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Due to an increasing demand, companies have started producing recycled products. However, little is known about the specific purchase behavior. Hence, this study analyses the factors influencing purchase intention for recycled products including differences related to different types of products and between Germany and South Africa. A quantitative study in Germany (n = 603) and South Africa (n = 692). shows that purchase intention is significantly higher in South Africa. The influencing factors (individual, product, and context related constructs) are the same in both countries, but they differ regarding their strength. Thus, the factor "attitude/environmental concern" has the strongest influence in South Africa, while it is "value/accessibility" in Germany. Furthermore, purchase intention for mobile phones is generally smaller than for t‐shirts and toilet paper. Purchase intention for recycled t‐shirts is significantly higher in South Africa than in Germany. [ABSTRACT FROM AUTHOR]

Introduction: Digitalization in medicine is steadily increasing. Complex treatments, scarce personnel resources and a high level of documentation are a constant burden on healthcare systems. The balancing between correct manual documentation in the digital records and limited staff resources is rarely successful. The aim of this study is to evaluate the adherence between documentation and lack of documentation in the treatment of critical care patients. Material and Methods: For the evaluation, data from the hospital information system (HIS) of several intensive care units (ICU) were examined in conjunction with data collected from a checklist. All boluses of sedatives, analgesics and catecholamines were documented paper based across all shifts and all weekdays and compared with corresponding digital data from the HIS (2019–2022) of previous years. Results: 939 complete digital patient records revealed a massive under-documentation of the medication administration compared to that applied according to the checklist. Only 12% of all administered catecholamines, 11% of α2-agonists, 33% of propofol, 92% of midazolam and 46% of opioids were found in the digital recordings. In comparison, the effect was more pronounced on weekdays compared to weekends. In addition, the highest documentation gap was found in the comparison of early shifts. Comparing neurosurgical vs. internal vs. anesthesiologic ICUs there was a highly significant difference between anesthesiologic ICUs compared with other disciplines (p < 0.0001). Discussion: Our data shows that there is a remarkable documentation gap and incongruence in the area of applied boli. Automated documentation by connecting syringe pumps that enter data directly into the HIS can not only reduce the workload, but also lead to comprehensive and legally required documentation of all administered medication. [ABSTRACT FROM AUTHOR]

In this paper, we estimate the causal effects of a set of active labor market programs for male unemployed refugees on welfare who entered Germany between, 2013 and September, 2016. Using rich administrative data, we employ covariate balancing propensity scores combined with inverse probability weighting to estimate effects up to 33 months after the start of treatment. Our results show that relatively short-term training in the form of Schemes by Providers and In-Firm Training, as well as longer-term Further Vocational Training programs have a positive impact on both the employment chances as well as labor market earnings of refugees in the medium run. So-called "One Euro Jobs", a public employment program, does not yield positive effects on employment or earnings. Sensitivity analyses confirm that our results are unlikely to be driven by unobserved confounding. [ABSTRACT FROM AUTHOR]

This paper aims to compare the sustainability assessment methods of DGNB and G-SEED, the two domestic green building rating systems, focusing on indoor environmental evaluation and reviewing recent laws, certifications systems, and guidelines from Germany and South Korea. According to existing studies, Korea's green building certification has similar evaluation items, environmental (62.6%), social aspects (25.4%), and economic aspects (3.0%) compared with DGNB. Continuing research comparing DGNB and G-SEED, this paper will present an insight into the DGNB and G-SEED green building rating systems' aspects and motives; furthermore, we intend to equate the sustainability assessment methods of the DGNB and G-SEED certification systems, in order to improve certification systems by comparing and finding solutions to differences, thereby making international systems more adaptable to each country. This analysis will unify property categorization systems and will promote green building and sustainable development globally. Findings: Regarding similarities and differences, the certification criteria for air, thermal, visual/light, and acoustic quality are based on domestic laws in both countries. DGNB and G-SEED are similar in terms of the requirements but differ in methods and domestic laws. Some findings regarding differences are that DGNB requires low VOC-emitting products, while G-SEED focuses on natural ventilation. Thermal comfort is measured through design-phase simulation in DGNB, while G-SEED lighting is evaluated on the basis of saving light energy. Finally, in G-SEED, acoustic quality is measured via indoor soundproofing performance, while DGNB takes room size into account. [ABSTRACT FROM AUTHOR]

This paper presents the investigation and analysis of speech accommodation effects in data obtained from Spanish learners of German with varying proficiency levels. The production data were recorded during a collaborative map task of the Spanish learners of German among each other and with a native speaker of German. The map task was designed to target words and phrases with specific segmental and suprasegmental characteristics. These characteristics were derived from contrastive analyses of Spanish and German. The main objectives of the paper were to investigate whether segmental and suprasegmental characteristics of the target language German are affected by phonetic accommodation to varying degrees and whether these differences depend on the proficiency level of the speaker or the interlocutor. The statistical analysis, using regression analyses, revealed inconsistent accommodation effects across learners of different proficiency levels as well as different linguistic phenomena. In line with previous findings the results can best be accounted for by an adaptation of a dynamic system approach. [ABSTRACT FROM AUTHOR]

Women are underrepresented in many areas of journalistic newsrooms. In this paper, we examine if this established effect persists in the new forms of journalistic communication, namely social media networks. We use mentions, retweets, and hashtags as measures of journalistic amplification and legitimation. Furthermore, we compare two groups of journalists in different stages of development: political and data journalists in Germany in 2021. Our results show that journalists identified as women tend to favor other women journalists in mentions and retweets on Twitter (now called X), compared to men. While both professions are dominated by men, with a high share of tweets authored by men, women mention and retweet other women more than their male colleagues. Female data journalists also leverage different sources than men. In addition, we found data journalists to be more inclusive of non-member sources in their networks compared to political journalists. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to develop an analytical framework to categorize the quality of industrial relations in foreign affiliates. Using the case of foreign affiliates in Germany, this paper further explores what factors shape the quality of industrial relations in foreign affiliates. Design/methodology/approach: Given the scarcity of research on industrial relations in foreign affiliates, this paper is based on conceptual work as well as on a comparative case investigation of 21 foreign affiliates in Germany, involving informants from both labor and management. Findings: Industrial relations in foreign affiliates in Germany can take four different qualities, based on the following: social partnership; conflict partnership; latently adversarial; and adversarial relations. While previous literature focused on country-of-origin effects, the authors' case-based investigation further revealed that both affiliate effects and multinational corporation (MNC) effects have a strong impact on the quality of industrial relations in foreign affiliates in Germany. Originality/value: This paper provides systematic evidence on the presumption that micro-organizational and MNC-specific factors are necessary to gain a deeper understanding of industrial relations in MNCs. Moreover, this paper contributes to the discussion on the quality of industrial relations in foreign affiliates in Germany, by placing results from both single-case studies and management surveys into perspective. [ABSTRACT FROM AUTHOR]

In Germany, as in many other European countries, vast changes in the welfare regime – towards workfare – have taken place. As a central activating element of workfare, sanctions were introduced to take effect by temporarily increasing deprivation through benefit cuts. This paper provides first quantitative insights on the effect of first sanctions on deprivation and contributes to the recent debate on the (un)constitutionality of sanctions, which re-emerged after a verdict of the Federal Constitutional Court, criticizing the lack of knowledge about the effects of sanctions on those affected. We implement a difference-in-differences propensity score matching approach that addresses selection on observables and individual time constant unobserved differences. High data accuracy is ensured by combining the "Panel Labour Market and Social Security" (PASS) with administrative data from the Federal Employment Agency. The results illustrate a slightly higher yet statistically insignificant level of deprivation for first-sanctioned unemployment/basic income recipients compared to non-sanctioned recipients. The results hint in the direction that higher levels of deprivation are not what activates the sanctioned beneficiaries to reintegrate into the labour market. We discuss whether the results imply a significant deviation from the socio-cultural subsistence minimum of sanctioned recipients and a failure of the welfare state. [ABSTRACT FROM AUTHOR]

