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Background: The Claim Evaluation Tools measure the ability to assess claims about treatment effects. The aim of this study was to adapt the German item sets to the target group of secondary school students (aged 11 to 16 years, grade 6 to 10) and to validate them accordingly. The scale's reliability and validity using Rasch's probabilistic test theory should be determined. Methods: We conducted a sequential mixed-method study comprising three stages: contextualisation and adaption of the items (stage 1), piloting of the item sets using qualitative interviews (stage 2) and a construct validation by testing the unidimensional Rasch scalability for each item set after data collection in one secondary school in Germany and two secondary schools in Austria. We explored summary and individual fit statistics and performed a distractor analysis (stage 3). Results: Secondary school students (n = 6) and their teachers (n = 5) participated in qualitative interviews in Germany. The qualitative interviews identified the need for minor modifications (e.g. reducing thematic repetitions, changing the order of the items). The data of 598 German and Austrian secondary school students were included to test for Rasch scalability. Rasch analyses showed acceptable overall model fit. Distractor analyses suggested that model fit could be improved by simplifying the text in the scenarios, removing and editing response options of some items. Conclusion: After the revision of some items, the questionnaires are suitable to evaluate secondary school students' ability to assess health claims. A future goal is to increase the pool of items being translated and tested. [ABSTRACT FROM AUTHOR]

Purpose: The importance of trust in student–university relations is relevant not only for the quality of the educational process and the satisfaction with studying achieved by students, but also for the importance of positive evaluation of HEIs to others. Therefore, the aim of this study is to identify the stages and mechanisms that build trust in student–university relations, the causes of trust violation and trust repair practices. Design/methodology/approach: Public university students from Poland (16) and Germany (12) took part in the study based on semi-structured interviews. The research procedure followed an inductive approach. In addition, the critical events technique was used to identify trust violation and trust repair practices. Findings: The study identifies the stages of the HEIs trust building process and the mechanisms upon which it is built. It attempts to catalogue trust violations, distinguishing three groups of "perpetrators" and categories of their differentiation in terms of their impact on trust. The study indicates ad hoc, informal methods of trust repair applied at HEIs and their conditions. Practical implications: This study provides useful guidance for managers on how to build and maintain trust in HEIs. Originality/value: The issue of trust building in HEIs is relatively new and therefore has not been sufficiently recognised to date. This study is the first to the author's knowledge to comprehensively address the problem of trust building, pointing out the mechanisms on which the formation of trust in HEIs is based. This study provides a novel contribution to the limited literature on trust violation and trust repair in HEIs. [ABSTRACT FROM AUTHOR]

Introduction: The SIGMO study (Sigmoidoscopy as an evidence-based colorectal cancer screening test – a possible option?) examines screening eligible populations' preferences for colorectal cancer (CRC) screening in Germany using a discrete choice experiment (DCE). Attribute identification and selection are essential for the construction of choice tasks and should be evidence-based. As a part of the SIGMO study this systematic review provides an overview of attributes included in studies eliciting stated preferences for CRC screening tests and their relative importance for decision-making. Methods: Systematic search (November 2021) for English-language studies published since January 2000 in PubMed, Embase, Web of Science, Biomedical Reference Collection: Corporate Edition, LIVIVO and PsycINFO. DCEs and conjoint analysis ranking or rating tasks on screening eligible populations' preferences for stool testing, sigmoidoscopy, and/or colonoscopy were included. Attributes were extracted and their relative importance was calculated and ranked. Risk of bias (RoB) of included studies was assessed using a modified GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Study selection and RoB rating were carried out independently by two reviewers. Data were extracted by one reviewer and checked by another one. Results: A total of 23 publications on 22 studies were included. Overall RoB was rated as serious/critical for 21 studies and as moderate for 2 studies. Main reasons for high RoB were non-random sampling, low response rates, lack of non-responder analyses, and, to a lesser extent, weaknesses in the measurement instrument and data analysis. Extracted attributes (n = 120) referred to procedure-related characteristics (n = 42; 35%), structural characteristics of health care (n = 24; 20%), test characteristics (n = 23; 19%), harms (n = 16; 13%), benefits (n = 13; 11%), and level of evidence (n = 2; 2%). Most important attributes were reduction in CRC mortality (and incidence) (n = 7), test sensitivity (n = 7), out-of-pocket costs (n = 4), procedure (n = 3), and frequency (n = 2). Conclusions: Health preference studies on CRC were found to have a high RoB. The composition of choice tasks revealed a lack of attributes on patient-important outcomes (like incidence reduction), while attributes not considered relevant for individual screening decisions (like sensitivity) were frequently used. Future studies eliciting stated preferences in cancer screening should apply the principles of informed decision-making in attribute identification and selection. [ABSTRACT FROM AUTHOR]

