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Purpose: Prospective physical education teachers (PPETs) acquire beliefs during acculturation, which is the time before teacher education begins. Beliefs are based on shared experiences and influential in PPETs' professional development. We examined German PPETs' shared beliefs through the lens of teaching quality, comprising classroom management, student support, and cognitive activation. Method: Three focus group discussions were conducted, in which 13 German PPETs were instructed to work on shared lesson planning. The data were analyzed using reflexive thematic analysis. Findings: The PPETs believed that physical education should enable students' participation in sports. Therefore, classroom management was reflected as "managing a physical education class as a prerequisite for the complexity of teaching." Student support was reflected as "providing easy access to sports for all students." Cognitive activation was reflected as "disregarding cognitive activation in favor of transmissive teaching." The PPETs drew on their own physical education experiences as former students. Conclusion: Longitudinal studies focusing on cognitive activation are recommended.

Background: The living situation of single parents is often characterised by sole responsibility for family and household, problems in reconciling work and family life, and a high risk of poverty. In a comparative perspective with parents in partner households, the health of single mothers and fathers was analysed, considering differences in their social status. Methods: The analyses are based on data from the GEDA studies 2019 – 2023 (7,999 women, 6,402 men). Prevalences for single mothers and fathers and mothers and fathers living in partner households were calculated for self-rated health, chronic diseases, depressive symptoms, smoking and utilisation of professional help for mental health problems. In multivariate models, adjustments were made for income, education, employment status and social support, and interactions with family type were included. Results: Single mothers and fathers show higher prevalences for all health indicators in comparison to parents living in partner households. Also after adjustment, the differences between family types remain significant. The health of single mothers also varies partially with income, employment status and social support. Conclusions: Health promotion measures have to consider that single parents are a heterogeneous group. In addition to strengthening personal skills, policy and setting-based interventions aim to reduce health inequalities.

Across the Global South, commercial development and technological innovations are transforming fish food systems in ways that significantly impact the livelihoods of small-scale producers and the food security of the poor. A crucial but understudied aspect of such transformations is the social relations in which fish food systems are embedded. Food system transformations change power relations and rework gendered economic roles and divisions of labour in ways that often marginalise women and other vulnerable groups. In this paper, we draw on feminist studies of gender and technology and feminist commodity chain analysis to investigate the impact of technological transformation on social relations in the ring seine fishery of Kerala, India. Kerala's ring seine fishery specifically targets small pelagics like sardine, mackerel, and anchovies, which have been identified as important to the food security and nutrition of the poor. Since the mid-1980s, when the ring seine was first introduced to enable small-scale fishers to compete with mechanised trawlers, these fishing units have expanded both in terms of numbers and in size, largely as a result of locally-driven technological innovation and adaptation. Though traditional arrangements of labour deployment and wage sharing have remained, rising competition and differentiation between fishermen have ensued. At the same time, changes in processing, distribution, and trade have reworked women's economic roles and position in the fishery, and questions about long-term profitability and sustainability have necessitated interventions in governance at various levels. Tracing the trajectory of technological innovation and changing social relations through the value chain, we assessed the gendered implications of fish food system transformations for livelihoods. We found that the increase in dimensions of the new gear increased both investments and operational costs of the fishing units rendering several of them uneconomical. Time-tested social norms have also changed as competition increased, which is much more pronounced between the smaller and larger fishing vessels. The traditional wage sharing pattern still remains ensuring income security for fishermen who cannot find work as crew on these fishing vessels. Women, however, have been most affected by the changes as they no longer are able to access the fish resource as earlier for engaging in post-harvest activities, such as marketing and fish drying.

Background: The panel infrastructure Health in Germany, which is currently being set up, is geared towards the needs of public health research in Germany. The panel will consist of extensive probability and non-probability samples. This infrastructure will be used to collect survey data, measurement data and laboratory data to describe the health situation on an ongoing basis and make them available promptly. Methods: For the initial drawing of the probability sample, the sampling frame of the residents’ registration offices (EMA) established in Germany is used. The study design follows a mixed-mode approach in which the invited persons can choose whether to participate in the survey online or in paper form. Four surveys per year are planned for the regular operation of the panel (regular annual wave). Ad-hoc studies on specific topics or acute issues are also possible. Conclusions: The panel provides a new infrastructure for continuous epidemiological studies to monitor the health of the population in Germany. This data basis strengthens the health monitoring and health reporting of the federal government, enabling a prompt and adaptable response to emerging data needs.