Against the background of climate protection and the rising costs of a fossil-fuel-based energy supply, the interest in the energy performance and indoor climate of buildings in real operation is rising. This paper, therefore, deals with the indoor climate investigation of two medium-sized office buildings in Germany by taking measurements over a whole year. These relate to one new building and one refurbished building. Sensors of various types were installed and operated in a large number of office rooms, so that in total results are available for over 100 rooms, typically occupied by one or two persons. The analysis focuses on the indoor temperature in summer and the air quality in winter based on the CO2 concentration. The comfort classes according to DIN EN 16798 including the adaptive comfort approach are used as a basis to cluster the results. Both buildings have movable sun protection and openable windows but no facilities for active cooling. They, thus, represent a large number of existing 'low tech' office buildings in Germany and central Europe. The results reflect the respective building concepts but also show a wide range between the rooms due to the user preferences and behaviour. The refurbished building shows better results, especially in terms of air quality but also in terms of summer room temperatures. This underlines the benefit of the targeted measures as a result of an analysis of the deficits in the existing building before the refurbishment. The additional measures for decentralised mechanical ventilation and passive cooling are having positive effects. As part of the projects, further measures to improve the indoor climate were investigated in both buildings. In one case, this involved CO2 traffic lights to stimulate personal window ventilation in winter, and in the other, the use of newly developed individual ceiling fans supports convective heat dissipation on the human body during hot spells in summer. The positive effect could be demonstrated for both measures. [ABSTRACT FROM AUTHOR]

This paper explores the knowledge transfer of internationally mobile scientists. It builds upon previous work on the development of methods for detecting the knowledge transfer of German scientists. Using abstract terms of publications covered in Scopus, this paper proposes a lexical‐based approach to identify knowledge transmitters. These scientists are characterized by acquiring knowledge from their co‐workers during their international stay and transferring it upon return to German co‐workers. Knowledge is operationalized as the co‐occurrence of rarely used abstract terms. Knowledge transfer is expressed as the diffusion of these term combinations in co‐authorship networks. The method developed was validated by contacting the bibliometrically identified knowledge transmitters and asking them what they believe they learned during their stay abroad. A control group of internationally mobile scientists without traceable knowledge transfer was similarly asked to report on their knowledge acquisition. The findings suggest that bibliometric data are capable of detecting knowledge transmitters among German scientists who were internationally mobile. The juxtaposition of the responses on their perceived knowledge acquisition and the bibliometrically identified lexical terms shows that the method proposed is well suited to studying the knowledge transfer of internationally mobile scientists. The strength of the method is its simplicity and high precision. [ABSTRACT FROM AUTHOR]

College students have been recognized as a risk group for substance use. Nevertheless, coherent risk factors for stimulant use remain to be elucidated. The objective of this paper is to identify risk factors associated with the recreational use of MDMA, cocaine, amphetamine and methamphetamine. An online questionnaire was distributed among colleges in Berlin. A sample of 12,914 college students participated, of which 9,382 met the inclusion criteria. Past-month prevalence was 7.0% for MDMA, 6.7% for amphetamine, 5.8% for cocaine and 0.1% for methamphetamine. Associated factors included male gender, "other" gender, homosexual and bisexual orientation, open relationship status or being single, engaging in sexual risk-taking behavior, having a psychiatric diagnosis, tobacco use, drinking alcohol and an increased number of (illicit) substances consumed in the past month and in life. Berlin college students showed a substantially higher prevalence of stimulant use compared to both the general population and college students in other cities. Certain parameters, e.g., polydrug use, were particularly high in this group. The results can be used in further development of prevention efforts. However, conclusions about causality are limited by the cross-sectional nature of this study, highlighting the necessity for longitudinal studies in this field. [ABSTRACT FROM AUTHOR]

Background: Although research on mathematics learning programs has taken off in recent years, little is known about how different person characteristics are related to practice behaviour with such programs. When implementing a mathematics learning program in the classroom, it might be important to know whether students with specific characteristics need more encouragement to make use of this learning opportunity. Objectives: Using a supply‐use model, we analysed the predictive power of students' cognitive characteristics (prior mathematics knowledge), personality traits (conscientiousness), motivational‐affective characteristics (mathematics self‐concept and mathematics anxiety), and family background characteristics (socioeconomic status and migration background) for practising with an adaptive arithmetic learning program. Methods: We used longitudinal data from 203 fifth graders from seven non‐academic‐track schools in Germany. Practice behaviour, measured by completed tasks in the learning program, was recorded weekly for every student over a period of 22 weeks. Results and Conclusions: The results of our multilevel analyses showed that mathematics anxious students practised less with the program. We did not find any relationship with the other characteristics. Takeaways: Our results suggest that mathematics anxious students need more encouragement when practising with a mathematics learning program; otherwise, they do not get the chance to benefit from the use. Lay Description: What is already known about this topic: The use of mathematics learning programmes in mathematics education has recently intensified.It is important that students practice with such learning programmes regularly over a longer period of time in order for them to achieve learning success.Students differ in their mathematics learning behaviour. What this paper adds: Little is known about how person characteristics are related to practice behaviour with mathematics learning programmes.Students may differ in their use of a mathematics learning programme, which is why cognitive characteristics, personality traits, motivational‐affective characteristics, and family background characteristics may affect students' practice behaviour. Implications for practice: Mathematics anxious students practiced less with a mathematics learning program, and need more encouragement to benefit equally from the implementation in school.Teachers should keep in mind that after the initial enthusiasm, practice with a programme may decrease over time, especially after school holidays. [ABSTRACT FROM AUTHOR]

Background: Formative assessments are needed to enable monitoring how student knowledge develops throughout a unit. Constructed response items which require learners to formulate their own free‐text responses are well suited for testing their active knowledge. However, assessing such constructed responses in an automated fashion is a complex task and requires the application of natural language processing methodology. In this article, we implement and evaluate multiple machine learning models for coding energy knowledge in free‐text responses of German K‐12 students to items in formative science assessments which were conducted during synchronous online learning sessions. Dataset: The dataset we collected for this purpose consists of German constructed responses from 38 different items dealing with aspects of energy such as manifestation and transformation. The units and items were implemented with the help of project‐based pedagogy and evidence‐centered design, and the responses were coded for seven core ideas concerning the manifestation and transformation of energy. The data was collected from students in seventh, eighth and ninth grade. Methodology: We train various transformer‐ and feature‐based models and compare their ability to recognize the respective ideas in students' writing. Moreover, as domain knowledge and its development can be formally modeled through knowledge networks, we evaluate how well the detection of the ideas within responses translated into accurate co‐occurrence‐based knowledge networks. Finally, in terms of the descriptive accuracy of our models, we inspect what features played a role for which prediction outcome and if the models pick up on undesired shortcuts. In addition to this, we analyze how much the models match human coders in what evidence within responses they consider important for their coding decisions. Results: A model based on a modified GBERT‐large can achieve the overall most promising results, although descriptive accuracy varies much more than predictive accuracy for the different ideas assessed. For reasons of comparability, we also evaluate the same machine learning architecture using the SciEntsBank 3‐Way benchmark with an English RoBERTa‐large model, where it achieves state‐of‐the‐art results in two out of three evaluation categories. Lay Description: What is already known about this topic?: Formative assessments are needed to test and monitor the development of learners' knowledge throughout a unit to provide them with appropriate automated feedback.Constructed response items which require learners to formulate their own free‐text responses are well suited for testing their active knowledge.Assessing constructed responses in an automated fashion is a widely researched topic, but the problem is far from solved and most of the work focuses on predicting holistic scores or grades.To allow for a more fine‐grained and analytic assessment of learners' knowledge, systems which go beyond predicting simple grades are required.To guarantee that models are stable and make their predictions for the correct reasons, methods for explaining the models are required. What this papers adds?: A core topic in physics education is the concept of energy.We implement and evaluate multiple systems based on natural language processing technology for assessing learners' conceptual knowledge about energy physics using transformer language models as well as feature‐based approaches.The systems assess students' knowledge about various forms of energy, indicators for the same and the transformation of energy from form into another.As our systems are based on machine learning methodology, we introduce a novel German short answer dataset for training them to detect the respective knowledge elements within students' free‐text responses.We evaluate the performance of these systems using this dataset as well as the well‐established SciEntsBand‐3‐Way dataset and manage to achieve, to our best knowledge, new state‐of‐the‐art results for the latter.Moreover, we apply methodology for explaining model predictions to assess whether predictions are carried out for the correct reasons. Implications for practice and/or policy: It is indeed possible to assess constructed responses for the demonstrated knowledge about energy physics in an analytic fashion using natural language processing.Transformer language models can outperform more specialized feature‐based approaches for this task in terms of predictive and descriptive accuracy.Co‐occurrences of different concepts within the same responses can lead models to learn undesired shortcuts which make them unstable. [ABSTRACT FROM AUTHOR]

