also H5N5) were found in dead wild birds of at least 53 species. The affected wild birds were water birds (including gulls, storks, herons, and cormorants) and scavenging birds (birds of prey, owls, and crows). In a number of cases, substantial gaps in farm biosecurity may have eased virus entry into the holdings. In a second wave of the epidemic starting from February 2017, there was epidemiological and molecular evidence for virus transmission of the infections between commercial turkey holdings in an area of high poultry density, which caused approximately 25% of the total number of outbreaks in poultry. Biosecurity measures in poultry holdings should be adapted. This includes, inter alia , wearing of stable-specific protective clothing and footwear, cleaning, and disinfection of equipment that has been in contact with birds and prevention of contacts between poultry and wild water birds.

Highly Pathogenic Avian Influenza H5N8 Clade 2.3.4.4b in Germany in 2016/2017

PubMed Central

Globig, Anja; Staubach, Christoph; Sauter-Louis, Carola; Dietze, Klaas; Homeier-Bachmann, Timo; Probst, Carolina; Gethmann, Jörn; Depner, Klaus R.; Grund, Christian; Harder, Timm C.; Starick, Elke; Pohlmann, Anne; Höper, Dirk; Beer, Martin; Mettenleiter, Thomas C.; Conraths, Franz J.

2018-01-01

Here, we report on the occurrence of highly pathogenic avian influenza (HPAI) H5Nx clade 2.3.4.4b in Germany. Between November 8, 2016, and September 30, 2017, more than 1,150 cases of HPAI H5Nx clade 2.3.4.4b in wild birds and 107 outbreaks in birds kept in captivity (92 poultry holdings and 15 zoos/animal parks) were reported in Germany. This HPAI epidemic is the most severe recorded in Germany so far. The viruses were apparently introduced by migratory birds, sparking an epidemic among wild birds across Germany with occasional incursions into poultry holdings, zoos and animal parks, which were usually rapidly detected and controlled by stamping out. HPAI viruses (mainly subtype H5N8, in a few cases also H5N5) were found in dead wild birds of at least 53 species. The affected wild birds were water birds (including gulls, storks, herons, and cormorants) and scavenging birds (birds of prey, owls, and crows). In a number of cases, substantial gaps in farm biosecurity may have eased virus entry into the holdings. In a second wave of the epidemic starting from February 2017, there was epidemiological and molecular evidence for virus transmission of the infections between commercial turkey holdings in an area of high poultry density, which caused approximately 25% of the total number of outbreaks in poultry. Biosecurity measures in poultry holdings should be adapted. This includes, inter alia, wearing of stable-specific protective clothing and footwear, cleaning, and disinfection of equipment that has been in contact with birds and prevention of contacts between poultry and wild water birds. PMID:29417053

Update: Multinational listeriosis outbreak due to 'Quargel', a sour milk curd cheese, caused by two different L. monocytogenes serotype 1/2a strains, 2009-2010.

PubMed

Fretz, R; Pichler, J; Sagel, U; Much, P; Ruppitsch, W; Pietzka, A T; Stöger, A; Huhulescu, S; Heuberger, S; Appl, G; Werber, D; Stark, K; Prager, R; Flieger, A; Karpísková, R; Pfaff, G; Allerberger, F

2010-04-22

We previously reported an outbreak of listeriosis in Austria and Germany due to consumption of Quargel cheese. It comprised 14 cases (including five fatalities) infected by a serotype 1/2a Listeria monocytogenes (clone 1), with onset of illness from June 2009 to January 2010. A second strain of L. monocytogenes serotype 1/2a (clone 2) spread by this product could be linked to further 13 cases in Austria (two fatal), six in Germany (one fatal) and one case in the Czech Republic, with onset of disease from December 2009 to end of February 2010.

Increased incidence of syphilis in men who have sex with men and risk management strategies, Germany, 2015.

PubMed

Jansen, Klaus; Schmidt, Axel J; Drewes, Jochen; Bremer, Viviane; Marcus, Ulrich

2016-10-27

In Germany, the number of reported syphilis cases increased between 11% and 22% per year between 2010 and 2014. We analysed syphilis surveillance data and data of four behavioural surveys on men who have sex with men (MSM) in Germany (2003, 2007, 2010, 2013) to assess if this rise is ongoing and to find possible explanations for it. Syphilis notifications increased in 2015 by 19% to a total of 6,834. This was mainly due to increasing notifications in MSM of all age groups in larger German cities. Data from the behavioural surveys on MSM in Germany showed a simultaneous increase of selective condom use as HIV-status-bases risk management strategy and the number of syphilis cases. MSM diagnosed with HIV reported condomless anal intercourse with non-steady partners more frequent than MSM not diagnosed with HIV or untested for HIV, but the latter also reported higher frequencies of this behaviour in the more recent surveys. Transmission in HIV-positive MSM probably plays an important, but not exclusive role, for the syphilis dynamics in Germany. A risk adapted routine screening for sexually active MSM and potentially innovative approaches to increase early screening and treatment of syphilis such as internet counselling, home sampling, home testing and broadening venue-based (rapid) testing, should be critically evaluated to effectively reduce syphilis infections. This article is copyright of The Authors, 2016.

Negotiating reform at an arm's length from the state: Disease Management Programmes and the introduction of clinical standards in Germany.

PubMed

Burau, Viola

2009-07-01

Studies of German health policy often highlight institutional constraints to reform. However, based on a case study of the introduction of clinical standards as part of the Disease Management Programmes for chronic illnesses, this article suggests that negotiating reform at an arm's length from the state can also lead to governance change, although the strengthening of hierarchy is not as prominent as that in some of the countries studied in this special issue. As such, the case of Germany offers interesting insights into the politics of governance change that occur in the shadow, but largely without the direct involvement of the state, which is typical of a corporatist health-care state. In this respect, the analysis identifies three leverages for change. First, the change in medical governance explicitly builds on earlier reforms and gives the reform alliance a competitive edge. Second, the organisations of the joint self-administration, as a more or less open ally of the state, play an influential role throughout the reform process. Importantly and third, this is complemented by the state steering at a distance.

Cross-sectional, descriptive study of Chagas disease among citizens of Bolivian origin living in Munich, Germany

PubMed Central

Navarro, Miriam; Berens-Riha, Nicole; Hohnerlein, Stefan; Seiringer, Peter; von Saldern, Charlotte; Garcia, Sarah; Blasco-Hernández, Teresa; Navaza, Bárbara; Shock, Jonathan; Bretzel, Gisela; Hoelscher, Michael; Löscher, Thomas; Albajar-Viñas, Pedro; Pritsch, Michael

2017-01-01

Purpose Chagas disease (CD) has become a global health issue mainly due to migration. Germany lacks surveillance data and is home to a large Latin American immigrant population. Recognising that Bolivia is the country with the highest CD prevalence in Latin America, this cross-sectional, descriptive pilot study investigated CD and associated factors among citizens of Bolivian origin living in Munich, Germany. Methods Participants completed a questionnaire in order to collect socioeconomic and health-related data. In addition, serology was performed. In case of positive serological tests, PCR diagnostic and clinical staging together with disease management was initiated. Qualitative research was conducted to identify personal and community barriers as well as strategies to increase CD awareness among the population at risk. Results Between June 2013 and June 2014, 43 people from Bolivia (or descendants) were enrolled. A total of 9.3% (4/43), of whom two women were of childbearing age, tested seropositive (ELISA and IFAT), and one also by PCR. For 2/4 positive participants, clinical evaluation was performed and the indeterminate form of CD was diagnosed. Knowledge about CD symptoms and ways of transmission were completely absent among 55.8% (24/43, 2/4 with CD) and 30.2% (13/43, 1/4 with CD) of participants, respectively. A total of 27.9% (12/43, 0/4 with CD) of participants had donated blood prior to the study, whereas 62.8% (27/43, 3/4 with CD) were motivated to donate blood in the future. The qualitative research identified lack of knowledge as well as stigma and fears related to CD. Conclusions Despite the small number of participants, the prevalence of CD as well as the potential risk of non-vectorial transmission was alarming. Campaigns adapted for Latin American migrants as well as control strategies should be developed and put in place in order to prevent non-vectorial transmission and actively detect cases of CD in Germany. PMID:28093440

The Integration of Biodiversity Education in the Initial Education of Primary School Teachers: Four Comparative Case Studies from Europe

ERIC Educational Resources Information Center

Lindemann-Matthies, Petra; Constantinou, Constantinos; Junge, Xenia; Kohler, Karlheinz; Mayer, Jurgen; Nagel, Ueli; Raper, George; Schule, Diane; Kadji-Beltran, Chrysanthi

2009-01-01

In this article, we present results from an international research study on biodiversity education in pre-service education of primary school teachers. The study was carried out between 2004-2006 in four teacher education institutions in Cyprus, England, Switzerland and Germany. We used document analyses and in-depth interviews with 27 teacher…

Treatment of the Theme Islam in German Geographical Education: Case Study of Bavarian Geographical Curriculum

ERIC Educational Resources Information Center

Zecha, Stefanie; Popp, Stephan

2014-01-01

Several previous studies have looked at the treatment of Islam and Muslim culture in western curricula. However in Germany, especially in Bavaria where Muslim immigration has been growing since the 1990s, no recent research has covered this theme. As a first step, an exploratory study of Islamic themes in the curricula of Bavarian secondary…

The Role of the Culture of Japanese Students in Acquisition of Academic English: An Ethnographic Study

ERIC Educational Resources Information Center

Mertin, Patricia Anne

2014-01-01

This ethnographic study examines the role of Japanese students' culture and its effects on the rate of acquisition of academic English. It is based on observation of classes in Japanese schools, both in Japan and Germany, as well as in an international school, together with interviews, questionnaires, student responses and case studies over a…

Phylogenetic analysis of human influenza A/H3N2 viruses isolated in 2015 in Germany indicates significant genetic divergence from vaccine strains.

PubMed

Mostafa, Ahmed; Abdelwhab, El-Sayed M; Slanina, Heiko; Hussein, Mohamed A; Kuznetsova, Irina; Schüttler, Christian G; Ziebuhr, John; Pleschka, Stephan

2016-06-01

Infections by H3N2-type influenza A viruses (IAV) resulted in significant numbers of hospitalization in several countries in 2014-2015, causing disease also in vaccinated individuals and, in some cases, fatal outcomes. In this study, sequence analysis of H3N2 viruses isolated in Germany from 1998 to 2015, including eleven H3N2 isolates collected early in 2015, was performed. Compared to the vaccine strain A/Texas/50/2012 (H3N2), the 2015 strains from Germany showed up to 4.5 % sequence diversity in their HA1 protein, indicating substantial genetic drift. The data further suggest that two distinct phylogroups, 3C.2 and 3C.3, with 1.6-2.3 % and 0.3-2.4 % HA1 nucleotide and amino acid sequence diversity, respectively, co-circulated in Germany in the 2014/2015 season. Distinct glycosylation patterns and amino acid substitutions in the hemagglutinin and neuraminidase proteins were identified, possibly contributing to the unusually high number of H3N2 infections in this season and providing important information for developing vaccines that are effective against both genotypes.

Climate signals derived from cell anatomy of Scots pine in NE Germany.

PubMed

Liang, Wei; Heinrich, Ingo; Simard, Sonia; Helle, Gerhard; Liñán, Isabel Dorado; Heinken, Thilo

2013-08-01

Tree-ring chronologies of Pinus sylvestris L. from latitudinal and altitudinal limits of the species distribution have been widely used for climate reconstructions, but there are many sites within the temperate climate zone, as is the case in northeastern Germany, at which there is little evidence of a clear climate signal in the chronologies. In this study, we developed long chronologies of several cell structure variables (e.g., average lumen area and cell wall thickness) from P. sylvestris growing in northeastern Germany and investigated the influence of climate on ring widths and cell structure variables. We found significant correlations between cell structure variables and temperature, and between tree-ring width and relative humidity and vapor pressure, respectively, enabling the development of robust reconstructions from temperate sites that have not yet been realized. Moreover, it has been shown that it may not be necessary to detrend chronologies of cell structure variables and thus low-frequency climate signals may be retrieved from longer cell structure chronologies. The relatively extensive resource of archaeological material of P. sylvestris covering approximately the last millennium may now be useful for climate reconstructions in northeastern Germany and other sites in the temperate climate zone.

Epidemiological analysis of a cluster within the outbreak of Shiga toxin-producing Escherichia coli serotype O104:H4 in Northern Germany, 2011.

PubMed

Scharlach, Martina; Diercke, Michaela; Dreesman, Johannes; Jahn, Nicola; Krieck, Manuela; Beyrer, Konrad; Claußen, Katja; Pulz, Matthias; Floride, Regina

2013-06-01

In May 2011 one of the worldwide largest outbreaks of haemolytic uraemic syndrome (HUS) and bloody diarrhoea caused by Shiga toxin-producing Escherichia coli (STEC) serotype O104:H4 occurred in Germany. One of the most affected federal states was Lower Saxony. We present the investigation of a cluster of STEC and HUS cases within this outbreak by means of a retrospective cohort study. After a 70th birthday celebration which took place on 7th of May 2011 among 72 attendants seven confirmed cases and four probable cases were identified, two of them developed HUS. Median incubation period was 10 days. Only 35 persons (48.6%) definitely answered the question whether they had eaten the sprouts that were used for garnishing the salad. Univariable analysis revealed different food items, depending on the case definition, with Odds Ratio (OR)>1 indicating an association with STEC infection, but multivariable logistic regression showed no increased risk for STEC infection for any food item and any case definition. Sprouts as the source for the infection had to be assumed based on the results of a tracing back of the delivery ways from the catering company to the sprouts producer who was finally identified as the source of the entire German outbreak. In this large outbreak several case-control studies failed to identify the source of infection. Copyright © 2012 Elsevier GmbH. All rights reserved.

Nonstate Actors and the Open Border Policy: The Border Security Case Study of Nepal and India

DTIC Science & Technology

2014-12-01

Washington headquarters Services, Directorate for Information Operations and Reports. 1215 Jefferson Davis Highway, Suite 1204. Arlington, VA 22202-4302... remuneration .”276 This massive migration of young and eager workers allowed Germany to take advantage of booming industries and markets. The impact on

Exploring Sources of Punitiveness among German Citizens

ERIC Educational Resources Information Center

Cochran, Joshua C.; Piquero, Alex R.

2011-01-01

Prior research examining punitive attitudes has typically focused on the United States and citizens' support for the death penalty or American "get-tough" criminal policies. Yet, little is known as to how punitive attitudes and their sources vary internationally. Using Germany as a case study, this article expands the scope of…

Content Analysis of Chemistry Curricula in Germany Case Study: Chemical Reactions

ERIC Educational Resources Information Center

Timofte, Roxana S.

2015-01-01

Curriculum-assessment alignment is a well known foundation for good practice in educational assessment, for items' curricular validity purposes. Nowadays instruments are designed to measure pupils' competencies in one or more areas of competence. Sub-competence areas could be defined theoretically and statistical analysis of empirical data by…

Public health management of invasive meningococcal disease in Baden-Wuerttemberg, Germany, 2012: adherence to guidance and estimation of resources required as determined in a survey of local health authorities.

PubMed

Murajda, Lukas; Aichinger, Elisabeth; Pfaff, Guenter; Hellenbrand, Wiebke

2015-04-12

Invasive meningococcal disease (IMD) incidence in Germany is low, but management of contacts to prevent subsequent cases still requires resources. Local public health authorities (LHA) advise antibiotic post-exposure prophylaxis (PEP) and vaccination to close contacts as defined in national guidance. We aimed to audit implementation of recommendations for IMD public health management in the state of Baden-Wuerttemberg, Germany, and to estimate associated costs. We surveyed all 38 LHAs in Baden-Wuerttemberg to evaluate knowledge of national guidance and implementation of IMD contact management using standardized questionnaires. For IMD cases notified in 2012, we requested numbers of household and other contacts ascertained, including advice given regarding PEP and post-exposure vaccination, plus staff time required for their management. We estimated costs for advised antibiotics, LHA staff time and visits to emergency departments according to published sources. The cost of preventing a subsequent case was estimated based on the number of household contacts that received PEP per IMD case and on the previous finding that ~284 household contacts must receive PEP to prevent one subsequent IMD case. Although LHAs were familiar with national recommendations, they did not advise PEP to 4% of household contacts, while 72% and 100% of school and health provider contacts, respectively, were advised PEP. Only 25% of household contacts of a case with a vaccine-preventable serogroup were advised post-exposure vaccination. A mean of 11.0 contacts/IMD case (range 0-51), of which 3.6 were household contacts, were recommended PEP. Per IMD case, mean costs for LHA staff were estimated at €440.86, for antibiotics at €219.14 and for emergency department visits to obtain PEP at €161.70 - a total of €821.17/IMD case. Preventing a subsequent IMD case would cost ~ €65,000. Our results provide insight into costs of IMD public health management in Germany. We identified marked underuse of post-exposure vaccination in household contacts and overuse of PEP in school and health care contacts. In view of an estimated 3-6 quality-adjusted life years lost per case of IMD, our estimated cost of €65,000 for preventing a subsequent case seems justifiable.

[Evolution of the literature on clinical neurology in Spain, France, Italy and Germany over the period 2000-2009].

PubMed

Inigo, Jesús; Iriarte, Jorge

2011-11-16

This study analyzes the productivity and visibility of Spanish publications in the area of clinical neurology in the period 2000-2009 and compared with those for Italy, France and Germany. We used the database Web of Science. The analysis (annual and in five-year) was restricted to the citable documents (original articles, reviews and proceedings papers). Bibliometric indicators used were the number of publications, citations received by publications and Hirsch's h-index. We also assessed the slope of the annual growth rate (b), the number of publications by language and the international collaboration. In the period 2000-2009 there were 46,114 publications in neurology clinic of which 6,998 were Spanish publications (h = 75), 11,629 in Italy (h = 101), French 9,745 (h = 102) and 20,143 in Germany (h = 124). The rate of increase in the total number of publications in Spain (b = 15) was lower than that observed in Italy (b = 65), Germany (b = 61) or France (b = 34). In the case of publications in English, the growth rate was higher for Spain (b = 37) than for France (b = 36) but lower than for Germany (b = 54) and Italy (b = 65). Although the total number of publications and the observed increase are lower in Spain compared to Italy, France or Germany, the Spanish publications in Clinical Neurology shows good trend indicators with regard to publications in English and international collaboration. This improvement was associated with greater visibility as showed by the five-year analysis of citations received by Spanish publications.

Patients’ subjective concepts about primary healthcare utilisation: the study protocol of a qualitative comparative study between Norway and Germany

PubMed Central

Herrmann, Wolfram J; Haarmann, Alexander; Flick, Uwe; Bærheim, Anders; Lichte, Thomas; Herrmann, Markus

2013-01-01

Background In Germany, utilisation of ambulatory healthcare services is high compared with other countries: While a study based on the process data of German statutory health insurances showed an average of 17.1 physician-patient-contacts per year, the comparable figure for Norway is about five. The usual models of healthcare utilisation, such as Rosenstock's Health Belief Model and Andersen's Behavioural Model, cannot explain these differences adequately. Organisational factors of the healthcare system, such as gatekeeping, do not explain the magnitude of the differences. Our hypothesis is that patients’ subjective concepts about primary healthcare utilisation play a major role in explaining different healthcare utilisation behaviour in different countries. Hence, the aim of this study is to explore these subjective concepts comparatively, between Germany and Norway. Methods/design With that aim in mind, we chose a comparative qualitative study design. In Norway and Germany, we are going to interview 20 patients each with qualitative episodic interviews. In addition, we are going to conduct participant observation in four German and four Norwegian primary care practices. The data will be analysed by thematic coding. Using selected categories, we are going to conduct comparative case and group analyses. Ethics and dissemination The study adheres to the Declaration of Helsinki. All interviewees will sign informed consent forms and all patients will be observed during consultation. Strict rules for data security will apply. Developed theory and policy implications are going to be disseminated by a workshop, presentations for experts and laypersons and publications. PMID:23794555

Lack of evidence for pre-symptomatic transmission of pandemic influenza virus A(H1N1) 2009 in an outbreak among teenagers; Germany, 2009.

PubMed

Hermes, Julia; Bernard, Helen; Buchholz, Udo; Spackova, Michaela; Löw, Johann; Loytved, Gunther; Suess, Thorsten; Hautmann, Wolfgang; Werber, Dirk

2011-11-01

Observations on the role of pre-symptomatic transmission in the spread of influenza virus are scanty. In June 2009, an outbreak of pandemic A(H1N1) 2009 infection occurred at a teenager's party in Germany. The objective of this study was to identify risk factors for pandemic A(H1N1) 2009 infection. We performed a retrospective cohort study among party guests. A case was defined as pandemic A(H1N1) 2009 infection confirmed by rRT-PCR who developed influenza-like illness between 1 and 5 June 2009. Contact patterns among party guests were evaluated. In eight (36%) of 27 party guests, the outcome was ascertained. A travel returnee from a country with endemic pandemic A(H1N1) 2009 who fell ill toward the end of the party was identified as the source case. Party guests with pandemic A(H1N1) 2009 infection had talked significantly longer to the source case than non-infected persons (P-value: 0·001). Importantly, none (0/9) of those who had left the party prior to the source case's symptom onset became infected compared to 7 (41%) of 17 who stayed overnight (P = 0·06), and these persons all had transmission-prone contacts to the source case. In this outbreak with one index case, there was no evidence to support pre-symptomatic transmission of pandemic A(H1N1) 2009. Further evidence is required, ideally from larger studies with multiple index cases, to more accurately characterize the potential for pre-symptomatic transmission of influenza virus. © 2011 Blackwell Publishing Ltd.

Occurrence of endocrine-disrupting and other wastewater compunds during water treatment with case studies from Lincoln, Nebraska and Berlin, Germany

USGS Publications Warehouse

Verstraeten, Ingrid M.; Heberer, T.; Vogel, J.R.; Speth, T.; Zuehlke, S.; Duennbier, U.

2003-01-01

Research on the fate and transport of endocrine-disrupting compounds and other organic wastewater compounds released into the environment and their potential presence in drinking water is in its infancy. Studies conducted during the last decade in Lincoln, Nebraska, and Berlin, Germany, indicate that removal of less polar compounds probably can be obtained through bank filtration, ground-water enrichment, and additional drinking-water and wastewater treatment processes. Polar compounds, such as atrazine and some metabolites, occur in drinking water obtained from contaminated surface water or ground water, but at concentrations generally lower than those occurring in wastewater and surface water. The results of the studies also suggest that concentrations of nonpolar estrogenic compounds decrease during drinking-water pretreatment processes such as bank filtration and ground-water enrichment.

From prescription-only (Rx) to over-the-counter (OTC) status in Germany 2006-2015: pharmacological perspectives on regulatory decisions.

PubMed

Barrenberg, Eva; Garbe, Edeltraut

2017-07-01

Little is known about the extent of switches from prescription-only (Rx) to over-the-counter (OTC) status in Europe and about the pharmacological properties of the switched substances. The objectives of this study were to provide an overview of the substances that were switched from Rx to OTC status in Germany between 2006 and 2015 and to assess their pharmacological properties. Session minutes of the German Expert Advisory Committee for Prescription-Only Issues, changes to the German Ordinance on Prescription-Only Medicines and the Summary of Product Characteristics of the switched substances were analysed. Pharmacological properties were studied in relation to the EU Guideline on Changing the Classification for the Supply of a Medicinal Product for Human Use (the 'EU switch guide'). Between 2006 and 2015, seven substances (almotriptan, omeprazole, benzydamine, ibuprofen/pseudoephedrine, racecadotril, ketotifen and levonorgestrel) were switched from Rx to OTC status in Germany. In all cases, the OTC status was restricted to certain indications, doses, pack sizes, or other limitations. Notwithstanding recommendations of the EU switch guide, some of the switched substances might interact with commonly used drugs potentially resulting in serious adverse drug reactions or have contraindications or warnings regarding substantial parts of the population. The stipulations of the EU switch guide were fully met for only some switches, while this was not completely the case for others. Further development of guidance on balancing risks and benefits of OTC availability is recommended.

Management of primary and metastasized melanoma in Germany in the time period 1976-2005: an analysis of the Central Malignant Melanoma Registry of the German Dermatological Society.

PubMed

Schwager, Silke S; Leiter, Ulrike; Buettner, Petra G; Voit, Christiane; Marsch, Wolfgang; Gutzmer, Ralf; Näher, Helmut; Gollnick, Harald; Bröcker, Eva Bettina; Garbe, Claus

2008-04-01

This study analysed the changes of excision margins in correlation with tumour thickness as recorded over the last three decades in Germany. The study also evaluated surgical management in different geographical regions and treatment options for metastasized melanoma. A total of 42 625 patients with invasive primary cutaneous melanoma, recorded by the German Central Malignant Melanoma Registry between 1976 and 2005 were included. Multiple linear regression analysis was used to investigate time trends of excision margins adjusted for tumour thickness. Excision margins of 5.0 cm were widely used in the late 1970s but since then have been replaced by smaller margins that are dependent on tumour thickness. In the case of primary melanoma, one-step surgery dominated until 1985 and was mostly replaced by two-step excisions since the early 1990s. In eastern Germany, one-step management remained common until the late 1990s. During the last three decades loco-regional metastases were predominantly treated by surgery (up to 80%), whereas systemic therapy decreased. The primary treatment of distant metastases has consistently been systemic chemotherapy. This descriptive retrospective study revealed a significant decrease in excision margins to a maximum of 2.00 cm. A significant trend towards two-step excisions in primary cutaneous melanoma was observed throughout Germany. Management of metastasized melanoma showed a tendency towards surgical procedures in limited disease and an ongoing trend to systemic treatment in advanced disease.

Principles of social security and health insurance for farmers in Poland and Germany--a comparative assessment.

PubMed

Posturzyńska, Agnieszka; Wojtyła, Andrzej; Hans, Lucyna; Morawik, Iwona; Strzemecka, Joanna; Jabłoński, Mirosław

2012-01-01

As landowners occupied with agricultural production comprise a sizeable part of the populations in mid- and western European countries, it seemed reasonable to assess the organization of health care systems concerning farmers and their families in Poland and Germany. Both countries have similar geographical conditions and rural environments. It so happens that in Poland the principles of the system of agricultural insurance (KRUS) is based on the experiences of Germany and France. Basically, both in Poland and Germany, the agricultural health insurance companies provide the same insurance cover as other health insurance companies. In both countries, under certain conditions, in the case of illness, the insured farmers receive instead of sickness benefit operational assistance and home help. In spite of the similarities that characterize both administrations, many particular differences are to be noted, e.g. the farmers' social insurance in Poland is subject to only one ministry, in contrast to Germany where two ministries are responsible for farmers' social insurance. In Poland, KRUS is a monopolistic organization, whereas in Germany, nine similar independent structures fulfil the task of a health insurance company. Needless to say, many more funds are available for prevention, treatment and rehabilitation in Germany than in Poland, due to obvious differences in the overall national income.

Der Ort des Padagogischen: Eine Sammelbesprechung bildungshistorischer Lokal- und Regionalstudien (The Locus of the Pedagogical: A Review of Local and Regional Studies in Educational History).

ERIC Educational Resources Information Center

Kemnitz, Heidemarie; Tenorth, Heinz-Elmar; Horn, Klaus-Peter

1998-01-01

Discusses the range and limitations of local and regional case studies based on studies of the educational history of Berlin (Germany), Jewish school systems under National Socialism, and women's education. Examines their content-related results as well as their systematic significance for research on the history of education (DSK)

Confidence and Perceived Competence of Preservice Teachers to Implement Biodiversity Education in Primary Schools--Four Comparative Case Studies from Europe

ERIC Educational Resources Information Center

Lindemann-Matthies, Petra; Constantinou, Costas; Lehnert, Hans-Joachim; Nagel, Ueli; Raper, George; Kadji-Beltran, Chrysanthi

2011-01-01

This multinational research study was carried out between 2004 and 2006 in four teacher education institutions in Cyprus, England, Switzerland, and Germany. With the help of a written questionnaire, the confidence and perceived competence of preservice primary teachers (N = 690) to deliver biodiversity education in school were investigated. Data…

Professional Competence of Student Teachers to Implement Species Identification in Schools -- A Case Study from Germany

ERIC Educational Resources Information Center

Lindemann-Matthies, Petra; Remmele, Martin; Yli-Panula, Eija

2017-01-01

This study investigates how well prepared student teachers are to implement species identification in school. Data were collected with the help of a questionnaire and a PowerPoint presentation in which local plant and animal species were presented. Participants (n = 357) correctly identified, on average, 23% of the plants and 44% of the animals.…

Radiofrequency electromagnetic fields emitted from base stations of DECT cordless phones and the risk of glioma and meningioma (Interphone Study Group, Germany).

PubMed

Schüz, Joachim; Böhler, Eva; Schlehofer, Brigitte; Berg, Gabriele; Schlaefer, Klaus; Hettinger, Iris; Kunna-Grass, Katharina; Wahrendorf, Jürgen; Blettner, Maria

2006-07-01

The objective of this study was to test the hypothesis that exposure to continuous low-level radiofrequency electromagnetic fields (RF EMFs) increases the risk of glioma and meningioma. Participants in a population-based case-control study in Germany on the risk of brain tumors in relation to cellular phone use were 747 incident brain tumor cases between the ages of 30 and 69 years and 1494 matched controls. The exposure measure of this analysis was the location of a base station of a DECT (Digital Enhanced Cordless Telecommunications) cordless phone close to the bed, which was used as a proxy for continuous low-level exposure to RF EMFs during the night. Estimated odds ratios were 0.82 (95% confidence interval: 0.29-2.33) for glioma and 0.83 (0.29-2.36) for meningioma. There was also no increasing risk observed with duration of exposure to DECT cordless phone base stations. Although the study was limited due to the small number of exposed subjects, it is still a first indication that residential low-level exposure to RF EMFs may not pose a higher risk of brain tumors.

[Infectious disease outbreaks in centralized homes for asylum seekers in Germany from 2004-2014].

PubMed

Kühne, Anna; Gilsdorf, Andreas

2016-05-01

Migration and imported infections are changing the distribution of infectious diseases in Europe. However little is known about the extent of transmission of imported diseases within Europe. Asylum seekers are of increasing importance for infectious disease epidemiology and can be particularly vulnerable for infections and disease progression due to stressful conditions of migration and incomplete vaccination status. The aim is to analyse transmission of infectious diseases in centralized homes for asylum seekers in national infectious disease surveillance data to identify relevant infectious diseases and possible public health measures to reduce transmission. German national notification data was systematically analysed from 2004 to 2014 for outbreaks reported to have occurred within centralized homes for asylum seekers followed by descriptive analysis of outbreak- and case-characteristics. From 2004 to 2014 the number of outbreaks in centralized homes for asylum seekers per year increased, a total of 119 outbreaks with 615 cases were reported. Cases in these outbreaks were caused by chicken pox (30 %), measles (20 %), scabies (19 %), rota-virus-gastroenteritis (8 %) and others (each <5 %). Of 119 outbreaks, two outbreaks of measles in centralized homes were connected to outbreaks outside the centralized homes. For 210 of 311 cases in 2014 the place of infection was reported, 87 % of those with known place of infection were infected in Germany. Infectious disease outbreaks in centralized homes for asylum seekers are reported increasingly often in Germany. Chicken pox, measles and scabies were the most frequent outbreak causing diseases. Spread of such outbreaks outside centralized homes for asylum seekers was rare and infectious diseases are mainly acquired in Germany. The majority of outbreaks in centralized homes for asylum seekers would be preventable with vaccinations at arrival and appropriate hygiene measures.

Religious Education Reform under the US Military Occupation: The Interpretation of State Shinto in Japan and Nazism in Germany

ERIC Educational Resources Information Center

Shibata, Masako

2004-01-01

This article discusses the treatment of religion in Japanese education in the post-World War Two period. During the Allied Military Occupation, Japan adopted the principle of the separation of state and religion as a means to democratize the totalitarian, ethno-nationalistic education system of pre-1945. The case of Germany is also dealt with here…

The Special Case of Disadvantaged Young People in Germany: How Stakeholder Interests Hinder Reform Proposals in Favour of a Training Guarantee

ERIC Educational Resources Information Center

Granato, Mona; Krekel, Elisabeth M.; Ulrich, Joachim Gerd

2015-01-01

Every year, tens of thousands of young people in Germany fail to find access to dual vocational education and training (VET), because they cannot find a company to hire them as apprentices. This particularly affects persons with poor school leaving qualifications, socially deprived persons or people with a migrant background. In order to improve…

The Potential and Reality of New Refugees Entering German Higher Education: The Case of Berlin Institutions

ERIC Educational Resources Information Center

Streitwieser, Bernhard; Brueck, Lukas; Moody, Rachel; Taylor, Margaret

2017-01-01

By the close of 2015, roughly 890,000 new refugees had arrived in Germany, more than half fleeing the ongoing Syrian Civil War. While Germany had been accustomed to heavy migration streams since the end of the Second World War, the speed of the refugee influx was unexpected. Federal, state, and municipal governments and German civil society,…

Using an outbreak to study the sensitivity of the surveillance of enterohaemorrhagic Escherichia coli and other enteropathic Escherichia coli in Bavaria, Germany, January to October 2011.

PubMed

Englund, H; Hautmann, W

2012-08-23

Following an outbreak of enterohaemorrhagic Escherichia coli (EHEC) in Germany 2011, we observed increases in EHEC and non-EHEC E. coli cases in Bavaria. We compared the demographic, clinical and laboratory features of the cases reported during the outbreak period, but not related to the outbreak, to the cases reported before and after. The number of EHEC and non-EHEC E. coli cases notified per week during the outbreak was fivefold and twofold higher respectively, compared to previous years. EHEC cases notified during the outbreak were more often reported with bloody diarrhoea, and less often with unspecified diarrhoea, compared to the other periods. They were more often hospitalised during the outbreak and the following period compared to the period before. Their median age (26.5 years, range: 0–90) was higher compared to before (14.5 years, range: 0–94) and after (5 years, range: 0–81). The median age of non-EHEC E. coli cases notified during the outbreak period (18 years, range 0–88) was also higher than before and after (2 years, p<0.001). The surveillance system likely underestimates the incidence of both EHEC and non-EHEC E. coli cases, especially among adults, and overestimates the proportion of severe EHEC cases. Testing all stool samples from patients with diarrhoea for enteropathic E. coli should be considered.

Operational Modelling of the Aerospace Propagation Environment. Volume II

DTIC Science & Technology

1978-11-01

distributed among a deeper layer as before. 3.2 Effect of the roughness parameter z0 on the height of the PaL For both cases of labile and stable...treated as separate ones . Visibility from such an area into a neighbouring one is of practical interest only in special cases which are dealt with...Schloss Kressbach, D-7400 Tublngen, F.R.Germany Report 1978 / 6 SUMMARY This paper presents an experimental and theoretical study on atmospheric

The Measels-Mumps-Rubella Vaccination from a health political and economical point of view

PubMed Central

Rosian-Schikuta, Ingrid; Fröschl, Barbara; Habl, Claudia; Stürzlinger, Heidi

2007-01-01

Introduction Measels, Mumps and Rubella (MMR) are highly contagious infectious diseases which may lead to severe complications. These diseases are vaccine-preventable. The present Health Technology Assessment report (report on technological consequences, HTA report) was commissioned by the German Institute of Medical Documentation and Information (DIMDI) and addresses various aspects of the MMR vaccination, the key question being how the MMR immunisation coverage rate can be increased in Germany. Objectives The objectives of this report were to describe the benefits of the MMR vaccination for Germany and to analyse how the desired MMR immunisation coverage of >95% can be achieved. Methods A systematic literature search was performed in 29 literature data bases. Particularly for epidemiological data and information on vaccination programs, this systematic search was supplemented by an extensive hand search, written and oral enquiries, as well as interviews with experts. A total of 200 texts were used to prepare this report. Results At 92.5% (as of 2004) based on the whole of Germany, the current immunisation coverage for measles in children is above the weighted EC-15-average of 90.67%. Statements can only be made regarding the probability of illness for measles, as no data is available for mumps and rubella. With 2.8 infections (per 100,000 residents) in 2006, Germany has not achieved the WHO target. Of cases submitted to the laboratory, only 32% were validated by diagnostic laboratory findings and 45% confirmed clinical-epidemiologically. There are only few economic analyses of vaccination programs in Germany. In international publications, mainly measels are validated economically. An analysis of the cost of measles for Germany shows potential cost savings. Unfortunately, no complete economic evaluation (cost-effectiveness, cost-benefit, or cost-utility analyses) for MMR vaccination has been performed for Germany. Analyses conducted in the US and a model calculation for a hypothetical Western-European country show a considerable cost saving potential for society in general as well as for the health care system. Interventions to increase the immunisation rate were categorized in three main groups according to their goals: interventions increasing the demand for vaccinations, those improving access to vaccination services and those aiming at the providers (e.g. physicians) of vaccinations. Discussion Various studies concluded that reminders to clients, provided in written, electronic or oral form, are a highly recommendable intervention. Provider based interventions were also strongly advised. Despite efforts made during the past years to achieve herd immunity in Germany, some deficits remain: i. e. there are still ample regional differences between and within German federal states. Conclusions In the authors’ opinion, a key point in increasing immunisation coverage is the development of a binding vaccination program for Germany with regionally differentiated immunisation targets. During the development of such a program, special emphasis should be placed on determining responsibilities of the federal government, the Laender and health insurance funds (e. g. in the case of a measles outbreak). PMID:21289946

The Measels-Mumps-Rubella Vaccination from a health political and economical point of view.

PubMed

Rosian-Schikuta, Ingrid; Fröschl, Barbara; Habl, Claudia; Stürzlinger, Heidi

2007-11-28

Measels, Mumps and Rubella (MMR) are highly contagious infectious diseases which may lead to severe complications. These diseases are vaccine-preventable. The present Health Technology Assessment report (report on technological consequences, HTA report) was commissioned by the German Institute of Medical Documentation and Information (DIMDI) and addresses various aspects of the MMR vaccination, the key question being how the MMR immunisation coverage rate can be increased in Germany. The objectives of this report were to describe the benefits of the MMR vaccination for Germany and to analyse how the desired MMR immunisation coverage of >95% can be achieved. A systematic literature search was performed in 29 literature data bases. Particularly for epidemiological data and information on vaccination programs, this systematic search was supplemented by an extensive hand search, written and oral enquiries, as well as interviews with experts. A total of 200 texts were used to prepare this report. At 92.5% (as of 2004) based on the whole of Germany, the current immunisation coverage for measles in children is above the weighted EC-15-average of 90.67%. Statements can only be made regarding the probability of illness for measles, as no data is available for mumps and rubella. With 2.8 infections (per 100,000 residents) in 2006, Germany has not achieved the WHO target. Of cases submitted to the laboratory, only 32% were validated by diagnostic laboratory findings and 45% confirmed clinical-epidemiologically. There are only few economic analyses of vaccination programs in Germany. In international publications, mainly measels are validated economically. An analysis of the cost of measles for Germany shows potential cost savings. Unfortunately, no complete economic evaluation (cost-effectiveness, cost-benefit, or cost-utility analyses) for MMR vaccination has been performed for Germany. Analyses conducted in the US and a model calculation for a hypothetical Western-European country show a considerable cost saving potential for society in general as well as for the health care system. INTERVENTIONS TO INCREASE THE IMMUNISATION RATE WERE CATEGORIZED IN THREE MAIN GROUPS ACCORDING TO THEIR GOALS: interventions increasing the demand for vaccinations, those improving access to vaccination services and those aiming at the providers (e.g. physicians) of vaccinations. Various studies concluded that reminders to clients, provided in written, electronic or oral form, are a highly recommendable intervention. Provider based interventions were also strongly advised. DESPITE EFFORTS MADE DURING THE PAST YEARS TO ACHIEVE HERD IMMUNITY IN GERMANY, SOME DEFICITS REMAIN: i. e. there are still ample regional differences between and within German federal states. In the authors' opinion, a key point in increasing immunisation coverage is the development of a binding vaccination program for Germany with regionally differentiated immunisation targets. During the development of such a program, special emphasis should be placed on determining responsibilities of the federal government, the Laender and health insurance funds (e. g. in the case of a measles outbreak).

Joint Operations Case Study. Weseruebung Nord: Germany’s Invasion of Norway, 1940

DTIC Science & Technology

1997-03-01

Generalleutnant Dietl, which draws heavily on Dietl’s reports and papers. See Gerda -Luise (Haenicke) Dietl and Kurt Hermann, eds., General Dietl: das...Sep. 1939-June 1941. History of the Second World War United Kingdom Military Series. Ed. J. R. M. Butler. London: HMSO, 1957. Dietl, Gerda

Towards a Taxonomy of Intergenerational Knowledge Transfer Practices: Insights from an International Comparison (Germany-Quebec)

ERIC Educational Resources Information Center

Kuyken, Kerstin; Ebrahimi, Mehran; Saives, Anne-Laure

2018-01-01

Purpose: This paper aims to develop a better understanding of intergenerational knowledge transfer (IKT) practices by adopting a context-related and comparative perspective. Design/methodology/approach: A qualitative case study design involving 83 interviews and non-participative observation in German and Quebec organizations has been chosen.…

International Videoconferencing for Public Health Education: Linking the U.S. and Germany

ERIC Educational Resources Information Center

Burke, Sloane C.; Chaney, Beth H.; Kirsten, Wolf

2010-01-01

Background: Video-linking with other countries provides a low-cost vehicle for students to learn more about health issues of other cultures and reflectively discuss the public health promotion and education activities of those countries in real time. Purpose: This article presents a case study of international videoconferencing in the higher…

Occurrence of Endocrine-Disrupting and Other Wastewater Compounds during Water Treatment with Case Studies from Lincoln, Nebraska and Berlin, Germany

EPA Science Inventory

Except for herbicides, research on the fate and transport of endocrine disrupting compounds and other organic wastewater compounds released into the environment and their potential presence in drinking water is in its infancy. Analytical methods still are being developed, evalua...

[Topical treatment of persistent cutaneous leishmaniasis with paromomycin].

PubMed

Flaig, M J; Rupec, J; Ruzicka, T; Rupec, R A

2007-08-01

Cutaneous leishmaniasis is an infectious disease with increasing prevalence in Germany. Diagnosis and therapy may be difficult due to the variability of the clinical and histomorphological picture and resistance to therapy. In this case study we report on a female patient with a persistent cutaneous leishmaniasis successfully treated with topical administration of paromomycin.

Cellular phones, cordless phones, and the risks of glioma and meningioma (Interphone Study Group, Germany).

PubMed

Schüz, Joachim; Böhler, Eva; Berg, Gabriele; Schlehofer, Brigitte; Hettinger, Iris; Schlaefer, Klaus; Wahrendorf, Jürgen; Kunna-Grass, Katharina; Blettner, Maria

2006-03-15

The widespread use of cellular telephones has generated concern about possible adverse health effects, particularly brain tumors. In this population-based case-control study carried out in three regions of Germany, all incident cases of glioma and meningioma among patients aged 30-69 years were ascertained during 2000-2003. Controls matched on age, gender, and region were randomly drawn from population registries. In total, 366 glioma cases, 381 meningioma cases, and 1,494 controls were interviewed. Overall use of a cellular phone was not associated with brain tumor risk; the respective odds ratios were 0.98 (95% confidence interval (CI): 0.74, 1.29) for glioma and 0.84 (95% CI: 0.62, 1.13) for meningioma. Among persons who had used cellular phones for 10 or more years, increased risk was found for glioma (odds ratio = 2.20, 95% CI: 0.94, 5.11) but not for meningioma (odds ratio = 1.09, 95% CI: 0.35, 3.37). No excess of temporal glioma (p = 0.41) or meningioma (p = 0.43) was observed in cellular phone users as compared with nonusers. Cordless phone use was not related to either glioma risk or meningioma risk. In conclusion, no overall increased risk of glioma or meningioma was observed among these cellular phone users; however, for long-term cellular phone users, results need to be confirmed before firm conclusions can be drawn.

Usutu virus, Austria and Hungary, 2010–2016

PubMed Central

Bakonyi, Tamás; Erdélyi, Károly; Brunthaler, René; Dán, Ádám; Weissenböck, Herbert; Nowotny, Norbert

2017-01-01

Usutu virus (USUV, Flaviviridae) was first reported in Europe in Austria in 2001, where it caused wild bird (mainly blackbird) mortality until 2005. Since 2006 no further USUV cases were diagnosed in the country. However, the virus emerged in other European countries (Hungary, Italy, Switzerland, Spain, Germany and the Czech Republic) between 2005 and 2011. In 2016, widespread USUV-associated wild bird mortality was observed in Germany, France, Belgium and the Netherlands. In this study, we report the results of passive monitoring for USUV in Austria and Hungary between 2010 and 2016. In Hungary, USUV caused sporadic cases of wild bird mortality between 2010 and 2015 (altogether 18 diagnosed cases), whereas in summer and autumn 2016 the number of cases considerably increased to 12 (ten blackbirds, one Eurasian jay and one starling). In Austria, USUV was identified in two blackbirds in 2016. Phylogenetic analyses of coding-complete genomes and partial regions of the NS5 protein gene revealed that USUVs from Hungary between 2010 and 2015 are closely related to the virus that emerged in Austria in 2001 and in Hungary in 2005, while one Hungarian sequence from 2015 and all sequences from Hungary and Austria from 2016 clustered together with USUV sequences reported from Italy between 2009 and 2010. The results of the study indicate continuous USUV circulation in the region and exchange of USUV strains between Italy, Austria and Hungary. PMID:29018253

The Impact on Vocational Training of Studies. Analysing and Forecasting Trends in Occupations. Case Studies in Germany, the Netherlands and Denmark. CEDEFOP Document.

ERIC Educational Resources Information Center

European Centre for the Development of Vocational Training, Thessaloniki (Greece).

This report describes a study to verify the impact on vocational training policies of research and development work carried out in the field of anticipation of educational and training needs, labor market forecasts, and skills analysis. Section I provides background. Section II presents the framework of the study. Section III includes the full…

Life Satisfaction and Risk of Chronic Diseases in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Germany Study

PubMed Central

Feller, Silke; Teucher, Birgit; Kaaks, Rudolf; Boeing, Heiner; Vigl, Matthaeus

2013-01-01

Objective The aim of the study was to examine the prospective association between life satisfaction and risk of type 2 diabetes mellitus, myocardial infarction, stroke, and cancer. Previous studies suggested that psychosocial factors may affect the development of chronic diseases but the impact of positive attitudes, in particular life satisfaction, is yet to be determined. Methods The analysis included 50,358 participants of the European Prospective Investigation into Cancer and Nutrition (EPIC)-Germany study in Potsdam and Heidelberg. Life satisfaction was assessed in a baseline interview and incident cases of chronic diseases were identified and verified during follow-up. Hazard ratios were calculated using Cox proportional hazards regression models that were systematically multivariable-adjusted for established risk factors and prevalent diseases. Results During an average of 8 years of follow-up 2,293 cases of cancer, 1,840 cases of type 2 diabetes mellitus, 440 cases of stroke, and 562 cases of myocardial infarction were observed. Women who were unsatisfied with life at baseline showed in all models a significantly increased risk of cancer (HR: 1.45; 95% CI: 1.18-1.78) and stroke (HR: 1.69; 95% CI: 1.05-2.73) as well as an increased risk of type 2 diabetes mellitus by trend across categories (p-trend=0.04) compared to women very satisfied with life. In men, a relationship between life satisfaction and stroke was found but did not persist after consideration of lifestyle factors and prevalent diseases. No significant association was observed between life satisfaction and risk of myocardial infarction. Conclusions The results of this study suggest that reduced life satisfaction is related to the development of chronic diseases—particularly in women and partly mediated by established risk factors. PMID:23977388

Hepatitis A virus infections and outbreaks in asylum seekers arriving to Germany, September 2015 to March 2016.

PubMed

Michaelis, Kai; Wenzel, Jürgen J; Stark, Klaus; Faber, Mirko

2017-04-26

From September 2015 to March 2016, hepatitis A notifications in Germany increased by 45% to 699 cases compared to 482 cases in the same period of the previous year. Children aged five to nine years were predominantly affected (22% of all cases in this period). We hypothesized that this increase could be explained by the marked influx of asylum seekers in this time period. We analysed national surveillance data and estimated the number of imported and autochthonous hepatitis A cases in asylum seekers. We also investigated molecular signatures of hepatitis A viruses sampled from asylum seekers to identify chains of transmission. We found that 40% (278 cases) of all 699 hepatitis A cases notified between September 2015 and March 2016 in Germany concerned asylum seekers. Most infections were acquired abroad, but at least 24% accounted for autochthonous infections. Among asylum seekers, children aged five to nine years were overrepresented with 97 of 278 (35%) notified cases. The analysed hepatitis A virus sequences were primarily subgenotype IB strains and clustered with previously isolated samples from the Middle East, Turkey, Pakistan and East Africa. Except one transmission from an asymptomatic child to a nursery nurse working in a mass accommodation, we are not aware of infection chains involving asylum seekers and German residents. We conclude that asylum-seeking children and adolescents are susceptible to hepatitis A virus infections, particularly children aged five to nine years. Measures to prevent secondary infections in asylum seekers such as extended hygiene measures and post-exposure prophylaxis seem advisable.