Objective: For an effective control of the SARS-CoV-2 pandemic with vaccines, most people in a population need to be vaccinated. It is thus important to know how to inform the public with reference to individual preferences–while also acknowledging the societal preference to encourage vaccinations. According to the health care standard of informed decision-making, a comparison of the benefits and harms of (not) having the vaccination would be required to inform undecided and skeptical people. To test evidence-based fact boxes, an established risk communication format, and to inform their development, we investigated their contribution to knowledge and evaluations of COVID-19 vaccines. Methods: We conducted four studies (1, 2, and 4 were population-wide surveys with N = 1,942 to N = 6,056): Study 1 assessed the relationship between vaccination knowledge and intentions in Germany over three months. Study 2 assessed respective information gaps and needs of the population in Germany. In parallel, an experiment (Study 3) with a mixed design (presentation formats; pre-post-comparison) assessed the effect of fact boxes on risk perceptions and fear, using a convenience sample (N = 719). Study 4 examined how effective two fact box formats are for informing vaccination intentions, with a mixed experimental design: between-subjects (presentation formats) and within-subjects (pre-post-comparison). Results: Study 1 showed that vaccination knowledge and vaccination intentions increased between November 2020 and February 2021. Study 2 revealed objective information requirements and subjective information needs. Study 3 showed that the fact box format is effective in adjusting risk perceptions concerning COVID-19. Based on those results, fact boxes were revised and implemented with the help of a national health authority in Germany. Study 4 showed that simple fact boxes increase vaccination knowledge and positive evaluations in skeptics and undecideds. Conclusion: Fact boxes can inform COVID-19 vaccination intentions of undecided and skeptical people without threatening societal vaccination goals of the population. [ABSTRACT FROM AUTHOR]

Introduction: Multiple sclerosis is a chronic inflammatory, degenerative disease of the central nervous system manifesting at first with relapses in about 85% of cases. In Germany, intravenous therapy with high-dose corticosteroids is the treatment standard of acute relapses. The treatment leads to a faster reduction of symptoms in about 25 of 100 treated patients but has no proven long-term benefits over placebo treatment. Intravenous treatment is not superior to oral treatment. Therefore, informed decisions on relapse management are required. An earlier randomised controlled trial showed that evidence-based patient information and education on relapse management leads to more informed decisions and more relapses not treated or treated with oral corticosteroids. This study aims to evaluate whether a web-based relapse management programme will positively change relapse management and strengthen autonomy in people with multiple sclerosis.Methods: The pragmatic double-blind randomised controlled trial is accompanied by a mixed-methods process evaluation and a health economic evaluation and follows the UK Medical Research Council guidance on developing and evaluating complex interventions. A total of 188 people with possible or relapsing-remitting multiple sclerosis with ≥ 1 relapse within the last year and/or ≥ 2 relapses within the last 2 years will be recruited and randomised using blocks. The intervention group receives a web- and dialogue-based decision aid on relapse management, a nurse-led webinar and access to a monitored chat forum. The control group receives standard information, which will be made available via the same online platform as the intervention. The primary endpoint is the proportion of relapses not treated or treated with oral corticosteroids. Key secondary endpoints are the annualised relapse rate, decision-making, empowerment, quality of life and cost-effectiveness. Facilitators and barriers will be assessed by mixed-methods process evaluation measures. The study ends when 81 relapses have been documented or after 24 months of observation per individual patient. Analyses will follow the intention-to-treat principle.Discussion: We hypothesise that the intervention will enhance patient empowerment and have a positive impact on patients' relapse management.Trial Registration: ClinicalTrials.gov NCT04233970 . Registered on 18 January 2020. [ABSTRACT FROM AUTHOR]

