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The political participation literature has documented a long-term trend of the normalization of noninstitutional participation that is often equated with the conventionalization of engagement in protest politics. Less is known on the extent to which noninstitutional forms are differentiated by their mobilization context. Population surveys find it difficult to contextualize individual engagement, and on-site surveys point to effects that are hard to generalize. This study fills this gap by emphasizing differentiation and distinguishing participation according to the issue of engagement. It introduces a conceptual distinction between political insiders and outsiders, defined based on the extent to which they are embedded in the organizational landscape of the dominant cleavage dimension. Using an original survey conducted in Germany during the Covid-19 crisis, the analysis demonstrates that general-population surveys are fit to examine issue-specific participation patterns. The results expose an insider and outsider divide, captured by the effect of attitudinal and behavioral indicators, and demonstrates that the two groups are equally likely to participate in noninstitutional forms. However, insiders engage on the established issues of climate and anti-racism, whereas outsiders engage on the new issues of Covid-19 related economic assistance and civil liberties restrictions. In addition, dynamic models reveal that noninstitutional participation is rooted in volatile issue preferences. Overall, the paper argues that participation during the Covid-19 crisis has furthered the trend towards a differentiated protest arena. [ABSTRACT FROM AUTHOR]

Motivated by the 150-year anniversary of the Naunyn–Schmiedeberg's Archives of Pharmacology in 2023, we studied the bibliometric development of the journal. We evaluated data from Editorial Reports, Clarivate, and Springer Nature databases. Several parameters representing the journal's performance, such as the impact factor and social impact, were analyzed over the years. We analyzed the journal's meta-data and wrote an algorithm to retrieve cities and countries of origin. We could see a decrease in publications from Germany and an increase in papers from Brazil, China, Egypt, and Iran during the last years. The decrease in publications from Germany is probably a zeitgeist effect because this country places a strong emphasis on high-impact factor papers for academic promotion and winning grants. Germany was the country with the most publications throughout the 100 most-cited articles. Most of these articles were published between 1970 and 1990, when neurotransmitters were the most published topic. Klaus Starke (Freiburg) and Manfred Göthert (Bonn) were prominent drivers of this field. The most common topics nowadays are "Drugs for the Treatment of Malignant Tumor Diseases" and "Immunopharmacology." The internationality of the journal substantially increased after introduction of English as mandatory language in the 1970s. The journal also experienced substantial COVID-19 pandemic-related effects. This paper is not only of relevance for the field of pharmacology but for science in general in the sense that Naunyn–Schmiedeberg's Archives of Pharmacology is a case study for profound changes in a traditional scientific journal, requiring permanent adjustment by editors, referees, publisher, authors, and readers alike. The development of the journal has been strongly influenced by historic and political developments, cultural attitudes (zeitgeist), language changes, global changes in research topics, and eminent individuals who published many papers in Naunyn–Schmiedeberg's Archives of Pharmacology. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, many countries used short-time work schemes, i.e., subsidies for temporary working hours reductions due to production drops. In Germany, regulations on entitlements and benefits have been much more generous during the pandemic than they were in noncrisis times. This paper conducts a factorial survey experiment among the workforce to investigate which amounts of short-time benefits and which associated replacement rates were perceived as appropriate during the pandemic. We interpret our findings in the context of the deservingness theory. Our results show that the assessments are partly consistent with the legal design features in Germany. One of our key findings is that, according to respondents, the short-time allowance should decrease slightly with an increasing duration of short-time work. In Germany, however, with the onset of the pandemic, a rule was temporarily implemented that step-wise increased short-time work benefits with the duration of short-time work. [ABSTRACT FROM AUTHOR]