Hepatitis A virus infections and outbreaks in asylum seekers arriving to Germany, September 2015 to March 2016

PubMed Central

Michaelis, Kai; Wenzel, Jürgen J; Stark, Klaus; Faber, Mirko

2017-01-01

From September 2015 to March 2016, hepatitis A notifications in Germany increased by 45% to 699 cases compared to 482 cases in the same period of the previous year. Children aged five to nine years were predominantly affected (22% of all cases in this period). We hypothesized that this increase could be explained by the marked influx of asylum seekers in this time period. We analysed national surveillance data and estimated the number of imported and autochthonous hepatitis A cases in asylum seekers. We also investigated molecular signatures of hepatitis A viruses sampled from asylum seekers to identify chains of transmission. We found that 40% (278 cases) of all 699 hepatitis A cases notified between September 2015 and March 2016 in Germany concerned asylum seekers. Most infections were acquired abroad, but at least 24% accounted for autochthonous infections. Among asylum seekers, children aged five to nine years were overrepresented with 97 of 278 (35%) notified cases. The analysed hepatitis A virus sequences were primarily subgenotype IB strains and clustered with previously isolated samples from the Middle East, Turkey, Pakistan and East Africa. Except one transmission from an asymptomatic child to a nursery nurse working in a mass accommodation, we are not aware of infection chains involving asylum seekers and German residents. We conclude that asylum-seeking children and adolescents are susceptible to hepatitis A virus infections, particularly children aged five to nine years. Measures to prevent secondary infections in asylum seekers such as extended hygiene measures and post-exposure prophylaxis seem advisable. PMID:28442750

Regulatory tasks of national medical associations - international comparison and the Israeli case

PubMed Central

2013-01-01

Background In many countries, NMAs, along with other stakeholders, play a part in the regulation of physicians. The purpose of this paper is to compare and explain the level of involvement of NMAs in physician regulation in several developed countries, with a specific emphasis on Israel. Methods The authors conducted a review of the literature on physician regulation, focusing on licensing and registration, postgraduate training and physician disciplinary measures. Detailed country specific information was also obtained via the websites of relevant NMAs and regulatory bodies and correspondence with select NMAs. Five test cases were examined in detail: Germany, Israel, the Netherlands, the United Kingdom and the United States. The Israeli case will be discussed at greater length. Results Medical licensing usually lies in the hands of the government (on the national or state level). Specialist training, on the other hand, is often self-regulated and entrusted in the hands of the profession, frequently under the direct responsibility of the NMA, as in Israel, the Netherlands and Germany. In all the countries presented, other than Germany, the NMA is not involved in instituting disciplinary procedures in cases of alleged physician misconduct. Discussion The extent to which NMAs fulfill regulatory functions varies greatly from country to country. The relationship between government and the profession in the area of regulation often parallels the dominant mode of governance in the health care system as a whole. Specifically, the level of involvement of the Israeli Medical Association in medical regulation is a result of political, historical and ideological arrangements shaped vis-à-vis the government over the years. Conclusions In Continental Europe, co-operation between the NMA and the government is more common than in the USA and the UK. The Israeli regulatory model emerged in a European-like fashion, closer to the Netherlands than to Germany. The Israeli case, as well as the others, demonstrates the importance of history and ideology in shaping contemporary regulatory models. PMID:23425333

Public health impacts of excess NOx emissions from Volkswagen diesel passenger vehicles in Germany

NASA Astrophysics Data System (ADS)

Chossière, Guillaume P.; Malina, Robert; Ashok, Akshay; Dedoussi, Irene C.; Eastham, Sebastian D.; Speth, Raymond L.; Barrett, Steven R. H.

2017-03-01

In September 2015, the Volkswagen Group (VW) admitted the use of ‘defeat devices’ designed to lower emissions measured during VW vehicle testing for regulatory purposes. Globally, 11 million cars sold between 2008 and 2015 are affected, including about 2.6 million in Germany. On-road emissions tests have yielded mean on-road NOx emissions for these cars of 0.85 g km-1, over four times the applicable European limit of 0.18 g km-1. This study estimates the human health impacts and costs associated with excess emissions from VW cars driven in Germany. A distribution of on-road emissions factors is derived from existing measurements and combined with sales data and a vehicle fleet model to estimate total excess NOx emissions. These emissions are distributed on a 25 by 28 km grid covering Europe, using the German Federal Environmental Protection Agency’s (UBA) estimate of the spatial distribution of NOx emissions from passenger cars in Germany. We use the GEOS-Chem chemistry-transport model to predict the corresponding increase in population exposure to fine particulate matter and ozone in the European Union, Switzerland, and Norway, and a set of concentration-response functions to estimate mortality outcomes in terms of early deaths and of life-years lost. Integrated over the sales period (2008-2015), we estimate median mortality impacts from VW excess emissions in Germany to be 1200 premature deaths in Europe, corresponding to 13 000 life-years lost and 1.9 billion EUR in costs associated with life-years lost. Approximately 60% of mortality costs occur outside Germany. For the current fleet, we estimate that if on-road emissions for all affected VW vehicles in Germany are reduced to the applicable European emission standard by the end of 2017, this would avert 29 000 life-years lost and 4.1 billion 2015 EUR in health costs (median estimates) relative to a counterfactual case with no recall.

Tularemia in Germany—A Re-emerging Zoonosis

PubMed Central

Faber, Mirko; Heuner, Klaus; Jacob, Daniela; Grunow, Roland

2018-01-01

Tularemia, also known as “rabbit fever,” is a zoonosis caused by the facultative intracellular, gram-negative bacterium Francisella tularensis. Infection occurs through contact with infected animals (often hares), arthropod vectors (such as ticks or deer flies), inhalation of contaminated dust or through contaminated food and water. In this review, we would like to provide an overview of the current epidemiological situation in Germany using published studies and case reports, an analysis of recent surveillance data and our own experience from the laboratory diagnostics, and investigation of cases. While in Germany tularemia is a rarely reported disease, there is evidence of recent re-emergence. We also describe some peculiarities that were observed in Germany, such as a broad genetic diversity, and a recently discovered new genus of Francisella and protracted or severe clinical courses of infections with the subspecies holarctica. Because tularemia is a zoonosis, we also touch upon the situation in the animal reservoir and one-health aspects of this disease. Apparently, many pieces of the puzzle need to be found and put into place before the complex interaction between wildlife, the environment and humans are fully understood. Funding for investigations into rare diseases is scarce. Therefore, combining efforts in several countries in the framework of international projects may be necessary to advance further our understanding of this serious but also scientifically interesting disease. PMID:29503812

Losing a Language in Childhood: A Longitudinal Case Study on Language Attrition

ERIC Educational Resources Information Center

Flores, Cristina

2015-01-01

This paper is based upon a longitudinal study of L2 attrition in a bilingual child who grew up in an L2 migration background (Germany) and moved to the country of origin (Portugal) at the age of nine, experiencing a "dominance shift from the L2 to the L1." The study aims to analyze the effects of language loss in L2 German. Data…

Public Opinion and Security Policy in the Federal Republic of Germany: Elite and Mass Opinion in a Comparative Perspective,

DTIC Science & Technology

1984-09-01

not want to fight for freedom could easily be disproved by a public poll of 1982, which indicated that "given the horrors of war today," the Germans...34peace .0 image" in Germany.7 This is especially the case in the evalutation of 7Peace groups particularly have very low confidence in the ability of the

Changing Structure of Rural Employment in the Federal Republic of Germany - the Case of Rural Youth, 1955-1980.

ERIC Educational Resources Information Center

Planck, Ulrich

Trends in employment in West Germany evolved from analysis of a rural youth survey based on interviews from 1955, 1968, and 1980. Persons surveyed were from 17 to 28 years of age and lived in settlements of 5,000 inhabitants or less. During the time period (1955-1980), the youth employment rate decreased from 74% to 67%. Agricultural jobs…

Large multistate outbreak of norovirus gastroenteritis associated with frozen strawberries, Germany, 2012.

PubMed

Bernard, H; Faber, M; Wilking, H; Haller, S; Höhle, M; Schielke, A; Ducomble, T; Siffczyk, C; Merbecks, S S; Fricke, G; Hamouda, O; Stark, K; Werber, D

2014-02-27

From 20 September through 5 October 2012, the largest recorded food-borne outbreak in Germany occurred. Norovirus was identified as the causative agent. We conducted four analytical epidemiological studies, two case–control studies and two surveys (in total 150 cases) in secondary schools in three different federal states. Overall, 390 institutions in five federal states reported nearly 11,000 cases of gastroenteritis. They were predominantly schools and childcare facilities and were supplied almost exclusively by one large catering company. The analytical epidemiological studies consistently identified dishes containing strawberries as the most likely vehicle, with estimated odds ratios ranging from 2.6 to 45.4. The dishes had been prepared in different regional kitchens of the catering company and were served in the schools two days before the peaks of the respective outbreaks. All affected institutions had received strawberries of one lot, imported frozen from China. The outbreak vehicle was identified within a week, which led to a timely recall and prevented more than half of the lot from reaching the consumer. This outbreak exemplifies the risk of large outbreaks in the era of global food trade. It underlines the importance of timely surveillance and epidemiological outbreak investigations for food safety.

Cases of Lyme disease reported in a military community.

PubMed

Underwood, P K; Armour, V M

1993-02-01

Lyme disease, a growing public health problem in the United States, is also an increasing threat in Europe. Cases identified in a military community in West Germany are presented and problems of diagnosis and treatment discussed.

Drifting Apart or Converging? Grades among Non-Traditional and Traditional Students over the Course of Their Studies: A Case Study from Germany

ERIC Educational Resources Information Center

Brändle, Tobias; Lengfeld, Holger

2017-01-01

Since 2009, German universities were opened by law to freshmen who do not possess the traditional graduation certificate required for entry into University, but who are rather vocationally qualified. In this article, we track the grades of these so-called non-traditional students and compare them to those of traditional students using a…

[The Balance of Care approach for the development of custom-fit health care services for people with dementia on the margins of care between home and nursing home: experiences with its application in Germany].

PubMed

Stephan, Astrid; Renom Guiteras, Anna; Juchems, Stefan; Meyer, Gabriele

2013-01-01

In Germany as in other countries of the European Union (EU), the majority of people with dementia are cared for by their informal caregivers at home. Across countries, however, there are considerable differences in the time to nursing home admission. The European research project RightTimePlaceCare intends to establish good practice recommendations for how to sustain the preferred living situation as long as possible. The Balance of Care approach was used to develop these recommendations, which combines empirical data, cost estimates and expert consensus, and thus implemented in a multinational context for the first time. In eight EU countries a survey was conducted among 2,014 people with dementia and their informal caregivers in nursing homes (n=1,223) or at home (n=791). Selected descriptive characteristics of the study participants were used for case type development. The case types were translated into 14 case vignettes, which were discussed by five to six expert panels (each consisting of three to four participants) per country. The experts (n=161) recommended the most suitable living place (at home or in a nursing home) and customised care packages for home care situations. Across all countries, the experts predominantly recommended care at home for four of the case types whose reference group of study participants actually lived in a nursing home. These case types represent a relevant part of the study population. In Germany, the experts judged the case vignettes as realistic but criticised that information relevant for proper decision making was missing. Expert group discussions always ended in consensus, and care at home was predominately recommended. The proposed care packages most often comprised standard care services, and hence appeared to be realistic and feasible. The development of country-specific recommendations is still ongoing. In order to assess economic feasibility, estimated costs of home care packages will be compared with costs of nursing home care. Further outcomes like the quality of life will be considered for good practice recommendation finding. Balance of Care supports the development of empirically based expert recommendations. The approach is widely applicable but seems to be particularly useful for the development of local custom-fit healthcare services. The clinical effectiveness, safety, and cost implications of the Balance of Care approach remain to be investigated in future studies. Copyright © 2013. Published by Elsevier GmbH.

Mental health of patients from different cultures in Germany.

PubMed

Wittig, U; Lindert, J; Merbach, M; Brähler, E

2008-01-01

Empirical studies on migration and mental health of migrants are still rare. In Germany they are often characterised by low sample sizes and are limited to certain diseases and geographical areas (old federal states). The comparability of their results is limited. Nonetheless, the assessment of migrants' health is necessary for adequate medical and psychosocial care for this target group. To provide data on mental health of migrants from Poland and from Vietnam in Germany. We have assessed a random sample of migrants from Poland (n=140) and from Vietnam (n=88) using the Giessen Subjective Complaints List - 24 (GSCL-24) and the Hospital Anxiety and Depression Scale (HADS). Additionally we asked migrants about their knowledge of health care institutions in case of psychosocial problems, their demands and the existing barriers to health care utilisation. Migrants from Poland and Vietnam have a higher general score of complaints of physical ill-health and higher anxiety and depression values than Germans. Psychosocial and medical institutions are visited less. Further analytical studies are needed to clarify health differences between these groups. Migrants are a heterogeneous group and only group-specific investigations will clarify associations between countries of origin, health status and use of health care institutions.

Retaining United States Department of Defense Civilian Employees through Disciplined Servant Leadership

ERIC Educational Resources Information Center

Slassi, Mohammed

2018-01-01

The following comparative case studies explored the applicability of servant leadership within the US military and how such leadership style contributes to commitment and retention of civil service employees. The research took place in a US Army post in Germany and in a US Air Force Base in Florida. Retaining civilian employees and raising their…

How Do National Career Systems Promote or Hinder the Emergence of New Research Lines?

ERIC Educational Resources Information Center

Laudel, Grit

2017-01-01

Early career researchers are faced with the expectation of their scientific communities to conduct independent research, which is reflected in the development of independent new research lines. This change must take place under conditions that vary between national career systems. Case studies for a chair system (Germany) and two tenure systems,…

The Role of Universities and Other Institutions in Successful Entrepreneurship: Some Insights from a Literature Review

ERIC Educational Resources Information Center

Zarate-Hoyos, German A.; Larios-Meoño, Fernando

2015-01-01

The purpose of this paper is to analyze the role of universities and other institutions in successful entrepreneurship. Insights are obtained following a literature review approach. Case studies from the United States (New York startup), Spain (Mondragon), and Germany provide strong evidence that universities are very instrumental in the creation,…

The Temptation of Documentation: Potential and Challenges of Videographic Documentation and Interpretation. A Case-Study from a Civic Education Research Project in Germany

ERIC Educational Resources Information Center

Winckler, Marie

2014-01-01

Insights into the civic education classroom can be gained through "videographic documentation". Videographic material offers, as I argue in this article, great possibilities: Through a "reconstructive approach" insights into dimensions of civic education such as spatial organisation, symbolic representation and non-verbal…

"Experimental Pedagogy" in Germany, Elaborated for Mathematics--A Case Study in Searching the Roots of PME

ERIC Educational Resources Information Center

Schubring, Gert

2012-01-01

PME, the International Group for the Psychology of Mathematics Education, was founded in 1976, at the "Third International Congress on Mathematical Education" in Karlsruhe, organised by the International Commission on Mathematics Instruction (ICMI). While PME is thus beyond coming of age and is reflecting its further orientation--due to…

Participants' Experiences in Hellinger's Family Constellation Work: A Grounded Theory Study

ERIC Educational Resources Information Center

Georgiadou, Sofia

2012-01-01

As a recently introduced to the U.S. model of intergenerational systemic therapy from Germany, Bert Hellinger's Family Constellation Work (FCW) has very limited research support. Hellinger himself has authored a number of publications referencing hundreds of cases, where he implemented his method to approach a broad array of physical,…

Rapid geographical clustering of wound botulism in Germany after subcutaneous and intramuscular injection of heroin.

PubMed

Galldiks, Norbert; Nolden-Hoverath, Silke; Kosinski, Christoph M; Stegelmeyer, Ulrike; Schmidt, Sylvia; Dohmen, Christian; Kuhn, Jens; Gerbershagen, Kathrin; Bewermeyer, Heiko; Walger, Peter; Biniek, Rolf; Neveling, Michael; Jacobs, Andreas H; Haupt, Walter F

2007-01-01

Wound infections due to Clostridium botulinum in Germany are rare and occur predominantly in heroin injectors, especially after subcutaneous or intramuscular injection of heroin ("skin popping"), which is contaminated with spores of C. botulinum. We report a rapid geographical clustering of cases in Germany in a region between Cologne, Bonn, and Aachen with wound botulism and consecutive systemic C. botulinum intoxication in intravenous drug users (IDUs) within 6 weeks in October and November 2005. A group of 12 IDUs with wound botulism after "skin popping." Clinical data were available in 11 (92%) of 12 patients; in 7 (58%) of the 12 cases, there was cranial nerve involvement including mydriasis, diplopia, dysarthria, and dysphagia, followed by progressing symmetric and flaccid paralysis of proximal muscles of the neck, arms, trunk, and respiratory muscles. Mechanical respiratory support was necessary. Five of the IDUs were treated with antitoxin, but mechanical respiratory support could not be avoided. The mean ventilation duration was 27.4 days (range 6-77 days). In 4 patients (33%), mechanical ventilation could be avoided; two were treated with antitoxin. This report describes rapid geographical clustering of wound botulism with severe respiratory complications in IDUs after "skin popping," which has not previously been reported either in Germany or any other European country. Based on these observations and those in other European countries, we conclude that there is a trend towards "skin popping," suggesting a change in injection practices in IDUs. Secondly, we conclude that the total number of cases with wound botulism is likely to increase because "skin popping" is the main risk factor.

Reservoir-Driven Heterogeneous Distribution of Recorded Human Puumala virus Cases in South-West Germany.

PubMed

Drewes, S; Turni, H; Rosenfeld, U M; Obiegala, A; Straková, P; Imholt, C; Glatthaar, E; Dressel, K; Pfeffer, M; Jacob, J; Wagner-Wiening, C; Ulrich, R G

2017-08-01

Endemic regions for Puumala virus (PUUV) are located in the most affected federal state Baden-Wuerttemberg, South-West Germany, where high numbers of notified human hantavirus disease cases have been occurring for a long time. The distribution of human cases in Baden-Wuerttemberg is, however, heterogeneous, with a high number of cases recorded during 2012 in four districts (H districts) but a low number or even no cases recorded in four other districts (L districts). Bank vole monitoring during 2012, following a beech (Fagus sylvatica) mast year, resulted in the trapping of 499 bank voles, the host of PUUV. Analyses indicated PUUV prevalences of 7-50% (serological) and 1.8-27.5% (molecular) in seven of eight districts, but an absence of PUUV in one L district. The PUUV prevalence differed significantly between bank voles in H and L districts. In the following year 2013, 161 bank voles were trapped, with reduced bank vole abundance in almost all investigated districts except one. In 2013, no PUUV infections were detected in voles from seven of eight districts. In conclusion, the linear modelling approach indicated that the heterogeneous distribution of human PUUV cases in South-West Germany was caused by different factors including the abundance of PUUV RNA-positive bank voles, as well as by the interaction of beech mast and the proportional coverage of beech and oak (Quercus spec.) forest per district. These results can aid developing local public health risk management measures and early warning models. © 2016 Blackwell Verlag GmbH.

Accidental mechanical asphyxia of children in Germany between 2000 and 2008.

PubMed

Meyer, F S; Trübner, K; Schöpfer, J; Zimmer, G; Schmidt, E; Püschel, K; Vennemann, M; Bajanowski, T; Althaus, L; Bach, P; Banaschak, S; Cordes, O; Dettmeyer, S R; Dressler, J; Gahr, B; Grellner, W; Héroux, V; Mützel, E; Tatschner, T; Zack, F; Zedler, B

2012-09-01

Accidents constitute one of the greatest risks to children, yet there are few medical reports that discuss the subject of accidental asphyxia. However, a systematic analysis of all documented cases in Germany over the years 2000-2008 has now been conducted, aiming at identifying patterns of accidental asphyxia, deducing findings, defining avoidance measures and recommending ways of increasing product safety and taking possible precautions. The analysis is based on a detailed retrospective analysis of all 91 relevant autopsy reports from 24 different German forensic institutes. A variety of demographic and morphological data was systematically collected and analysed. In 84 of the 91 cases, the sex of the victim was reported, resulting in a total of 57 boys (68 %) and 27 girls (32 %). The age spread ranged between 1 day and 14 years, with an average of 5.9 years. Most accidents occurred in the first year of life (20 %) or between the ages of 1 and 2 years (13 %). In 46 % of cases, the cause of death was strangulation, with the majority occurring in the home environment. In 31 % of all cases, the cause of death was positional asphyxia, the majority resulting from chest compression. In 23 % of cases, the cause of death was aspiration, mainly of foreign bodies. Today, accidental asphyxiation is a rare cause of death in children in Germany. Nevertheless, the majority of cases could have been avoided. Future incidence can be reduced by implementing two major precautions: increasing product safety and educating parents of potentially fatal risks. Specific recommendations relate to children's beds, toys and food.

National trends and differences in morbidity among surgical approaches for radical prostatectomy in Germany.

PubMed

Stolzenburg, Jens Uwe; Kyriazis, Iason; Fahlenbrach, Claus; Gilfrich, Christian; Günster, Christian; Jeschke, Elke; Popken, Gralf; Weißbach, Lothar; von Zastrow, Christoph; Leicht, Hanna

2016-11-01

In this study, we document trends in radical prostatectomy (RP) employment in Germany during the period 2005-2012 and compare the morbidity of open (ORP), laparoscopic and robotic-assisted RP based on nationwide administrative data of Allgemeine Ortskrankenkassen (AOK) German local healthcare funds. Administrative claims data of all AOK patients subjected to RP during 2005-2012 (57,156 cases) were used to evaluate the employment of minimally invasive RP (MIRP) procedures, pelvic lymph node dissection (PLND) and nerve-sparing approaches during this period. In addition, data from the most recent three-year period of our dataset (2010-2012) were used to compare the morbidity among the different surgical approaches. Study end points comprised 30-day mortality, 30-day transfusion, 1-year reintervention and 30-day adverse events, as well as 1-year overall complications. A 20 % reduction in RP utilization from 2007 to 2012 was documented. ORP remained the predominant RP approach in Germany. MIRP approaches carried a lower risk of 30-day transfusions, 1-year reinterventions and 1-year overall complications than ORP when adjusting for confounding factors. PLND was associated with an increased risk of complications, while age in the highest quintile and the presence of comorbidities were independent risk factors for morbidity and mortality. Lack of pathological data was the main limitation of the study. RP utilization in Germany is dropping, but the use of MIRP has risen steadily during the years 2005-2012, which is expected to have a positive impact on the morbidity of the operation.

Occupational obstructive airway diseases in Germany: Frequency and causes in an international comparison

DOE Office of Scientific and Technical Information (OSTI.GOV)

Latza, U.; Baur, X.

2005-08-01

Occupational inhalative exposures contribute to a significant proportion of obstructive airway diseases (OAD), namely chronic obstructive pulmonary disease (COPD) and asthma. The number of occupational OAD in the German industrial sector for the year 2003 are presented. Other analyses of surveillance data were retrieved from Medline. Most confirmed reports of OAD are cases of sensitizer induced occupational asthma (625 confirmed cases) followed by COPD in coal miners (414 cases), irritant induced occupational asthma (156 cases), and isocyanate asthma (54 cases). Main causes of occupational asthma in Germany comprise flour/flour constituents (35.9%), food/feed dust (9.0%), and isocyanates (6.5%). Flour and grainmore » dust is a frequent cause of occupational asthma in most European countries and South Africa. Isocyanates are still a problem worldwide. Although wide differences in the estimated incidences between countries exist due to deficits in the coverage of occupational OAD, the high numbers necessitate improvement of preventive measures.« less

Cross-sectional, descriptive study of Chagas disease among citizens of Bolivian origin living in Munich, Germany.

PubMed

Navarro, Miriam; Berens-Riha, Nicole; Hohnerlein, Stefan; Seiringer, Peter; von Saldern, Charlotte; Garcia, Sarah; Blasco-Hernández, Teresa; Navaza, Bárbara; Shock, Jonathan; Bretzel, Gisela; Hoelscher, Michael; Löscher, Thomas; Albajar-Viñas, Pedro; Pritsch, Michael

2017-01-16

Chagas disease (CD) has become a global health issue mainly due to migration. Germany lacks surveillance data and is home to a large Latin American immigrant population. Recognising that Bolivia is the country with the highest CD prevalence in Latin America, this cross-sectional, descriptive pilot study investigated CD and associated factors among citizens of Bolivian origin living in Munich, Germany. Participants completed a questionnaire in order to collect socioeconomic and health-related data. In addition, serology was performed. In case of positive serological tests, PCR diagnostic and clinical staging together with disease management was initiated. Qualitative research was conducted to identify personal and community barriers as well as strategies to increase CD awareness among the population at risk. Between June 2013 and June 2014, 43 people from Bolivia (or descendants) were enrolled. A total of 9.3% (4/43), of whom two women were of childbearing age, tested seropositive (ELISA and IFAT), and one also by PCR. For 2/4 positive participants, clinical evaluation was performed and the indeterminate form of CD was diagnosed. Knowledge about CD symptoms and ways of transmission were completely absent among 55.8% (24/43, 2/4 with CD) and 30.2% (13/43, 1/4 with CD) of participants, respectively. A total of 27.9% (12/43, 0/4 with CD) of participants had donated blood prior to the study, whereas 62.8% (27/43, 3/4 with CD) were motivated to donate blood in the future. The qualitative research identified lack of knowledge as well as stigma and fears related to CD. Despite the small number of participants, the prevalence of CD as well as the potential risk of non-vectorial transmission was alarming. Campaigns adapted for Latin American migrants as well as control strategies should be developed and put in place in order to prevent non-vectorial transmission and actively detect cases of CD in Germany. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Relevance of medical reports in criminal investigations of cases of suspected child abuse.

PubMed

Janßen, Katharina; Greif, Dominik; Rothschild, Markus A; Banaschak, Sibylle

2017-07-01

If a case of physical child abuse is suspected in Germany, the general feeling is often that "it does not matter whether you make a report or not" because, generally, no conviction is made anyway. This study investigates the juridical analysis of complaint cases of physical child abuse [criminal complaint parag. 225 StGB (German penal code) with filial victim]. It focuses on the doctor's role and the impact of their practice in relation to a later conviction. It is based on the analysis of 302 files of the enquiry from 2004-2009 from the department of public prosecution in Cologne, Germany. Besides general epidemiological data on the reporting person, the affected child and the presumed offender, the documents were reassessed for the relevance of medical reports for successful convictions. Only 7% (n = 21) of 302 complaints led to a conviction. In 38.1% (n = 8) of those cases, a medical report was mentioned as a piece of evidence, and just in two cases a (legal) medical report was quoted and mentioned as relevant for the conviction. 50% of the complaint cases with legal medical expertise led to a trial. In contrast, only 30.2% with a common medical report and 7.3% without a report led to a trial. The results show how a medical report existed in only a few cases. In those cases, the rate of performed trials was higher than for those without a medical report, but the report played a minor part when reasoning a verdict.

Occupational risk factors for testicular cancer: a registry-based case-control study in Rhineland Palatinate – Germany

PubMed Central

Yousif, Lamyaa; Hammer, Gaël P.; Emrich, Katharina; Blettner, Maria; Zeeb, Hajo

2013-01-01

Objectives: Testicular cancer affects mainly men below the age of 50. An association with occupation and social status has been suggested but risk factors are not well understood. A registry-based case-control study focusing on occupation was performed in Germany. Methods: All 348 testicular cancer cases with available gainful occupational information registered between 2000 and 2005; as well as 564 suitable controls (from a pool of other cancers) were drawn from the Cancer Registry of Rhineland-Palatinate. Unconditional logistic regression was used to compute odds ratios (OR) and associated 95% confidence intervals (CI). Results: Slightly elevated OR were observed for technicians and related professionals (OR 1.62, 95% CI 1.00–2.63) and for clerical support workers (OR 1.71, 95% CI 1.14–2.56). This increase was highest in the age group 20–50 for technicians (OR 2.02, 95% CI 1.23–3.33) and clerks (OR 2.00, 95% CI 1.30–3.09), respectively. An association with testicular cancer was observed for no other occupation. Conclusion: An increased risk of testicular cancer was observed for technicians and related professionals and clerical support workers. This could be related to socioeconomic status or sedentary life style, two factors that were identified in previous studies. While the feasibility of a purely registry-based study was shown, missing occupational data and the choice of cancer controls represent challenges to the validity of this approach. PMID:24265602

Climate suitability for the transmission of Dirofilaria immitis and D. repens in Germany.

PubMed

Sassnau, R; Daugschies, A; Lendner, M; Genchi, C

2014-09-15

Recently concerns are increasing that dirofilarial nematodes may spread from endemic areas in southern, eastern and central Europe to countries in northern regions of Europe. The increasing number of autochthonous cases of canine Dirofilaria repens infections in Germany indicates that worms of this genus may invade new areas, and climate change may be a key factor in this scenario. Thus analysis of long term development of regional temperature is a pivotal factor in risk analysis related to transmission of these worms. Such information is important for suggestions of counteracting strategies, such as definition of periods of increased transmission risk and, consequently, time slots most suited for preventative measures. In this study, mean daily temperature data from 34 geographical clustered weather stations representing all parts of Germany were analyzed. It is concluded that the increasing trend for average daily temperatures observed in the period from 1984 to 2013 has led to climatic conditions that allow the completion of dirofilarial life cycles in large parts of Germany between May and October. Autochthonous infection with D. repens is already established in some regions and targeted diagnosis and medical prophylaxis is advisable for dogs assumedly exposed during risk of transmission periods. It appears likely that global warming will support further spread of D. repens. Furthermore for the population of dogs the spread of the more pathogenic species D. immitis in hitherto non-endemic Germany is a potential risk if mean temperatures rise to a level suitable for parasite development in the abundant vector mosquitoes during the warmer seasons. Copyright © 2014 Elsevier B.V. All rights reserved.

Case-control study on risk factors for acute hepatitis E in Germany, 2012 to 2014.

PubMed

Faber, Mirko; Askar, Mona; Stark, Klaus

2018-05-01

BackgroundNotified cases of hepatitis E have increased 40-fold in the past 10 years in Germany. Food safety is a major concern as hepatitis E virus (HEV) RNA has been detected in ready-to-eat retail-level food products. The objective of this case-control study was to assess risk factors for autochthonous symptomatic hepatitis E and explore reasons for delays in diagnosis. Methods: Demographic, clinical and exposure data from notified hepatitis E cases and individually matched population controls were collected in semi-standardised telephone interviews. Conditional logistic regression analysis was used to calculate matched odds ratios (mOR) and population attributable fractions (PAF). Results: In total, 270 cases and 1,159 controls were included (mean age 53 years, 61% men in both groups). Associated with disease were: consumption of undercooked pork liver, pork, wild boar meat, frankfurters, liver sausage and raw vegetables; contact with waste water (occupational) and various host factors (mORs between 1.9 and 34.1, p value < 0.03). PAF for frankfurters and liver sausage were 17.6%, and 23.6%, respectively. There were statistically significant differences in the clinical presentation and hospitalisation proportion of acute hepatitis E in men and women. Diagnosis was preceded by more invasive procedures in 29.2% of patients, suggesting that hepatitis E was not immediately considered as a common differential diagnosis. Conclusions: Our study suggests that there are indeed sex-specific differences in disease development and lends important epidemiological evidence to specific ready-to-eat pork products as a major source for autochthonous hepatitis E. A review of existing consumer recommendations and production methods may be indicated.

When Iron Crumbles: Berlin and the Wall. A Social Studies Unit Recommended for Grades 9-12 and Community College.

ERIC Educational Resources Information Center

Chan, Adrian; And Others

This unit, designed for use with high school and community college students, uses primary materials, literature, and interactive lesson plans to present the city of Berlin (Germany) as a case study of some of the 20th century's most significant events. In lesson 1, students take a pre-test, view a video about the Berlin Wall, and discuss the kinds…

From Education to Work: Cross-National Perspectives. Revisitations of Papers Delivered at the Conference at the University of Toronto (April 18-20, 1996).

ERIC Educational Resources Information Center

Heinz, Walter R., Ed.

This volume is composed of 13 comparable longitudinal studies that draw on survey data and case studies of young people in Canada, Germany, Great Britain, and the United States. "Introduction: Transitions to Employment in a Cross-National Perspective" (Walter R. Heinz) provides a context and an overview. Part I has four chapters that…

Usutu virus, Austria and Hungary, 2010-2016.

PubMed

Bakonyi, Tamás; Erdélyi, Károly; Brunthaler, René; Dán, Ádám; Weissenböck, Herbert; Nowotny, Norbert

2017-10-11

Usutu virus (USUV, Flaviviridae) was first reported in Europe in Austria in 2001, where it caused wild bird (mainly blackbird) mortality until 2005. Since 2006 no further USUV cases were diagnosed in the country. However, the virus emerged in other European countries (Hungary, Italy, Switzerland, Spain, Germany and the Czech Republic) between 2005 and 2011. In 2016, widespread USUV-associated wild bird mortality was observed in Germany, France, Belgium and the Netherlands. In this study, we report the results of passive monitoring for USUV in Austria and Hungary between 2010 and 2016. In Hungary, USUV caused sporadic cases of wild bird mortality between 2010 and 2015 (altogether 18 diagnosed cases), whereas in summer and autumn 2016 the number of cases considerably increased to 12 (ten blackbirds, one Eurasian jay and one starling). In Austria, USUV was identified in two blackbirds in 2016. Phylogenetic analyses of coding-complete genomes and partial regions of the NS5 protein gene revealed that USUVs from Hungary between 2010 and 2015 are closely related to the virus that emerged in Austria in 2001 and in Hungary in 2005, while one Hungarian sequence from 2015 and all sequences from Hungary and Austria from 2016 clustered together with USUV sequences reported from Italy between 2009 and 2010. The results of the study indicate continuous USUV circulation in the region and exchange of USUV strains between Italy, Austria and Hungary.Emerging Microbes &Infections (2017) 6, e85; doi:10.1038/emi.2017.72; published online 11 October 2017.

National states and international science: A comparative history of international science congresses in Hitler's Germany, Stalin's Russia, and cold war United States.

PubMed

Doel, Ronald E; Hoffmann, Dieter; Krementsov, Nikolai

2005-01-01

Prior studies of modern scientific internationalism have been written primarily from the point of view of scientists, with little regard to the influence of the state. This study examines the state's role in international scientific relations. States sometimes encouraged scientific internationalism; in the mid-twentieth century, they often sought to restrict it. The present study examines state involvement in international scientific congresses, the primary intersection between the national and international dimensions of scientists' activities. Here we examine three comparative instances in which such restrictions affected scientific internationalism: an attempt to bring an international aerodynamics congress to Nazi Germany in the late 1930s, unsuccessful efforts by Soviet geneticists to host the Seventh International Genetics Congress in Moscow in 1937, and efforts by U.S. scientists to host international meetings in 1950s cold war America. These case studies challenge the classical ideology of scientific internationalism, wherein participation by a nation in a scientist's fame spares the scientist conflict between advancing his science and advancing the interests of his nation. In the cases we consider, scientists found it difficult to simultaneously support scientific universalism and elitist practices. Interest in these congresses reached the top levels of the state, and access to patronage beyond state control helped determine their outcomes.

Occupational skin cancer due to UV-irradiation--Analyses of notified cases as "virtually-certain" occupational disease in Germany between 2005 and 2011.

PubMed

Schmitt, Jochen; Diepgen, Thomas L

2014-06-01

UV-induced skin cancer is not yet included in the German ordinance on occupational diseases and can only be notified and recognized acknowledged as "virtually-certain" occupational disease. The objective of the study was to analyze notified and acknowledged cases of occupational skin cancer due to UV-irradiation in Germany between 2005 and 2011. All notified cases of occupational skin cancer due to UV-irradiation have been analyzed which have been registered by the German Statutory accident insurance as of May 2012 were analyzed. The data analyze was descriptive stratified annually for presenting time trends.Data analysis was descriptive, stratified by year to defect time trends. Notified cases have increased annually with a total of 548 registered cases of occupational skin cancer induced by UV-irradiation between 2005 and 2011, and 74 recognized acknowledged cases. In 56 cases the procedure was not yet finished. Squamous cell carcinoma (SCC) and in-situ squamous cell carcinoma (actinic keratosis, Bowen's disease) were most frequent and have been the most frequentlyobserved in 333 notified cases. and between 15.6 % and 24.9 % have been recognizedof cases with SCC and actinic keratosis were recognized, respectively. 184 patients with basal cell carcinoma were notified but only 6.5 % recognized acknowledged and only 3 cases with exclusive basal cell carcinoma. Out of 50 notified patients with Mmelanoma only one was recognizedacknowledged. The results are in good agreement with the proposal of the German Minister of labor to establish UV-induced skin cancer as a new occupational disease. © 2014 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Power, Profits, and Politics: Energy Security and Cooperation in Eurasia

NASA Astrophysics Data System (ADS)

Svyatets, Ekaterina

This study explores varying outcomes of energy cooperation, defined as diplomatic relations, bilateral trade, and investment in oil and natural gas. Tests of theories pertinent to energy security - broadly speaking, realism, liberalism, and domestic politics---reveal that they alone can offer only a narrow and one-sided explanation, not embracing the complexity of energy issues. Nevertheless, using them as a starting point, this study outlined a structured framework that incorporates three variables---economic potential, geopolitical rivalry, and domestic interest groups---that are applied to the cases of U.S.-Russia, U.S.-Azerbaijan, and Russia-Germany energy ties. This study concludes that if the economic potential (defined by geographic proximity and resource availability) is very high, such as in the case of Russia-Germany, states can overcome geopolitical rivalries and historical enmities in favor of energy cooperation. However, if the economic potential is relatively low (because of geographic obstacles or easily available alternative suppliers, as in the cases of U.S.-Russia and U.S.-Azerbaijan), then geopolitics prevails---for example, to bypass Russia or to limit American access to contracts in Russia when U.S.-Russian relations are strained. In all the cases explored here, domestic interest groups have mixed influence: if they are united along energy issues, they usually successfully achieve their energy policy goals, although the impact of these groups often becomes intertwined with state interests. In other situations, when powerful interest groups are divided or focused on non-energy-related issues (such as ethnic priorities), their influence over energy deals is much lower.

Trouble with bleeding: risk factors for acute hepatitis C among HIV-positive gay men from Germany--a case-control study.

PubMed

Schmidt, Axel J; Rockstroh, Jürgen K; Vogel, Martin; An der Heiden, Matthias; Baillot, Armin; Krznaric, Ivanka; Radun, Doris

2011-03-08

To identify risk factors for hepatitis C among HIV-positive men who have sex with men (MSM), focusing on potential sexual, nosocomial, and other non-sexual determinants. Outbreaks of hepatitis C virus (HCV) infections among HIV-positive MSM have been reported by clinicians in post-industrialized countries since 2000. The sexual acquisition of HCV by gay men who are HIV positive is not, however, fully understood. Between 2006 and 2008, a case-control study was embedded into a behavioural survey of MSM in Germany. Cases were HIV-positive and acutely HCV-co-infected, with no history of injection drug use. HIV-positive MSM without known HCV infection, matched for age group, served as controls. The HCV-serostatus of controls was assessed by serological testing of dried blood specimens. Univariable and multivariable regression analyses were used to identify factors independently associated with HCV-co-infection. 34 cases and 67 controls were included. Sex-associated rectal bleeding, receptive fisting and snorting cocaine/amphetamines, combined with group sex, were independently associated with case status. Among cases, surgical interventions overlapped with sex-associated rectal bleeding. Sexual practices leading to rectal bleeding, and snorting drugs in settings of increased HCV-prevalence are risk factors for acute hepatitis C. We suggest that sharing snorting equipment as well as sharing sexual partners might be modes of sexual transmission. Condoms and gloves may not provide adequate protection if they are contaminated with blood. Public health interventions for HIV-positive gay men should address the role of blood in sexual risk behaviour. Further research is needed into the interplay of proctosurgery and sex-associated rectal bleeding.

Contamination during production of heater-cooler units by Mycobacterium chimaera potential cause for invasive cardiovascular infections: results of an outbreak investigation in Germany, April 2015 to February 2016.

PubMed

Haller, Sebastian; Höller, Christiane; Jacobshagen, Anja; Hamouda, Osamah; Abu Sin, Muna; Monnet, Dominique L; Plachouras, Diamantis; Eckmanns, Tim

2016-04-28

Invasive infections with Mycobacterium chimaera were reported in patients with previous open chest surgery and exposure to contaminated heater-cooler units (HCUs). We present results of the surveillance of clinical cases and of contaminated HCUs as well as environmental investigations in Germany up until February 2016. Clinical infections occurred in five male German cases over 50 years of age (range 53-80). Cases had been exposed to HCUs from one single manufacturer during open chest surgery up to five years prior to onset of symptoms. During environmental investigations, M. chimaera was detected in samples from used HCUs from three different countries and samples from new HCUs as well as in the environment at the manufacturing site of one manufacturer in Germany. Our investigation suggests that at least some of the M. chimaera infections may have been caused by contamination of HCUs at manufacturing site. We recommend that until sustainable measures for safe use of HCUs in operation theatres are implemented, users continue to adhere to instructions for use of HCUs and Field Safety Notices issued by the manufacturer, implement local monitoring for bacterial contamination and continuously check the websites of national and European authorities for current recommendations for the safe operation of HCUs.

Just War and Postmodern Warfare: A German Case Study

DTIC Science & Technology

2015-04-01

warfare construct, Germany is shaping a military concept based on recent conflicts and unfettered by biases of conventional strategies, organizations...remain sovereign while subconsciously evolving toward liberal democratic ideas. In respecting each country’s political sensitivities, Germany’s...before exhausting all diplomatic, economic and information instruments. Whereas the term AU/ACSC/PINSON/AY15 13 “interests” may bias the United

Learner Agency and Non-Native Speaker Identity in Pedagogical Lingua Franca Conversations: Insights from Intercultural Telecollaboration in Foreign Language Education

ERIC Educational Resources Information Center

Kohn, Kurt; Hoffstaedter, Petra

2017-01-01

This article discusses insights gained from a case study on telecollaboration for intercultural communication in foreign language school contexts. Focus was on non-native English and German lingua franca conversations between pairs of students (aged 14-16, B1 level) from schools in France, Germany, the Netherlands and Spain. Telecollaboration…

Education under the Regime of PISA & Co.: Global Standards and Local Traditions in Conflict--The Case of Germany

ERIC Educational Resources Information Center

Münch, Richard

2014-01-01

Background: The PISA study (assessing the competences of 15-year-old students in their mother tongue, in mathematics and in natural sciences) deals with the benchmarking of the OECD member states when it comes to meeting globally defined educational standards. Transnational educational experts now form the most powerful group within the…

Re-Purposing an OER for the Online Language Course: A Case Study of "Deutsch Interaktiv" by the Deutsche Welle

ERIC Educational Resources Information Center

Dixon, Edward M.; Hondo, Junko

2014-01-01

This paper will describe pedagogical approaches for re-purposing an open educational resource (OER) designed and produced by the Deutsche Welle. This free online program, "Deutsch Interaktiv," consists of authentic digital videos, slideshows and audio texts and gives a contemporary overview of the culture and language in Germany, Austria…

Bimodal Bilingual Language Development of Hearing Children of Deaf Parents

ERIC Educational Resources Information Center

Hofmann, Kristin; Chilla, Solveig

2015-01-01

Adopting a bimodal bilingual language acquisition model, this qualitative case study is the first in Germany to investigate the spoken and sign language development of hearing children of deaf adults (codas). The spoken language competence of six codas within the age range of 3;10 to 6;4 is assessed by a series of standardised tests (SETK 3-5,…

Someone to Watch Over Me? Privacy and Governance Strategies for CCTV and Emerging Surveillance Technologies

DTIC Science & Technology

2008-03-01

Zoufal Colonel, United States Army Reserve B.A., University of Illinois, 1978 M.A.P.A., University of Illinois, 1980 J.D., University of Illinois...9 6. Case Studies of the United Kingdom, France, and Germany........11 7. The Chicago Experience...E. PROBLEM STATEMENT ...........................................................................14 1. The Rise of CCTV Surveillance in the United

Locus of Control in Mexican Students: The Case of the Missing Fatalist.

ERIC Educational Resources Information Center

Cole, David L.; Cole, Shirley

This study investigated the extent to which a stereotype of Mexicans or Chicanos as fatalistic is supported by their locus of control scores. Original data for the paper came from locus of control scores on college students in four nations (U.S.A., Mexico, Ireland, and West Germany) and from Anglo and Chicano high school students in southern…

Enterprise Planning for Change; Co-ordination of Manpower and Technical Planning. Industrial Relations Aspects of Manpower Policy, No. 5.

ERIC Educational Resources Information Center

Wedderburn, Dorothy

Forty case studies made by research teams of independents or governmental agencies in Austria, Canada, France, Germany, Norway, Sweden, United Kingdom, and the United States were analyzed to provide managements and trade unions with illustrations of present systems of technical and manpower changes at the enterprise level and to describe the…

Are Graduates Preferred to Those Completing Initial Vocational Education and Training? Case Studies on Company Recruitment Strategies in Germany, England and Switzerland

ERIC Educational Resources Information Center

Hippach-Schneider, Ute; Weigel, Tanja; Brown, Alan; Gonon, Philipp

2013-01-01

The German and Swiss economies value skilled work highly and initial vocational education and training (IVET) has been the predominant traditional pathway into such work. However, concerns about a more "knowledge-based society" and the "academic shift in the labour market" are starting to undermine the status associated with…

The Potential of the Non-Formal Educational Sector for Supporting Chemistry Learning and Sustainability Education for All Students--A Joint Perspective from Two Cases in Finland and Germany

ERIC Educational Resources Information Center

Affeldt, Fiona; Tolppanen, Sakari; Aksela, Maija; Eilks, Ingo

2017-01-01

Non-formal education has been suggested as becoming more and more important in the last decades. As the aims of non-formal education are broad and diverse, a large variety of non-formal learning activities is available. One of the emerging fields in many countries, among them Finland and Germany, has been the establishment of non-formal laboratory…

"Voices of the people": linguistic research among Germany's prisoners of war during World War I.

PubMed

Kaplan, Judith

2013-01-01

This paper investigates the history of the Royal Prussian Phonographic Commission, a body that collected and archived linguistic, ethnographic, and anthropological data from prisoners-of-war (POWs) in Germany during World War I. Recent literature has analyzed the significance of this research for the rise of conservative physical anthropology. Taking a complementary approach, the essay charts new territory in seeking to understand how the prison-camp studies informed philology and linguistics specifically. I argue that recognizing philological commitments of the Phonographic Commission is essential to comprehending the project contextually. My approach reveals that linguists accommodated material and contemporary evidence to older text-based research models, sustaining dynamic theories of language. Through a case study based on the Iranian philologist F. C. Andreas (1846-1930), the paper ultimately argues that linguistics merits greater recognition in the historiography of the behavioral sciences. © 2013 Wiley Periodicals, Inc.

[Initial experiences with amisulpride, an in Germany novel, atypical neuroleptic drug in treatment of adolescents with psychiatric disorders].

PubMed

Göpel, C; Marcus, A

2001-08-01

In addition to conventional antipsychotic drugs, during the past decade an increasing number of atypical neuroleptics has been introduced in the treatment of juvenile schizophrenic and schizoaffective disorders. In 1999 Germany legalized the benzamide amisulpride for the treatment of acute and chronic schizophrenic symptoms. Preliminary treatment results are reported here. Ten adolescent cases are presented with regard to the efficacy, side effects and dosage of amisulpride. Preliminary results on the use of amisulpride are promising. The rate of side effects is tolerable. Amisulprise seems to constitute a useful alternative in the treatment of juvenile schizophrenia for those who suffer from intolerable side effects of classical or atypical neuroleptics. Controlled studies are warranted to further clarify its efficacy and safety in the treatment of adolescents.

The Fate of Mrs Robinson: Criteria for Recognition of Whole-Body Vibration Injury as AN Occupational Disease

NASA Astrophysics Data System (ADS)

HULSHOF, C. T. J.; VAN DER LAAN, G.; BRAAM, I. T. J.; VERBEEK, J. H. A. M.

2002-05-01

Several recently published critical reviews conclude that there is strong epidemiological evidence for a relationship between occupational exposure to whole-body vibration (WBV), low back pain (LBP) and back disorders. Whether this exposure is only a modest or a substantial risk factor for the onset and recurrence of LBP is still a matter of debate. In spite of this controversy, four European Union countries have decided to recognize and compensate LBP and certain spinal disorders as an occupational disease. In this paper, we review the criteria currently in use for the recognition of this occupational disease. A search of the literature was performed; additional information was obtained in work visits to national occupational disease institutes in Germany, France and Belgium, in annual reports and national statistics on occupational diseases. Belgium was the first country to add WBV injury to the official list of occupational diseases (1978), followed by Germany (1993), the Netherlands (1997), and France (1999). The incidence of newly recognized cases in 1999 varied considerably: 763 in Belgium, 269 in France, 16 in Germany, and 10 reported cases in the Netherlands. The findings of this review indicate that significant differences exist in the established and applied diagnostic and exposure criteria in the four EU countries. This is illustrated by the case of Mrs Robinson, a 41-year-old forklift driver with LBP, who would probably get recognition and compensation in the Netherlands and Belgium but would be rejected in France and Germany. The development of uniform internationally accepted criteria is recommended, also from an epidemiological point of view, as many data are collected in the process of recognition of this occupational disease.

[Cases of poisoning in Germany. Disease entity, documentation, and aspects of the event].

PubMed

Hahn, A; Begemann, K; Stürer, A

2014-06-01

Cases of poisoning account for a distinct share of accidents in Germany, which is particularly high for accidents involving children. Cases of poisoning resulting from suicidal intent or abuse are not counted as accidents. Compared to other cases of disease and accidents, the numerical documentation of cases of poisoning is inadequate. Presently, there is no institution in Germany that could make available representative and meaningful data on the current state of poisoning. Owing to intensive scientific cooperation between the poison information centers (funded by the federal states) and the Poison and Product Documentation Center at the Federal Institute for Risk Assessment (BfR DocCenter) as well as to international cooperation, harmonized and standardized tools have been developed for the appropriate documentation and reporting of procedures to account for poisoning accidents. The first evaluation for 2005-2012 based on published and processed figures for the Federal Republic of Germany yielded the following results: Of approximately 230,000 telephone inquiries received in 2012, about 207,000 involved exposure of humans to different noxae. An annual increase of 3-5 % was recorded. For 2011, analyses of subsets processed by means of standardized methods yielded the following results: Medicines were involved in about 39 % of the cases recorded (of these, medicinal products for humans in 99 %); chemical/physicochemical agents in about 26 % (of these, cleaning and maintenance products in 46 %); products of daily use in about 14 % (of these, cosmetics in 40 %); and plants in about 10 %. More than 90 % of cases were acute poisoning and less than 5 %, chronic poisoning. Regarding the degree of severity of poisoning, an asymptomatic course was reported for 44 % of the cases; minor manifestations were experienced in 30 %, moderate ones in 6 %, and severe manifestations in 2 % of the cases recorded. Fatal cases were rare (< 0.1 %). The majority of cases (67 %) were caused by poisoning accidents, followed by suicidal action (20 %), with abuse and industrial poisoning (4 %) in third position; 1 % of the cases of poisoning were attributed to adverse drug reactions (ADR) and mistaking a medicinal product for another one. Infants aged 1-2 years have the highest risk of poisoning. A panel of the BfR Committee for the Assessment of Poisonings has already developed proposals for a national monitoring scheme of poisoning incidents. The aim is to prepare annual reports similar to the report of the National Poison Data System (NPDS) maintained by the American Association of Poison Control Centers (AAPCC) in the USA.

Incidence of intussusception in early infancy: a capture-recapture estimate for Germany.

PubMed

Weiß, S; Streng, A; Kries, R von; Liese, J; Wirth, S; Jenke, A C

2011-12-01

Rotavirus (RV) vaccination with the first generation vaccine (Rotashield) has been associated with intussusception (IS). Reliable age specific baseline incidence data for children ≤6 months of age in particular is fundamental for further post marketing monitoring of potential effects of recently introduced new RV vaccines. IS incidence was estimated by a 2-source capture-recapture calculation (CRC) based on ESPED (German Paediatric Surveillance Unit) reports and on hospital discharge records for 2006 and 2007. ESPED as well as hospital records were validated according to the Brighton Collaboration's Group definition for definite IS. Children that have been treated for IS in a hospital in one of two states of Germany (North-Rhine Westphalia and Bavaria). The annual IS incidence for infants <1 year in Germany calculated with the CRC estimate in Germany was 61.7/100 000 (95% CI: 54.5-70.1). However, the incidence appeared to vary by month of age over a range of 19.2/100 000 cases (95% CI: 12.5-30.4) in the first 3 months of life to 98.5/100 000 cases (95% CI: 80.9-120.6) during the 6 (th) to 8 (th) month. The male to female ratio for infants was 1.7:1 (95%CI: 1.6-1.8). The average incidence estimate for IS in infants (< 1 year) confirms previous estimates in Germany and Switzerland. However, age specific baseline incidence estimates for IS substantially vary during the first year of life. This has to be taken into account when analysing episodes of IS potentially associated with RV vaccination. © Georg Thieme Verlag KG Stuttgart · New York.