The anaerobic biodegradation of 2,4,5-trichlorophenoxyacetic acid (2,4,5-T) was investigated using enrichment cultures from freshwater sediments at two different sites in the region of Halle, central Germany. 2,4,5-T and different organic acids or hydrogen were added as possible electron acceptor and electron donors, respectively. The primary enrichment cultures from Saale river sediment completely degraded 2,4,5-T to 3-chlorophenol (3-CP) (major product) and 3,4-dichlorophenol (3,4-DCP) during a 28-day incubation period. Subcultures showed ether cleavage of 2,4,5-T to 2,4,5-trichlorophenol and its stoichiometric dechlorination to 3-CP only in the presence of butyrate. In contrast, the primary enrichment culture from sediment of Posthorn pond dechlorinated 2,4,5-T to 2,5-dichlorophenoxyacetic acid (2,5-D), which, in the presence of butyrate, was degraded further to products such as 3,4-DCP, 2,5-DCP, and 3CP, indicating ether cleaving activities and subsequent dechlorination steps. Experiments with pure cultures of Dehalococcoides mccartyi and Desulfitobacterium hafniense demonstrated their specific dechlorination steps within the overall 2,4,5-T degradation pathways. The results indicate that the route and efficiency of anaerobic 2,4,5-T degradation in the environment depend heavily on the microorganisms present and the availability of slowly fermentable organic compounds. [ABSTRACT FROM AUTHOR]

Background: Prostate-specific antigen (PSA) based screening for early detection of prostate cancer is common although it is associated with both benefits and potential harms (e.g., the risk of overdiagnosis). Evidence-based health information could help individuals make informed decisions about whether to undergo PSA testing or not. This evaluation aimed to determine whether the written health information materials available in Germany provide appropriate information for informed decision-making on PSA based screening. Methods: A list of criteria was developed and used to systematically assess the quality of information on the benefits and harms of prostate cancer screening included in written health information materials. Fourteen information materials identified by information requests and online searches were evaluated independently by two of three reviewers. Consensus was achieved with a third reviewer. Results: Of the 14 information materials evaluated, 10 (71%) list the ability to reduce the absolute risk of death from prostate cancer as a benefit of PSA testing, 9 (64%) point out the risks of follow-up diagnostics, 13 (93%) describe the risks of the available prostate cancer treatments, and all 14 specify the risk of overdiagnosis. The minority provide numerical data on benefits and risks. Partially mismatched framing was identified in four cases: two information materials report only the relative frequencies of benefits, and two report only the absolute frequencies of harms. Half of the materials encouraged participation using downplaying or frightening language. Conclusions: The majority of health information materials in Germany describe the benefits and harms of PSA based screening, including overdiagnosis, but often lack adequate balance, neutrality and numbers. [ABSTRACT FROM AUTHOR]

What is the discipline of Public Administration (PA) ultimately for? The German community has recently entered new deliberations on this recurrent question, with several papers and workshops addressing the present and future of their national discipline. This article uses original survey data to introduce the views of the German community at large and analyzes intellectual commonalities against a background of institutional fragmentation. It scrutinizes preferences for epistemological positions, research aims, and publication strategies, while also investigating potentials for cooperation through interdisciplinary exchange and theoretical or thematic concordance. The results show a community in intellectual crisis. Faced with fears of decreasing reputation and influence, German PA is still divided about its purpose and separated by disciplinary borders. [ABSTRACT FROM AUTHOR]

This article challenges the view that sociological explanation is based on methodological individualism and suggests using relational concepts for constructing explanations of social phenomena. It develops a relational concept of social mechanisms based on sociological systems theory and illustrates its explanatory power by drawing on research on changes in educational organizations in Germany. [ABSTRACT FROM AUTHOR]

