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Whilst the link between young people's well‐being and the creative arts is strengthening, there is a lack of research which focuses on the roles that artists play to help teachers and parents engage young people in the creative arts. This paper explores the benefits of and barriers to artists working in education in six European countries (England, Iceland, Germany, Greece, Italy and Austria). Using the '5A's model of creativity' and a view of professional development taking place within 'landscapes of practice', the data were analysed in order to explain how creativity is operationalised in the different contexts. Our study highlights the need for policy at a national and transnational level to value the creative arts in order to help teachers cross boundaries and utilise the full potential of the creative arts in schools. Our study also highlights that further research is needed into how artists shape teaching and curriculum and how schools engage parents in the creative arts in order to build an evidence‐base relating to young people's positive mental health that can affect policy at these levels. [ABSTRACT FROM AUTHOR]

In Germany and continental Europe, more broadly, race and ethnicity are concepts that are not widely used and are increasingly erased from the legislation. Nevertheless, race and ethnicity are still used as social markers and often merely replaced with other terms (e.g., cultural background). The goal of this paper is threefold. First, we point to the danger of treating race and ethnicity as essentialist categories, which is still common in developmental science research. Second, we want to outline specific problems that occur when doing research on ethnicity and race with children and adolescents in the European race‐mute context. Third, we suggest that future research ought to focus more on constructions of Whiteness and reproduction of power differences among ethnic majority populations. In doing so, we draw on examples from our own research on ethnic‐racial identity and ethnic‐racial socialization. [ABSTRACT FROM AUTHOR]

Abstract: This paper explores practical and ethical dilemmas for professionals when securing the protection of children in the complex non‐clinical setting of individual families. It is based on a cross‐country study on cultural encounters in interventions against child physical abuse and neglect in four countries (England/Wales, Germany, Portugal, and Slovenia). Drawing on national reports of legal‐organizational frameworks and socio‐cultural backgrounds of European child protection systems, it also presents the results of a series of focus groups with professionals. Data were analysed to identify implicit and explicit discursive constructions as well as normative representations and from this deriving the key ethical issues and dilemmas. Despite a shared normative framework across Europe, intervention cultures vary across the four countries and between the different stakeholder groups. Although each child protection system faced widespread mistrust, policy approaches differ, some relying on strong and detailed guidance whereas others stress professional skill and judgement. We conclude that despite a shared commitment to the protection of children, deliberations and perceived ethical dilemmas suggest interdependency between differences in system cultures and policy approaches that inform the character of professional interventions in the four countries. [ABSTRACT FROM AUTHOR]

Aim: To investigate nursing/midwifery students, Clinical Mentors, Link Teachers and Head Nurses experiences within "Dedicated Education Unit" model in 6 European clinical placements and analyse the necessary elements for a powerful clinical learning environment. Design: A multi‐country, phenomenological, qualitative study. Methods: Focus group interviews were performed to identify the personal and organizational factors of importance for students and nurses/midwives. Results: Data analysis produced 4 main themes (1) Clinical placement organization, (2) students' clinical knowledge and skill acquisition, (3) students, and nurses/midwives' experiences within the DEU model and (4) factors for creating an effective learning environment. Conclusions: A close educational‐service collaboration, a realistic clinical placement planning, a focus on student learning process and an investment in professionals' education and development among others, are elements to set up a powerful clinical learning environment. Implications for the profession: It is considered advisable and urgent to improve the working conditions of nurses/midwives and the learning environments of students as a strategy to alleviate the global shortage of nurses and respond to the increasingly demanding health needs of the population. Impact: Due to the close relationship between students' learning and features of the clinical environment nurse educators seek innovative models which allow students to manage patient care and their transition to professional practice. To implement new learning strategies, identifying students, nurses and midwives perceptions and suggestions is a powerful information to evaluate implementation process and outcomes. Public Contribution: Our findings could help academic and clinical managers to meet the human and organizational requirements to create a successful learning environment in every student placement. [ABSTRACT FROM AUTHOR]

