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Although the paper industry processes polymeric materials and discharges large amounts of wastewater, no research on microplastics in the wastewater from paper mills has been published to date. This study is the first to investigate this issue. The wastewater treatment plants of twelve representatively selected German paper mills were investigated using an analysis protocol based on µ-Raman spectroscopy. The results show that treated process water from surface waters is negligible as a source of microplastics (MPs) ≥ 20 µm. The microplastics concentrations in untreated wastewater range from 10 6 to 10 8 (MPs ≥ 20 µm)/m 3 . Sources of microplastics in wastewater include recovered paper, functional polymers, and coating colors, among others. The most frequently detected polymers are polyethylene and polystyrene. In four cases, moving bed biofilm reactors were identified as a source of microplastics. The microplastics concentration in treated wastewater ranges from 10 2 to 10 4 (MPs ≥ 20 µm)/m 3 . Hence, the removal rate of the wastewater treatment plants exceeds 99 %. Mechanical treatment and the activated sludge process have the highest removal rates of all treatment stages. The loads emitted into surface waters range from 10 6 to 10 8 (MPs ≥ 20 µm)/h, comparable to municipal wastewater treatment plants with a population equivalent of over 10,000 inhabitants. Compared with other wastewater-related emissions (the total emissions of municipal wastewater treatment plants, or combined sewer overflow), the contribution of paper mills to microplastics in the aquatic environment is low. The results of the removal efficiency can be transferred to other branches of industry and municipal wastewater treatment plants., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Felix Steinfeld reports financial support was provided by German Federal Ministry of Economic Affairs and Climate Action. Antje Kersten reports financial support was provided by German Federal Ministry of Economic Affairs and Climate Action. Samuel Schabel reports financial support was provided by German Federal Ministry of Economic Affairs and Climate Action. Jutta Kerpen reports financial support was provided by German Federal Ministry of Economic Affairs and Climate Action. Felix Steinfeld reports writing assistance was provided by AngloDoc. Felix Steinfeld reports administrative support was provided by Kuratorium für Forschung und Technik in der Papier- und Zellstoffindustrie im VDP e.V. Antje Kersten reports administrative support was provided by Kuratorium für Forschung und Technik in der Papier- und Zellstoffindustrie im VDP e.V. Samuel Schabel reports administrative support was provided by Kuratorium für Forschung und Technik in der Papier- und Zellstoffindustrie im VDP e.V. Jutta Kerpen reports administrative support was provided by Kuratorium für Forschung und Technik in der Papier- und Zellstoffindustrie im VDP e.V. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

In the future, learning will be essentially characterized by the ability to regulate the learning process and monitor success independently from a teacher. The technical possibilities offer better access to learning contents, precise and more individualized feedback, and learning phases adapted precisely to the needs of the learner in terms of scope and pace. In this study, we investigate an important aspect of the digitization of teaching/learning processes using the example of laboratory scripts for chemistry students at university. The focus is on looking up terms and concepts in preparation for the lab internships, firstly in a paper-based glossary and secondly in a digital glossary. During a two-day study, a total of 16 students prepared for experiments on two topics with completely identical materials. We then studied the influence of content knowledge, motivation, and cognitive load. While all students show significant learning achievements, there are no significant differences between the groups. Furthermore, results show that pure digitization of information has no effect, despite the theoretically assumed advantages.

The way medical students learn anatomy is constantly evolving. Nowadays, technologies such as tablets support established learning methods like drawing. In this study, the effect of drawing on a tablet on medical students' anatomy learning was investigated compared to drawing or summarizing on paper. The quality of drawings or summaries was assessed as a measure of the quality of strategy implementation. Learning outcome was measured with an anatomy test, both immediately afterward and after 4-6 weeks to assess its sustainability. There were no significant group differences in learning outcome at both measurement points. For all groups, there was a significant medium strength correlation between the quality of the drawings or summaries and the learning outcome (p < 0.05). Further analysis revealed that the quality of strategy implementation moderated outcomes in the delayed test: When poorly implemented, drawing on a tablet (M = 48.81) was associated with lower learning outcome than drawing on paper (M = 58.95); The latter (M = 58.89) was related to higher learning outcome than writing summaries (M = 45.59). In case of high-quality strategy implementation, drawing on a tablet (M = 60.98) outperformed drawing on paper (M = 52.67), which in turn was outperformed by writing summaries (M = 62.62). To conclude, drawing on a tablet serves as a viable alternative to paper-based methods for learning anatomy if students can make adequate use of this strategy. Future research needs to identify how to support student drawing, for instance, by offering scaffolds with adaptive feedback to enhance learning.

