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Objective. To sort out the literature related to conjunctival bacteria and summarize research hotspots and trends of this field. Materials and Methods. The relevant literature data from 1900 to 2019 was retrieved from the Web of Science Core Collection database. After manual selection, each document record includes title, author, keywords, abstract, year, organization, and citation. We imported the downloaded data into CiteSpace V (version 5.5R2) to draw the knowledge map and conduct cooperative network analysis, discipline and journal analysis, cluster analysis, and burst keyword analysis. Results. After manual screening, there were 285 relevant papers published in the last 28 years (from 1991 to 2019), and the number is increasing year by year. The publications of conjunctival bacteria were dedicated by 1381 authors of 451 institutions in 56 countries/regions. The United States dominates this field (82 literatures), followed by Germany (23 literatures) and Japan (23 literatures). Overall, most cited papers were published with a focus on molecular biology, genetics, nursing, and toxicology. Most papers fall into the category of ophthalmology, veterinary sciences, and pharmacology and pharmacy. The only organized cluster is the "postantibiotic effect," and the top 5 keywords with the strongest citation bursts include "postoperative endophthalmiti(s)," "infectious keratoconjunctiviti(s)," "conjunctiviti(s)," "resistance," and "diversity". Conclusion. The global field of conjunctival bacteria has expanded in the last 28 years. The United States contributes most. However, there are little cooperation among authors and institutions. Overall, this bibliometric study organized one cluster, "postantibiotic effect", and identified the top 5 hotspots in conjunctival bacteria research: "postoperative endophthalmiti(s)," "infectious keratoconjunctiviti(s)," "conjunctiviti(s)," "resistance," and "diversity". Thus, further research focuses on these topics that may be more helpful to prevent ocular infection and improve prophylaxis strategies to bring a benefit to patients in the near future. [ABSTRACT FROM AUTHOR]

Ageing well has been associated with the responsibility to age actively, successfully, or healthily in public and research discourses. This connection of individual responsibility with ageing has been criticised in Social Gerontology for neglecting the access to social, economic, and health resources. This paper investigates (individual) responsibility, informal support, and public initiatives in discourses on older immigrants in Germany. The research framework employs a sociology of knowledge approach to discourse, which guided the discourse analysis of German policy reports, guidelines and handbooks on ageing and migration from 2000 to 2019 (43 documents in total). The results reveal that besides public initiatives concerning long-term care, health promotion, and social services, informal solutions through social networks are frequently emphasised in the data. The focus, thereby, is on long-term care, which is presented as a responsibility of the extended family. Thus, resources are situated in the family, social networks, and ethnic group, which should be opened and connected with public services; however, the focus is shifting from older immigrants towards local municipalities. This study provides a discourse perspective on the construction of resources and challenges for older immigrants concerning health, care, and social services and offers an assessment of the cultural and integrating/excluding qualities in active ageing discourses. [ABSTRACT FROM AUTHOR]

Background and Objective. Research has shown that children's motor performance (MP) and body composition (BC) are positively related to health and influence physical activity across the lifespan. As an intervention for improving MP and BC in childhood, engagement in a sports club (SC) is an important key strategy. Therefore, the aim of the study is to examine the stability of MP and BC and their associations with SC participation. Methods. MP and BC of 295 children (161 girls) with a mean age of 8.42 ± 0.36 years were measured annually with the German Motor Test 6‐18. Based on self‐reports, children were divided into three groups according to consistent (CON), partial (PAR), and nonparticipation (NO) in SC. NO and PAR were then combined into NO‐PAR. The stability of MP and BC was determined using Pearson's correlation coefficient (r). Associations of SC participation, MP, and BC were examined using robust mixed‐model ANOVA (mmANOVA) additionally with first grade as covariate (ANCOVA). Results. More girls (39%) than boys (25%) were classified in PAR. The stability of MP (r =.755) and BMI (r =.889) was moderately high. Children in CON (r =.847) showed lower stability in BMI than NO‐PAR (r =.923). mmANOVA revealed better overall MP for both sexes in CON except for balance and BMI. Boys in CON showed better performance in flexibility, endurance, and speed than NO‐PAR. ANCOVA confirmed unadjusted results for boys. Conclusion. Lower stability of BMI due to CON indicates a greater variance in ranking and thus the chance to adjust weight management in childhood. Girls' MP benefited less from SC participation, which may be due to their more frequent rates in PAR. Therefore, interventions to increase engagement in SC should focus on a stepwise approach from none to partial and finally to long‐term participation. [ABSTRACT FROM AUTHOR]