Background: There is considerable public and political interest in the use of cannabis products for medical purposes.Methods: The task force of the European Pain Federation (EFIC) conducted a survey with its national chapters representatives on the status of approval of all types of cannabis-based medicines, the covering of costs and the availability of a position paper of a national medical association on the use of medical cannabis for chronic pain and for symptom control in palliative/supportive care.Results: Thirty-one out of 37 contacted councillors responded. Plant-derived tetrahydrocannabinol/cannabidiol (THC/CBD) oromucosal spray is approved for spasticity in multiple sclerosis refractory to conventional treatment in 21 EFIC chapters. Plant-derived THC (dronabinol) is approved for some palliative care conditions in four EFIC chapters. Synthetic THC analogue (nabilone) is approved for chemotherapy-associated nausea and vomiting refractory to conventional treatment in four EFIC chapters'. Eight EFIC chapters' countries have an exceptional and six chapters an expanded access programme for medical cannabis. German and Israeli pain societies recommend the use of cannabis-based medicines as third-line drug therapies for chronic pain within a multicomponent approach. Conversely, the German medical association and a team of finish experts and officials do not recommend the prescription of medical cannabis due to the lack of high-quality evidence of efficacy and the potential harms.Conclusions: There are marked differences between the countries represented in EFIC in the approval and availability of cannabis-based products for medical use. EFIC countries are encouraged to collaborate with the European Medicines Agency to publish a common document on cannabis-based medicines.Significance: There are striking differences between European countries in the availability of plant-derived and synthetic cannabinoids and of medical cannabis for pain management and for symptom control in palliative care and in the covering of costs by health insurance companies or state social security systems. [ABSTRACT FROM AUTHOR]

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Aim: The aim of the study was to test the psychometric properties of the Facilitative Student–Patient Relationship (FSPR) Scale in clinical practicum in hospital settings within six European countries. Design: A multi‐country, cross‐sectional survey design was applied. Methods: A convenience sample of graduating nursing students (N = 1,796) completed the FSPR Scale. Psychometric testing was carried out through explorative factor analysis and confirmatory factor analysis. Internal consistency was assessed using Cronbach's alpha. Results: Both validity and reliability of the scale were confirmed. The explorative factor analysis yielded a two‐factor construct explaining 47.7% of the total variance, identifying two sub‐scales: caring relationship and learning relationship. Confirmatory factor analysis confirmed the two‐factor structure. The Cronbach alpha coefficients (0.8–0.9) indicated acceptable reliability of the scale. [ABSTRACT FROM AUTHOR]

Background: The effectiveness of allergen immunotherapy (AIT) in seasonal and perennial allergic rhinitis (AR) depends on the definition of pollen exposure intensity or time period. We recently evaluated pollen and symptom data from Germany to examine the new definitions of the European Academy of Allergy and Clinical Immunology (EAACI) on pollen season and peak pollen period start and end. Now, we aim to confirm the feasibility of these definitions to properly mirror symptom loads for grass and birch pollen-induced allergic rhinitis in other European geographical areas such as Austria, Finland and France, and therefore their suitability for AIT and clinical practice support., Methods: Data from twenty-three pollen monitoring stations from three countries in Europe and for 3 years (2014-2016) were used to investigate the correlation between birch and grass pollen concentrations during the birch and grass pollen season defined via the EAACI criteria, and total nasal symptom and medication scores as reported with the aid of the patient's hay-fever diary (PHD). In addition, we conducted a statistical analysis, together with a graphical investigation, to reveal correlations and dependencies between the studied parameters., Results: The analysis demonstrated that the definitions of pollen season as well as peak pollen period start and end as proposed by the EAACI are correlated to pollen-induced symptom loads reported by PHD users during birch and grass pollen season. A statistically significant correlation (slightly higher for birch) has been found between the Total Nasal Symptom and Medication Score (TNSMS) and the pollen concentration levels. Moreover, the maximum symptom levels occurred mostly within the peak pollen periods (PPP) following the EAACI criteria., Conclusions: Based on our analyses, we confirm the validity of the EAACI definitions on pollen season for both birch and grass and for a variety of geographical locations for the four European countries (including Germany from a previous publication) analyzed so far. On this basis, the use of the EAACI definitions is supported in future clinical trials on AIT as well as in daily routine for optimal patient care. Further evaluation of the EAACI criteria in other European regions is recommended., (© 2019 The Authors. Allergy published by John Wiley & Sons Ltd.)