Progress monitoring of academic achievement is an essential element to prevent learning disorders. A prominent approach is curriculum-based measurement (CBM). Various studies have documented positive effects of CBM on students' achievement. Nevertheless, the use of CBM is associated with additional work for teachers. The use of tablets may be of help here. Yet, although many advantages of computer- or tablet-based assessments are being discussed in the literature (e. g. innovative item formats, adaptive testing, automated scoring and feedback), there are still concerns regarding the comparability of different assessment modes (paper-pencil vs. tablet). In the study presented, we analyze the CBM data of 98 fourth graders. They processed the exact same computation items once with paper and pen and once in a tablet application. The analyses point to comparable results in the test modes, although some significant deviations can be found at item level. In addition, the children report perceived benefits when working with the tablet.

The model advanced training regulations define the content of advanced training to achieve the qualification of medical specialist in internal medicine and rheumatology. There are currently no criteria for issuing the authorization in advanced training. This position paper describes the criteria proposed by the German Society for Rheumatology and Clinical Immunology (DGRh), which should be the foundation for the issuance of authorization for advanced training in the field of internal medicine and rheumatology and for the assessment of the duration. The model advanced training regulations 2018 and the advanced training plan recommended by experts function as the basis for this. Based on the criteria, the authorization for advanced training to advanced specialist training in internal medicine and rheumatology can be allocated in a standardized, graded and transparent manner throughout Germany. This enables an optimal quality of advanced training in rheumatology, which can be adapted to the future developments in the discipline., Competing Interests: Einhaltung ethischer Richtlinien. Interessenkonflikt: A. Pfeil, M. Fleck, M. Aringer, X. Baraliakos, D. Ernst, I. Haase, C. Hillebrecht, B.F. Hoyer, G. Keyßer, I. Kötter, A. Krause, M. Krusche, H.-M. Lorenz, F. Proft, F. Schuch, D. Vossen, A. Voormann, U. Wagner, J. Wollenhaupt und C. Specker geben an, dass kein Interessenkonflikt besteht. Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien., (© 2024. The Author(s).)

This position paper from the Digital Public Health Section of the German Public Health Association defines digital public health (DiPH) and describes its goals and potential. It also addresses the current situation and challenges as well as the need for action in Germany. The focus here is on the presentation of the nationwide promotion of (digital) health literacy; the application of DiPH in prevention, health promotion, and healthcare; the use of innovative preventive strategies for the prevention of non-communicable diseases; and the teaching of DiPH in academic public health programs. Finally, relevant measures and demands to strengthen DiPH in Germany are summarized., Competing Interests: Einhaltung ethischer Richtlinien. Interessenkonflikt: L. Maaß, C. Dockweiler, Z. Hocke-Bolte, S. Hoffmann, F. Fischer, S. Forberger, J. Gebert, F. Holl, R. Hrynyschyn, S. Kernebeck, C. Pischke, J. Posselt und J. Spallek geben an, dass kein Interessenkonflikt besteht. Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien., (© 2024. The Author(s).)

The German school system employs centrally organized performance assessments (some of which are called "VERA") as a way of promoting lesson development. In recent years, several German federal states introduced a computer-based performance testing system which will replace the paper-pencil testing system in the future. Scores from computer-based testing are required to be equivalent to paper-pencil testing scores so that the new testing medium does not lead to disadvantages for students. Therefore, the current study aimed at investigating the size of the mode effect and the moderating impact of students' gender, academic achievement and mainly spoken language in everyday life. In addition, the variance of the mode effect across tasks was investigated. The study was conducted in four German federal states in 2019 using a field experimental design. The test scores of 5140 eighth-graders from 165 schools in the subject German were analysed. The results of multi-level modelling revealed that students' test scores in the computerized version of the VERA test were significantly lower than in the paper-pencil version. Students with a lower academic achievement were more disadvantaged by the VERA computerized test. The results were inconsistent regarding the interactions between testing mode and students' gender and mainly spoken language in everyday life. The variance of the mode effect across tasks was high. Research into different subjects and in other federal states and countries under different testing conditions might yield further evidence about the generalizability of these results.