SEIR (Susceptible–Exposed–Infected–Recovered) approach is a classic modeling method that is frequently used to study infectious diseases. However, in the vast majority of such models transitions from one population group to another are described using the mass-action law. That causes inability to reproduce observable dynamics of an infection such as the incubation period or progression of the disease's symptoms. In this paper, we propose a new approach to simulate the epidemic dynamics based on a system of differential equations with time delays and instant transitions to approximate durations of transition processes more correctly and make model parameters more clear. The suggested approach can be applied not only to Covid-19 but also to the study of other infectious diseases. We utilized it in the development of the delay-based model of the COVID-19 pandemic in Germany and France. The model takes into account testing of different population groups, symptoms progression from mild to critical, vaccination, duration of protective immunity and new virus strains. The stringency index was used as a generalized characteristic of the non-pharmaceutical government interventions in corresponding countries to contain the virus spread. The parameter identifiability analysis demonstrated that the presented modeling approach enables to significantly reduce the number of parameters and make them more identifiable. Both models are publicly available. [ABSTRACT FROM AUTHOR]

Publications in peer-reviewed journals are the most important currency in science. But what about publications in non-peer-reviewed magazines? The objective of this study was to analyze the publications of scientists, with a focus on pharmacologists, in the non-peer-reviewed German science magazine Biospektrum from 1999 to 2021. Biospektrum is edited by five scientific societies in Germany including the Society for Experimental and Clinical Society Pharmacology and Toxicology (DGPT) and provides opportunities to researchers to showcase their research to a broad audience. We analyzed 3197 authors of 1326 articles. Compared to the fields of biochemistry, microbiology, and genetics, pharmacology was largely underrepresented. Just three institutions in Germany contributed most papers to Biospektrum. Researchers with a doctoral degree were the largest author group, followed by researchers with a habilitation degree. Among all major fields, women were underrepresented as authors, particularly as senior authors. The Covid pandemic leads to a drop of publications of female first authors but not last authors. Compared to publications in the peer-reviewed journal Naunyn–Schmiedeberg's Archives of Pharmacology (Zehetbauer et al., Naunyn-Schmiedebergs Arch Pharmacol 395:39–50 (2022)), female pharmacologists were underrepresented in the Biospektrum. Thus, German pharmacologists as a group do not value investing in "social impact" gained by publications in Biospektrum, and this attitude is even more prominent among female pharmacologists. Investing less in "social impact" by female pharmacologists may result in reduced visibility on the academic job market and may contribute to reduced opportunities to achieve high academic positions. [ABSTRACT FROM AUTHOR]

In times of crises, such as the refugee crisis or the corona pandemic, the workload in public administrations increases because of the demands of citizens or short-term legal changes. In addition, there is an increasing need for digitalization or to be able to react flexibly to changes. Agile process models and agile practices are appropriate to overcome these challenges. The objective of this paper is to investigate how public administrations can measure their degree of agility to identify potential for improving it. The authors conducted a descriptive single-case study which included multiple units of analysis in a public administration in Germany. The case study was supported by their questionnaire for measuring the degree of agility. One outcome of this study is a conceptual framework that can be used to drive agile transformation in public administrations by continuously measuring agility. Therefore, a questionnaire for measuring agility at team level in public administrations has been developed. The application of the questionnaire in three teams provide insights into dysfunctionality in the interdisciplinary teams as well as optimization potential in terms of affinity to change. The adoption of agility in public administration is a challenge, given that resistance to change is still prevalent. A transformational change is a constant journey, and therefore, the measurement of progress plays an important role in the continuous improvement of an organization. The applied approach delivers high potential for improvement in terms of agility and provides interesting insights for both practitioners and academics. [ABSTRACT FROM AUTHOR]

This paper investigates the changes in time use, working conditions and subjective time wealth during the COVID-19 pandemic in Germany. Our analysis draws on panel data collected before and during the first lockdown among 786 employees. It employs a recently developed scale on time wealth which has been suggested as a comprehensive measure to capture the subjective experience of time. We provide separate analyses according to gender and essential occupation. First-difference regressions are applied to examine how changes in time use and changes in working conditions during the lockdown affected subjective time wealth. Our results show a general growth in time wealth during the lockdown which is, among other factors, driven by a decline in work hours and an increase in sleep duration. We also find positive effects on time wealth from decreased time pressure at work, more autonomy in organising one's working day, and an improved reconciliation of work and private life. This study contributes to existing research by identifying key aspects how to improve time wealth among employees. [ABSTRACT FROM AUTHOR]