Purpose: Prospective physical education teachers (PPETs) acquire beliefs during acculturation, which is the time before teacher education begins. Beliefs are based on shared experiences and influential in PPETs' professional development. We examined German PPETs' shared beliefs through the lens of teaching quality, comprising classroom management, student support, and cognitive activation. Method: Three focus group discussions were conducted, in which 13 German PPETs were instructed to work on shared lesson planning. The data were analyzed using reflexive thematic analysis. Findings: The PPETs believed that physical education should enable students' participation in sports. Therefore, classroom management was reflected as "managing a physical education class as a prerequisite for the complexity of teaching." Student support was reflected as "providing easy access to sports for all students." Cognitive activation was reflected as "disregarding cognitive activation in favor of transmissive teaching." The PPETs drew on their own physical education experiences as former students. Conclusion: Longitudinal studies focusing on cognitive activation are recommended. [ABSTRACT FROM AUTHOR]

ObjectivesMental health is essential for overall health and is influenced by different social determinants. The aim of this paper was to examine which determinants are associated with mental health inequalities among people with selected citizenships in Germany.MethodsData were derived from the multilingual interview survey “German Health Update: Fokus (GEDA Fokus)” among adults with Croatian, Italian, Polish, Syrian, or Turkish citizenship (11/2021–05/2022). Poisson regressions were used to calculate prevalence ratios for symptoms of depression (PHQ-9) and anxiety disorder (GAD-7).ResultsSociodemographic (sex, income, age, household size) and psychosocial (social support and self-reported discrimination) determinants were associated with symptoms of depression and/or anxiety disorder. The prevalence of mental disorders varied most by self-reported discrimination.ConclusionOur findings suggest mental health inequalities among people with selected citizenships living in Germany. To reduce these, social inequities and everyday discrimination need to be addressed in structural prevention measures as well as in interventions on the communal level. Protective factors (e.g., social support) are also important to reduce mental health inequalities on the individual and community level.

Background: The health situation of people with a history of migration is influenced by a variety of factors. This article provides an overview of the health of people with selected citizenships using various indicators. Methods: The analyses are based on the survey ‘German Health Update: Fokus (GEDA Fokus)’, which was conducted from November 2021 to May 2022 among people with Croatian, Italian, Polish, Syrian and Turkish citizenship. The prevalence for each health outcome is presented and differentiated by sociodemographic and migration-related characteristics. Poisson regressions were performed to identify relevant factors influencing health situation. Results: Self-assessed general health, the presence of depressive symptoms, prevalence of current smoking and the utilisation of general and specialist healthcare differed according to various factors considered here. In addition to sociodemographic determinants, the sense of belonging to society in Germany and self-reported experiences of discrimination were particularly associated with health outcomes. Conclusions: This article highlights the heterogeneity of the health situation of people with a history of migration and points to the need for further analyses to identify the reasons for health inequalities.

Abstract Background Rituximab has become a standard treatment for non‐Hodgkin lymphoma. Clinical studies have demonstrated the efficacy of rituximab in combination with standard chemotherapies in the treatment of follicular lymphoma (FL) and diffuse large B cell lymphoma (DLBCL) patients. This non‐interventional study aimed to evaluate the effectiveness and safety of subcutaneous (SC) rituximab in routine clinical practice. Methods Adult patients with previously untreated CD20 positive DLBCL or FL who received rituximab SC and chemotherapy as first‐line treatment were observed between 07/2014 and 07/2019 at 99 institutions in Germany. Primary endpoint was the (unconfirmed) complete remission (CR/CRu) rate. Primary outcome was analyzed inferentially; other variables were evaluated descriptively. Results Overall 583 patients (247 FL; 336 DLBCL) were evaluated. CR/CRu rates were 51.4% (95% CI: 45.2; 57.6) in the FL set and 48.5% (95% CI: 43.2; 53.8) in the DLBCL set. Regarding progression‐free survival in the FL group, the probability of being event‐free was 94.2% in the first year and 86.2% in the second year. An overall response was achieved in 85.8% (FL) and 85.4% patients (DLBCL). Patient satisfaction at the end of study with the time saving simplification of the SC vs. intravenous route was 98% for FL and 97% for DLBCL. 45.3% of FL and 47.0% of DLBCL patients experienced an adverse event of grade ≥3. Serious adverse events of grade ≥3 occurred in 27.9% FL and 32.4% DLBCL patients, with the highest incidences for leucopenia, anemia, nausea, and fatigue. No new safety signals were detected. Conclusions The results confirmed the effectiveness and safety of rituximab SC in both the FL and the DLBCL group. Satisfaction of patients and nurses with SC administration was high.

