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Objective: Endometriosis affects approximately 10% of women of reproductive age and leads to significant morbidity and financial burden. Consequently, countries such as France and Germany are formulating strategies to combat endometriosis. In this study, we propose the implementation of our three‐dimensional model (3D‐E) to raise awareness about endometriosis and enhance timely diagnosis, treatment, and long‐term care for affected patients. Methods: Based on the adapted Six Sigma Principle and the modified recommendation of Sales et al. for implementing evidence‐based findings into a clinical routine, we first conducted a comprehensive investigation to identify risk factors leading to diagnostic delay of endometriosis. After identifying improvable factors, the applicable options were selected due to defined criteria such as integrability in the clinical routine, cost‐effectiveness, and evidence‐based‐principle. Finally, solutions feasible for health care providers were integrated and the 3D‐E model was established. Results: Some of the main risk factors contributing to diagnostic delays are symptoms acceptance and misinterpreted symptoms, especially if presenting to nongynecologists in cases of extragenital endometriosis with atypical presentation. Therefore, we tried to sensitize colleagues (first dimension) with a review paper in Germany's largest medical journal and started an elective for medical students (second dimension) at our university. In order to involve additional health care professionals in endometriosis care (third dimension), we are preparing the concept of the EndoNurse. Conclusion: The 3D‐E model is a relatively low‐cost, comprehensive, and worldwide adaptable approach for facilitating knowledge transfer, sensitizing health care providers, and improving endometriosis diagnostics and therapy for patients with endometriosis who are in the center of the model. Synopsis: The 3D‐E model could have the potential to be a first step to improve endometriosis awareness and care. [ABSTRACT FROM AUTHOR]

Background: Computer‐based assessment allows for the monitoring of reader behaviour. The identification of patterns in this behaviour can provide insights that may be useful in informing educational interventions. Objectives: Our study aims to explore what different patterns of reading activity exist, and investigates their interpretation and consistency across different task sets (units), countries, and languages. Three patterns were expected: on‐task, exploring and disengaged. Methods: Using log data from the PISA 2012 digital reading assessment (9226 students from seven countries), we conducted hierarchical cluster analyses with typical process indicators of digital reading assessments. We identified different patterns and explored whether they remained consistent across different units. To validate the interpretation of the identified patterns, we examined their relationship to performance and student characteristics (gender, socio‐economic status, print reading skills). Results and Conclusions: The results indicate a small number of transnational clusters, with unit‐specific differences. Cluster interpretation is supported by associations with student characteristics—for example, students with low print reading skills were more likely to show a disengaged pattern than proficient readers. Exploring behaviour tended to be exhibited only once across the three units: It occurred in the first unit for proficient readers and in later units for less skilled readers. Major Takeaways: Behavioural patterns can be identified in digital reading tasks that may prove useful for educational monitoring and intervention. Although task situations are designed to evoke certain behaviours, the interpretation of observed behavioural patterns requires validation based on task requirements, assessment context and relationships to other available information. Lay Description: What is already known about the subject matter?: Students differ in how they read, comprehend and use digital information.Indicators from process data provide insight about how students engage with digital reading tasks. What does this paper add to the subject matter?: Based on multiple process indicators, a small number of clusters indicating different behavioural activity can be distinguished.These clusters can be described as on‐task, passive, hasty, exploring, disengaged, persistent and lost interest.A meaningful interpretation of the clusters must consider the requirements of the underlying tasks. Implications for practice and/or policy: Knowledge of how students engage with digital resources may provide useful feedback for teachers to guide students' learning or intervene when they struggle.Educational monitoring: The high comparability of country‐specific results suggests an invariant set of solution strategies in the digital reading assessment. [ABSTRACT FROM AUTHOR]

Cave carbonates, seemingly growing in defiance of gravity, have attracted the community's interest for more than a century. This paper focusses on 'helictites', contorted vermiform speleothems with central capillaries. Petrographic, crystallographic and geochemical data of calcitic and aragonitic helictites (recent to 347 ka) from three caves in Western Germany are placed in context with previous work. Aragonitic helictites from one site, the Windloch Cave, form exceptionally large and complex structures that share similarities with the celebrated helictite arrays in the Asperge Cave in France. Aragonitic and calcitic helictites differ significantly in their crystal fabrics and internal geometry. Calcitic helictites are best described as a composite crystal fabric consisting of fibrous mesocrystals. Aragonite helictites display a complex fabric of acicular to platy crystals, some of which show evidence for growth‐twinning and perhaps crystallisation via a monoclinal precursor stage. The micro‐tomographic characterisation of several orders of channels and their complex architecture raises important questions regarding fluid migration and helictite architecture. In terms of their isotope geochemistry, helictites are depleted in 13C to various degrees, isotope values that are controlled by the mixing of fluids and mineralogy‐related fractionation. Regarding their δ18O values, most helictites overlap with other calcitic and aragonitic speleothems. Previous models explaining the twisted morphology of helictites are discussed from the viewpoint of fluid migration and CO2 degassing rates, mineralogy and helictite petrography. For the complex aragonitic helicities documented here, the most likely mechanisms to explain the contorted growth forms include the internal capillary network combined with localised (sector) growth at the helictite tip. The morphologically simpler calcitic helictites are best explained by capillary and surface flow. Future work should include geomicrobiology to assess the significance of induced mineralisation and transmission electron microscopy analysis to more quantitatively assign crystallographic properties. [ABSTRACT FROM AUTHOR]

