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In Nazi Germany (1933–45), reclaiming waste became an intrinsic component of the regime's economy as well as its ideological, racial, and expansionist ambitions. National Socialist interventions into waste streams began in 1934 with salvage campaigns. The state then brought urban waste policies and municipal waste services under its control, restructuring and 'Aryanising' the waste salvage trade. Moreover, both consumers and producers were prompted to collect and reprocess waste. Over time, the gradual expansion of the Nazi waste recovery policies and campaigns – here referred to as the 'Nazi waste exploitation regime' – brought forth a determined vision of a circular economy in which no waste whatsoever should escape its reclamation for the national community or Volksgemeinschaft. This article sketches the actors, structures, and objectives of this waste exploitation regime for the case of rags and paper and uncovers its entanglement with Nazi racist and genocidal ideology and expansionism. [ABSTRACT FROM AUTHOR]

Several studies have investigated the relationship between the energy performance of buildings and housing prices. First, this paper identifies a price premium for energy efficiency within the German rental market. Then, the indexed price differences and associated marginal benefits are compared with the marginal costs of energy retrofits. An extensive database of Germany's largest online platform for housing over a time span from 2016 to 2020 is used in a hedonic regression approach. In addition, to extract the marginal costs of energy consumption abatement, a dataset of 1048 rental units regarding green-retrofit measures is utilized. Although a significant green premium is identified in the rental market, the findings suggest that it is not high enough to compensate landlords for the money they have to spend to retrofit. The marginal costs exceed the marginal benefits by far. Furthermore, it is found that the German government's recent plans to split the carbon tax between landlords and tenants do not change this because the price per metric ton of carbon is insufficiently high. Limitations with respect to the data basis and consequently to the interpretation of the results exist. Nevertheless, the findings can help both tenants and landlords in their decision-making, as well as policy makers in the implementation of decarbonization efforts. [ABSTRACT FROM AUTHOR]

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease affecting approximately 1% of the population. The patient journey through the German health care system leads to high disease burden and substantial treatment costs. The EsmAiL study showed that an innovative, interprofessional, multimodal care-concept reduces disease activity and burden of HS compared to standard care. This paper examines the costs of treating HS in Germany and compares them with those of the innovative care concept implemented in EsmAiL. EsmAiL was a two-arm, multicenter, prospective randomized controlled trial including 553 adults with HS. The study was registered in the German Clinical Trials Registry (DRKS00022135). The control group (CG) remained in standard care, whereas the intervention group (IG) was referred to specialized so-called 'acne-inversa-centres (AiZ)' where patients were treated with a structured, interdisciplinary approach. The present paper analyses the treatment costs for a subpopulation based on health insurance cost data from the two largest German health insurers. Quality-Adjusted Life Years (QALY) was assessed based on Dermatology Life Quality Index (DLQI). Total annual treatment costs per patient were €3,966.07 in standard care (n = 89) and €3,974.37 in the innovative care (n = 93). The costs per additional QALY amounted to €12,698.72 in the IG. Given the conventional and established threshold of €22,600 to €33,900 per QALY, the innovative treatment in AiZ proved to be cost-effective. Treatment costs of HS are substantial and increase with disease severity. The new form of care is cost-effective and is expected to decrease costs in the long run. A structured, multimodal form of care reduces costs in the treatment of Hidradenitis suppurativa compared to standard care. [ABSTRACT FROM AUTHOR]

Smaller towns in rural regions are important anchors for regional development, but they are not usually considered particularly innovative and open to new ideas. This paper asks how the network of small and medium-sized towns, Cittaslow, could establish slowing down as something new in local development. Against the theoretical background of sociological innovation research, an analytical framework of social innovation is elaborated to analyse Cittaslow using four case studies: two German and two Italian towns. Based on fieldwork in the four towns, this paper shows that discourse and communication on slowing down, local projects labelled as slow and new cooperation structures go hand in hand. This leads to the conclusion that new ways of local development need a communicative umbrella under which projects and stakeholders come together. The paper furthermore demonstrates that the analytical framework, with its triad of semantics, pragmatics and grammar, is extremely helpful for analysing spatial development and has the potential to be adapted as a tool for policy strategies. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has affected how people go about their daily lives, often in various and substantial ways. This study aims to prospectively evaluate the changes in social participation during the COVID-19 pandemic in persons with a high risk for a severe COVID-19 course in Germany. A paper-pencil-based survey was conducted starting at March 2021. Participants filled out questionnaires at four time points based on their COVID-19 vaccination status: before COVID-19 vaccination, one month, six months and twelve months after COVID-19 vaccination. Social participation measures included the Pandemic Social Participation Questionnaire (PSP-Q) and the Index for measuring participation restrictions (IMET). Repeated measures ANOVA and paired t-test were used to test for changes between time-points. Repeated measures correlation was used to assess the relationship between social participation and local COVID-19 incidences. Data from 245 participants was analyzed before and one month after COVID-19 vaccination. In addition, data from 156 participants was analyzed at time points one, six and twelve months after COVID-19. PSP-Q and IMET scores changed significantly after participants received a COVID-19 vaccination. Between one month and twelve months after vaccination, social participation improved significantly measured by PSP-Q. Social participation was negatively correlated with regional COVID-19 incidences before and after COVID-19 vaccination. Social participation was positively correlated with COVID-19 incidences between one month and twelve months after COVID-19 vaccination. Social participation improved in persons with a high risk for a severe COVID-19 course during the pandemic. The local COVID-19 incidence showed a negative association with social participation only until the fall of 2021 when it was used as the sole metric to regulate COVID-19 protective measures. Although our data describes the trends in social participation, further studies are needed to identify the influencing factors for the observed increase in social participation. [ABSTRACT FROM AUTHOR]

This paper aims to discuss the influence of migration policy risk on market segmentation of housing and rental markets in the Euro Area. Policy risk is represented by the Migration Policy Uncertainty Index (MPUI) and Migration Fear Index (MFI) of Germany and the United Kingdom; in this study, whether these indexes influence the interaction between the housing and rental markets of the two countries and euro-area countries was examined. The empirical results showed that the influence of the United Kingdom's migration policy risk on the euro-area countries is higher than that of Germany. The United Kingdom's MPUI and MFI significantly contribute to the influence of the United Kingdom's housing market on other markets except for Belgium and Spain. Compared with housing market connectedness, the rental market connectedness is less influenced by migration policy risk and migration fear. This may be because variables related to short-term residence policies influence the rental market. The high policy risk is more likely to influence decisions related to long-term house purchase, but not those related to short-term residence. Finally, this study found that the higher the uncertainty of the migration policies of the United Kingdom and Germany is, the higher the house market segmentation is. [ABSTRACT FROM AUTHOR]