This paper argues that, although Japan's and Germany's energy transition paths differ in detail, a trend towards decentralisation is clearly evident in both countries. Based on comprehensive screening, own stocktaking and the results of a stakeholder dialogue, this paper highlights the motivation for different local actors to enter the energy market in both countries. Although there are challenges to success in a market dominated by large energy companies, this paper argues that the benefits to local communities outweigh the efforts. Overall, it is shown that democratisation and the decentralisation of the energy system are suitable to facilitate a successful transformation process in both countries. [ABSTRACT FROM AUTHOR]

The administrative burden for physicians in the hospital can affect the quality of patient care. The Service Center Medical Informatics (SMI) of the University Hospital Würzburg developed and implemented the smartphone-based mobile application (MA) ukw.mobile1 that uses speech recognition for the point-of-care ordering of radiological examinations. The aim of this study was to examine the usability of the MA workflow for the point-of-care ordering of radiological examinations. All physicians at the Department of Trauma and Plastic Surgery at the University Hospital Würzburg, Germany, were asked to participate in a survey including the short version of the User Experience Questionnaire (UEQ-S) and the Unified Theory of Acceptance and Use of Technology (UTAUT). For the analysis of the different domains of user experience (overall attractiveness, pragmatic quality and hedonic quality), we used a two-sided dependent sample t-test. For the determinants of the acceptance model, we employed regression analysis. Twenty-one of 30 physicians (mean age 34 ± 8 years, 62% male) completed the questionnaire. Compared to the conventional desktop application (DA) workflow, the new MA workflow showed superior overall attractiveness (mean difference 2.15 ± 1.33), pragmatic quality (mean difference 1.90 ± 1.16), and hedonic quality (mean difference 2.41 ± 1.62; all p <.001). The user acceptance measured by the UTAUT (mean 4.49 ± 0.41; min. 1, max. 5) was also high. Performance expectancy (beta = 0.57, p =.02) and effort expectancy (beta = 0.36, p =.04) were identified as predictors of acceptance, the full predictive model explained 65.4% of its variance. Point-of-care mHealth solutions using innovative technology such as speech-recognition seem to address the users' needs and to offer higher usability in comparison to conventional technology. Implementation of user-centered mHealth innovations might therefore help to facilitate physicians' daily work. [ABSTRACT FROM AUTHOR]

To investigate determinants of willingness to adopt telerehabilitation, willingness of technology use, core affect regarding using telerehabilitation, and digital competencies in rehabilitation professionals in Austria and Germany before and during the COVID-19 pandemic. A cross-sectional paper-based and online survey was conducted before and during COVID-19, respectively, with three cohorts of rehabilitation professionals. Outcomes were the willingness to adopt telerehabilitation evaluated using the extended Unified Theory of Acceptance and Use of Technology; willingness of technology use using the short scale for assessing the willingness of technology use; digital competencies and core affect using the Digital Competence Framework and semantic differential, respectively. Multivariate ordinal regression analysis was performed to determine predictors. Included were 603 rehabilitation professionals. Analysis revealed differences between Austria and Germany and before and during the pandemic for most outcomes. German residency, the pandemic, and a higher educational level were most important predictors of higher willingness to adopt telerehabilitation, willingness of technology use, digital competencies, and positive core affect. The pandemic increased most aspects of willingness to adopt telerehabilitation, willingness of technology use, digital competencies, and positive core affect. Results confirm that rehabilitation professionals with higher degrees are more prone to adopt innovations in healthcare.Registration: German Clinical Trials Register (DRKS00021464) The willingness to adopt telerehabilitation is associated with external factors increasing the need for alternative rehabilitation delivery, such as COVID-19, and with financial facilitators, such as reimbursement. As the willingness to adopt telerehabilitation is higher among speech and language therapists and dietitians, efforts are necessary to enhance its use in physiotherapists and occupational therapists. As a higher willingness to adopt telerehabilitation was observed in younger rehabilitation professionals and those with higher education, increasing the importance of telerehabilitation in education curricula and further knowledge transfer into practice for those already working in the field seems necessary. [ABSTRACT FROM AUTHOR]

• Childcare policy responses towards Covid-19 differed in European welfare states. • Policy responses cause informalization of childcare to different degrees. • Informalization of childcare is mainly connected with social risks for women. • Cultural and institutional differences help to understand varying policy responses. The closure of extra-familial childcare facilities by European governments in 2020 was an important part of interventions against the spread of the COVID-19 pandemic. One consequence was that childcare was provided by parents at home, mainly by women. As a result, women mainly experienced financial and employment risks related to this "informalization" of childcare. The childcare policies of European welfare states differ in the extent to which they include measures to reduce the social risks related to informalization. Against this backdrop, this paper asks: How should one understand cross-national differences in childcare policies during the pandemic? We are also particularly interested in the effects of childcare policies on the social risks connected with the informalization of childcare and what these mean for the gendered division of paid work and care. Differences in childcare policies during the pandemic are commonly explained in terms of the path dependence of such policies. Using the theoretical approach of "care arrangement," this article introduces a broader theoretical framework that considers the role of cultural and institutional factors for understanding the cross-national differences in childcare policies during the pandemic. We introduce the findings of a comparative empirical study of childcare policies in three European welfare states—Denmark, Germany and England—that represent different types of care arrangements. This paper uses policy and media documents, quantitative data on childcare and women's employment, cultural ideas and secondary analysis of empirical studies. We find that governments did not per se respond to the pandemic based on institutional path dependence regarding childcare policies, while the integration of culture into the theoretical framework allows for a more comprehensive understanding. [ABSTRACT FROM AUTHOR]

Objective: The prognosis for ovarian cancer patients remains poor. A key to maximizing survival rates is early detection and treatment. This requires an accurate prediction of malignancy. Our study seeks to improve the accuracy of prediction by focusing on early subjective assessment of malignancy. We therefore investigated the assessment of patients themselves in comparison to the assessment of physicians.Methods: One thousand three hundred and thirty patients participated in a prospective and multicenter study in six hospitals in Berlin. Using univariate analysis and multivariate logistic regression models, we measured the accuracy of the early subjective assessment in comparison to the final histological outcome. Moreover, we investigated factors related to the assessment of patients and physicians.Results: The patients' assessment of malignancy is remarkably accurate. With a positive predictive value of 58%, the majority of patients correctly assessed a pelvic mass as malignant. With more information available, physicians achieved only a slightly more accurate prediction of 63%.Conclusions: For the first time, our study considered subjective factors in the diagnostic process of pelvic masses. This paper demonstrates that the patients' personal assessment should be taken seriously as it can provide a significant contribution to earlier diagnosis and thus improved therapy and overall prognosis. [ABSTRACT FROM AUTHOR]

Background: Incontinence is a common disorder among older adults with a higher prevalence in nursing home settings than in community dwellings. There is a wide variety of absorbent continence products on the market used to manage continence. Aim: The study aimed to investigate the experience of caregivers of residents with incontinence in care home settings using the new MoliCare Premium Form design and to compare some of the product features with the previous design. Method: A questionnaire focusing on the key performance characteristics of the product was developed and administered to 74 nurses in Germany to obtain their opinions on the use of MoliCare Premium Form products. Findings: More than 90% of respondents rated each key performance aspect of the new product design as 'good' and 'OK'. More than 60% of the caregivers found the new product design to be better performing and 93% preferred the new design to the previous version. Conclusion: The newly redesigned continence pad performed very well on each of the individual performance features, indicating the high quality and optimised design of the product. The new design was found to be suitable and effective for individuals with incontinence. [ABSTRACT FROM AUTHOR]