Membrane-bound angiotensin-converting enzyme 2 (ACE2) receptor acts as the entry point for the novel coronavirus, SARS-CoV-2. Polymorphisms in the ACE2 gene may alter viral binding, regulate the expression of ACE2, and thus, affect disease severity. In this study, 68 COVID-19 patients with varying degrees of severity and 40 healthy controls were enrolled. The genetic landscape of the ACE2 gene was explored by whole exome sequencing of 29 individuals, and specific regions of ACE2 were analyzed for the rest of the participants via PCR, followed by barcode-tagged sequencing. The mean soluble ACE2 level in the plasma of healthy controls and patients did not vary significantly but was higher in the patient group (3.77 ± 1.55 ng/mL vs. 3.94 ± 1.42 ng/mL). Analysis of exon 1, exon 2, and exon 8 of the ACE2 gene revealed that these regions are highly conserved in our population. Investigation of exon 11 and its flanking intronic region revealed that deletions in a stretch of 18T nucleotides in the noncoding region significantly decrease ACE2 levels in plasma, as individuals harboring wild-type variants had higher plasma ACE2 levels compared to those harboring T1del, T2del, and T3del variants. However, the intronic variants were not found to be significantly associated with disease severity. [ABSTRACT FROM AUTHOR]

Inactivity and an unhealthy diet amongst others have led to an increased prevalence of overweight and obesity even in young children. Since most health behaviours develop during childhood health promotion has to start early. The setting kindergarten has been shown as ideal for such interventions. “Join the Healthy Boat” is a kindergarten-based health promotion programme with a cluster-randomised study focussing on increased physical activity, reduced screen media use, and sugar-sweetened beverages, as well as a higher fruit and vegetable intake. Intervention and materials were developed using Bartholomew’s Intervention Mapping approach considering Bandura’s social-cognitive theory and Bronfenbrenner’s ecological framework for human development. The programme is distributed using a train-the-trainer approach and currently implemented in 618 kindergartens. The effectiveness of this one-year intervention with an intervention and a control group will be examined in 62 kindergartens using standardised protocols, materials, and tools for outcome and process evaluation. A sample of 1021 children and their parents provided consent and participated in the intervention. Results of this study are awaited to give a better understanding of health behaviours in early childhood and to identify strategies for effective health promotion. The current paper describes development and design of the intervention and its implementation and planned evaluation. Trial Registration. The study is registered at the German Clinical Trials Register (DRKS), Freiburg University, Germany, ID: DRKS00010089. [ABSTRACT FROM AUTHOR]

Introduction. Managing polypharmacy is particularly demanding for general practitioners as coordinators of care. Recently, a German guideline for polypharmacy in primary care has been published. This paper describes the content and delivery of a tailored intervention, which aims at improving the implementation of guideline recommendations for polypharmacy into practice, considering individual barriers. Materials and Methods. Firstly, barriers for implementation and the corresponding strategies to address them have been identified. On this basis, an intervention consisting of a workshop for health care professionals and educational materials for patients has been developed. The workshop focused on knowledge, awareness, and skills. The educational materials included a tablet computer. Practice teams will elaborate individual concepts of how to implement the recommendations into their practice. The workshop has been evaluated by the participants by means of a questionnaire. Results. During the workshop 41 possible sources of medication errors and 41 strategies to improve medication management have been identified. Participants evaluated the workshop overall positively, certifying its relevancy to practice. Discussion. The concept of the workshop seemed appropriate to impart knowledge about medication management to the participants. It will have to be evaluated, if the intervention finally resulted in an improved implementation of the guideline recommendations. [ABSTRACT FROM AUTHOR]