Background: Since its academic inception in the 1960s, Germany's general practice has seen numerous dissertations, many of which are housed in the 'Archive of German language General Practice' (ADAM). Aim: This study aims to provide the first comprehensive overview of dissertation topics from the discipline of general- and family medicine in Germany, establishing a foundation for advancing research. Method: We employed a systematic review approach, examining 801 dissertations from both ADAM and online sources. Each topic was identified, categorized, and finalized through consensus by two independent reviewers. Results: Our analysis encompassed 486 dissertations from ADAM, 176 from the German national library, and 139 from university libraries. A total of 167 unique research topics were identified. The predominant themes included medical education (n = 49), medication orders (n = 39), frequent consultation issues (n = 33), complementary medicine (n = 32), and screening measures (n = 29). The use of qualitative methods was constantly rising, from no qualitative methods used from 1965–1974, up to 22% of dissertations in recent years. Conclusion: The diversity of 167 research topics underscores the vastness and complexity of general practice in Germany. This structured overview is pivotal for facilitating focused and interconnected research endeavors in the field. [ABSTRACT FROM AUTHOR]

In 2015, the Programme for International Student Assessment (PISA) introduced multiple changes in its study design, the most extensive being the transition from paper- to computer-based assessment. We investigated the differences between German students' text responses to eight reading items from the paper-based study in 2012 to text responses to the same items from the computer-based study in 2015. Two response features - information quantity and relevance proportion - were extracted by natural language processing techniques because they are crucial indicators for the response process. Showcasing potential differential relationships, we additionally examined gender differences. Modelling effects of the round of assessment, gender, and response correctness on the response features, we analysed responses from 15-year-olds and ninth-graders in Germany. Results revealed differences in the text responses between the rounds of assessment in that students included more information overall in 2015, and the proportions of relevance varied substantially across items. As the study investigated the mode change in PISA's natural (not experimental) setting, the differences could mirror cohort trends or design changes. However, with the evidence reported, we conclude that the differences could indicate mode effects. [ABSTRACT FROM AUTHOR]

Classroom management is an emotionally demanding task for mathematics teachers, especially if students exhibit frequent discipline problems. Intense classroom conflicts can result in persistent latent emotional dispositions, such as fear or anger, that teachers are not directly aware of but that have a strong influence on their classroom management. However, little is known about the relationship between mathematics teachers' latent emotions and their classroom management strategies. This paper reports on findings from an exploratory, video-based single case study in an urban secondary school in Germany. One mathematics double lesson (95 minutes in total) was videotaped to conduct a depth-hermeneutical analysis of identified classroom management strategies and the corresponding latent teacher emotions. The results suggest that mathematics teachers use classroom management strategies not only to establish orderly lessons but also to regulate intense latent emotions that arise during classroom teaching. [ABSTRACT FROM AUTHOR]

This paper studies the conditions under which quality conventions in coffee can be revised. It shows how value is captured by a collective composed by Colombian producers overseeing coffee quality attributes, engaging in relational approaches and building knowledge with international buyers. Interviews were conducted with selected organic producers in Santa Marta, Colombia and buyers (e.g. in Germany, the Netherlands). Due to the sound relations between the staff of the producer organization and a German buyer, the manager of the collective proposed to also export roasted coffee in addition to green coffee. Although roasting at origin is not common in coffee exports, in the case analyzed existing hesitations were abandoned. Eye-level relationships, trust based on a relational approach and knowledge were key to achieving a collective quality construction and subsequent value capture by producers. Over time, these producers have improved their material quality techniques and become more familiar with the places where their coffee circulates and is valued, allowing them to influence the commercial spheres of the coffee business. The discussion is not about changing quality conventions, but on how quality conventions are institutionalized and the narratives behind them. [ABSTRACT FROM AUTHOR]

The disruptions associated with health and energy crisis have emphasized the need for hyperlocal cities. However, in Europe, a tool to measure the efficiency of land use and accessibility planning for localizing urban mobility is missing. In this paper, we construct a comparable 15-Minute-Walking City (15-MWC) index that assesses the walking performance of 121 European metropolitan areas and seven amenity types. The data are combined equally following the PROMETHEE II multicriteria approach to assign a final score and to present a ranking of 15-Minutes cities. The main visualization demonstrates European-level disparities and indicates that most of leading cities are in Germany, while most of the worst performers are in the UK. We also reveal a statistically significant difference in 15-MWC performance due to their GDP per capita disparities. The empirical results may serve as a referencing tool for cross-city comparisons and may support policymakers when designing transport and city-planning strategies. [ABSTRACT FROM AUTHOR]

Multi-locality - a lifestyle involving living in several places - is very diverse. Involving temporary presences and absences, it can impact local communities and the environment. This paper looks at the effects of multi-local lifestyles in three rural districts in Lower Saxony, Germany, evaluating quantitative surveys and qualitative interviews with multi-local residents, company representatives and officials. The methods are supplemented by visualizations and reflexive photography. Multi-locals can be seen as both an opportunity and a risk for civic involvement: multi-locality makes it possible to avoid relocation, but the limited periods of presence make it unlikely for multi-locals to become involved locally. Likewise, multi-locality impacts the environment, leading to an increasing volume of traffic and higher land consumption, even if it less significant than the impact of daily commuting. [ABSTRACT FROM AUTHOR]

Companies across the globe have intensified the digital interconnectedness of their manufacturing processes. Much attention was devoted to how industrial employment will be affected in this new production paradigm. In this paper, we use survey data collected from German industrial workers in 2014 and 2020 to contribute to the literature on digitalisation and industrial employment. This is the first scientific study on Industry 4.0 that empirically deals with the development of key parameters of industrial employment over time. Our findings support the argument that whilst increased digital interconnectedness creates more opportunities for highly skilled workers, the extent to which manual workers will be substituted is often overestimated. Second, our data suggests that the operations of larger companies tend to be more highly digitally interconnected than those of smaller firms. We also provide evidence that German industrial workers are less likely to expect substantial job losses through digitalisation than in 2014. [ABSTRACT FROM AUTHOR]

In striving to achieve the Paris Agreement and the 2030 Agenda, governments have the opportunity to implement their climate and sustainability goals more coherently. Such coherence requires the coordination of interdependent policies across different policy fields, sectors and actors. This paper explores how governments design and implement synergic solutions to concomitantly achieve both international agendas. With the empirical cases of Germany and South Africa, we investigate two independent approaches to the synergic solution of a just energy transition, whereby countries aim to phase out coal as a means to tackle climate change while also ensuring that the achievement of other Sustainable Development Goals (SDGs) is not hindered. Methodologically, we apply a deductive qualitative approach consisting of literature review, semi-structured interviews, and content analysis. To that end, we examine relevant policies and institutional arrangements by applying a combined conceptual framework of energy justice and just transition in both countries. We find major challenges in overcoming environmental, economic and social burdens of the coal phase-out, especially related to jobs and inequality (SDGs 8, 10) and the Water-Energy-Food-Land nexus (SDGs 2, 6, 7, 15). Through the selection of Germany and South Africa, we illustrate how countries with different political, social and economic backgrounds strive to manage such a transition. Our developed framework and case-studies' findings point towards important considerations when designing just energy transition pathways, such as ensuring inclusiveness in decision-making, thoroughly assessing social, economic and environmental impacts, and adequately coordinating across different actors and the local, provincial and national levels. [ABSTRACT FROM AUTHOR]