Aim: This study aimed to identify the factors influencing the changes in the number of teeth present and the number of healthy or filled surfaces between two time points. Materials and Methods: Repeated cross‐sectional data from population‐based studies, namely the German Oral Health Studies (DMS‐III vs. DMS‐V), the Studies of Health in Pomerania (SHIP‐START‐0 vs. SHIP‐TREND‐0), and the Jönköping study (2003 vs. 2013), were analysed. Oaxaca decomposition models were constructed for the outcomes (number of teeth, number of healthy surfaces, and number of filled surfaces). Results: The number of teeth increased between examinations (DMS: +2.26 [adults], +4.92 [seniors], SHIP: +1.67, Jönköping: +0.96). Improvements in education and dental awareness brought a positive change in all outcomes. An increase in powered toothbrushing and inter‐dental cleaning had a great impact in DMS (adults: +0.25 tooth, +0.78 healthy surface, +0.38 filled surface; seniors: +1.19 teeth, 5.79 healthy surfaces, +0.48 filled surface). Inter‐dental cleaning decreased by 4% between SHIP‐START‐0 and SHIP‐TREND‐0, which negatively affected the outcomes. Conclusions: From this study, it can be concluded that education may be the most important factor having a direct and indirect effect on the outcomes. However, for better oral health, powered toothbrushing and inter‐dental cleaning should not be neglected. [ABSTRACT FROM AUTHOR]

Many researchers and practitioners consider ethnic segregation in neighbourhoods or schools detrimental to migrants' acculturation in host societies. Empirically, however, segregation is a 'mixed bag' and its effects depend crucially on the investigated acculturation domain (e.g., negative for language skills, positive for well‐being). As most prior studies have focused on a restricted spectrum of acculturation, a comprehensive assessment within one single study is needed to establish comparability across different acculturation domains. Among over 8000 immigrant‐background students from four countries, we investigated the association of classroom segregation, defined as opportunities for contact with natives and other migrants, with a broad spectrum of acculturation (academic, attitude‐related, identity‐related, social, health‐related, and psychological criteria). Some findings were consistent (e.g., academic acculturation), some were contrary to prior research (e.g., social acculturation). In sum, our results shed light on the 'mixed bag' of segregation and contribute to the understanding of a crucial social issue. [ABSTRACT FROM AUTHOR]

Cross‐country migration in Europe can have multiple advantages. Among others, it can function as a buffer against economic downturns that come along with inferior employment and education opportunities, especially for young adults. However, cross‐country mobility of young adults in Europe remains low, as language barriers, the loss of social ties or cultural differences create obstacles for migration. Against this background, Germany has launched a mobility assistance programme that supports young adults from EU member states who wish to enter the dual education system in Germany. To assess the causal impact of this programme, we compare migration flows to Germany from participating and non‐participating countries in a difference‐in‐differences framework. Our results reveal a substantial programme effect that is larger for countries with above‐average youth unemployment rates. These results add to previous migration research and reveal that migration flows are indeed sensitive to policy initiatives aimed at increasing migration. [ABSTRACT FROM AUTHOR]