Background: Study results on the impact of the COVID-19 pandemic on mental health in the first year of the pandemic are contradictory. The GEDA 2019/2020 study makes it possible to examine changes in depressive symptoms in the population. Methods: A standardised telephone interview was used to survey a random sample of the population in Germany aged 15 and older. To exclude seasonal effects, 10,220 interviewees from the period April 2019 to January 2020 were compared with 11,900 from the period April 2020 to January 2021. Depressive symptoms were assessed with the internationally established 8-item Patient Health Questionnaire (PHQ-8). Results: The prevalence of depressive symptoms decreased from 9.2% to 7.6% in the first year of the pandemic. Changes differ between women and men as well as between age and education groups. The analysis of individual symptoms suggests that it is not about a reduction of mental disorders of the depressive type in the narrower sense, but rather a decrease in stress-associated individual symptoms. Conclusions: The decrease in stress-associated depressive symptoms in parts of the population can be interpreted as an indication that pandemic-related changes in everyday life and the working environment may have had a positive effect on individual areas of mental health in certain groups, at least temporarily in the first year of the pandemic. The continuing strong social inequality in depressive symptoms to the disadvantage of low education groups confirms that the need for social situation-related health promotion and prevention with regard to the living and working conditions of socially disadvantaged people must not be lost sight of in times of pandemic. For groups in the population that partly showed a worsening of symptoms in this phase of the pandemic, e.g. the diminished ability to concentrate of very old men, targeted support options should be created in the future.

Physical education (PE) is one setting in which pupils may acquire knowledge and skills to lead physically active lives. PE teachers play a key role in fostering respective health-related competences in pupils. For this, they themselves need appropriate professional competences. The purpose of this article is to highlight research trends on, and to propose a heuristic model for PE teachers’ health-related professional competence. Research trends and gaps are identified by a narrative literature review. The heuristic model describes several knowledge domains, beliefs, motivational orientations, and self-regulation as subdimensions of health-related professional competence. It is intended to provide an overview of important competence aspects and to serve as an orientation for further work.

The spread of the coronavirus SARS-CoV-2 in 2020 and the containment measures associated therewith have changed many aspects of daily life. An impact on health even beyond infections itself is assumed as well. The health situation of the population in the first phase of the pandemic was thus analysed using data from the German Health Update (GEDA 2019/2020-EHIS). By continuing the survey, the analyses for 2020 are completed (n=26,507 participants), whereby the focus is now on the third phase of the pandemic (second wave of infection, gradual reintroduction of containment measures). The health indicators are presented on a monthly basis. As in the first phase of the pandemic, no pandemic-related changes were observed for tobacco smoking/ second-hand smoke exposure and for received/lack of/provided support. In contrast to the first phase of the pandemic, declines in utilisation of medical services and depressive symptoms are not observed in the third phase. The increase in body weight/body mass index after the first phase of the pandemic did not continue. The survey period allows for a comparison of the periods before and as of the pandemic situation. A decrease in the medical services utilisation and depressive symptoms as well as an increase in the body weight/body mass index is observed in the period from March 2020 to January 2021 compared to the pre-pandemic period from April 2019 to March 2020.