Background and Objectives: The timely determination and evaluation of laboratory parameters in patients with acute life- or organ-threatening diseases and disease states in the emergency room or intensive care units can be essential for diagnosis, initiation of therapy, and outcome. The aim of the position paper is to define the time requirements for the provision of laboratory results in emergency and intensive care medicine. Requirements for point-of-care testing (POCT) and the (central) laboratory can be derived from the urgency., Methods: Expert groups from the DGKL (Deutsche Gesellschaft für Klinische Chemie und Laboratoriumsmedizin) and DIVI (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin) developed a classification about the urgency for the determination of laboratory parameters as well as recommendations on the necessary organizational framework and quality assurance measures using national and international guidelines, review articles, and original papers., Results: Three levels of urgency are defined, based on the turnaround time of the most common laboratory parameters: emergency 1, with a turnaround time of no more than 15 min; emergency 2, with a turnaround time of a maximum of 60 min; urgent case, with a turnaround time within 4 h. In addition, a recommendation is made when to provide the results for the main ward rounds in the intensive care unit and the emergency department., Conclusions: The recommendations allow the organizational and technical regulations for each hospital to be aligned with the urgency of the provision of the test results to the medical team based on the medical requirements., Competing Interests: Einhaltung ethischer Richtlinien. Interessenkonflikt: C. Hermes: Mitgliedschaften in Fachverbänden und Vorstandstätigkeiten in der Pflegekammer NRW (Vorstand) und Bundespflegekammer. Vertretung Bundesressort NRW und der DGIIN. M. Spannagl: Vorstand INSTAND e. V., Gesellschaft zur Qualitätssicherung in med. Laboratorien. C. Waydhas: Schriftleitung der Zeitschrift Notfall + Rettungsmedizin. O. Kumpf, H. Mutlak, F. Walcher, P.B. Luppa, DIVI und DGKL geben an, dass kein Interessenkonflikt besteht. Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien., (© 2024. The Author(s).)

This position paper is based on the authors' many years of clinical experience and basic science research on the diagnosis and treatment of children and adolescents with a presymptomatic early stage of type 1 diabetes. The benefits as well as potential disadvantages of early detection of type 1 diabetes by islet autoantibody screening are critically discussed. In addition, the perspectives of delaying the onset of the clinical metabolic disease through treatment with teplizumab are addressed. Today, we see the chance for a relevant improvement in therapeutic options and life perspectives of affected children and adolescents. Important next steps for the implementation of islet autoantibody screening in Germany are the training of pediatricians who should inform families about the screening, establishment of a few transregional laboratories that carry out the test, and expansion of regional capacities for the training and care of children with an early stage of type 1 diabetes., Competing Interests: A.G.Z. ist Mitglied im Data Monitoring Committee (DMC) der Protect-Studie und der Petite-Studie (Teplizumab). O.K. ist National-Principle Investigator für Deutschland in der PROTECT-Studie (Teplizumab). R.B. ist Principle Investigator in der Protect-Studie (Teplizumab). Die weiteren Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Based on the relevance of an established and broad foundation of physical activity in healthcare, this position paper of the DNVF working group Physical Activity-Related Health Services research presents current conceptual approaches to physical activity-related health services in Germany and highlights the need for interprofessional and interdisciplinary approaches. Three central positions are outlined and elaborated in order to integrate the evidence on health benefits of physical activity and exercise more strongly into healthcare and to show that, against the background of the challenges in the German healthcare system, physical activity-related health services can make a cost-effective and high-quality contribution to improve healthcare. These three positions include 1) the integration of all professional groups involved in healthcare into physical activity-related health services, 2) the greater integration of physical activity professions and physical activity interventions into all healthcare contexts and 3) the systematic consideration of physical activity- and exercise-related expertise in clinical guidelines., Competing Interests: JW ist Konsortialführer des genannten MOVE-ONKO Projektes und Koordinator der S3-Leitlinie Bewegungstherapie bei onkologischen Erkrankungen. JW und KE haben an der S2k-Leitlinie in der pädiatrischen Onkologie mitgearbeitet. GS ist Konsortialpartner des genannten ImPuls-Projekts. SP ist Mitarbeiter im DVGS e. V., der als Fachverband Bewegungsfachkräfte qualifiziert, für die qualitätsgesicherte Umsetzung von Bewegung in allen Versorgungskontexten eintritt und Mandatstragende für die Mitarbeit an Leitlinien entsendet. CT ist Professor für Physiotherapie an der Hochschule für Gesundheit Bochum, die einen primärqualifizierenden Bachelor-Studiengang „Physiotherapie“ anbietet und für die Vollakademisierung der Physiotherapie eintritt. BW ist im Präsidium der Deutschen Vereinigung für Sportwissenschaft (dvs) und vertritt im Ressort „Gesundheit und Bewegung“ die Interessen der Sportwissenschaft. Alle Autorinnen und Autoren haben Projekterfahrung mit der Entwicklung, Implementierung und/oder Evaluation von bewegungsbezogenen Interventionen in verschiedenen Versorgungskontexten. AS, CT, LG und SP sind im Sprecherrat der AG bewegungsbezogene Versorgungsforschung und verweisen auf die Darlegung ihrer entsprechenden Interessen (https://dnvf.de/gruppen/ag-bewegungsbezogene-versorgungsforschung.html). Alle anderen Autorinnen und Autoren sind Mitglied der AG Bewegungsbezogenen Versorgungsforschung und geben an, keine Interessenkonflikte zu haben., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