In Situational Action Theory (SAT), crime is seen as the result of the interplay between individual and setting characteristics. This replication study focuses on the perception–choice process. The perception–choice process refers to the process whereby one sees the breaking of rules (stated in laws) as an action alternative and deliberately (or habitually) carries out an act of rule-breaking, given that one sees the breaking of a specific rule as an action alternative. The unique contribution of this study to the empirical literature is that it tests the interaction between choosing a violent response, propensity, and exposure to scenario criminogeneity using a web-based randomized scenario study. The results indicate that individuals who have low levels of crime propensity rarely choose a violent response, independent of scenario criminogeneity (as measured by provocation and the absence of monitoring agents). The likelihood of choosing a violent response increases as a result of the interplay between scenario criminogeneity and crime propensity. The implications for future tests of SAT are discussed. [ABSTRACT FROM AUTHOR]

The overall purpose of this study is to contribute to bridging the gap between people- and place-oriented approaches in the study of crime causation. To achieve this we will explore some core hypotheses derived from Situational Action Theory about what makes young people crime prone and makes places criminogenic, and about the interaction between crime propensity and criminogenic exposure predicting crime events. We will also calculate the expected reduction in aggregate levels of crime that will occur as a result of successful interventions targeting crime propensity and criminogenic exposure. To test the hypotheses we will utilize a unique set of space–time budget, small area community survey, land-use and interviewer-led questionnaire data from the prospective longitudinal Peterborough Adolescent and Young Adult Development Study (PADS+) and an artificial neural network approach to modelling. The results show that people’s crime propensity (based on their personal morals and abilities to exercise self-control) has the bulk of predictive power, but also that including criminogenic exposure (being unsupervised with peers and engaged in unstructured activities in residential areas of poor collective efficacy or commercial centres) demonstrates a substantial increase in predictive power (in addition to crime propensity). Moreover, the results show that the probability of crime is strongest when a crime-prone person is in a criminogenic setting and, crucially, that the higher a person’s crime propensity the more vulnerable he or she is to influences of criminogenic exposure. Finally, the findings suggest that a reduction in people’s crime propensity has a much bigger impact on their crime involvement than a reduction in their exposure to criminogenic settings. [ABSTRACT FROM AUTHOR]

Objective Patients making treatment decisions require understandable evidence-based information. However, evidence on graphical presentation of benefits and side-effects of medical treatments is not conclusive. The study evaluated a new space-saving format, CLARIFIG (clarifying risk figures), aiming to facilitate accuracy of comprehension. Methods CLARIFIG displays groups of patients with and without treatment benefits as coloured sectors of a proportional bar graph representing in total 100 patients. Supplementary icons indicate the corresponding group's actual condition. The study used an application showing effects of immunotherapy intended to slow disease progression in multiple sclerosis ( MS). In a four-arm web-based randomized controlled trial, CLARIFIG was compared to the reference standard, multifigure pictographs ( MFP), regarding comprehension (primary outcome) and processing time. Both formats were presented as static and animated versions. People with MS were recruited through the website of the German MS society. Results Six hundred and eighty-two patients were randomized and analysed for the primary end point. There were no differences in comprehension rates ( MFPstatic=46%, CLARIFIGstatic=44%; P=.59; MFPanimated=23%, CLARIFIGanimated=30%; P=.134). Processing time for CLARIFIG was shorter only in the animated version ( MFPstatic=162 seconds, CLARIFIGstatic=155 seconds; P=.653; MFPanimated=286 seconds, CLARIFIGanimated=189 seconds; P≤.001). However, both animated versions caused more wrong answers and longer processing time than static presentation ( MFPstatic vs animated: P≤.001/.001, CLARIFIGstatic vs animated: P=.027/.017). Conclusion Comprehension of the new format is comparable to MFP. CLARIFIG has the potential to simplify presentation in more complex contexts such as comparison of several treatment options in patient decision aids, but further studies are needed. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effectiveness of a multi-component evidence-based education programme on disease modifying therapies in multiple sclerosis. Design: Controlled trial with two consecutive patient cohorts and a gap of two months between cohorts. Setting: Three neurological rehabilitation centres. Subjects: Patients with multiple sclerosis within rehabilitation. Interventions: Control group (CG) participants were recruited and received standard information. Two months later, intervention group (IG) participants were recruited and received a six-hour nurse-led interactive group education programme consisting of two parts and a comprehensive information brochure. Main measures: Primary endpoint was "informed choice", comprising of adequate risk knowledge in combination with congruency between attitude towards immunotherapy and actual immunotherapy uptake. Further outcomes comprised risk knowledge, decision autonomy, anxiety and depression, selfefficacy, and fatigue. Results: A total of 156 patients were included (IG=75, CG=81). The intervention led to significantly more participants with informed choice (IG: 47% vs. CG: 23%, P=0.004). The rate of persons with adequate risk knowledge was significantly higher in the IG two weeks after the intervention (IG: 54% vs. CG: 31%, P=0.007), but not after six months (IG: 48% vs. CG: 31%, P=0.058). No significant differences were shown for positive attitude towards disease modifying therapy (IG: 62% vs. CG: 71%,P=0.29) and for disease modifying therapy status after six months (IG: 61.5% vs CG: 68.6%, P=0.39). Also no differences were found for autonomy preferences and decisional conflict after six months. Conclusion: Delivering evidence-based information on multiple sclerosis disease modifying therapies within a rehabilitation setting led to a marked increase of informed choices. [ABSTRACT FROM AUTHOR]