Most of the patients with head and neck squamous cell carcinoma (HNSCC) are diagnosed with locally advanced disease. Standards of care for curative-intent treatment of this patient group are either surgery and adjuvant radio(chemo)therapy (aRCT) or definitive chemoradiation. Despite these treatments, especially pathologically intermediate and high-risk HNSCC often recur. The ADRISK trial investigates in locally advanced HNSCC and intermediate and high risk after up-front surgery if the addition of pembrolizumab to aRCT with cisplatin improves event-free sur-vival compared to aRCT alone. ADRISK is a prospective, randomized controlled investiga-tor-initiated (IIT)-phase II multicenter trial within the German Interdisciplinary Study Group of German Cancer Society (IAG-KHT). Patients with primary resectable stage III and IV HNSCC of the oral cavity, oropharynx, hypopharynx and larynx with pathologic high (R1, extracapsular nodal extension) or intermediate risk (R0

Nonalcoholic steatohepatitis (NASH) is induced by steatosis and metabolic inflammation. While involvement of the innate immune response has been shown, the role of the adaptive immune response in NASH remains controversial. Likewise, the role of regulatory T cells (Treg) in NASH remains unclear although initial clinical trials aim to target these regulatory responses. High‐fat high‐carbohydrate (HF‐HC) diet feeding of NASH‐resistant BALB/c mice as well as the corresponding recombination activating 1 (Rag)‐deficient strain was used to induce NASH and to study the role of the adaptive immune response. HF‐HC diet feeding induced strong activation of intrahepatic T cells in BALB/c mice, suggesting an antigen‐driven effect. In contrast, the effects of the absence of the adaptive immune response was notable. NASH in BALB/c Rag1−/− mice was substantially worsened and accompanied by a sharp increase of M1‐like macrophage numbers. Furthermore, we found an increase in intrahepatic Treg numbers in NASH, but either adoptive Treg transfer or anti‐cluster of differentiation (CD)3 therapy unexpectedly increased steatosis and the alanine aminotransferase level without otherwise affecting NASH. Conclusion: Although intrahepatic T cells were activated and marginally clonally expanded in NASH, these effects were counterbalanced by increased Treg numbers. The ablation of adaptive immunity in murine NASH led to marked aggravation of NASH, suggesting that Tregs are not regulators of metabolic inflammation but rather enhance it.

(1) Background: In critically ill cardiac patients, parenteral and enteral food and drug administration routes may be used. However, it is not well known how drug absorption and metabolism are altered in this group of adult patients. Here, we analyze drug absorption and metabolism in patients after cardiogenic shock using the pharmacokinetics of therapeutically indicated esomeprazole. (2) Methods: The pharmacokinetics of esomeprazole were analyzed in a consecutive series of patients with cardiogenic shock and controls before and after elective cardiac surgery. Esomeprazole was administered orally or with a nasogastric tube and once as an intravenous infusion. (3) Results: The maximum plasma concentration and AUC of esomeprazole were, on average, only half in critically ill patients compared with controls (p < 0.005) and remained lower even seven days later. Interestingly, esomeprazole absorption was also markedly compromised on day 1 after elective surgery. The metabolites of esomeprazole showed a high variability between patients. The esomeprazole sulfone/esomeprazole ratio reflecting CYP3A4 activity was significantly lower in critically ill patients even up to day 7, and this ratio was negatively correlated with CRP values (p = 0.002). The 5′-OH-esomeprazole and 5-O-desmethyl-esomeprazol ratios reflecting CYP2C19 activity did not differ significantly between critically ill and control patients. (4) Conclusions: Gastrointestinal drug absorption can be significantly reduced in critically ill cardiac patients compared with elective patients with stable cardiovascular disease. The decrease in bioavailability indicates that, under these conditions, any vital medication should be administered intravenously to maintain high levels of medications. After shock, hepatic metabolism via the CYP3A4 enzyme may be reduced.