This essay explores the material imperatives of nineteenth-century statistical ambition, at a time when the nature of paper itself underwent rapid change. It expands the concept of paper technologies to include knowledge about the materials themselves, as well as the infrastructures, techniques, and agreements that made it possible for the right kind of paper to be made available for particular purposes. Taking the production of the forms for the Prussian census as a case in point, it argues that the enumeration effort of Prussian census statisticians went far beyond designing a form, collecting information, noting and compiling figures, or creating tables. Paper knowledge to define and control the material substance of the forms mattered as much as political impetus and statistical methods in getting the census right. [ABSTRACT FROM AUTHOR]

Paper-based visual analogue scale (VAS) items were developed 100 years ago. Although they gained great popularity in clinical and medical research for assessing pain, they have been scarcely applied in other areas of psychological research for several decades. However, since the beginning of digitization, VAS have attracted growing interest among researchers for carrying out computerized and paper-based data assessments. In the present study, we investigated the research question "Which different design characteristics of paper-based VAS items are preferred by women and men?" Based on a sample of 115 participants (68 female), our results revealed that the respondents preferred a paper-based VAS item with a horizontal, 8-cm long, 3 DTP ("desktop publishing point") wide, black line, with flat line endpoints, and the ascending numerical anchors "0" and "10", both for women and men. Although we did not identify any gender difference in these characteristics, our findings uncovered clear preferences on how to design paper-based VAS items.

Objective: After over 25 years of developing clinical practice guidelines, the Association of the Scientific Medical Societies in Germany (AWMF) held a symposium to discuss the following topics in order to improve the way evidence is implemented in the delivery of care: expansion of the data pool for guideline development, the regulatory policy framework for this expansion, the transfer of clinical practice guideline statements to medical practice, the associated opportunities and risks resulting from the European legislation., Methods: The AWMF held its Berlin Forum on 27 April 2022 where experts from scientific medical societies and national institutions in the healthcare sector reported their experiences and perceptions on the topics mentioned. Three writing groups compiled the key statements from these contributions to and discussions made at the Berlin Forum into a position paper., Results: The AWMF recommends the following:- The creation of a digital infrastructure that serves the quality assurance of clinical practice guidelines and makes their content available at the bedside and during consultations- An increase in the number of industry-independent clinical trials on prevention, diagnostics and therapy with medicinal products, medical devices or other procedures - The funding of registry structures to generate point-of-care healthcare data- The reduction of excessive bureaucratic hurdles at both the national and EU level., Conclusions: By making concrete recommendations in this position paper, the AWMF maps out the steps required to improve the translation of evidence to the delivery of clinical care., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2024 Wörmann et al.)