The present study examined the relationships between emotional well‐being (positive and negative affect), sleep‐related variables (sleep quality, sleep duration, and change in sleep quality and duration compared to weeks before lockdown), and worrying about coronavirus disease (COVID‐19) challenges during the beginning of the outbreak in Europe. In addition, four different coping strategies were investigated. The study was conducted in Germany with data from 665 participants (53.8% female; 18–73 years), who completed an online questionnaire in April 2020. The results revealed that COVID‐19 worry was associated with impaired well‐being and sleep. Meaning‐ and problem‐focused coping were the most frequently used coping strategies, and showed positive associations with well‐being and sleep. Social and avoidance coping were associated with decreased well‐being and worse sleep outcomes. Three coping strategies showed moderating effects. People who worried more showed higher levels of positive affect when they used problem‐focused coping compared to those who did not. Similarly, highly worried participants showed lower levels of negative affect when they reported using meaning‐focused coping more often. In contrast, social coping increased the risk of high negative affect levels in worried participants. In conclusion, problem‐focused and meaning‐focused coping strategies seemed to be most effective in coping with COVID‐19 challenges. [ABSTRACT FROM AUTHOR]

1. Climate change has forced species to shift distribution, alter migration behaviour, or change phenology. One of these adaptation strategies is aestivation to overcome hot, dry summers. For example, the abundance of the Great Banded Grayling Brintesia circe Fabricius (Lepidoptera, Nymphalidae) in Southern Germany used to show one flight peak between June and August, while now, a bimodal phenological record suggests 3–4 weeks of aestivation during the driest summer weeks. 2. To study this new phenomenon, a capture‐mark‐recapture study was performed in two nature reserves in Southern Germany during 92 days in 2019 and 2020. Gender, wing condition, and exact location of individuals of B. circe were recorded. These data show that in June (first flight period), 76%, 481 of 635 captured individuals were males, while in late August and September (second flight period), ≥95%, 452 of 462 were females. No individual marked during the first flight period was recaptured during the second flight period. 3. The results imply that mating takes place during the first flight period only, especially females aestivate, probably to avoid oviposition during the hottest and driest parts of the summer and that an unknown part of the population may disperse out or into the investigated habitats. This behaviour appears to have changed during the last decades probably as an adaptation to climate change. Females of B. circe are forced to oviposit later in summer as earlier eggs laid during hotter and drier times are less likely to develop successfully. [ABSTRACT FROM AUTHOR]

Summary: Background: Non‐alcoholic fatty liver disease (NAFLD), prediabetes and type 2 diabetes mellitus are known to be closely linked with obesity as early as during childhood. Objectives: The study aimed to determine the prevalence of prediabetes and T2DM in children with obesity with or without increased transaminases. Methods: Data from the observational multicentre (n = 51), cross‐sectional Adipositas Patienten Verlaufsbeobachtung registry were analyzed. Mild increase (mild group) was defined by alanine transaminase (ALT) >24 to ≤50 U/L and moderate to severe increase (advanced group) by ALT > 50 U/L. Prediabetes and T2DM were defined according to recent IDF/ISPAD guidelines. Results: The prevalence of prediabetes and T2DM was 11.9% (95% CI: 11.0–12.8) and 1.4% (95% CI: 1.1–1.7) among all participants (n = 4932; male = 2481; mean age 12.9 ± 2.7 years; BMI‐SDS 2.1 ± 0.5; Tanner stage 3.2 ± 1.5). The prevalence of impaired glucose metabolism (prediabetes and T2DM) was 13.8% (95% CI: 12.1–15.4) in the mild, 21.9% (95% CI: 18.8–25.1) in the advanced group, 10.7% (95% CI: 9.4–11.9) in the control group. Mild and advanced groups had greater odds ratios for prediabetes [1.42; 95% CI: 1.17–1.72, 2.26‐fold; (1.78–2.86), respectively], the advanced group also for T2DM [2.39 (1.36–4.21)] compared to controls. While an increase in transaminases predominantly affected boys, girls within the advanced group had a higher T2DM prevalence than males (5.4 vs. male 2.1%). Conclusions: Children with obesity and increased liver transaminases as surrogates of NAFLD should be screened for T2DM. [ABSTRACT FROM AUTHOR]