Epidemiology of invasive aspergillosis and azole resistance in patients with acute leukaemia: the SEPIA Study.

PubMed

Koehler, Philipp; Hamprecht, Axel; Bader, Oliver; Bekeredjian-Ding, Isabelle; Buchheidt, Dieter; Doelken, Gottfried; Elias, Johannes; Haase, Gerhard; Hahn-Ast, Corinna; Karthaus, Meinolf; Kekulé, Alexander; Keller, Peter; Kiehl, Michael; Krause, Stefan W; Krämer, Carolin; Neumann, Silke; Rohde, Holger; La Rosée, Paul; Ruhnke, Markus; Schafhausen, Philippe; Schalk, Enrico; Schulz, Katrin; Schwartz, Stefan; Silling, Gerda; Staib, Peter; Ullmann, Andrew; Vergoulidou, Maria; Weber, Thomas; Cornely, Oliver A; Vehreschild, Maria J G T

2017-02-01

Invasive aspergillosis (IA) is a serious hazard to high-risk haematological patients. There are increasing reports of azole-resistant Aspergillus spp. This study assessed the epidemiology of IA and azole-resistant Aspergillus spp. in patients with acute leukaemia in Germany. A prospective multicentre cohort study was performed in German haematology/oncology centres. The incidence of probable and proven aspergillosis according to the revised EORTC/MSG criteria was assessed for all patients with acute leukaemia [acute myeloid leukaemia (AML) and acute lymphoblastic leukaemia (ALL)]. Cases were documented into a web-based case report form, and centres provided data on standards regarding prophylactic and diagnostic measures. Clinical isolates were screened centrally for azole resistance and, if applicable, underlying resistance mechanisms were analysed. Between September 2011 and December 2013, 179 cases of IA [6 proven (3.4%) and 173 probable (96.6%)] were diagnosed in 3067 patients with acute leukaemia. The incidence of IA was 6.4% among 2440 AML patients and 3.8% among 627 ALL patients. Mortality at Day 84 was 33.8% (49/145) and attributable mortality was 26.9% (39/145). At Day 84, 53 patients (29.6%) showed a complete response, 25 (14.0%) a partial response and 17 (9.5%) a deterioration or failure. A total of 77 clinical Aspergillus fumigatus isolates were collected during the study period. Two episodes of azole-resistant IA (1.1%) were caused by a TR/L98H mutation in the cyp51A gene. With only two cases of IA due to azole-resistant A. fumigatus, a change of antifungal treatment practices in Germany does not appear warranted currently. Copyright © 2016 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

Differences in incidence and survival of oral cavity and pharyngeal cancers between Germany and the United States depend on the HPV-association of the cancer site.

PubMed

Jansen, L; Buttmann-Schweiger, N; Listl, S; Ressing, M; Holleczek, B; Katalinic, A; Luttmann, S; Kraywinkel, K; Brenner, H

2018-01-01

The epidemiology of squamous cell oral cavity and pharyngeal cancers (OCPC) has changed rapidly during the last years, possibly due to an increase of human papilloma virus (HPV) positive tumors and successes in tobacco prevention. Here, we compare incidence and survival of OCPC by HPV-relation of the site in Germany and the United States (US). Age-standardized and age-specific incidence and 5-year relative survival was estimated using data from population-based cancer registries in Germany and the US Surveillance Epidemiology and End Results (SEER) 13 database. Incidence was estimated for each year between 1999 and 2013. Relative survival for 2002-2005, 2006-2009, and 2010-2013 was estimated using period analysis. The datasets included 52,787 and 48,861 cases with OCPC diagnosis between 1997 and 2013 in Germany and the US. Incidence was much higher in Germany compared to the US for HPV-unrelated OCPC and more recently also for HPV-related OCPC in women. Five-year relative survival differences between Germany and the US were small for HPV-unrelated OCPC. For HPV-related OCPC, men had higher survival in the US (62.1%) than in Germany (45.4%) in 2010-2013. These differences increased over time and were largest in younger patients and stage IV disease without metastasis. In contrast, women had comparable survival for HPV-related OCPC in both countries. Strong survival differences between Germany and the US were observed for HPV-related OCPC in men, which might be explained by differences in HPV-attributable proportions. Close monitoring of the epidemiology of OCPC in each country is needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Characteristics of patients with fibromyalgia in France and Germany.

PubMed

Perrot, S; Winkelmann, A; Dukes, E; Xu, X; Schaefer, C; Ryan, K; Chandran, A; Sadosky, A; Zlateva, G

2010-07-01

Few studies have comprehensively assessed the burden associated with fibromyalgia (FM). This cross-sectional, observational study evaluates the impact of FM on patients in France and Germany. A total of 299 FM patients were recruited from 33 physician offices in France and Germany during routine visits. Patients completed a survey that included the Brief Pain Inventory-Short Form (BPI-sf), Fibromyalgia Impact Questionnaire (FIQ), EuroQol 5D (EQ-5D) and the Hospital Anxiety and Depression Scale (HADS) to describe their pain, FM and health-related quality of life (HRQOL). FM severity was defined using patients' FIQ total scores with 0 to < 39, 39 to < 59 and 59-100, representing mild, moderate and severe FM, respectively. Site staff completed case report forms using patients' medical records. Mean (standard deviation, SD) age was 54.2 (12.6); 81% of patients were women. The mean (SD) FIQ total score was 53.3 (19.6); 33% and 44% of patients reported moderate and severe FM, respectively. Most patients (91%) were receiving prescription medications for FM during the study. Patients reported a mean (SD) EQ-5D health state valuation of 0.44 (0.33) and a mean (SD) BPI-sf Pain Severity Index score of 4.9 (1.8). Forty-one percent of patients reported some level of disruption in their employment because of FM; employed patients missed a mean (SD) of 2.2 (4.6) workdays during the past 4 weeks. An increase in FM severity was significantly associated with increased pain severity, productivity loss, sleep disturbance and higher anxiety and depression (p < 0.0001). There is a substantial burden of illness including treatment limitations for FM patients in France and Germany.

Severe influenza cases in paediatric intensive care units in Germany during the pre-pandemic seasons 2005 to 2008.

PubMed

Streng, Andrea; Grote, Veit; Liese, Johannes G

2011-08-31

Data on complications in children with seasonal influenza virus infection are limited. We initiated a nation-wide three-year surveillance of children who were admitted to a paediatric intensive care unit (PICU) with severe seasonal influenza. From October 2005 to July 2008, active surveillance was performed using an established reporting system for rare diseases (ESPED) including all paediatric hospitals in Germany. Cases to be reported were hospitalized children < 17 years of age with laboratory-confirmed influenza treated in a PICU or dying in hospital. Twenty severe influenza-associated cases were reported from 14 PICUs during three pre-pandemic influenza seasons (2005-2008). The median age of the patients (12 males/8 females) was 7.5 years (range 0.1-15 years). None had received vaccination against influenza. In 14 (70%) patients, the infection had been caused by influenza A and in five (25%) by influenza B; in one child (5%) the influenza type was not reported. Patients spent a median of 19 (IQR 12-38) days in the hospital and a median of 11 days (IQR 6-18 days) in the PICU; 10 (50%) needed mechanical ventilation. Most frequent diagnoses were influenza-associated pneumonia (60%), bronchitis/bronchiolitis (30%), encephalitis/encephalopathy (25%), secondary bacterial pneumonia (25%), and ARDS (25%). Eleven (55%) children had chronic underlying medical conditions, including 8 (40%) with chronic pulmonary diseases. Two influenza A- associated deaths were reported: i) an 8-year old boy with pneumococcal encephalopathy following influenza infection died from cerebral edema, ii) a 14-year-old boy with asthma bronchiale, cardiac malformation and Addison's disease died from cardiac and respiratory failure. For nine (45%) patients, possibly permanent sequelae were reported (3 neurological, 3 pulmonary, 3 other sequelae). Influenza-associated pneumonia and secondary bacterial infections are relevant complications of seasonal influenza in Germany. The incidence of severe influenza cases in PICUs was relatively low. This may be either due to the weak to moderate seasonal influenza activity during the years 2005 to 2008 or due to under-diagnosis of influenza by physicians. Fifty% of the observed severe cases might have been prevented by following the recommendations for vaccination of risk groups in Germany.

[Imported tropical fish causes ciguatera fish poisoning in Germany].

PubMed

Zimmermann, Katharina; Eisenblätter, Anneka; Vetter, Irina; Ebbecke, Martin; Friedemann, Miriam; Desel, Herbert

2015-01-01

Ciguatera is a seafood-borne illness caused by consumption of tropical fish contaminated with ciguatoxins, lipophilic polyethers that are produced in benthic dinoflagellates and accumulate through the marine food chain. Ciguatera cases in Europe usually occur in travellers returning from tropical and subtropical regions of the Pacific and Carribean, where ciguatera is endemic. In 2012, several cases of ciguatera occurred in Germany due to sale of contaminated fish products originating from the Indian Ocean. Although the symptomatology in these cases were typical of ciguatera, with patients reporting gastrointestinal discomfort including nausea, vomiting and diarrhea as well as neurological effects including widespread intense pruritus, paresthesias, hypothermia or altered temperature sensation and diffuse pain, correct diagnosis was delayed in all cases due to lack of awareness of the treating medical practitioners. In light of increasing global mobility, trade, and occurrence of ciguatoxic fish in previously non-endemic areas, ciguatera should be considered as a possible diagnosis if gastrointestinal and neurological symptoms occur shortly after consumption of fish. Georg Thieme Verlag Stuttgart.

[The sequential traumatisation of a Sinti-child Holocaust-survivor].

PubMed

Purucker, Michael

2004-05-01

The subject of this case-report is the life-history, nosogenesis and history of compensation claims of a 64-years old Sinti-woman, who survived Nazi-persecution and WWII as a child. She and her mother spent 3 years in a concentration camp. At the end of the war she witnessed her mothers death. Her life is characterised by psychosomatic symptoms, disorders of psychosexual development, including infertility, and a chronic Post Traumatic Stress Disorder. The non-treated course of the Holocaust survivor syndrom, described by Niederland, which was mostly denied in Germany, could be now shown by detailed exploration and the reanalysis of former expert reports of her symptoms. Furthermore, this case report presents the internationally described characteristics of long-term effects in children that have survived the Holocaust. These symptoms are typical of cases that were not been treated throughout life. The former lack of acceptance in Germany of these long-term effects has - like in this and other cases - lead to development into a chronic disorder.

Russian in the University Curriculum: A Case-Study of the Impact of the First World War on Language Study in Higher Education in Britain

ERIC Educational Resources Information Center

Muckle, James

2008-01-01

The outbreak of the First World War and the emergence of Russia as Britain's "glorious ally" swiftly changed public attitudes in Britain, which had been largely, but not entirely, hostile to Russia. The sense that Britain needed to cure its 'abysmal ignorance' of Russia, coupled with the strong desire to replace Germany, the enemy, as a…

Why we need multi-level health workforce governance: Case studies from nursing and medicine in Germany.

PubMed

Kuhlmann, Ellen; Larsen, Christa

2015-12-01

Health workforce needs have moved up on the reform agendas, but policymaking often remains 'piece-meal work' and does not respond to the complexity of health workforce challenges. This article argues for innovation in healthcare governance as a key to greater sustainability of health human resources. The aim is to develop a multi-level approach that helps to identify gaps in governance and improve policy interventions. Pilot research into nursing and medicine in Germany, carried out between 2013 and 2015 using a qualitative methodology, serves to illustrate systems-based governance weaknesses. Three explorative cases address major responses to health workforce shortages, comprising migration/mobility of nurses, reform of nursing education, and gender-sensitive work management of hospital doctors. The findings illustrate a lack of connections between transnational/EU and organizational governance, between national and local levels, occupational and sector governance, and organizations/hospital management and professional development. Consequently, innovations in the health workforce need a multi-level governance approach to get transformative potential and help closing the existing gaps in governance. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

How managed a market? Modes of commissioning in England and Germany

PubMed Central

2013-01-01

Background In quasi-markets governance over healthcare providers is mediated by commissioners. Different commissioners apply different combinations of six methods of control ('media of power') for exercising governance: managerial performance, negotiation, discursive control, incentives, competition and juridical control. This paper compares how English and German healthcare commissioners do so. Methods Systematic comparison of observational national-level case studies in terms of six media of power, using data from multiple sources. Results The comparison exposes and contrasts two basic generic modes of commissioning: 1. Surrogate planning (English NHS), in which a negotiated order involving micro-commissioning, provider competition, financial incentives and penalties are the dominant media of commissioner power over providers. 2. Case-mix commissioning (Germany), in which managerial performance, an 'episode based' negotiated order and juridical controls appear the dominant media of commissioner power. Conclusions Governments do not necessarily maximise commissioners' power over providers by implementing as many media of power as possible because these media interact, some complementing and others inhibiting each other. In particular, patient choice of provider inhibits commissioners' use of provider competition as a means of control. PMID:23734631

Does elite success trigger mass participation in table tennis? An analysis of trickle-down effects in Germany, France and Austria.

PubMed

Haut, Jan; Gaum, Christian

2017-08-02

There is a widespread belief that success at the elite level leads to increasing mass participation in sports. However, this assumption is merely supported by empirical evidence and is analyzed here for the case of table tennis. Therefore long-term data (1964-2014) on participation in Germany, France and Austria is statistically tested for effects of success by the countries' athletes at international competitions. Results indicate that no general trickle-down effect can be confirmed for table tennis in the countries observed. Rather, findings are ambivalent, as a strong positive effect was found for the Austrian case, but a paradox relation for the German case, where elite success has been accompanied by decreasing participation in the last decades. Accordingly, as an "automatic" trickle-down effect is unlikely, more specific analyses and strategies seem necessary to use elite success as a lever for the promotion of the sport.

[Conjunctival melanoma : Standard operating procedures in diagnosis, treatment and follow-up care].

PubMed

Glossmann, Jan-Peter; Skoetz, Nicole; Starbatty, Barbara; Bischoff, Martina; Leyvraz, Serge; Westekemper, Henrike; Heindl, Ludwig M

2018-06-01

In cases of rare cancer entities, such as malignant melanoma of the conjunctiva, there are often no evidence-based national guidelines available. Standard operating procedures (SOP) are an alternative in these cases. The aim of this project was to develop a consensus SOP for diagnosis, treatment, and follow-up care of conjunctival melanomas between the 14 Centers of Excellence in Germany supported by German Cancer Aid. The SOP was prepared according to a defined process including timelines, flow of information, and roles. This is the first consensus SOP of the Centers of Excellence in Germany (certified by the German Cancer Aid) regarding diagnosis, treatment, and follow-up for malignant melanomas of the conjunctiva.

Cancer survival among children of Turkish descent in Germany 1980–2005: a registry-based analysis

PubMed Central

Spix, Claudia; Spallek, Jacob; Kaatsch, Peter; Razum, Oliver; Zeeb, Hajo

2008-01-01

Background Little is known about the effect of migrant status on childhood cancer survival. We studied cancer survival among children of Turkish descent in the German Cancer Childhood Registry, one of the largest childhood cancer registries worldwide. Methods We identified children of Turkish descent among cancer cases using a name-based approach. We compared 5-year survival probabilities of Turkish and other children in three time periods of diagnosis (1980–87, 1988–95, 1996–2005) using the Kaplan-Meier method and log-rank tests. Results The 5-year survival probability for all cancers among 1774 cases of Turkish descent (4.76% of all 37.259 cases) was 76.9% compared to 77.6% in the comparison group (all other cases; p = 0.15). We found no age- or sex-specific survival differences (p-values between p = 0.18 and p = 0.90). For the period 1980–87, the 5-year survival probability among Turkish children with lymphoid leukaemia was significantly lower (62% versus 75.8%; p < 0.0001), this remains unexplained. For more recently diagnosed leukaemias, we saw no survival differences for Turkish and non-Turkish children. Conclusion Our results suggest that nowadays Turkish migrant status has no bearing on the outcome of childhood cancer therapies in Germany. The inclusion of currently more than 95% of all childhood cancer cases in standardised treatment protocols is likely to contribute to this finding. PMID:19040749

Molecular diagnostics for the detection of Bokeloh bat lyssavirus in a bat from Bavaria, Germany.

PubMed

Freuling, Conrad M; Abendroth, Björn; Beer, Martin; Fischer, Melina; Hanke, Dennis; Hoffmann, Bernd; Höper, Dirk; Just, Frank; Mettenleiter, Thomas C; Schatz, Juliane; Müller, Thomas

2013-11-06

A brain sample of a Natterer's bat tested positive for rabies with classical virological techniques. Molecular techniques confirmed the presence of Bokeloh bat lyssavirus (BBLV) in Germany for the second time. Sequence analysis revealed a close genetic relationship to the initial German BBLV case. Using a TaqMan RT-PCR specific for BBLV viral RNA was detected in various other organs albeit with differences in the relative viral load. Copyright © 2013 Elsevier B.V. All rights reserved.

Integrated landscape planning and remuneration of agri-environmental services. Results of a case study in the Fuhrberg region of Germany.

PubMed

V Haaren, Christina; Bathke, Manfred

2008-11-01

Until now, existing remuneration of environmental services has not sufficiently supported the goals of spending money more effectively on the environment and of motivating farmers. Only a small share of the budgets for agriculture in the EU, as well as in US and other countries, is available for buying environmental goods and services beyond the level of good farming practice (GFP). This combined with the insufficient targeting of compensation payments to areas where special measures are needed leads to an unsatisfactorily low impact of agri-environment measures compared to other driving forces that stimulate the intensification of farming. The goal of this paper is to propose a management concept that enhances the ecological and cost efficiency of agri-environment measures. Components of the concept are a comprehensive environmental information base with prioritised goals and targets (available in Germany from landscape planning) and new remuneration models, which complement conventional compensation payments that are based upon predetermined measures and cost. Comprehensive landscape planning locates and prioritises areas which require environmental action. It contains the information that authorities need to prioritise funding for environmental services and direct measures to sites which need environmental services beyond the level of GFP. Also appropriate remuneration models, which can enhance the cost efficiency of public spending and the motivation of the farmers, can be applied on the base of landscape planning. Testing of the planning methodology and of one of the remuneration models (success-oriented remuneration) in a case study area ("Fuhrberger Feld" north of Hanover, Germany) demonstrated the usability of the concept and led to proposals for future development of the methodology and its application in combination with other approaches.

International outbreak of Salmonella Oranienburg due to German chocolate.

PubMed

Werber, Dirk; Dreesman, Johannes; Feil, Fabian; van Treeck, Ulrich; Fell, Gerhard; Ethelberg, Steen; Hauri, Anja M; Roggentin, Peter; Prager, Rita; Fisher, Ian S T; Behnke, Susanne C; Bartelt, Edda; Weise, Ekkehard; Ellis, Andrea; Siitonen, Anja; Andersson, Yvonne; Tschäpe, Helmut; Kramer, Michael H; Ammon, Andrea

2005-02-03

This report describes a large international chocolate-associated Salmonella outbreak originating from Germany. We conducted epidemiologic investigations including a case-control study, and food safety investigations. Salmonella (S.) Oranienburg isolates were subtyped by the use of pulsed-field gel electrophoresis (PFGE). From 1 October 2001 through 24 March 2002, an estimated excess of 439 S. Oranienburg notifications was registered in Germany. Simultaneously, an increase in S. Oranienburg infections was noted in other European countries in the Enter-net surveillance network. In a multistate matched case-control study in Germany, daily consumption of chocolate (matched odds ratio [MOR]: 4.8; 95% confidence interval [CI]: 1.3-26.5), having shopped at a large chain of discount grocery stores (MOR: 4.2; CI: 1.2-23.0), and consumption of chocolate purchased there (MOR: 5.0; CI: 1.1-47.0) were associated with illness. Subsequently, two brands from the same company, one exclusively produced for that chain, tested positive for S. Oranienburg. In two other European countries and in Canada chocolate from company A was ascertained that also contained S. Oranienburg. Isolates from humans and from chocolates had indistinguishable PFGE profiles. No source or point of contamination was identified. Epidemiological identification of chocolate as a vehicle of infections required two months, and was facilitated by proxy measures. Despite the use of improved production technologies, the chocolate industry continues to carry a small risk of manufacturing Salmonella-containing products. Particularly in diffuse outbreak-settings, clear associations with surrogates of exposure should suffice to trigger public health action. Networks such as Enter-net have become invaluable for facilitating rapid and appropriate management of international outbreaks.

International outbreak of Salmonella Oranienburg due to German chocolate

PubMed Central

Werber, Dirk; Dreesman, Johannes; Feil, Fabian; van Treeck, Ulrich; Fell, Gerhard; Ethelberg, Steen; Hauri, Anja M; Roggentin, Peter; Prager, Rita; Fisher, Ian ST; Behnke, Susanne C; Bartelt, Edda; Weise, Ekkehard; Ellis, Andrea; Siitonen, Anja; Andersson, Yvonne; Tschäpe, Helmut; Kramer, Michael H; Ammon, Andrea

2005-01-01

Background This report describes a large international chocolate-associated Salmonella outbreak originating from Germany. Methods We conducted epidemiologic investigations including a case-control study, and food safety investigations. Salmonella (S.) Oranienburg isolates were subtyped by the use of pulsed-field gel electrophoresis (PFGE). Results From 1 October 2001 through 24 March 2002, an estimated excess of 439 S. Oranienburg notifications was registered in Germany. Simultaneously, an increase in S. Oranienburg infections was noted in other European countries in the Enter-net surveillance network. In a multistate matched case-control study in Germany, daily consumption of chocolate (matched odds ratio [MOR]: 4.8; 95% confidence interval [CI]: 1.3–26.5), having shopped at a large chain of discount grocery stores (MOR: 4.2; CI: 1.2–23.0), and consumption of chocolate purchased there (MOR: 5.0; CI: 1.1–47.0) were associated with illness. Subsequently, two brands from the same company, one exclusively produced for that chain, tested positive for S. Oranienburg. In two other European countries and in Canada chocolate from company A was ascertained that also contained S. Oranienburg. Isolates from humans and from chocolates had indistinguishable PFGE profiles. No source or point of contamination was identified. Epidemiological identification of chocolate as a vehicle of infections required two months, and was facilitated by proxy measures. Conclusions Despite the use of improved production technologies, the chocolate industry continues to carry a small risk of manufacturing Salmonella-containing products. Particularly in diffuse outbreak-settings, clear associations with surrogates of exposure should suffice to trigger public health action. Networks such as Enter-net have become invaluable for facilitating rapid and appropriate management of international outbreaks. PMID:15691371

Risk Factors for Sporadic Non-Pregnancy Associated Listeriosis in Germany—Immunocompromised Patients and Frequently Consumed Ready-To-Eat Products

PubMed Central

Preußel, Karina; Milde-Busch, Astrid; Schmich, Patrick; Wetzstein, Matthias; Stark, Klaus; Werber, Dirk

2015-01-01

Non-pregnancy associated (N-PA) listeriosis, caused by Listeria monocytogenes, is a rare but severe disease, and is predominantly food-borne. Most cases appear sporadic and their infection vehicle remains unknown. Incidence has increased since 2008 in Germany. We aimed to identify underlying conditions and foods associated with sporadic N-PA listeriosis in Germany. We performed a nationwide case-control study from March 2012-December 2013. Cases were sporadic N-PA listeriosis patients notified to public health. Control subjects were age (40–65 years, 66–75 years, ≥76 years) frequency-matched persons from a nationwide random telephone sample. A structured questionnaire collected information on underlying diseases, therapies and >60 food items. We conducted multivariable logistic regression analysis, adjusting for host factors identified by causal diagram theory, and calculated population attributable fractions. We enrolled 109 cases and 1982 controls. Cases’ median age was 69 years, 55% were male, 44% received immunosuppressive therapy within 3 months prior to illness onset; a further 28% had at least one immunocompromising disease. In multivariable analysis, immunosuppressive therapy (OR 8.8, 95%CI 4.9–15.6), immunocompromising disease (OR 2.7; 95%CI 1.4–5.2), gastric acid suppression (OR 3.0; 95%CI 1.4–6.3), the consumption of cold cooked sausages (OR 2.6; 95%CI 1.6–4.4), the preferred consumption of packaged cheese (OR 2.1; 95%CI 1.3–3.5) and pre-sliced cheese (OR 2.2; 95%CI 1.3–3.7) were significantly associated with N-PA listeriosis. These foods accounted for 59% of all cases. Typical high risk foods, e.g. cold seafood, certain types of cheeses, tended to be negatively associated with disease. In conclusion, immunosuppressive therapy and frequently consumed ready-to-eat foods are the main risk factors for sporadic N-PA listeriosis in Germany. To reduce their risk, immunocompromised persons should consume the identified foods well before the ‘use-by’ date. The microbiological criteria for Listeria monocytogenes in ready-to-eat foods may insufficiently protect persons who are markedly immunocompromised. PMID:26599484

Characterization of tick-borne encephalitis (TBE) foci in Germany and Latvia (1997-2000).

PubMed

Süss, Jochen; Schrader, Christina; Abel, Ulrich; Bormane, Antra; Duks, Arnis; Kalnina, Vaira

2002-06-01

Knowledge concerning the prevalence of the tick-borne encephalitis virus (TBEV) in wild living tick populations is very important for understanding the epidemiology of the disease and for immuno prophylactic strategy. In Germany high and low risk areas of TBE exist. In the years 1997-2000, 533 autochthonous clinical TBE cases were recorded, in the high-risk areas of Bavaria and Baden-Wuerttemberg 140 and 363, and in the low risk areas in Hesse (Odenwald) and Rhineland-Palatinate 22 and 8, respectively. Corresponding to these case reports we have measured the virus prevalence in free living ticks in these four risk areas and compared these findings with the situation in high-risk areas in Latvia. In the years 1997-2000, 2,797 clinical TBE cases were recorded in Latvia. For the studies in Germany, a total of 17,398 Ixodesricinus ticks (14,860 nymphs and 2,538 adults) were collected by flagging and examined for TBEV, in Latvia the corresponding numbers were 525 I. ricinus ticks (350 adults and 175 nymphs) and 281 I. persulcatus ticks (adults only). Information concerning annual and seasonal differences of the TBEV prevalence in natural TBE foci is not available in Germany. This paper is a continuation of the study (Süss et al., 1999), starting in 1997. We investigated every year, in May and September, the virus prevalence in ticks in high risk areas of Bavaria (8 foci) and Baden-Wuerttemberg (5 foci). A total of 15,400 ticks (13,100 nymphs and 2,300 adults) were examined for TBEV. The ticks were tested for the presence of TBEV-RNA using a sensitive, nested-RT-PCR. The virus prevalence in the Bavarian foci of the whole tick population ranged from 0.3 to 2.0% during these four years, in adults between 1.2 and 5.3% and in nymphs between 0.1 and 1.4%. In the high-risk areas of Baden-Wuerttemberg, in the Black Forest, the estimated virus prevalence rates of investigated ticks varied from 0.2 to 3.4%, in adults from 0 to 4.8%, and in nymphs from 0.2 to 3.4%. Using the same methods, we have also tested the low risk areas in the Odenwald (840 nymphs, 160 adults) and in Rhineland-Palatinate (920 nymphs, 78 adults). Ticks were collected in those areas where most TBE cases were registered. The virus prevalence in the Odenwald was 0% in adults and 0.5% in nymphs, whereas in ticks from Rhineland-Palatinate we have not found any positive PCR signal. Sequence data of the PCR products have shown that all strains in Germany were closely related to the central European virus prototype Neudoerfl. In I. ricinus ticks, collected in Riga county, the following virus prevalence rates were found: in females 2.4%, in males 3.7%, and in all adults 3.0%, in nymphs 2.4% and in the I. ricinus tick population examined 2.8%. The virus prevalence in I. persulcatus, collected in the eastern parts of Latvia was 6% in females, 4% in males and 5% in all adults. All the PCR products were sequenced and a phylogenetic tree was constructed. Studies in natural foci of TBE in Latvia have shown that I. ricinus carried the central European virus subtype (prototype Neudoerfl) whereas in I. persulcatus two strains have been found, the central European virus subtype (prototype Neudoerfl) and the Siberian virus subtype (prototype Vasilchenko). Sequences of the Far Eastern subtype have not been detected yet.

Babies and bearded dragons: sudden increase in reptile-associated Salmonella enterica serovar Tennessee infections, Germany 2008.

PubMed

Weiss, Bettina; Rabsch, Wolfgang; Prager, Rita; Tietze, Erhard; Koch, Judith; Mutschmann, Frank; Roggentin, Peter; Frank, Christina

2011-09-01

In 2008 a marked increase in Salmonella enterica serovar Tennessee infections in infants occurred in Germany. In March and April 2008, eight cases were notified compared to a median of 0-1 cases in 2001-2006. We carried out an investigation including a case-control study to identify the source of infection. A patient was a child < 3 years of age with Salmonella Tennessee isolated from stool from September 1, 2007, through December 31, 2008, identified through the national surveillance system. A control was a child with a notified rotavirus infection in the matching district, frequency matched by age group. We conducted telephone interviews on feeding, herbal infusions, and animal contact. Matched odds ratios (mOR) were calculated using exact conditional logistic regression. For Salmonella Tennessee isolates, pulsed-field gel electrophoresis and multiple-locus variable number tandem repeat analysis were performed. Further cloacal swab samples of reptiles kept in case households were investigated. We identified 18 cases < 3 years. Ten children were male; median age was 3 months (1-32 months). In 8 of 16 case households reptiles were kept. Direct contact between child and reptile was denied. Other forms of reptile contact were reported in four of the remaining eight households. Ten case- and 21 control-patients were included in the study. Only keeping of a reptile and "any reptile contact" were associated with Salmonella Tennessee infection (mOR 29.0; 95% CI 3.1 ± ∞ and mOR 119.5; 95% CI 11.7 - ∞). Identical Salmonella Tennessee strains of child and reptile kept in the same household could be shown in 2 cases. Reptiles were the apparent source of Salmonella Tennessee infection in these infants. Indirect contact between infants and reptiles seems to be sufficient to cause infection and should therefore be avoided.

[How do authors of systematic reviews restrict their literature searches when only studies from Germany should be included?

PubMed

Pieper, Dawid; Mathes, Tim; Palm, Rebecca; Hoffmann, Falk

2016-11-01

The use of search filters (e. g. for study types) facilitates the process of literature searching. Regional limits might be helpful depending on the research question. Regional search filters are already available for some regions, but not for Germany. Our aim is to give an overview of applied search strategies in systematic reviews (SRs) focusing on Germany. We searched Medline (via Pubmed) applying a focused search strategy to identify SRs focusing on Germany in January 2016. Study selection and data extraction were performed by two reviewers independently. The search strategies with a focus on Germany were analyzed in terms of reasonableness and completeness relying on the Peer Review of Electronic Search Strategies (PRESS) criteria. A narrative evidence synthesis was performed. In total, 36 SRs (13 written in English) were included. 78% were published in 2012 or later. The majority (89%) of SRs utilized at least two different sources for their search with databases and checking references being the most common. 17 SRs did not use any truncations, ten SRs did not restrict their search to Germany, six SRs reported to have searched for German OR Germany. Only ten articles searched for the term Germany (occasionally jointly with the term Deutschland) without any use of an adjective such as German. There is a high interest in regionally focused SRs. The identified search strategies revealed a need for improvement. It would be helpful to develop a regional search filter for Germany that is able to identify studies performed in Germany. Copyright © 2016. Published by Elsevier GmbH.

National Human Research Ethics: A Preliminary Comparative Case Study of Germany, Great Britain, Romania, and Sweden

PubMed Central

Gallagher, Bernard; Berman, Anne H.; Bieganski, Justyna; Jones, Adele D.; Foca, Liliana; Raikes, Ben; Schiratzki, Johanna; Urban, Mirjam; Ullman, Sara

2016-01-01

Although international research is increasing in volume and importance, there remains a dearth of knowledge on similarities and differences in “national human research ethics” (NHREs), that is, national ethical guidelines (NEGs), Institutional Review Boards (IRBs), and research stakeholder’ ethical attitudes and behaviors (EABs). We begin to address this situation by reporting upon our experiences in conducting a multinational study into the mental health of children who had a parent/carer in prison. The study was conducted in 4 countries: Germany, Great Britain, Romania, and Sweden. Data on NHREs were gathered via a questionnaire survey, two ethics-related seminars, and ongoing contact between members of the research consortium. There was correspondence but even more so divergence between countries in the availability of NEGs and IRBs and in researcher’ EABs. Differences in NHREs have implications particularly in terms of harmonization but also for ethical philosophy and practice and for research integrity. PMID:27746664

Low and Declining Risk for Malaria in Visitors to Indonesia: A Review of Local Indonesian and European Travelers' Data and a Suggestion for New Prophylactic Guidelines.

PubMed

Johansson Århem, Katarina M; Gysin, Nicole; Nielsen, Henrik V; Surya, Asik; Hellgren, Urban

2015-01-01

The world's malaria map is constantly changing and with it the risk for travelers to contract malaria. While some efforts to appreciate the malaria situation for indigenous populations in Indonesia have been made recently, there is only sparse data in the literature on the risk for travelers to Indonesia. Data were collected from the Indonesian Ministry of Health (MoH), the World Health Organization (WHO), the Indonesian official statistics website Badan Pusat Statistik (BPS), and from the different European national surveillance bodies. Finally, a comparison between recent official guidelines for prevention of malaria in travelers from Germany, the United States, the UK, and from WHO was done. Data from Denmark, Germany, Sweden and Switzerland show a steady decline of imported cases of malaria from Indonesia from 1997 to 2013, with a leveling off during the last few years. In our study material, the Plasmodium falciparum incidence 2009 to 2013 was 0.35 cases per 100,000 visits and the Plasmodium vivax incidence 1.3 cases per 100,000 visits, with a 95% confidence interval of 0.1-0.9 and 0.7-2.2, respectively. Indonesian data also show a decline of malaria cases-the Annual Parasite Index (API) for all species of malaria has decreased from 4.68 cases per 1,000 inhabitants in 1990 to 1.38 cases per 1,000 inhabitants in 2013. Based on these data updated recommendations for malaria prophylaxis in travelers to Indonesia are suggested. © 2015 International Society of Travel Medicine.

Countering resistance to protected-area extension.

PubMed

Lindenmayer, David; Thorn, Simon; Noss, Reed

2018-04-01

The establishment of protected areas is a critical strategy for conserving biodiversity. Key policy directives like the Aichi targets seek to expand protected areas to 17% of Earth's land surface, with calls by some conservation biologists for much more. However, in places such as the United States, Germany, and Australia, attempts to increase protected areas are meeting strong resistance from communities, industry groups, and governments. We examined case studies of such resistance in Victoria, Australia, Bavaria, Germany, and Florida, United States. We considered 4 ways to tackle this problem. First, broaden the case for protected areas beyond nature conservation to include economic, human health, and other benefits, and translate these into a persuasive business case for protected areas. Second, better communicate the conservation values of protected areas. This should include highlighting how many species, communities, and ecosystems have been conserved by protected areas and the counterfactual (i.e., what would have been lost without protected area establishment). Third, consider zoning of activities to ensure the maintenance of effective management. Finally, remind citizens to think about conservation when they vote, including holding politicians accountable for their environmental promises. Without tackling resistance to expanding the protected estate, it will be impossible to reach conservation targets, and this will undermine attempts to stem the global extinction crisis. © 2017 Society for Conservation Biology.

Interim Report on Studies on "The Role of the Company in Generating Qualifications: The Training Impact of Work Organization." CEDEFOP Panorama. Meeting Report. Meeting of 31.03. and 1.04. 1st Edition.

ERIC Educational Resources Information Center

Reis, Fernanda Oliveira

A meeting was held to discuss the findings of case studies examining the role of companies in generating qualifications and the training impact of work organization in Germany, Denmark, Spain, and France. New forms of work organization (NFOT) were identified and examined from the standpoint of sources of organizational change, the main areas of…

[Self-Stigma of Depression Scale SSDS - Evaluation of the German Version].

PubMed

Makowski, Anna Christin; Mnich, Eva E; von dem Knesebeck, Olaf

2017-05-12

Objectives A better understanding of self-stigma facilitates the development and evaluation of anti-stigma measures. In this study, the Self-Stigma of Depression Scale (SSDS) is applied for the first time in Germany. The focus lies on feasibility and psychometric characteristics of the scale. Methods Data stem from a representative population survey in Germany (N = 2,013). The 16 items of the original SSDS are used to assess anticipated self-stigma in case of depression. Main component analysis is applied to analyze the factor structure. Results The original version of the SDSS could not be replicated in the German sample. Instead of four, three factors emerged in the German version. They are similar to three subscales of the original SSDS: "social inadequacy", "help-seeking inhibition" and "self-blame". The internal reliability of the total scale as well as of the first two subscales is acceptable. Conclusion SSDS is a multidimensional construct and can serve as an important instrument in research regarding self-stigma of depression in Germany. A further development of the German scale is recommended in order to gain greater insight into the nature of (anticipated) depression self-stigma. © Georg Thieme Verlag KG Stuttgart · New York.

Bullying Involvement of Korean Children in Germany and in Korea

ERIC Educational Resources Information Center

Bae, Hwa-ok

2016-01-01

This study compared bullying involvement of Korean or Korean-German children living in Germany with children in Korea, and examined children's perceptions of school environment associated with bullying involvement of the children. This study included 105 Korean or Korean-German children living in the Bayern State of Germany as the study sample and…

Company reference estimates for productivity loss due to migraine and productivity gains using rizatriptan 10 mg in Germany.

PubMed

Yoon, M-S; Katsarava, Z; Liedert, B; Krobot, K J; Diener, H C; Limmroth, V

2006-03-01

The prevalence of migraine in Germany is up to 14% in the female and up to 8% in the male population and peaks between the age of 35 and 45. Few studies have investigated the productivity loss and resulting costs attributable to migraine in Germany or addressed the question whether these costs can be reduced by optimal treatment. In recent years, 5-HT(1B/D) agonists (so-called triptans), a generation of drugs highly specific for migraine treatment, have been introduced. Seven 5-HT(1B/D) agonists have been approved in Germany with more than 20 dosage forms. We present a model that enables employers to estimate the annual cost of migraine and the annual cost that could be saved by treatment of migraine with rizatriptan compared with the use of non-specific antimigraine medication. A representative German company with 10,000 employees is used for the reference case analysis. This company is predicted to have 580 female and 284 male employees with migraine. These employees are estimated to lose 6992 workdays or 31.8 person years of productive effort annually due to migraine, valued approximately 1,431,719 euros. The value of work loss that could be avoided by treating migraine with rizatriptan is estimated at 619,094 euros annually. These data indicate that costs arising from lost productivity can be reduced by treating migraine headaches with a triptan.

Discrepancies Between Planned and Actual Operating Room Turnaround Times at a Large Rural Hospital in Germany

PubMed Central

Morgenegg, Regula; Heinze, Franziska; Wieferich, Katharina; Schiffer, Ralf; Stueber, Frank; Luedi, Markus M.; Doll, Dietrich

2017-01-01

Objectives While several factors have been shown to influence operating room (OR) turnaround times, few comparisons of planned and actual OR turnaround times have been performed. This study aimed to compare planned and actual OR turnaround times at a large rural hospital in Northern Germany. Methods This retrospective study examined the OR turnaround data of 875 elective surgery cases scheduled at the Marienhospital, Vechta, Germany, between July and October 2014. The frequency distributions of planned and actual OR turnaround times were compared and correlations between turnaround times and various factors were established, including the time of day of the procedure, patient age and the planned duration of the surgery. Results There was a significant difference between mean planned and actual OR turnaround times (0.32 versus 0.64 hours; P <0.001). In addition, significant correlations were noted between actual OR turnaround times and the time of day of the surgery, patient age, actual duration of the procedure and staffing changes affecting the surgeon or the medical specialty of the surgery (P <0.001 each). The quotient of actual/planned OR turnaround times ranged from 1.733–3.000. Conclusion Significant discrepancies between planned and actual OR turnaround times were noted during the study period. Such findings may be potentially used in future studies to establish a tool to improve OR planning, measure OR management performance and enable benchmarking. PMID:29372083

Yield of active screening for tuberculosis among asylum seekers in Germany: a systematic review and meta-analysis

PubMed Central

Bozorgmehr, Kayvan; Razum, Oliver; Saure, Daniel; Joggerst, Brigitte; Szecsenyi, Joachim; Stock, Christian

2017-01-01

All asylum seekers in Germany undergo upon-entry screening for tuberculosis TB, but comprehensive evidence on the yield is lacking. We compared the national estimates with the international literature in a systematic review and meta-analysis of studies reporting the yield of TB, defined as the fraction of active TB cases detected among asylum seekers screened in Germany upon entry. We searched 11 national and international databases for empirical studies and the internet for grey literature published in English or German without restrictions on publication time. Among 1,253 screened articles, we identified six articles reporting the yield of active TB based on German data, ranging from 0.72 (95% confidence interval (CI): 0.45–1.10) to 6.41 (95% CI: 4.19–9.37) per 1,000 asylum seekers. The pooled estimate across all studies was 3.47 (95% CI: 1.78–5.73; I2 = 94.9%; p < 0.0001) per 1,000 asylum seekers. This estimate was in line with international evidence (I2 = 0%; p for heterogeneity 0.55). The meta-analysis of available international estimates resulted in a pooled yield of 3.04 (95% CI: 2.24–3.96) per 1,000. This study provides an estimate across several German federal states for the yield of TB screening in asylum seekers. Further research is needed to develop more targeted screening programmes. PMID:28367795

A systematic review of publications studies on medical tourism.

PubMed

Masoud, Ferdosi; Alireza, Jabbari; Mahmoud, Keyvanara; Zahra, Agharahimi

2013-01-01

Medical tourism for any study area is complex. Using full articles from other databases, Institute for Scientific Information (ISI), Science Direct, Emerald, Oxford, Magiran, and Scientific Information Database (SID), to examine systematically published articles about medical tourism in the interval 2000-2011 paid. Articles were obtained using descriptive statistics and content analysis categories were analyzed. Among the 28 articles reviewed, 11 cases were a kind of research articles, three cases were case studies in Mexico, India, Hungary, Germany, and Iran, and 14 were case studies, review documents and data were passed. The main topics of study included the definition of medical tourism, medical tourists' motivation and development of medical tourism, ethical issues in medical tourism, and impact on health and medical tourism marketing. The findings indicate the definition of medical tourism in various articles, and medical tourists are motivated. However, most studies indicate the benefits of medical tourism in developing countries and more developed countries reflect the consequences of medical tourism.

A systematic review of publications studies on medical tourism

PubMed Central

Masoud, Ferdosi; Alireza, Jabbari; Mahmoud, Keyvanara; Zahra, Agharahimi

2013-01-01

Introduction: Medical tourism for any study area is complex. Materials and Methods: Using full articles from other databases, Institute for Scientific Information (ISI), Science Direct, Emerald, Oxford, Magiran, and Scientific Information Database (SID), to examine systematically published articles about medical tourism in the interval 2000-2011 paid. Articles were obtained using descriptive statistics and content analysis categories were analyzed. Results: Among the 28 articles reviewed, 11 cases were a kind of research articles, three cases were case studies in Mexico, India, Hungary, Germany, and Iran, and 14 were case studies, review documents and data were passed. The main topics of study included the definition of medical tourism, medical tourists’ motivation and development of medical tourism, ethical issues in medical tourism, and impact on health and medical tourism marketing. Conclusion: The findings indicate the definition of medical tourism in various articles, and medical tourists are motivated. However, most studies indicate the benefits of medical tourism in developing countries and more developed countries reflect the consequences of medical tourism. PMID:24251287

Germany's Persistent Balance-of-Payments Disequilibrium Revisited. German Studies Notes.

ERIC Educational Resources Information Center

Kindleberger, Charles P.

This essay compares Germany's persistent financial disequilibrium with the balance of payments situation in the United States. Delivered at a Symposium on German Economic Growth and Stability, the author concentrates on Germany's balance of payments surplus and presents U.S. figures mainly as a point of comparison. The material on Germany has been…

The opportunities for and obstacles against prevention: the example of Germany in the areas of tobacco and alcohol

PubMed Central

2010-01-01

Background Recent years have seen a growing research and policy interest in prevention in many developed countries. However, the actual efforts and resources devoted to prevention appear to have lagged well behind the lip service paid to the topic. Discussion We review the evidence on the considerable existing scope for health gains from prevention as well as for greater prevention policy efforts in Germany. We also discuss the barriers to "more and better" prevention and provide modest suggestions about how some of the obstacles could be overcome. Summary In Germany, there are substantial health gains to be reaped from the implementation of evidence-based, cost-effective preventive interventions and policies. Barriers to more prevention include social, historical, political, legal and economic factors. While there is sufficient evidence to scale up prevention efforts in some public health domains in Germany, in general there is a comparative shortage of research on non-clinical preventive interventions. Some of the existing barriers in Germany are at least in principle amenable to change, provided sufficient political will exists. More research on prevention by itself is no panacea, but could help facilitate more policy action. In particular, there is an economic efficiency-based case for public funding and promotion of research on non-clinical preventive interventions, in Germany and beyond, to confront the peculiar challenges that set this research apart from its clinical counterpart. PMID:20718995

[Convergence tendencies in inpatient oncological care after implementation of diagnosis-related groups in Germany].

PubMed

Lüngen, M; Rath, T; Schwartze, D; Büscher, G; Bokern, E

2009-12-01

An increase of the convergence of medical services towards specialised hospitals with high case numbers is often assumed as a result of the implementation of diagnosis-related groups (DRG; case-based lump sum reimbursement). So far, estimates of the extent to which this effect occurs after the recent implementation of DRGs are not available in Germany. Claims data of about 23,600,000 insured within the inclusive period 2004-2007 were analysed. All cases with the main diagnosis of lung cancer, prostate cancer, and colorectal cancer were included in the study. Broken down by entities and years, graphical and statistical concentration measures as well as the percentages of different hospital size classes were calculated. Increasing case numbers could be observed for all entities within the period (lung cancer:+25.7%; prostate cancer:+12.5%; colorectal cancer:+8.1%). The concentration measures showed hardly any changes in the course of time. The absolute increase of case numbers seems to affect those hospitals with case numbers higher than 50 per year above average [lung cancer cases in a hospital group including hospitals with more than 50 cases 2004 (percentage): 78.1% and 2007: 81.6%; prostate cancer: 67.4% and 71.7%; colorectal: 72.5% and 75.9%], whereas case numbers of hospital groups including hospitals with case numbers less than 50 per year remain unchanged or grow more slowly. The convergence of oncological services towards a few specialised centres has not yet been accelerated by the implementation of DRG's. Fundamentally, relative changes can be noticed due to case number increases in large centres, not because of service cutbacks and shifts from smaller hospitals. Reasons for this could either be the inflexibility of capacity planning or control options of the statutory health insurance. Further research of convergence tendencies and its drivers is required to be able to draw any benefit from efficiency and quality potentials. Copyright Georg Thieme Verlag KG Stuttgart . New York.

Increasing use of radical prostatectomy for locally advanced prostate cancer in the USA and Germany: a comparative population-based study.

PubMed

Hager, B; Kraywinkel, K; Keck, B; Katalinic, A; Meyer, M; Zeissig, S R; Scheufele, R; Wirth, M P; Huber, J

2017-03-01

Current guidelines do not recommend a preferred treatment modality for locally advanced prostate cancer. The aim of the study was to compare treatment patterns found in the USA and Germany and to analyze possible trends over time. We compared 'Surveillance Epidemiology and End Results' (SEER) data (USA) with reports from four German federal epidemiological cancer registries (Eastern Germany, Bavaria, Rhineland-Palatinate, Schleswig-Holstein), both from 2004 to 2012. We defined locally advanced prostate cancer as clinical stage T3 or T4. Exclusion criteria were metastatic disease and age over 79 years. We identified 9127 (USA) and 11 051 (Germany) patients with locally advanced prostate cancer. The share was 2.1% in the USA compared with 6.0% in Germany (P<0.001). In the United States, the utilization of radiotherapy (RT) and radical prostatectomy (RP) was comparably high with 42.0% (RT) and 42.8% (RP). In Germany, the major treatment option was RP with 36.7% followed by RT with 22.1%. During the study period, the use of RP increased in both countries (USA P=0.001 and Germany P=0.003), whereas RT numbers declined (USA P=0.003 and Germany P=0.002). The share of adjuvant RT (aRT) was similar in both countries (USA 21.7% vs Germany 20.7%). We found distinctive differences in treating locally advanced prostate cancer between USA and Germany, but similar trends over time. In the last decade, a growing number of patients underwent RP as a possible first step within a multimodal concept.

Educational Transfer as Transformation: A Case Study about the Emergence and Implementation of Dual Apprenticeship Structures in a German Automotive Transplant in the United States

ERIC Educational Resources Information Center

Gessler, Michael

2017-01-01

The apprenticeship system in Germany is carried out both by companies and vocational schools (the Dual System). The question of whether the German Dual System is transferable is currently being asked in vocational education and training research. The analysis of current transfer discourses alludes to a research desideratum: the actual approaches…

Different Types of Action Research to Promote Chemistry Teachers' Professional Development--A Joined Theoretical Reflection on Two Cases from Israel and Germany

ERIC Educational Resources Information Center

Mamlok-Naaman, Rachel; Eilks, Ingo

2012-01-01

Action research is defined as using research activities to develop concrete societal practices. Action research understands the change of practice as being already a central aim of the research process itself, and it also seeks to contribute to the professional development of all participants in the particular field of study. Even though (or maybe…

The German Skills Machine: Sustaining Comparative Advantage in a Global Economy. Policies and Institutions: Germany, Europe, and Transatlantic Relations, Volume 3.

ERIC Educational Resources Information Center

Culpepper, Pepper D., Ed.; Finegold, David, Ed.

This book examines the effectiveness and distributive ramifications of the institutions of German skill provision as they functioned at home in the 1990s and as they served as a template for reform in other industrialized countries. The volume relies on multiple sources of data, including in-firm case studies, larger-scale surveys of companies,…

Attitudes towards patient gender among psychiatric hospital staff: results of a case study with focus groups.