Background: Patients can only make well-informed decisions if the information they are given by health professionals is based on scientific evidence. In this study, we assessed the foundation in evidence of free, publicly available telephone consultations in Germany. Methods: From March 2013 to January 2014, four hidden clients seeking information asked standardized questions about three medical topics (screening for colorectal cancer, for glaucoma, and for trisomy 21) and three dental ones (the sealing of dental fissures, professional dental cleaning, and mercury detoxification). Depending on the topic, the questions addressed such issues as the risk of disease and the purpose, content, validity, benefits, and risks of potential diagnostic and therapeutic measures. All identifiable telephone consultation services that provided counselling on the above topics were included in the study (23 government-sponsored institutions, 31 institutions independently run by physicians, 521 institutions under religious auspices, 25 dental counselling services). Results: Of the 599 telephone consultation services that were identified, 567 were contacted; 404 did not offer any relevant counselling. A total of 293 conversations were held with the remaining 163 consultation services. Six of these conversations fully met predefined criteria for evidence-based counselling. The percentage of appropriate answers to the key questions on each topic was 5% for colorectal cancer screening (7/140), 23.8% for glaucoma screening (25/105), 33.9% for trisomy 21 screening (121/357), 27.5% for the sealing of dental fissures (28/102), 16.2% for professional dental cleaning (19/117), and 12.9% for mercury detoxification (12/93). The percentage of appropriate answers also varied depending on the type of institution: 26.8% for government-sponsored institutions (67/250), 4.5% for institutions independently run by physicians (4/88), and 31.1% for institutions under religious auspices (82/264). Conclusion: The medical and dental counselling now offered over the telephone by the types of institutions included in this study does not satisfy the criteria for evidence-based health information. [ABSTRACT FROM AUTHOR]

An important prerequisite for the success of the digitisation of the healthcare system are risk-literate users. Risk literacy means the ability to weigh potential benefits and harms of digital technologies and information, to use digital services critically, and to understand statistical evidence. How do people find reliable and comprehensible health information on the Internet? How can they better assess the quality of algorithmic decision systems? This narrative contribution describes two approaches that show how the competence to make informed decisions can be promoted.Evidence-based and reliable health information exists on the Internet but must be distinguished from a large amount of unreliable information. Various institutions in the German-speaking world have therefore provided guidance to help laypersons make informed decisions. The Harding Center for Risk Literacy in Potsdam, for example, has developed a decision tree ("fast-and-frugal tree"). When dealing with algorithms, natural frequency trees (NFTs) can help to assess the quality and fairness of an algorithmic decision system.Independent of reliable and comprehensible digital health services, further tools for laypersons to assess information and algorithms should be developed and provided. These tools can also be included in institutional training programmes for the promotion of digital literacy. This would be an important step towards the success of digitisation in prevention and health promotion.