This paper investigates the acceptance of Autonomous Vehicles (AVs) in Japan, the UK and Germany and speculates on the implications for policy and practice. Three on-line surveys of 3,000 members of the public in total, which were conducted in January 2017 (Japan), March 2018 (UK) and November/December 2018 (Germany) were analysed using Principal Component Analysis and then with an Ordered Logit Model. It finds that acceptance of AVs was higher amongst people with higher expectations of the benefits of AVs, those with less knowledge of AVs, and those with lower perceptions of risk. It also finds frequent drivers and car passengers to be more accepting, but that socio-economic factors were mostly insignificant. Finally, there were significant cultural differences between the levels of acceptance between Japan (broadly positive), the UK (broadly neutral) and Germany (broadly negative). These findings suggest that AV promoters should raise (or at least maintain) expectations of AVs among the public; engage with the public to reverse the negative perception of AVs; address AV-generated fears; not bother targeting people by socio-economic group; target frequent car drivers and passengers with information about what AVs could do for them; and target countries where AVs already enjoy a positive image. [ABSTRACT FROM AUTHOR]

The paper deals with the application of stochastic optimization principles for investment decision making. The authors present the investment management system based on an adequate portfolio model. For optimal portfolio construction and stock selection, the method of stochastically informative expertise and ranging is used. Investment portfolios in equity and currency markets are formed considering investor risk tolerance and risk preference level, as well as an individual utility function. Investment portfolios are constructed according to three criteria: return, risk, and reliability. The markets of Germany, the USA, and China, as well as foreign exchange markets, are analysed. The results reveal the efficient investment possibilities in the mentioned markets, allowing to reach investment return substantially exceeding market index return. Along with that, an innovative stochastic clustering methodology for investment assets is proposed. The obtained results are of great value for individual as well as institutional investors and are a suitable means to form efficient investment strategies in financial markets. [ABSTRACT FROM AUTHOR]

The increasing inequality of private income and wealth requires the redistribution of financial resources. Thus, several financial support schemes allocate budget across countries or regions. This work shows how to estimate private wealth at low regional levels by means of a modified Fay–Herriot approach that deals with (a) unit and item non-response, especially with used multiple imputation, (b) the skewness of the wealth distribution, and (c) inconsistencies of the regional estimates with the national direct estimate. One compelling example for financial redistribution is the promoted catching-up process of East Germany after the German reunification. This work shows that 25 years after the reunification differences are more diverse than just between the East and the West by estimating private wealth at two regional levels in Germany. The analysis is based on the Household Finance and Consumption Survey (HFCS) that the European Central Bank launched for all euro area countries in 2010. Although the application in this paper focuses particularly on Germany, the approach proposed is applicable to the other countries participating in the HFCS as well as to other surveys that make use of multiple imputation. [ABSTRACT FROM AUTHOR]

Middle-class parents' strategies of reproduction and social closure and their role as a driver of school segregation are already well-reported. Our two independent research projects in Finland and Germany have additionally revealed a somewhat surprising and not yet fully understood tendency of certain middle-class parents to actively avoid the most reputable schools. Using these findings as a starting point, the paper investigates the motives and reasoning behind middle-class parents' avoidance strategies in the cities of Espoo (Finland) and Mülheim an der Ruhr (Germany). The analysis shows that in educational transitions where choice is not constrained by a risk of children being left behind, some families with high educational resources and imbued with a certain ethos give precedence to 'ordinary' schools over highly selective elite schools. If this ethos can be skilfully integrated into urban educational policies, it may help develop effective equality strategies supported by parents and seen as justified by them. [ABSTRACT FROM AUTHOR]

Marburger Bund is the largest doctors' union in Europe representing about 125,000 salaried doctors in Germany and fights for fair working conditions, appropriate salaries, quality in training, and improvements in the work-life balance. Following a decision of 127th Marburger Bund General Assembly 2015, criteria should be developed to be applied by participants to assess independence in planning and delivery of individual CME activities. This position paper describes the role of methodological and medical competence generation and use of data (evidence) independent sources of information independence of faculty in CME language in medical education conduct of independent CME, and independence of (passive) physician participants in CME Measures are defined by which independence in CME may be achieved and how this may change the process of CME delivery. [ABSTRACT FROM AUTHOR]

A growing refugee and migration crisis has imploded on European shores, immobilizing E.U. countries and fuelling a rise in far-right parties. Against this backdrop, this paper investigates the question of how to foster pluralism and a cosmopolitan desire for living with others who are newcomers. It does so by investigating community-based, citizen-led initiatives that open communities to newcomers, such as refugees and migrants, and foster cultural pluralism in ways that transform understandings of who is a citizen and belongs to the community. This study focuses on initiatives which seek to build solidarity and social relations with newcomers, but in ways that challenge citizen/non-citizen binaries based on one of our field research sites: Berlin, Germany. The paper brings insights from critical citizenship studies, exploring how citizenship is constituted through everyday practices, into dialogue with radical cosmopolitanism, particularly through Derrida’s works on ‘unconditional hospitality’. This radical cosmopolitan literature theorizes possibilities for building relational ontologies between guest and host, citizen and newcomer, in ways that are not based on exclusion, but engagement with difference and which challenge antagonistic forms of self-other and citizen-non-citizen dichotomies. Illustrative examples based on community-led initiatives in Berlin demonstrate how this spirit of radical communitarianism is put into practice through everyday lived experience and demonstrate that it is possible to develop a cosmopolitan spirit through exchange and transformation of both the self and other by engaging with rather than seeking to eliminate difference in the aims of constituting a universal around which cosmopolitanism can be built. [ABSTRACT FROM PUBLISHER]

This paper describes the characterization of a new infectious bronchitis virus (IBV) strain D181, that rapidly evolved from a low-level incidental finding in 2017 to become the second most isolated IBV strain in Dutch layers and breeders in 2018, as well as being found in samples from Germany and Belgium. Based on the sequence of the S gene and the results of cross-neutralization tests, D181 can be considered as a new serotype and the second lineage within genotype II (GII-2). The experimental infection of SPF hens confirmed the ability of D181 to cause a drop in egg production, and immunohistochemistry showed presence of the virus in the trachea, lung and conjunctiva at 5 days post inoculation and in the caecal tonsils at 5 and 8 days post inoculation. In silico analysis of several widely used PCR primers indicated that primer sets adapted for GII might be needed to detect D181, as many general S1 primers might miss it. [ABSTRACT FROM AUTHOR]