PubMed

Krumm, Silvia; Kilian, Reinhold; Becker, Thomas

2006-03-01

There is an increasing awareness of gender-related issues in psychiatry. However, empirical findings on attitudes of psychiatric staff towards patient gender are limited. Gender-related issues are particularly relevant in the debate about mixed versus segregated sex wards, yet while the appropriateness of mixed-sex wards is questioned in Great Britain this is not the case in Germany. To investigate attitudes of psychiatric staff towards both patient gender and mixed versus segregated sex wards, we conducted a case study using focus groups with members of professional teams. We evaluated the transition process from two single-sex wards to two mixed-sex wards in a 330-bed psychiatric hospital in a rural area in south Germany. Staff described female patients as more externally oriented, motivating of others, demanding, and even sexually aggressive. Male patients, on the other hand, were described as more quiet, modest, or lazy. Furthermore, participants described the mixing process as a positive development whereas they did not see a need for gender-separated wards in order to protect vulnerable female patients. Some gender descriptions by professionals are "reversed" in comparison with gender stereotypes supposed to be present in wider society. The perception of crossed gender norms may affect staff attitudes towards the vulnerability of female patients in psychiatric settings and the provision of single-sex wards in in-patient psychiatric care. Practical implications are discussed against the background of a high rate of female patients with sexual abuse histories.

Questionnaire-based survey on the distribution and incidence of canine babesiosis in countries of Western Europe

PubMed Central

Halos, Lénaïg; Lebert, Isabelle; Abrial, David; Danlois, Fabien; Garzik, Karin; Rodes, Daniel; Schillmeier, Monika; Ducrot, Christian; Guillot, Jacques

2014-01-01

The incidence of canine babesiosis may vary considerably from one country to another depending on the distribution of the causative parasite species and their specific vectors. The aim of the present study was to evaluate the clinical occurrence of canine babesiosis diagnosed in European veterinary clinics and propose an updated map of the disease distribution in Western Europe. Questionnaires were sent to companion animal veterinary clinics in Spain, France, Benelux, Germany and Austria. The annual number of babesiosis cases in 2010, the number of practitioners in the clinic and the location of the clinic were recorded. The total numbers of dogs and practitioners in each country were used for definition of the reference populations and the annual incidence of canine babesiosis was calculated by dividing the total number of reported babesiosis cases by the total number of dogs in the veterinary practices involved in the study. Data were georeferenced for distribution map construction. The overall annual incidence of clinical babesiosis amongst the investigated dog population was 0.7%, with significant variations amongst countries and regions. Three epidemiological situations were described: (i) Spain, with co-existence of several species of piroplasms and patchy distribution of babesiosis, (ii) France, with overall presence of babesiosis due to Babesia canis and local variations and (iii) Benelux, Germany and Austria, with overall low prevalence of the disease associated with localised description related either to imported cases or to small autochthonous foci of B. canis infection. PMID:24626325

[Psychiatric Emergencies in the Emergency Room of the Ulm University Hospital in 2000 and 2010].

PubMed

Freudenmann, Roland W; Espe, Johannes; Lang, Dirk; Klaus, Jochen; Gahr, Maximilian; Schönfeldt-Lecuona, Carlos

2017-01-01

Objective: Despite of the importance of psychiatric emergencies (PE) requiring treatment at an emergency room (ER) little is known about their frequency and current trends in terms of quantity and quality. Methods: A retrospective analysis of all PE treated at the ER of the University Hospital Ulm (Germany) in 2000 and 2010. Results: 6 % (2000) or 5 % (2010) of the ER cases were PE. Despite an increase from 369 to 430 cases (+ 16,5 %) their share decreased because of an even stronger increase of other emergencies (+ 33 %). The most frequent PE in 2000 was alcohol intoxication (37,7 %), while it was intoxication with prescribed and/or illicit drugs in 2010 (47,9 %). Patients with alcohol intoxications were significantly younger in 2010 as compared with 2000. Suicide attempts were seen in every fourth PE. They were significantly more frequent in 2010. PEs were generally more frequent in the evening and over the night. Conclusion: This study provides first insight into current trends in PE treated at the ER in Germany. Our data provide an empirical starting point for optimizing clinical care, although the study is limited by its retrospective and mono-centric design. © Georg Thieme Verlag KG Stuttgart · New York.

Louse-borne relapsing fever (Borrelia recurrentis) diagnosed in 15 refugees from northeast Africa: epidemiology and preventive control measures, Bavaria, Germany, July to October 2015.

PubMed

Hoch, Martin; Wieser, Andreas; Löscher, Thomas; Margos, Gabriele; Pürner, Friedrich; Zühl, Jürgen; Seilmaier, Michael; Balzer, Lukas; Guggemos, Wolfgang; Rack-Hoch, Anita; von Both, Ulrich; Hauptvogel, Katja; Schönberger, Katharina; Hautmann, Wolfgang; Sing, Andreas; Fingerle, Volker

2015-01-01

We report 15 imported louse-borne relapsing fever (LBRF) cases in refugees in Bavaria, Germany. One patient died. Epidemiological findings confirmed that all were young males from the Horn of Africa (12 from Somalia), who had similar migration routes converging in Sudan continuing through Libya and Italy. The majority likely acquired their infection during migration. Healthcare workers should be aware of LBRF in refugees passing through north Africa to ensure correct treatment and preventive measures.

Childhood cancer and residential radon exposure - results of a population-based case-control study in Lower Saxony (Germany).

PubMed

Kaletsch, U; Kaatsch, P; Meinert, R; Schüz, J; Czarwinski, R; Michaelis, J

1999-09-01

A population-based case-control study on risk factors for childhood malignancies was used to investigate a previously reported association between elevated indoor radon concentrations and childhood cancer, with special regard to leukaemia. The patients were all children suffering from leukaemia and common solid tumours (nephroblastoma, neuroblastoma, rhabdomyosarcoma, central nervous system (CNS) tumours) diagnosed between July 1988 and June 1993 in Lower Saxony (Germany) and aged less than 15 years. Two population-based control groups were matched by age and gender to the leukaemia patients. Long-term (1 year) radon measurements were performed in those homes where the children had been living for at least 1 year, with particular attention being paid to those rooms where they had stayed most of the time. Due to the sequential study design, radon measurements in these rooms could only be done for 36% (82 leukaemias, 82 solid tumours and 209 controls) of the 1038 families initially contacted. Overall mean indoor radon concentrations (27 Bq m(-3)) were low compared with the measured levels in other studies. Using a prespecified cutpoint of 70 Bq m(-3), no association with indoor radon concentrations was seen for the leukaemias (odds ratio (OR): 1.30; 95% confidence interval (95% CI): 0.32-5.33); however, the risk estimates were elevated for the solid tumours (OR: 2.61; 95% CI: 0.96-7.13), mainly based on 6 CNS tumours. We did not find any evidence for an association between indoor radon and childhood leukaemia, which is in line with a recently published American case-control study. There is little support for an association with CNS tumours in the literature.

Detailed geomorphological mapping from high resolution DEM data (LiDAR, TanDEM-X): two case studies from Germany and SE Tibet

NASA Astrophysics Data System (ADS)

Loibl, D.

2012-04-01

Two major obstacles are hampering the production of high resolution geomorphological maps: the complexity of the subject that should be depicted and the enormous efforts necessary to obtain data by field work. The first factor prevented the establishment of a generally accepted map legend; the second hampered efforts to collect comprehensive sets of geomorphological data. This left geomorphologists to produce applied maps, focusing on very few layers of information and often not sticking to any of the numerous standards proposed in the second half of the 20th century. Technological progress of the recent years, especially in the fields of digital elevation models, GIS environments, and computational hardware, today offers promising opportunities to overcome the obstacles and to produce detailed geomorphological maps even for remote or inhospitable regions. The feasibility of detailed geomorphological mapping from two new sets of digital elevation data, the 1 m LiDAR DTM provided by Germany's State Surveying Authority and the upcoming TanDEM-X DEM, has been evaluated in two case studies from a low mountain range in Germany and a high mountain range in SE Tibet. The results indicate that most layers of information of classical geomorphological maps (e.g. the German GMK) can be extracted from this data at appropriate scales but that significant differences occur concerning the quality and the grades of certainty of key contents. Generally, an enhancement of the geomorphographical, especially the geomorphometrical, and a weakening of geomorphogenetical contents was observed. From these findings, theoretical, methodological, and cartographical remarks on detailed geomorphological mapping from DEM data in GIS environments were educed. As GIS environments decouple data and design and enable the geomorphologist to choose information layer combinations freely to fit research topics, a general purpose legend becomes obsolete. Yet, a unified data structure is demanded to ensure that data collected by different scientists or in different studies can be exchanged and reused.

Psychology as science and as discipline: the case of Germany.

PubMed

Gundlach, Horst

2006-01-01

This paper examines the history of psychology in Germany. It directs attention to the salient role played by examination regulations in the development of psychology. To highlight this, the term "discipline" is employed not as a synonym of "science" but according to its original meaning, as denoting a social entity consisting of teachers, disciples, more or less canonised subject matters, examinations, and resulting changes of the social status of the examinee. In the early nineteenth century a succession of state rescripts and regulations introduced to university curricula an examination subject named psychology, thereby making psychology an obligatory subject of university lectures, and creating a discipline of psychology next to the science of psychology. The two were far from being identical. This situation, thus far neglected in historiography, profoundly influenced the further development of psychology in Germany.

Investigating Lateral Boundary Forcing of Weather Research and Forecasting (WRF) Model Forecasts for Artillery Mission Support

DTIC Science & Technology

2013-01-01

the internal variability, such as the storm track or rainfall pattern (8). Arguments have emerged for the use of small domains in certain cases as...Sensitivity experiments were performed with the WRF-ARW over Meiningen, Germany for two strong wintertime extratropical cyclones. These cases were chosen

Estimating the under-reporting of norovirus illness in Germany utilizing enhanced awareness of diarrhoea during a large outbreak of Shiga toxin-producing E. coli O104:H4 in 2011--a time series analysis.

PubMed

Bernard, Helen; Werber, Dirk; Höhle, Michael

2014-03-01

Laboratory-confirmed norovirus illness is reportable in Germany since 2001. Reported case numbers are known to be undercounts, and a valid estimate of the actual incidence in Germany does not exist. An increase of reported norovirus illness was observed simultaneously to a large outbreak of Shiga toxin-producing E. coli O104:H4 in Germany in 2011--likely due to enhanced (but not complete) awareness of diarrhoea at that time. We aimed at estimating age- and sex-specific factors of that excess, which should be interpretable as (minimal) under-reporting factors of norovirus illness in Germany. We used national reporting data on laboratory-confirmed norovirus illness in Germany from calendar week 31 in 2003 through calendar week 30 in 2012. A negative binomial time series regression model was used to describe the weekly counts in 8∙2 age-sex strata while adjusting for secular trend and seasonality. Overall as well as age- and sex-specific factors for the excess were estimated by including additional terms (either an O104:H4 outbreak period indicator or a triple interaction term between outbreak period, age and sex) in the model. We estimated the overall under-reporting factor to be 1.76 (95% CI 1.28-2.41) for the first three weeks of the outbreak before the outbreak vehicle was publicly communicated. Highest under-reporting factors were here estimated for 20-29 year-old males (2.88, 95% CI 2.01-4.11) and females (2.67, 95% CI 1.87-3.79). Under-reporting was substantially lower in persons aged <10 years and 70 years or older. These are the first estimates of (minimal) under-reporting factors for norovirus illness in Germany. They provide a starting point for a more detailed investigation of the relationship between actual incidence and reporting incidence of norovirus illness in Germany.

Health Care Response to CCHF in US Soldier and Nosocomial Transmission to Health Care Providers, Germany, 2009

PubMed Central

Paolino, Kristopher M.; Osborn, Erik C.; Rusnak, Janice M.; Günther, Stephan; Pool, Jane; Rollin, Pierre E.; Allan, Patrick F.; Schmidt-Chanasit, Jonas; Rieger, Toni; Kortepeter, Mark G.

2015-01-01

In 2009, a lethal case of Crimean–Congo hemorrhagic fever (CCHF), acquired by a US soldier in Afghanistan, was treated at a medical center in Germany and resulted in nosocomial transmission to 2 health care providers (HCPs). After his arrival at the medical center (day 6 of illness) by aeromedical evacuation, the patient required repetitive bronchoscopies to control severe pulmonary hemorrhage and renal and hepatic dialysis for hepatorenal failure. After showing clinical improvement, the patient died suddenly on day 11 of illness from cerebellar tonsil herniation caused by cerebral/cerebellar edema. The 2 infected HCPs were among 16 HCPs who received ribavirin postexposure prophylaxis. The infected HCPs had mild or no CCHF symptoms. Transmission may have occurred during bag-valve-mask ventilation, breaches in personal protective equipment during resuscitations, or bronchoscopies generating infectious aerosols. This case highlights the critical care and infection control challenges presented by severe CCHF cases, including the need for experience with ribavirin treatment and postexposure prophylaxis. PMID:25529825

[Tuberculosis in cattle - surprisingly re-emerging or continuously present?].

PubMed

Moser, I; Köhler, H; Menge, C

2014-01-01

Tuberculosis in cattle, caused by Mycobacterium (M.) bovis/M. caprae, is globally one of the most important zoonotic diseases in cattle. It was widespread in Germany until the second half of the 20th century. Due to the effective control and eradication campaigns in Germany, the epidemic was almost eradicated. Consequently, Germany was regarded as essentially tuberculosis free since the end of 1961 (West) and the end of 1978 (East). By declaring the unified Germany "officially free of tuberculosis" (OTF) in 1996, freedom from tuberculosis was officially ratified by the European Commission. The prerequisite was the detection of tuberculosis in less than 0.1% of the cattle holdings per year in Germany. This status has been steadily maintained hitherto, thus resulting in some loss of awareness of bovine tuberculosis by veterinarians, farmers and the public over many decades. After 1996, the number of notified outbreaks had been on average less than 10 per 200,000 cattle holdings per year for many years. It was the year 2008 when the numbers increased. Based in part on subsequently enhanced ante mortem testing efforts, 46 outbreaks were notified in 2013. Bavaria and Lower Saxony were the federal states with the highest number of cases. Consequently, the national tuberculosis regulation was revised in 2009, 2012 and 2013 to form the basis for a modification of tuberculosis surveillance. Regionally, an improvement of the control strategy was considered necessary. In addition to the traditionally applied examination and detection methods of the tuberculin skin test (ante mortem) and bacteriological culture (post mortem), the gamma-interferon-release assay (ante mortem) and the molecular detection of the causative pathogen (post mortem) were introduced into the official collection of recommended methods. Consequently, the diagnostic procedure of tuberculosis has been accelerated. However, in many cases the increase in the range of available test systems did not increase the ease in the interpretation of results.

Assumptions in the European Union biofuels policy: frictions with experiences in Germany, Brazil and Mozambique.

PubMed

Franco, Jennifer; Levidow, Les; Fig, David; Goldfarb, Lucia; Hönicke, Mireille; Mendonça, Maria Luisa

2010-01-01

The biofuel project is an agro-industrial development and politically contested policy process where governments increasingly become global actors. European Union (EU) biofuels policy rests upon arguments about societal benefits of three main kinds - namely, environmental protection (especially greenhouse gas savings), energy security and rural development, especially in the global South. Each argument involves optimistic assumptions about what the putative benefits mean and how they can be fulfilled. After examining those assumptions, we compare them with experiences in three countries - Germany, Brazil and Mozambique - which have various links to each other and to the EU through biofuels. In those case studies, there are fundamental contradictions between EU policy assumptions and practices in the real world, involving frictional encounters among biofuel promoters as well as with people adversely affected. Such contradictions may intensify with the future rise of biofuels and so warrant systematic attention.

Mortality factors and diseases in free-ranging Eurasian cranes (Grus grus) in Germany.

PubMed

Fanke, Jane; Wibbelt, Gudrun; Krone, Oliver

2011-07-01

Detailed postmortem examinations were performed on 167 free-ranging Eurasian Cranes (Grus grus) from Germany, collected between September 1998 and December 2008 to evaluate causes of death and diseases. The most common causes of mortality were traumatic injuries (n=105, 62.9%) from collisions with power lines (n=39, 23.4%) and wire fences (n=12, 7.2%). A group of 28 Eurasian Cranes (16.8%) died from organophosphate intoxication. Predation by White-tailed Sea Eagles (Haliaeetus albicilla) and red foxes (Vulpes vulpes) occurred in four cases (2.4%). Pathologic changes due to infectious diseases were associated with Aspergillus spp. (n=7, 4.2%), endoparasites (n=7, 4.2%), avian poxvirus (n=6, 3.6%), Mycobacterium spp. (n=2, 1.2%), and adenovirus infection (n=1, 0.6%). A severe Strigea spp. infection (n=1, 0.6%) and a leiomyosarcoma (n=1, 0.6%) were newly recognized diseases in Eurasian Cranes in this study.

Transmission risk of Borrelia burgdorferi sensu lato from Ixodes ricinus ticks to humans in southwest Germany.

PubMed Central

Maiwald, M.; Oehme, R.; March, O.; Petney, T. N.; Kimmig, P.; Naser, K.; Zappe, H. A.; Hassler, D.; von Knebel Doeberitz, M.

1998-01-01

The risk of Borrelia burgdorferi infection and the value of antibiotic prophylaxis after tick bite are controversial. In this study, performed in two areas of southwestern Germany, ticks were collected from 730 patients and examined by the polymerase chain reaction (PCR) for B. burgdorferi. To assess whether transmission of B. burgdorferi occurred, the patients were clinically and serologically examined after tick removal and during follow-up examinations. Data from all tick bites gave a total transmission rate of 2.6% (19 patients). Eighty-four ticks (11.3%) were PCR positive. Transmission occurred to 16 (26.7%) of 60 patients who were initially seronegative and could be followed up after the bite of an infected tick. These results indicate that the transmission rate from infected ticks in Europe is higher than previously assumed. Examination of ticks and antibiotic prophylaxis in the case of positivity appears to be indicated. PMID:9747761

Migration Background Influences Consumption Patterns Based on Dietary Recommendations of Food Bank Users in Germany.

PubMed

Stroebele-Benschop, Nanette; Depa, Julia; Gyngell, Fiona; Müller, Annalena; Eleraky, Laila; Hilzendegen, Carolin

2018-03-29

People with low income tend to eat less balanced than people with higher income. This seems to be particularly the case for people with migration background. This cross-sectional study examined the relation of consumption patterns of 597 food bank users with different migration background in Germany. Questionnaires were distributed assessing sociodemographic information and consumption patterns. Analyses were conducted using binary logistic regressions. Models were controlled for age, gender, type of household and education. The group of German food bank users consumed fewer fruits and vegetables and less fish compared to all other groups with migration background (former USSR, Balkan region, Middle East). A significant predictor for fruit and vegetable consumption was migration status. Participants from the former USSR consumed less often SSBs compared to the other groups. Dietary recommendations for low income populations should take into consideration other aspects besides income such as migration status.

Zur Soziolinguistik in der Bundesrepublik Deutschland (Sociolinguistics in the Federal Republic of Germany)

ERIC Educational Resources Information Center

Jachnow, Helmut

1975-01-01

Traces the history of sociolinguistic studies in West Germany from the early nineteenth century with Humboldt and reports on the state and purposes of sociolinguistic studies in present-day Federal Republic of Germany. Available from Liber Laeromedel, Box 1205, S-22105 Lund, Sweden (Text is in German.) (TL)

Health care system change and the cross-border transfer of ideas: influence of the Dutch model on the 2007 German health reform.

PubMed

Leiber, Simone; Gress, Stefan; Manouguian, Maral-Sonja

2010-08-01

To increase understanding of the cross-border transfer of ideas through a case study of the 2007 German health reform, this article draws on Kingdon's approach of streams and follows two main objectives: first, to understand the extent to which the German health reform was actually influenced by the Dutch model and, second, in theoretical terms, to inform inductively on how ideas from abroad enter government agendas. The results show that the streams of problem recognition and policy proposals have not been predominantly influenced by the cross-border transfer of ideas from the Netherlands to Germany. The Dutch experience was taken into consideration only after a policy window opened by a shift in politics in the third, the political, stream: the change of government in 2005. In many respects, the way Germany learned from the Netherlands in this case sharply contrasts with an image of solving policy problems by either lesson drawing or transnational deliberation. Instead, the process was dominated by problem solving in the sphere of politics, that is, finding a way to prove the grand coalition was capable of acting.

Importance of molecular typing in confirmation of the source of a national hepatitis A virus outbreak in Norway and the detection of a related cluster in Germany.

PubMed

Guzman-Herrador, Bernardo R; Panning, Marcus; Stene-Johansen, Kathrine; Borgen, Katrine; Einöder-Moreno, Margot; Huzly, Daniela; Jensvoll, Laila; Lange, Heidi; Maassen, Sigrid; Myking, Solveig; Myrmel, Mette; Neumann-Haefelin, Christoph; Nygård, Karin; Wenzel, Jürgen J; Øye, Ann Kristin; Vold, Line

2015-11-01

In March 2014, after an increase of notifications of domestically acquired hepatitis A virus infections, an outbreak investigation was launched in Norway. Sequenced-based typing results showed that these cases were associated with a strain that was identical to one causing an ongoing multinational outbreak in Europe linked to frozen mixed berries. Thirty-three confirmed cases with the outbreak strain were notified in Norway from November 2013 to June 2014. Epidemiological evidence and trace-back investigations linked the outbreak to the consumption of a berry mix cake. Identification of the hepatitis A virus outbreak strain in berries from one of the implicated cakes confirmed the cake to be the source. Subsequently, a cluster in Germany linked to the cake was also identified.

Health-resource use and costs associated with fibromyalgia in France, Germany, and the United States

PubMed Central

Knight, Tyler; Schaefer, Caroline; Chandran, Arthi; Zlateva, Gergana; Winkelmann, Andreas; Perrot, Serge

2013-01-01

Background Fibromyalgia (FM) is a chronic disorder characterized by widespread, persistent pain. Prospective and retrospective studies have demonstrated substantial health-care costs associated with FM in a number of countries. This study evaluated and compared health-resource use (HRU) and associated costs related to FM in routine clinical practice across the US, France, and Germany. Methods Two separate, cross-sectional, observational studies of subjects with FM were conducted: one in the US and one in France and Germany. HRU related to prescription medication, physician office visits, diagnostic tests, and hospitalizations was abstracted from chart review; patient out-of-pocket costs and lost productivity were collected via subject self-report. Costs were assigned to HRU based on standard algorithms. Direct and indirect costs were evaluated and compared by simple linear regression. Results A total of 442 subjects (203 US, 70 France, 169 Germany) with FM were analyzed. The mean (standard deviation) age in the US, France, and Germany was 47.9 (10.9), 51.2 (9.5), and 49.2 (9.8), respectively (P = 0.085). Most subjects were female (95% US, 83% France, 80% Germany) (P < 0.001). Adjusted annual direct costs per subject for FM were significantly higher in the US ($7087) than in France ($481, P < 0.001) or Germany ($2417, P < 0.001). Adjusted mean annual indirect costs per subject for FM were lower in the US ($6431) than in France ($8718) or Germany ($10,001), but represented a significant proportion of total costs in all countries. Conclusion The significant HRU and costs associated with FM in the US, France, and Germany documented in this study highlight the substantial global economic burden of FM. Indirect costs represented a significant proportion of the total costs, particularly in Europe. Comparisons between the three countries show differences in HRU, with significantly higher direct costs in the US compared with France and Germany. PMID:23637545

Building Partner Capacity (BPC): Analyzing Historical Case Studies

DTIC Science & Technology

2016-02-01

military society that valued rigidity and operating in harmony as one machine. Adolf Hitler seized on these cultural themes, came to power in 1933, and...ruled Germany to his suicide in 1945. By embracing these two cultural ideals, which in part led to WWII and the holocaust Hitler created a focused...war machine that almost took over Europe. Hitler not only demanded total obedience and subordination of the individual to the group but an

Legal Responses to Terrorism: Case Study of the Republic of Kenya

DTIC Science & Technology

2012-12-01

Institution Press, 2005), 180. 7 Ibid. 8 Ibid. 4 political, and social implications.”9 The United States, Germany, and the U.K. issued travel...Following the publication of the 2003 bill, the East African Law Society (EALS) issued a statement querying the necessity of such legislation. It argued...grounds without adducing actual proof.22 In light of these issues of context and contention, this thesis will explore past and future antiterrorism

Vocational Training and Innovative Practices in the Environmental Sector: A Comparison of Ten EU [European Union] Member States with Specimen Cases. Synthesis Report in the Context of the "Observing Innovations in Vocational Training" Project. CEDEFOP Panorama.

ERIC Educational Resources Information Center

Loos, Roland

This report provides specialist information and application-oriented recommendations to implement innovative environmental vocational education and training (VET) measures and practices. Chapter 1 explains study method and structure. Chapter 2 provides an overview of the current state of environmental VET in Austria, Denmark, Finland, Germany,…

An Assessment of Debt-for-Education Swaps. Case Studies on Swap Initiatives between Germany and Indonesia and between Spain and El Salvador

ERIC Educational Resources Information Center

Cassimon, Danny; Essers, Dennis; Renard, Robrecht

2011-01-01

A decade has passed since participants in the World Education Forum committed themselves to achieve, by 2015, the six Education for All (EFA) goals under the Dakar Framework for Action. Despite significant progress, some of the goals are likely to be missed by a large margin. Besides the absence of a well co-ordinated multi-donor approach in…

Product environmental footprint of strawberries: Case studies in Estonia and Germany.

PubMed

Soode-Schimonsky, Eveli; Richter, Klaus; Weber-Blaschke, Gabriele

2017-12-01

The environmental impacts of strawberries have been assessed in several studies. However, these studies either present dissimilar results or only focus on single impact categories without offering a comprehensive overview of environmental impacts. We applied the product environmental footprint (PEF) methodology to broadly indicate the environmental impacts of various strawberry production systems in Germany and Estonia by 15 impact categories. Data for the 7 case studies were gathered from two farms with organic and two farms with conventional open field production systems in Estonia and from one farm with conventional open field and one farm with a polytunnel and greenhouse production system in Germany. The greenhouse production system had the highest environmental impact with a PEF of 0.0040. In the field organic production systems, the PEF was 0.0029 and 0.0028. The field conventional production systems resulted in a PEF of 0.0008, 0.0009 and 0.0002. Polytunnel PEF was 0.0006. Human toxicity cancer effects, particulate matter and human toxicity non-cancer effects resulted in the highest impact across all analysed production systems. The main contributors were electricity for cooling, heating the greenhouse and the use of agricultural machinery including fuel burning. While production stage contributed 85% of the total impact in the greenhouse, also other life cycle stages were important contributors: pre-chain resulted in 71% and 90% of impact in conventional and polytunnels, respectively, and cooling was 47% in one organic system. Environmental impact from strawberry cooling can be reduced by more efficient use of the cooling room, increasing the strawberry yield or switching from oil shale electricity to other energy sources. Greenhouse heating is the overall impact hotspot even if it based on renewable resources. A ranking of production systems based on the environmental impact is possible only if all relevant impacts are included. Future studies should aim for detailed results across a variety of impact categories and follow product category rules in defining the life cycle stages. Copyright © 2017 Elsevier Ltd. All rights reserved.

Children's Perspective on Learning: An International Study in Denmark, Estonia, Germany and Sweden

ERIC Educational Resources Information Center

Sandberg, Anette; Broström, Stig; Johansson, Inge; Frøkjaer, Thorleif; Kieferle, Christa; Seifert, Anja; Roth, Angela; Tuul, Maire; Ugaste, Aino; Laan, Meeli

2017-01-01

This article explores how some children in Denmark, Estonia, Germany and Sweden describe their perspective on learning. The aim of the international study is to gain knowledge of how preschool children in Sweden, Denmark, Estonia and Germany reflect and perceive their learning in preschool and other surrounding social contexts. The results are…

Short-term effects of air temperature on mortality and effect modification by air pollution in three cities of Bavaria, Germany: A time-series analysis

EPA Science Inventory

Background: Air temperature has been shown to be associated with mortality; however, only very few studies have been conducted in Germany. This study examined the association between daily air temperature and cause-specific mortality in Bavaria, Southern Germany. Moreover, we inv...

Case-Based Planning: An Integrated Theory of Planning, Learning and Memory

DTIC Science & Technology

1986-10-01

rtvoeoo oldo II nocomtmry and Idonltly by block numbor) planning Case-based reasoning learning Artificial Intelligence 20. ABSTRACT (Conllnum...Computational Model of Analogical Prob- lem Solving, Proceedings of the Seventh International Joint Conference on Artificial Intelligence ...Understanding and Generalizing Plans., Proceedings of the Eight Interna- tional Joint Conference on Artificial Intelligence , IJCAI, Karlsrhue, Germany

International variation in GP treatment strategies for subclinical hypothyroidism in older adults: a case-based survey.

PubMed

den Elzen, Wendy P J; Lefèbre-van de Fliert, Anne A; Virgini, Vanessa; Mooijaart, Simon P; Frey, Peter; Kearney, Patricia M; Kerse, Ngaire; Mallen, Christian D; McCarthy, Vera J C; Muth, Christiane; Rosemann, Thomas; Russell, Audrey; Schers, Henk; Stott, David J; de Waal, Margot W M; Warner, Alex; Westendorp, Rudi G J; Rodondi, Nicolas; Gussekloo, Jacobijn

2015-02-01

There is limited evidence about the impact of treatment for subclinical hypothyroidism, especially among older people. To investigate the variation in GP treatment strategies for older patients with subclinical hypothyroidism depending on country and patient characteristics. Case-based survey of GPs in the Netherlands, Germany, England, Ireland, Switzerland, and New Zealand. The treatment strategy of GPs (treatment yes/no, starting-dose thyroxine) was assessed for eight cases presenting a woman with subclinical hypothyroidism. The cases differed in the patient characteristics of age (70 versus 85 years), vitality status (vital versus vulnerable), and thyroid-stimulating hormone (TSH) concentration (6 versus 15 mU/L). A total of 526 GPs participated (the Netherlands n = 129, Germany n = 61, England n = 22, Ireland n = 21, Switzerland n = 262, New Zealand n = 31; overall response 19%). Across countries, differences in treatment strategy were observed. GPs from the Netherlands (mean treatment percentage 34%), England (40%), and New Zealand (39%) were less inclined to start treatment than GPs in Germany (73%), Ireland (62%), and Switzerland (52%) (P = 0.05). Overall, GPs were less inclined to start treatment in 85-year-old than in 70-year-old females (pooled odds ratio [OR] 0.74 [95% confidence interval [CI] = 0.63 to 0.87]). Females with a TSH of 15 mU/L were more likely to get treated than those with a TSH of 6 mU/L (pooled OR 9.49 [95% CI = 5.81 to 15.5]). GP treatment strategies of older people with subclinical hypothyroidism vary largely by country and patient characteristics. This variation underlines the need for a new generation of international guidelines based on the outcomes of randomised clinical trials set within primary care. © British Journal of General Practice 2015.

International variation in GP treatment strategies for subclinical hypothyroidism in older adults: a case-based survey

PubMed Central

den Elzen, Wendy PJ; Lefèbre-van de Fliert, Anne A; Virgini, Vanessa; Mooijaart, Simon P; Frey, Peter; Kearney, Patricia M; Kerse, Ngaire; Mallen, Christian D; McCarthy, Vera JC; Muth, Christiane; Rosemann, Thomas; Russell, Audrey; Schers, Henk; Stott, David J; de Waal, Margot WM; Warner, Alex; Westendorp, Rudi GJ; Rodondi, Nicolas; Gussekloo, Jacobijn

2015-01-01

Background There is limited evidence about the impact of treatment for subclinical hypothyroidism, especially among older people. Aim To investigate the variation in GP treatment strategies for older patients with subclinical hypothyroidism depending on country and patient characteristics. Design and setting Case-based survey of GPs in the Netherlands, Germany, England, Ireland, Switzerland, and New Zealand. Method The treatment strategy of GPs (treatment yes/no, starting-dose thyroxine) was assessed for eight cases presenting a woman with subclinical hypothyroidism. The cases differed in the patient characteristics of age (70 versus 85 years), vitality status (vital versus vulnerable), and thyroid-stimulating hormone (TSH) concentration (6 versus 15 mU/L). Results A total of 526 GPs participated (the Netherlands n = 129, Germany n = 61, England n = 22, Ireland n = 21, Switzerland n = 262, New Zealand n = 31; overall response 19%). Across countries, differences in treatment strategy were observed. GPs from the Netherlands (mean treatment percentage 34%), England (40%), and New Zealand (39%) were less inclined to start treatment than GPs in Germany (73%), Ireland (62%), and Switzerland (52%) (P = 0.05). Overall, GPs were less inclined to start treatment in 85-year-old than in 70-year-old females (pooled odds ratio [OR] 0.74 [95% confidence interval [CI] = 0.63 to 0.87]). Females with a TSH of 15 mU/L were more likely to get treated than those with a TSH of 6 mU/L (pooled OR 9.49 [95% CI = 5.81 to 15.5]). Conclusion GP treatment strategies of older people with subclinical hypothyroidism vary largely by country and patient characteristics. This variation underlines the need for a new generation of international guidelines based on the outcomes of randomised clinical trials set within primary care. PMID:25624308

[Amblyopia. Epidemiology, causes and risk factors].

PubMed

Elflein, H M

2016-04-01

Amblyopia is the main cause for mostly monocular, impaired vision in childhood. Treatment and prevention of amblyopia is only effective during childhood. Ophthalmological screening of children does not yet exist in Germany. The prevalence of amblyopia in Germany is 5.6%, which is higher than in reports from studies in Australia; however, the prevalence of amblyopia is not comparable in these studies due to different definitions of amblyopia and the inclusion/exclusion criteria of the study cohorts. At present it is unknown at what age ophthalmological screening should be carried out to prevent amblyopia and the appropriate frequency of screening examinations. Amblyopia is a disorder of the visual cortex that is due to suppression and deprivation of one eye leading to unilateral visual impairment. Approximately 50% of cases of amblyopia are caused by anisometropia, 25% by strabismus and in every sixth person by a combination of both. Other causes, such as unilateral congenital cataracts are relatively rare. A variety of factors, such as ocular pathologies, premature birth, familial disposition and general diseases are associated with an increased risk for amblyopia.

Cultural differences in stigma surrounding schizophrenia: comparison between Central Europe and North Africa.

PubMed

Angermeyer, Matthias C; Carta, Mauro G; Matschinger, Herbert; Millier, Aurélie; Refaï, Tarek; Schomerus, Georg; Toumi, Mondher

2016-04-01

Exploring cultural differences may improve understanding about the social processes underlying the stigmatisation of people with mental illness. To compare public beliefs and attitudes about schizophrenia in Central Europe and North Africa. Representative national population surveys conducted in Germany (2011) and in Tunisia (2012), using the same interview mode (face to face) and the same fully structured interview. In Tunisia, respondents showed a stronger tendency to hold the person with schizophrenia responsible for the condition. At the same time they expressed more prosocial reactions and less fear than their German counterparts. In Germany, the desire for social distance was greater for more distant relationships, whereas in Tunisia this was the case for close, family-related relationships. Stigma differs between Tunisia and Germany more in form than in magnitude. It manifests particularly in those social roles which 'matter most' to people within a given culture. © The Royal College of Psychiatrists 2015.

The flood of June 2013 in Germany: how much do we know about its impacts?

NASA Astrophysics Data System (ADS)

Thieken, Annegret H.; Bessel, Tina; Kienzler, Sarah; Kreibich, Heidi; Müller, Meike; Pisi, Sebastian; Schröter, Kai

2016-07-01

In June 2013, widespread flooding and consequent damage and losses occurred in Central Europe, especially in Germany. This paper explores what data are available to investigate the adverse impacts of the event, what kind of information can be retrieved from these data and how well data and information fulfil requirements that were recently proposed for disaster reporting on the European and international levels. In accordance with the European Floods Directive (2007/60/EC), impacts on human health, economic activities (and assets), cultural heritage and the environment are described on the national and sub-national scale. Information from governmental reports is complemented by communications on traffic disruptions and surveys of flood-affected residents and companies. Overall, the impacts of the flood event in 2013 were manifold. The study reveals that flood-affected residents suffered from a large range of impacts, among which mental health and supply problems were perceived more seriously than financial losses. The most frequent damage type among affected companies was business interruption. This demonstrates that the current scientific focus on direct (financial) damage is insufficient to describe the overall impacts and severity of flood events. The case further demonstrates that procedures and standards for impact data collection in Germany are widely missing. Present impact data in Germany are fragmentary, heterogeneous, incomplete and difficult to access. In order to fulfil, for example, the monitoring and reporting requirements of the Sendai Framework for Disaster Risk Reduction 2015-2030 that was adopted in March 2015 in Sendai, Japan, more efforts on impact data collection are needed.

Implementing the Espoo Convention in transboundary EIA between Germany and Poland

DOE Office of Scientific and Technical Information (OSTI.GOV)

Albrecht, Eike

Poland and Germany have a long common border which leads to the necessity to cooperate and consult each other in the case of large-scale projects or infrastructure measures likely to cause negative transboundary effects on the environment. There are already binding provisions for transboundary EIA. In the area of the UN Economic Commission for Europe (UNECE), transboundary EIA is intended to be legally binding for the Member States by the Espoo Convention which was ratified by Germany 8.8.2002 and by Poland 12.6.1997. Due to corresponding directives, the same is applicable in the context of the European Union. In German legislation,more » this issue is regulated by Art. 8 of the Federal EIA Act in regard to transboundary participation of administration and by Art. 9a in respect of transboundary public participation. However, these EIA regulations on transboundary participation do not surpass a certain detail level, as they have to be applied between Germany and all neighbouring states. Therefore both countries decided to agree on more detailed provisions in particular regarding procedural questions. During the 12th German-Polish Environmental Council, Germany and Poland reached an agreement on 11.4.2006 in Neuhardenberg/Brandenburg an agreement upon the implementation of the Espoo Convention, the so called Neuhardenberg Agreement. This article assesses the agreement under consideration of already existing law and discusses major improvements and problems.« less

Orthopedics research output from China, USA, UK, Japan, Germany and France: A 10-year survey of the literature.

PubMed

Xin, Z; Jin, C; Zhengrong, G; Liehu, C; Weizong, W; Quan, L; Xiao, C; Jiacan, S

2016-11-01

In the past decade, researchers have made great progress in the field of Orthopedics. However, the research status of different countries is unclear. To summarize the number of published articles, we assessed the cumulative impact factors in top orthopedic journals. The aims of the study were to measure: 1) the quality and quantity of publications in orthopedics-related journals from China and other five counties, 2) the trend of the number of publications in orthopedics-related journals. The related journals were selected based on the 2014 scientific citation index (SCI) and articles were searched based on the PubMed database. To assess the quantity and quality of research output, the number of publications including clinical trials, randomized controlled trials, meta-analyses, case reports, reviews, citations, impact factors, number of articles in the top 10 journals and most popular journals were recorded. A total of 143,138 orthopedics articles were published from 2005 to 2014. The USA accounts for 24.9% (35,763/143,138) of the publications, followed by UK (7878/143,138 (5.5%)), Japan (7133/143,138 (5.0%)), Germany (5942/143,138 (4.2%)), China (4143/143,138 (2.9%)) and France (2748/143,138 (1.9%)). The ranking for accumulated impact factors as follows: USA, UK, Japan, Germany, France and China. The mean impact factor's order is USA, China, Germany, Japan, France, UK, and interestingly the mean impact factors in Japan is similar to the Germany in 2005-2014. The USA had the highest percentage of articles in the top 10 journals, while China owns the least. The USA had the highest number of average citations, while Japan had lowest number of average citations. According to this study, we can conclude that the USA has had been leading the orthopedics research in the past 10 years. Although China still falls behind, it has made considerable progress in the orthopedics research, not only in quantity but also quality. IV. Copyright © 2016. Published by Elsevier Masson SAS.

[Geriatric health care structures in Germany. The cross-border cooperation in geriatric medicine as a needs-driven further development].

PubMed

van den Heuvel, D; Veer, A; Greuel, H-W

2014-01-01

To cover future needs of specialised geriatric patient-centred care, existing structures need to be developed further. Taking into account regional structures of providing care, the Federal Association of Geriatric Medicine in Germany developed the concept of Cross-Border Cooperation in Geriatric Medicine. This concept combines specific geriatric expertise provided by inpatient health care with specialised networking in ambulatory treatment of elderly with a typical geriatric profile. The objective is to provide geriatric patients with a holistic and specific care and case management that overcomes existing limitations.

Wartime nuclear weapons research in Germany and Japan.

PubMed

Grunden, Walter E; Walker, Mark; Yamnazaki, Masakatsu

2005-01-01

This article compares military research projects during the Second World War to develop nuclear weapons in Germany and Japan, two countries who lost the war and failed to create nuclear weapons. The performance and motivations of the scientists, as well as the institutional support given the work, is examined, explaining why, in each case, the project went as far as it did-but no further. The story is carried over into the postwar period, when the two cultures and their scientists had to deal with the buildup of nuclear weapons during the cold war and the new nuclear power industry.

Cost-effectiveness analysis of a vaccination program for the prevention of herpes zoster and post-herpetic neuralgia in adults aged 50 and over in Germany.

PubMed

Préaud, Emmanuelle; Uhart, Mathieu; Böhm, Katharina; Aidelsburger, Pamela; Anger, Delphine; Bianic, Florence; Largeron, Nathalie

2015-01-01

Herpes zoster (HZ; shingles) is a common viral disease that affects the nerves and surrounding skin causing a painful dermatomal rash and leading to debilitating complications such as, mainly, post-herpetic neuralgia (PHN). Currently, there is no effective treatment for HZ and PHN. The objective of this study was to assess the cost-effectiveness of a HZ vaccination program in Germany. An existing Markov Model was adapted to the German healthcare setting to compare a vaccination policy to no vaccination on a lifetime time-horizon, considering 2 scenarios: vaccinating people starting at the age of 50 or at the age of 60 years, from the perspective of the statutory health insurance (SHI) and the societal perspective. According to the perspective, vaccinating 20% of the 60+ German population resulted in 162,713 to 186,732 HZ and 31,657 to 35,793 PHN cases avoided. Corresponding incremental cost-effectiveness ratios (ICER) were 39,306 €/QALY from the SHI perspective and 37,417 €/QALY from a societal perspective. Results for the 50+ German population ranged from 336,468 to 394,575 HZ and from 48,637 to 56,087 PHN cases avoided from the societal perspective. Corresponding ICER were 39,782 €/QALY from a SHI perspective and 32,848 €/QALY from a societal perspective. Sensitivity analyses showed that results are mainly impacted by discount rates, utility values and use of alternative epidemiological data.The model indicated that a HZ vaccination policy in Germany leads to significant public health benefits and could be a cost-effective intervention. The results were robust and consistent with local and international existing literature.

Association of diabetic foot care and amputation rates in Germany.

PubMed

Kröger, Knut; Moysidis, Theodoros; Feghaly, Michel; Schäfer, Erika; Bufe, Alexander

2016-10-01

Podologists are nurses who care for the diabetic foot (orthotics, offloading devices, blisters, calluses, treatment of fungus infection and patient education). In contrast to podiatrists, they are not qualified to perform any surgical treatment or wound care. We analysed whether there is an association between the decrease in major amputations and the number of podologic foot care (PFC) visits prescribed in Germany. Detailed list of all major lower limb amputations (OPS 5-864) performed from 2007 to 2011 was provided by the Federal Statistical Office. Data were separated for the 16 federal states in Germany. Detailed lists of the number of PFC treatments for each of the 5 years were derived from the federal report of the statutory health insurance. The total numbers of hospitalised cases per year having diabetes mellitus documented as an additional diagnosis were used to adjust for the different rates of people with diabetes in each federal state. Within a 5-year time period, population-based major amputations per 100 000 people dropped from 21·7 in 2007 to 17·5 in 2011 (-18·5%); whereas the number of PFC treatments per 1000 insured increased from 22 in 2007 to 60 in 2011 (+172·7%). The total number of major amputations divided by the total number of hospitalised cases with the additional diagnosis of diabetes mellitus (DM) shows an inverse correlation with the number of PFC treatments per 1000 insured (Pearson's correlation factor is -0·52049). The five countries with the highest increase in PFC compared with the five countries with the lowest increase (35·6 versus 15·4 per 1000 insured) will have only small differences in the decrease in major amputation rates in this period (-5·1 versus -3·4 per 100.000). There is a strong association between increasing utilisation PFC and decreasing major amputations in Germany. Further study is required to document the cost-effectiveness of this service. © 2014 The Authors. International Wound Journal © 2014 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Retrospective multicenter matched case-control study on the risk factors for narcolepsy with special focus on vaccinations (including pandemic influenza vaccination) and infections in Germany.

PubMed

Oberle, Doris; Pavel, Jutta; Mayer, Geert; Geisler, Peter; Keller-Stanislawski, Brigitte

2017-06-01

Studies associate pandemic influenza vaccination with narcolepsy. In Germany, a retrospective, multicenter, matched case-control study was performed to identify risk factors for narcolepsy, particularly regarding vaccinations (seasonal and pandemic influenza vaccination) and infections (seasonal and pandemic influenza) and to quantify the detected risks. Patients with excessive daytime sleepiness who had been referred to a sleep center between April 2009 and December 2012 for multiple sleep latency test (MSLT) were eligible. Case report forms were validated according to the criteria for narcolepsy defined by the Brighton Collaboration (BC). Confirmed cases of narcolepsy (BC level of diagnostic certainty 1-4a) were matched with population-based controls by year of birth, gender, and place of residence. A second control group was established including patients in whom narcolepsy was definitely excluded (test-negative controls). A total of 103 validated cases of narcolepsy were matched with 264 population-based controls. The second control group included 29 test-negative controls. A significantly increased odd ratio (OR) to develop narcolepsy (crude OR [cOR] = 3.9, 95% confidence interval [CI] = 1.8-8.5; adjusted OR [aOR] = 4.5, 95% CI = 2.0-9.9) was detected in individuals immunized with pandemic influenza A/H1N1/v vaccine prior to symptoms onset as compared to nonvaccinated individuals. Using test-negative controls, in individuals immunized with pandemic influenza A/H1N1/v vaccine prior to symptoms onset, a nonsignificantly increased OR of narcolepsy was detected when compared to nonvaccinated individuals (whole study population, BC levels 1-4a: cOR = 1.9, 95% CI = 0.5-6.9; aOR = 1.8, 95% CI = 0.3-10.1). The findings of this study support an increased risk for narcolepsy after immunization with pandemic influenza A/H1N1/v vaccine. Copyright © 2017 Elsevier B.V. All rights reserved.

[Dangerous cosmetic products in Germany : Analysis of the RAPEX database of the European Commission].

PubMed

Elsner, P; Schliemann, S

2017-11-01

Cosmetic products are subject to the European Cosmetics Regulation: They shall not harm human health when used under "normal or reasonably foreseeable conditions". Hazardous cosmetic products are reported by the EU Member States to the EU Commission and are listed in the database of the European Rapid Alert System RAPEX. The reports from Germany on dangerous cosmetic products from the years 2005-3/2017 in the European RAPEX database were systematically analyzed. During the study period, 157 dangerous cosmetic products were reported from Germany. The most common product categories were bleaching creams (24.2%) because of the content of hydroquinone, mercury or corticosteroids, creams/lotions/gels (10.8%) mainly due to microbiological contamination, henna products (10.2%) because of sensitizing concentrations of paraphenylene diamine, and nail adhesives (8.9%) because of high levels of methyl methacrylate. Hazardous cosmetic products appear to be rare in view of the high market volume of cosmetics, even though the total number of official investigations the RAPEX reports based on is not known. Dermatologists should inform the competent monitoring authorities in case of a suspected harm to health caused by dangerous cosmetic products so that the products can be examined and, if necessary, withdrawn from the market.

Decision-tree model for health economic comparison of two long-acting somatostatin receptor ligand devices in France, Germany, and the UK.

PubMed

Marty, Rémi; Roze, Stéphane; Kurth, Hannah

2012-01-01

Long-acting somatostatin receptor ligands (SRL) with product-specific formulation and means of administration are injected periodically in patients with acromegaly and neuroendocrine tumors. A simple decision-tree model aimed at comparing cost savings with ready-to-use Somatuline Autogel(®) (lanreotide) and Sandostatin LAR(®) (octreotide) for the UK, France, and Germany. The drivers of cost savings studied were the reduction of time to administer as well as a reduced baseline risk of clogging during product administration reported for Somatuline Autogel(®). The decision-tree model assumed two settings for SRL administration, ie, by either hospital-based or community-based nurses. In the case of clogging, the first dose was assumed to be lost and a second injection performed. Successful injection depended on the probability of clogging. Direct medical costs were included. A set of scenarios were run, varying the cost drivers, such as the baseline risk of clogging, SRL administration time, and percentage of patients injected during a hospital stay. Costs per successful injection were less for Somatuline Autogel(®)/Depot, ranging from Euros (EUR) 13-45, EUR 52-108, and EUR 127-151, respectively, for France, Germany, and the UK. The prices for both long-acting SRL were the same in France, and cost savings came to 100% from differences other than drug prices. For Germany and the UK, the proportion of savings due to less clogging and shorter administration time was estimated to be around 32% and 20%, respectively. Based on low and high country-specific patient cohort size estimations of individuals eligible for SRL treatment among the patient population with acromegaly and neuroendocrine tumors, annual savings were estimated to be up to EUR 2,000,000 for France, EUR 6,000,000 for Germany, and EUR 7,000,000 for the UK. This model suggests that increasing usage of the Somatuline device for injection of SRL might lead to substantial savings for health care providers across Europe.

[Comparison between the Austrian and German DRG systems in hand surgery].

PubMed

Lotter, O; Jaminet, P; Schwarzach, S; Schaller, H E

2013-02-01

Diagnosis-Related Groups (DRG) are a patient classification system grouping related types of patients treated to the resources they consumed. In this analysis, we compared the Austrian and the German DRG systems. The 15 most common hand surgical diagnoses and their corresponding operative treatment were transferred into the Austrian system. Thus, the length of stay and the reimbursement of both countries could be obtained and compared. The mean values and the median values of the upper and lower thresholds of length of stay as well as the average length of stay were all lower in Austria compared to Germany. Reimbursement in Germany was higher in 13 of 19 cases. Total proceeds amounted to 1.67 million in the German and 1.70 million in the Austrian health care system. Considering the purchasing power applying consumer prize parities, the difference of reimbursement between the countries rose to 130,000 which equals a difference of almost 8%. Reimbursement of the top 15 diagnoses in hand surgery in Austria is 8% higher than in Germany. Except for one case, mean values as well as upper and lower thresholds of length of stay are considerably shorter in Austria. Comparison of international data to refine a national compensation system is advocated.

[Diagnosis related groups in stroke treatment. An analysis from the stroke data bank of the German Stroke Foundation].