Breast cancer is the most frequent type of malignancy among women throughout Germany. The present analysis aimed to identify information needs and aspects of health literacy in women of working age newly diagnosed with breast cancer. PIAT is a prospective multicenter cohort study in which patients were asked about their information needs at 3 assessment points: postoperatively, after 10 weeks, and after 40 weeks. The present analysis includes data from 1,344 female patients after the first assessment point. In addition to descriptive analyses, logistic regression analyses were calculated. Results of the study show that, in addition to sociodemographic characteristics, the level of health literacy and the employment status of the women who responded to the inquiry influence specific unmet information needs. Most frequently mentioned unmet information needs relate to supplementary naturopathy, nutrition, health-promoting measures, and working during breast cancer. Patients with breast cancer are often provided with large amounts of information during their hospital stay indicating this information is not targeted to patient needs and may be overwhelming. The results show that information on everyday life needs such as supplementary naturopathy were important for the sample newly diagnosed with breast cancer. Employed women in particular have questions regarding working during cancer or tax relief. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is an inflammatory and neurodegenerative disease of the central nervous system of potential autoimmune origin that is frequently associated with psychological disorders and cognitive deficits, as well as with fatigue, stress, and psychosocial burden. These factors often cause decreased quality of life, social withdrawal, and unemployment. We describe the development of a cognitive-behavioral group intervention based on the concept of metacognition and evaluation of the feasibility and acceptance of the program as a rehabilitation tool. Methods: Metacognitive Training in MS (MaTiMS) consists of six modules, each 90 minutes in duration. We tested acceptance and design of the program in six focus groups (entire sample, n = 27). Framework analysis of transcripts was used to identify key topics and categories. Program modules were revised in accordance with appropriate recommendations of focus group members. We subsequently evaluated MaTiMS in two groups (n = 5, n = 6) in a rehabilitation center. Neuropsychological functioning as well as coping self-efficacy, depression, stress, perceived cognitive deficit, fatigue, and quality of life were assessed. Acceptance of MaTiMS from the patient perspective was also studied. Results: The modules were highly accepted by patients. Pre-post assessments showed significant improvements in the Coping Self Efficacy Scale (P = .007), the Würzburger Fatigue Inventory for MS Score (P = .028), and the Hamburg Quality of Life Questionnaire in Multiple Sclerosis Mood subscale (P = .046). Conclusions: These preliminary results suggest that MaTiMS represents a feasible psychological group training program that may foster improvements in self-efficacy, fatigue, and mood. The next step will be an evaluation of the program in a randomized controlled trial. [ABSTRACT FROM AUTHOR]

Background: International and national societies claim a patient centred approach including shared decision making (SDM) in diabetes care. In a previous project, a SDM programme on the prevention of myocardial infarction has been developed. It is aimed at supporting patients with type 2 diabetes to make informed choices on preventive options, to share the decision making process with the health care team, and to improve adherence to the chosen treatment. In this study, the programme will be implemented and evaluated in primary care practices. Methods/Design: A cluster randomised, controlled trial will be conducted to compare the SDM programme with standard care enrolling patients with type 2 diabetes (N = 306) from primary care practices (N = 24). The intervention programme comprises a six hours provider training, a patient decision aid including evidence-based information, a 90 minutes structured teaching session provided by medical assistants, a sheet to document the patients' individual treatment goals, and a structured consultation with the general practitioner for sharing information, setting treatment goals, and for adapting treatment regimens if necessary. Patients in the control group receive a brief extract of recommendations of the German National Disease Management Guideline on the treatment of patients with type 2 diabetes. Primary outcome measure is adherence to blood pressure treatment and statin treatment at 6 months follow-up. Secondary outcome measures comprise informed choice and the achievement of patients' treatment goals. Analyses will be carried out on intention-to-treat basis. Concurrent qualitative methods will be used to explore the implementation processes. Discussion: At the end of this study, information on the efficacy of the SDM programme in the primary care context will be available. In addition, processes that might interfere with or that might promote a successful implementation will be identified. [ABSTRACT FROM AUTHOR]