The definition for special education needs (SEN) and the policies for its assessment varies widely between countries. This paper aims to investigate similarities and differences through a Swedish-German comparative approach. Based on the distinction between categorical and relational perspectives as expressions of specific thought styles, 58 SEN assessment reports from both countries were qualitatively analysed. The results demonstrate the maintenance of the categorical perspective in terms of focusing on the pupil's 'failure'. This result is even more notable in the German examples than the Swedish cases. Exceptionally and in both countries, a relational perspective emerges, taking teaching and the social environment into account. In conclusion, we suggest a flexible SEN approach with a stronger emphasis on the relation between the individual and the learning environment. [ABSTRACT FROM AUTHOR]

Germany strives to transition its energy supply system toward a high share of renewables, a development accompanied by an increasingly decentralized supply structure. The country’s energy strategy represents an influential top-down mechanism, but the process is also driven from the bottom up. The German federal states (Laender) experiment and innovate, and some explicitly strive to be forerunners in renewable energy policy. Due to different geographic, economic and demographic structures, however, they set different priorities and their strategies are not always aligned with the national strategy. In addressing these issues, this paper explores the advantages and constraints which multi-level governance poses to Germany’s transition towards a renewable energy system. It refers to the academic debate on German federalism and reinforced diffusion of renewable electricity production by horizontal and vertical dynamics in multi-level systems. In focusing on renewable energy policy at the national and subnational level, as well as their interplay, this paper asks whether national and subnational renewable energy policies are aligned hence providing for a multi-level reinforcement of the ongoing energy transition process. It shows that the Energy transition is on the one hand advanced through experimentation at the subnational level of the Laender. It claims that on the other hand the Laender risk increased inefficiencies and macroeconomic cost if they focus on an inwardly directed policy and argues for enhanced coordination efforts. It argues that the mechanisms of cooperative federalism in Germany’s renewable energy policy are inadequate with regard to the implementation of the “German Energiewende”. The present multi-level governance structure does not provide for the necessary integration of national and subnational energy policies. [ABSTRACT FROM PUBLISHER]

The principles of sustainable development are becoming extremely relevant for organisations. In the case of universities, these institutions can act as agents in promoting these principles within society. The literature contains a wide range of studies which show how universities may play a critical role in disseminating sustainability principles on the one hand, and their translation into practice, on the other. At present, many higher education institutions are becoming more aware of their impact on the environment, and trying to understand the environmental needs and implications of their operations. Going further, some universities are incorporating sustainability principles into their activities. One of the questions that universities are now facing is how education for sustainable development can be translated into practice so that it can be effective in transforming society. This paper will discuss the need for and the usefulness of integrative approaches to implement sustainable development in higher education. In addition to a theoretical review of the state of the art, the paper will use case studies from the Hamburg University of Applied Sciences (Germany) and Bournemouth University (UK) to illustrate the effectiveness of integration of sustainable development principles in university research and teaching activities, and the many benefits integrative approaches may bring about. [ABSTRACT FROM AUTHOR]

This paper employs socioeconomic and remote sensing data to develop a novel approach to analysing the morphological urban spatial structure in select German city-regions. Furthermore, the suggested multidimensional procedure facilitates the analysis of the implications of different urban spatial structures in terms of physical urban form. All analyses are conducted on the spatial scale of 1 km? grid cells to allow for spatially detailed results and to account for intra-municipality differences in the urban spatial structures in the study regions. The results indicate fundamental differences among the study regions' distribution of employees and built-up volumes and, as a result, among their urban spatial structures. Both employees and built-up volumes are found to be highly spatially clustered primarily within the core cities but with notable exceptions, which thus qualifies the regions as polycentric. This finding is consistent with prior research but also reveals that built-up volumes can be understood as physical manifestations of proximity advantages to which firms and employees are subject. [ABSTRACT FROM AUTHOR]

This study targets hitherto largely understudied empirical processes and activities through which certain ideas and imaginaries are being commercialised and used by corporate actors in the global Early Childhood Education and Care (ECEC) industry. The aim is to analyse and critically discuss representations of the Scandinavian ECEC regime in the context of ECEC export. This is achieved empirically through a case study of a Swedish education company and its expansion in Germany, as well as by devoting analytical attention to the social, political and fantasmatic logics in the processes that constitute and characterise the "Scandinavian ECEC offer" as it is being exported. The analysis draws on corporate documents, websites and interviews with top-level company representatives. The analysis highlights how the Scandinavian ECEC regime is made up of four interlinked elements; equality, the autonomous child, integration of care and learning and outdoor pedagogy, aligned and sustained by "gripping" and "sticking" forces in fantasmatic logics that hide contingencies. In summary, the powerful imaginary of the Scandinavian ECEC regime, bringing accessibility, social justice, gender equality, nature, democracy, children's rights and autonomy, serves to conceal the political and ideological dimension of the economic logic of capitalism. [ABSTRACT FROM AUTHOR]

This article analyzes the power relations in the field of German economics. By incorporating the capital and field theory of Pierre Bourdieu, the study investigates the distribution of economic, social, and symbolic capital on economists in Germany. In a first step, the three forms of capital have been defined and operationalized on publicly available information. This leads to eight main samples of economists. In a second step, information on these economists have been collected to derive indicators regarding their paradigmatic stance and institutional background. The findings indicate a monopolization of mainstream economics and concentration of resources on the large economic departments. Furthermore, these characteristics relate to an increased importance of Colander's Edge, an almost complete marginalization of heterodox economics and a significant center-periphery disparity. Thus, in the field of economics in Germany, a social structural verticalization and elitism of universities as well as a paradigm monism can be observed. [ABSTRACT FROM AUTHOR]