Purpose: This study illustrates the huge untapped potential of quantifying the impact of culture in making meaningful comparisons across groups. Our focus is on cross‐national differences in nurses' reports of their relations with physicians, and how the measurement of this complex construct and the evaluation of true differences are related to dimensions of national culture. Design: We examine across 14 European countries the association between indices of national culture from the seminal work of Hofstede and 39,435 nurses' ratings of their relations with physicians. Multilevel confirmatory factor analysis was used to evaluate strong factorial invariance across countries and to examine the influence of power distance and masculinity. Findings: There was wide variation across countries in nurses' reports of their relations with physicians. Strong factorial invariance was shown for a one‐factor model, which confirmed that across countries the seven survey items measure a common factor of physician‐nurse relations. This model showed no country bias for any of the seven survey items, which suggests that differences across countries reflect true differences. These true differences were significantly associated with variation in country values of power distance, which showed a significant negative correlation with physician–nurse relations. Conclusions: Continuously pursuing a better understanding of characteristics that impact the studied indicators, such as national culture, is elementary to better understand the construct under study. In this application, country values of power distance negatively impacted nurse‐reported relations with physicians, which strongly varied across countries. Clinical Relevance: Better nurse‐reported relations between nurses and physicians link to higher nurse job satisfaction, lower emotional exhaustion, better nurse‐perceived quality of care, and lower patient mortality. The Practice Environment Scale of the Nursing Work Index is an excellent instrument to characterize variation in working relations between nurses and physicians as well as physicians' professional posture towards nurses. [ABSTRACT FROM AUTHOR]

The aim of this study was to conduct a prospective analysis of the association between negative life events (NLEs) and respiratory infections in children genetically at risk for islet autoimmunity (IA) and type 1 diabetes (T1D). Long‐ and short‐term temporal associations between NLEs and rate of respiratory infection episodes (RIEs) in 5,618 children in The Environmental Determinants of Diabetes in the Young study for at least 1 up to 4 years were analysed. All models were adjusted for demographic, day care, season of infection, and psychosocial factors associated with the rate of child RIEs between study visits. The rate of child RIEs was 26% higher in Europe (Sweden, Finland, Germany) than in the United States (rate ratio [RR] = 1.26, p < 0.001). However, the percentage of child NLEs (odds ratio [OR] = 1.18, p < 0.001) and mother NLEs (OR = 1.83, p < 0.001) was higher in the United States compared with Europe. In both continents (Europe, RR = 1.12, p < 0.001; United States, RR = 1.07, p = 0.006), high child cumulative NLEs (>1 NLE per year since study inception) was significantly associated with an increased rate of child RIEs. This large‐scale prospective study confirms observations that stress may increase the susceptibility for infections in paediatric populations and suggests at least one mechanism by which stress could increase risk for IA and T1D in genetically at risk children. [ABSTRACT FROM AUTHOR]

The invasive box‐tree moth Cydalima perspectalis causes damage to horticultural box trees (Buxus spp.) in private gardens and parks in Europe and defoliation of large areas of European native box trees Buxus sempervirens, which grow in the understorey of deciduous forests. In some parts of their distribution area, wild native box trees are infected by the box rust Puccinia buxi, a fungus which does not occur in the native range of C. perspectalis. We examined whether the infection of P. buxi deters grazing by C. perspectalis in 31 wild box‐tree stands in forests in north‐western Switzerland and south‐western Germany. On average, 82.4% of the box trees were infested by P. buxi (among‐site variation 20%–100%), or 18.5% of their leaves. Linear mixed‐effect (LME) models revealed that the percentage of rust‐infected leaves was influenced by the local box‐tree density and the slope aspect of the forest site. 9.5% of the leaves showed grazing damage by C. perspectalis. LME showed that the percentage of leaves with grazing damage was affected by the elevation of the site and the percentage of rust‐infected leaves. The effect of box rust infection on food choice and larval performance (survival and growth rate) was examined in two experiments. In food‐choice tests, larvae of C. perspectalis did not show any preference for uninfected or rust‐infected box‐tree leaves and consumed similar amounts of leaf tissue of either type. However, when larvae were reared on leaves with three different degrees of P. buxi‐infection (and uninfected leaves as control), both survival and growth rate decreased with increasing degree of rust infection. This indicates that larval performance of C. perspectalis is reduced by the box rust. In the case of an outbreak of C. perspectalis, however, larvae may indiscriminately defoliate wild box trees. [ABSTRACT FROM AUTHOR]