Using new data from a three-wave panel survey administered in Germany between May 2020 and May 2021, this paper studies the impact of a negative shock affecting all strata of the population, such as the development of COVID-19, on preferences for redistribution. Exploiting the plausibly exogenous change in the severity of the infection rate at the county level, we show that, contrary to some theoretical expectations, the worse the crisis, the less our respondents expressed support for redistribution. We provide further evidence that this is not driven by a decrease in inequality aversion but might be driven by the individuals' level of trust. [ABSTRACT FROM AUTHOR]

SEIR (Susceptible–Exposed–Infected–Recovered) approach is a classic modeling method that is frequently used to study infectious diseases. However, in the vast majority of such models transitions from one population group to another are described using the mass-action law. That causes inability to reproduce observable dynamics of an infection such as the incubation period or progression of the disease's symptoms. In this paper, we propose a new approach to simulate the epidemic dynamics based on a system of differential equations with time delays and instant transitions to approximate durations of transition processes more correctly and make model parameters more clear. The suggested approach can be applied not only to Covid-19 but also to the study of other infectious diseases. We utilized it in the development of the delay-based model of the COVID-19 pandemic in Germany and France. The model takes into account testing of different population groups, symptoms progression from mild to critical, vaccination, duration of protective immunity and new virus strains. The stringency index was used as a generalized characteristic of the non-pharmaceutical government interventions in corresponding countries to contain the virus spread. The parameter identifiability analysis demonstrated that the presented modeling approach enables to significantly reduce the number of parameters and make them more identifiable. Both models are publicly available. [ABSTRACT FROM AUTHOR]

In this paper, we investigate the impact of the COVID-19 pandemic on German household income in 2020 using a micro-level approach. We combine a microsimulation model with novel labour market transition techniques to simulate the COVID-19 shock on the German labour market. We find the consequences of the labour market shock to be highly regressive with a strong impact on the poorest households. However, this effect is nearly entirely offset by automatic stabilisers and discretionary policy measures. We explore the cushioning effect of these policies in detail, showing that short-time working schemes and especially the one-off payments for children are effective in cushioning the income loss of the poor. [ABSTRACT FROM AUTHOR]

Social network theories are used extensively to analyze the international migration of Chinese to overseas regions in the era of Market Economy Reform since 1978. Attention is paid especially on the role of social networks among overseas Chinese on disaster relief in China. Focusing on the ongoing COVID-19 pandemic, this paper investigates how social networks work as a crucial mechanism through which Chinese immigrants in Germany initiated and delivered monetary and material donations to China in early 2020 and then organized self-help in their everyday lives in Germany in late 2020. Different from previous studies, this paper scrutinizes social networks for disaster relief on the macro, meso, and micro levels. Multi-site ethnographic fieldwork in China and Germany combined with online and offline data collected from focus group sessions, interviews with individuals, participant observations, surveys, analysis of news reports on the pandemic, and analysis on relevant policies are utilized comprehensively to collect data on the three levels. This research discovers that internet tools – represented by WeChat – have integrated tightly into the traditional social networks of Chinese immigrants and consolidated the cultural cohesion from overseas Chinese to their connections in China. This paper aims at contributing to present studies on Chinese new immigrants, social network, and disaster management theories with an updated ethnographic case on the COVID-19 pandemic from Germany. [ABSTRACT FROM AUTHOR]

Aim: With the COVID-19 pandemic, we witnessed an increase in purchases of certain products, such as toilet paper, disinfectants, or groceries. In the present study, we examined the individual and socio-psychological determinants of stockpiling behavior. For this purpose, we defined an explanatory model based on the Health Belief Model (HBM), which includes threat perceptions, barriers and benefits, and self-efficacy beliefs as main predictors of health-related behaviors, and extended the model to include social norms. Subject and methods: Participants were recruited via social media platforms and data collection was conducted via an online survey. The final sample included 861 German respondents (male = 199, female = 642, mean age = 36.76, SD = 12.38). Results: Perceived barriers of stockpiling, such as financial constraints or regulations in supermarkets, turned out to be the strongest predictors of stockpiling. Regarding the role of threat perception, the perceived severity of the disease in particular was positively related to stockpiling behavior. Finally, our results suggest a significant impact of social cues, showing that descriptive normative beliefs are associated with stockpiling behavior. Conclusion: Based on these findings, we propose targeted interventions to a) reduce perceived benefits of stockpiling and severity beliefs related to COVID-19, b) emphasize disadvantages of stockpiling, and c) reduce media exposure of stockpiling behavior to prevent panic buying. [ABSTRACT FROM AUTHOR]