Introduction: In squamous cell carcinoma of the esophagus (ESCC), therapeutical options in 2nd-line treatment are scarce with immune checkpoint inhibition being the only approved one. Ramucirumab/paclitaxel is an approved 2nd-line treatment in metastatic esophagogastric adenocarcinoma. We assessed safety and efficacy of ramucirumab/paclitaxel for ESCC. Methods: This prospective, randomized, open-label, multicenter, phase II trial evaluated paclitaxel (80 mg/m2 days 1, 8, 15) plus ramucirumab (8 mg/kg days 1, 15) (investigational arm A) versus paclitaxel alone (80 mg/m2 days 1, 8, 15) (standard arm B), both q4w, in advanced/metastatic ESCC refractory or intolerant to fluoropyrimidine and platinum-based drugs. Primary endpoint was overall survival (OS) rate at 6 months. Results: From 3/2019 to 4/2021, 21/186 planned patients were included (arm A 11 patients; arm B 10 patients) in 9 German centers. Due to slow accrual, the study was terminated prematurely. OS at 6 months was 72.7% for ramucirumab/paclitaxel and 50.0% for paclitaxel. The study design did not allow statistical comparison of the arms. PFS (3.8 vs. 3.5 months), OS (12.1 vs. 9.2 months), ORR (18.2% vs. 20.0%) and DCR (54.5% vs. 60.0%) were comparable in both arms. Most common treatment-related adverse events (TRAEs) in arm A were leucopenia (54.5%), fatigue (27.3%), and peripheral sensory neuropathy (18.2%). 27.3% in arm A and 50.0% in arm B had TRAEs ≥ grade 3. Conclusion: Ramucirumab/paclitaxel shows an acceptable tolerability and numerically improved OS at 6 months. Due to the small number of patients, the current trial must be considered exploratory and more data are needed in this indication. Plain Language Summary: Metastatic and unresectable ESCCs still show poor prognosis. After failure or intolerance to first-line therapy, treatment options are limited and checkpoint inhibitors are the only approved therapeutic option. Our study adds further evidence to the use of antiangiogenic drugs in second-line treatment of advanced ESCC. Ramucirumab in combination with paclitaxel showed numerically improved OS and PFS compared to paclitaxel alone. However, due to the small sample size, the results have to be considered exploratory and more data are needed in this indication. We do not recommend the use of ramucirumab/paclitaxel in second-line treatment of advanced ESCC outside of clinical trials. [ABSTRACT FROM AUTHOR]

Objectives: Mental health is essential for overall health and is influenced by different social determinants. The aim of this paper was to examine which determinants are associated with mental health inequalities among people with selected citizenships in Germany. Methods: Data were derived from the multilingual interview survey "German Health" Update: Fokus (GEDA Fokus)" among adults with Croatian, Italian, Polish, Syrian, or Turkish citizenship (11/2021-05/2022). Poisson regressions were used to calculate prevalence ratios for symptoms of depression (PHQ-9) and anxiety disorder (GAD-7). Results: Sociodemographic (sex, income, age, household size) and psychosocial (social support and self-reported discrimination) determinants were associated with symptoms of depression and/or anxiety disorder. The prevalence of mental disorders varied most by self-reported discrimination. Conclusion: Our findings suggest mental health inequalities among people with selected citizenships living in Germany. To reduce these, social inequities and everyday discrimination need to be addressed in structural prevention measures as well as in interventions on the communal level. Protective factors (e.g., social support) are also important to reduce mental health inequalities on the individual and community level. [ABSTRACT FROM AUTHOR]

Well‐trained, competent therapists are crucial for safe and effective psychedelic‐assisted therapy (PAT). The question whether PAT training programs should require aspiring therapists to undergo their own PAT—commonly referred to as "experiential training"—has received much attention within the field. In this article, we analyze the potential benefits of experiential training in PAT by applying the framework developed by Rolf Sandell et al. concerning the functions of any training therapy (the therapeutic, modeling, empathic, persuasive, and theoretical functions). We then explore six key domains in which risks could arise through mandatory experiential training: physical and psychological risks; negative impact on therapeutic skill; justice, equity, diversity, and inclusion; dual relationships; privacy and confidentiality; and undue pressure. Ultimately, we argue that experiential training in PAT should not be mandatory. Because many PAT training programs already incorporate experiential training methods, our exploration of potential harms and benefits may be used to generate comprehensive risk‐mitigation strategies. [ABSTRACT FROM AUTHOR]