PubMed

Weimar, C; Stausberg, J; Kraywinkel, K; Wagner, M; Busse, O; Haberl, R L; Diener, H-C

2002-08-02

The upcoming introduction of diagnosis related groups (DRG) as an exclusive base for future calculation of hospital proceeds in Germany requires a thorough analysis of cost data for various diseases. To compare the resulting combined cost weights of the Australian Refined DRG system (AR-DRG) with the proceeds based on actual per-day rates in stroke treatment. Between 1998 and 1999, data from 6520 patients (median age 68 years, 43% women) with acute stroke or transient ischemic attack (TIA) were prospectively documented in 15 departments of Neurology with an acute stroke unit, 9 departments of general Neurology and 6 departments of Internal Medicine. Prior to grouping cases into DRGs, all available data were transferred into ICD-10-SGB-V 2.0 or the Australian procedure system (MBS-Extended). Hospital proceeds for the respective cases were calculated based on per-day rates of the documenting hospitals. The resulting cost weights demonstrate a good homogeneity compared to the length of stay. When introducing the AR-DRG with a uniform base rate in Germany, a relative decrease of hospital proceeds can be expected in Neurology Departments and for treatment of TIAs. Preservation of the existing structure of acute stroke care in Germany requires a supplement to a uniform base rate in Neurology departments.

Prevention of homicidal violence in schools in Germany: the Berlin Leaking Project and the Networks Against School Shootings Project (NETWASS).

PubMed

Leuschner, Vincenz; Bondü, Rebecca; Schroer-Hippel, Miriam; Panno, Jennifer; Neumetzler, Katharina; Fisch, Sarah; Scholl, Johanna; Scheithauer, Herbert

2011-01-01

Since 1999, Germany has experienced at least twelve serious cases of targeted school violence. This article describes two projects designed to fill the gap between universal prevention and emergency response in preventing severe forms of school violence in Germany. The Berlin Leaking Project examined the viability of preventive efforts based on early identification of leaking behavior that often precedes targeted school attacks. Leaking refers to any behavior or communication that indicates a student is preparing to carry out a violent attack. This would include explicit or implied threats of violence, apparent fascination with prior acts of violence such as Columbine, and any evidence of planning or preparation to carry out an attack. The NETWASS project will test a training program and intervention strategy based on those findings, examining the usefulness of a threat assessment approach to prevent violence by training teachers to recognize leaking behavior by students. This approach is extended by training teachers on a larger scale to identify leaking and then having a school-based team evaluate the student and initiate appropriate interventions, such as mental health services, and in some cases, law enforcement action. Copyright © 2011 Wiley Periodicals, Inc., A Wiley Company.

Aircraft-Assisted Pilot Suicides: Lessons to be Learned.

PubMed

Vuorio, Alpo; Laukkala, Tanja; Navathe, Pooshan; Budowle, Bruce; Eyre, Anne; Sajantila, Antti

2014-08-01

Aircraft assisted suicides were studied in the United States, United Kingdom, Germany, and Finland during 1956-2012 by means of literature search and accident case analysis. According to our study the frequency varied slightly between the studies. Overall, the new estimate of aircraft assisted suicides in the United States in a 20-yr period (1993-2012) is 0.33% (95% CI 0.21-0.49) (24/7244). In the detailed accident case analysis, it was found that in five out of the eight cases from the United States, someone knew of prior suicidal ideation before the aircraft assisted fatality. The caveats of standard medico-legal autopsy and accident investigation methods in investigation of suspected aircraft assisted suicides are discussed. It is suggested that a psychological autopsy should be performed in all such cases. Also the social context and possibilities of the prevention of aviation-related suicides were analyzed. In addition, some recent aircraft assisted suicides carried out using commercial aircraft during scheduled services and causing many casualties are discussed.

Polymorphisms of genes coding for ghrelin and its receptor in relation to colorectal cancer risk: a two-step gene-wide case-control study

PubMed Central

2010-01-01

Background Ghrelin, an endogenous ligand for the growth hormone secretagogue receptor (GHSR), has two major functions: the stimulation of the growth hormone production and the stimulation of food intake. Accumulating evidence also indicates a role of ghrelin in cancer development. Methods We conducted a case-control study to examine the association of common genetic variants in the genes coding for ghrelin (GHRL) and its receptor (GHSR) with colorectal cancer risk. Pairwise tagging was used to select the 11 polymorphisms included in the study. The selected polymorphisms were genotyped in 680 cases and 593 controls from the Czech Republic. Results We found two SNPs associated with lower risk of colorectal cancer, namely SNPs rs27647 and rs35683. We replicated the two hits, in additional 569 cases and 726 controls from Germany. Conclusion A joint analysis of the two populations indicated that the T allele of rs27647 SNP exerted a protective borderline effect (Ptrend = 0.004). PMID:20920174

Polymorphisms of genes coding for ghrelin and its receptor in relation to colorectal cancer risk: a two-step gene-wide case-control study.

PubMed

Campa, Daniele; Pardini, Barbara; Naccarati, Alessio; Vodickova, Ludmila; Novotny, Jan; Steinke, Verena; Rahner, Nils; Holinski-Feder, Elke; Morak, Monika; Schackert, Hans K; Görgens, Heike; Kötting, Judith; Betz, Beate; Kloor, Matthias; Engel, Christoph; Büttner, Reinhard; Propping, Peter; Försti, Asta; Hemminki, Kari; Barale, Roberto; Vodicka, Pavel; Canzian, Federico

2010-09-28

Ghrelin, an endogenous ligand for the growth hormone secretagogue receptor (GHSR), has two major functions: the stimulation of the growth hormone production and the stimulation of food intake. Accumulating evidence also indicates a role of ghrelin in cancer development. We conducted a case-control study to examine the association of common genetic variants in the genes coding for ghrelin (GHRL) and its receptor (GHSR) with colorectal cancer risk. Pairwise tagging was used to select the 11 polymorphisms included in the study. The selected polymorphisms were genotyped in 680 cases and 593 controls from the Czech Republic. We found two SNPs associated with lower risk of colorectal cancer, namely SNPs rs27647 and rs35683. We replicated the two hits, in additional 569 cases and 726 controls from Germany. A joint analysis of the two populations indicated that the T allele of rs27647 SNP exerted a protective borderline effect (Ptrend = 0.004).

The Technology in the Programs of Life Sciences in Turkey and Sachunterricht in Germany

ERIC Educational Resources Information Center

Keskin, Tuba

2017-01-01

The purpose of this study is to compare the gains of the Life Sciences program in Turkey and the Life sciences program (Sachunterricht) used in the state of Niedersachsen in Germany. The study aiming to compare the technology-related acquisitions in Life sciences program in Turkey and Germany is a comparative education research that used…

Deficits in knowledge, attitude, and practice towards blood culture sampling: results of a nationwide mixed-methods study among inpatient care physicians in Germany.

PubMed

Raupach-Rosin, Heike; Duddeck, Arne; Gehrlich, Maike; Helmke, Charlotte; Huebner, Johannes; Pletz, Mathias W; Mikolajczyk, Rafael; Karch, André

2017-08-01

Blood culture (BC) sampling rates in Germany are considerably lower than recommended. Aim of our study was to assess knowledge, attitudes, and practice of physicians in Germany regarding BC diagnostics. We conducted a cross-sectional mixed-methods study among physicians working in inpatient care in Germany. Based on the results of qualitative focus groups, a questionnaire-based quantitative study was conducted in 2015-2016. In total, 706 medical doctors and final-year medical students from 11 out of 16 federal states in Germany participated. BC sampling was considered an important diagnostic tool by 95% of the participants. However, only 23% of them would collect BCs in three scenarios for which BC ordering is recommended by present guidelines in Germany; almost one out of ten physicians would not have taken blood cultures in any of the three scenarios. The majority of participants (74%) reported not to adhere to the guideline recommendation that blood culture sampling should include at least two blood culture sets from two different injection sites. High routine in blood culture sampling, perceived importance of blood culture diagnostics, the availability of an in-house microbiological lab, and the department the physician worked in were identified as predictors for good blood culture practice. Our study suggests that there are substantial deficits in BC ordering and the application of guidelines for good BC practice in Germany. Based on these findings, multimodal interventions appear necessary for improving BC diagnostics.

Economic viability of stapes surgery in Germany.

PubMed

Savvas, E; Maurer, J

2009-04-01

The purpose of this study was to determine the economic viability of stapes surgery in Germany. We compared the cost of the operation to the retail value and average cost of a lifelong supply of hearing aids. Retrospective study. Tertiary referral centre. One hundred and sixty-four consecutive cases of primary stapedotomy performed on patients with otosclerosis at our institution served as the representative group for the calculation. The post-operative air-bone gap average at the frequencies 500, 1000, 2000 and 4000 Hz was less than 10 dB for 62 per cent of the patients, and less than 20 dB for 92 per cent of the patients. There was a post-operative sensorineural hearing loss in 1.2 per cent of the patients. Analysis showed that, even for an elderly patient aged 65 years with a life expectancy of 15 years, the cost of a lifelong supply of hearing aids was greater than that of a stapedotomy procedure. Based on our group of patients, the stapedotomy procedure proved to be euro 800,000 K cheaper than treatment with an averagely priced hearing aid. The economic benefit was still present when taking into account possible revision surgery in 5-10 per cent of cases, and also when, in addition to the surgery, a post-operative hearing aid was required, in for example 20 per cent of cases. Stapes surgery is economically beneficial for the individual patient as well as for the general patient cohort, irrespective of age. The stapedotomy procedure also prevents the known disadvantages of conventional hearing aids, thus improving the patient's quality of life.

Costs and effects of a state-wide health promotion program in primary schools in Germany - the Baden-Württemberg Study: A cluster-randomized, controlled trial.

PubMed

Kesztyüs, Dorothea; Lauer, Romy; Kesztyüs, Tibor; Kilian, Reinhold; Steinacker, Jürgen M

2017-01-01

To evaluate the cost-effectiveness of the state-wide implementation of the health promotion program "Join the Healthy Boat" in primary schools in Germany. Cluster-randomized intervention trial with wait-list control group. Anthropometric data of 1733 participating children (7.1 ± 0.6 years) were taken by trained staff before and after a one year intervention period in the academic year 2010/11. Parents provided information about the health status, and the health behaviour of their children and themselves, parental anthropometrics, and socio-economic background variables. Incidence of abdominal obesity, defined as waist-to-height ratio (WHtR) ≥ 0.5, was determined. Generalized linear models were applied to account for the clustering of data within schools, and to adjust for baseline-values. Losses to follow-up and missing data were analysed. From a societal perspective, the overall costs, costs per pupil, and incremental cost-effectiveness ratio (ICER) to identify the costs per case of averted abdominal obesity were calculated. The final regression model for the incidence of abdominal obesity shows lower odds for the intervention group after an adjustment for grade, gender, baseline WHtR, and breakfast habits (odds ratio = 0.48, 95% CI [0.25; 0.94]). The intervention costs per child/year were €25.04. The costs per incidental case of averted abdominal obesity varied between €1515 and €1993, depending on the different dimensions of the target group. This study demonstrates the positive effects of state-wide, school-based health promotion on incidental abdominal obesity, at affordable costs and with proven cost-effectiveness. These results should support allocative decisions of policymakers. An early start to the prevention of abdominal obesity is of particular importance because of its close relationship to non-communicable diseases. German Clinical Trials Register (DRKS), Freiburg University, Germany, DRKS-ID: DRKS00000494.

Costs and effects of a state-wide health promotion program in primary schools in Germany – the Baden-Württemberg Study: A cluster-randomized, controlled trial

PubMed Central

Kesztyüs, Tibor; Kilian, Reinhold; Steinacker, Jürgen M

2017-01-01

Aim To evaluate the cost-effectiveness of the state-wide implementation of the health promotion program “Join the Healthy Boat” in primary schools in Germany. Methods Cluster-randomized intervention trial with wait-list control group. Anthropometric data of 1733 participating children (7.1 ± 0.6 years) were taken by trained staff before and after a one year intervention period in the academic year 2010/11. Parents provided information about the health status, and the health behaviour of their children and themselves, parental anthropometrics, and socio-economic background variables. Incidence of abdominal obesity, defined as waist-to-height ratio (WHtR) ≥ 0.5, was determined. Generalized linear models were applied to account for the clustering of data within schools, and to adjust for baseline-values. Losses to follow-up and missing data were analysed. From a societal perspective, the overall costs, costs per pupil, and incremental cost-effectiveness ratio (ICER) to identify the costs per case of averted abdominal obesity were calculated. Results The final regression model for the incidence of abdominal obesity shows lower odds for the intervention group after an adjustment for grade, gender, baseline WHtR, and breakfast habits (odds ratio = 0.48, 95% CI [0.25; 0.94]). The intervention costs per child/year were €25.04. The costs per incidental case of averted abdominal obesity varied between €1515 and €1993, depending on the different dimensions of the target group. Conclusion This study demonstrates the positive effects of state-wide, school-based health promotion on incidental abdominal obesity, at affordable costs and with proven cost-effectiveness. These results should support allocative decisions of policymakers. An early start to the prevention of abdominal obesity is of particular importance because of its close relationship to non-communicable diseases. Trial registration German Clinical Trials Register (DRKS), Freiburg University, Germany, DRKS-ID: DRKS00000494. PMID:28222101

Strengthening health data on a rare and heterogeneous disease: sarcoma incidence and histological subtypes in Germany.

PubMed

Ressing, Meike; Wardelmann, Eva; Hohenberger, Peter; Jakob, Jens; Kasper, Bernd; Emrich, Katharina; Eberle, Andrea; Blettner, Maria; Zeissig, Sylke Ruth

2018-02-12

The population-based incidence of sarcoma and its histological subtypes in Germany is unknown. Up-to-date information on a disease with an incidence comparable to other cancer entities is of high public health relevance. The aim of this study was to determine this incidence and to detect significant changes in incidence trends using data from German epidemiological cancer registries. Pooled data from the German Centre for Cancer Registry Data with a primary diagnosis occurring in 2013 were used. To date, this is the latest data on cancer incidence available for Germany. All German cancer registries with sufficient completeness were included (10 out of 11), covering a population of 70.0 million people, representing 87% of the German population. All malignant sarcomas according to the RARECARE Project and the WHO classification 2002 were considered for analysis and, above all, gastrointestinal stromal tumours (GIST) of uncertain behaviour. Sensitivity analysis was performed excluding certain histologies. The analysis included 3404 cases in men and 3442 cases in women diagnosed in 2013. The age adjusted sarcoma incidence (European standard) was 7.4 (men) and 6.6 (women) per 100,000 inhabitants. About 70% of sarcomas were soft tissue sarcomas, about 22% GIST, and about 9% bone sarcomas. The most common histological subtypes besides GIST were fibrosarcomas (14%) and liposarcomas (12%) in men and complex mixed and stromal neoplasms (22%), non-uterine leiomysarcomas (10%) and fibrosarcomas (9%) in women. Considering the trend for the years of diagnosis 2004 to 2013, there was a significant increase in incidence for GIST while the incidence of soft tissue sarcomas (only men) as well as of bone sarcoma stayed constant over time. As to soft tissue sarcoma in women, the incidence stayed constant up to the year 2009 and significantly decreased afterwards. This study is the first detailed analysis of a German-wide population-based sarcoma incidence showing results comparable to the incidence detected in the RARECARE Project.

Content analysis of press coverage during the H1N1 influenza pandemic in Germany 2009-2010.

PubMed

Husemann, Sabine; Fischer, Florian

2015-04-15

The H1N1 influenza pandemic occurred in Germany between April 2009 and August 2010. Pandemics often lead to uncertainty amongst the public and so risk communication on health-related issues is one of the key areas of action for health authorities and other healthcare institutions. The mass media may contribute to risk communication, so this study analysed press coverage during the H1N1 pandemic in Germany. A comprehensive analysis of the press coverage during the H1N1 pandemic was conducted in two steps. First, a temporal analysis was carried out of newspaper articles over the entire course of the pandemic, a total of 15,353 articles. The newspaper articles were obtained from the database Nexis. The total number of articles about the influenza pandemic during each individual week was plotted against the number of incident influenza cases during that week. Second, a quantitative content analysis of 140 newspaper articles from selected dates was conducted. This study indicates that media awareness seems to be strongly related to the actual situation in the pandemic, because changes in the number of infected people were associated with nearly identical changes in the number of newspaper articles. Few articles contained information on the agent of the influenza or support measures. Information on vaccination was included in 32.9% of all articles. Almost half of the articles (48.6%) used case reports. Fear appeals were used in only 10.7% of the newspaper articles; 32.9% of the articles contained the message characteristic "self-efficacy". The newspaper articles that were analysed in the content analysis included different information and message characteristics. The extent of information provided differed during the pandemic. As current research indicates, the use of message characteristics such as fear appeals and self-efficacy, which were also included in the analysed newspaper articles, can help to make health messages effective.

Occupation and malignant lymphoma: a population based case control study in Germany

PubMed Central

Mester, B; Nieters, A; Deeg, E; Elsner, G; Becker, N; Seidler, A

2006-01-01

Aims To identify occupations suspected to be associated with malignant lymphoma and to generate new hypotheses about occupational risks in a multicentre, population based case control study. Methods Male and female patients with malignant lymphoma (n = 710) aged 18–80 years of age were prospectively recruited in six study regions in Germany. For each newly recruited lymphoma case, a sex, region, and age matched control was drawn from the population registers. Odds ratios and 95% confidence intervals for major occupations and industries were calculated using conditional logistic regression analysis, adjusted for smoking (in pack‐years) and alcohol consumption. Patients with specific lymphoma subentities were additionally compared with the entire control group using unconditional logistic regression analysis. Results The following economic/industrial sectors were positively associated with lymphoma: food products, beverages, tobacco; paper products, publishing and printing; and metals. Chemicals; real estate, renting, and business activities were negatively associated with lymphoma diagnosis. The authors observed an increased overall lymphoma risk among architects; maids; farmers; glass formers; and construction workers. Shoemaking and leather goods making was negatively associated with the lymphoma diagnosis (although based on small numbers). In the occupational group analysis of lymphoma subentities, Hodgkin's lymphoma was significantly associated only with rubber and plastic products making; diffuse large B cell lymphoma risk was considerably increased among metal processors; follicular lymphoma showed highly significant risk increases for several occupational groups (medical, dental, and veterinary workers; sales workers; machinery fitters; and electrical fitters); and multiple myeloma showed a particularly pronounced risk increase for farmers as well as for agriculture and animal husbandry workers. Conclusions The results partly confirm previously defined occupational risks. Occupational risk factors for follicular lymphomas might differ from the overall risk factors for malignant lymphoma. PMID:16361401

[Comparison of hand surgery in the German and Italian DRG systems].

PubMed

Lotter, O; Dolderer, J; Stahl, S; Atzei, A; Haerle, M; Schaller, H E

2011-12-01

Diagnosis-related groups (DRGs) are a patient classification system grouping related types of patients treated to the resources they consumed. In this analysis we compared the Italian and the German DRG systems regarding hand surgery with an emphasis on reimbursement of clinical cases. The 15 most common hand surgical diagnoses and their corresponding operative treatment in our clinic in 2009 were processed using a DRG grouper. The underlying data were transferred to the Italian system. Thus, the length of stay and the reimbursement of both countries could be obtained and compared. The latter was adjusted and corrected by the purchasing power of each country. The mean of the upper threshold of length of stay was 10 days in the German as well as the Italian system whereas the median was 2 times higher in Italy (6 vs. 12 days). Fifteen out of 19 cases showed higher reimbursement in Germany. The case mix index (CMI) of 0.917 in Germany represents a mean payment of 2,676 € per case. In Italy the hypothetical CMI of 0.635 resulted in a mean reimbursement of 1,853 € per case. The biggest difference in remuneration could be found for replantation of multiple fingers. For this service the German health-care system pays 12,320 € more than the Italian. Total proceeds of the top 15 diagnoses applying the number of cases treated in our clinic revealed 1.7 million € in the German and 1.2 million € in the Italian DRG system. Considering the purchasing power utilizing consumer prize parities, the difference of reimbursement between the countries decreased to 300,000 €. There is no mean length of stay per DRG in Italy, only the upper threshold of length of stay is determined. In most cases the latter is higher in Italy compared to Germany. The consumption of resources for finger replantation is not adequately represented in the Italian DRG system compared to finger amputation. Reimbursement of inpatient care is influenced by multiple factors not being subject to the free market economy. For this reason only descriptive comparison is feasible. © Georg Thieme Verlag KG Stuttgart · New York.

Malpractice claims and unintentional outcome of tonsil surgery and other standard procedures in otorhinolaryngology

PubMed Central

Windfuhr, Jochen P.

2015-01-01

Background: Septoplasty, tonsillectomy (with and without adenoidectomy) and cervical lymph node excision are amongst the most common 50 inpatient operations in Germany. Intracapsular tonsillectomies (i.e. tonsillotomies) are increasingly performed. The aim of this study was to evaluate technical traps and pitfalls as well as alleged medical malpractice associated with tonsillectomy (TE), adenoidectomy (AE), tonsillotomy (TT), septoplasty (SP) and cervical lymph node excision (LN). Methods: A questionnaire was sent to the Regional Medical Conciliation Boards, Medical Services of the Health Insurance Companies (MDK) and Regional Institutes of Forensic Medicine in Germany to collect anonymized cases of complications following TE, TT, AE, LN and SP. The results were discussed in the light of the contemporary medical literature and published trials and verdicts in Germany. Results: The response rate of our survey was 55.9%. The Institutes of Forensic Medicine contributed nine cases, 49 cases were submitted by the Regional Conciliation Boards and none by MDK. All forensic cases were associated with exsanguinations following tonsillectomy including two children (5 and 8 years of age) and seven adults (aged 20 to 69 years). The fatal post-tonsillectomy hemorrhage (PTH) had occurred 8.7 days on average; four patients experienced the bleeding episode at home (day 5, 8, 9 and 17, respectively). Repeated episodes of bleeding requiring surgical intervention had occurred in 6 patients. Three Conciliation Boards submitted decicions associated with TT (1), AE (4), LN (3), SP (16) and TE (25). Cases with lethal outcome were not registered. Only three of the 49 cases were assessed as surgical malpractice (6.1%) including lesion of the spinal accessory nerve, wrong indication for TE and dental lesion after insertion of the mouth gag. The review of the medico legal literature yielded 71 published verdicts after AE and TE (29), LN (28) and SP (14) of which 37 resulted in compensation of malpractice after LN (16; 57%), TE (10; 37%), SP (8; 57%) and AE (2; 100%). There were 16 cases of PTH amongst 27 trials after TE resulting either in death (5) or apallic syndrome (5). Bleeding complications had occurred on the day of surgery in only 2 patients. 16 trials were based on malpractice claims following SP encompassing lack of informed consent (6), anosmia (4), septal perforation (2), frontobasal injury (2) and dry nose (2). Trials after LN procedures were associated exclusively with a lesion of the spinal accessory nerve (28), including lack of informed consent in 19 cases. 49 cases (69%) were decided for the defendant, 22 (31%) were decided for the plaintiff with monetary compensation in 7 of 29 AE/TE-trials, 9 of 28 LN-trials and 6 of 14 SP-trials. Lack of informed consent was not registered for AE/TE but LN (11) and SP (2). Conclusion: Complicated cases following TE, TT, ATE, SP and LN are not systematically collected in Germany. It can be assumed, that not every complicated case is published in the medical literature or law journals and therefore not obtainable for scientific research. Alleged medical malpracice is proven for less than 6% before trial stage. Approximately half of all cases result in a plaintiff verdict or settlement at court. Proper documentation of a thourough counselling, examination, indication, informed consent and follow-up assists the surgeon in litigation. An adequate complication management of PTH is essential, including instructions for the patients/parents, instructions for the medical staff and readily available surgical instruments. Successful outcome of life-threatening PTH is widely based on a proper airway management in an interdisciplinary approach. Electrosurgical tonsillectomy techniques were repeatedly labeled as a risk factor for bleeding complications following TE. Institutions should analyse the individual PTH rate on a yearly basis. Contradictory expert opinions and verdicts of the courts concerning spinal accesory nerve lesions following LN are due to a lack of a surgical standard. PMID:24403976

Urban shrinkage in Germany and the USA: a comparison of transformation patterns and local strategies.

PubMed

Wiechmann, Thorsten; Pallagst, Karina M

2012-01-01

Many American and European cities have to deal with demographic and economic trajectories leading to urban shrinkage. According to official data, 13% of urban regions in the US and 54% of those in the EU have lost population in recent years. However, the extent and spatial distribution of declining populations differ significantly between Europe and the US. In Germany, the situation is driven by falling birth rates and the effects of German reunification. In the US, shrinkage is basically related to long-term industrial transformation. But the challenges of shrinking cities seldom appeared on the agendas of politicians and urban planners until recently. This article provides a critical overview of the development paths and local strategies of four shrinking cities: Schwedt and Dresden in eastern Germany; Youngstown and Pittsburgh in the US. A typology of urban growth and shrinkage, from economic and demographic perspectives, enables four types of city to be differentiated and the differences between the US and eastern Germany to be discussed. The article suggests that a new transatlantic debate on policy and planning strategies for restructuring shrinking cities is needed to overcome the dominant growth orientation that in most cases intensifies the negative consequences of shrinkage.

Outbreak-related mumps vaccine effectiveness among a cohort of children and of young adults in Germany 2011

PubMed Central

Takla, Anja; Böhmer, Merle M; Klinc, Christina; Kurz, Norbert; Schaffer, Alice; Stich, Heribert; Stöcker, Petra; Wichmann, Ole; Koch, Judith

2014-01-01

Mumps outbreaks in populations with high 2-dose vaccination coverage and among young adults are increasingly reported. However, data on the duration of vaccine-induced protection conferred by mumps vaccines are scarce. As part of a supra-regional outbreak in Germany 2010/11, we conducted two retrospective cohort studies in a primary school and among adult ice hockey teams to determine mumps vaccine effectiveness (VE). Via questionnaires we collected information on demography, clinical manifestations, and reviewed vaccination cards. We estimated VE as 1-RR, RR being the rate ratio of disease among two-times or one-time mumps-vaccinated compared with unvaccinated persons. The response rate was 92.6% (100/108—children cohort) and 91.7% (44/48—adult cohort). Fourteen cases were identified in the children and 6 in the adult cohort. In the children cohort (mean age: 9 y), 2-dose VE was 91.9% (95% CI 81.0–96.5%). In the adult cohort (mean age: 26 y), no cases occurred among the 13 2-times vaccinated, while 1-dose VE was 50.0% (95% CI –9.4–87.1%). Average time since last vaccination showed no significant difference for cases and non-cases, but cases were younger at age of last mumps vaccination (children cohort: 2 vs. 3 y, P = 0.04; adult cohort: 1 vs. 4 y, P = 0.03). We did not observe signs of waning immunity in the children cohort. Due to the small sample size VE in the adult cohort should be interpreted with caution. Given the estimated VE, very high 2-dose vaccination coverage is required to prevent future outbreaks. Intervention efforts to increase coverage must especially target young adults who received <2 vaccinations during childhood. PMID:24091837

Outbreak-related mumps vaccine effectiveness among a cohort of children and of young adults in Germany 2011.

PubMed

Takla, Anja; Böhmer, Merle M; Klinc, Christina; Kurz, Norbert; Schaffer, Alice; Stich, Heribert; Stöcker, Petra; Wichmann, Ole; Koch, Judith

2014-01-01

Mumps outbreaks in populations with high 2-dose vaccination coverage and among young adults are increasingly reported. However, data on the duration of vaccine-induced protection conferred by mumps vaccines are scarce. As part of a supra-regional outbreak in Germany 2010/11, we conducted two retrospective cohort studies in a primary school and among adult ice hockey teams to determine mumps vaccine effectiveness (VE). Via questionnaires we collected information on demography, clinical manifestations, and reviewed vaccination cards. We estimated VE as 1-RR, RR being the rate ratio of disease among two-times or one-time mumps-vaccinated compared with unvaccinated persons. The response rate was 92.6% (100/108--children cohort) and 91.7% (44/48--adult cohort). Fourteen cases were identified in the children and 6 in the adult cohort. In the children cohort (mean age: 9 y), 2-dose VE was 91.9% (95% CI 81.0-96.5%). In the adult cohort (mean age: 26 y), no cases occurred among the 13 2-times vaccinated, while 1-dose VE was 50.0% (95% CI -9.4-87.1%). Average time since last vaccination showed no significant difference for cases and non-cases, but cases were younger at age of last mumps vaccination (children cohort: 2 vs. 3 y, P=0.04; adult cohort: 1 vs. 4 y, P=0.03). We did not observe signs of waning immunity in the children cohort. Due to the small sample size VE in the adult cohort should be interpreted with caution. Given the estimated VE, very high 2-dose vaccination coverage is required to prevent future outbreaks. Intervention efforts to increase coverage must especially target young adults who received<2 vaccinations during childhood.

Efficacy of Economic Sanctions: North Korea and Iran Case Study

DTIC Science & Technology

2011-03-08

rate, as interpreted by Hufbauer, Schott, and Elliot ( HSE ), remained steady at thirty-four percent just as it had been since World War II. The end of...Germany, France, and Great Britain that diffused US economic power. HSE wrote: “The absence of an overriding global security threat made it harder for the...industrial countries to reconcile their different strategies and priorities for using sanctions in regional trouble spots.”8 In 1985 HSE published

Social democratic government and spatial distribution of health care facilities. The case of hospital beds in Germany.

PubMed

Bennema-Broos, M; Groenewegen, P P; Westert, G P

2001-06-01

In this paper, the hypothesis that the spatial distribution of hospital beds is more even in countries with socialist or social democratic governments than in countries with conservative or Christian democratic governments was tested. To avoid the confounding influences of historical and institutional differences between countries, we used the Federal Republic of Germany as a case study. The German federal states have their own governments who play an important role in creating structures for the planning of hospital facilities. The test of the hypothesis was largely quantitative. At the level of federal states the rank correlation was computed between the weighted number of years of left-wing government participation and the coefficient of variation in the number of hospital beds per 1000 inhabitants. In addition to this, the hospital plans of two federal states were studied. The hypothesis was supported by the data, showing a positive association between the number of years of left-wing government participation and regional variation in the number of hospital beds. A comparison of the hospital plans of two contrasting federal states showed less government interference in hospital planning in the state with a tradition of right-wing government. There seems to be a relation between left-wing government participation in West German states and a more equal distribution of the number of hospital beds per 1,000 inhabitants.

Maternalism, race, class and citizenship: aspects of illegitimate motherhood in Nazi Germany.

PubMed

Joshi, Vandana

2011-01-01

This article juxtaposes three types of illegitimate motherhood that came in the wake of the Second World War in Nazi Germany. The first found institutional support in the Lebensborn project, an elite effort to raise the flagging birth-rates, which at the same time turned a new page in the history of sexuality. The second came before the lower courts in the form of paternity and guardianship suits that had a long precedent, and the third was a social practice that the regime considered a ‘mass crime' among its female citizenry: namely, forbidden unions between German women and prisoners of war. Through these cases the article addresses issues such as morality, sexuality, paternity, citizenship and welfarism. The flesh-and-blood stories have been culled from the Lebensborn Dossiers and Special Court files, as well as cases from the lower courts.

NREL Case Study Leads to International Partnership (Fact Sheet)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

2013-12-01

In 2012, NREL analysts produced a case study, "Integrating Variable Renewable Energy in Electric Power Markets: Best Practices from International Experience," which drew upon dozens of interviews with international experts involved in crafting effective policies and markets. The report proposed a cross-cutting initiative to transform the world's power systems by implementing two complementary strategies: the large‐scale deployment of renewable energy, and a combination of comprehensive energy efficiency and smarter grids. This recommendation led to the launch of the 21st Century Power Partnership in April 2012, and its membership has since grown to include Denmark, Finland, Germany, India, Mexico, Spain, andmore » the United States. NREL, together with its affiliated Joint Institute for Strategic Energy Analysis, are the operating agents.« less

Investigation of travel-related cases in a multinational outbreak: example of the Shiga-toxin producing E. coli outbreak in Germany, May-June 2011.

PubMed

Devaux, I; Varela-Santos, C; Payne-Hallström, L; Takkinen, J; Bogaardt, C; Coulombier, D

2015-12-01

Early investigation of travel-related cases in an outbreak of an emerging infectious disease can provide useful information to epidemiologists to characterize the exposure, while they may differ in demographic profiles from cases reported in the country where the outbreak has occurred. During the spring 2011 E. coli outbreak in Germany, we proposed a methodological approach to collect a minimal set of demographic and clinical data that are relatively easy to obtain and available at an early stage of an outbreak investigation. Ninety-eight STEC O104 travel-related cases were reported in a survey by seven EU countries, Switzerland, Canada and the USA. We found a mean incubation period (n = 50) of 8·5 days, which confirmed previous estimations communicated by the Robert Koch Institute. No significant association was found between the duration of the incubation period and possible demographic and clinical factors, although the older the age, the shorter the incubation period that was observed. Such approach and observations are informative for further investigations of outbreaks of enterohaemorrhagic E. coli or other emerging infectious diseases.

[Rabies in France: an update].

PubMed

Jaussaud, R; Strady, C; Liénard, M; Strady, A

2000-08-01

In 1996, rabies was responsible for more than 35,000 deaths worldwide. Three cases of human rabies that had been contracted abroad were diagnosed in France during the same year. Cases notified in 1997 followed exposure outside the country. Fox, bat, and dog rabies are reviewed on the basis of the latest epidemiological data obtained in France. Two cases of fox rabies diagnosed in 1998 occurred at the border between France and Germany, thus preventing five French departments bordering Germany from being officially declared rabies-free in 1999. The campaigns for oral immunization of foxes that are led since 1986 are responsible for the decrease in rabies incidence. Though not well known, bat rabies is a reality in France, involving either European virus strains (five cases all over the country) or African virus strains that are carried along by imported tropical bats. Dogs rabies is also today an imported disease. The decrease in risk for rabies has resulted from the conjunction of multiple efforts: extensive programs aimed at oral vaccination of foxes in France and its neighboring countries, efficient epidemiological survey, sanitary controls at borders, ban on importing tropical bats. Furthermore, recommendations for preventive pre-exposure immunization have recently been changed, leading to modifications of the French licensing form.

[Constrained competition in parallel drug importation: the case of simvastatin in Germany, the Netherlands, and the United Kingdom].

PubMed

Costa-Font, Joan; Kanavos, Panos

2007-01-01

To examine the effects of parallel simvastatin importation on drug price in three of the main parallel importing countries in the European Union, namely the United Kingdom, Germany, and the Netherlands. To estimate the market share of parallel imported simvastatin and the unit price -both locally produced and parallel imported- adjusted by defined daily dose in the importing country and in the exporting country (Spain). Ordinary least squares regression was used to examine the potential price competition resulting from parallel drug trade between 1997 and 2002. The market share of parallel imported simvastatin progressively expanded (especially in the United Kingdom and Germany) in the period examined, although the price difference between parallel imported and locally sourced simvastatin was not significant. Prices tended to rise in the United Kingdom and Germany and declined in the Netherlands. We found no evidence of pro-competitive effects resulting from the expansion of parallel trade. The development of parallel drug importation in the European Union produced unexpected effects (limited competition) on prices that differ from those expected by the introduction of a new competitor. This is partially the result of drug price regulation scant incentives to competition and of the lack of transparency in the drug reimbursement system, especially due to the effect of informal discounts (not observable to researchers). The case of simvastatin reveals that savings to the health system from parallel trade are trivial. Finally, of the three countries examined, the only country that shows a moderate downward pattern in simvastatin prices is the Netherlands. This effect can be attributed to the existence of a system that claws back informal discounts.

In-Firm Trainers of Young People in the Framework of the Dual Vocational Training System of the Federal Republic of Germany.

ERIC Educational Resources Information Center

von Gilardi, Rudiger; Schulz, Winfried

This study of the vocational training system in the Federal Republic of Germany was conducted by the European Centre for the Development of Vocational Training through site visits, seminars, research papers, and discussion. The study found that the majority of young people in the Federal Republic of Germany (currently 1.8 million) receive their…

Teaching about Modern Germany: Instructional Materials for the Social Studies Classroom. Correlation Charts Indicating Content and Skills Addressed by Each Lesson.

ERIC Educational Resources Information Center

Goethe House, New York, NY.

This instructional booklet for the social studies classroom is a companion to a series about modern day Germany. The materials describe the documents in the series and present correlation charts for content and skills: (1) "A Kid Like Me across the Sea"; (2) "Communities and Regions"; (3) "Overview of Germany"; (4)…

Estimating the under-reporting of norovirus illness in Germany utilizing enhanced awareness of diarrhoea during a large outbreak of Shiga toxin-producing E. coli O104:H4 in 2011 – a time series analysis

PubMed Central

2014-01-01

Background Laboratory-confirmed norovirus illness is reportable in Germany since 2001. Reported case numbers are known to be undercounts, and a valid estimate of the actual incidence in Germany does not exist. An increase of reported norovirus illness was observed simultaneously to a large outbreak of Shiga toxin-producing E. coli O104:H4 in Germany in 2011 – likely due to enhanced (but not complete) awareness of diarrhoea at that time. We aimed at estimating age- and sex-specific factors of that excess, which should be interpretable as (minimal) under-reporting factors of norovirus illness in Germany. Methods We used national reporting data on laboratory-confirmed norovirus illness in Germany from calendar week 31 in 2003 through calendar week 30 in 2012. A negative binomial time series regression model was used to describe the weekly counts in 8∙2 age-sex strata while adjusting for secular trend and seasonality. Overall as well as age- and sex-specific factors for the excess were estimated by including additional terms (either an O104:H4 outbreak period indicator or a triple interaction term between outbreak period, age and sex) in the model. Results We estimated the overall under-reporting factor to be 1.76 (95% CI 1.28-2.41) for the first three weeks of the outbreak before the outbreak vehicle was publicly communicated. Highest under-reporting factors were here estimated for 20–29 year-old males (2.88, 95% CI 2.01-4.11) and females (2.67, 95% CI 1.87-3.79). Under-reporting was substantially lower in persons aged <10 years and 70 years or older. Conclusions These are the first estimates of (minimal) under-reporting factors for norovirus illness in Germany. They provide a starting point for a more detailed investigation of the relationship between actual incidence and reporting incidence of norovirus illness in Germany. PMID:24580831

Teleconsultation in diagnostic pathology: experience from Iran and Germany with the use of two European telepathology servers.

PubMed

Mireskandari, Masoud; Kayser, Gian; Hufnagl, Peter; Schrader, Thomas; Kayser, Klaus

2004-01-01

Eighty pathology cases were sent independently to each of two telepathology servers. Cases were submitted from the Department of Pathology at the University of Kerman in Iran (40 cases) and from the Institute of Pathology in Berlin, Germany (40 cases). The telepathology servers were located in Berlin (the UICC server) and Basel in Switzerland (the iPATH server). A scoring system was developed to quantify the differences between the diagnoses of the referring pathologist and the remote expert. Preparation of the cases, as well as the submission of images, took considerably longer from Kerman than from Berlin; this was independent of the server system. The Kerman delay was mainly associated with a slower transmission rate and longer image preparation. The diagnostic gap between referrers' and experts' diagnoses was greater with the iPATH system, but not significantly so. The experts' response time was considerably shorter for the iPATH system. The results showed that telepathology is feasible for requesting pathologists working in a developing country or in an industrialized country. The key factor in the quality of the service is the work of the experts: they should be selected according to their diagnostic expertise, and their commitment to the provision of telepathology services is critical.

Prevalence of pain medication prescriptions in France, Germany, and the UK - a cross-sectional study including 4,270,142 patients.

PubMed

Jacob, Louis; Kostev, Karel

2018-01-01

The goal of the present study was to analyze the prevalence of pain medication prescriptions in general practices in France, Germany, and the UK. This study included all patients aged ≥18 years followed in 2016 in general practitioner practices in France, Germany and the UK. The primary outcome was the prevalence of patients receiving prescriptions for pain medications in France, Germany, and the UK in 2016. The following drugs were included in the analysis: anti-inflammatory and antirheumatic products, non-steroids and analgesics including opioids, antimigraine preparations, and other analgesics and antipyretics. Demographic variables included age and gender. This study included 4,270,142 patients. The prevalences of pain medication prescriptions were 57.3% in France, 29.6% in Germany, and 21.7% in the UK. Although this prevalence generally remained consistent between age groups in France (54.3%-60.3%), it increased with age in Germany (18-30 years: 23.8%; >70 years: 35.8%) and in the UK (18-30 years: 9.3%; >70 years: 43.8%). Finally, the prevalence of pain medication prescriptions was higher in women than in men in all three countries. Paracetamol was prescribed to 82.3% and 60.1% of patients receiving pain medication in France and the UK, respectively, whereas ibuprofen was prescribed to 46.5% of individuals in Germany. The prevalence of pain medication prescriptions was higher in France than in Germany and the UK. Further research is needed to gain a better understanding of the differences in the prescription patterns between these three European countries.

Learning from Lessons: studying the structure and construction of mathematics teacher knowledge in Australia, China and Germany

NASA Astrophysics Data System (ADS)

Chan, Man Ching Esther; Clarke, David J.; Clarke, Doug M.; Roche, Anne; Cao, Yiming; Peter-Koop, Andrea

2018-03-01

The major premise of this project is that teachers learn from the act of teaching a lesson. Rather than asking "What must a teacher already know in order to practice effectively?", this project asks "What might a teacher learn through their activities in the classroom and how might this learning be optimised?" In this project, controlled conditions are created utilising purposefully designed and trialled lesson plans to investigate the process of teacher knowledge construction, with teacher selective attention proposed as a key mediating variable. In order to investigate teacher learning through classroom practice, the project addresses the following questions: To what classroom objects, actions and events do teachers attend and with what consequence for their learning? Do teachers in different countries attend to different classroom events and consequently derive different learning benefits from teaching a lesson? This international project combines focused case studies with an online survey of mathematics teachers' selective attention and consequent learning in Australia, China and Germany. Data include the teacher's adaptation of a pre-designed lesson, the teacher's actions during the lesson, the teacher's reflective thoughts about the lesson and, most importantly, the consequences for the planning and delivery of a second lesson. The combination of fine-grained, culturally situated case studies and large-scale online survey provides mutually informing benefits from each research approach. The research design, so constituted, offers the means to a new and scalable vision of teacher learning and its promotion.

Using the reference framework for good measles management in practice--a case study from North Rhine-Westphalia.

PubMed

Schröter, Matthias; Schröder-Bäck, Peter; Brand, Helmut

2009-12-01

In 2005, WHO Europe reconfirmed the objective of eradicating measles and fixed a strategy plan for the years 2005 up to 2010. While a downward trend of measles infections in Germany between 2001 and 2004 could be observed, as many as 780 cases of measles were reported in 2005 and in 2006 even 2.281 cases. These high figures in 2006 were almost exclusively caused by an outbreak in the German region of North Rhine-Westphalia. This case study describes how a reference framework for good health management of measles prevention was applied for this region. As a result, various recommendations for action could be given, among them the recommendation to implement individual vaccination reminder systems for parents and bonus systems for parents. Based on these results, a comprehensive policy concept has been drawn up and has become the subject of a political agreement process in this region. Thus this case study shows a paradigm how reference frameworks for good health management can be utilised in practice.

Expertise in Clinical Psychology. The Effects of University Training and Practical Experience on Expertise in Clinical Psychology

PubMed Central

Vollmer, Sabine; Spada, Hans; Caspar, Franz; Burri, Salome

2013-01-01

How do university training and subsequent practical experience affect expertise in clinical psychology? To answer this question we developed methods to assess psychological knowledge and the competence to diagnose, construct case conceptualizations, and plan psychotherapeutic treatment: a knowledge test and short case studies in a first study, and a complex, dynamically evolving case study in the second study. In our cross-sectional studies, psychology students, trainees in a certified postgraduate psychotherapist curriculum, and behavior therapists with more than 10 years of experience were tested (100 in total: 20 each of novice, intermediate, and advanced university students, postgraduate trainees, and therapists). Clinical knowledge and competence increased up to the level of trainees but unexpectedly decreased at the level of experienced therapists. We discuss the results against the background of expertise research and the training of clinical psychologists (in Germany). Important factors for the continuing professional development of psychotherapists are proposed. PMID:23543213

FY16 Summary Report: Participation in the KOSINA Project

DOE Office of Scientific and Technical Information (OSTI.GOV)

Matteo, Edward N.; Hansen, Francis D.

Salt formations represent a promising host for disposal of nuclear waste in the United States and Germany. Together, these countries provided fully developed safety cases for bedded salt and domal salt, respectively. Today, Germany and the United States find themselves in similar positions with respect to salt formations serving as repositories for heat-generating nuclear waste. German research centers are evaluating bedded and pillow salt formations to contrast with their previous safety case made for the Gorleben dome. Sandia National Laboratories is collaborating on this effort as an Associate Partner, and this report summarizes that teamwork. Sandia and German research groupsmore » have a long-standing cooperative approach to repository science, engineering, operations, safety assessment, testing, modeling and other elements comprising the basis for salt disposal. Germany and the United States hold annual bilateral workshops, which cover a spectrum of issues surrounding the viability of salt formations. Notably, recent efforts include development of a database for features, events, and processes applying broadly and generically to bedded and domal salt. Another international teaming activity evaluates salt constitutive models, including hundreds of new experiments conducted on bedded salt from the Waste Isolation Pilot Plant. These extensive collaborations continue to build the scientific basis for salt disposal. Repository deliberations in the United States are revisiting bedded and domal salt for housing a nuclear waste repository. By agreeing to collaborate with German peers, our nation stands to benefit by assurance of scientific position, exchange of operational concepts, and approach to elements of the safety case, all reflecting cost and time efficiency.« less

An Active Old Age--Senior Citizens in Germany.

ERIC Educational Resources Information Center

Metzler, Birgit

1998-01-01

Life expectancies are rising all over the world, leading to higher proportions of older adults in the population. This is especially true in Japan and Germany. In Germany today, "old" no longer means necessarily "poor and frail." Through volunteer work, lifelong learning, study tours, and participation in sports, older Germans…

Is there a link between infant botulism and sudden infant death? Bacteriological results obtained in central Germany.

PubMed

Böhnel, H; Behrens, S; Loch, P; Lube, K; Gessler, F

2001-10-01

Despite the fact that botulism was described in Germany for the first time by Kerner in 1820, the disease is almost forgotten in this country. Only about 10-20 cases of classical botulism (intoxication) are recorded every year, including 1-2 cases of clinical infant botulism. As we assumed a high incidence of botulism to be connected with cases of sudden infant death (SID), we undertook the research work presented here. From every case of unexpected infant death up to 12 months of age, standardised specimens (blood, liver and intestine) were taken at autopsy. They were tested for the presence of botulinum neurotoxin (BoNT) and/or bacterial forms of Clostridium botulinum with subsequent BoNT neutralisation tests by the international standard mouse bioassay. Age, sex, pathological findings and season were recorded. Over a 5-year period, 75 samples including 57 SID cases were tested. Free toxin was found in nine and bacterial forms were detected in six samples. Toxin neutralisation revealed the definite presence of BoNT/BoNT producing bacteria (mainly type E), whereas another 11 toxin tests were inconclusive. According to international literature, these 15 cases are to be interpreted as infant botulism. the results show a remarkable incidence of infant botulism without any known previous medical history, partly hidden as sudden infant death. We propose to systematically search for botulism in connection with sudden infant death.

Implementation of Enhanced Recovery After Surgery (ERAS) Pathways in Gynecologic Oncology. A NOGGO-AGO* survey of 144 Gynecological Departments in Germany.

PubMed

Muallem, Mustafa Zelal; Dimitrova, Desislava; Pietzner, Klaus; Richter, Rolf; Feldheiser, Aarne; Scharfe, Irina; Schmeil, Iryna; Hösl, Teresa Maria; Mustea, Alexander; Wimberger, Pauline; Burges, Alexander; Kimmig, Rainer; Sehouli, Jalid

2016-08-01

To gather standardized information of current perioperative management of gynecological oncology patients and to evaluate up to what extent the Enhanced Recovery after Surgery (ERAS) elements are established in the clinical routine of gynecologic oncology units in Germany. We performed a multi-centric nationwide survey among 654 primary, secondary and maximal health care gynecological departments in Germany. A multiple-choice questionnaire based on the principles of ERAS was developed to gather information about perioperative management of two fictional cases in gynecological oncology. One hundred four units (22%) have been taken the survey. Only 49.5% of surveyed hospitals claimed to be adherent to more than 70% of ERAS elements in managing perioperative period of primary cytoreductive surgery in ovarian cancer patients. 21% of these hospitals implemented more than 80% and only 8.4% implemented more than 90%. The results in border-line tumors operations did not differ from those of ovarian cancer operations. The implementation of ERAS elements in gynecologic oncology in Germany is still not satisfying as only half of the departments will now be able to apply 70% of these principles. Therefore, we plan the second step of this survey in order to be able to build a consistent structured reporting platform between gynecological oncology units in Germany to facilitate the wide implementation and standardization of ERAS protocol. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

GIS-based estimation of the winter storm damage probability in forests: a case study from Baden-Wuerttemberg (Southwest Germany).

PubMed

Schindler, Dirk; Grebhan, Karin; Albrecht, Axel; Schönborn, Jochen; Kohnle, Ulrich

2012-01-01

Data on storm damage attributed to the two high-impact winter storms 'Wiebke' (28 February 1990) and 'Lothar' (26 December 1999) were used for GIS-based estimation and mapping (in a 50 × 50 m resolution grid) of the winter storm damage probability (P(DAM)) for the forests of the German federal state of Baden-Wuerttemberg (Southwest Germany). The P(DAM)-calculation was based on weights of evidence (WofE) methodology. A combination of information on forest type, geology, soil type, soil moisture regime, and topographic exposure, as well as maximum gust wind speed field was used to compute P(DAM) across the entire study area. Given the condition that maximum gust wind speed during the two storm events exceeded 35 m s(-1), the highest P(DAM) values computed were primarily where coniferous forest grows in severely exposed areas on temporarily moist soils on bunter sandstone formations. Such areas are found mainly in the mountainous ranges of the northern Black Forest, the eastern Forest of Odes, in the Virngrund area, and in the southwestern Alpine Foothills.

Operating room management and operating room productivity: the case of Germany.

PubMed

Berry, Maresi; Berry-Stölzle, Thomas; Schleppers, Alexander

2008-09-01

We examine operating room productivity on the example of hospitals in Germany with independent anesthesiology departments. Linked to anesthesiology group literature, we use the ln(Total Surgical Time/Total Anesthesiologists Salary) as a proxy for operating room productivity. We test the association between operating room productivity and different structural, organizational and management characteristics based on survey data from 87 hospitals. Our empirical analysis links improved operating room productivity to greater operating room capacity, appropriate scheduling behavior and management methods to realign interests. From this analysis, the enforcing jurisdiction and avoiding advance over-scheduling appear to be the implementable tools for improving operating room productivity.

[Onychocola canadensis Sigler in onychomycosis : A new dermatophyte-like mould in Germany].