A cornerstone of well-being research is that the resource-rich are happier with their lives than the resource-poor and better positioned to cope with stressful life events. This paper addresses the role of various resources—human, economic, social, and psychological capital—in life satisfaction during the coronavirus pandemic, using panel data from Germany and the United Kingdom for 2020 and 2021. Cross-sectionally, we find life satisfaction to be clearly related to all these forms of capital, with psychological capital being the strongest predictor of life satisfaction. Longitudinally, the capital endowments in 2020 did not predict changes in life satisfaction within individuals from 2020 to 2021, except for psychological capital. Our results suggest two things: first, the unfolding pandemic did not heighten well-being inequalities; and second, weathering the pandemic required psychological resources in the first place. [ABSTRACT FROM AUTHOR]

In the social and behavioral sciences, surveys are frequently used to collect data. During the COVID-19 pandemic, surveys provided political actors and public health professionals with timely insights on the attitudes and behaviors of the general population. These insights were key in guiding actions to fight the pandemic. However, the data quality of these surveys remains unclear because systematic knowledge about how the survey data were collected during the COVID-19 pandemic is lacking. This is unfortunate, since decades of survey research have shown that survey design impacts data. Our Survey Data Collection and the COVID-19 Pandemic (SDCCP) project deals with this research gap. We collected rich metadata on survey design for 717 social and behavioral science surveys carried out in Germany during the first two years of the COVID-19 pandemic. In this data descriptor, we present a unique resource for a systematic assessment of the survey data collection practices and quality of surveys conducted in Germany during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Students' well-being, learning activities, and learning success are key student outcomes that can be affected by challenging times such as the COVID-19 pandemic. Thus, it is vital to investigate the role of important personal (resilience, self-efficacy) and social resources (support from family, friends, teachers, important other) for central student outcomes (life satisfaction as a vital aspect of well-being, learning activities, and learning success) alongside perception of the COVID-19 situation. While the pandemic affected all of society, adolescents as a group who face core developmental challenges were especially vulnerable towards being negatively affected by the pandemic. Thus, analyses are based on 220 adolescent students (60.9% female, 37.7% male, 1.4% diverse) in Germany who were 16.21 years old on average (SD = 0.88) at time of data collection in May 2021. Students filled out an online questionnaire on sociodemographics and variables of interest. Path models revealed that perceiving the COVID-19 pandemic as stressful was negatively related to life satisfaction (β = -.27). Furthermore, perceiving the COVID-19 pandemic as stressful was negatively related to students' self-efficacy (β = -.22) and positively to support from an important other (β =.32). Moreover, several resources were mainly positively related to our central student outcomes (β =.13-.41), and perception of the COVID-19 situation mediated two of those relations. Results underscore the importance of students' self-efficacy, which was related to all student outcomes. Furthermore, the results and methodological issues can impact further research and practice. [ABSTRACT FROM AUTHOR]

The COVID-19 outbreak forced widespread changes in minors' daily life with a risk of compromising well-being. So far, little is known about how health-related quality of life (HRQoL) of young refugees has developed during this time, although they belong to a vulnerable group. In a cross-sectional analysis during the first year of the pandemic, minors aged 8 to 16 years with and without refugee experience (n each = 156) were surveyed, using self-report questionnaires on HRQoL and perceived COVID-related stress. In a longitudinal analysis with refugee minors aged 8 to 18 years (n = 91) HRQoL and possible relevant predictors (gender, age, duration of stay, mental health) were assessed in 2019 (pre-pandemic). HRQoL was reassessed in 2020 (peri-pandemic). No difference was detected between minors with and without refugee experience in terms of peri-pandemic HRQoL. A proportion of 36% (refugee minors) and 44% (non-refugee minors) reported low peri-pandemic HRQoL. However, refugee minors reported more COVID-related stress (difficulties in following school). Longitudinally, HRQoL of refugee minors increased from pre- to peri-pandemic times. Older age, lower pre-pandemic HRQoL, and pre-pandemic externalizing problem behavior predicted worse peri-pandemic HRQoL. The findings suggest a certain resilience of refugee minors but also show a continued vulnerability. Therefore, minors at risk should be identified and their psychosocial needs addressed. [ABSTRACT FROM AUTHOR]