Plant-based diets reduce the risk of cardiovascular disease but also increase the risk of certain micronutrient deficiencies, particularly, of vitamin B12 (B12). The extent to which the unsupervised use of oral nutrient supplements is sufficient to prevent these deficiencies is not well established. We analyzed nutrient intake, laboratory biomarkers, supplementation behavior, and B12 status adequacy amongst young, healthy, physically active omnivores, lacto-ovo-vegetarians and vegans from Germany. We recruited 115 participants (n = 40 omnivores; n = 37 lacto-ovo-vegetarians, and n = 38 vegans) with comparable age, sex, marital status, physical activity and educational levels through online advertisements and local newspapers in Freiburg, Germany. Energy intake and macronutrient distribution were comparable across diets. Major differences included intake of fiber, cholesterol, and several vitamins. Vegans had the lowest intake of B12 from foods (0.43 (0.58) µg/d), compared to omnivores (2.14 (2.29) µg/d) and lacto-ovo-vegetarians (0.98 (1.34) µg/day). Multivariate analysis of 36 blood biomarkers revealed that three major classes of biomarkers contributed the most to the clustering of individuals by dietary group, namely, biomarkers of B12 status (B12, holoTC, Hcy), iron (iron, ferritin, transferrin) and lipid metabolism (vitamin A, HDL, LDL, total cholesterol, TAG). This suggests that nutrients that modify the metabolic pathways represented by these biomarkers have the most penetrating effect on health status across diets. Analysis of B12 status (including 4cB12) revealed adequacy in omnivores and vegans, and a poorer B12 status amongst lacto-ovo-vegetarians. Fewer lacto-ovo-vegetarians used B12 supplements compared to vegans (51% versus 90%). Even amongst homogeneously healthy Germans, each diet manifested with measurable differences in dietary intakes and biomarkers of health. Plant-based diets, in particular the vegan diet, exhibited the most favorable patterns of lipid metabolism and glycemic control, but the lowest food intake of B12. Supplementation of healthy vegans with B12 (median 250 µg B12/day, over 1 year) secured an adequate B12 status that was comparable to that of healthy omnivores. Clinical Trial Registry: German Clinical Trial register number: DRKS00027425 Plant-based diets, in particular the vegan diet, exhibited the most favorable patterns of lipid metabolism and glycemic control, but the lowest food intake of B12. Analysis of B12 status (including 4cB12) revealed adequacy in omnivores and vegans, and a poorer B12 status amongst lacto-ovo-vegetarians. Supplementation with B12 (median 250 µg B12/day, over 1 year) in healthy physically-active vegans secured an adequate B12 status that was comparable to that of healthy omnivores. [ABSTRACT FROM AUTHOR]

Background: Potential risk contacts for HIV transmission may lead to presentations to the emergency department (ED) for counseling and initiation of post-exposure prophylaxis (PEP). Objective: To examine the impact of German health insurance covering pre-exposure prophylaxis (PrEP) following Sept 1st 2019 for certain risk groups on the frequency and reasons for PEP counseling in a university-based ED in Germany. Methods: In a before-after study design, all persons aged ≥18 years who presented for PEP counseling were analyzed retrospectively. We compared characteristics of presentations in the 18 months prior to PrEP coverage on Sept 1st, 2019, with those in the following 18 months. Results: 154 ED presentations occurred in the first study period, and 155 ED presentations in the second period. Regarding the reasons for ED visits, no statistically significant difference was found [occupational risk contact (18.2 vs. 26.5%, p = 0.081), sexual risk contact (74.7 vs. 69.0%, p = 0.266), other non-occupational risk contact (7.1 vs. 4.5%, p = 0.329)]. For men who have sex with men (MSM), no statistically significant differences were found [38.9 (n = 60) vs. 35.5% (n = 55), p = 0.537]. All persons presenting to the HIV outpatient clinic after ED PEP initiation (n = 60 vs. n = 52) tested negative for HIV 3 months later. Conclusion: In this study, reasons to present for PEP counseling to a university ED showed no change following the implementation of PrEP coverage by health insurances. Therefore, PEP remains an important prevention for HIV transmission and presentations to the ED for PEP counseling may provide an opportunity to educate persons at risk of HIV infection about PrEP, thereby helping to prevent new HIV infections. [ABSTRACT FROM AUTHOR]

Balancing the demand for ecosystem services (ES) with available supply is one key challenge for decision making in sustainable landscape management. ES demand is context-specific. Therefore, the assessment of perceptions articulated by multiple societal actors in different regions can help to identify differences and commonalities in predominant preferences for landscapes and their ES. The goal of this study was to investigate four societal actor groups (citizens, farmers, foresters, nature managers) in 12 study regions across Bavaria, Germany, with respect to their valuation of landscapes and ES provided by certain landscape elements. The 2,438 participants mapped specific locations and selected landscape elements that they perceived as valuable, and further elaborated on this value in open statements. We applied qualitative content analysis, word frequency analysis, spatial location-density analysis, and statistical testing. The perceived value of landscape elements for ES differed across actor groups and regions. Preference for landscape elements was driven by topography and land use and was significantly associated with actor groups. The most apparent differences occurred between farmers and nature managers. Generally, participants preferred forests, water bodies, natural landscapes, and distinct geographical structures. The landscape was mostly valued for its habitat, diverse wildlife, recreational purposes, climate-regulating functions, and provisioning of water and food. We conclude that, although differences exist among societal actors, the study respondents highly valued the importance of functioning and diverse ecosystems. The high perceived value for many ecosystem services and species protection suggests that ambitious policy measures are supported by different societal actors. [ABSTRACT FROM AUTHOR]

Due to the COVID-19 pandemic many employees perform under increasingly digital conditions. Enabling home office environments became mandatory for companies wherever possible in consideration of the ongoing pandemic. Simultaneously, studies reported on digital stress. The current literature lacks rigorous research into digital stress on psychosomatic outcomes, emotions, and disease. Therefore, we endeavor to understand how digital stress developed over the course of the pandemic and if it predicts differences in negative emotions and physical complaints in the home office setting. To answer the research question, we conducted an online survey among 441 employees in 2020 and 398 employees in 2022 from three municipal administrations in Germany, who were working from home at least occasionally. We used a cluster analysis to detect digitally stressed employees. Regression analyses were performed on digital stress, negative emotions, and physical complaints. The analysis revealed an increase from 9 to 20% in digital stress, while negative emotions and physical complaints did not show evident differences. In the multivariate model, we observe a change in the proportion of digitally stressed employees between 4 and 17%, while the control variables explain around 9%. Digital stress did not significantly affect either negative emotions or physical complaints. However, digital stress appeared to exert a more substantial predictive influence on negative emotions. The study emphasizes rising digital stress, which contradicts a positive adaption to the digital working conditions within the observed period. The psychosomatic relations are low or lagged. Further research investigating digital stress and countermeasures, especially to understand how to prevent harmful long-term effects such as distress resulting from working from home conditions, is needed. [ABSTRACT FROM AUTHOR]