Objective: Currently, there is an intensive discussion on advancing and expanding outpatient rhinosurgical procedures. Many questions about how to stratify into out- and inpatient procedures are still not sufficiently clarified. Particularly, the use of nasal packing materials is not adequately discussed., Material and Methods: Development of a checklist to stratify sinunasal procedures into in- or outpatient procedures with consideration of current scientific literature and risk factors., Results and Conclusions: After comprehensive assessment of the literature and analysis of specific risk factors, a list of sinunasal procedures is presented, which should be performed as inpatient procedures. We present a checklist for in- and outpatient sinunasal procedures, which considers social, medical and surgical factors as well as the use of nasal packing materials. Furthermore, a checklist is added to assess, whether patients are ready for discharge after a planned outpatient procedure., Competing Interests: Rainer Weber: Empfang von Honoraren oder Beratungsgebühren: GSK, Hommel Pharma, Infectopharm, KARL STORZ, Sanofi-Aventis, Sidroga, Spiggle & Theis, Stryker Bernhard Olzowy: Vortragshonorare für Radiofrequenzchirurgiekurse seitens der Fa. Neuwirth Medical Products, die selbstauflösende Chitosantamponaden (PosisepX) vertreibt. Frank Haubner: Honorare für Vorträge bei folgenden Firmen: Brainlab, Spiggle&Theis, RG Ärzteberatung, Neuwirth Robert Böscke: Reisekosten, Vortragshonorare: Sanofi, GSK Achim Beule: Vorträge für AstraZeneca, GlaxoSmithKline, Happersberger otopront, Medtronic, Novartis, Sanofi Aventis, Xion; Beratertätigkeit für AstraZeneca, GlaxoSmithKline, Medtronic, Novartis, Sanofi Aventis, Durchführung von wissenschaftlichen Studien an der Uniklinik Münster für Allakos, AstraZeneca, BioMed Elements/EU, Bristol Myers Squibb, GlaxoSmithKline, Happersberger otopront/AiF,Sanofi Aventis, Winicker Norimed; insgesamt aber keine Tätigkeiten mit Schwerpunkt „Nasentamponaden“ oder mit Bezug zu dieser Publikation Thomas Kühnel: Glaxo Smith Kline: Advisory Board; Karl Storz Endoskope: bezahlte Tätigkeit bei Operationskursen; Sanofi: Advisory Board (Einladung), Vortragstätigkeit; Dt. Fachgesellschaft für HNO-Heilkunde, Kopf- und Halschirurgie; Dt. Fachgesellschaft für Schädelbasischirurgie, (Thieme. All rights reserved.)

Vitiligo is a common disorder characterized by the visible loss of skin pigmentation. Non-segmental vitiligo (NSV) is the major subtype. The disease is caused by autoimmune-mediated destruction of melanocytes. Vitiligo leads to stigmatization and a significant reduction in quality of life. Disregarding the psychosocial burden, vitiligo is sometimes viewed solely as a cosmetic problem and, according to a global survey, is diagnosed on average only after 2.4 years. This delay contributes to a considerable burden of disease, including suicidal ideation. Stigmatization promotes the development of psychological comorbidities such as anxiety and depressive disorders, with prevalence rates varying by country and study (0.1%-67.9%). Data for Germany are heterogeneous and largely based on estimates. Due to psychosocial factors, the inflammatory component, and a higher incidence of somatic comorbidities, NSV may be regarded as an inflammatory systemic disease. We recommend optimizing care by incorporating the assessment of quality of life as a standard in routine care, in addition to monitoring disease activity. Moreover, early screening for psychological comorbidities is crucial to initiate appropriate treatment before the condition becomes chronic and cumulative (irreversible) impairments occur. The goal is a personalized and patient-centered integrated care approach that sustainably improves the health status of those affected., (© 2024 The Author(s). Journal der Deutschen Dermatologischen Gesellschaft published by Wiley‐VCH GmbH on behalf of Deutsche Dermatologische Gesellschaft.)

Inquiry-based learning (IBL) is a type of problem-based learning. While IBL aims at reflecting the work of practicing researchers, only some students will pursue an academic career. We therefore designed a course that provides opportunities for IBL by applying participant observation to internship work experience inside and outside academia. Using this internship course as an example, we investigated, how master's students in health science executed an IBL assignment regarding the application of participant observation and presentation of findings. In addition, the understanding of occupational fields provided through the IBL assignment was examined.To determine whether learning objectives were met, a document analysis of IBL assignments comprising presentation slides and field protocols was performed. Within content analysis, a category grid was used examining (a) suitability of chosen research objectives, (b) execution of field protocols, (c) sufficiency of reporting and (d) extent of reflection.49 IBL assignments from the years 2020-2022 were included. Sides of IBL observations were: (a) organizations providing health care (n = 28); (b) administrations of health care (n = 8); and (c) research institutes (n = 13). Within students' field protocols, the level of detail of descriptions differed. 30 assignments included reflection on the methods used and research experience. In about a third of IBL assignments, indication of observation type, theoretical background and data analysis was missing.Using participant observation of internship work-experience for IBL can serve as a teaching tool for students to develop methodological skills. For future courses, we developed a checklist to strengthen reporting, reflection and use of theory. As internships are often integrated in degree programs in health sciences similar courses could be implemented in different programs, given qualified methodological guidance., (© 2024. The Author(s).)