Purpose: This paper summarises the results of 4 national surveys on the numbers, utilisation and technique of myocardial perfusion SPECT (MPS) from 2012 to 2021. Methods: A one-page questionnaire for information on MPS in 2012, 2015, 2018 and 2021 was sent to German centres practising nuclear medicine. To check for representativeness, the numbers obtained were related to official annual data and furthermore to the numbers of invasive coronary angiography procedures (ICA). Results: MPS examinations increased by > 40% from 2012 to 2021 and showed a centralisation with increasing MPS per centre. In 2020, a mild impact of the COVID-19 pandemic could be observed in the form of only a slight MPS increase, which was compensated in the following year. Outpatient care cardiologists represent the most important referrer (70%). Mostly, 2-day protocols were used. One-day protocols and stress-only protocols showed insignificant changes. The use of exercise stress decreased steadily. In 2021, exercise stress was replaced by pharmacological stress as the most frequent stress modality. Camera systems showed a shift to more SPECT-CT systems. The use of gated SPECT increased to almost 90%. Quantitative scoring showed an increasing acceptance. The ratio of invasive coronary angiographies (ICA) to MPS was between 3.9 and 4.5. A significant proportion of ICA in the context of CCS (chronic coronary syndrome) was performed without prior testing for ischaemia. Conclusion: The 2012 to 2021 MPS surveys reveal a continuously growing number of examinations with only a mild temporary effect of the COVID-19 pandemic and a centralisation with increasing numbers per centre. Performance and technical data reveal a high-grade adherence of MPS practice to the current ESC guideline. A large potential of non-invasive diagnostics remains for the future. [ABSTRACT FROM AUTHOR]

Background: A good health care system and, especially, the provision of efficient hospital care are the goals of national and regional health policies. However, the scope of general hospital care in the 16 federal states in Germany varies considerably from region to region. The objectives of this paper are to evaluate the technical efficiencies of all general hospitals of the 16 federal states for the period from 2015 to 2020, to find out the relation between the exogenous factors and score of efficiency, and also the influence of the COVID-19 pandemic on the results of the technical efficiency of hospital care in the German states. Methods: A two-step approach was used. First, an input-oriented Data Envelopment Analysis model with constant returns to scale and variable returns to scale was applied for the 6-year period from 2015 to 2020. The calculation of technical efficiency according to the input-oriented DEA model contains the three components—total technical efficiency (TTE), pure technical efficiency (PTE) and scale efficiency (SE). In the second stage, the influence of exogenous variables on the previously determined technical efficiency was evaluated by applying the tobit regression analysis. Results: Although the level of average technical efficiency of about 90% is high, total technical efficiency deteriorated steadily from 2015 to 2020. Its lowest point at around 78%, was in the year 2020. The deterioration of the average technical efficiency is notably influenced by the lower results in the years 2019 and 2020. The decomposition of technical efficiency also revealed that the deterioration of overall average efficiency was influenced by both pure technical efficiency (PTE) and scale efficiency (SE). Based on the tobit regression analysis performed, it was possible to conclude that the change in the efficiency score can be explained by the influence of exogenous factors only from 6.4% for overall efficiency and from 7.1% for scale efficiency. Conclusions: The results of the analysis of the overall technical efficiency reveal that the aggregated data of all general hospitals of all 16 federal states show a steadily worsening total technical efficiency every year since 2015. Although, especially, the deterioration of the year 2020 with the occurrence of COVID-19 pandemic, contributes to a deteriorated efficiency average, the deterioration of the efficiency values, based on the analysis performed, is also observable between the years 2016 and 2019. Considering the output generated, for inefficient units and the relevant policy authorities in the hospital sector, it can be recommended that the number of beds and in particular the number of physicians, should be reduced as inputs. Based on this study, it is also recommended that decisions to increase the efficiency of general hospitals should be made with consideration of exogenous factors such as the change in the number of general hospitals or the population density in the respective state, as these had explanatory value in connection with the increase in efficiency values. Due to the wide variation in the size of the federal states, the recommendation is more appropriate for federal states with low population density. [ABSTRACT FROM AUTHOR]