Background: In a global comparison, in 2006 Germany was the first in the world to switch naratriptan to an OTC medication but since then only almotriptan has been switched. Therefore, Germany has fallen behind recently because of the failure to carry out further switches. Objectives: The aim of this extensive evaluation of various surveys among pharmacies, physicians, patients and stakeholders was to investigate whether there is an obvious need for an Rx-to-OTC switch of further triptans. In addition, reasons for or against such a switch should be evaluated. Setting: The surveys were distributed in several ways. Most were based on online tools and were performed in 2017, 2018 and 2019. Methods: Several surveys have been initiated using different methodologies. The pharmacist surveys were only conducted digitally. The physician surveys were first digitally based on an online platform. A paper form could also be edited manually and returned by fax. The respective questionnaires consisted of 5 to 17 questions on the topic of switching and could all be answered in about 5 to 10 min. BAH Health Monitor hosted the patient surveys and included telephone interviews. The stakeholder survey was performed by personal interviews. The surveys on economic calculations among patients were conducted digitally. Main outcome measure: Sumatriptan and other Rx triptans are suitable and should be switched to OTC status. Results: Nine hundred forty pharmacists and pharmaceutical technical assistants took part in the initial pharmacist survey. In the subsequent pharmacist surveys, the volume of participants was even higher and reached almost 4000. For the physician survey, 540 answers were received, and the BAH Health Monitor addressed about 1000 telephone interviews. Within the stakeholder survey, 24 interviews were carried out with 32 participants from a range of professional backgrounds; most are part of the German switch process. Finally, the patient survey related to economic calculations was based on 175 answers. Seventy percent of the participating physicians < 50 years old supported a switch of further triptans. For the question about how safe OTC triptans are, 41% of the 3568 participants from the Marpinion pharmacy survey voted that they are safe. Conclusion: With a Rx-to-OTC switch of further triptans, patients would have an easier, faster and safe way to treat their migraine attacks. Impact of findings on practice statements: The outcome of these surveys and interviews provides information for all participants in the German switch process about their decision-making behaviour. Furthermore, it allows deeper insights into patients' needs and may help to fulfil them. The results can provide information about the German process and German needs worldwide and stimulate discussion about Rx-to-OTC switches. [ABSTRACT FROM AUTHOR]

Copyright of Annual Yearbook of the Faculty of Philosophy is the property of Faculty of Philosophy, "Ss. Cyril & Methodius" University in Skopje and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Arxiu d'Etnografia de Catalunya is the property of Universitat Rovira I Virgili and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Egg freezing has led to heated debates in healthcare policy and bioethics. A crucial issue in this context concerns the distinction between "medical" and "social" egg freezing (MEF and SEF)—contrasting objections to bio-medicalization with claims for oversimplification. Yet such categorization remains a criterion for regulation. This paper aims to explore the "regulatory boundary-work" around the "medical"–"social" distinction in different egg freezing regulations. Based on systematic documents' analysis we present a cross-national comparison of the way the "medical"–"social" differentiation finds expression in regulatory frameworks in Austria, Germany, Israel, and the Netherlands. Findings are organized along two emerging themes: (1) the definition of MEF and its distinctiveness—highlighting regulatory differences in the clarity of the definition and in the medical indications used for creating it (less clear in Austria and Germany, detailed in Israel and the Netherlands); and (2) hierarchy of medical over social motivations reflected in usage and funding regulations. Blurred demarcation lines between "medical" and "social" are further discussed as representing a paradoxical inclusion of SEF while offering new insights into the complexity and normativity of this distinction. Finally, we draw conclusions for policymaking and the bioethical debate, also concerning the related cryopolitical aspects. [ABSTRACT FROM AUTHOR]

Background: Health care costs of migraine constitute a major issue in health economics. Several publications analyzed health care costs for adult migraine patients, based on questionnaires or secondary (health insurance) data. Although migraine often starts already in primary school age, data on migraine related costs in children is scarce. In this paper we aimed to assess the migraine-related health care costs in 6 to 11 year old children in Germany. Methods: Using claims data of a large German health insurer (BARMER), overall annual health care costs of 6 to 11 year old children with a diagnosis of migraine in 2017 (n = 2597) were compared to a control group of 6 to 11 year old children without a headache diagnosis between 2013 and 2017 (n = 306,926). The association of migraine and costs was modeled by generalized linear regression (Gamma regression) with adjustment for sex, age and comorbidities. Results: Children with migraine caused considerably higher annual per capita health care costs than children without a headache diagnosis (migraine group: € 1018, control group: € 618). Excess costs directly related to migraine amounted to € 115. The remaining excess costs were related to comorbidities, which were more frequent in the migraine group. Mental and behavioural disorders constituted the most expensive comorbidity, accounting for € 105 of the € 400 annual excess costs in the migraine group. Conclusion: 6 to 11 year old children with a migraine diagnosis cause significant direct and comorbidity related excess costs in the German health care system. [ABSTRACT FROM AUTHOR]

To investigate effects of diaper-free times, elimination communication (EC) and early toilet training, a web-based survey was conducted for caregivers. The more diaper-free times an infant experienced during day, the earlier it was toilet trained (P <.001), which was enhanced by the usage of cloth diapers. The amount of diaper-free times significantly reduced the caregiver's continuous sleep, the occurrence of rashes and balm usage (P <.001) and lead to a more regular defecation frequency. Cloth diaper usage had no effect on rashes or balm usage, but on diaper change rate (P <.001). We could show that, although not as effective as full-time EC, part-time EC is more effective if cloth diapers are used, provided they are changed frequently. Furthermore, EC causes a more regular defecation in infants between 1 and 2 years. [ABSTRACT FROM AUTHOR]

• Our methodology combines the subsystem approach to IO analysis and panel data regressions to capture how the productive linkages between services and manufacturing affect export performance. • In spite of the heterogeneous productive structures, the estimated price and income elasticities of export demand exhibited by the four Mediterranean economies do not differ much from the German ones. • The effect of labor costs on export performance is negligible in the five economies. • Non-price factors act as the main drivers of export growth. • Stronger linkages between KIBS and manufacturing stimulate non-price competitiveness. The relationship between manufacturing and services is not a matter of cost but rather one of innovation and product differentiation through the expansion of KIBS. Following the onset of the Eurozone crisis, Mediterranean economies (Greece, Italy, Portugal, Spain) followed the example set by Germany, implementing structural reforms with the aim of restraining labor costs and transitioning to export-led growth. Using input–output tables, this paper analyzes the role of labor costs and non-price factors in the export performance of the manufacturing sectors in these Mediterranean economies and in Germany. We estimate an export model taking subsystems as units of analysis, permitting us to consider how the productive linkages between manufacturing and services affect export growth. Our results show that the effect of labor costs on export performance has been negligible in these five economies, while non-price factors stand out as the main drivers of export growth. In addition, we find that the development of stronger linkages between knowledge-intensive business services (KIBS) and manufacturing provides a substantial stimulus for non-price competitiveness. [ABSTRACT FROM AUTHOR]

Individuals in need of long-term care and their relatives prefer to receive and give care in their domestic environment for as long as possible. Residential long-term care is to be avoided for as long as possible. To achieve this goal, the care setting must be optimally oriented to the needs of the person in need of care. Moreover, relatives who provide care must be professionally supported. The Regional Care Competence Center (ReKo), launched on October 1, 2019, is a quasi-experimental study (two groups and pre-post design), funded by the Innovation Fund. As part of the ReKo project, people in need of care and their relatives are assisted by a case management (CM) system. An independent CM, supported by an IT network that includes the most important service providers, is to establish a comprehensive CM for people in need of care. Based on a literature review, this paper aimed to take a conceptual approach to the ReKo project by drawing on previous research and comparing the findings with the ReKo approach. The review considered CM projects that defined avoidance of hospitalization and/or delay in the transition of care recipients to long-term inpatient care as endpoints. Using PubMed and Google Scholar, the study screened 270 articles, abstracted and quality-assessed data, and included eight randomized clinical trials, two other studies, and seven reviews in the analysis. The review results and ReKo approaches are presented along the dimensions of clinical and medical benefits, community and public health benefits, economic benefits, and political and legislative benefits. CM organizations will continue to be established internationally in aging societies. The questions of improving quality of care, avoiding service costs, and the costs of establishing a CM must be raised, even if clear evidence is difficult to provide. [ABSTRACT FROM AUTHOR]