PubMed

Nenoff, P; Schorlemmer, B; Uhrlaß, S; Baunacke, A; Baunacke, A; Friedrichs, C; Iffländer, J; Syhre, E; Schneider, A; Krüger, C; Maier, T

2016-09-01

Moulds or non-dermatophyte moulds (NDM) are being increasingly isolated as causative agent of onychomycoses. Known causes of a NDM-OM are Scopulariopsis brevicaulis, Fusarium, Aspergillus, Acremonium, Neoscytalidium dimidiatum, Arthrographis kalrae, and Chaetomium. In this article, 5 patients with suspected nail infection due to Onychocola canadensis are reported for the first time in Germany. Systemic antifungal agents are not considered to be effective in NDM onychomycosis. In individual cases, however, terbinafine seems to be effective in Onychocola canadensis infection of the nails. Treatment of choice represents, however, nontraumatic nail avulsion using 40 % urea ointment followed by antifungal nail lacquer with ciclopirox olamine or amorolfine.

Hypertension in Germany.

PubMed

Neuhauser, Hannelore; Diederichs, Claudia; Boeing, Heiner; Felix, Stephan B; Jünger, Claus; Lorbeer, Roberto; Meisinger, Christine; Peters, Annette; Völzke, Henry; Weikert, Cornelia; Wild, Philipp; Dörr, Marcus

2016-12-02

Hypertension is a key risk factor. However, population data based on blood pressure measurements in Germany are scarce. Standardized blood pressure (BP) measurements and medication data from seven population-based studies conducted in Germany between 1994 and 2012 (66 845 participants, 25-74 years) were analyzed: the EPICPotsdam study (1994-1998, EPIC), the KORA-S4 Study (1999-2001) in Augsburg, and the Gutenberg Health Study (2007-2012, GHS) in Mainz/Mainz-Bingen provided data for descriptive comparisons. Time trends were analyzed based on identical study regions for the German National Health Interview and Examination Survey 1998 (BGS98) and the German Health Examination Survey for Adults (2008-11, DEGS1) as well as the Study of Health in Pomerania (SHIP) in Northeast Germany (1997-2001) and the SHIP-TREND study (2008-2012). BP data were adjusted for study-specific measurement devices based on calibration studies. After adjustment for study-specific measurement devices, mean systolic and diastolic BP values were lower and treatment proportions higher in recent (2007-2012) compared to older (1994-2001) studies. Mean BP decrease was most pronounced (systolic ≥ 10 mmHg) in the elderly (55-74 years). The regional SHIP-TREND data for Northeast Germany showed a decrease in mean systolic BP in young men aged 25 to 34 years; on a national level according to the DEGS1 data, however, no such decrease was observed for this group. New data add evidence for lower BP in Germany. However, the prevention potential remains high. Future research based on population-based data should place a special focus on blood pressure data in young men.

[Education of medical students in urology in Germany: present status].

PubMed

Strunk, T; Mueller, S C

2011-02-01

There is a growing demand for doctors in Germany and diseases of the genitourinary tract have become more prevalent in recent years. Politicians plan to increase the number of students in an already heavily overloaded system but data on quality and structure of medical education in Urology are lacking. The purpose of this study was to investigate the extent and quality of undergraduate medical education in urology. Departments of Urology at German University Hospitals were surveyed using a questionnaire. Questions covered four different fields of medical education and answers were analyzed by descriptive statistics. Of the teachers involved in medical education 97% are physicians and 4% of these have special didactic qualifications. On average 1 teacher is responsible for 13 students and 44% of departments also have to carry out medical duties during teaching lessons. More than half of the departments offer modern learning forms, such as e-learning, problem-oriented learning or skills laboratory training. Urology departments at German University Hospitals spend much time on medical education. Nearly all physicians are involved in medical education, whether they are experienced or not and in many cases teaching is carried out in parallel to patient care. In more than half of the cases modern education tools were employed which implies a good standard of quality but there are no data on outcome.

Discipline building in Germany: women and genetics at the Berlin Institute for Heredity Research.

PubMed

Stamhuis, Ida H; Vogt, Annette B

2017-06-01

The origin and the development of scientific disciplines has been a topic of reflection for several decades. The few extensive case studies support the thesis that scientific disciplines are not monolithic structures but can be characterized by distinct social, organizational and scientific-technical practices. Nonetheless, most disciplinary histories of genetics confine themselves largely to an uncontested account of the content of the discipline or occasionally institutional factors. Little attention is paid to the large number of researchers who, by their joint efforts, ultimately shaped the discipline. We contribute to this aspect of disciplinary historiography by discussing the role of women researchers at the Institute for Heredity Research, founded in 1914 in Berlin under the directorship of Erwin Baur, and the sister of the John Innes Institute at Cambridge. This paper investigates how and why Baur built a highly successful research programme that relied on the efforts of his female staff, whose careers, notably Elisabeth Schiemann's, are also assessed in toto. These women undertook the necessary 'technoscience' and in some cases innovative work and helped increase the prestige of the institute and its director. Together they played a pivotal role in the establishment of genetics in Germany. Without them the discipline would have developed much more slowly and along a divergent path.

Adverse drug reactions in Germany: direct costs of internal medicine hospitalizations.

PubMed

Rottenkolber, Dominik; Schmiedl, Sven; Rottenkolber, Marietta; Farker, Katrin; Saljé, Karen; Mueller, Silke; Hippius, Marion; Thuermann, Petra A; Hasford, Joerg

2011-06-01

German hospital reimbursement modalities changed as a result of the introduction of Diagnosis Related Groups (DRG) in 2004. Therefore, no data on the direct costs of adverse drug reactions (ADRs) resulting in admissions to departments of internal medicine are available. The objective was to quantify the ADR-related economic burden (direct costs) of hospitalizations in internal medicine wards in Germany. Record-based study analyzing the patient records of about 57,000 hospitalizations between 2006 and 2007 of the Net of Regional Pharmacovigilance Centers (Germany). All ADRs were evaluated by a team of experts in pharmacovigilance for severity, causality, and preventability. The calculation of accurate person-related costs for ADRs relied on the German DRG system (G-DRG 2009). Descriptive and bootstrap statistical methods were applied for data analysis. The incidence of hospitalization due to at least 'possible' serious outpatient ADRs was estimated to be approximately 3.25%. Mean age of the 1834 patients was 71.0 years (SD 14.7). Most frequent ADRs were gastrointestinal hemorrhage (n = 336) and drug-induced hypoglycemia (n = 270). Average inpatient length-of-stay was 9.3 days (SD 7.1). Average treatment costs of a single ADR were estimated to be approximately €2250. The total costs sum to €434 million per year for Germany. Considering the proportion of preventable cases (20.1%), this equals a saving potential of €87 million per year. Preventing ADRs is advisable in order to realize significant nationwide savings potential. Our cost estimates provide a reliable benchmark as they were calculated based on an intensified ADR surveillance and an accurate person-related cost application. Copyright © 2011 John Wiley & Sons, Ltd.

Instream coliform gradients in the Holtemme, a small headwater stream in the Elbe River Basin, Northern Germany

NASA Astrophysics Data System (ADS)

Karthe, Daniel; Lin, Pei-Ying; Westphal, Katja

2017-09-01

The Holtemme is a small headwater stream in North Germany's Elbe River Basin. According to German and European legislation, hygienic monitoring is not mandatory for such water bodies which are neither drinking water sources nor categorized as bathing waters. Consequently, relatively little is known about the occurrence of-potentially pathogenic-bacteria and viruses in Germany's streams and rivers. The Holtemme was selected for a case study because it is relatively well monitored for both chemical water quality and aquatic ecology, but not for hygiene. Originating in the mountains of Harz Nature Park, the 47 km long Holtemme is characterized by a strong longitudinal gradient in chemical water quality, which is related to different land uses and the influx of treated wastewater from two urban areas (Wernigerode and Halberstadt). Waste water loads received by the Holtemme are comparatively high when compared to similarly small streams. In 2015, total coliform concentrations between more than 200 and 77,010 bacteria per 100 mL, and fecal coliform concentrations between 5 and 24,060 bacteria per 100 mL were observed in the Holtemme's main channel. The highest concentrations were typically found below the outlets of the two wastewater treatment plants. The treated wastewater contained total and fecal coliform concentrations of up to 200,500 and 83,100 per 100 mL, respectively; however, there were significant temporal variations. While the observed concentrations are unproblematic from a legal perspective (because no maximum permissible limits are defined for streams in Germany), they would exceed the tolerable limits for bathing waters in the EU, indicating moderate to critical pollution limits.

Spatial Analysis of Hospital Incidence and in Hospital Mortality of Abdominal Aortic Aneurysms in Germany: Secondary Data Analysis of Nationwide Hospital Episode (DRG) Data.

PubMed

Kuehnl, Andreas; Salvermoser, Michael; Erk, Alexander; Trenner, Matthias; Schmid, Volker; Eckstein, Hans-Henning

2018-06-01

This study aimed to analyze the spatial distribution and regional variation of the hospital incidence and in hospital mortality of abdominal aortic aneurysms (AAA) in Germany. German DRG statistics (2011-2014) were analysed. Patients with ruptured AAA (rAAA, I71.3, treated or not) and patients with non-ruptured AAA (nrAAA, I71.4, treated by open or endovascular aneurysm repair) were included. Age, sex, and risk standardisation was done using standard statistical procedures. Regional variation was quantified using systematic component of variation. To analyse spatial auto-correlation and spatial pattern, global Moran's I and Getis-Ord Gi* were calculated. A total of 50,702 cases were included. Raw hospital incidence of AAA was 15.7 per 100,000 inhabitants (nrAAA 13.1; all rAAA 2.7; treated rAAA 1.6). The standardised hospital incidence of AAA ranged from 6.3 to 30.3 per 100,000. Systematic component of variation proportion was 96% in nrAAA and 55% in treated rAAA. Incidence rates of all AAA were significantly clustered with above average values in the northwestern parts of Germany and below average values in the south and eastern regions. Standardised mortality of nrAAA ranged from 1.7% to 4.3%, with that of treated rAAA ranging from 28% to 52%. Regional variation and spatial distribution of standardised mortality was not different from random. There was significant regional variation and clustering of the hospital incidence of AAA in Germany, with higher rates in the northwest and lower rates in the southeast. There was no significant variation in standardised (age/sex/risk) mortality between counties. Copyright © 2018. Published by Elsevier B.V.

Working Hours and Wishes Concerning Working Hours among Women in Western and Eastern Germany. Results of an Empirical Study from 1995. IAB Labour Market Research Topics No. 27.

ERIC Educational Resources Information Center

Beckmann, Petra

The actual and desired working hours of women in western and eastern Germany were examined by surveying a random sample of 6,742 western and eastern German women aged 18-65 years. Of the women interviewed, 1,800 from western Germany and 1,341 from eastern Germany were in dependent employment. An overall response rate of 52.8% was achieved.…

Quantifying the impact of human activity on temperatures in Germany

NASA Astrophysics Data System (ADS)

Benz, Susanne A.; Bayer, Peter; Blum, Philipp

2017-04-01

Human activity directly influences ambient air, surface and groundwater temperatures. Alterations of surface cover and land use influence the ambient thermal regime causing spatial temperature anomalies, most commonly heat islands. These local temperature anomalies are primarily described within the bounds of large and densely populated urban settlements, where they form so-called urban heat islands (UHI). This study explores the anthropogenic impact not only for selected cities, but for the thermal regime on a countrywide scale, by analyzing mean annual temperature datasets in Germany in three different compartments: measured surface air temperature (SAT), measured groundwater temperature (GWT), and satellite-derived land surface temperature (LST). As a universal parameter to quantify anthropogenic heat anomalies, the anthropogenic heat intensity (AHI) is introduced. It is closely related to the urban heat island intensity, but determined for each pixel (for satellite-derived LST) or measurement point (for SAT and GWT) of a large, even global, dataset individually, regardless of land use and location. Hence, it provides the unique opportunity to a) compare the anthropogenic impact on temperatures in air, surface and subsurface, b) to find main instances of anthropogenic temperature anomalies within the study area, in this case Germany, and c) to study the impact of smaller settlements or industrial sites on temperatures. For all three analyzed temperature datasets, anthropogenic heat intensity grows with increasing nighttime lights and declines with increasing vegetation, whereas population density has only minor effects. While surface anthropogenic heat intensity cannot be linked to specific land cover types in the studied resolution (1 km × 1 km) and classification system, both air and groundwater show increased heat intensities for artificial surfaces. Overall, groundwater temperature appears most vulnerable to human activity; unlike land surface temperature and surface air temperature, groundwater temperatures are elevated in cultivated areas as well. At the surface of Germany, the highest anthropogenic heat intensity with 4.5 K is found at an open-pit lignite mine near Jülich, followed by three large cities (Munich, Düsseldorf and Nuremberg) with annual mean anthropogenic heat intensities > 4 K. Overall, surface anthropogenic heat intensities > 0 K and therefore urban heat islands are observed in communities down to a population of 5,000.

Determinants of sports, cycling, walking and overall leisure-time physical activity among postmenopausal women in Germany.

PubMed

Steindorf, Karen; Chang-Claude, Jenny; Flesch-Janys, Dieter; Schmidt, Martina E

2010-11-01

Convincing evidence exists for a beneficial effect of physical activity (PA) on health and well-being for elderly women. Nevertheless, many women in Germany are insufficiently physically active. Activity promotion programmes should target women in particular need. Thus, we examined subject-related determinants of PA for postmenopausal women in Germany. Associations of sociodemographic, anthropometric, lifestyle and health-related factors with activity since the age of 50 years were assessed with multiple linear and logistic regression models, regarding overall leisure-time PA (LPA) in metabolic equivalent hours per week, engagement in sports (ever v. never), cycling (yes v. no) and walking (≥3·5 v. <3·5 h/week). All controls from a population-based case-control study carried out in 2002-2005 in Germany (MARIE study). A total of 6569 postmenopausal women. We found significant associations of overall LPA, sports, cycling and walking in postmenopausal years with several characteristics, among others: obese v. normal BMI (adjusted OR: ORsports = 0·73; ORcycling = 0·60; ORwalking = 0·63), tall v. short (ORsports = 1·49), worker v. medium employee (ORsports = 0·47), working full time v. unemployed/retired (ORsports = 0·80; ORwalking = 0·56), current v. non-smoker (ORsports = 0·62; ORcycling = 0·62; ORwalking = 0·82), non-German nationality (ORsports = 0·58; ORcycling = 0·41). Parity seemed more relevant than marital status for sports or cycling activity. Further, CVD, hypertension and diabetes were significantly associated with lower activity (ORsports = 0·77, 0·79 and 0·80; ORcycling = 0·80, 0·75 and 0·85, respectively). Our results suggest potential target groups for promoting sports, cycling or walking activity. Postmenopausal women with chronic diseases may need to be stronger encouraged by their physicians to engage in adequate PA for the management of their diseases.

Using radiative transfer models to study the atmospheric water vapor content and to eliminate telluric lines from high-resolution optical spectra

NASA Astrophysics Data System (ADS)

Gardini, A.; Maíz Apellániz, J.; Pérez, E.; Quesada, J. A.; Funke, B.

2013-05-01

The Radiative Transfer Model (RTM) and the retrieval algorithm, incorporated in the SCIATRAN 2.2 software package developed at the Institute of Remote Sensing/Institute of Enviromental Physics of Bremen University (Germany), allows to simulate, among other things, radiance/irradiance spectra in the 2400--24 000 Å range. In this work we present applications of RTM to two case studies. In the first case the RTM was used to simulate direct solar irradiance spectra, with different water vapor amounts, for the study of the water vapor content in the atmosphere above Sierra Nevada Observatory. Simulated spectra were compared with those measured with a spectrometer operating in the 8000--10 000 Å range. In the second case the RTM was used to generate telluric model spectra to subtract the atmospheric contribution and correct high-resolution stellar spectra from atmospheric water vapor and oxygen lines. The results of both studies are discussed.

A case study analysing the process of analogy-based learning in a teaching unit about simple electric circuits

NASA Astrophysics Data System (ADS)

Paatz, Roland; Ryder, James; Schwedes, Hannelore; Scott, Philip

2004-09-01

The purpose of this case study is to analyse the learning processes of a 16-year-old student as she learns about simple electric circuits in response to an analogy-based teaching sequence. Analogical thinking processes are modelled by a sequence of four steps according to Gentner's structure mapping theory (activate base domain, postulate local matches, connect them to a global match, draw candidate inferences). We consider whether Gentner's theory can be used to account for the details of this specific teaching/learning context. The case study involved video-taping teaching and learning activities in a 10th-grade high school course in Germany. Teaching used water flow through pipes as an analogy for electrical circuits. Using Gentner's theory, relational nets were created from the student's statements at different stages of her learning. Overall, these nets reflect the four steps outlined earlier. We also consider to what extent the learning processes revealed by this case study are different from previous analyses of contexts in which no analogical knowledge is available.

Fatal Bioprosthetic Aortic Valve Endocarditis Due to Cardiobacterium valvarum▿

PubMed Central

Geißdörfer, Walter; Tandler, René; Schlundt, Christian; Weyand, Michael; Daniel, Werner G.; Schoerner, Christoph

2007-01-01

Cardiobacterium valvarum was isolated from the blood of a 71-year-old man with fatal aortic valve endocarditis. The API NH system was used for phenotypic characterization of the C. valvarum strain. This is the first case of infective endocarditis caused by C. valvarum in Germany and the first case worldwide affecting a prosthetic valve and lacking an obvious dental focus. PMID:17475754

Racialised Norms in Apprenticeship Systems in England and Germany

ERIC Educational Resources Information Center

Chadderton, Charlotte; Wischmann, Anke

2014-01-01

In this paper, we consider the issue of the under-representation of young people from minority ethnic/migrant backgrounds in apprenticeships in England and Germany. Whilst there are many studies on apprenticeships in England and Germany, few focus on under-representation or discrimination, even fewer on ethnic under-representation, and there are…

Changing Traditions in Germany's Public Schools. International Studies in Education Series.

ERIC Educational Resources Information Center

Dichanz, Horst; Zahorik, John A.

Understanding German elementary and secondary schools requires knowledge of political, geographic, economic, and social aspects of Germany. German schools have developed in accordance with the prevailing influences of their times. People and events, throughout the past 400 years, are discussed. The legal status of education in Germany is similar…

Society and Social Justice: Problems of Political Education in West Germany.

ERIC Educational Resources Information Center

George, Siegfried

1981-01-01

Discusses social justice in West Germany within the context of the experience of Nazism, the economic disaster after World War II, and the successful development of the economy and welfare state since 1949. Refers to various textbooks and recent empirical studies on the political attitudes of students in West Germany. (Author/KC)

Occupational risk factors for prostate cancer in an area of former coal, iron, and steel industries in Germany. Part 1: Results from a study performed in the 1980s.

PubMed

Dickhut, Silvia; Urfer, Wolfgang; Reich, Susanne; Bandel, Tiemo; Bremicker, Karl-Dieter; Neugebauer, Wolfgang; Sökeland, Jürgen; Bolt, Hermann M; Golka, Klaus

2016-01-01

Prostate cancer is the most frequent occurring malignancy in men in many Western countries. Unfortunately, only a few studies on occupational risk factors have been published. Thus, the aim of this study was to investigate possible occupational risk factors in a former center of coal, iron, and steel industries the greater Dortmund area, located in the western part of Germany. In three local departments of urology, a total of 238 prostate cancer cases and 414 patients with benign prostatic hyperplasia as controls were requested to provide information for all jobs ever performed for 6 mo or longer. Jobs performed less than 10 yr prior to diagnosis were excluded from the analysis due to the latency of prostate cancer. In addition, data on smoking habits and age were obtained. Analysis of data was performed by means of logistic regression. Hard coal miners and, based on fewer cases, painters, stratified by age, showed a significantly elevated prostate cancer risk. Smoking history did not influence prostate cancer risk. The causes of the observed increased prostate cancer risk in hard coal miners cannot be explained by merely the risk factor "male sexual hormones." In former decades, underground hard coal miners were exposed to high concentrations of dust and different xenobiotics such as hydraulic oils. Surprisingly, in a study performed about a decade later in the same area, prostate cancer risk in underground hard coal miners was found to be reduced. However, exposure to colorants was associated with an increased prostate cancer risk.

The use of HIV post-exposure prophylaxis in forensic medicine following incidents of sexual violence in Hamburg, Germany: a retrospective study.

PubMed

Ebert, Julia; Sperhake, Jan Peter; Degen, Olaf; Schröder, Ann Sophie

2018-05-18

In Hamburg, Germany, the initiation of HIV post-exposure prophylaxis (HIV PEP) in cases of sexual violence is often carried out by forensic medical specialists (FMS) using the city's unique Hamburg Model. FMS-provided three-day HIV PEP starter packs include a combination of raltegravir and emtricitabine/tenofovir. This study aimed to investigate the practice of offering HIV PEP, reasons for discontinuing treatment, patient compliance, and whether or not potential perpetrators were tested for HIV. We conducted a retrospective study of forensic clinical examinations carried out by the Hamburg Department of Legal Medicine following incidents of sexual violence from 2009 to 2016. One thousand two hundred eighteen incidents of sexual violence were reviewed. In 18% of these cases, HIV PEP was initially prescribed by the FMS. HIV PEP indication depended on the examination occurring within 24 h after the incident, no/unknown condom use, the occurrence of ejaculation, the presence of any injury, and the perpetrator being from population at high risk for HIV. Half of the HIV PEP recipients returned for a reevaluation of the HIV PEP indication by an infectious disease specialist, and just 16% completed the full month of treatment. Only 131 potential perpetrators were tested for HIV, with one found to be HIV positive. No HIV seroconversion was registered among the study sample. Provision of HIV PEP by an FMS after sexual assault ensures appropriate and prompt care for victims. However, patient compliance and completion rates are low. HIV testing of perpetrators must be carried out much more rigorously.

Barriers and facilitators to care for the terminally ill: a cross-country case comparison study of Canada, England, Germany, and the United States.

PubMed

Klinger, Christopher A; Howell, Doris; Zakus, David; Deber, Raisa B

2014-02-01

Why do many patients not die at their preferred location? Analyze system-level characteristics influencing the ability to implement best practices in delivering care for terminally ill adults (barriers and facilitators). Cross-country comparison study from a "most similar-most different" perspective, triangulating evidence from a scoping review of the literature, document analyses, and semi-structured key informant interviews. Case study of Canada, England, Germany, and the United States. While similar with regard to leading causes of death, patient needs, and potential avenues to care, different models of service provision were employed in the four countries studied. Although hospice and palliative care services were generally offered with standard care along the disease continuum and in various settings, and featured common elements such as physical, psycho-social, and spiritual care, outcomes (access, utilization, etc.) varied across jurisdictions. Barriers to best practice service provision included legislative (including jurisdictional), regulatory (e.g. education and training), and financial issues as well as public knowledge and perception ("giving up hope") challenges. Advance care planning, dedicated and stable funding toward hospice and palliative care, including caregiver benefits, population aging, and standards of practice and guidelines to hospice and palliative care, were identified as facilitators. Successful implementation of effective and efficient best practice approaches to care for the terminally ill, such as shared care, requires concerted action to align these system-level characteristics; many factors were identified as being essential but not sufficient. Policy implementation needs to be tailored to the respective health-care system(s), monitored, and fine-tuned.

[Deaths from propofol abuse : Survey of institutes of forensic medicine in Germany, Austria and Switzerland].

PubMed

Maier, C; Iwunna, J; Tsokos, M; Mußhoff, F

2017-02-01

Previous references suggesting a high mortality of propofol addiction in medical personnel were mostly based on surveys of the heads of medical departments or case reports; therefore, a questionnaire was sent to 48 forensic medicine departments in Germany, Austria and Switzerland concerning the number of autopsies carried out between 2002-2112 on medical personnel with the suspicion of abuse of propofol or other analgesics. The response rate was 67%. In 16 out of the 32 responding departments 39 deaths (27 males) were observed with previous connections to anesthesiology, intensive care or emergency departments of which 22 were physicians, 13 nurses, 2 other personnel and 2 were unknown. Propofol was the major cause of death in 33 cases (85%), in 8 cases including 7 with propofol, an unintentional accident was recorded and 29 were determined to be suicide. In 14 cases chronic abuse was denied but actually excluded by toxicological analysis in only 2 cases. In 11 cases involving suicide the question of abuse was not investigated. This survey confirmed previous data about the central role of propofol for the fatal outcome of addiction and suicide of anesthetists and other medical personnel. A dual prevention strategy with low-threshold offers for persons at risk and strategies for early detection is urgently needed including a stricter control of dispensing, improvement in forensic medical documentation and the use of toxicological investigations in every case of suspected abuse.

Gambling experiences, problems, research and policy: gambling in Germany.

PubMed

Ludwig, Monika; Kräplin, Anja; Braun, Barbara; Kraus, Ludwig

2013-09-01

The objective of this paper is to present an overview of gambling in Germany, including historical development, legislative and economic changes as well as treatment options and their effectiveness. The available scientific literature and research reports on gambling in Germany were reviewed to obtain relevant information on history, commercialization, legislation, treatment and research agenda. Gambling in Germany is characterized by compromises between protective and economic efforts. At present, gambling is illegal in Germany, and provision is subject to the state monopoly. Mere gaming machines (specific slot machines) are not classified as gambling activity, permitting commercial providers. In recent years, implementing regulations for state gambling and gaming machines have been changed. Concerning the treatment of pathological gambling, various options exist; treatment costs have been covered by health and pension insurance since 2001. Information on the effectiveness of treatment in Germany is limited. Similarly, the number of peer-reviewed publications on gambling is small. German gambling legislation was subject to major changes in the past years. Based on the available body of research (longitudinal), studies on risk and protective factors and the aetiology of pathological gambling are needed. The effectiveness of pathological gambling treatment in Germany and the impact of gambling regulations on gambling behaviour also need to be investigated. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

NASA/DOD Aerospace Knowledge Diffusion Research Project. Paper 62: The Influence of Knowledge Diffusion on Aeronautics Innovation: The Research, Development, and Production of Large Commercial Aircraft in France, Germany, and the United Kingdom

NASA Technical Reports Server (NTRS)

Golich, Vicki L.; Pinelli, Thomas E.

1997-01-01

This paper focuses on how European public policies-individually and collectively - influence the diffusion of knowledge and technology. It begins with an overview of the roles played historically and currently by European governments in the Research, Development and Production (RD&P) of Large Commercial Aircraft (LCA). The analytical framework brings together literature from global political economy, comparative politics, business management, and science and technology policy studies. It distinguishes between the production of knowledge, on the one hand, and the dissemination of knowledge, on the other. France, Germany, and the United Kingdom serve as the analytical cases. The paper concludes with a call for additional research in this area, some tentative lessons learned, and a discussion of the consequences of national strategies and policies for the diffusion of knowledge and technology in an era of globalizaton.

NASA/DOD Aerospace Knowledge Diffusion Research Project. Paper 62: The Influence of Knowledge Diffusion on Aeronautics Innovation: The Research, Development, and Production of Large Commercial Aircraft in France, Germany, and the United Kingdom

NASA Technical Reports Server (NTRS)

Pinelli, Thomas E.; Golich, Vicki L.

1997-01-01

This paper focuses on how European public policies-individually and collectively - influence the diffusion of knowledge and technology. It begins with an overview of the roles played historically and currently by European governments in the research, development and production (RD&P) of large commercial aircraft (LCA). The analytical framework brings together literature from global political economy, comparative politics, business management, and science and technology policy studies. It distinguishes between the production of knowledge, on the one hand, and the dissemination of knowledge, on the other. France, Germany, and the United Kingdom serve as the analytical cases. The paper concludes with a call for additional research in this area, some tentative lessons learned, and a discussion of the consequences of national strategies and policies for the diffusion of knowledge and technology in an era of globalization.

Assessing climate impacts of planning policies-An estimation for the urban region of Leipzig (Germany)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schwarz, Nina, E-mail: nina.schwarz@ufz.de; Bauer, Annette, E-mail: annette.bauer@ufz.de; Haase, Dagmar, E-mail: dagmar.haase@ufz.d

2011-03-15

Local climate regulation by urban green areas is an important urban ecosystem service, as it reduces the extent of the urban heat island and therefore enhances quality of life. Local and regional planning policies can control land use changes in an urban region, which in turn alter local climate regulation. Thus, this paper describes a method for estimating the impacts of current land uses as well as local and regional planning policies on local climate regulation, using evapotranspiration and land surface emissivity as indicators. This method can be used by practitioners to evaluate their policies. An application of this methodmore » is demonstrated for the case study Leipzig (Germany). Results for six selected planning policies in Leipzig indicate their distinct impacts on climate regulation and especially the role of their spatial extent. The proposed method was found to easily produce a qualitative assessment of impacts of planning policies on climate regulation.« less

Causal Relationships Among Time Series of the Lange Bramke Catchment (Harz Mountains, Germany)

NASA Astrophysics Data System (ADS)

Aufgebauer, Britta; Hauhs, Michael; Bogner, Christina; Meesenburg, Henning; Lange, Holger

2016-04-01

Convergent Cross Mapping (CCM) has recently been introduced by Sugihara et al. for the identification and quantification of causal relationships among ecosystem variables. In particular, the method allows to decide on the direction of causality; in some cases, the causality might be bidirectional, indicating a network structure. We extend this approach by introducing a method of surrogate data to obtain confidence intervals for CCM results. We then apply this method to time series from stream water chemistry. Specifically, we analyze a set of eight dissolved major ions from three different catchments belonging to the hydrological monitoring system at the Bramke valley in the Harz Mountains, Germany. Our results demonstrate the potentials and limits of CCM as a monitoring instrument in forestry and hydrology or as a tool to identify processes in ecosystem research. While some networks of causally linked ions can be associated with simple physical and chemical processes, other results illustrate peculiarities of the three studied catchments, which are explained in the context of their special history.

Characterization of Puumala hantavirus in bank voles from two regions in the Netherlands where human cases occurred.

PubMed

de Vries, A; Vennema, H; Bekker, D L; Maas, M; Adema, J; Opsteegh, M; van der Giessen, J W B; Reusken, C B E M

2016-07-01

Puumala hantavirus (PUUV) is the most common and widespread hantavirus in Europe and is associated with a mild form of haemorrhagic fever with renal syndrome in humans, called nephropathia epidemica. This study presents the molecular characterization of PUUV circulating in bank voles in two regions of the Netherlands. Most human cases of hantavirus infection are from these two regions. Phylogenetic analysis of the (partial) S, M and L-segments indicated that the Dutch strains belong to the CE lineage, which includes PUUV strains from France, Germany and Belgium. We have identified two distinct groups of PUUV, corresponding with their geographic origin and with adjoining regions in neighbouring countries.

[Health risk railroad noise - prognosis of potential health risks subsequent to night-time exposure to railroad noise in the German part of the Transversal Rotterdam Genova].

PubMed

Greiser, E

2014-12-01

Based on risk coefficients for cardiovascular and psychiatric disease derived from a case-control study in the vicinity of a major German airport, statistics on persons exposed to night-time railroad noise in the vicinity of the Rotterdam-Genova Transversal, and on health expenditure calculations by the Federal Statistical Office of Germany a prognosis on effects of railroad noise was performed. It resulted for 1 10-year period in nearly 75 000 excess cases of diseases, nearly 30 000 excess deaths and health expenditures of 3.8 billion euros. © Georg Thieme Verlag KG Stuttgart · New York.

How healthcare states matter: comparing the introduction of clinical standards in Britain and Germany.

PubMed

Burau, Viola; Fenton, Laura

2009-01-01

This paper aims to identify variation in the introduction of New Public Management reforms in healthcare and how this variation is related to country-specific healthcare states. The analysis uses the introduction of clinical standards in Britain and Germany as cases. The two countries are characterised by interesting differences in relation to the institutional set-up of healthcare states and as such present ideal cases to explore the specific ways of how healthcare states filter clinical standards as tools of a generic managerialism. Both countries have introduced clinical standards but, importantly, the substantive nature of clinical standards differs, reflecting differences in initial institutional conditions. More specifically, in Britain clinical standards have taken the form of two parallel policies, which strengthen hierarchy-based governing and redefine professional self-regulation. In Germany, by contrast, clinical standards come in one single policy, which strengthens the hybrid of network- and hierarchy-based governing and to some extent also pure hierarchy-based forms of governing. First, with its cross-country comparative focus, the analysis is able to identify systematic variations across healthcare states and the specific ways in which they impact on the introduction of New Public Management. Second, with its focus on clinical standards, the analysis deals with the governance of medical practice as one of the central areas of healthcare states.

Continuing medical education and professional revalidation in Europe: five case examples.

PubMed

Maisonneuve, Hervé; Matillon, Yves; Negri, Alfonso; Pallarés, Luis; Vigneri, Ricardo; Young, Howard L

2009-01-01

Since reliable information is scarce to describe continuing medical education (CME) and revalidation in Europe, we carried out a survey in 5 selected countries (France, Germany, Italy, Spain, and the United Kingdom). A tested questionnaire was sent to 2 experts per country (except in Germany), during August-September 2004. In the analyzed countries medical societies, medical associations, and employers are the main CME providers. Pharmaceutical industry sponsorship accounts on the average for more than 50% of the CME financing in those countries. In all 5 countries, CME accreditation systems exist; the national health authorities and medical associations are mainly responsible for them. In France, Italy, and Germany CME is mandatory; in Spain and the United Kingdom it is voluntary. CME credits/points are mainly used for professional career purposes. Revalidation systems have not been introduced in any of these countries, although in the United Kingdom it is being introduced as part of a relicensing process. Recommendations for the implementation of a European system of CME/CPD harmonization are made by the authors.

Polyflex stenting of tracheomalacia after surgery for congenital tracheal stenosis.

PubMed

Tibballs, James; Fasulakis, Stephen; Robertson, Colin F; Berkowitz, Robert G; Massie, John; Brizard, Christian; Rose, Elizabeth; Bekhit, Elhamy; Eyres, Robert; Ragg, Philip

2007-01-01

Polyflex self-expanding stents (Rüsch, Germany) were used in three young children who had presented with life-threatening long-segment tracheal stenosis with bronchial stenosis in two cases. Two children had slide tracheoplasties and subsequently aortic homografts and another tracheal resection and autotracheoplasty. However, in all cases persistent lower tracheal malacia necessitated stenting. Complications of granuloma, stent migration or dislodgement occurred in all cases. A fatal tracheo-aortic fistula occurred in one child. Granuloma in one was treated successfully with steroids. One child survives.

"What the patient wants…": Lay attitudes towards end-of-life decisions in Germany and Israel.

PubMed

Inthorn, Julia; Schicktanz, Silke; Rimon-Zarfaty, Nitzan; Raz, Aviad

2015-08-01

National legislation, as well as arguments of experts, in Germany and Israel represent opposite regulatory approaches and positions in bioethical debates concerning end-of-life care. This study analyzes how these positions are mirrored in the attitudes of laypeople and influenced by the religious views and personal experiences of those affected. We qualitatively analyzed eight focus groups in Germany and Israel in which laypeople (religious, secular, affected, and non-affected) were asked to discuss similar scenarios involving the withholding or withdrawing of treatment, physician-assisted suicide, and euthanasia. In both countries, respect for patient autonomy and patients' wishes to die with dignity found broad consent. Laypeople argued in favor of accepting such wishes when they were put down in an advance directive. Laypeople in non-religious groups in both countries argued on the basis of a respect for autonomy for the possibility of euthanasia in severe cases but, at the same time, cautioned against its possible misuse. National contrast was apparent in the moral reasoning of lay respondents concerning the distinction between withholding and withdrawing treatment. The modern religious laypeople in Israel, especially, argued strongly, on the basis of the halakhic tradition, against allowing the withdrawal of treatment in accord with a patient's wish. We conclude by discussing the emergent notion of shared responsibility and views of professional responsibility, which we connect through relevant cultural themes such as religion and national culture.

Integrated care experiences and outcomes in Germany, the Netherlands, and England.

PubMed

Busse, Reinhard; Stahl, Juliane

2014-09-01

Care for people with chronic conditions is an issue of increasing importance in industrialized countries. This article examines three recent efforts at care coordination that have been evaluated but not yet included in systematic reviews. The first is Germany's Gesundes Kinzigtal, a population-based approach that organizes care across all health service sectors and indications in a targeted region. The second is a program in the Netherlands that bundles payments for patients with certain chronic conditions. The third is England's integrated care pilots, which take a variety of approaches to care integration for a range of target populations. Results have been mixed. Some intermediate clinical outcomes, process indicators, and indicators of provider satisfaction improved; patient experience improved in some cases and was unchanged or worse in others. Across the English pilots, emergency hospital admissions increased compared to controls in a difference-in-difference analysis, but planned admissions declined. Using the same methods to study all three programs, we observed savings in Germany and England. However, the disease-oriented Dutch approach resulted in significantly increased costs. The Kinzigtal model, including its shared-savings incentive, may well deserve more attention both in Europe and in the United States because it combines addressing a large population and different conditions with clear but simple financial incentives for providers, the management company, and the insurer. Project HOPE—The People-to-People Health Foundation, Inc.

Ampicillin resistance of invasive Haemophilus influenzae isolates in Germany 2009-2012.

PubMed

Lâm, Thiên-Trí; Claus, Heike; Elias, Johannes; Frosch, Matthias; Vogel, Ulrich

2015-10-01

In this retrospective study covering a four-year observation period (2009-2012) the prevalence of aminopenicillin resistance of invasive Haemophilus influenzae (Hi) in Germany was analyzed. The main resistance mechanism against aminopenicillins is conferred by β-lactamase production, which can be inhibited by clavulanate or sulbactam. Apart from that, β-lactamase negative ampicillin resistance (BLNAR) has been reported due to mutations in the penicillin-binding protein PBP3. The prevalence of BLNAR varies considerably in different countries. Representative data from Germany have not been reported. We analyzed 704 culture positive cases with bacteraemia or detection of Hi in cerebrospinal fluid; 82 isolates (11.6%) were phenotypically resistant to ampicillin. Among these isolates, 65 (79.3%) showed β-lactamase production, and 17 isolates (20.7%) were phenotypic BLNAR Hi. The proportion of ampicillin resistant isolates remained stable over the observation period. Analysis of the PBP3 sequences of 133 isolates with different susceptibility phenotypes including susceptible, BLNAR, and β-lactamase positive isolates, revealed a high genetic diversity. Previously described PBP3 mutations were associated to elevated MIC values, albeit not exclusively, since few highly susceptible strains were found to be positive for the mutations. Furthermore, since ampicillin susceptible strains with elevated MIC values frequently harboured these mutations, prediction of the resistance phenotype using ftsI sequencing appears to be impossible. Copyright © 2015 Elsevier GmbH. All rights reserved.

Measles, mumps, rubella and VZV: importance of serological testing of vaccine-preventable diseases in young adults living with HIV in Germany.

PubMed

Schwarze-Zander, C; Draenert, R; Lehmann, C; Stecher, M; Boesecke, C; Sammet, S; Wasmuth, J C; Seybold, U; Gillor, D; Wieland, U; Kümmerle, T; Strassburg, C P; Mankertz, A; Eis-Hübinger, A M; Jäger, G; Fätkenheuer, G; Bogner, J R; Rockstroh, J K; Vehreschild, J J

2017-01-01

Measles, mumps, rubella (MMR) and varicella zoster virus (VZV) infection can cause serious diseases and complications in the HIV-positive population. Due to successful vaccination programmes measles, mumps and congenital rubella syndrome has become neglected in Germany. However, recent outbreaks of measles have occurred from import-associated cases. In this cross-sectional study the serostatus for MMR and VZV in 2013 HIV-positive adults from three different university outpatient clinics in Bonn (n = 544), Cologne (n = 995) and Munich (n = 474) was analysed. Sera were tested for MMR- and VZV-specific immunglobulin G antibodies using commercial immunoassays. Seronegativity was found in 3% for measles, 26% for mumps, 11% for rubella and 2% for VZV. Regarding MMR, 35% of patients lacked seropositivity against at least one infectious agent. In multivariable analysis younger age was strongly associated with seronegativity against all four viruses, measles, mumps, rubella (P < 0·001, P < 0·001 and P = 0·001, respectively) and VZV (P = 0·001). In conclusion, there is high need for MMR and VZV vaccination in people living with HIV in Germany born in 1970 or later. Thus, systematic MMR and VZV antibody screening and vaccination should be implemented in the HIV-positive population to prevent serious disease and complications of vaccine-preventable diseases.

Attitudes and Beliefs of Pig Farmers and Wild Boar Hunters Towards Reporting of African Swine Fever in Bulgaria, Germany and the Western Part of the Russian Federation.

PubMed

Vergne, T; Guinat, C; Petkova, P; Gogin, A; Kolbasov, D; Blome, S; Molia, S; Pinto Ferreira, J; Wieland, B; Nathues, H; Pfeiffer, D U

2016-04-01

This study investigated the attitudes and beliefs of pig farmers and hunters in Germany, Bulgaria and the western part of the Russian Federation towards reporting suspected cases of African swine fever (ASF). Data were collected using a web-based questionnaire survey targeting pig farmers and hunters in these three study areas. Separate multivariable logistic regression models identified key variables associated with each of the three binary outcome variables whether or not farmers would immediately report suspected cases of ASF, whether or not hunters would submit samples from hunted wild boar for diagnostic testing and whether or not hunters would report wild boar carcasses. The results showed that farmers who would not immediately report suspected cases of ASF are more likely to believe that their reputation in the local community would be adversely affected if they were to report it, that they can control the outbreak themselves without the involvement of veterinary services and that laboratory confirmation would take too long. The modelling also indicated that hunters who did not usually submit samples of their harvested wild boar for ASF diagnosis, and hunters who did not report wild boar carcasses are more likely to justify their behaviour through a lack of awareness of the possibility of reporting. These findings emphasize the need to develop more effective communication strategies targeted at pig farmers and hunters about the disease, its epidemiology, consequences and control methods, to increase the likelihood of early reporting, especially in the Russian Federation where the virus circulates. © 2014 Blackwell Verlag GmbH.

Imported Malaria in Children in Industrialized Countries, 1992–2002

PubMed Central

Stäger, Katrin; Legros, Fabrice; Krause, Gérard; Low, Nicola; Bradley, David; Desai, Meghna; Graf, Simone; D’Amato, Stefania; Mizuno, Yasutaka; Janzon, Ragnhild; Petersen, Eskild; Kester, John; Steffen, Robert

2009-01-01

Children account for an appreciable proportion of total imported malaria cases, yet few studies have quantified these cases, identified trends, or suggested evidence-based prevention strategies for this group of travelers. We therefore sought to identify numbers of cases and deaths, Plasmodium species, place of malaria acquisition, preventive measures used, and national origin of malaria in children. We analyzed retrospective data from Australia, Denmark, France, Germany, Italy, Japan, the Netherlands, Sweden, Switzerland, the United Kingdom, and the United States and data provided by the United Nations World Tourism Organization. During 1992–2002, >17,000 cases of imported malaria in children were reported in 11 countries where malaria is not endemic; most (>70%) had been acquired in Africa. Returning to country of origin to visit friends and relatives was a risk factor. Malaria prevention for children should be a responsibility of healthcare providers and should be subsidized for low-income travelers to high-risk areas. PMID:19193261

[Ketoconazole-induced hepatitis. Case report].

PubMed

Henning, H; Kasper, B; Lüders, C J

1983-12-01

Since Oct. 1981 a new systemic antifungal drug Ketoconazole is available in the Federal Republic of Germany that has proven effective even in severe cases with fungal infections. This case-study will call attention on a rare but important side effect, namely Ketoconazole induced hepatitis. As an acute icteric viral hepatitis, type Non-A-Non-B-hepatitis possibly misdiagnosed only a carefully compiled history of the recent intake of drugs points at the real cause of hepatitis. In our case-report we observed a considerable increase in serum enzymes, especially GOT, GPT and GLDH after a drug-challenge with two tablets. We recommend so-called liver functions tests 2 to 3 weeks after beginning of therapy and further-on in monthly intervals. Histologically at that time toxic hydropic changes of the liver cells and a mesenchymal reaction with portal and intralobular mainly eosinophilic infiltration could be established. The serum enzymes came to normal only after 12 weeks.

German law on circumcision and its debate: how an ethical and legal issue turned political.

PubMed

Aurenque, Diana; Wiesing, Urban

2015-03-01

The article aims to illuminate the recent debate in Germany about the legitimacy of circumcision for religious reasons. The aim is both to evaluate the new German law allowing religious circumcision, and to outline the resulting conflict between the surrounding ethical and legal issues. We first elucidate the diversity of legal and medical views on religious circumcision in Germany. Next we examine to what extent invasive and irreversible physical interventions on infant boys unable to given their consent should be carried out for non-medical reasons. To this end, the potential benefits and harms of circumcision for non-medical reasons are compared. We argue that circumcision does not provide any benefits for the 'child as a child' and poses only risks to boys. We then set out to clarify and analyse political (rather than ethical) justifications of the new circumcision law. We demonstrate through this analysis how the circumcision debate in Germany has been transformed from a legal and ethical problem into a political issue, due at least in part to Germany's unique historical context. Although such a particular political sensibility is entirely comprehensible, it raises particular problems when it comes to framing and responding to medical ethical issues - as in the case of religious circumcision. © 2013 John Wiley & Sons Ltd.

Migrants' educational success through innovation: The case of the Hamburg bilingual schools

NASA Astrophysics Data System (ADS)

Duarte, Joana

2011-12-01

Although Germany has experienced net in-migration for the past five decades, this fact has only recently been officially acknowledged. Furthermore, Germany is marked by a general monolingual self-concept very much attached to the idea of a nation-state with one homogeneous language. However, in large urban areas of Germany about 35 per cent of the population has a migration background, as has almost every second child enrolling in primary school. Hence the country is marked by this dichotomy between a monolingual policy discourse and a multilingual society, manifested in everyday life and, as a consequence, in educational institutions. The fact is that this political attitude towards Germany's own migration history and migrants has led to an educational gap between students with a migration background and their monolingual peers. In 2000, a project was started in Hamburg, aiming to overcome this educational gap and involving the creation of bilingual schools for some of the largest migrant languages. Bilingual classes were thus set up for the following language combinations: German-Portuguese, German-Italian, German-Spanish and German-Turkish, and were evaluated by the University of Hamburg. This paper reports on the model used and the specific school outcomes of the students attending these classes.

[Frailty in Germany: status and perspectives : Results from a workshop of the German Society for Epidemiology].

PubMed

Fuchs, Judith; Scheidt-Nave, Christa; Gaertner, Beate; Dapp, Ulrike; von Renteln-Kruse, Wolfgang; Saum, Kai-Uwe; Thorand, Barbara; Strobl, Ralf; Grill, Eva

2016-12-01

A standardized, valid and comparable operationalization and assessment of frailty in population-based studies is essential in order to describe the prevalence and determinants of frailty in the population. After an introduction to the subject the main goal of a workshop at the 9th annual meeting of the German Society for Epidemiology (DGEpi) was to present approaches and results from four different studies in Germany. The following four population-based studies were used to describe frailty in Germany: the German health interview and examination survey for adults (DEGS1), the epidemiological study on the chances of prevention, early recognition and optimized treatment of chronic diseases in the older population (ESTHER), the cooperative health research in the region Augsburg (KORA Age) study and the longitudinal urban cohort ageing study (LUCAS) in Hamburg. The four studies consistently showed that frailty is widespread in older and oldest-old persons in Germany. It is obvious that frailty represents a relevant concept in Germany even if there is currently no uniform basis for operationalization. Concepts and instruments for the collation of frailty should be included in future population-based studies in order to make a better assessment of older people's health situation and to describe the unused potential for prevention in an aging society.

The Soviet Withdrawal from Eastern Europe: A Move in Crisis

DTIC Science & Technology

1991-02-15

90-130, 6 July 1990, pp. 15-16. Lapskiy, V. "Future Germany : European Bridge ." Izvesti[a, 16 July 1990, Morning Edition, p. 3, in FBIS-SOV-90-138...ending it’s military involvement in Czechoslovakia, East Germany , Hungary, and Poland. Accounts of the Soviet military withdrawal need to be studied in...in Czechoslovakia, East Germany , Hungary, and Poland. The cascading accounts of the Soviet military withdrawal need to be studied in order to access

The Unequal Structure of the German Education System: Structural Reasons for Educational Failures of Turkish Youth in Germany.

PubMed

Fernandez-Kelly, Patricia

The paper examines the educational experiences of Turkish youth in Germany with special references to the statistical data of Educational Report, PISA surveys. The results of the educational statistics of Germany show that more than group characteristics like social and cultural capital, structural and institutional factors (multi-track system with its selective mechanism, education policy, context of negative reception of Germany, institutional discrimination, and lack of intercultural curriculum) could have a decisive role in hampering the educational and labor market integration and social mobility of Turkish youth. This can be explained by a mix of factors: the education system which does not foster the educational progress of children from disadvantaged families; the high importance of school degrees for accessing to the vocational training system and the labor market; and direct and indirect institutional discrimination in educational area in Germany. Thus, this work suggests that the nature of the education system in Germany remains deeply "unequal," "hierarchical" and "exclusive." This study also demonstrates maintaining the marginalized position of Turkish children in Germany means that the country of origin or the immigrants' background is still a barrier to having access to education and the labor market of Germany.

[Regulations of sickness certification as a factor for increased health care utilization in Germany].

PubMed

Herrmann, Wolfram J; Haarmann, Alexander; Bærheim, Anders

2015-01-01

In Germany, utilization of ambulatory health care is high compared to other countries. Classical models of health care utilization cannot sufficiently explain these differences. The aim of this study was to explore relevant factors which can explain the higher health care utilization in Germany. In this article, we focus on regulations regarding sickness certification as a potential factor. An explorative qualitative study design. We conducted episodic interviews with 20 patients in Germany and 20 patients in Norway and participant observation in four primary care practices each. Additionally, we conducted a context analysis of relevant health care system related factors which emerged during the study. Qualitative data analysis was done by thematic coding in the framework of grounded theory. The need for a sickness certificate was an important reason for encounter in Germany, especially regarding minor illnesses. Sickness certification is a societal topic. GPs play a double role regarding sickness certification, both as the patients' advocate and as an expert witness for social security services. In Norway, longer periods of self-administered sickness certification and more differentiated possibilities of sickness certification have been introduced successfully. Our results point to regulations regarding sickness certification as a relevant factor for higher health care utilization in Germany. In pilot studies, the effect of extended self-certification of sickness and part-time sickness certification should be further assessed. Copyright © 2015. Published by Elsevier GmbH.

Lymphogranuloma venereum in men screened for pharyngeal and rectal infection, Germany.

PubMed

Haar, Karin; Dudareva-Vizule, Sandra; Wisplinghoff, Hilmar; Wisplinghoff, Fabian; Sailer, Andrea; Jansen, Klaus; Henrich, Birgit; Marcus, Ulrich

2013-03-01

To determine prevalence of lymphogranuloma venereum among men who have sex with men in Germany, we conducted a multicenter study during 2009-2010 and found high rates of rectal and pharyngeal infection in men positive for the causative agent, Chlamydia trachomatis. Many infections were asymptomatic. An adjusted C. trachomatis screening policy is justified in Germany.