Questions: Vascular epiphytes make up about 9% of all vascular plants globally but are clearly underrepresented in the temperate zones. The accidental epiphytic occurrence of terrestrial species, in contrast, is common at these latitudes and can provide important insights in the evolution of obligate epiphytes. Here, we present the results of the first two annual censuses of a planned long‐term study on accidental epiphytes. We particularly aim to identify: (a) the abundance and species richness of accidental epiphytes; (b) the dynamics of accidental epiphytism; (c) occupied substrates and microsites; and (d) suitable host tree species. Location: Harz Mountains, Germany, Central Europe. Methods: We surveyed more than 1,200 trees in a low mountain range in two consecutive years for epiphytic individuals of vascular plants, considering host tree species and occupied microsites. Results: About one quarter of the surveyed trees hosted epiphytic plants, totalling 1 450 (2016) and 1 350 (2017) individuals, respectively. These belonged to more than 100 species and 39 different families. The majority of epiphytic individuals newly emerged in 2017, whereas one‐third persisted since 2016 (or earlier) and a smaller proportion even reproduced in the epiphytic habitat. Accidental epiphytes were mostly restricted to host tree species providing water‐storing substrates such as extensive moss pads or arboreal soil accumulated in crotches. Compared to tropical epiphyte communities, accidental epiphytes in the temperate zones show a higher turnover, as they are less consistent in species abundance and composition in time. Conclusion: For the majority of the observed species, epiphytism indeed is an accidental phenomenon. Undoubtedly, abiotic conditions limit the occurrence of obligate epiphytes at higher latitudes, but the presence and persistence of numerous epiphytic individuals illustrate that abiotic conditions do not per se preclude epiphytic occurrence of vascular plants in the north‐temperate zone. Besides water shortage, the availability of suitable host trees is a decisive environmental factor that contributes to limit epiphytism of vascular plants in Central Europe. [ABSTRACT FROM AUTHOR]

The spatial dependence of meteorological variables is crucial for many impacts, for example, droughts, floods, river flows, energy demand, and crop yield. There is thus a need to understand how well it is represented in downscaling (DS) products. Within the COST Action VALUE, we have conducted a comprehensive analysis of spatial variability in the output of over 40 different DS methods in a perfect predictor setup. The DS output is evaluated against daily precipitation and temperature observations for the period 1979–2008 at 86 sites across Europe and 53 sites across Germany. We have analysed the dependency of correlations of daily temperature and precipitation series at station pairs on the distance between the stations. For the European data set, we have also investigated the complexity of the downscaled data by calculating the number of independent spatial degrees of freedom. For daily precipitation at the German network, we have additionally evaluated the dependency of the joint exceedance of the wet day threshold and of the local 90th percentile on the distance between the stations. Finally, we have investigated regional patterns of European monthly precipitation obtained from rotated principal component analysis. We analysed Perfect Prog (PP) methods, which are based on statistical relationships derived from observations, as well as Model Output Statistics (MOS) approaches, which attempt to correct simulated variables. In summary, we found that most PP DS methods, with the exception of multisite analog methods and a method that explicitly models spatial dependence yield unrealistic spatial characteristics. Regional climate model‐based MOS methods showed good performance with respect to correlation lengths and the joint occurrence of wet days, but a substantial overestimation of the joint occurrence of heavy precipitation events. These findings apply to the spatial scales that are resolved by our observation network, and similar studies with higher resolutions, which are relevant for small hydrological catchment, are desirable. [ABSTRACT FROM AUTHOR]