Background: The underlying mechanisms of post-COVID syndrome (PCS) are still not fully understood. While pre-existing conditions have been described as a risk factor for severe PCS in the general population, data specific to different occupational groups in this context is lacking. This study aimed to investigate the impact of pre-existing conditions on severe post-COVID syndrome among the occupational group of healthcare and social services employees. Methods: Baseline data from a longitudinal, observational study were analysed. In February 2021, health workers who had a COVID-19 infection in 2020 were surveyed about sequelae of the infection. Factors influencing severe PCS with at least one persistent symptom categorised as severe were subjected to a multivariate logistic regression analysis. Results: Of a total of 2,053 participants, 21.5% had severe PCS. Underlying respiratory (OR 1.94; CI 1.44–2.61), cardiovascular (OR 1.35; CI 1.04–1.77) and urogenital (OR 1.79; CI 1.10–2.91) disease were risk factors for severe PCS overall. Respiratory and mental illnesses had a statistically significant impact on persistent fatigue/exhaustion, concentration/memory difficulties and shortness of breath categorised as severe. Urogenital disease was associated with severe fatigue/exhaustion. Other significant risk factors for severe PCS were female sex, smoking, physical exercise and hospitalisation due to COVID-19 infection. Conclusion: Workers in healthcare and social services with pre-existing conditions may face a higher risk of developing severe PCS. Additional analyses performed as part of the longitudinal study will show if and how this result changes over time. [ABSTRACT FROM AUTHOR]

Simple Summary: Taste and smell alterations (TSAs) are a distressing yet underdiagnosed side effect in cancer patients undergoing chemotherapy. However, long-term investigations using both questionnaires and chemosensory tests are scarce. We examined the prevalence of quantitative and qualitative TSAs, as well as their connection with clinical characteristics such as age, sex, anorexia, and neuropathy. We also compared patients receiving perpetual or temporary chemotherapy. All patients were examined up to five times within 12 to 24 months, commencing before the beginning of chemotherapy. We found TSAs in approximately 4 out of 5 patients during chemotherapy. The highest prevalence was documented among patients above 60 years of age as well as among those reporting anorexia or presenting signs of neuropathy. Post-therapy, taste and smell function recovered; however, scores did not reach baseline levels within 6 to 12 months. Future investigations will assess potential interventions to prevent or reduce TSAs. Previous data regarding chemotherapy-induced olfactory and gustatory dysfunction (CIOGD) are heterogeneous due to inconsistent study designs and small numbers of patients. To provide consistent, reliable data, we conducted a cohort study using standardized testing. Patients diagnosed with lymphoma, leukemia, or gastrointestinal malignancies were examined up to five times (T1 to T5), beginning prior to chemotherapy. We examined patients receiving temporary treatment up to 12 months post-therapy. Clinical assessment included extensive questionnaires, psychophysical tests of olfactory and gustatory function, and measurement of peripheral neuropathy. Statistical analysis included non-parametric tests to evaluate the longitudinal development of CIOGD. Our data (n = 108) showed a significant decline in olfactory and gustatory testing during chemotherapy (p-values < 0.001). CIOGD appeared stronger among patients above 60 years, while sex did not matter significantly. However, we identified distinct associations between CIOGD and reported anorexia as well as with higher neuropathy scores. Self-assessment appeared less sensitive to chemosensory dysfunction than psychophysical testing. Post-therapy, olfactory and gustatory function regenerated, though baseline levels were not attained within 6 to 12 months. In conclusion, our data highlight the wide prevalence and slow recovery of CIOGD. Understanding CIOGD as a potential neurotoxic effect may disclose new therapeutic prospects. [ABSTRACT FROM AUTHOR]

Purpose: Poor mental health in men and women is attributable to disparities in physical traits, social roles, power and health-seeking behaviours. This study aims to examine the gender differences in mental health among Pakistan and German university students and focuses on their right to seek mental health care. Design/methodology/approach: Data on depression, anxiety and stress symptoms, as well as positive mental health (PMH), resilience, social support and life satisfaction, were gathered from Pakistani and German students. Findings: In contrast to the Pakistani group, where no such gender differences were seen, women in Germany reported higher degrees of stress, anxiety and depression, as well as a lower level of overall good mental health. In comparison to German men and women, Pakistani women scored equally high on resilience. While gender had no bearing on life happiness in either Pakistan or Germany, women in both countries perceived more social support than men did. Research limitations/implications: The study's strengths include its large sample size and battery of mental health measures. The results of partial weak measurement Invariance (MI) on the stress subscale underlined the importance of using MI in cross-cultural studies. The validity of a direct comparisons on sum score between different language versions or country samples shall be cautious. Still, there are limitations. Firstly, the authors did not differentiate gender and biological sex, and there was no group of non-binary gender. Pakistani (N = 1,840) and German (N = 7,890) students were in unequal numbers. Again, only university students were sampled, so the results cannot be generalised to older (probably less educated) populations. Self-reported data that mainly obtained via online survey were the third limitation. This design is cost-effective and easy to administer for cross-cultural survey research. However, social desirability and memory bias are common in self-report inventories. Fourthly, although English is an official language in Pakistan and the medium of instruction in education, the authors recommend future study to use questionnaires that have been translated and validated into Urdu (Pakistan's national language) and investigate gender differences in a general population. Fifthly, this is a cross-sectional survey; the authors were not able to explore the causality or risk factors that contribute to the poor mental well-being in Pakistan students in general or the relatively worse mental health in German women. Future studies may investigate the mechanism behind the phenomena observed in this study with longitudinal or experimental design. Last but not least, Germany and Pakistan differ in so many different aspects from culture, religions and history to social structure and economic status, which make it hard to claim whether the observed differences were due to national differences, cultural differences, economic differences, gender inequality differences or other effects. It would be helpful for future studies to include more country samples with clear definitions of different "culture" aspects for a better understanding of gender differences in other countries and in different mental well-being constructs. Practical implications: The current study is the first attempt to compare the gender difference patterns in positive and negative mental health between European and South Asian counties and focuses on gender-specific approaches. Although Pakistani university students reported in general worse mental well-being, the differences between the two genders in mental health (e.g. depression, anxiety, general PMH) were not as pronounced as in the German student sample. Gender comparisons in these mental health constructs would help to improve protective factors against mental illness and to develop appropriate management programmes based on cultural differences. The results suggest that the gender differences found in western countries cannot always be directly translated into the South Asian cultural framework. Our results also highlight the importance of improving the general situation of Pakistan (students) instead of focusing on one gender. At the same time, in Germany, prevention and intervention plans are more warranted for women. It could be that once the general situation in Pakistan is improved, the gender-related differences in mental health will be clearly observed. Originality/value: These findings imply the significance of cultural context when inferring gender variations in mental health. Moreover, it supports the advancement of comprehensive policies to reduce gender-related mental health inequalities and focuses on the equal rights of men and women to get mental health care. [ABSTRACT FROM AUTHOR]

This paper presents the results of a comparative curriculum-based study conducted to analyse the way dictionaries and the development of lexicographical skills are addressed in primary education in Germany and Spain. To carry out the study, the curricula of two language subjects taught throughout the country were selected, namely First Language (German and Spanish, respectively) and First Foreign Language (English). Within the methodology framework for documentary analysis, several thematic categories will be identified inductively from explicit references located in the selected curricula that will serve as tertium comparationis. The main objective is to find out whether the curriculum regulations consider dictionaries and the development of specific skills for using them in this first stage of education as part of the process of training literacy in the first language and foreign language teaching-learning context. [ABSTRACT FROM AUTHOR]