Discrepancies exist between guideline recommendations and real-world practice of blood pressure (BP) measurements. The aim of this study was to assess, with a nationwide, questionnaire-based survey, the current practice of BP measurement and associated BP values in German medical practices. A nationwide survey in German medical practices was performed in the period from 10 May 2021 to 15 August 2021. The questionnaire was divided into five sections. The current office BP (OBP) values as well as the current drug therapy were recorded. In addition, the implementation of office BP (OBP) and home BP monitoring (HBPM) was queried. For analysis, questionnaires were scanned and automatically digitised. A total of 7049 questionnaires were analysed, the majority of which came from general practitioners (66%) and internal medicine practices (34%). The average OBP (SD) was 140.0 (18)/82.7 (11) mmHg. 40.8% of treated patients had OBP in the controlled range, with monotherapy (34.7%) or dual combination therapy (38.2%) prescribed in most cases. OBP was taken from a single measurement in 66.3% of cases, and in 21.8% from 23 measurements. OBP was mostly measured after a rest period (87.1%) and in a separate room (80.4%). HBPM was performed in 62.3% of patients; however, in 24.9% of the participants HBP measurements were recorded once a week or less. In this nationwide survey in German medical practices, BP control remains at below 50%, while monotherapy is prescribed in around one third of patients. Moreover, office measurements and HBPM are often not performed according to current guideline recommendations. What is the context? Elevated blood pressure (hypertension) is an important risk factor for diseases such as stroke or heart attack. However, sufficient drug therapy can significantly reduce the risk of complications such as a stroke. An adequate blood pressure measurement is the basis for diagnostics and successful therapy. In order to measure blood pressure as accurately as possible, recommendations for performing blood pressure measurements (at home as well as in the office) have been published by medical societies. Research suggests that blood pressure is not always measured according to these recommendations. However, there are no current studies for Germany. What is new? In this study, we analysed the results of a survey in which medical practices and pharmacies throughout Germany were asked about blood pressure measurement and blood pressure therapy. The key results of our study suggest that: • The blood pressure of many participants with known hypertension is not within the desired target range. • Office blood pressure measurements are often not performed as suggested by guidelines. This mainly affects time-consuming work steps such as repeating the measurement several times. • Home blood pressure is not recorded in a structured form, as suggested, but rather according to a random pattern by the patient. What is important? This study suggests that blood pressure control is not sufficient in the study participants. Furthermore, blood pressure measurement as an important tool for hypertension management is frequently not performed as proposed by guidelines. [ABSTRACT FROM AUTHOR]

With global geopolitical changes, marketers have increasingly employed advertisements featuring ethnic and religious minority endorsers. Researchers have examined the effects of this practice, where endorsers' ethnicity and religious associations are interlinked. The present research disentangles the potential effects of these two factors and tests their underlying mechanism. Study 1 (N=336) shows that the endorser's belongingness to a religious minority group negatively affects attitudinal and behavioral consumer responses. Furthermore, the results indicate that sociomoral disgust mediates the effects of religion on consumer responses. Study 2 (N=306) supports a moderated mediation model where religious and ethnic identity moderates the indirect effect of ads featuring a religious minority endorser. Additionally, weaker effects for consumers' ethnic identity moderating the indirect effect of ads featuring ethnic minority endorsers were found. The results indicate a strong category dominance of religion for the evaluation of ethnic and religious minority endorsers. The findings theoretically contribute to our understanding of the diverse effects of featuring religious and ethnic minority endorsers in advertisements. Theoretical and managerial implications are discussed. [ABSTRACT FROM AUTHOR]

SEA practice in Germany has been growing since its introduction and so has the number of SEA research projects and publications. This paper provides a meta-review of German SEA effectiveness research published between 2004 and 2018. In this context, we discuss: (1) What is the status quo of SEA application in Germany? (2) What dimensions of SEA effectiveness have been addressed in research to date? and (3) How effective is SEA in Germany? Our findings indicate that there is room and need for SEA improvement, for example, with regards to the practice of screening, transparency, and quality management. With a focus of previous SEA research on the dimension of procedural effectiveness, future research should aim at other dimensions and their interactions (substantive, transactive, knowledge and learning, legitimacy). [ABSTRACT FROM AUTHOR]

Trend significance of time series that are serially correlated is once more addressed. Most conventional techniques to "pre-whiten" the series prior to calculating trends rely on the assumption of autoregressive residual noise, AR(1). Monthly recordings of 40 water level stations in Germany are investigated, revealing strong memory up to lag 2. A new scheme (PW(p)) is introduced that extends pre-whitening to AR(p) with p > 1. It performs well on surrogate series with prescribed trend and memory. For seven series the estimated trends are unrealistically off, raising doubts about the validity of the basic assumptions of short-memory noise. The series are characterized by a hockey stick pattern from which any pre-whitening produces trends that are all but plausible. The pattern also reveals that pre-whitening is not invariant under time reversal. Regardless of the validity of the noise model, these special cases serve as a warning for using pre-whitening in general. [ABSTRACT FROM AUTHOR]

The flood history of the transboundary Moselle River has so far not been analysed at the watershed scale. This study is based on a large collection of historical archives in hydrology dating to the beginning of the instrumental period. Many valuable archives are made available by the authors but data are discontinuous and heterogeneous. We describe homogenization and reconstruction methods leading to an original flood dataset covering the entire Moselle basin over the last two centuries. The flood series show that the basin is predominantly affected by oceanic floods that mostly occur in winter and that severe flooding generally affects the entire basin. A flood frequency analysis shows that the series are stationary and that flood quantiles obtained with short measured record series and reconstructed series are quite similar. However, although long historical series give robustness to the frequency analyses they also highlight bias and uncertainties related to sampling. [ABSTRACT FROM AUTHOR]

For gay and bisexual men who are confronted with minority stress, online dating sites may provide opportunities for coping. Extant research has largely neglected this, and those pieces that did address it did not sufficiently account for different motivations of use. Two survey studies served to explore links between minority stress, online dating use, and well-being (Study 1: N = 97, Study 2: N = 25,884). The present work finds evidence that the use of online dating sites may have limited buffering effects on associations between minority stress and well-being. The findings contribute to existing work on online dating and the mental health of gay and bisexual men. [ABSTRACT FROM AUTHOR]

This paper applies a sentiment index to check the influence of regional developed countries like Japan and Germany on the sentiments in regional developing countries like Pakistan and Turkey, respectively. The index has been created using a principal component approach with modified proxies. The results indicate that there is a significant influence of developed markets on developing markets also the sentiment index created in this study is good indicator regarding the return pattern of the stock exchange. This study has followed the footsteps of previous studies for methodology and the time period which is used ranged from 29 December 2004 to 31 December 2014. The weekly data has been collected with Wednesday prices so to avoid the white noise, start-of-the week and end-of-the week effect. [ABSTRACT FROM AUTHOR]