We estimate the effects of shocks to interest rate expectations on the four largest euro area economies. We identify these shocks in a Bayesian vector autoregressive (BVAR) model augmented by survey expectations. We separate the expectations shocks from standard monetary policy shocks by assuming that they do not affect the current policy rate. Our sign restrictions also ensure that these shocks do not contain central bank information shocks. We find that an expected decline in the future short‐term rate leads to an increase in output and prices. The increases do not become larger for changes to interest rate expectations further in the future, that is, we do not find evidence of a forward guidance puzzle. Using the multicountry structure of our model, we test for cross‐country differences in the shocks' effects and find output and price effects to be greatest in Germany. We also compare the effects of shocks to interest rate expectations to those of standard monetary policy shocks and show the first type to affect output and prices more strongly in Germany and France. [ABSTRACT FROM AUTHOR]

Participating in further training is strategically important for employees to ensure their employability. Particularly for employees in low‐skilled jobs, works councils — firm‐level organizations that represent employees — constitute an important employee advocacy instrument in European countries, such as France and Germany. With comprehensive co‐determination rights, works councils can influence firms' hiring policies, job design and career paths (e.g. promotions). Using German firm‐level data, we empirically investigate the influence of works councils on firms' training provision for employees in firms below and above the industry level of technology. The results show that works councils have a positive effect on the percentage of employees in general, and of employees in low‐skilled jobs in particular, participating in training, but only for firms below the industry level of technology. These results show the importance of works councils in supporting training in such firms and enhancing the employment prospects of employees in low‐skilled jobs. In contrast, firms above the industry level of technology invest in training with or without a works council, indicating that the training interests of employers and employees are aligned. [ABSTRACT FROM AUTHOR]

We study productivity‐level distributions of manufacturing firms in France and Germany, and how these distributions evolved across the Great Recession. We show the presence of a systematic productivity advantage of German firms over French ones in the decade 2003–2013, but the gap has narrowed down after the Great Recession. Convergence is explained by the better growth performance of French firms in the post‐recession period, especially of those located in the top percentiles of the productivity distribution. We also highlight the role of sectoral growth, firm size, and export intensity in explaining the above convergence. In contrast, the contribution of allocative efficiency was small. [ABSTRACT FROM AUTHOR]

Background and purpose: Social engagement is an important active aging strategy to promote older adults' mental health. The purposes of this study were to compare social engagement in older populations around the world and explore associations with mental health outcomes. Materials and methods: An international cross‐sectional survey was conducted from 2017 to 2019. Data were retrieved from The International Social Survey Programme for a secondary data analysis across 30 countries. This study applied the Taxonomy of Social Activities and its six levels as operational definitions for a consistent concept of social engagement for international comparisons. Results: In total, 9403 older adults with a mean age of 72.85 ± 6.40 years responded. The highest levels of older adults' social engagement were found in Switzerland, Thailand, and New Zealand. Older adults of a higher age, with a lower educational level, who were permanently sick or disabled, who had no partner, who were widowed or whose civil partner had died, who lived alone, and who had lower self‐placement in society had significantly lower social engagement than did their counterparts. In the regression model, older adults' social engagement positively predicted general health, self‐accomplishment, and life satisfaction, but negatively predicted loneliness and depression. Conclusions: In aging societies worldwide, encouraging older adults' social engagement would be beneficial to promote mental health. Implications for nursing practice and health policies: Community professional nurses can develop strategies of social engagement based on the needs and sociodemographic factors of older adults to improve their mental health. Developing efficient strategies and local policies by learning from successful experiences in other countries is important to promote social engagement in aging societies. [ABSTRACT FROM AUTHOR]

What explains the creation of the EU corona recovery fund? Why did the Union agree on a large‐scale financial response to the corona pandemic, despite member states' very different immediate reactions to the crisis and their opposing attitudes towards common debt? This article argues for the decisiveness of France and Germany's role within the Union and their tight bilateral political cooperation. The 'embedded bilateralism' approach to European integration and EU politics explains how and why France and Germany, starting from different poles, came together and established joint positions, paving the way for an overall European compromise. Focusing on these two countries' particular leadership role advances the theoretical debate about the actors most crucial for driving European integration, especially in times of severe crisis. [ABSTRACT FROM AUTHOR]

When foster care is discussed in research, emotions are mostly kept out of the scope. This article explores emotions narrated by young people in foster care and by their foster carers. It brings together findings from two studies: The first used biographical interviews conducted with 100 young people from Germany, while the second draws on ethnographic interviews with 12 young people from France and England. The analysis, in line with relevant literature, shows that although emotions are hardly mentioned directly, they seem to be highly relevant in understanding the experience of foster care. Therefore, we suggest, professionalism and emotions need to be understood as complementary elements. [ABSTRACT FROM AUTHOR]

Participation and representation of disadvantaged groups are important, but partly still understudied aspects of democratic politics. The present article looks at the inclusion of migrant representatives in urban governance networks making use of original survey data from 40 large cities in France and Germany. We find that about half of policy‐relevant urban actors in both countries and across cities cooperate with migrant associations regularly. This indicates that urban governance networks are furthering the civic and political presence of migrants. Cooperation with migrant associations is more likely when specific representative local institutions (foreigner/integration councils) exist, and is also boosted by the overall density of governance networks in a city. Politicians and local administrators remain central actors in such networks, while social welfare organizations emerge as important interlocutors with migrant associations. The article identifies and discusses differences between the two countries. [ABSTRACT FROM AUTHOR]

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