Introduction: With advancements in communication technologies and internet connectivity, avatar robots for children who cannot attend school in person due to illness or disabilities have become more widespread. Introducing these technologies to the classroom aims to offer possibilities of social and educational inclusion. While implementation is still at an experimental level, several of these avatars have already been introduced as a marketable service. However, various obstacles impede widespread acceptance. Methods: In our explorative qualitative case study we conducted semistructured interviews with eight individuals involved in the implementation of the avatar robots AV1 in Germany and eleven participants involved with implementing OriHime in Japan. We analyzed and compared implementation processes, application areas, access and eligibility, and the potential and limitations of avatars at schools. Results: We identified structural similarities and differences in both countries. In the German cases the target is defined as temporary use for children who cannot attend school in person because of childhood illness, with the clear goal of returning to school. Whereas in Japan OriHime is also implemented for children with physical or developmental disabilities, or who cannot attend school in person for other reasons. Discussion: Our study suggests that avatar technologies bear high potential for children to stay socially and educationally connected. Yet, structures need establishing that grant equal access to avatar technologies. These include educational board regulations, budgets for funding avatar technologies and making them accessible to the public, and privacy protection standards that are adequate, yet do not create implementation hurdles that are too high. Furthermore, guidelines or training sessions on technical, educational and psychosocial aspects of including avatar technologies in the classroom for teachers are important for successful implementation. Since our Japanese cases suggest that expanding the area of application beyond childhood illness is promising, further research on the benefits for different groups is needed. [ABSTRACT FROM AUTHOR]

Simple Summary: This study explored advanced diagnostic methods that are used for identifying skin cancer in high-risk melanoma patients. A total of 410 patients were examined using a combination of three advanced imaging techniques: 3D total body photography, digital dermoscopy, and reflectance confocal microscopy. These methods were used in addition to regular skin exams. Results showed that the specialized imaging detected 16 melanomas in 39 removed pigmented lesions, while regular exams detected only 7 melanomas in 163 removed lesions. This indicates that specialized imaging was much more efficient. Each imaging method found melanomas that the others did not. The study concludes that combining these three imaging techniques improves melanoma detection and reduces unnecessary skin removals in high-risk patients. Modern diagnostic procedures, such as three-dimensional total body photography (3D-TBP), digital dermoscopy (DD), and reflectance confocal microscopy (RCM), can improve melanoma diagnosis, particularly in high-risk patients. This study assessed the benefits of combining these advanced imaging techniques in a three-step programme in managing high-risk patients. This study included 410 high-risk melanoma patients who underwent a specialised imaging consultation in addition to their regular skin examinations in outpatient care. At each visit, the patients underwent a 3D-TBP, a DD for suspicious findings, and an RCM for unclear DD findings. The histological findings of excisions initiated based on imaging consultation and outpatient care were compared. Imaging consultation detected sixteen confirmed melanomas (eight invasive and eight in situ) in 39 excised pigmented lesions. Outpatient care examination detected seven confirmed melanomas (one invasive and six in situ) in 163 excised melanocytic lesions. The number needed to excise (NNE) in the imaging consultation was significantly lower than that in the outpatient care (2.4 vs. 23.3). The NNE was 2.6 for DD and 2.3 for RCM. DD, 3D-TBP, or RCM detected melanomas that were not detected by the other imaging methods. The three-step imaging programme improves melanoma detection and reduces the number of unnecessary excisions in high-risk patients. [ABSTRACT FROM AUTHOR]

Simple Summary: Functional MRI has become established in the surgery of brain metastases (BM) as a preoperative diagnostic tool to identify intact eloquent cortex areas. Evidence shows that by allowing surgeons to spare these intraoperatively, patients' postoperative outcome is improved in terms of significantly reduced mortality and morbidity. The influence specifically of BM on the fMRI signal and brain networks has scarcely been investigated, as most studies to date refer only to primary brain tumors or include various tumor entities. Our work examined how BM affect cortical activation and brain networks using task-based fMRI. We found a qualitative attenuation of patients' fMRI signal in the metastasis-affected hemisphere compared to the contralateral hemisphere and alterations in all examined brain networks of the patients compared to healthy controls, and also in the contralateral hemisphere. Thus, our results provide insights into the behavior of BM during fMRI examination and their impact on the integrity of the brain. To date, there are almost no investigations addressing functional connectivity (FC) in patients with brain metastases (BM). In this retrospective study, we investigate the influence of BM on hemodynamic brain signals derived from functional magnetic resonance imaging (fMRI) and FC. Motor-fMRI data of 29 patients with BM and 29 matched healthy controls were analyzed to assess percent signal changes (PSC) in the ROIs motor cortex, premotor cortex, and supplementary motor cortex and FC in the sensorimotor, default mode, and salience networks using Statistical Parametric Mapping (SPM12) and marsbar and CONN toolboxes. In the PSC analysis, an attenuation of the BOLD signal in the metastases-affected hemisphere compared to the contralateral hemisphere was significant only in the supplementary motor cortex during hand movement. In the FC analysis, we found alterations in patients' FC compared to controls in all examined networks, also in the hemisphere contralateral to the metastasis. This indicates a qualitative attenuation of the BOLD signal in the affected hemisphere and also that FC is altered by the presence of BM, similarly to what is known for primary brain tumors. This transformation is not only visible in the infiltrated hemisphere, but also in the contralateral one, suggesting an influence of BM beyond local damage. [ABSTRACT FROM AUTHOR]

Red ginger extract (RGE) boasts high antioxidant activity due to its bioactive compounds but suffers from poor water solubility and dispersibility. This study aimed to improve these properties by converting RGE into liquid and powdered aquaresins. Diacetyl tartaric acid ester of mono- and diglycerides (DATEM) were used as emulsifiers due to their balanced hydrophile-lipophile balance (HLB). Aquaresins were prepared using plating methods due to their practicability and vacuum methods for the powdered form. The optimal RGE:DATEM ratio and characteristics of the aquaresins were investigated. A 45% RGE and 5% DATEM formulation yielded the highest levels of phenolic compounds, flavonoids, and 6-gingerol, while maintaining potent antioxidant activity over 60 days. The plating method significantly enhanced bioactive compound concentration compared to the vacuum method. Adding silicon dioxide and γ-cyclodextrin improved physical properties and antioxidant stability. The 45:5 RGE:DATEM ratio offered superior chemical properties and antioxidant activity in liquid aquaresin, while the plating method contributed to better chemical characteristics and antioxidant activity in powdered form. This study paves the way for incorporating RGE into various food and pharmaceutical applications. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 outbreak necessitated physical distancing, as part of secondary prevention, at a personal and professional level. Working from home (WFH) became increasingly important. In this study, the impact of the COVID-19 pandemic restrictions on physical and mental health is investigated, compared with pre-pandemic data, and with employees who WFH and are on-site. Methods: Data from the German Saxon longitudinal study population were used. Attitudes towards WFH as well as mental and physical health assessments during the COVID-19 pandemic were examined. Comparisons were made with corresponding pre-pandemic scores and between employees WFH and on-site in 2022. Results: In total, 319 participants with equal gender distribution were included. Of those, 86 worked from home stating better organizability of their work, more time for partnership, less stress, and greater work satisfaction. Compared to pre-pandemic data, the D-score, PHQ-4, G-Score, and PHQ-SSS-8 showed a significant increase. No difference in physical or mental health between employees WFH and on-site was observed. Conclusion: In general, COVID-19 restrictions had a negative impact on mental and physical health. Although WFH is well accepted, it did not show significant health benefits. [ABSTRACT FROM AUTHOR]

Reflecting team is a structured and guided method for peer collaborative reflection on critical incidents in teaching. The present evaluation study combining quantitative and qualitative data investigates the perceived usefulness and central insights associated with the participation in a reflecting team session. This method was implemented among three groups of teachers in Germany: student teachers, school teachers, and higher education teachers. All three groups reported high levels of perceived usefulness of the method and provided insights into their central experiences in connection with the reflecting team. Differences between the three groups in terms of perceived usefulness and central insights of peer reflection stem from participants' distinct organizational and educational contexts and show various ways of how teachers can derive benefits from the reflecting team method. [ABSTRACT FROM AUTHOR]