In medical studies, pharmacology is a subject with a high teaching and study load. The COVID-19 pandemic–related switch to distance learning implies challenges for students and teachers. To identify changes of behavior, attitudes, and needs among students and teachers in clinical pharmacology during the pandemic, regular surveys were conducted at Ulm University, Germany. Overall, 884 students and 5 teachers answered the survey. Over time, students' usage of learning materials in print form and further literature (textbooks, guidelines) constantly decreased. In turn, most students used digital materials provided via a learning management system. Attitudes and opinions of students and teachers significantly differed regarding (i) the benefit of certain teaching formats and learning materials, (ii) open-mindedness towards e-learning, and (iii) future visions. Most students and lecturers stated that they spent more time on study or teaching-related activities, respectively, and had less contact with fellow students or colleagues in comparison to pre-pandemic times. Furthermore, the subjective teaching load for most lecturers (80%) increased during the pandemic. To identify determinants of learning success, the survey data were correlated with students' gradings in the written exams of clinical pharmacology. In the first online semester (summer term 2020), the use of paper-based learning scripts was correlated with better exam grades. No correlation with grade was found for any other learning materials. Age was inversely correlated with exam grading. Striking a balance between the future visions and needs of students and teachers implies a particular challenge for the educational system of the next years. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity is associated with various health outcomes. Restrictive measures to contain the spread of the Coronavirus Disease 2019 (COVID-19) pandemic, like lockdowns and school closures, affected children's daily structure, physical activity, dietary habits, and sleep quality, possibly exacerbating risk factors for childhood obesity and higher body mass index (BMI) in children. Poor socioeconomic conditions may have led to relatively higher risk for elevated BMI levels following pandemic measures. In this study, the impact of measures related to the COVID-19 pandemic on the BMI of third graders was investigated regarding children's socioeconomic background (SEB). Methods: Data from 41,728 children (8.84 ± 0.56 years, 20,431 female) were collected in the context of a cohort study. Children were tested either before the pandemic (preCOVID: Sept2017–March2020, n = 26,314), or following the first (postLDI: Aug2020–Dec2020, n = 6657) or second lockdown in Germany (postLDII: Aug2021–Jan2022, n = 8757). SEB was based on the official school type classification of the state of Berlin. Outcome was BMI standard deviation scores (SDS). Results: Significant effects of Time and SEB revealed elevated BMIs in postLDI (M = 0.23, p = 0.011) and postLDII (M = 0.22, p = 0.011) compared to preCOVID (M = 0.17) cohorts and higher BMIs for children with lower SEB (b = − 0.13, p < 0.001). A significant Time × SEB interaction indicated that the effect of SEB on children's BMI increased in response to lockdowns, especially in postLDII (b = − 0.05, p = 0.006). Results suggest that the COVID-19-related measures lead to increased BMI in children, and that children of lower SEB were at particular risk for higher BMIs following lockdowns. Conclusions: These findings highlight the dependency of children's BMI on societal circumstances. Over the course of two lockdowns in Germany, children have experienced BMI increments, particularly in low socioeconomic areas. Authorities are called into action to counteract increasing rates of childhood weight by promoting physical activity of children and establishing related post-pandemic offers. Key Points: Children's weight status and health could be affected in the short and long term as a consequence of increased BMI in primary school cohorts following COVID-19 pandemic-related lockdowns. Children from lower socioeconomic backgrounds are at particularly high risk of poor weight status and have higher BMIs. This socioeconomic gradient increased in post-lockdown cohorts, which is why the health of socioeconomically disadvantaged children may have been disproportionally affected by the pandemic. Authorities and policymakers are called upon to take countermeasures to minimize the impact of the COVID-19 pandemic on children's weight status and to counteract risks of increasing childhood obesity rates, especially in socioeconomically poorer regions. [ABSTRACT FROM AUTHOR]