Background. LACC trial demonstrated inferiority of laparoscopic approach for the treatment of early-stage cervical cancer. There are still limited data from retrospective trials regarding whether survival outcomes after laparoscopic radical hysterectomy are equivalent to those after open abdominal radical hysterectomy. In this study, we present results of combined vaginal radical laparoscopic hysterectomy in the treatment of early-stage cervical cancer. Methods. This retrospective study was carried out at the Department of Gynecology in Mathilden Hospital (Herford, Germany). Between January 2008 and April 2018, all the patients with invasive cervical cancer who underwent combined vaginal assisted radical laparoscopic hysterectomy (VARLH) without the use of any uterine manipulator were enrolled to the study. Results. A total number of 124 patients with diagnosis of invasive cervical cancer were enrolled in the study. All of the patients underwent minimally invasive surgery and were divided according to FIGO 2019: stage IA (25.9%), IB1 (25.0%), IB2-IIB (28.4%), and III/IV (20.7%). Overall, the mean age of the patients was 51.84 years. After a study collection, a median follow-up was 45.6 (range 23.7-76.5) months. The 3- and 5-year disease-free survival rates for early-stage cervical cancer were both 98%, and the 3- and 5-year overall survival rates were 100% and 97%, respectively. We have not observed any recurrence in our study group of patients with early-stage cervical cancer. Conclusions. Combined VARLH can be considered a safe and effective procedure for the treatment of early-stage cervical cancer. Surgical strategy with oncological principles determines the quality and long-term success of the operation in early cervical cancer regardless of laparoscopic approach. [ABSTRACT FROM AUTHOR]

Introduction. Equity in health is an essential issue and it would appear that it is not guaranteed for all human beings, especially refugee groups. The aim of this qualitative descriptive study was to explore the experiences of refugees, health care professionals, and administrators of refugee health care in a host country. Methods. The study used qualitative methods which consisted of a convenience sample of stakeholders directly and indirectly involved in care for refugees and refugees themselves. The study participants were located in a rural area in the federal state of Schleswig-Holstein, Germany. Focus groups and interviews were conducted with 25 participants. A semistructured interview guideline was used for the focus groups and interviews. The data were evaluated using qualitative content analysis. Results. Four main categories were identified which are important for equity in health care: legal aspects, sociocultural aspects, environmental aspects, and communication aspects. Legal frameworks and language barriers were perceived as strong barriers for accessing health care. Conclusions. The findings suggest that the host countries should address the specific needs of this population group at a systemic and individual level. Based on the views of the participants interviewed it can be concluded that the refugee population group is particularly affected by limited access to health care services. Bureaucratic barriers, unfamiliarity with a new health system, and language issues all contribute to limiting access to health care services. [ABSTRACT FROM AUTHOR]

Objective. The suitability of self-ratings and observer ratings within organisational management approaches is controversial. The aim of this study was to compare the degree of agreement between self-rated and observer-rated occupational psychosocial demands. The comparison took place within a work-activity and not worker-centred assessment, according to official policies for psychosocial risk assessment. Through simultaneous application of two versions of the same instrument, we aimed to reduce the rating bias to a minimum demonstrating the suitability of self-ratings and observer ratings in companies of all kinds. Methods. A multimethod online assessment of 22 different work activities was conducted in Germany from October 2016 to October 2017. Workers (self-ratings) and occupational safety and health (OSH) committees (observer ratings) rated the occupational psychosocial risks of each activity with the same instrument (N = 669). The instrument measured psychosocial risk conditions at work. Reliability and agreement indices were computed. Results. The within-group agreement (WGA; rwg,mean =  .42) of the workers' self-ratings was good for each psychosocial risk and the interrater reliability (IRR) was excellent on average (ICC 2 =  .77) with a medium effect size of ICC 1 =  .15. The interrater agreement (IRA) between the two groups varied across the activities depending on rating group and activity composition (from ICCunjust,mean =  .39 to ICCunjust,mean =  .86) but was good to excellent on average (ICCunjust,mean =  .71). Conclusion. The reasonable agreement and excellent reliability in workers' self-ratings justify aggregation of item means at the group level. Furthermore, if the work activities are homogenous and the committee consists of members from different OSH specialties, observer ratings and self-ratings provide comparable results. According to this study's results, both methods are reliable assessment strategies in the context of psychosocial risk assessment. The observer rating approach is especially suitable for small-to-medium enterprises that do not have access to a large anonymous survey assessment. [ABSTRACT FROM AUTHOR]