Working time reduction (WTR) is back on the agenda, but there is no systematic knowledge of key actors in the WTR debate, their motives, the forms of WTR advocated, and their approach. Therefore, this article examines the promotion of WTR in Germany, Spain, and Ireland, countries with different industrial relations regimes. The comparative qualitative content analysis shows that WTR's promotion varies: it is an individual worker issue in Germany, a political initiative in Spain, and a social campaign in Ireland. The primary motive is workers' well-being, with additional emphases on economic, environmental, and societal aspects. These findings have implications for WTR's future prospects. [ABSTRACT FROM AUTHOR]

Disengaged responding poses a severe threat to the validity of educational large-scale assessments, because item responses from unmotivated test-takers do not reflect their actual ability. Existing identification approaches rely primarily on item response times, which bears the risk of misclassifying fast engaged or slow disengaged responses. Process data with its rich pool of additional information on the test-taking process could thus be used to improve existing identification approaches. In this study, three process data variables—text reread, item revisit, and answer change—were introduced as potential indicators of response engagement for multiple-choice items in a reading comprehension test. An extended latent class item response model for disengaged responding was developed by including the three new indicators as additional predictors of response engagement. In a sample of 1,932 German university students, the extended model indicated a better model fit than the baseline model, which included item response time as only indicator of response engagement. In the extended model, both item response time and text reread were significant predictors of response engagement. However, graphical analyses revealed no systematic differences in the item and person parameter estimation or item response classification between the models. These results suggest only a marginal improvement of the identification of disengaged responding by the new indicators. Implications of these results for future research on disengaged responding with process data are discussed. [ABSTRACT FROM AUTHOR]

Background: Implantology, as a recognized therapeutic approach, is gaining prominence. The decision-making process and success of implant therapy are closely linked to patient knowledge and expectations. This study aims to explore the association between age and knowledge regarding oral implants. Methods: Participants were categorized into three age groups (ag): ag 1 (35–44 years), ag 2 (65–74 years), and ag 3 (75 years and older). A total of 400 participants per age group were randomly selected using data from the residents' registration office of Berlin, Germany. Structured telephone interviews were conducted between 2016 and 2017, employing a 67-item questionnaire covering awareness, information level, cost estimation, attitudes, and experiences with oral implants. Results: Despite a low overall knowledge level across all age groups, there was no significant correlation between age and knowledge about oral implants. Awareness increased with age. Information sources varied, with friends, acquaintances, and dentists playing key roles. Participants expressed diverse opinions on implants, with durability and stability identified as crucial characteristics. Significant differences in knowledge were observed between age groups regarding awareness, information sources, and perceptions of dentists offering implants. Conclusions: The study suggests a need for targeted educational programs, emphasizing age-appropriate information sources to enhance health literacy in oral implantology, particularly among older individuals. Educating physicians on oral implant basics is also crucial. Implementing these measures could empower individuals to make informed decisions about oral implant treatment, thereby contributing to improved oral health outcomes. [ABSTRACT FROM AUTHOR]

Background: Volunteers have always been integral to hospice and palliative care. However, their roles have been left relatively undefined and broad. Aim: This study aims to examine the role of hospice volunteers in German inpatient hospice and palliative care. The question we seek to answer is: What do hospice volunteers contribute to everyday life in inpatient hospice and palliative care units? Methods: We undertook a multicenter, on-site qualitative interview study, utilizing problem-centered interviews with 16 volunteers from five inpatient hospice units and one hospital palliative care unit. Interviews were analyzed using grounded theory. Results: Analysis of the interviews revealed three typical characteristics of how hospice volunteers' describe their own role: (1) performing small acts of kindness, (2) creating a family-like atmosphere, (3) expecting emotional experiences. A common theme across all categories is the emphasis on spontaneous actions and personal experiences. The process of dying becomes an experience interpreted by volunteers as enriching, as a gift, as a "teacher". Conclusion: Granting hospice volunteers freedom to act spontaneously and intuitively benefits hospice and palliative care delivery. Organizations should leave sufficient room for spontaneity in order to involve volunteers effectively. Open and unstandardized roles facilitate dynamic work practices. [ABSTRACT FROM AUTHOR]

Somatoform disorders (SD), commencing during adolescence, represent a major problem in health care systems. While literature underlines the high presence of mental health problems among children and adolescents afflicted by somatic symptoms in the general population, limited evidence is available on the prevalence of comorbid somatic symptoms in child and adolescent psychiatric populations. We assessed the prevalence of somatic symptoms, depression, and anxiety by validated questionnaires in an inpatient cohort. We further screened for the presence of SD. Out of 434 inpatients aged 11–17 years, 371 were included and a total of n = 288 (77.6%) children and adolescents participated in the study. A total of 93.8% of the inpatients reported somatic symptoms within the past six months and still almost half (45.7%) of the sample reported at least one somatic symptom within the last seven days prior to inquiry. Relating to the past six months, 59.5% were positively screened for SD, and 44.6% reported symptoms eligible for positive screening within the past seven days prior to the survey. Somatoform symptomatology was highly associated with anxiety and depression scores, but functional decline was amenable to the number of somatic symptoms only. We provide evidence that somatic symptoms are frequent in children and adolescents being treated in child and adolescent psychiatry and are relevant to everyday functioning. Screening for somatic symptoms should be introduced in the routine diagnostic procedures for early detection of SD in the commencing stages. [ABSTRACT FROM AUTHOR]

Purpose: According to most models of spoken word recognition, listeners probabilistically activate a set of lexical candidates, which is incrementally updated as the speech signal unfolds. Speech carries segmental (speech sound) as well as suprasegmental (prosodic) information. The role of the latter in spoken word recognition is less clear. We investigated how suprasegments (tone and voice quality) in three North Germanic language varieties affected lexical access by scrutinizing temporally fine-grained neurophysiological effects of lexical uncertainty and information gain. Method: Three event-related potential (ERP) studies were reanalyzed. In all varieties investigated, suprasegments are associated with specific word endings. Swedish has two lexical “word accents” realized as pitch falls with different timings across dialects. In Danish, the distinction is in voice quality. We combined pronunciation lexica and frequency lists to calculate estimates of lexical uncertainty about an unfolding word and information gain upon hearing a suprasegmental cue and the segment upon which it manifests. We used single-trial mixed-effects regression models run every 4 ms. Results: Only lexical uncertainty showed solid results: a frontal effect at 150-400 ms after suprasegmental cue onset and a later posterior effect after 200 ms. While a model including only segmental information mostly performed better, it was outperformed by the suprasegmental model at 200-330 ms at frontal sites. Conclusions: The study points to suprasegmental cues contributing to lexical access over and beyond segments after around 200 ms in the North Germanic varieties investigated. Furthermore, the findings indicate that a previously reported “pre-activation negativity” predominantly reflects forward-looking processing. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to examine the Coronavirus disease 2019(COVID-19) vaccine policies disparities and effectiveness in Germany, Denmark and Bulgaria, with a view to providing lessons for global vaccination and response to possible outbreak risks. Methods: This study analyzed big data through public information on the official websites of the Ministries of Health of the European Union, Germany, Denmark and Bulgaria and the official websites of the World Health Organization. We systematically summarized the COVID-19 vaccine policies of the three countries, and selected the following six indicators for cross-cutting vaccination comparisons: COVID-19 vaccine doses administered per 100 people, COVID-19 vaccination rate, the share of people with fully vaccinated, the share of people only partly vaccinated, cumulative confirmed COVID-19 cases per million, cumulative confirmed COVID-19 deaths per million. Meanwhile, we selected the following four indicators for measuring the effectiveness of COVID-19 vaccine policy implementation: daily cases per million, daily deaths per million, the effective reproduction rate (Rt), the moving-average case fatality rate (CFR). Results: Although these three EU countries had the same start time for vaccination, and the COVID-19 vaccine supply was coordinated by the EU, there are still differences in vaccination priorities, vaccination types, and vaccine appointment methods. Compared to Germany and Denmark, Bulgaria had the least efficient vaccination efforts and the worst vaccination coverage, with a vaccination rate of just over 30% as of June 2023, and the maximum daily deaths per million since vaccination began in the country was more than three times that of the other two countries. From the perspective of implementation effect, vaccination has a certain effect on reducing infection rate and death rate, but the spread of new mutant strains obviously aggravates the severity of the epidemic and reduces the effectiveness of the vaccine. Among them, the spread of the Omicron mutant strain had the most serious impact on the three countries, showing an obvious epidemic peak. Conclusions: Expanding vaccination coverage has played a positive role in reducing COVID-19 infection and mortality rates and stabilizing Rt. Priority vaccination strategies targeting older people and at-risk groups have been shown to be effective in reducing COVID-19 case severity and mortality in the population. However, the emergence and spread of new variant strains, and the relaxation of epidemic prevention policies, still led to multiple outbreaks peaking. In addition, vaccine hesitancy, mistrust in government and ill-prepared health systems are hampering vaccination efforts. Among the notable ones are divergent types of responses to vaccine safety issue could fuel mistrust and hesitancy around vaccination. At this stage, it is also necessary to continue to include COVID-19 vaccination in priority vaccination plans and promote booster vaccination to prevent severe illness and death. Improving the fairness of vaccine distribution and reducing the degree of vaccine hesitancy are the focus of future vaccination work. [ABSTRACT FROM AUTHOR]