Spatial and temporal patterns of trends in annual and seasonal precipitation over Germany during 1951–2013 were analysed using the ensemble empirical mode decomposition (EEMD) method. Three widely used and recognized high‐resolution observation‐based gridded precipitation products, the Climatic Research Unit (CRU) time‐series data, Global Precipitation Climatology Centre (GPCC) Full Data Reanalysis data and the EU‐FP6 project ENSEMBLES derived data set (EOBS), were used and compared. Comparison among different products showed that the CRU used a considerably lower number of gauge stations (maximum 36) in the construction of gridded product over Germany and should be used with great caution for other applications, and overall CRU presented less precipitation and smaller inter‐annual variability; GPCC and EOBS agreed well in the spatial and temporal distribution of seasonal and annual precipitation, as well as the identified trends. The spatiotemporal analysis of trends showed that trends in precipitation during 1951–2013 were, in most cases, highly nonlinear and varying over time. In particular, the spring, summer and autumn precipitation showed large variations in trends. Therefore, the assumption of linear trends on which previous studies were based is invalid. Annual precipitation showed increasing trends in over 66% of Germany (particularly northern and eastern Germany), and the magnitude of increasing trends were generally enhanced over time, e.g. GPCC showed that the average magnitude of increasing trends rose from 6.3% for the 1951–1980 period to 12% for the 1951–2013 period. There were considerable spatial and temporal variabilities in trends in seasonal precipitation totals over Germany. This study is among one of the first studies applying the EEMD method to a comprehensive analysis of time‐varying trends in precipitation over Germany, which is expected to improve our understanding of the complex and nonlinear regional climate system. Spatial and temporal patterns of the EEMD‐derived trend of the four seasonal precipitation totals (DJF, MAM, JJA, SON; the trend is presented as the percentage of the climatology mean during the whole period 1951–2013 for easy interpretation and comparison) from EOBS for five different periods, with ending years of 1980, 1990, 2000, 2010 and 2013. [ABSTRACT FROM AUTHOR]

Abstract: Which parties use simple language in their campaign messages, and do simple campaign messages resonate with voters’ information about parties? This study introduces a novel link between the language applied during election campaigns and citizens’ ability to position parties in the ideological space. To this end, how complexity of campaign messages varies across parties as well as how it affects voters’ knowledge about party positions is investigated. Theoretically, it is suggested that populist parties are more likely to simplify their campaign messages to demarcate themselves from mainstream competitors. In turn, voters should perceive and process simpler campaign messages better and, therefore, have more knowledge about the position of parties that communicate simpler campaign messages. The article presents and validates a measure of complexity and uses it to assess the language of manifestos in Austria and Germany in the period 1945–2013. It shows that political parties, in general, use barely comprehensible language to communicate their policy positions. However, differences between parties exist and support is found for the conjecture about populist parties as they employ significantly less complex language in their manifestos. Second, evidence is found that individuals are better able to place parties in the ideological space if parties use less complex campaign messages. The findings lead to greater understanding of mass‐elite linkages during election campaigns and have important consequences for the future analysis of manifesto data. [ABSTRACT FROM AUTHOR]

Background: ‘Paediatric bipolar disorder’ (PBD) is a controversial diagnosis where often prepubertal children as well as adolescents, who may have a range of psychiatric disorders or symptoms, are diagnosed with a severe mental illness requiring lifelong medication. Clinically, it has often been applied in the United States but rarely in most other countries. A meta‐analysis (Van Meter et al., Journal of Clinical Psychiatry, , 72, 1250) claimed that the prevalence of PBD was similar to adults at 1.8% with no difference between the United States and other countries. This conclusion has been highly cited. Methods: The heterogeneous nature of the original 12 epidemiological surveys warrants a qualitative analysis, rather than statistical meta‐analysis as performed by Van Meter et al. (Journal of Clinical Psychiatry, 2011, 72, 1250). Thus, the meta‐analysis and each of the 12 studies (six from the United States; six from other countries) were reexamined. Results: Most of the 12 surveys predated the emergence of the PBD hypothesis. The 12 surveys were mainly of adolescents and at times young adults with few prepubertal children. Prevalence rates in the 12 studies suggest a lower rate of bipolar disorder, especially in non‐US samples. For example, the Van Meter et al. (Journal of Clinical Psychiatry, 2011, 72, 1250) meta‐analysis chose a rate of 2.8% by summation of adolescent and parent responses in a Dutch survey, however the rate fell to 0% if requiring concordance of adolescent and parent responses. Indeed, it could be argued that four of the non‐US studies show 0% rates of PBD. Conclusions: Rates of PBD were generally substantially lower than 1.8%, particularly in non‐US surveys, and if both parent and adolescent reports were required to meet the diagnostic threshold they fell to close to zero. The reanalysis suggests that bipolar disorder is rare before the expected age of onset in later adolescence. [ABSTRACT FROM AUTHOR]