Background: Recent analyses have shown that in health services research in Germany, healthcare organisations are often considered primarily as a study setting, without fully taking their complex organisational nature into account, neither theoretically nor methodologically. Therefore, an initiative was launched to analyse the state of Organisational Health Services Research (OHSR) in Germany and to develop a strategic framework and road map to guide future efforts in the field. This paper summarizes positions that have been jointly developed by consulting experts from the interdisciplinary and international scientific community., Methods: In July 2023, a scoping workshop over the course of three days was held with 32 (inter)national experts from different research fields centred around OHSR topics using interactive workshop methods. Participants discussed their perspectives on OHSR, analysed current challenges in OHSR in Germany and developed key positions for the field's development., Results: The seven agreed-upon key positions addressed conceptual and strategic aspects. There was consensus that the field required the development of a research agenda that can guide future efforts. On a conceptual level, the need to address challenges in terms of interdisciplinarity, terminology, organisation(s) as research subjects, international comparative research and utilisation of organisational theory was recognized. On a strategic level, requirements with regard to teaching, promotion of interdisciplinary and international collaboration, suitable funding opportunities and participatory research were identified., Conclusions: This position paper seeks to serve as a framework to support further development of OHSR in Germany and as a guide for researchers and funding organisations on how to move OHSR forward. Some of the challenges discussed for German OHSR are equally present in other countries. Thus, this position paper can be used to initiate fruitful discussions in other countries., Competing Interests: LA ist Vorstandsmitglied der DGMS und des DNVF. Sie ist Mitglied des Editorial Boards des Journal of Health Care Services and Implementation. JB erhält Fördermittel für mehrere OVF-Projekte in Australien und Europa. ME ist Vorsitzender der Society for Studies in Organizing Healthcare (SHOC). Die Arbeit des Instituts für Arbeitsmedizin, Sozialmedizin und Versorgungsforschung, Universitätsklinikum Tübingen, wird durch einen zweckungebundenen Zuschuss des Arbeitgeberverbands der Metall- und Elektroindustrie Baden-Württemberg (Südwestmetall) unterstützt. Die übrigen Autor*innen erklären, dass keine Interessenkonflikte bestehen., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