Background: Social health inequalities are still of great public health importance in modern societies. The COVID-19 pandemic may have affected social inequalities in people's health due to containment measures. As these measures particularly affected children, they might have been particularly vulnerable to increased social inequalities. The aim of the study was to describe health inequalities during the pandemic based on language delay (LD) in children in order to inform public health interventions for a population at risk of long-term health and education inequalities. Methods: Data of 5–7 year old children from three consecutive school entry surveys in the German federal state of Brandenburg were used, including data compulsorily collected before the pandemic (2018/2019: n = 19,299), at the beginning of the pandemic (2019/2020: n = 19,916) and during the pandemic (2020/2021: n = 19,698). Bivariate and multivariate binary regression analyses [OR, 95% CI] cross-sectionally examined the relationship between the prevalence of LD [yes/no] and social inequalities, operationalized by family socioeconomic position [SEP low/middle/high], migration background [native-German language/non-native German language] and length of kindergarten attendance [< 4 years/ ≥ 4 years]. Factors contributing to inequality in LD were examined by socioeconomic stratification. Results: Cross-sectionally, LD prevalence has decreased overall (2018/2019: 21.1%, 2019/2020: 19.2%, 2020/2021: 18.8%), and among children from both high SEP and native German-speaking families. As LD prevalence increased among children from families with low SEP and remained stable among non-native German speakers, social inequalities in LD prevalence increased slightly during the pandemic i) by low SEP (2018/2019: OR = 4.41, 3.93–4.94; 2020/2021: OR = 5.12, 4.54–5.77) and ii) by non-German native language (2018/2019: OR = 2.22, 1.86–2.66; 2020/2021: OR = 2.54, 2.19–2.95). During the pandemic, both migration background and kindergarten attendance determined LD prevalence in the high and middle SEP strata. However, the measured factors did not contribute to LD prevalence in children from families with low SEP. Conclusion: Social inequalities in LD increased due to opposing trends in prevalence comparing low and high SEP families. To promote health equity across the life course, early childhood should be of interest for tailored public health actions (e.g. through targeted interventions for kindergarten groups). Further analytical studies should investigate determinants (e.g., parental investment). [ABSTRACT FROM AUTHOR]

The first years of retirement have often been seen as a typical time window to take up (or intensify) voluntary work. Due to the changing context of retirement and historical differences in resources, the role of retirement for volunteering may have changed with historical time. We compared individuals aged 60–70 in five cross-sectional waves (1999, 2004, 2009, 2014, 2019) of the German Survey on Volunteering (Deutscher Freiwilligensurvey: FWS) to investigate how the association of retirement status and volunteering has changed. We found a negative association of retirement and volunteering, which was not significant once controlling for age, education, gender and region. While engagement levels seem to have increased with historical time, voluntary work seems to have become less time consuming. There were no historical differences in the association of retirement and volunteering. Our results highlight the role of historical time and contextual factors when investigating volunteering and post-retirement activities. [ABSTRACT FROM AUTHOR]

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Background: Intensive care units (ICUs) are often too noisy, exceeding 70–80 dBA, which can have negative effects on staff. The corresponding recommendation of the World Health Organization (average sound pressure level below 35 dBA) is often not achieved. To date there is a lack of intervention studies examining the extent to which unit-based noise management in ICUs contributes to a reduction in noise exposure for the staff. The study therefore aims to provide answers to 1) how unit-based noise management sustainably reduces the subjective noise exposure among staff, and 2) how this intervention affects other noise-related topics. Methods: We performed a monocentric prospective longitudinal study with three measurement points in a German university hospital in three ICUs. We collected data from different healthcare professionals and other professional groups between October 2021 and August 2022 using an online questionnaire. Data were analyzed using descriptive and inference statistics. Results: A total of n = 179 participants took part in the surveys. The majority of participants were nurses or pediatric nurses. Most participants worked more than 75% full-time equivalent. Staff on the three ICUs reported high levels of noise exposure. No significant changes in noise exposure over time were observed. Participants were already aware of the topic and believed that a behavior change could positively influence the noise environment. Conclusions: This study provides an initial insight into how a unit-based noise management could contribute to a reduction in the subjective noise exposure among staff in ICUs. The results of this study highlight the importance of this topic. Future studies should aim to research aspects of adherence and their facilitators or barriers, which promote the sustained implementation of noise-reducing measures by staff. Trial registration: German Clinical Trials Register (DRKS): DRKS00025835; Date of registration: 12.08.2021. [ABSTRACT FROM AUTHOR]

Purpose: Sociodemographic and structural conditions have consequences for the labor market participation of young persons with disabilities (YPWD) in vocational rehabilitation (VR). As the type of program determines the labor market chances, we analyze the processes of selecting active labor market programs (ALMP) in VR. Which factors determine the allocation to (1) programs in general and (2) moreover, the allocation to specific programs? Materials and methods: We conduct logistic (1) and multinomial regression (2) using register data of the German Federal Employment Agency. Besides variables on the micro level, we control for a wide range of structural and organizational influences. The sample comprises VR and employment biographies of 255,009 YPWD accepted to VR between 2010 and 2015. Program participation is restricted to start 180 days after VR acceptance. Results: Sociodemographic factors, like age and the status before entering VR as well as the local apprenticeship market as a structural condition, highly influence the general allocation to ALMP. For the allocation to specific ALMP, sociodemographics (age, education, type of disability, status before entering VR) are highly relevant. Furthermore, structural conditions (regional structure of subsidized vocational training and of the apprenticeship market as well as local work possibilities on a special labor market for PWD) and – to a lesser extent - re-organization processes at the FEA (NEO, VR cohort) are important determinants. Conclusion: (Automatic) paths into VR programs for especially persons with mental disabilities in sheltered workshop are clearly shown. Furthermore, it is somewhat questionable that YPWD participate more often in sheltered workshops in regions where sheltered work possibilities are more common, as well as where NEO was implemented locally; and participate more often in company-external vocational training where VR service providers are commissioned to a greater extent. [ABSTRACT FROM AUTHOR]

In 2021, the federal government of the United States expanded a set of income transfers that led to strong reductions in child poverty. This research note uses microdata from more than 50 countries and U.S. data spanning more than 50 years to place the 2021 child poverty rate in historical and international perspective. We demonstrate that whether using the Supplemental Poverty Measure (SPM), relative poverty measures, or an absolute poverty measure, the U.S. child poverty rate in 2021 was at its lowest level since at least 1967. The U.S. tax and transfer system reduced the 2021 SPM child poverty rate by more than 75% relative to the pre-tax/transfer child poverty rate; this reduction was three times the mean reduction effect between 1967 and 2019. These policy changes improved the country's standing from having a relative poverty rate twice that of Germany's in 2019 to the same as Germany's in 2021. Moreover, the U.S. progressed from reducing child poverty at less than half the rate of Norway in 2019 to a rate comparable to Norway in 2021. However, the U.S. success was temporary: after the expiration of the 2021 income provisions, the child poverty rate doubled and returned to being higher than in most other high-income countries. [ABSTRACT FROM AUTHOR]