Communication Indicators. II. 100 Years of Mass Communication in Germany. Communication and Society 4.

ERIC Educational Resources Information Center

Galli, Anton; Vogler, Kurt

This report summarizes the findings of a Unesco-sponsored study designed to identify quantitative relationships between mass communication and economic growth in the Federal Republic of Germany. The first and second sections of the report outline the most important economic and social lines of development in Germany from the end of the nineteenth…

Cultural Reflections: Work, Politics, and Daily Life in Germany. Social Studies Grades 9-12. Update 2002.

ERIC Educational Resources Information Center

Blankenship, Glen; Tinkler, D. William

This instructional package, consisting of a text and 16 transparencies, is designed for the high school classroom. The three lessons in this instructional package are: (1) "The German Worker" (six activities); (2) "Government in Germany" (seven activities); and (3) "Culture and Daily Life in Germany" (six activities).…

Professionalisation in General Adult Education in Germany--An Attempt to Cut a Path through a Jungle

ERIC Educational Resources Information Center

Dausien, Bettina; Schwendowius, Dorothee

2009-01-01

The article summarizes the findings of a study on adult learning professions in Europe (ALPINE) commissioned by DG Education and Culture. It explores the current professional and social situation of staff in non-vocational adult education in Germany. It describes the structures and organisations of general adult education in Germany and…

Case-control study on analgesics and nephropathy (SAN): protocol

PubMed Central

Heinemann, Lothar AJ; Garbe, Edeltraut; Lewis, Michael; van der Woude, Fokko; Graf, Helmut

2005-01-01

Background The association between intake of non-phenacetin-containing analgesics and the occurrence of chronic renal failure is still controversially discussed. A new epidemiologic study was planned and conducted in Germany and Austria. Methods/design The objective of the international, multicenter case-control study was to evaluate the association between end-stage renal disease (ESRD) and use of non-phenacetin-containing analgesics with particular emphasis on combined formulations. A targeted sample of 1000 new (incident) dialysis patients, aged less than 50 years, was planned to recruit between January 1, 2001 and December 31, 2004. The age limit was chosen to avoid contamination of the study population with phenacetin-containing analgesics to the extent possible. Four control subjects per ESRD case, matched by age, sex, and region were selected from the population living in the region the case came from. Lifetime exposure to analgesics and potential renal risk factors were recorded in a single face-to-face interview. A set of aids was introduced to reinforce the memory of study participants. A standardized, pre-tested interview questionnaire (participants), a medical documentation sheet (physicians in dialysis centres), a logbook for all activities (dialysis centres) were used to collect the necessary data. Quality management consisted of the standardized procedures, (re-) training and supervision of interviewers, regular checks of all incoming data for completeness and plausibility. The study is scientifically independent and governed by a international Scientific Advisory Committee that bridged the gap between the sponsoring companies and the investigators. Also other advisory groups assisted the managing committee of the study. All relevant German and Austrian nephrological associations supported the study, and the study design was carefully reviewed and approved by the Kidney Foundation of Germany. Discussion The study is expected to answer the main research question by end 2005. There is however a high potential for various biases that we tried to address with adequate measure. One limitation however cannot be overcome: The methodologically needed age-limitation of the study will make it not easy to generalize the results to age groups over 50 years. It might be suggested to repeat the study for persons over 50 years in 10 years when contamination with phenacetin use early in life is likely to be outgrown. PMID:16086834

Autochthonous leptospirosis in South-East Austria, 2004-2012.

PubMed

Hoenigl, Martin; Wallner, Carina; Allerberger, Franz; Schmoll, Friedrich; Seeber, Katharina; Wagner, Jasmin; Valentin, Thomas; Zollner-Schwetz, Ines; Flick, Holger; Krause, Robert

2014-01-01

Leptospirosis is one of the world's mostly spread zoonoses causing acute fever. Over years, leptospirosis has been reported to occur rarely in Austria and Germany (annual incidence of 0.06/100,000 in Germany). Only imported cases have been on the increase. Objectives of this case-series study were to retrospectively assess epidemiologic and clinical characteristics of leptospirosis illnesses in South-East Austria, to describe risk exposures for autochthonous infections, and to compare patients with imported versus autochthonous infection. During the 9-year period between 2004 and 2012, 127 adult patients (49 females, 78 males) who tested positive by rapid point-of-care test for Leptospira-specific IgM (Leptocheck®) were identified through electronic hospital databases. Follow-up telephone interviews were conducted with 82 patients. A total of 114 (89.8%) of the 127 patients enrolled had acquired leptospirosis within Austria and 13 (10.2%) had potentially imported infections. Most autochthonous cases were diagnosed during the months of June and July, whereas fewest were diagnosed during the winter months. Exposure to rodents, recreational activities in woods or wet areas, gardening, cleaning of basements or huts were the most common risk exposures found in autochthonous infection. Serogroups Australis (n = 23), Sejroe (n = 22), and Icterohaemorrhagiae (n = 11) were identified most frequently by MAT testing in autochthonous infections. Patients with imported leptospirosis were significantly younger, less likely to be icteric and had significantly lower liver transaminase levels (p = 0.004) than those with autochthonous infections. Leptospirosis is endemic in South-East Austria. In contrast to reports from other countries we found a relatively high proportion of leptospirosis cases to be female (39% vs. ∼ 10%), likely the result of differing risk exposures for South-East Austria.

Outbreak investigation in two groups of coach passengers with gastroenteritis returning from Germany to the Netherlands in February 2009.

PubMed

Visser, H; Verhoef, L; Schop, W; Götz, H M

2010-07-15

In February 2009, an outbreak of 38 cases of gastroenteritis occurred among the participants of two Dutch coach trips (A and B) who visited the same hotel in Germany. We initiated an outbreak investigation to determine possible risk of food-borne infection. A retrospective cohort study was performed among 87 passengers using a self-administered questionnaire. The response rate was 75 of 87 (86%). Mean age was 65 years. Cases were defined as participants of the two coach trips who had diarrhoea and/or vomiting at least once within 24 hours in the period between 7 and 14 February 2009. We distinguished early and late cases, with symptoms starting within or after 72 hours of arrival in the hotel. Overall attack-rate was 38 of 75 (51%). Microbiological investigation was performed on stool samples of two passengers from Coach A and two passengers from Coach B. Identical norovirus genotype II.4 sequences were detected in all four samples. Univariate analysis revealed a potential risk for early cases from juice consumption , which was most clearly seen for Coach B on day of arrival (juice at lunch: relative risk (RR): 3.9, 95% confidence interval (CI): 1.3-11.7; juice at dinner: RR: 5.5, 95% CI: 1.6-18.1). A dose-response relationship was found. This outbreak was probably caused by using the taps of juice served in large containers with a tap for self-service, due to environmental contamination through person-to-person transmission. Still the role of either contaminated juice or contact with contaminated juice cannot be ruled out.

Analgesics use and ESRD in younger age: a case-control study

PubMed Central

van der Woude, Fokke J; Heinemann, Lothar AJ; Graf, Helmut; Lewis, Michael; Moehner, Sabine; Assmann, Anita; Kühl-Habich, Doerthe

2007-01-01

Background An ad hoc peer-review committee was jointly appointed by Drug Authorities and Industry in Germany, Austria and Switzerland in 1999/2000 to review the evidence for a causal relation between phenacetin-free analgesics and nephropathy. The committee found the evidence as inconclusive and requested a new case-control study of adequate design. Methods We performed a population-based case-control study with incident cases of end-stage renal disease (ESRD) under the age of 50 years and four age and sex-matched neighborhood controls in 170 dialysis centers (153 in Germany, and 17 in Austria) from January 1, 2001 to December 31, 2004. Data on lifetime medical history, risk factors, treatment, job exposure and intake of analgesics were obtained in a standardized face-to-face interview using memory aids to enhance accuracy. Study design, study performance, analysis plan, and study report were approved by an independent international advisory committee and by the Drug Authorities involved. Unconditional logistic regression analyses were performed. Results The analysis included 907 cases and 3,622 controls who had never used phenacetin-containing analgesics in their lifetime. The use of high cumulative lifetime dose (3rd tertile) of analgesics in the period up to five years before dialysis was not associated with later ESRD. Adjusted odds ratios with 95% confidence intervals were 0.8 (0.7 – 1.0) and 1.0 (0.8 – 1.3) for ever- compared with no or low use and high use compared with low use, respectively. The same results were found for all analgesics and for mono-, and combination preparations with and without caffeine. No increased risk was shown in analyses stratifying for dose and duration. Dose-response analyses showed that analgesic use was not associated with an increased risk for ESRD up to 3.5 kg cumulative lifetime dose (98 % of the cases with ESRD). While the large subgroup of users with a lifetime dose up to 0.5 kg (278 cases and 1365 controls) showed a significantly decreased risk, a tiny subgroup of extreme users with over 3.5 kg lifetime use (19 cases and 11 controls) showed a significant risk increase. The detailed evaluation of 22 cases and 19 controls with over 2.5 kg lifetime use recommended by the regulatory advisors showed an impressive excess of other conditions than analgesics triggering the evolution of ESRD in cases compared with controls. Conclusion We found no clinically meaningful evidence for an increased risk of ESRD associated with use of phenacetin-free analgesics in single or combined formulation. The apparent risk increase shown in a small subgroup with extreme lifetime dose of analgesics is most likely an indirect, non-causal association. This hypothesis, however, cannot be confirmed or refuted within our case-control study. Overall, our results lend support to the mounting evidence that phenacetin-free analgesics do not induce ESRD and that the notion of "analgesic nephropathy" needs to be re-evaluated. PMID:18053232

Learning about the history of landscape use for the future: consequences for ecological and social systems in Swedish Bergslagen.

PubMed

Angelstam, Per; Andersson, Kjell; Isacson, Maths; Gavrilov, Dmitri V; Axelsson, Robert; Bäckström, Mattias; Degerman, Erik; Elbakidze, Marine; Kazakova-Apkarimova, Elena Yu; Sartz, Lotta; Sädbom, Stefan; Törnblom, Johan

2013-03-01

Barriers and bridges to implement policies about sustainable development and sustainability commonly depend on the past development of social-ecological systems. Production of metals required integration of use of ore, streams for energy, and wood for bioenergy and construction, as well as of multiple societal actors. Focusing on the Swedish Bergslagen region as a case study we (1) describe the phases of natural resource use triggered by metallurgy, (2) the location and spatial extent of 22 definitions of Bergslagen divided into four zones as a proxy of cumulative pressure on landscapes, and (3) analyze the consequences for natural capital and society. We found clear gradients in industrial activity, stream alteration, and amount of natural forest from the core to the periphery of Bergslagen. Additionally, the legacy of top-down governance is linked to today's poorly diversified business sector and thus municipal vulnerability. Comparing the Bergslagen case study with other similar regions in Russia and Germany, we discuss the usefulness of multiple case studies.

Iran: U.S. Concerns and Policy Responses

DTIC Science & Technology

2010-09-22

Ahmadinejad. In that case he opposed Ahmadinejad’s incorporation of the position of coordinator of the Hajj (major pilgrimage to Mecca) into the Tourism ...in 2005 to Kish Island. Iran was given a U.S. letter on these cases at a March 31, 2009, meeting in the Netherlands on Afghanistan. Three American...assistance to the Arak facility. 22Voting in favor: United States, Australia, Britain, France, Germany, Canada, Argentina, Belgium, Ghana, Ecuador

 Autochthonous infection with hepatitis E virus related to subtype 3a, France: a case report.

PubMed

Saint-Jacques, Pauline; Tissot-Dupont, Hervé; Colson, Philippe

2016-01-01

Hepatitis E virus (HEV) recently emerged in Europe as a cause of autochthonous acute hepatitis and a porcine zoonosis. European autochthonous cases almost exclusively involved viruses of genotype 3, subtype 3a being only recently reported in France, from farm pigs. We report an autochthonous human infection with a HEV related to subtype 3a in Southeastern France. A 55-year-old human immunodeficiency virus-infected man presented liver cytolysis in June 2014. HEV RNA was detected in serum and three months later, anti-HEV IgM and IgG were positive whereas HEV RNA was no more detectable in serum. No biological or clinical complication did occur. HEV phylogeny based on two capsid gene fragments showed clustering of sequences obtained from the case-patient with HEV-3a, mean nucleotide identity being 91.7 and 91.3% with their 10 best GenBank matches that were obtained in Japan, South Korea, USA, Canada, Germany and Hungria from humans, pigs and a mongoose. Identity between HEV sequence obtained here and HEV-3a sequences obtained at our laboratory from farm pigs sampled in 2012 in Southeastern France was only 90.2-91.4%. Apart from these pig sequences, best hits from France were of subtypes 3i, 3f, or undefined. The patient consumed barely cooked wild-boar meat; no other risk factor for HEV infection was documented. In Europe, HEV-3a has been described in humans in England and Portugal, in wild boars in Germany, and in pigs in Germany, the Netherlands, and, recently, France. These findings suggest to gain a better knowledge of HEV-3a circulation in France.

Integration of molecular typing results into tuberculosis surveillance in Germany-A pilot study.

PubMed

Andrés, Marta; Göhring-Zwacka, Elke; Fiebig, Lena; Priwitzer, Martin; Richter, Elvira; Rüsch-Gerdes, Sabine; Haas, Walter; Niemann, Stefan; Brodhun, Bonita

2017-01-01

An integrated molecular surveillance for tuberculosis (TB) improves the understanding of ongoing TB transmission by combining molecular typing and epidemiological data. However, the implementation of an integrated molecular surveillance for TB is complex and requires thoughtful consideration of feasibility, demand, public health benefits and legal issues. We aimed to pilot the integration of molecular typing results between 2008 and 2010 in the German Federal State of Baden-Württemberg (population 10.88 Million) as preparation for a nationwide implementation. Culture positive TB cases were typed by IS6110 DNA fingerprinting and results were integrated into routine notification data. Demographic and clinical characteristics of cases and clusters were described and new epidemiological links detected after integrating typing data were calculated. Furthermore, a cross-sectional survey was performed among local public health offices to evaluate their perception and experiences. Overall, typing results were available for 83% of notified culture positive TB cases, out of which 25% were clustered. Age <15 years (OR = 4.96, 95% CI: 1.69-14.55) and being born in Germany (OR = 2.01, 95% CI: 1.44-2.80) were associated with clustering. At cluster level, molecular typing information allowed the identification of previously unknown epidemiological links in 11% of the clusters. In 59% of the clusters it was not possible to identify any epidemiological link. Clusters extending over different counties were less likely to have epidemiological links identified among their cases (OR = 11.53, 95% CI: 3.48-98.23). The majority of local public health offices found molecular typing useful for their work. Our study illustrates the feasibility of integrating typing data into the German TB notification system and depicts its added public health value as complementary strategy in TB surveillance, especially to uncover transmission events among geographically separated TB patients. It also emphasizes that special efforts are required to strengthen the communication between local public health offices in different counties to enhance TB control.

Vocational Education and Training for the Hotel and Catering Industry in the Federal Republic of Germany. Report of a Visiting Party. Studies in Vocational Education and Training in the Federal Republic of Germany. Number Eight.

ERIC Educational Resources Information Center

Ripper, Chris, Ed.; Russell, Russ, Ed.

A party of vocational educators from the United Kingdom (UK) traveled to the Federal Republic of Germany (FRG) to examine West German vocational education and training for the hotel and catering industry. During the study, the investigators examined the training with respect to regulations, the content of training, and the structure of the…

Study on the occurrence of Trichinella spp. in raccoon dogs in Brandenburg, Germany.

PubMed

Mayer-Scholl, Anne; Reckinger, Sabine; Schulze, Christoph; Nöckler, Karsten

2016-11-15

In recent years the raccoon dog population in Germany has risen dramatically and a steady westward expansion can still be seen. In addition to the highest Trichinella prevalence in wild boar and the most reported Trichinella cases in domestic swine from backyard farms, the North-Eastern part of Germany also has the highest raccoon dog density in the country. Due to their distinct scavenging behavior, raccoon dogs play a significant role as Trichinella reservoir. Therefore, to increase the knowledge on Trichinella spp. in raccoon dogs, we performed a study on the occurrence of Trichinella in the North-Eastern federal state of Brandenburg. In total 1527 raccoon dogs were examined between 2000 and 2014. An average of 1.9% of the raccoon dogs were Trichinella spp. positive. 90% of the positive animals were infected with Trichinella spiralis and one animal each with Trichinella britovi and Trichinella pseudospiralis. In T. spiralis infected animals, the number of larvae found in the muscle tissue ranged between 0.5 and 235 larvae per gram (lpg), with a median of 14 larvae. A tentative temporal increase in Trichinella occurrence was seen between the time periods 2008 to 2010 and 2011 to 2014. Based on the size of the raccoon dog hunting bags of the past decade, the species spread in westerly and north-westerly direction is evident. An interesting question is how the raccoon dog will influence the Trichinella prevalence in the sylvatic cycle in these regions in the years to come. Copyright © 2016 Elsevier B.V. All rights reserved.

Qualitative comparison of soil erosion, runoff and infiltration coefficients using small portable rainfall simulators in Germany, Spain and France

NASA Astrophysics Data System (ADS)

Rodrigo Comino, Jesús; Iserloh, Thomas; Morvan, Xavier; Malam Issa, Oumarou; Naisse, Christophe; Keesstra, Saskia; Cerdà, Artemi; Prosdocimi, Massimo; Arnáez, José; Lasanta, Teodoro; Concepción Ramos, María; José Marqués, María; Ruiz Colmenero, Marta; Bienes, Ramón; Damián Ruiz Sinoga, José; Seeger, Manuel; Ries, Johannes B.

2016-04-01

Small portable rainfall simulators are considered as a useful tool to analyze soil erosion processes in cultivated lands. European research groups of Spain (Valencia, Málaga, Lleida, Madrid and La Rioja), France (Reims) or Germany (Trier) have used different rainfall simulators (varying in drop size distribution and fall velocities, kinetic energy, plot forms and sizes, and field of application)to study soil loss, surface flow, runoff and infiltration coefficients in different experimental plots (Valencia, Montes de Málaga, Penedès, Campo Real and La Rioja in Spain, Champagne in France and Mosel-Ruwer valley in Germany). The measurements and experiments developed by these research teams give an overview of the variety in the methodologies with rainfall simulations in studying the problem of soil erosion and describing the erosion features in different climatic environments, management practices and soil types. The aim of this study is: i) to investigate where, how and why researchers from different wine-growing regions applied rainfall simulations with successful results as a tool to measure soil erosion processes; ii) to make a qualitative comparison about the general soil erosion processes in European terroirs; iii) to demonstrate the importance of the development a standard method for soil erosion processes in vineyards, using rainfall simulators; iv) and to analyze the key factors that should be taken into account to carry out rainfall simulations. The rainfall simulations in all cases allowed knowing the infiltration capacity and the susceptibility of the soil to be detached and to generate sediment loads to runoff. Despite using small plots, the experiments were useful to analyze the influence of soil cover to reduce soil erosion and to make comparison between different locations or the influence of different soil characteristics.

Joint use of Disparate Data for the Surveillance of Zoonoses: A Feasibility Study for a One Health Approach in Germany.

PubMed

Wendt, A; Kreienbrock, L; Campe, A

2016-11-01

Zoonotic diseases concern human and animal populations and are transmitted between both humans and animals. Nevertheless, surveillance data on zoonoses are collected separately for the most part in different databases for either humans or animals. Bearing in mind the concept of One Health, it is assumed that a global view of these data might help to prevent and control zoonotic diseases. In following this approach, we wanted to determine which zoonotic data are routinely collected in Germany and whether these data could be integrated in a useful way to improve surveillance. Therefore, we conducted an inventory of the existing data collections and gathered information on possible One Health surveillance areas in Germany by approaching experts through a scoping survey, personal interviews and during a workshop. In matching the information between the status quo for existing data collections and the possible use cases for One Health surveillance, this study revealed that data integration is currently hindered by missing data, missing pathogen information or a lack of timeliness, depending on the surveillance purpose. Therefore, integrating the existing data would require substantial efforts and changes to adapt the collection procedures for routine databases. Nevertheless, during this study, we observed a need for different stakeholders from the human and animal health sectors to share information to improve the surveillance of zoonoses. Therefore, our findings suggest that before the data sets from different databases are integrated for joint analyses, the surveillance could be improved by the sharing of information and knowledge through a collaboration of stakeholders from different sectors and institutions. © 2016 Blackwell Verlag GmbH.

Willkommen in Deutschland?. Russische Investoren im Spiegel der Tagespresse

NASA Astrophysics Data System (ADS)

Golinski, Sophie; Henn, Sebastian

2017-04-01

Russian investments in Germany have grown in importance. In many cases, their increasing influence has raised severe concerns among various interest groups that are cyclically reproduced in the media. This is problematic as mediated resentments are likely to hinder the welcoming atmosphere requested by business agents and policy makers, and thus also the acceptance of foreign investors in a host society. Since there is limited knowledge on how the media portray Russian investments, this article analyses the extent and structure of newspaper reporting on their engagement in Germany through two German newspapers. Moreover, we elaborate on the portrayal of Russian investors and critically reflect on it by taking expert opinions into account.

Success of commonly used operating room management tools in reducing tardiness of first case of the day starts: evidence from German hospitals.

PubMed

Ernst, Christian; Szczesny, Andrea; Soderstrom, Naomi; Siegmund, Frank; Schleppers, Alexander

2012-09-01

One of the declared objectives of surgical suite management in Germany is to increase operating room (OR) efficiency by reducing tardiness of first case of the day starts. We analyzed whether the introduction of OR management tools by German hospitals in response to increasing economic pressure was successful in achieving this objective. The OR management tools we considered were the appointment of an OR manager and the development and adoption of a surgical suite governance document (OR charter). We hypothesized that tardiness of first case starts was less in ORs that have adopted one or both of these tools. Using representative 2005 survey data from 107 German anesthesiology departments, we used a Tobit model to estimate the effect of the introduction of an OR manager or OR charter on tardiness of first case starts, while controlling for hospital size and surgical suite complexity. Adoption reduced tardiness of first case starts by at least 7 minutes (mean reduction 15 minutes, 95% confidence interval (CI): 7-22 minutes, P < 0.001). Reductions in tardiness of first case starts figure prominently the objectives of surgical suite management in Germany. Our results suggest that the appointment of an OR manager or the adoption of an OR charter support this objective. For short-term decision making on the day of surgery, this reduction in tardiness may have economic implications, because it reduced overutilized OR time.

Trends in Authoritarianism: A Study of Adolescents in West Germany and the United States Since 1945.

ERIC Educational Resources Information Center

Lederer, Gerda

1982-01-01

Surveys carried out in the United States in 1966 and 1978 and in West Germany in 1945 and 1979 showed significant decreases in authoritarianism scale scores in adolescents over time. Although the degree of attitude change was greater in West Germany, American adolescents appear somewhat more authoritarian (in relation to school, family and…

The Paper Implementation of the German Educational Standards in Geography for the Intermediate School Certificate in the German Federal States

ERIC Educational Resources Information Center

Schöps, Andreas

2017-01-01

Up to the publication of the results of Germany's first participation in the PISA study in 2001, there had been no national educational standards in Germany's 16 federal states. In the aftermath of the discussions about the disappointing outcomes, Germany's federal states decided to develop national standards, yet focusing on "core…

Lymphogranuloma Venereum in Men Screened for Pharyngeal and Rectal Infection, Germany

PubMed Central

Dudareva-Vizule, Sandra; Wisplinghoff, Hilmar; Wisplinghoff, Fabian; Sailer, Andrea; Jansen, Klaus; Henrich, Birgit; Marcus, Ulrich

2013-01-01

To determine prevalence of lymphogranuloma venereum among men who have sex with men in Germany, we conducted a multicenter study during 2009–2010 and found high rates of rectal and pharyngeal infection in men positive for the causative agent, Chlamydia trachomatis. Many infections were asymptomatic. An adjusted C. trachomatis screening policy is justified in Germany. PMID:23621949

Images of Germany: Past and Present. A Film Collection, Series II Instructional Activities.

ERIC Educational Resources Information Center

Blankenship, Glen; Hutcheson, Gwen

This booklet offers classroom activities for use with 15 social studies-related films for teaching about Germany. The series of 25-minute films are made available by Deutsche Welle Television and Goethe House New York. Lessons in the booklet include: (1) "Germany Since 1945: A Focus on Berlin"; (2) "'I'll Get You All Out of Here!' A…

The Role of the Company in Generating Skills: The Learning Effects of Work Organisation. Germany. CEDEFOP Document.

ERIC Educational Resources Information Center

Grunewald, Uwe; Zimmer, Gerhard; Sauter, Edgar

This document reports the findings of a 3-year study of company strategies and the training impact of labor organization in Germany. Among the topics discussed in the theoretical overview presented in section 1 are the following: the growing importance of learning in a working environment; Germany's continuing training "system" and…

Seasonal and ascending trends in the incidence of carriage of extended-spectrum ß-lactamase-producing Escherichia coli and Klebsiella species in 2 German hospitals.

PubMed

Kaier, Klaus; Frank, Uwe; Conrad, Andreas; Meyer, Elisabeth

2010-11-01

Extended-spectrum ß-lactamase (ESBL)-producing strains of bacteria have become a major public health concern. In the present study, the incidence of carriage of ESBL-producing strains was analyzed for general trends and seasonality. Monthly data on ESBL-producing strains were collected retrospectively at 2 large university hospitals in Germany. The mean monthly temperatures for the 2 settings were collected from Germany's national meteorological service. Multivariable time series analyses were performed to explain variations in the monthly incidence densities of carriage of ESBL-producing bacteria (number of cases involving ESBL-producing Escherichia coli and/or Klebsiella species per 1,000 patient days). For the final models, we incorporated variables for the ascending linear trends and other variables representing the mean monthly temperature. Our models demonstrated that there was an increasing trend in the incidences of carriage of ESBL-producing bacteria. In addition, the incidences of carriage of all ESBL-producing bacteria responded positively to the mean temperature, meaning that during the summer, more cases involving ESBL-producing bacteria were detected than during the winter. The same methodology was also applied to the incidence of methicillin-resistant Staphylococcus aureus carriage, but no association was found with the mean temperature. In the present study, we demonstrated that the monthly incidence of carriage of ESBL-producing bacteria was highly correlated with the mean monthly temperature, a fact that should be considered in experimental studies as an additional parameter influencing the incidence of ESBL-producing bacteria.

Dollar Summary of Prime Contract Awards with Principal Place of Performance Outside the U.S. by Country and Contractor, FY83.

DTIC Science & Technology

1983-01-01

GERMANY 55 55 KOHLEN GRUB GERMANY 9,706 9,706 KOLLER WOLFGANG GERMANY 28 28 KOLLSMANN 0MBN SYSTEM TECHN IK GERMANY 37 37 KONTRO#4 ELEKTRONI C GMBH... KRAUSE GERMANY 56 56 WAGNER GLAS UND GEBAEUDEREINIGUNG GERMANY 374 374 WAGNER GMSM GERMANY 138 136 WAGNER H GERMANY 570 570 WAGNER H a S GARTEN... WOLFGANG PRAYON GERMANY 34 34 WOLLERSHE I M ALFRED GERMANY 47 47 WORMSER AUIOBUSSETRI ED GERMANY 178 178 WUERSCHINGER HANS GERMANY 73 73 WUEST BAU

International Inspiration

ERIC Educational Resources Information Center

Finkel, Ed

2017-01-01

As the U.S. Department of Labor (DOL) expands its Registered Apprenticeship College Consortium (RACC) among community colleges and employer partners, those involved are looking to countries like Germany and Switzerland for inspiration. In some cases, that has meant partnering with companies from those countries, which have had more comprehensive…

Complex seismic anisotropy beneath Germany from shear wave splitting and surface wave models

NASA Astrophysics Data System (ADS)

Campbell, L.; Long, M. D.; Becker, T. W.; Lebedev, S.

2013-12-01

Seismic anisotropy beneath stable continental interiors likely reflects a host of processes, including deformation in the lower crust, frozen anisotropy from past deformation processes in the lithospheric mantle, and present-day mantle flow in the asthenosphere. Because the anisotropic structure beneath continental interiors is generally complicated and often exhibits heterogeneity both laterally and with depth, a complete characterization of anisotropy and its interpretation in terms of deformational processes is challenging. In this study, we aim to expand our understanding of continental anisotropy by characterizing in detail the geometry and strength of azimuthal anisotropy beneath Germany and the surrounding region, using a combination of shear wave splitting and surface wave constraints. We utilize data from long-running broadband stations in and around Germany, collected from a variety of national and temporary European networks. We measure the splitting of SKS, SKKS, and PKS phases, with the aim of obtaining the best possible backazimuthal coverage. Preliminary results indicate that anisotropy beneath Germany is generally complex; we observe shear wave splitting patterns that are complicated and are inconsistent with a single horizontal layer of anisotropy beneath the station. Observed delay times are generally small (<1 sec), and there is a preponderance of null *KS arrivals in the dataset, with null measurements detected over a fairly large range of backazimuths. We also observe dramatic differences in splitting patterns over relatively short horizontal distances. Although we note backazimuthal variations in splitting at several stations, we do not observe a clear 90-degree periodicity that one would expect for the case of multiple anisotropic layers. We are currently carrying out comparisons between our observed splitting patterns and those predicted from tomographic models of azimuthal anisotropy derived from surface wave observations. The ultimate goal of this work is to combine different types of observations (shear wave splitting, surface wave models, and eventually anisotropic receiver function analysis) to place precise constraints on the anisotropic structure beneath Germany, and to interpret this structure in terms of on-going and past deformational processes in the crust and mantle.

Does one size really fit all? The effectiveness of a non-diagnosis-specific integrated mental health care program in Germany in a prospective, parallel-group controlled multi-centre trial.

PubMed

Mueller-Stierlin, Annabel Sandra; Helmbrecht, Marina Julia; Herder, Katrin; Prinz, Stefanie; Rosenfeld, Nadine; Walendzik, Julia; Holzmann, Marco; Dinc, Uemmueguelsuem; Schützwohl, Matthias; Becker, Thomas; Kilian, Reinhold

2017-08-01

The Network for Mental Health (NWpG-IC) is an integrated mental health care program implemented in 2009 by cooperation between health insurance companies and community mental health providers in Germany. Meanwhile about 10,000 patients have been enrolled. This is the first study evaluating the effectiveness of the program in comparison to standard mental health care in Germany. In a parallel-group controlled trial over 18 months conducted in five regions across Germany, a total of 260 patients enrolled in NWpG-IC and 251 patients in standard mental health care (TAU) were recruited between August 2013 and November 2014. The NWpG-IC patients had access to special services such as community-based multi-professional teams, case management, crisis intervention and family-oriented psychoeducation in addition to standard mental health care. The primary outcome empowerment (EPAS) and the secondary outcomes quality of life (WHO-QoL-BREF), satisfaction with psychiatric treatment (CSQ-8), psychosocial and clinical impairment (HoNOS) and information about mental health service needs (CAN) were measured four times at 6-month intervals. Linear mixed-effect regression models were used to estimate the main effects and interaction effects of treatment, time and primary diagnosis. Due to the non-randomised group assignment, propensity score adjustment was used to control the selection bias. NWpG-IC and TAU groups did not differ with respect to most primary and secondary outcomes in our participating patients who showed a broad spectrum of psychiatric diagnoses and illness severities. However, a significant improvement in terms of patients' satisfaction with psychiatric care and their perception of treatment participation in favour of the NWpG-IC group was found. Providing integrated mental health care for unspecific mentally ill target groups increases treatment participation and service satisfaction but seems not suitable to enhance the overall outcomes of mental health care in Germany. The implementation of strategies for ameliorating the needs orientation of the NWpG-IC should be considered. German Clinical Trial Register DRKS00005111 , registered 26 July 2013.

Hematology research output from Chinese authors and other countries: a 10-year survey of the literature.

PubMed

Zhang, Lei; Ye, Xin; Sun, Yi; Deng, An-mei; Qian, Bao-hua

2015-02-06

Hematologic disease affects people of all ages worldwide. In the past decade, researchers have made great progress in the field of hematology. In the present study we compared the hematology research output from China and other countries (USA, Germany, UK, Japan and South Korea) over the past 10 years and 5 years. The related articles were extracted based on the PubMed database. We recorded the number of publications, clinical trials, randomized controlled trials, meta-analyses, case reports, reviews, citations, impact factors, articles in the top 10 journals and most published journals to assess the quantity and quality of research output in each region. A total of 120,641 hematology-related articles were published from 2004 to 2013. The USA accounted for 27.13% (32,732/120,641) of the publications, followed by Germany (7,479/120,641; 6.20%), Japan (6,347/120,641; 5.26%), the UK (5,453/120,641; 4.52%), China (2,924/120,641; 2.42%) and South Korea (1,413/120,641; 1.17%). The ranking for cumulative impact factors was as follows: USA; Germany; UK; Japan; China and South Korea. The median impact factors in the UK, USA, and Germany were higher than Japan, South Korea, and China. Interestingly, the median impact factors in the three Asia countries were similar both in 2004-2013 and 2009-2013. The UK had the highest percentage of publications in the top 25% of journals, while China lagged behind and ranked last. When comparing the number of articles in the top 10 journals, the results were similar to the IF findings. Germany had the highest number of average citations, while China had the lowest number of average citation. The status of hematology research output from the 6 countries in 2009-2013 had little difference from 2004-2013. Thus, the USA has had a dominant role in hematologic research in the past 10 years. Overall, the quality of publications in European countries was better than Asia countries. Although China has made considerable progress in hematology research, the quality of research needs improvement.

Reimbursement of burns by DRG in four European countries: an analysis.

PubMed

Lotter, O; Jaminet, P; Amr, A; Chiarello, P; Schaller, H E; Rahmanian-Schwarz, A

2011-11-01

To analyze the German, Austrian, Italian and Spanish Diagnosis-Related Group (DRG)-systems regarding burns. We analyzed 78 cases of inpatients with burns which were processed by national DRG-groupers. DRGs were linked to thresholds concerning length of stay as well as reimbursement tables of the respective countries. Fifty-one % of cases showed higher reimbursement in Germany compared to Austria, 55% compared to Italy and 67% as against Spain. Total proceeds are highest in Austria with 1,577,000 €, followed by Italy with 1,569,000 €, Germany with 1,502,000 € and Spain with 902,596 €. No correlation was found between macroeconomic key figures and our data. International comparison of reimbursement of burns by DRG could be a useful instrument for benchmarking while not depending solely on political decisions or country-specific cost data. For better comparability, hospital indices based on healthcare baskets should be discussed. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

[Fumaria officinalis (fumitory)--clinical applications].

PubMed

Hentschel, C; Dressler, S; Hahn, E G

1995-07-10

Fumaria officinalis-fumitory or earth smoke-is a medicinal plant which has long had a role to play in empirical medicine in numerous countries. A review of the literature, however, reveals very few studies that support its use for dermatological indications (milk crust, eczema, scabies, etc.) or as a diuretic or laxative. This contrasts with its use to treat functional diseases of the biliary system. Although no placebo-controlled studies have been done, a number of empirical reports, clinical case reports and animal experimental studies have been published. Accordingly, in Germany, Fumaria officinalis is approved for the indication "colicky pain affecting the gallbladder and biliary system, together with the gastrointestinal tract".

Application fields for the new Object Management Group (OMG) Standards Case Management Model and Notation (CMMN) and Decision Management Notation (DMN) in the perioperative field.

PubMed

Wiemuth, M; Junger, D; Leitritz, M A; Neumann, J; Neumuth, T; Burgert, O

2017-08-01

Medical processes can be modeled using different methods and notations. Currently used modeling systems like Business Process Model and Notation (BPMN) are not capable of describing the highly flexible and variable medical processes in sufficient detail. We combined two modeling systems, Business Process Management (BPM) and Adaptive Case Management (ACM), to be able to model non-deterministic medical processes. We used the new Standards Case Management Model and Notation (CMMN) and Decision Management Notation (DMN). First, we explain how CMMN, DMN and BPMN could be used to model non-deterministic medical processes. We applied this methodology to model 79 cataract operations provided by University Hospital Leipzig, Germany, and four cataract operations provided by University Eye Hospital Tuebingen, Germany. Our model consists of 85 tasks and about 20 decisions in BPMN. We were able to expand the system with more complex situations that might appear during an intervention. An effective modeling of the cataract intervention is possible using the combination of BPM and ACM. The combination gives the possibility to depict complex processes with complex decisions. This combination allows a significant advantage for modeling perioperative processes.

[Survey of Specialist Pulmonary Medicine Health Care Structures for Patients with Interstitial Lung Disease in Nordrhein-Westfalen, Germany - A Pilot Project of the Western German Respiratory Society (WdGP)].

PubMed

Hagmeyer, L; Haidl, P; Westhoff, M; Schulte, W; Randerath, W; Lorenz, J

2018-05-22

 Survey of specialist pulmonary medicine health care structures for patients with interstitial lung disease (ILD) in Nordrhein-Westfalen, Germany.  The Western German Respiratory Society initiated a voluntary registration of ILD expert centers. Structural quality and processes were evaluated by questionnaire.  49 centers were registered, 46 allowed analysis of their center data (15 pulmonology specialist practices, 34 hospital pulmonology departments). Specialist practices saw a median of 360 ILD patients per year (26 % first diagnosis), hospital departments a median of 105 ILD patients per year (63 % first diagnosis). 10 centers diagnose more than 100 new ILD cases per year. Specialist practices report median 50 bronchoscopies per year, hospital departments median 1396. 78 % of the centers participate in a multidisciplinary ILD case conference.  Several ILD expert centers were identified in Nordrhein-Westfalen. Outpatient care mainly involves the monitoring of ILD patients, inpatient services focus on complex initial diagnostics or cases with unusual disease behaviour. ILD centers meeting regional health care needs should be supported in their development. © Georg Thieme Verlag KG Stuttgart · New York.

The Unequal Structure of the German Education System: Structural Reasons for Educational Failures of Turkish Youth in Germany

PubMed Central

Fernandez-Kelly, Patricia

2014-01-01

The paper examines the educational experiences of Turkish youth in Germany with special references to the statistical data of Educational Report, PISA surveys. The results of the educational statistics of Germany show that more than group characteristics like social and cultural capital, structural and institutional factors (multi-track system with its selective mechanism, education policy, context of negative reception of Germany, institutional discrimination, and lack of intercultural curriculum) could have a decisive role in hampering the educational and labor market integration and social mobility of Turkish youth. This can be explained by a mix of factors: the education system which does not foster the educational progress of children from disadvantaged families; the high importance of school degrees for accessing to the vocational training system and the labor market; and direct and indirect institutional discrimination in educational area in Germany. Thus, this work suggests that the nature of the education system in Germany remains deeply “unequal,” “hierarchical” and “exclusive.” This study also demonstrates maintaining the marginalized position of Turkish children in Germany means that the country of origin or the immigrants’ background is still a barrier to having access to education and the labor market of Germany. PMID:26719817

[Importance of epidemiology and control of the fox tapeworm, Echinococcus multilocularis, in Germany].

PubMed

Daugschies, A

1995-08-01

A review is given on the epidemiology and control of Echinococcus multilocularis with emphasis on the particular situation in Germany. Recent studies have demonstrated a comparatively frequent general occurrence of the parasite in fox populations in Germany apart from the traditional endemic areas in the Southwest. Final conclusions concerning a putative spread of the parasite from the highly endemic areas in the Southwest of Germany to the North and the East can not be drawn to date due to a lack of data. New and traditional diagnostic tools, as well as prophylactic and therapeutic measures are discussed.

Calf-Level Factors Associated with Bovine Neonatal Pancytopenia – A Multi-Country Case-Control Study

PubMed Central

Jones, Bryony A.; Sauter-Louis, Carola; Henning, Joerg; Stoll, Alexander; Nielen, Mirjam; Van Schaik, Gerdien; Smolenaars, Anja; Schouten, Matthijs; den Uijl, Ingrid; Fourichon, Christine; Guatteo, Raphael; Madouasse, Aurélien; Nusinovici, Simon; Deprez, Piet; De Vliegher, Sarne; Laureyns, Jozef; Booth, Richard; Cardwell, Jackie M.; Pfeiffer, Dirk U.

2013-01-01

Bovine neonatal pancytopenia (BNP), a high fatality condition causing haemorrhages in calves aged less than 4 weeks, was first reported in 2007 in Germany and subsequently observed at low incidence in other European countries and New Zealand. A multi-country matched case-control study was conducted in 2011 to identify calf-level risk factors for BNP. 405 BNP cases were recruited from 330 farms in Belgium, France, Germany and the Netherlands by laboratory confirmation of farmer-reported cases. Up to four calves of similar age from the same farm were selected as controls (1154 calves). Risk factor data were collected by questionnaire. Multivariable modelling using conditional logistic regression indicated that PregSure®BVD (PregSure, Pfizer Animal Health) vaccination of the dam was strongly associated with BNP cases (adjusted matched Odds Ratio - amOR 17.8 first lactation dams; 95% confidence interval – ci 2.4, 134.4; p = 0.005), and second or more lactation PregSure-vaccinated dams were more likely to have a case than first lactation vaccinated dams (amOR 2.2 second lactation; ci 1.1, 4.3; p = 0.024; amOR 5.3 third or more lactation; ci 2.9, 9.8; p = <0.001). Feeding colostrum from other cows was strongly associated with BNP if the dam was not PregSure-vaccinated (amOR 30.5; ci 2.1, 440.5; p = 0.012), but the effect was less if the dam was PregSure-vaccinated (amOR 2.1; ci 1.1, 4.0; p = 0.024). Feeding exclusively dam’s milk was a higher risk than other types of milk (amOR 3.4; ci 1.6, 7.5; p = 0.002). The population attributable fractions were 0.84 (ci 0.68, 0.92) for PregSure vaccination, 0.13 (ci 0.06, 0.19) for feeding other cows’ colostrum, and 0.15 (ci 0.08, 0.22) for feeding dam’s milk. No other calf-level factors were identified, suggesting that there are other important factors that are outside the scope of this study, such as genetics, which explain why BNP develops in some PregSure-colostrum-exposed calves but not in others. PMID:24312485

The integration of two health systems: social stratification, work and health in East and West Germany.

PubMed

Lüschen, G; Niemann, S; Apelt, P

1997-03-01

This is an analysis of system integration, social stratification and work for health status and health care in East and West Germany. It is based on aggregate data and representative survey data of random samples of 2554 adults in both subsystems. Findings show that there were marked differences in life-expectancy prior to unification. The integration of the two systems, which occurred almost totally with regard to terms of West German health care organization, shows adjustment problems in the East for the public Health-Care-Funds and few if any for ambulatory care. The work situation has an impact on health, but there are no significant differences for East versus West. Social stratification variables show an influence on subjective health status for education (East) and for income, social status (West), while physician utilization (despite a preference of specialists by those with higher status) is not significantly determined by stratification variables in either East or West Germany. Beyond the central focus on work and stratification determinants a major finding pertains to a comparatively worse health situation for the aged and for women in what was the former East Germany. System models of Capitalism versus Socialism fit the results and recent history of the two systems to only a limited degree, as the West German corporate health system shows clear limits in following free market principles. The East German system, regardless of its centralized organization and move towards a socialist system, never fully abandoned the traditional model of German health care. Unlike the East German health system, that of West Germany, with its general expansion to 92% of the population, shows an increasing effect for social redistribution. The latter may be a reason why standard indicators of social stratification show less of an impact on health and health care than expected, while conditions at work clearly determine the health of people-the latter being the case in both the former East and West Germany.

Employed and expecting in Germany: A qualitative investigation into pregnancy-related occupational stress and coping behavior.

PubMed

Lojewski, Julia; Flothow, Annegret; Harth, Volker; Mache, Stefanie

2018-01-01

Previous studies demonstrate a higher risk for pregnant women to experience stressors within the work context and therefore suggest a higher risk for occupational stress. However, the interaction between work and pregnancy in Germany is currently an area without much active research, even though it is a common occurrence. This qualitative study explores stressors, coping behaviors and related consequences for pregnant employees in Germany. Furthermore, the study researches intervention possibilities for the purpose to prevent the target group from negative health outcomes. Thirteen semi-standardized interviews with employed pregnant women living and working in Germany were conducted. The interviews were recorded and verbatim transcribed. Data was analyzed by Mayring's structuring qualitative content analysis. Compounding the results, the interviewed women noted most frequently stressors in relation to their employer/line manager due to their pregnant condition. Even though the women showed various adaptive coping behaviors, the identified negative consequences, mainly on their emotional wellbeing. Various intervention possibilities to improve the pregnant employee's situation were mentioned. This study was able to explore broad insights into the topic of pregnant employees in Germany. Therefore, this study underlines the actuality and relevance of the topic and is able to contribute to a scientific discussion about pregnancy at the workplace.

Whole genome sequencing of Brucella melitensis isolated from 57 patients in Germany reveals high diversity in strains from Middle East.

PubMed

Georgi, Enrico; Walter, Mathias C; Pfalzgraf, Marie-Theres; Northoff, Bernd H; Holdt, Lesca M; Scholz, Holger C; Zoeller, Lothar; Zange, Sabine; Antwerpen, Markus H

2017-01-01

Brucellosis, a worldwide common bacterial zoonotic disease, has become quite rare in Northern and Western Europe. However, since 2014 a significant increase of imported infections caused by Brucella (B.) melitensis has been noticed in Germany. Patients predominantly originated from Middle East including Turkey and Syria. These circumstances afforded an opportunity to gain insights into the population structure of Brucella strains. Brucella-isolates from 57 patients were recovered between January 2014 and June 2016 with culture confirmed brucellosis by the National Consultant Laboratory for Brucella. Their whole genome sequences were generated using the Illumina MiSeq platform. A whole genome-based SNP typing assay was developed in order to resolve geographically attributed genetic clusters. Results were compared to MLVA typing results, the current gold-standard of Brucella typing. In addition, sequences were examined for possible genetic variation within target regions of molecular diagnostic assays. Phylogenetic analyses revealed spatial clustering and distinguished strains from different patients in either case, whereas multiple isolates from a single patient or technical replicates showed identical SNP and MLVA profiles. By including WGS data from the NCBI database, five major genotypes were identified. Notably, strains originating from Turkey showed a high diversity and grouped into seven subclusters of genotype II. MLVA analysis congruently clustered all isolates and predominantly matched the East Mediterranean genetic clade. This study confirms whole-genome based SNP-analysis as a powerful tool for accurate typing of B. melitensis. Furthermore it allows special allocation and therefore provides useful information on the geographic origin for trace-back analysis. However, the lack of reliable metadata in public databases often prevents a resolution below geographic regions or country levels and corresponding precise trace-back analysis. Once this obstacle is resolved, WGS-derived bacterial typing adds an important method to complement epidemiological surveys during outbreak investigations. This is the first report of a detailed genetic investigation of an extensive collection of B. melitensis strains isolated from human cases in Germany.

Rheum rhaponticum Extract (ERr 731): Postmarketing Data on Safety Surveillance and Consumer Complaints.

PubMed

Chang, Jyh-Lurn; Montalto, Michael B; Heger, Peter W; Thiemann, Eva; Rettenberger, Reinhard; Wacker, Jürgen

2016-06-01

Postmarketing surveillance data for a commercially available extract of Rheum rhaponticum (ERr 731) have not been published since the beginning of the reporting in 1993 in Germany about adverse events (AEs) that were believed to be associated with it. The extract is derived from the plant's roots and is indicated for menopausal relief. In Germany, the extract has been marketed as Phytoestrol N and other related products-Phyto-Strol, Phyto-Strol Loges, and Phyto-Strol compact and as femi-loges. In the United States and Canada and in South Africa, the product had been marketed as Estrovera. The study's objective was to summarize the AE reports from Germany from 1993 to June 2014 and also to assess consumers' complaints in North America and South Africa from the date of the extract's launch to June 2014. AE reports recorded by 2 German holders of marketing authorizations, Chemisch-Pharmazeutische Fabrik Göppingen, for Phytoestrol N, and Dr. Loges + Co. GmbH, for femi-loges, were collected and analyzed. Consumers' complaints in North America and South Africa that had been captured by the US distributor of Estrovera were also collected and analyzed. From 1993 to June 2014, approximately 140 million daily doses of the extract were placed on the German market, and 124 AE reports were recorded. The most common of those AEs were hypersensitivity, with 74 reactions, and gastrointestinal symptoms, with 47 reactions. From January 2009 to June 2014, approximately 13 million tablets of the supplement were sold in North America, and 79 complaints from consumers associated with a physical response to it had been recorded. The main complaints were gastrointestinal symptoms, with 23 cases, and failure to work as suggested, with 22 cases. From the date of the product's launch in South Africa in February 2011 to June 2014, no consumer complaints have been reported. The records related to postmarketing surveillance and consumers' complaints suggest that the extract of R rhaponticum is generally safe for consumption.

[Outpatient Drain Management in Patients with Clinically Relevant Postoperative Pancreatic Fistula (CR-POPF) - Current Status in Germany].

PubMed

Hempel, Sebastian; Püttmann, Pamela; Kahlert, Christoph; Seifert, Lena; Mees, Sören Torge; Welsch, Thilo; Weitz, Jürgen; Distler, Marius

2018-06-01

Postoperative pancreatic fistula (POPF) is a common complication after pancreatic surgery and is associated with extended hospitalisation, increased medical costs, and reduced quality of life. The aim of the present study was to assess the treatment of POPF in Germany, with a special focus on outpatient drain management in patients with clinically relevant POPF (CR-POPF). A questionnaire evaluating postoperative management once a CR-POPF is diagnosed - especially focusing on ambulatory drain management - was developed and sent to 211 German hospitals performing > 12 pancreatic operations per year. Statistical analysis was carried out using SPSS 21. The final response rate was 62% (n = 131). Outpatient drainage management is performed by most of the responding hospitals (n = 100, 76.3%). However, 30% of hospitals (n = 40) perform outpatient treatment only in 5% of their cases with clinically relevant POPF. There was no correlation between case load of the pancreatic centres and frequency of outpatient drain management. In general, discharge criteria for patients with drained POPF (n = 98, 74.8%), the drain management itself (n = 95, 72.5%) and criteria for drain removal (n = 74, 56.5%) are not standardised but made individually. In centres with standardised drain management criteria for drain removal, these criteria were drain volume < 20 ml (29.8%), no fluid collection (25.2%), no elevation of drain amylase/lipase (25.2%) and no specific symptoms (22.1%). This is the first survey in Germany evaluating outpatient drain management in patients with CR-POPF. Although the data in the literature are rare, the majority of German pancreatic surgeons perform outpatient drain management. However, discharge criteria, outpatient care and drain removal are standardised in only the minority of centres. Therefore, we recommend the evaluation of discharge criteria and a management algorithm for patients with drained CR-POPF to improve the perioperative course. Georg Thieme Verlag KG Stuttgart · New York.