Background: Delirium is a serious complication in patients in intensive care units. Previous surveys on delirium management in daily practice showed low adherence to published guidelines. Aim: To evaluate delirium management in nurses and physicians working in intensive care units in German-speaking countries and to identify related differences between nurses and physicians. Design: The study used an open online survey with multiple-choice responses. Methods: An invitation for participation was spread via journals and electronic resources using a snowball system. Apart from recording socio-demographical characteristics, the survey collected data on delirium assessment, delirium-related processes, non-pharmacological prevention and treatment and barriers for implementation. Differences between nurses and physicians were tested by Fisher's exact test with sequential Bonferroni correction. Results: The survey was conducted in autumn 2016, and 559 clinicians participated. More nurses than physicians reported screening for delirium. The majority of clinicians reported screening for delirium when this was suspected; more than 50% used validated instruments. Half of the clinicians had delirium-related structures implemented, such as two thirds reporting delirium-related processes. Most cited barriers were lack of time and missing knowledge about delirium and its assessment. With significant difference, physicians recommended more than nurses early removal of catheters and daily interprofessional goals for patients. Conclusion: In German-speaking countries, assessment of delirium needs further improvement, leading to accurate assessment. Delirium-related structures and processes appear to be implemented widely, with only a few differences between nurses and physicians. Relevance to clinical practice: Nurses and physicians in this survey reported similar perceptions and attitudes towards management of delirium. Both professions need more knowledge and inter-professional training on when and how to use validated assessment instruments. [ABSTRACT FROM AUTHOR]

This study uses price information relating to 12 towns and wage information from 18 towns to develop a real wage index for unskilled urban labourers in Germany during the three-and-a-half centuries preceding the onset of rapid industrialization. Combining the new series with information from other parts of Europe establishes two stages of real wage divergence during the seventeenth to nineteenth century. The first occurred in the middle of the seventeenth century when real wages in centres of trade and finance located on the rim of the North Sea rose far above the level prevailing in their hinterland. The second stage unfolded from the second quarter of the eighteenth century when the real wage in south England, northern and central Italy, and Germany began to diverge; Germany followed a middle path between the other two countries. The second commercial revolution, which improved business techniques and promoted Smithian growth, goes a long way towards accounting for this development. [ABSTRACT FROM AUTHOR]

The article discusses the cash equity markets in Germany which performs major role in modern economics. Topics discussed include history of cash equity markets in Germany, launch of electronic trading in Germany, benefits of the Xetra Trading System, the Markets in Financial Instruments Directive (MIFID) which is the basic law of securities trading in Europe since 2007, the developments regarding the cash equity markets and future of cash equity markets in Europe and Germany.

While the collapse of party membership in the last half-century has consumed much of the focus of party scholarship, the notion of membership itself is surprisingly under-theorised. This article presents a tripartite framework for understanding party membership as a constructed concept: from the perspective of the state, the individual and the political party. As organisational mediators and strategic electoral actors, political parties construct varying notions of membership in order to mobilise resources and gain legitimacy, while balancing the participatory demands of citizens with the legal and normative expectations imposed by the state. Using a number of illustrative examples from Europe and beyond, the article analyses the development of supporters' networks and the extension of participatory opportunities to non-members. Designed in part to address this membership decline and to offer individuals a different way of engaging with political parties, these initiatives are seen as a crucial step in the evolution of modern parties towards looser, more individualised and amorphous networks of affiliation. [ABSTRACT FROM AUTHOR]