Histomonosis has become an important disease of turkeys since the ban of effective feed additives and therapeutics. Some critical risk factors for pathogen introduction into a farm have already been identified but open questions remain. Therefore, a retrospective case–control-study was used to identify the most significant risk factors for Histomonas (H.) meleagridis-introduction into a turkey farm. A total of 113 questionnaires were collected from 73 control-farms and 40 Histomonas-positive case-farms in Germany between 20 April 2021 and 31 January 2022. The data were analysed for possible risk factors by descriptive and univariate, single- and multi-factorial analysis. The presence of earthworms, snails and beetles, as vectors of H. meleagridis, as well as the proximity to other poultry-keeping farms in addition to a frequent observation of wild birds nearby the turkey farm, showed the highest risk potential for histomonosis outbreaks. Furthermore, poor biosecurity measures seem to have increased the probability for an outbreak. Insufficient climate management, straw as litter material and an inadequate litter refill frequency might have promoted a favourable humidity for vector- or pathogen survival providing important areas for improved disease control measures in the future. A retrospective case–control-study was conducted to identify impactful risk factors for a H. meleagridis introduction. The probability of a histomonosis outbreak was increased by the presence of vectors and reservoirs nearby a farm. Impactful risk factors concerning biosecurity measures, climate and litter management were identified. [ABSTRACT FROM AUTHOR]

This article examines the long-term development of two strategic alliances between major Spanish (RUI and Iberostar) and German (TUI and Neckermann) tourist firms. Our research builds on the literature on foreign direct investment and institutionalism applied to cross-border cooperation, yet using business history research methods. The study aims to understand how the local Spanish context shaped the interaction between foreign and domestic firms and how this interaction influenced the development of the Spanish companies. Our cases suggest that the Spanish institutional framework affected the nature and strength of alliances. Foreign partners were crucial in providing financial and commercial support, brand consolidation, market knowledge and reputation. However, local actors also played an important role as proactive partners eager to develop their domestic business and upgrade their existing capabilities. Ultimately this strategy would contribute to the internationalisation of Spanish firms after 1990. [ABSTRACT FROM AUTHOR]

Background: In Germany, oral emergency contraception (EC) with the active ingredients levonorgestrel (LNG) and ulipristal acetate (UPA) is available as over-the-counter (OTC) medicine only from community pharmacies (CPs). Because of the window of effect, which is limited to only a few days, CPs have a great responsibility to provide rapid and unimpeded access, while also ensuring "adequate" counseling. The aim was—for the first time in Europe and thus also in Germany for the methodology used in this study—to investigate immediate availability, pricing, and aspects of counseling. Methods: Covert mystery calls were conducted in a random sample of CPs stratified by districts in the German capital Berlin. Each of the 263 CPs included was called once at random by one of two trained female student mystery callers. They simulated a product-based scenario for the UPA original ellaOne®, citing a contraceptive failure one day ago as the reason. Results: Of 257 successfully called CPs, UPA preparations were immediately available in 98.4% (253/257) and LNG preparations in 86.8% (184/212) of CPs. Prices for UPA preparations varied from €15.95 to €42.95 (∆ 169%; median €35.00 [interquartile range (IQR) €5.91]) and for LNG preparations from €10.60 to €32.49 (Δ 207%; median €22.00 [IQR €5.76]). Information about the correct different window of effect of UPA and LNG preparations was provided in 69.8% (127/182) of CPs. UPA preparations were recommended in 63.1% (111/176) and LNG preparations in 17.2% (30/174) of CPs. Information was provided on how to take them as soon as possible in 30.8% (44/143) of CPs and on how to use them after vomiting in 46.0% (64/139). Conclusions: Berlin CPs support access through high immediate availability, especially to UPA preparations. However, access is hampered by high absolute price ranges of both UPA and LNG preparations, which could ideally be minimized by a comparison app. It is positive that CPs promote the benefits of UPA preparations by recommending them noticeably more often than LNG preparations. However, there are deficiencies in giving advice, so there is a need to raise awareness among pharmacy staff to ensure "adequate" counseling in advance over the phone. [ABSTRACT FROM AUTHOR]

We explored patient satisfaction with baricitinib, an oral Janus kinase inhibitor, in patients with atopic dermatitis (AD) treated in routine clinical practice. Adults with moderate-to-severe AD treated with baricitinib in clinical practice for ≥4 weeks in France, Germany, and the UK completed a one-time online survey under market research methodologies. Treatment satisfaction was assessed using a Likert scale and abbreviated Treatment Satisfaction Questionnaire for Medication (TSQM-9). Patients reported demographic, disease, and treatment information. Data were analyzed descriptively. The survey was completed by 170 patients with a mean age of 39.3 years (SD = 13.5), 59% (n = 101) were female. At baricitinib initiation, 79% rated their AD as "Severe", yet 28% reported body surface area (BSA) involvement ≥10%. Most were "Satisfied" or "Very satisfied" (76%/18%) with baricitinib, with high rates reported for controlling itch (36%/56%). Itch improvements were noted by 97% of patients. Some tapered/stopped (50%/32%) topical corticosteroid use, aligned with reported improvements on the patient global assessment and BSA. Mean TSQM-9 convenience score was 78.0 (SD = 14.0). Satisfaction with itch control was particularly high, reflected in rates of improvement in itch since starting baricitinib. On the TSQM-9, the convenience score was the highest. Many patients tapered/stopped concomitant topicals, indicating baricitinib's effect in controlling AD symptoms. [ABSTRACT FROM AUTHOR]

Despite national recommendations for use of pneumococcal vaccines, rates of community-acquired pneumonia (CAP) and invasive pneumococcal disease (IPD) remain high in Germany. New pneumococcal conjugate vaccines (PCVs) with expanded coverage have the potential to reduce the pneumococcal disease burden among adults. Using a Markov model, we evaluated the lifetime outcomes/costs comparing 20-valent PCV (PCV20) with standard of care (SC) vaccinations for prevention of CAP and IPD among adults aged ≥60 years and at-risk adults aged 18–59 years in Germany. PCV20 also was compared with sequential vaccination with 15-valent PCV (PCV15) followed by PPSV23 in a scenario analysis. Over the course of a lifetime (82 years), use of PCV20vs. SC would prevent 54,333 hospitalizations, 26368 outpatient CAP cases, 10946 disease-related deaths yield 74,694 additional life-years (LYs), while lowering total medical costs by 363.2 M €. PCV20 remained cost saving (i.e. dominant) versus SC even in numerous sensitivity analyses, including a sensitivity analysis assuming moderate effectiveness of the SC pneumococcal polysaccharide vaccine against noninvasive pneumococcal CAP. In several scenario analyses and a probabilistic sensitivity analysis, PCV20 was also cost-saving compared toPCV15 PPSV23 vaccination. One dose of PCV20 among adults aged ≥60 years and adults aged 18–59 years with moderate- and high-risk conditions wouldsubstantially reduce pneumococcal disease, save lives, and be cost saving compared with SC. [ABSTRACT FROM AUTHOR]