Evaluation of the Non-Formal Forest Education Sector in the State of North Rhine-Westphalia, Germany: Organisations, Programmes and Framework Conditions

ERIC Educational Resources Information Center

Grimm, Anne; Mrosek, Thorsten; Martinsohn, Anna; Schulte, Andreas

2011-01-01

Although a large number of different organisations offer various forest education programmes within Germany, specific information (i.e., sectoral and programme content and provision at a state level) is lacking. This study used a survey of all 61 forest education organisations (43 respondents) in the state of North Rhine-Westphalia, Germany, to…

Germany Since Unification. Workshop Leader's Manual. An Introduction to Social Studies Instructional Resource Materials for Teaching about Germany Since Unification.

ERIC Educational Resources Information Center

Blankenship, Glen

This manual is designed to offer support for the instructional resources guides on "Germany since Unification." It provides the basis for a full-day inservice training session on the use of those materials. The format can be modified to meet the needs of leaders, audiences, and time frames. Using the materials developed by teachers and…

The Support of the Sciences and Humanities in West Germany and the United States. German Studies Notes.

ERIC Educational Resources Information Center

Indiana Univ., Bloomington. Inst. of German Studies.

The document contains the texts of three presentations from a conference on financial support of the sciences and humanities in West Germany and the United States. The first paper explains financial support of the sciences and the humanities in West Germany. Awards and uses of funds are primarily determined by the scholarly community, which also…

Regional and temporal variations in coding of hospital diagnoses referring to upper gastrointestinal and oesophageal bleeding in Germany.

PubMed

Langner, Ingo; Mikolajczyk, Rafael; Garbe, Edeltraut

2011-08-17

Health insurance claims data are increasingly used for health services research in Germany. Hospital diagnoses in these data are coded according to the International Classification of Diseases, German modification (ICD-10-GM). Due to the historical division into West and East Germany, different coding practices might persist in both former parts. Additionally, the introduction of Diagnosis Related Groups (DRGs) in Germany in 2003/2004 might have changed the coding. The aim of this study was to investigate regional and temporal variations in coding of hospitalisation diagnoses in Germany. We analysed hospitalisation diagnoses for oesophageal bleeding (OB) and upper gastrointestinal bleeding (UGIB) from the official German Hospital Statistics provided by the Federal Statistical Office. Bleeding diagnoses were classified as "specific" (origin of bleeding provided) or "unspecific" (origin of bleeding not provided) coding. We studied regional (former East versus West Germany) differences in incidence of hospitalisations with specific or unspecific coding for OB and UGIB and temporal variations between 2000 and 2005. For each year, incidence ratios of hospitalisations for former East versus West Germany were estimated with log-linear regression models adjusting for age, gender and population density. Significant differences in specific and unspecific coding between East and West Germany and over time were found for both, OB and UGIB hospitalisation diagnoses, respectively. For example in 2002, incidence ratios of hospitalisations for East versus West Germany were 1.24 (95% CI 1.16-1.32) for specific and 0.67 (95% CI 0.60-0.74) for unspecific OB diagnoses and 1.43 (95% CI 1.36-1.51) for specific and 0.83 (95% CI 0.80-0.87) for unspecific UGIB. Regional differences nearly disappeared and time trends were less marked when using combined specific and unspecific diagnoses of OB or UGIB, respectively. During the study period, there were substantial regional and temporal variations in the coding of OB and UGIB diagnoses in hospitalised patients. Possible explanations for the observed regional variations are different coding preferences, further influenced by changes in coding and reimbursement rules. Analysing groups of diagnoses including specific and unspecific codes reduces the influence of varying coding practices.

Tularaemia in Berlin - two independent cases in travellers returning from central Anatolia, Turkey, February 2011.

PubMed

Schubert, A; Splettstoesser, W; Bätzing-Feigenbaum, J

2011-05-05

Tularaemia, though rare, has recently been increasingly reported in Germany. Most cases are indigenous infections. This report describes two epidemiologically independent infections with Francisella tularensis subspecies holarctica detected in Berlin in February 2011 that were acquired in central Anatolia, Turkey. In Turkey, there have been repeated tularaemia outbreaks since 2000 and the disease should therefore be considered as a differential diagnosis in travellers returning from that country.

New Guiding Principles in Educational Policy: The Case of Germany.

ERIC Educational Resources Information Center

Weiss, Manfred

1993-01-01

Whereas the shift toward pluralism, choice, deregulation, and parent empowerment reflects the market ideology's advance into education in other industrialized countries, the force driving the German movement is loss of political legitimization and the conflict-ridden state of educational policy. Past strategies for securing legitimization…

Present state of beech bark disease in Germany

Treesearch

Klaus J. Lang

1983-01-01

Beech bark disease can be found at present time in young and old stands (20-150 years old) of Fagus sylvatica. The present state of the disease may be described as "normal" and apart from some cases, it is no threat to the existence of the stands.

Environmental Policy-Making and Their Impacts in the Case of Acid Rain Abatement.

ERIC Educational Resources Information Center

Boehmer-Christiansen, Sonja

1992-01-01

Great Britain and Germany accepted European Community acid rain reduction directives. Discusses the differences in the amount of reduction required from each country, the strategies adopted to attain those reductions, and the levels of emission reductions already achieved.(52 references) (MDH)

Can "Vocationalisation" of Education Go Too Far? The Case of Switzerland

ERIC Educational Resources Information Center

Meyer, Thomas

2009-01-01

While countries with predominantly academic school-based upper secondary education have been "discovering" vocational education and training (VET) for some time, countries with "vocationalised" education systems such as Austria, Germany or Switzerland are critically reviewing their own situations. This paper takes up the case…

The Insurgent Movement in Ukraine During 1940s-1950s: Lessons Learned from the Case Study of the Ukrainian Insurgent Army (OUN-UPA)

DTIC Science & Technology

2012-06-08

partitioned between several major powers; the Soviet Union in the East, Romania in the South and Southwest, and Poland and Czechoslovakia in the West. Anti...effective, what aspects could be considered as effective activities and why the insurgency was ultimately succumbed to defeat by the Soviet Union ...the most radical OUN wing decided to wage an uncompromising war on “two fronts;” against Nazi Germany and Communist Soviet Union . The OUN became the

Contractors on the Battlefield: A Case Study of the Airborne Reconnaissance Low (ARL) Life-Cycle Logistics Support Contract - March 2000 Through August 2001

DTIC Science & Technology

2001-12-01

military vehicles, so they were forced to go to Heidelberg, Germany, to rent Ford Broncos (equivalent to U.S. Ford Explorers). They were also...several of the technicians had family ties to the area. The unit was relocated to El Paso, Texas, in late 1999. Following the relocation, more than...half of the contractor’s personnel resigned. Several were transferred to South Korea. Many individuals did not want to live in the El Paso area, and

US metric study mission to the United Kingdom and the Federal Republic of Germany: Report of the NASA representative (Executive Summary)

NASA Technical Reports Server (NTRS)

Vlannes, P. N.

1976-01-01

The trip report is given of the NASA representative of the U.S. metric study mission to the United Kingdom and the Federal Republic of Germany. The mission was organized and conducted under the aegis of the American National Metric Council to learn at first hand the progress of metrication in the United Kingdom and the progress of metrication in the aerospace industry in both the United Kingdom and the Federal Republic of Germany. Representatives of the mission included a cross section of government, industry, labor, and other segments of the private sector. After general and special meetings in the United Kingdom, U.S. members with aerospace related interests met with aerospace representatives in the Federal Republic of Germany.

Developments in Adult Education Structures. Five National Studies.

ERIC Educational Resources Information Center

Council of Europe, Strasbourg (France). Committee for Out-of-School Education and Cultural Development.

Five separate national studies describe and analyze government involvement in various continuing education delivery systems in five European countries: Germany, France, Italy, the Netherlands, and Norway. The German study traces the historical background of further education in the Federal Republic of Germany, the provisions of the 1974 North…

FHWA Study Tour for Pedestrian and Bicyclist Safety in England, Germany, and The Netherlands

DOT National Transportation Integrated Search

1994-10-01

This report documents the findings of a U.S. study team that visited England, The Netherlands, and Germany. The trip sponsored by the Federal Highway Administration was taken September 3-19, 1993. Members of the study team also spent one day in Basel...

Case study for the assessment of the biogeophysical effects of a potential afforestation in Europe

PubMed Central

2013-01-01

Background A regional-scale sensitivity study has been carried out to investigate the climatic effects of forest cover change in Europe. Applying REMO (regional climate model of the Max Planck Institute for Meteorology), the projected temperature and precipitation tendencies have been analysed for summer, based on the results of the A2 IPCC-SRES emission scenario simulation. For the end of the 21st century it has been studied, whether the assumed forest cover increase could reduce the effects of the greenhouse gas concentration change. Results Based on the simulation results, biogeophysical effects of the hypothetic potential afforestation may lead to cooler and moister conditions during summer in most parts of the temperate zone. The largest relative effects of forest cover increase can be expected in northern Germany, Poland and Ukraine, which is 15–20% of the climate change signal for temperature and more than 50% for precipitation. In northern Germany and France, potential afforestation may enhance the effects of emission change, resulting in more severe heavy precipitation events. The probability of dry days and warm temperature extremes would decrease. Conclusions Large contiguous forest blocks can have distinctive biogeophysical effect on the climate on regional and local scale. In certain regions of the temperate zone, climate change signal due to greenhouse gas emission can be reduced by afforestation due to the dominant evaporative cooling effect during summer. Results of this case study with a hypothetical land cover change can contribute to the assessment of the role of forests in adapting to climate change. Thus they can build an important basis of the future forest policy. PMID:23369380

Investigation of a scabies outbreak in a kindergarten in Constance, Germany.

PubMed

Ariza, L; Walter, B; Worth, C; Brockmann, S; Weber, M-L; Feldmeier, H

2013-03-01

In industrialized countries, scabies occurs sporadically or in the form of protracted epidemics, typically in nursing homes for elderly people. Outbreaks of scabies in a kindergarten are very rare. The main goal of our study was to investigate an outbreak of scabies in a kindergarten and to identify risk factors for the infestation with the ectoparasitosis. We investigated an outbreak of scabies in a kindergarten in the City of Constance, southern Germany, with a particular pedagogical concept. Risk factors indicating a transmission of Sarcoptes mites through body contact or via fomites were assessed using questionnaires and by following the daily routine in the kindergarten. A total of 16 cases were identified. The attack rate was significantly higher in nursery teachers (risk ratio 42.1) compared to children (risk ratio 10.5). In all cases, scabies had developed rather recently, with minimal clinical manifestations. In nursery teachers, the probability of scabies was 4.4 times higher in those teachers who hugged children regularly. Children who preferably played with their own soft toys had a lower probability of developing scabies [risk ratio 0.14, 95 % confidence interval (CI) 0.05-0.42; p = 0.04]. It seems conceivable that the particular pedagogical concept of the kindergarten favored the spread of Sarcoptes mites. We were unable to show whether transmission had preferably occurred through body contact or via fomites.

Fusarium Keratitis in Germany

PubMed Central

Stasch, Serena; Kaerger, Kerstin; Hamprecht, Axel; Roth, Mathias; Cornely, Oliver A.; Geerling, Gerd; Mackenzie, Colin R.; Kurzai, Oliver; von Lilienfeld-Toal, Marie

2017-01-01

ABSTRACT Fusarium keratitis is a destructive eye infection that is difficult to treat and results in poor outcome. In tropical and subtropical areas, the infection is relatively common and associated with trauma or chronic eye diseases. However, in recent years, an increased incidence has been reported in temperate climate regions. At the German National Reference Center, we have observed a steady increase in case numbers since 2014. Here, we present the first German case series of eye infections with Fusarium species. We identified Fusarium isolates from the eye or eye-related material from 22 patients in 2014 and 2015. Thirteen isolates belonged to the Fusarium solani species complex (FSSC), 6 isolates belonged to the Fusarium oxysporum species complex (FOSC), and three isolates belonged to the Fusarium fujikuroi species complex (FFSC). FSSC was isolated in 13 of 15 (85%) definite infections and FOSC in 3 of 4 (75%) definite contaminations. Furthermore, diagnosis from contact lens swabs or a culture of contact lens solution turned out to be highly unreliable. FSSC isolates differed from FOSC and FFSC by a distinctly higher MIC for terbinafine. Outcome was often adverse, with 10 patients requiring keratoplasty or enucleation. The use of natamycin as the most effective agent against keratitis caused by filamentous fungi was rare in Germany, possibly due to restricted availability. Keratitis caused by Fusarium spp. (usually FSSC) appears to be a relevant clinical problem in Germany, with the use of contact lenses as the predominant risk factor. Its outcome is often adverse. PMID:28747368

Leukemia and exposure to ionizing radiation among German uranium miners.

PubMed

Möhner, Matthias; Lindtner, Manfred; Otten, Heinz; Gille, Hans-G

2006-04-01

It is well known that uranium miners are at an increased risk of lung cancer. Whether they also have an increased risk for other cancer sites remains under discussion. The aim of this study was to examine the leukemia risk among miners. An individually matched case-control study of former uranium miners in East Germany was conducted with 377 cases and 980 controls. Using conditional logistic regression models, a dose-response relationship between leukemia risk and radon progeny could not be confirmed. Yet, a significantly elevated risk is seen in the category > or = 400 mSv when combining gamma-radiation and long-lived radionuclides. The results suggest that an elevated risk for leukemia is restricted to employees with a very long occupational career in underground uranium mining or uranium processing. Moreover, the study does not support the hypothesis of an association between exposure to short-lived radon progeny and leukemia risk. Copyright 2006 Wiley-Liss, Inc.

Recycling behaviour in healthcare: waste handling at work.

PubMed

Vogt, Joachim; Nunes, Katia R A

2014-01-01

This article reviews the motivational factors for environmental behaviour in general, presenting a case study on recycling disposable plastics in hospitals. Results show that 90% of over 600 employees from six analysed hospitals in Germany reported that the recycling of disposable plastics on the wards makes sense from an environmental and economic point of view. The case study reports an assessment of recycling attitudes and problems of hospital staff, mainly nurses. Employees in eco-certified hospitals were much more satisfied and reported fewer problems with the recycling system. The gender effect was significant only for saving energy, while age correlated with nearly all reported pro-environmental behaviour at home. At work, the mere introduction of a recycling system was insufficient to achieve good recycling results. Based on the study findings, recommendations are given aimed at improving the safety and sustainability of the recycling system.

Trends in alcohol-related mortality in East and West Germany, 1980-2014: age, period and cohort variations.

PubMed

Piontek, Daniela; Kraus, Ludwig

2018-05-01

Several indicators suggest that the extent and trends of alcohol-related mortality differ between East and West Germany. Regional drinking patterns and differences in health-care systems are assumed to affect the risk of dying from an alcohol-induced disease. The study addresses two questions: (1) what are the unbiased and independent age, period and cohort effects on alcohol-related mortality trends in Germany; and (2) do these trends differ between East and West Germany? Data on alcohol-related mortality for East and West Germany came from the national causes of death register for the years 1980-2014. Analyses included all deaths fully attributable to alcohol based on the International Classification of Diseases (ICD-9 and ICD-10). Gender-stratified age-period-cohort analyses were conducted using the intrinsic estimator model. Age effects showed a concave pattern with a peak at ages 55-64 years in both regions. Incidence rate ratios (IRR) in East Germany were highest in the years 1990-1994 (men and women: IRR = 1.52) and declined thereafter. In West Germany, IRR were lowest in 1980-1984 (men: IRR = 0.81, women: IRR = 0.75) and stabilized at approximately 1.10 since 1995-1999. Cohort effects showed continuously lower IRR for those born after 1955-1959 in the East and those born after 1945-1949 in the West. Patterns for males and females were comparable. The results suggest that alcohol-related mortality showed different trends in East and West Germany, which can be explained partly by different drinking patterns before and changes in the health-care system after the reunification. © 2018 Society for the Study of Addiction.

Hydro-mechanically coupled finite-element analysis of the stability of a fractured-rock slope using the equivalent continuum approach: a case study of planned reservoir banks in Blaubeuren, Germany

NASA Astrophysics Data System (ADS)

Song, Jie; Dong, Mei; Koltuk, Serdar; Hu, Hui; Zhang, Luqing; Azzam, Rafig

2018-05-01

Construction works associated with the building of reservoirs in mountain areas can damage the stability of adjacent valley slopes. Seepage processes caused by the filling and drawdown operations of reservoirs also affect the stability of the reservoir banks over time. The presented study investigates the stability of a fractured-rock slope subjected to seepage forces in the lower basin of a planned pumped-storage hydropower (PSH) plant in Blaubeuren, Germany. The investigation uses a hydro-mechanically coupled finite-element analyses. For this purpose, an equivalent continuum model is developed by using a representative elementary volume (REV) approach. To determine the minimum required REV size, a large number of discrete fracture networks are generated using Monte Carlo simulations. These analyses give a REV size of 28 × 28 m, which is sufficient to represent the equivalent hydraulic and mechanical properties of the investigated fractured-rock mass. The hydro-mechanically coupled analyses performed using this REV size show that the reservoir operations in the examined PSH plant have negligible effect on the adjacent valley slope.

Economic burden of deep infiltrating endometriosis of the bowel and the bladder in Germany: The statutory health insurance perspective.

PubMed

Koltermann, Katharina C; Schlotmann, Andreas; Schröder, Helmut; Willich, Stefan N; Reinhold, Thomas

2016-12-01

Until now, there has been little discussion of the costs of the deep infiltrating endometriosis (DIE) of the bowel or the bladder. The aim of the present secondary data analysis was to describe the population affected by this disease and to determine the economic burden in Germany from a payer's perspective. Health claims data of women diagnosed with DIE of the bladder or bowel, who were surgically treated as inpatients between Jan 1, 2008 and Dec 31, 2012, were evaluated retrospectively. All data were extrapolated on a national statutory health insurance (SHI) level and normalized based on the year of surgery (index year). Case-individual information on age, comorbidities and prescribed drugs were presented for the index year. Direct medical cost data were analysed before and after the index year, differentiated by cost sector and age group. The data of 825 women with DIE were analysed. Sample size for different time points varied depending on insurance eligibility and continuous case information. The average age at surgery was 39 years. Besides DIE, 41 % of the women had at least one additional disease of the peritoneum. The mean annual total healthcare costs per DIE case were 12,868 Euros in the index year. Before surgery, mean annual costs varied between 548 and 2,475 Euros per case and after surgery between 1,739 and 2,818 Euros per case. In total, mean costs were higher in younger women as compared to older women, with a cost difference of 616 Euros over all time points. Direct costs are highest during the year of surgical treatment, but DIE of the bowel and bladder places a substantial burden on the SHI also before and after surgery. Further studies on indirect costs would be desirable to complete the knowledge on the economic burden of DIE. Copyright © 2016. Published by Elsevier GmbH.

[Prevalence of Gastroschisis, Omphalocele, Spina Bifida and Orofacial Clefts of Neonates from January 2000 to December 2010 in Leipzig, Saxony, Saxony-Anhalt and Germany].

PubMed

Bremer, S; Kiess, W; Thome, U; Knüpfer, M; Bühligen, U; Vogel, M; Friedrich, A; Janisch, U; Rißmann, A

2018-02-01

Malformations are the most common cause of death in infancy. Numerous studies indicate an increased prevalence of malformations in neonates in recent years in some countries around the world. This study analyzed local and national trends of the prevalences of gastroschisis, omphalocele, spina bifida and orofacial clefts during 2000 till 2010 in Leipzig, Saxony, Saxony-Anhalt and Germany. The prevalence of neonatal malformations was studied retrospectively from January 2000 till December 2010 using 4 sources from Leipzig, Saxony, Saxony-Anhalt and Germany. Between 2000 and 2010, the prevalence in Germany and in Saxony, respectively was 1.97/2.12 (gastroschisis), 1.63/1.48 (omphalocele), 5.80/8.11 (orofacial clefts) and 2.92/2.50 (spina bifida) of 10 000 live births. In Saxony, a small increase in prevalence was detected (OR/year: 1.01-1.09). In Germany, the prevalence of malformations also increased significantly (OR/year: 1.01-1.04) with the exception of the prevalence of spina bifida which seemed to decline (OR/year 0.986 (0.97-1.0), p-adjust=0.04). Whether or not there has been an actual increase in the prevalence of neonatal malformations in Germany over the years or the apparent increase is just due to bias, coding errors, multiple reporting and/or false registration and codification remains unclear. Importantly, in Germany, since prevalence of malformations is monitored prospectively only in Saxony-Anhalt and Rhineland-Palatinate, only in these states is it possible to recognize recent changes. For early identification of changes in prevalence and timely implementation of preventive measures, a nationwide register or additional regional registers are deemed necessary. © Georg Thieme Verlag KG Stuttgart · New York.

An imported case of bloody diarrhea in the Czech Republic caused by a hybrid enteroaggregative hemorrhagic Escherichia coli (EAHEC) O104:H4 strain associated with the large outbreak in Germany, May 2011.

PubMed

Marejková, M; Roháčová, H; Reisingerová, M; Petráš, P

2012-03-01

A large outbreak caused by a rare Shiga toxin-producing Escherichia coli serotype O104:H4 occurred in Germany in May to July 2011. The National Reference Laboratory for E. coli and Shigella investigated the stool sample from an American tourist with bloody diarrhea who arrived in the Czech Republic from Germany where she consumed salads with raw vegetable a week ago. Using culture of the enriched stool on extended-spectrum β-lactamase agar, we isolated E. coli strain which belonged to serotype O104:H4 as determined by conventional and molecular serotyping. The strain contained the major virulence characteristics of enterohemorrhagic E. coli (stx (2) encoding Shiga toxin 2) and enteroaggregative E. coli (aggA encoding aggregative adherence fimbriae I). This unique combination of virulence traits demonstrated that this strain belongs to the hybrid enteroaggregative hemorrhagic E. coli clone which caused the German outbreak. Using advanced culture and molecular biological approaches is the prerequisite for identification of new, unusual pathogens.

Molecular epidemiological view on Shiga toxin-producing Escherichia coli causing human disease in Germany: Diversity, prevalence, and outbreaks.

PubMed

Fruth, Angelika; Prager, Rita; Tietze, Erhard; Rabsch, Wolfgang; Flieger, Antje

2015-10-01

Infections by intestinal pathogenic Escherichia coli (E. coli) are among those causing a high mortality and morbidity due to diarrheal disease and post infection sequelae worldwide. Since introduction of the Infection Protection Act in Germany 2001, these pathogens rank third among bacterial infections of the gastrointestinal tract. As a major pathovar Shiga toxin-producing E. coli (STEC) which include enterohemorrhagic E. coli (EHEC) play a leading role in occurrence of sporadic cases and disease outbreaks. An outstanding example is the large outbreak in spring 2011 caused by EHEC/EAEC O104:H4. To monitor and trace back STEC infections, national surveillance programs have been implemented including activities of the German National Reference Centre for Salmonella and other Enteric Bacterial Pathogens (NRC). This review highlights advances in our understanding of STEC in the last 20 years of STEC surveillance by the NRC. Here important characteristics of STEC strains from human infections and outbreaks in Germany between 1997 and 2013 are summarized. Copyright © 2015. Published by Elsevier GmbH.

The Effect of Union Status at First Childbirth on Union Stability: Evidence from Eastern and Western Germany.

PubMed

Schnor, Christine

2014-01-01

It is often assumed that cohabitation is much less stable than marriage. If cohabitation becomes more common among parents, children may be increasingly exposed to separation. However, little is known about how the proportion of cohabiting parents relates to their separation behavior. Higher shares of childbearing within cohabitation might reduce the proportion of negatively selected couples among cohabiting parents, which could in turn improve their union stability. This study focuses on parents who were cohabiting when they had their first child. It compares their union stability within a context in which they represent the majority or the minority. The German case is well-suited to this research goal because non-marital childbearing is common in eastern Germany (60 %) but not in western Germany (27 %). The data came from the German Family Panel (pairfam), and include 1,844 married and cohabiting mothers born in 1971-1973 and 1981-1983. The empirical results suggest that the union stability of cohabiting mothers is positively related to their prevalence: survival curves showed that eastern German cohabiting mothers had a greater degree of union stability than their western German counterparts. This difference increased in the event-history model, which accounted for the particular composition of eastern German society, including the relatively low level of religious affiliation among the population. Controlling for unobserved heterogeneity did not change this result. In sum, these findings indicate that context plays an important role in the union stability of cohabiting parents.

Cost-effectiveness analysis of telemedical devices for pre-clinical traffic accident emergency rescue in Germany.

PubMed

Auerbach, H; Schreyögg, J; Busse, R

2006-01-01

The purpose of this study is to assess the cost-effectiveness (net costs per life year gained) of telemedical devices for pre-clinical traffic accident emergency rescue in Germany. Two equipment versions of a telemedical device are compared from a societal perspective with the baseline in Germany, i.e. the non-application of telemedicine in emergency rescues. The analysis is based on retrospective statistical data covering a period of 10 years with discounted costs not adjusted for inflation. Due to the uncertainty of data, certain assumptions and estimates were necessary. The outcome is measured in terms of "life years gained" by reducing therapy-free intervals and improvements in first-aid provided by laypersons. The introduction of the basic equipment version, "Automatic Accident Alert", is associated with net costs per life year gained of euro 247,977 (at baseline assumptions). The full equipment version of the telemedical device would lead to estimated net costs of euro 239,524 per life year gained. Multi-way sensitivity-analysis with best and worst case scenarios suggests that decreasing system costs would disproportionately reduce total costs, and that rapid market penetration would largely increase the system's benefit, while simultaneously reducing costs. The net costs per life year gained in the application of the two versions of the telemedical device for pre-clinical emergency rescue of traffic accidents are estimated as quite high. However, the implementation of the device as part of a larger European co-ordinated initiative is more realistic.

Eugenics Past and Present: Remembering Buck v. Bell.

ERIC Educational Resources Information Center

Berson, Michael J.; Cruz, Barbara

2001-01-01

Provides background information about the eugenics movement. Focuses on eugenics in the United States detailing the case, Buck v. Bell, and eugenics in Germany. Explores the present eugenic movement, focusing on "The Bell Curve," China's one child policy, and the use of eugenic sterilizations in the United States and Canada. Includes…

Worlds of Higher Education Transformed: Toward Varieties of Academic Capitalism

ERIC Educational Resources Information Center

Schulze-Cleven, Tobias; Olson, Jennifer R.

2017-01-01

This article explores the changing character and consequences of state authorities' evolving relationships with universities in the United States, Germany, and Norway--typical cases for different national worlds of higher education. It argues that across the three OECD countries, welfare states have strengthened market principles in university…

The Provincial Reconstruction Teams in Afghanistan - A Model for Future Nation Building Operations

DTIC Science & Technology

2009-05-01

public at home. In the case of Germany, restrictions and tight rules of engagements (RoE) are the political solution. Using PRTs can make the...concept w ith integrated strategies on nation-builder’s is hinde red by departmental egoism , intergovernmental rivalries, and political shortsightedness

Trends in the Restructuring of German Universities

ERIC Educational Resources Information Center

Pritchard, Rosalind

2006-01-01

What happens when a highly regulated educational system--one featuring academic freedom, a national outlook, and an input-oriented, state-run bureaucracy--attempts to internationalize and introduce management structures that are outcome-oriented, deregulated, and more efficient? In the case of Germany, examined in this article, it has long been…

[A case of legionnaire's disease in Germany (author's transl)].

PubMed

Missalek, W; Helmecke, G

1979-12-07

Severe bronchopneumonia in a 66-year-old patient failed to respond to sensitivity-tested antibiotics, with only erythromycin providing improvement. The indirect immunofluorescence test for legionnaire's disease gave a highly significant titre rise (eightfold). Legionnaire's disease should be considered in the differential diagnosis of treatment-resistant bronchopneumonia.

Creating a Common Grammar for European Higher Education Governance

ERIC Educational Resources Information Center

Magalhaes, Antonio; Veiga, Amelia; Ribeiro, Filipa M.; Sousa, Sofia; Santiago, Rui

2013-01-01

This paper addresses the interaction between European Union policies and national higher education sectors in the countries involved in the TRUE project (England, France, Germany, Italy, The Netherlands, Norway, Portugal and Switzerland) making the case for European governance. Relevant for this matter is the role of political processes that…

Teaching in Germany and the Rhetoric of Culture.

ERIC Educational Resources Information Center

Alred, Gerald J.

1997-01-01

Uses the cross-cultural concepts of context and time to examine the rhetoric of German university students in an English business writing course. Provides a fresh perspective for American teachers in increasingly multinational, multicultural classrooms. Suggests how Aristotle's concepts of ethos, logos, and pathos together with the case method and…

Does acceptance of power distance influence propensities for problematic Internet use? Evidence from a cross-cultural study.

PubMed

Montag, Christian; Duke, Éilish; Sha, Peng; Zhou, Min; Sindermann, Cornelia; Li, Mei

2016-12-01

Several studies suggest that Asian countries are particularly afflicted by problematic Internet use (PIU). The present study investigates whether individual differences in the acceptance of power distance can be linked to overuse of the Internet in Germany and in China. Power distance has been discussed as an essential dimension on which Asian and Western societies differ. In the present study, we investigate two large non-clinical samples from Germany (n = 297) and China (n = 556) to address this question. Both in Germany and in China, high acceptance of power distance was positively associated with PIU. These effects were more pronounced in China compared with Germany. Moreover, the observed effects were stronger in males compared with females. Clearly, these findings are just a starting point and need to be replicated in the future. Clinical populations and a further important difference variable - collectivism - also merit consideration in future work. © 2015 Wiley Publishing Asia Pty Ltd.

The Recently Discovered Bokeloh Bat Lyssavirus: Insights Into Its Genetic Heterogeneity and Spatial Distribution in Europe and the Population Genetics of Its Primary Host.

PubMed

Eggerbauer, Elisa; Troupin, Cécile; Passior, Karsten; Pfaff, Florian; Höper, Dirk; Neubauer-Juric, Antonie; Haberl, Stephanie; Bouchier, Christiane; Mettenleiter, Thomas C; Bourhy, Hervé; Müller, Thomas; Dacheux, Laurent; Freuling, Conrad M

2017-01-01

In 2010, a novel lyssavirus named Bokeloh bat lyssavirus (BBLV) was isolated from a Natterer's bat (Myotis nattereri) in Germany. Two further viruses were isolated in the same country and in France in recent years, all from the same bat species and all found in moribund or dead bats. Here we report the description and the full-length genome sequence of five additional BBLV isolates from Germany (n=4) and France (n=1). Interestingly, all of them were isolated from the Natterer's bat, except one from Germany, which was found in a common Pipistrelle bat (Pipistrellus pipistrellus), a widespread and abundant bat species in Europe. The latter represents the first case of transmission of BBLV to another bat species. Phylogenetic analysis clearly demonstrated the presence of two different lineages among this lyssavirus species: lineages A and B. The spatial distribution of these two lineages remains puzzling, as both of them comprised isolates from France and Germany; although clustering of isolates was observed on a regional scale, especially in Germany. Phylogenetic analysis based on the mitochondrial cytochrome b (CYTB) gene from positive Natterer's bat did not suggest a circulation of the respective BBLV sublineages in specific Natterer's bat subspecies, as all of them were shown to belong to the M. nattereri sensu stricto clade/subspecies and were closely related (German and French positive bats). At the bat host level, we demonstrated that the distribution of BBLV at the late stage of the disease seems large and massive, as viral RNA was detected in many different organs. © 2017 Elsevier Inc. All rights reserved.

Comparison of Shedding Characteristics of Seasonal Influenza Virus (Sub)Types and Influenza A(H1N1)pdm09; Germany, 2007–2011

PubMed Central

Suess, Thorsten; Remschmidt, Cornelius; Schink, Susanne B.; Schweiger, Brunhilde; Heider, Alla; Milde, Jeanette; Nitsche, Andreas; Schroeder, Kati; Doellinger, Joerg; Braun, Christian; Haas, Walter; Krause, Gérard; Buchholz, Udo

2012-01-01

Background Influenza viral shedding studies provide fundamental information for preventive strategies and modelling exercises. We conducted a prospective household study to investigate viral shedding in seasonal and pandemic influenza between 2007 and 2011 in Berlin and Munich, Germany. Methods Study physicians recruited index patients and their household members. Serial nasal specimens were obtained from all household members over at least eight days and tested quantitatively by qRT-PCR for the influenza virus (sub)type of the index patient. A subset of samples was also tested by viral culture. Symptoms were recorded daily. Results We recruited 122 index patients and 320 household contacts, of which 67 became secondary household cases. Among all 189 influenza cases, 12 were infected with seasonal/prepandemic influenza A(H1N1), 19 with A(H3N2), 60 with influenza B, and 98 with A(H1N1)pdm09. Nine (14%) of 65 non-vaccinated secondary cases were asymptomatic/subclinical (0 (0%) of 21 children, 9 (21%) of 44 adults; p = 0.03). Viral load among patients with influenza-like illness (ILI) peaked on illness days 1, 2 or 3 for all (sub)types and declined steadily until days 7–9. Clinical symptom scores roughly paralleled viral shedding dynamics. On the first day prior to symptom onset 30% (12/40) of specimens were positive. Viral load in 6 asymptomatic/subclinical patients was similar to that in ILI-patients. Duration of infectiousness as measured by viral culture lasted approximately until illness days 4–6. Viral load did not seem to be influenced by antiviral therapy, age or vaccination status. Conclusion Asymptomatic/subclinical infections occur infrequently, but may be associated with substantial amounts of viral shedding. Presymptomatic shedding may arise in one third of cases, and shedding characteristics appear to be independent of (seasonal or pandemic) (sub)type, age, antiviral therapy or vaccination; however the power to find moderate differences was limited. PMID:23240050

The volume-outcome relationship and minimum volume standards--empirical evidence for Germany.

PubMed

Hentschker, Corinna; Mennicken, Roman

2015-06-01

For decades, there is an ongoing discussion about the quality of hospital care leading i.a. to the introduction of minimum volume standards in various countries. In this paper, we analyze the volume-outcome relationship for patients with intact abdominal aortic aneurysm and hip fracture. We define hypothetical minimum volume standards in both conditions and assess consequences for access to hospital services in Germany. The results show clearly that patients treated in hospitals with a higher case volume have on average a significant lower probability of death in both conditions. Furthermore, we show that the hypothetical minimum volume standards do not compromise overall access measured with changes in travel times. Copyright © 2014 John Wiley & Sons, Ltd.

Comparing Empirically Historical Awareness in East and West Germany.

ERIC Educational Resources Information Center

Borries, Bodo von; Lehmann, Rainer H.

A study compared the historical awareness of 2,000 East and West German children in the sixth, ninth, and twelfth grades. Because of differing school systems and the general design of the study, researchers analyzed ninth grade data. The study was conducted during the disintegration and reunification of Germany. Students from the two regions…

A historical case of beaten-copper cranium.

PubMed

Rühli, Frank J; Nicklisch, Nicole; Alt, Kurt W

2007-01-01

The authors present the oldest historical case of a so-called beaten-copper cranium. The typical pattern was identified on a skull from a child, probably a boy, who died at approximately 6 years of age and was buried in a provisional cemetery used during the siege of Hanau, Germany, in 1635 and 1636. Morphological and radiological analyses of the severe digitate impressions ubiquitous on the child's endocranium support the diagnosis of chronically elevated intracranial pressure due to hydrocephalus.

[Electroconvulsive therapy in nonconsenting patients].

PubMed

Besse, M; Methfessel, I; Wiltfang, J; Zilles, D

2017-01-01

Electroconvulsive therapy (ECT) is a potent and successful method for the treatment of severe psychiatric disorders. Severe depressive and psychotic disorders may lead to legal incapacity and inability to consent. In Germany, administration of ECT against the patient's will is feasible under certain constellations and is regulated under the terms of the guardianship law. This article outlines the prevalence, effectiveness and tolerability of ECT when applied in nonconsenting patients. Case report and literature review. The literature on ECT as a treatment in nonconsenting patients is relatively sparse. In 2008 the prevalence in Germany was less than 0.5 % of all patients receiving ECT. Case reports and case series suggest a good and equal level of effectiveness when compared to consenting patients. In the course of treatment the majority of patients consented to receive further ECT and retrospectively judged ECT as helpful. The use of ECT is a highly effective treatment in severe psychiatric disorders even when administered as treatment in nonconsenting patients. It can be lifesaving and lead to a rapid improvement of symptoms and relief from severe suffering also from the patients' perspective. Thus, it seems unethical not to consider ECT as a treatment against the nonautonomous will of legally incompetent patients in individual cases. Nevertheless, physicians should always seek to obtain the patients' consent as soon as possible for both legal and ethical reasons.

Kids in Germany: Comparing Students from Different Cultures.

ERIC Educational Resources Information Center

Fitzhugh, William P.

This unit of study, intended for intermediate grade students, focuses on comparing students from different cultures: Germany and the United States. The unit addresses National Social Studies Standards (NCSS) standards; presents an introduction, such as purpose/rationale; cites a recommended grade level; states objectives; provides a time…

An optical investigation of dentinal discoloration due to commonly endodontic sealers, using the transmitted light polarizing microscopy and spectrophotometry.

PubMed

Suciu, Ioana; Ionescu, Ecaterina; Dimitriu, Bogdan Alexandru; Bartok, Ruxandra Ioana; Moldoveanu, Georgiana Florentina; Gheorghiu, Irina Maria; Suciu, Ileana; Ciocîrdel, Mihai

2016-01-01

The aim of this study was to establish the degree of tooth crown staining by commonly used endodontic sealers. Crown discolorations by tooth canal sealers [AH Plus (Dentsply DeTrey Gmbh, Konstanz, Germany); Endofill (Produits Dentaires SA, Vevey, Switzerland); Apexit (Dentsply DeTrey Gmbh, Konstanz, Germany); and MTA Fillapex (Angelus, Londrina, Brazil)] were tested on extracted human premolars. The samples were divided into five groups of five samples each, after root canal sealing. Five teeth were used as control groups. The spectrophotometric method was performed in order to quantify in terms of color change of the coronal part (it was also recorded a track on how the color changes over time). For the microscopic study of the extracted dental specimens subjected to this study, polarized transmitted light microscopy was used. This method involves the development of special microscopic preparations, called "thin sections". In our case, the thin section was performed on 20 prepared and obturated recently extracted teeth. The degree of discoloration was determined after one week and three months using spectrophotometry and polarized light microscopy. All sealers usually cause some degree of discoloration on the cervical aspect of the crowns that increases in time. AH Plus and Endofill caused the greatest discoloration, followed by Apexit and MTA Fillapex.

Introduction of interdisciplinary teaching: two case studies : commentary on "teaching science, technology, and society to engineering students: a sixteen year journey".

PubMed

Spitzer, Hartwig

2013-12-01

Interdisciplinary courses on science, engineering and society have been successfully established in two cases, at Bilkent University, Ankara, Turkey, and at the University of Hamburg, Germany. In both cases there were institutional and perceptual barriers that had to be overcome in the primarily disciplinary departments. The ingredients of success included a clear vision of interdisciplinary themes and didactics, and the exploitation of institutional opportunities. Haldun M. Ozaktas in Ankara used the dynamics of an accreditation process to establish courses on engineering and society. At the University of Hamburg the introduction of optional courses into all curricula allowed for the establishment of a seminar series on physics and society, as well as on peace education and peace building. Both of these approaches have a weakness in common: the courses can disappear once their initiators have left, unless the interdisciplinary themes are integrated into compulsory core curricula.

[Surgical research in Germany. Organization, quality and international competitiveness].

PubMed

Menger, M D; Laschke, M W

2012-04-01

Surgical research in Germany is performed within surgical clinics by individual working groups or in surgical research divisions. Additionally, a few independent institutes and departments of surgical research have been established at medical faculties. The number of these institutions, however, is too small. To increase productivity in surgical research, structural changes are necessary, including additional establishment of further institutes and professorships. The quality of clinical research in surgery in Germany is critically discussed. International comparison shows that Germany has a low ranking with respect to the number of clinical studies published in leading surgical journals. However, there has been some improvement in the quality of clinical studies performed in surgical departments during the last 15 years. The establishment of the study center of the German Society of Surgery shows that excellent clinical studies with adequate numbers of patients can also be performed in Germany and can be published in leading journals. Accordingly, there is need to distribute the structures and the competence necessary to perform clinical studies in a standardized manner to all surgical departments involved in clinical research. The experimental surgical research in Germany is not adequately visible, although over the last 10 years the most relevant publications from institutions for surgical research have been placed in journals with a mean impact factor of 8. This may be due to the fact that 85% of these top publications are published in non-surgical journals. The aim for the future must therefore be to increase the impact factor and, thus, the attractiveness of surgical journals. This may be achieved by publishing the highest quality results from experimental surgical research not in non-surgical but in surgical journals.

Monitoring the Urban Tree Cover for Urban Ecosystem Services - The Case of Leipzig, Germany

NASA Astrophysics Data System (ADS)

Banzhaf, E.; Kollai, H.

2015-04-01

Urban dynamics such as (extreme) growth and shrinkage bring about fundamental challenges for urban land use and related changes. In order to achieve a sustainable urban development, it is crucial to monitor urban green infrastructure at microscale level as it provides various urban ecosystem services in neighbourhoods, supporting quality of life and environmental health. We monitor urban trees by means of a multiple data set to get a detailed knowledge on its distribution and change over a decade for the entire city. We have digital orthophotos, a digital elevation model and a digital surface model. The refined knowledge on the absolute height above ground helps to differentiate tree tops. Grounded on an object-based image analysis scheme a detailed mapping of trees in an urbanized environment is processed. Results show high accuracy of tree detection and avoidance of misclassification due to shadows. The study area is the City of Leipzig, Germany. One of the leading German cities, it is home to contiguous community allotments that characterize the configuration of the city. Leipzig has one of the most well-preserved floodplain forests in Europe.

Determination of soil erosion in a steep hill slope with different land-use types: a case study in Mertesdorf (Ruwertal/Germany).

PubMed

Hacisalihoglu, Sezgin

2007-04-01

Inappropriate land use is one of the main reasons for soil erosion and land degradation. Vine growing plays an important role in many semiarid regions all over the world as a permanent plant cover in terms of preventing erosion, sustainable use of land and water resources, defense against desertification and settling population in rural areas. In this paper, in a steep hill slope of the village Mertesdorf (Ruwertal/Germany), Algemeine boden abtrags gleichung (ABAG) have been applied to determine and compare the soil erosion amounts between the different land use types such as vine growing, forest lands, grasslands, shrubs and new forestations. The results show that the soil erosion amounts differs in a high ratio between the land use types. Soil erosion amounts in the vine growing areas are the highest (6.47 t/ha/year), then comes with 1.19 t/ha/year the over grazed grasslands and the lowest erosion amounts have been determined, as expected, in the forest lands (0.66 t/ha/year).

Winning Bodies and Souls: State Building and the Necessity of Nationalism

DTIC Science & Technology

2008-12-01

the citizens that live within its territory. The RAND study, America’s Role in Nation Building: from Germany to Iraq, nicely encapsulates the...neglect of nationalism in the theory and practice of the state building when it blithely observes that:   What principally distinguishes Germany , Japan...Nation Building: From Germany to Iraq (Santa Monica: RAND, 2003), xix. 6 This argument views nation-building projects as primarily the result of what

Active Labour Market Policy and Gender Mainstreaming in Germany: Gender-Specific Aspects of Participation and Destination in Selected Instruments of the Federal Employment Service. IAB Labour Market Research Topics.

ERIC Educational Resources Information Center

Muller, Petra; Kurtz, Beate

The equality of the opportunities available to males and females in Germany's labor market was examined. The study compared employment patterns among women and men and the extent to which selected discretionary benefits of Germany's Federal Employment Service benefit women and men. Selected results were as follows: (1) women are under-represented…

Product Failures in Respirators and Consumables: Analysis of Field Safety Notices of 2005-2013 Publicized by the Federal Institute for Drugs and Medical Devices in Germany.

PubMed

Hannig, Jürgen; Siekmeier, Rüdiger

2015-01-01

The current European system governed by the three EC directives 93/42/EEC (Medical Device Directive), 98/79/EC (In-Vitro Diagnostic Directive) and 90/385/EEC (Active Implantable Medical Device Directive) regulates marketing and post-market surveillance of medical devices in the European Economic Area (EEA). In cases of incidents raising the field safety corrective actions (FSCA), manufacturers have to inform the responsible Competent Authority (CA; in Germany this is the Federal Institute for Drugs and Medical Devices, BfArM) and the public by field safety notices (FSN). In this study we analyzed FSN of respirators and consumables directly required for their function, whereas devices for anesthesia and gas delivery were excluded. FSCA and FSN of 2005-2013 publicized by BfArM for the included products were analyzed with respect to the MEDDEV 2.12-1 rev. 8. In total, 60 FSCA were publicized. German and English FSN were found in 59/53 cases, respectively. FSN were clearly characterized as FSN in 44/38 cases and declaration of the type of action in 45/44 cases, respectively. Product names were provided in all cases. Lot numbers or other information for product characterization were available in 7/7 and 43/40 cases, respectively. Detailed information regarding FSCA and product malfunction was found in all cases. Information on product related risks with previous use of affected devices was provided in 42/38 cases. In 53/53 cases manufacturers provided information to mitigate product related risks. Requests to pass FSN to persons needing awareness in the organization were found in 27/24 cases. Contact data were provided in 53/48 cases, respectively. Confirmation that a CA was informed was found in 28/26 cases and in 19/15 cases a customer confirmation was included. The identified risks were: total loss of function (19/16), short circuit (1/1) and burn (3/3), and inhalation of foreign particles (1/1) which might cause severe risk to patients and users. The most frequent FSCA were product modifications and customer information. The data suggest that there is an annually increasing number of FSCA on devices included in our study. Most FSN fulfill the criteria of MEDDEV 2.12-1 rev. 8. However, there are differences between German and English FSN, e.g., regarding the distribution to persons needing awareness, missing statement that a CA was informed, and missing customer confirmation. Due to the importance of FSN for reduction of product related risks in FSCA, the type and content of FSN should be further improved.

[Assessing incident cardiovascular and metabolic diseases in epidemiological cohort studies in Germany].

PubMed

Herrmann, Wolfram J; Weikert, Cornelia; Bergmann, Manuela; Boeing, Heiner; Katzke, Verena A; Kaaks, Rudolf; Tiller, Daniel; Greiser, Karin Halina; Heier, Margit; Meisinger, Christa; Schmidt, Carsten Oliver; Neuhauser, Hannelore; Heidemann, Christin; Jünger, Claus; Wild, Philipp S; Schramm, Sara Helena; Jöckel, Karl-Heinz; Dörr, Marcus; Pischon, Tobias

2018-04-01

Cardiovascular and metabolic diseases are a major cause of mortality and loss of quality of life in Germany. Research into risk factors of these diseases requires large population-based cohort studies. Complete and accurate assessment of the incidence of cardiovascular and metabolic diseases is a key element for valid interpretation of the results from such studies. Our aim was to identify population-based cohort studies with incidence of cardiovascular and metabolic diseases in Germany and to summarize their methods for assessment and classification of disease endpoints, including myocardial infarction, type 2 diabetes, stroke, heart failure, and arterial hypertension. Within the framework of a workshop, representatives of the ascertained population-based cohort studies in Germany with incidence of cardiovascular or metabolic diseases were invited to present and to systematically provide information on their methods of endpoint identification. We identified eight studies from different regions in Germany with a total of 100,571 participants, aged 18-83 years at baseline. Self-reporting by study participants is the major source for further inquiries to assess disease endpoints in these studies. Most studies use additional data sources to verify the incidence of diseases, such as documents provided by the treating physician or hospital. Our results highlight the central role of self-reporting and the efforts associated with identification and verification of disease endpoints in cohort studies. They also provide a basis for future population-based studies that aim for standardized assessment of the incidence of cardiovascular and metabolic diseases.

Laparoscopy for bowel obstruction--a contradiction? Results of a multi-institutional survey in Germany.

PubMed

Zimmermann, M; Hoffmann, M; Laubert, T; Bruch, H P; Keck, T; Benecke, C; Schlöricke, E

2016-05-01

The purpose of the present study was to investigate on the acceptance and frequency of laparoscopic surgery for the management of acute and chronic bowel obstruction in a general patient population in German hospitals. To receive an authoritative opinion on laparoscopic treatment of bowel obstruction in Germany, a cross-sectional online study was conducted. We designed an online-based survey, supported by the German College of Surgeons (Berufsverband der Deutschen Chirurgen, BDC) to get multi-institutional-based data from various level providers of patient care. Between January and February 2014, we received completed questionnaires from 235 individuals (16.7 %). The participating surgeons were a representative sample of German hospitals with regard to hospital size, level of center size, and localization. A total of 74.9 % (n = 176) of all responders stated to use laparoscopy as the initial step of exploration in expected bowel obstruction. This procedure was highly statistically associated with the frequency of overall laparoscopic interventions and laparoscopic experience. The overall conversion rate was reported to be 29.4 %. This survey, investigating on the use of laparoscopic exploration or interventions in bowel obstruction, was able to show that by now, a majority of the responding surgeons accept laparoscopy as an initial step for exploration of the abdomen in the case of bowel obstruction. Laparoscopy was considered to be at least comparable to open surgery in an emergency setting. Furthermore, data analysis demonstrated generally accepted advantages and disadvantages of the laparoscopic approach. Indications for or against laparoscopy are made after careful consideration in each individual case.

The Desirability of Medieval Germany: Some Observations on an Introductory Course

ERIC Educational Resources Information Center

Jillings, Lewis G.; Murdoch, Brian O.

1975-01-01

This paper discusses the problems and advantages of a course in Medieval Germany, including history, culture and literature along with language. Attention is given to issues and texts to be studied. (CHK)

Geochemical characteristics of peat from two raised bogs of Germany

NASA Astrophysics Data System (ADS)

Mezhibor, A. M.

2016-11-01

Peat has a wide range of applications in different spheres of human activity, and this is a reason for a comprehensive study. This research represents the results of an ICP-MS study of moss and peat samples from two raised bogs of Germany. Because of the wide use of sphagnum moss and peat, determining their geochemical characteristics is an important issue. According to the results obtained, we can resume that the moss samples from Germany are rich in Cu, As, Y, Zr, Nb, and REE. The geochemical composition of the bogs reflects the regional environmental features and anthropogenic influence.

Improving Intercultural Education at Chinese Institutions from German Experience

ERIC Educational Resources Information Center

Huang, Lihe

2015-01-01

In this reflection paper, Lihe Huang describes his experience studying abroad in Germany as a visiting scholar. Through the well-designed introductory seminar and study tour arranged by the Alexander von Humboldt Foundation, which provided the grant for Huang's research on foreign languages teaching and intercultural education in Germany, he…

Motivation for Academically Gifted Students in Germany and the United States: A Phenomenological Study

ERIC Educational Resources Information Center

Bourgeois, Steven James

2012-01-01

Recent trends toward globalization have engendered interest in comparative educational systems, pointing toward more fundamental change beyond the current focus upon accountability measures. This phenomenological study considered the effect of extrinsic motivators on the intrinsic motivation of academically gifted students in Germany and the…