The genomes of two novel Dehalococcoides mccartyi strains, DCMB5 and BTF08, enriched from the heavily organohalide-contaminated megasite around Bitterfeld ( Germany), were fully sequenced and annotated. Although overall similar, the genome sequences of the two strains reveal remarkable differences in their genetic content, reflecting a specific adaptation to the contaminants at the field sites from which they were enriched. The genome of strain BTF08 encodes for 20 reductive dehalogenases, and is the first example of a genome containing all three enzymes that are necessary to couple the complete reductive dechlorination of PCE to ethene to growth. The genes encoding trichloroethene and vinyl chloride reductive dehalogenases, tceA and vcrA, are located within mobile genetic elements, suggesting their recent horizontal acquisition. The genome of strain DCMB5 contains 23 reductive dehalogenase genes, including cbrA, which encodes a chlorobenzene reductive dehalogenase, and a gene cluster encoding arsenic resistance proteins, both corresponding to typical pollutants at its isolation site. [ABSTRACT FROM AUTHOR]

The article presents a study which aims to conduct retrospective cohort study to estimate the perception and risk awareness of multiple sclerosis (MS) patients which treated motoxantrone in Hamburg, Germany. The study made use of an wilcoxon rank-sum test to compare knowledge and risk awareness before reading the brochure.The results of the study show that the accuracy of LK risk estimation increased by reading the information.

Background: Patients want to be more involved in medical decision-making. To this end, some decision aids are now available. Methods: We present an overview of this subject, in which we explain the terms "shared decision-making", "decision aid", and "evidence- based patient information" and survey information on the available decision aids in German and other languages on the basis of a literature search in MEDLINE, EMBASE and PsycInfo and a current Cochrane Review. We also searched the Internet for providers of decision aids in Germany. Results: Decision aids exist in the form of brochures, decision tables, videos, and computer programs; they address various topics in the prevention, diagnosis, and treatment of disease. They typically contain information on the advantages and disadvantages of the available options, as well as guidance for personal decision-making. They can be used alone or as a part of structured counseling or patient education. Minimal quality standards include an adequate evidence base, completeness, absence of bias, and intelligibility. Our search revealed 12 randomized controlled trials (RCTs) of decision aids in German and 106 RCTs of decision aids in other languages. These trials studied the outcome of the use of decision aids not just with respect to clinical developments, but also with respect to patient knowledge, adherence to treatment regimens, satisfaction, involvement in decision-making, autonomy preference, and decisional conflicts. Conclusion: Only a small fraction of the available decision aids were systematically developed and have been subjected to systematic evaluation. Patients are still not receiving the help in decision-making to which medical ethics entitles them. Structures need to be put in place for the sustainable development, evaluation and implementation of high-quality decision aids. INSETS: Criteria for evidence-based patient information (4);Phases of development and implementation (10), as…;KEY MESSAGES. [ABSTRACT FROM AUTHOR]

Extracts of sediments from an area of concern in the Elbe river basins (Spittelwasser creek) were analyzed with the Ames-fluctuation test and in parallel with gas chromatography/mass spectrometry for compound identification. The standard test strains TA 98 and TA 100 showed mutagenicity mainly in medium-polar fractions of the sediment extracts. PAHs contribute to the overall mutagenic potential of the sample. Especially, cyclopenta[c,d]pyrene that was previously not defined as a priority hazardous substance has to be considered as well. The addition of metabolically competent test strains, which overexpress nitroreductase and acetyltransferase (e.g., YG1041 and YG1042) to the test battery, increased significantly the sensitivity of the Ames test for medium polar to polar genotoxins. The increased mutagenicity that was found in these bacterial strains indicates the presence of nitroarenes and/or aromatic amines. In fact, a number of heterocyclic and nitrogen-substituted aromatic compounds were identified in the sediments of the Spittelwasser creek of which methyl parathion, 1-naphthylamine, and N-phenyl-2-naphthylamine are mutagenic. Environ. Mol. Mutagen., 2011. © 2010 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

A bibliography on German parapsychology and occultism is presented for the book "The Stepchildren of Science: Psychical Research and Parapsychology in Germany, C. 1870-1939."

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