Background: Pharmacist-led medication reviews are considered a valuable measure to address risks of polypharmacy. The software Medinspector® is used in community pharmacies to assist the performance of this complex service by structuring the medication review process and supporting pharmacists in their decision-making with targeted clinical knowledge. Key feature is a computerized risk assessment of both the initial and adjusted medication regimen of a patient in multiple domains, thus aiming to support the identification and solving of drug-related problems. This study will examine the effects of medication reviews performed with the clinical decision support system in daily routine practice on medication-related and patient-reported outcomes in elderly patients with polypharmacy. Methods: A prospective, before–after observational study is conducted in German community pharmacies aiming to include 148 patients aged 65 or older, who chronically use five or more active pharmaceutical substances with systemic effects and utilize the software-supported medication review service. The study is based on routine documentation within the software over the course of the medication review, including a patient's baseline medication, the medication proposed by pharmacists, and the final medication regimen. A software-implemented questionnaire comprising self-developed and literature-derived instruments is used to collect patient-reported outcome data at baseline and follow-up. Primary outcome is the appropriateness of medication measured with an adapted version of the Medication Appropriateness Index (MAI). Secondary medication-related outcomes are medication underuse, exposition towards anticholinergic/sedative drugs, number of drugs in long-term use and the implementation of pharmacist-proposed medication adjustments by the physicians. Secondary patient-reported outcomes are symptom burden, medication-related quality of life, adherence, fulfillment of medication review-related goals, and perception of the service. Discussion: With the recently introduced remuneration of community pharmacist-led MR in Germany, the demand for digital tools supporting the MR process is assumed to rise. The OPtiMed-study is expected to create evidence on the effects of a novel tool on patient care in a vulnerable patient population. Trial registration German Clinical Trials Register, DRKS00027410. Registered 22 December 2021, https://www.drks.de/drks%5fweb/navigate.do?navigationId=trial.HTML&TRIAL%5fID=DRKS00027410. Also available on the WHO meta-registry: https://trialsearch.who.int/?TrialID=DRKS00027410 [ABSTRACT FROM AUTHOR]

Unconditional intergovernmental grants are popular with economists but increasingly rarely observed in practice. Conversely, earmarking grants became a common form of the centres' support to states in federalist countries, though they are seriously flawed by welfare loss induced by the intended reallocation of states' provision of goods and services. Conditional grants bring states' governments a dilemma: intergovernmental grants increase states' revenues and enhance welfare, but the revenue gain is paid with amendments on the expenditure side, which harms welfare. We introduce the notion of price-shifting fungibility. It describes the effect of grant-receiving states minimizing the distortionary impact of conditional grants by lowering the prices or quality of the targeted good. By reducing the expenditure for the subsidized good, states create financial leeway to promote goods and services other than the targeted interest. By doing so, they can compensate for the welfare loss caused by conditional grants. We provide a simple theoretical model and some empirical evidence. [ABSTRACT FROM AUTHOR]

To examine stroke inpatients' real-life wayfinding behaviour and how the built environment of rehabilitation clinics might influence their behaviour and experiences. Stroke inpatients in seven rehabilitation clinics were observed (n = 70), each over the course of 12 consecutive hours. Their paths through the clinic and the locations of encountered wayfinding-related events were mapped on the floor plans and described in the written notes. The observations were supplemented by a survey asking patients about their wayfinding experiences. For a third of observed patients, at least one wayfinding-related event was observed on the observation day, and 50% of patients reported getting lost in their clinic at least once. Most wayfinding-related events occurred between patient rooms and therapy rooms, and patients frequently relied on backtracking or the help of the staff to find their way. Clinics' layout organization was found to play a role in the wayfinding behaviour of patients. Wayfinding is a common challenge that stroke inpatients encounter in rehabilitation clinics. Avoiding multiple decision nodes on the paths between patient rooms and therapy rooms and creating distinct identities for corridor segments in the decision nodes and the areas in front of elevators would likely improve wayfinding performance. [ABSTRACT FROM AUTHOR]

Role expectations of physicians providing health care for hunger strikers have been discussed in the context of prisons and detention centres. Ethical guidance for physicians in these situations is codified in the Declaration of Malta. In the last years, new forms of collective, public hunger strikes of asylum seekers have occurred. We have aimed at reconstructing the experiences of health-care personnel involved in one of such cases. Semi-structured interviews with nine participants (physicians and paramedics) that had been involved in a public collective hunger strike of asylum seekers in Germany were conducted. We identified three health-care provider groups: voluntary physicians, emergency service providers and medical consultants for the authorities. Role conflicts arising from multiple loyalty situations with obligations towards different stakeholders (e.g., strikers, employers, authorities) were perceived as the greatest challenge especially for voluntary doctor and emergency service provider participants. Such conflicts culminated in feeling instrumentalized for political goals. The results illustrate that professional challenges in the health care during a public collective hunger strike differ in various aspects from those described in the literature on custodial settings. We recommend expanding and adapting the medico-ethical guidance. [ABSTRACT FROM AUTHOR]

Studies on cultural ecosystem services (CES) in urban forests using Public Participation GIS mapping are a well-established field of research. However, far fewer studies do exist that also illuminate perceived disservices, thus omitting an important part of human-forest relationships. Advancing knowledge on unpleasant places can promote outdoor recreation and help forest managers focus on disservices that matter. This study aims at spatially identifying people's perceptions in urban forests with focus on unpleasant experiences. We elicited perceived disservices and CES spatially by collecting Public Participation GIS data (PPGIS) from city dwellers in three urban forests in Germany's Southwest (755 respondents mapped 1552 places of disservices). We investigated relationships between sociodemographic characteristics and the number of mapped places using Spearman's rank. We also explored the spatial concurrence between disservices and CES using Spearman's rank. We identified a hierarchy of importance of forest visitors' perceived dislikes. We revealed that negative perceptions of urban forest visitors originated broadly from people and their traces and rarely from the ecosystem according to existing ecosystem disservices typologies (EDS). We found a significant relationship between age and the number of mapped services. We found clusters of disliked places and correlations between disservices and CES, indicating that hotspots of CES in turn are also hotspots of disservices. We conclude that city foresters may best address disservices by advancing guidance-concepts for spatial movements of urban forest visitors within the forest to avoid conflicting clusters of various stakeholders. Our results may help city foresters to better manage both the forest and visitors' various interests. [ABSTRACT FROM AUTHOR]

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This study focuses on the efforts of Sir Charles Addis to defend the pre-1914 system of cosmopolitan capitalism. Our central research question is to understand why this merchant banker fought in preserve cosmopolitan capitalism when so many of his peers acquiesced in and even championed its demise. Addis's moral ideal was an international economic order in which the nationality of firms was irrelevant to the strategies of managers. The First World War dramatically increased the salience of firm nationality in international business. Addis, who was a committed classical liberal, fought against this trend to a degree that is hard to explain with reference to economic self-interest alone. The article, which is based on a range of sources including Addis's diary, explores Addis's connections to, and views of, 'German' bankers, his relations with the British government, and the political economy of the reparations imposed on Germany by the Versailles Peace settlement. [ABSTRACT FROM AUTHOR]