Both tobacco cessation and low-dose CT screening in at-risk individuals reduce lung cancer-specific and all-cause mortality. As part of a national screening program for the early detection of lung cancer, smoking cessation must be a mandatory part of the counseling given to participants. This increases the cost-benefit effectiveness of the screening program. As part of the initial consultation evidence-based measures for smoking cessation must be offered to smoking participants of the screening program in form of a minimal intervention. If participants do not want to participate in a quit smoking measure they must actively refuse (opt-out rule). The costs of quitting smoking, including the costs of withdrawal-inhibiting medication, have to be fully covered by statutory health insurance for participants in the lung cancer screening program., Competing Interests: Alexander Rupp ist Berater der Firma Sanero Medical GmbH Stuttgart, die eine Internetplattform und eine digitale Gesundheitsanwendung (DiGA) zur Tabakentwöhnung betreibt.Christa Rustler ist Leiterin des Büros des Deutschen Netz rauchfreier Krankenhäuser und Gesundheitseinrichtungen (DNRfK), welches zur Implementierung des „rauchfrei tickets“ Zuwendungen der Bundeszentrale für gesundheitliche Aufklärung (BZgA) erhält.Die anderen Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Background and Objective: Despite the proven effectiveness of organized PSA-based screening in reducing prostate cancer-related mortality, there is currently no program in Germany covered by statutory health insurance. In accordance with the EU Council Decision (2022/0290(NLE)), the German Society of Urology (DGU) has developed a concept for risk-adapted prostate cancer early detection., Materials and Methods: Based on a literature review of current screening studies, an algorithm for PSA-based prostate cancer early detection was developed., Results: Risk-adapted prostate cancer screening involves PSA testing in the age group of 45-70 years, followed by PSA-based individual risk stratification and stepwise expansion of diagnostics through magnetic resonance imaging (MRI) to biopsy. While initially up to 2.6 million men will undergo PSA testing, a reduction in these initial examinations to fewer than 200,000 men per year will occur from year four onwards., Conclusions: The presented algorithm provides clear recommendations for risk-adapted PSA-based early detection for prostate cancer for urologists and patients. The goal is to improve diagnosis of clinically significant prostate cancer, while reducing overdiagnosis and overtreatment., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Up to the publication of the results of Germany's first participation in the PISA study in 2001, there had been no national educational standards in Germany's 16 federal states. In the aftermath of the discussions about the disappointing outcomes, Germany's federal states decided to develop national standards, yet focusing on "core subjects" and leaving geography disregarded. Consequently, the DGfG, which is the governing body of all professional geography associations in Germany, agreed on solving the problem on its own and published its own Educational Standards in Geography in 2006. Even though there have been countless efforts to foster the implementation of these widely-accepted, yet without legislative validation, standards we do not know exactly to what extent they have been implemented in the particular German federal states. The study presented here addresses this research gap bifid: Firstly, a research tool designed to analyze the paper implementation (i.e., putting into place new policies and procedures with the adoption of an innovation as the rationale for the policies and procedures, Fixsen et al., 2005, p. 6) of standards in curricula is introduced. Secondly, the results of a thorough examination of all curricula valid for the grammar schools in Germany are presented and discussed. As it becomes obvious, the Educational Standards have become increasingly implemented within the past years despite a lack of support by the legislations of the 16 federal states. However, there are some gaps that remain to be closed in order to ensure a complete, entirely successful paper implementation, ranging from particular areas of competence within the curricula in some states that have not adopted standards based geography instruction.

This article addresses the striking resemblance of a late nineteenth-century obstetrical simulator to contemporary commercial paper dolls. This period is often characterised in histories of medicine as one of increasing institutionalisation and professionalisation of childbirth through hospital training and state regulation. But this narrative is only part of the story. It marginalises the perspective of patients and midwives, and those outside of the geographic 'West', and it silences aspects of medical culture: social and caring relationships, emotion, play, and humour. While these aspects of medical history are less well represented in textual sources, material objects like Shibata Kōichi's 'Obstetrical Pocket-Phantoms' can help to give a fuller picture. Beginning by situating Shibata's phantoms in the conventional histories of obstetric training and the intermedial spaces of the clinic and lecture theatre, I then ask how the phantoms might have been used and understood differently outside of these spaces. Using Robin Bernstein's concept of 'scriptive things', I employ a visual and material study of the objects, informed by the wider cultural contexts of dolls and popular print culture in Germany, the USA and Japan, to argue for a history of Shibata's phantoms as paper dolls that encouraged many forms of play: from learning and explorative, to mothering and caring, to humorous and subversive. By acknowledging that Shibata's phantoms would also have been recognised as paper dolls, I present a history that centres unrecorded aspects of, and under-studied agents in, medical culture. [ABSTRACT FROM AUTHOR]

Introduction: We report an investigation on collaboration practices in research papers published in the most prestigious English-medium astrophysics journals. Method: We propose an evaluation method based on three numerical indicators to study and compare, in absolute terms, three different types of collaboration (international, national and local) and authors' mobility on the basis of co-authorship. Analysis: We analysed 300 randomly selected research papers in three different time periods and used the student's t-test to determine whether the paired two-sample differences observed were statistically significant or not. Results: International collaboration is more common than national and local collaboration. International, national and local authors' mobility and intra-national collaboration do not seriously affect the indicators of the principal levels of collaboration. International collaboration and authors' mobility are more relevant for authors publishing in European journals, whereas national and intra-national collaboration and national mobility are more important for authors publishing in US journals. Conclusions: We explain the observed differences and patterns in terms of the specific scope of each journal and the socio-economic and political situation in both geographic contexts (Europe and the USA). Our study provides a global picture of collaboration practices in astrophysics and its possible application to many other sciences and fields would undoubtedly help bring into focus the really big issues for overall research management and policy.