Integrated strategies of health promotion at the municipal level are receiving particular attention in public health policy and practice in Germany. These strategies are intended to provide a coordinated approach to health promotion during the entire lifespan, with a particular focus on vulnerable communities. They are also intended to be participatory in both their design and implementation, involving all sectors of the social welfare, educational and healthcare systems, civil society, and the general public. PartKommPlus—German Research Consortium for Healthy Communities is examining such strategies using participatory forms of research. The goal is to determine how participation can best be planned and implemented and what effects this participation has. In this article the work of PartKommPlus from the first funding phase (2015–2018) will be described with particular attention to the lessons learned and the forms of impact which are being considered as part of the participatory research process. [ABSTRACT FROM AUTHOR]

Objective. The aim of this study is to measure the motor development and tracking of physical fitness (PF) components of primary school children of Trier in Germany. Methods. Two longitudinal cohorts, of 1768 children (915 f, 853 m) aged 5–11, were measured. In longitudinal cohort 1, a total of 116 female and 137 male participants aged 6.80±0.42 years at baseline were measured four times from grade 1 to grade 4 (response: 40.4%). Participants of longitudinal cohort 2 (166 f, 149 m; 6.70±0.36 years at baseline, response: 42.6%) were examined three times from grade 1 to grade 3 with the German Motor Test 6–18 (DMT 6–18). Results. Physical fitness increased significantly over time in all test tasks except flexibility. Gender-specific differences were found in 20 m sprint, 6-minute run, balancing backwards, jumping sideways, and stand and reach. 74.4% of PF stability coefficients were moderate (r=0.30 to 0.60). Stability of PF declined with increased time frames. Tracking was lower in girls than in boys. Flexibility showed the highest stability among PF variables (r > 0.50). BMI showed the overall highest stability coefficient with r > 0.7. Conclusions. Gender-specific differences of PF were obvious but cannot always be secured statistically in primary school. Tracking was only moderate. Variability in the timing and speed of the adolescent growth spurt and sexual maturation influence stability of PF. Results from longitudinal cohort 2 largely confirm those from longitudinal cohort 1. [ABSTRACT FROM AUTHOR]

We compared the cost-utility analysis for edoxaban at both doses with that of dabigatran at both doses, rivaroxaban, and apixaban (non vitamin K antagonist oral anticoagulants, NOAC) in a German population. Data of clinical outcome events were taken from edoxaban’s ENGAGE-AF, dabigatran’s RE-LY, rivaroxaban’s ROCKET, and apixaban’s ARISTOTLE trials. The base-case analyses of a 65-year-old person with a CHADS2 score >1 gained 0.17 and 0.21 quality-adjusted life years over warfarin for 30 mg od and 60 mg od edoxaban, respectively. The incremental cost-effectiveness ratio was 50.000 and 68.000 euro per quality-adjusted life years for the higher and lower dose of edoxaban (Monte Carlo simulation). These findings were also similar to those for apixaban and more cost-effective than the other NOAC regimens. The current market costs for direct oral anticoagulants are high in relation to the quality of life gained from a German public health care insurance perspective. The willingness-to-pay threshold was lowest for 60 mg edoxaban compared to all direct oral anticoagulants and for 30 mg edoxaban compared to dabigatran and rivaroxaban. [ABSTRACT FROM AUTHOR]