As the COVID-19 pandemic further unfolds, it becomes a key theoretical and practical question to identify trajectories of child psychological well-being and to explore risk and resilience factors for developmental adjustment. The current study addressed this research gap by means of an ecological design: A (lockdown)–B (relaxation)–B (relaxation)–A (lockdown). We collected parental reports via online questionnaires over four measurement occasions during the COVID-19 pandemic in Germany (non-probabilistic sample): from the first lockdown (T1—spring 2020, N = 1769) to the following period of relaxation (T2—summer 2020, n = 873; T3—fall 2020, n = 729) on to the second lockdown (T4—winter 2020/21, n = 748). Key measures at T1–T4 were child emotional and behavioral problems as well as hyperactivity, child emotional and family-related well-being, parental strain, and parent–child relationship quality. We found evidence for quadratic growth models. While child problem behaviors (b = 0.32, p < 0.001) and emotional well-being (b = − 0.33, p < 0.001) improved after the first lockdown during subsequent periods of relaxation before worsening again in the second lockdown, child family-related well-being steadily decreased over all four measurement points (T1–T2: p < 0.001; T2–T3: p = 0.045; T3–T4: p = 0.030). Importantly, parental stress emerged as a strong risk factor (ps < 0.11) and the parent–child relationship quality constituted a resilience factor (p = 0.049) for child psychological well-being. These findings have major implications for policies aiming to further child health during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Using a unique dataset of establishments in Germany surveyed during the Covid-19 pandemic, this study investigates whether personnel adjustments during the crisis differed between establishments with and without a works council. Our regression analyses show that the hiring and dismissal rate as well as the churning rate were lower in establishments with a works council. In contrast, the net employment growth rate over the pandemic and the implementation of short-time work did not differ significantly between establishments with and without a works council. We conclude that worker co-determination did indeed make a difference in terms of higher employment stability for the incumbent workforce during the pandemic. [ABSTRACT FROM AUTHOR]

This paper explores the supply chain (SC) disruption impacts to the performance outcomes of a semiconductor company during the Covid-19 pandemic and proposes appropriate risk mitigation strategies to overcome the crisis. The research uses a single case study methodology and 24 SC employees from Belgium and Germany who take part in the survey. To measure the effect of SC disruptions to the firm's financial performance, some quarterly financial statement data are used from 2018 to 2021. The regression analysis results show that there is no significant impact of SC disruptions to the firm's productivity and non-financial performance. The paired samples t-test suggests that there is no significant change in the firm's financial performance before and during Covid-19 either due to the market's political and economic stability or the semiconductor company develops effective SC risk management strategies. [ABSTRACT FROM AUTHOR]

We develop a novel approach integrating epidemiological and economic models that allows data-based simulations during a pandemic. We examine the economically optimal opening strategy that can be reconciled with the containment of a pandemic. The empirical evidence is based on data from Germany during the SARS-CoV-2 pandemic. Our empirical findings reject the view that there is necessarily a conflict between health protection and economic interests and suggest a non-linear U-shape relationship: it is in the interest of public health and the economy to balance non-pharmaceutical interventions in a manner that further reduces the incidence of infections. Our simulations suggest that a prudent strategy that leads to a reproduction number of around 0.75 is economically optimal. Too restrictive policies cause massive economic costs. Conversely, policies that are too loose lead to higher death tolls and higher economic costs in the long run. We suggest this finding as a guide for policy-makers in balancing interests of public health and the economy during a pandemic. [ABSTRACT FROM AUTHOR]

In order to slow the spread of the CoViD-19 pandemic, governments around the world have enacted a wide set of policies limiting the transmission of the disease. Initially, these focused on non-pharmaceutical interventions; more recently, vaccinations and large-scale rapid testing have started to play a major role. The objective of this study is to explain the quantitative effects of these policies on determining the course of the pandemic, allowing for factors like seasonality or virus strains with different transmission profiles. To do so, the study develops an agent-based simulation model, which explicitly takes into account test demand and behavioral changes following positive tests. The model is estimated using data for the second and the third wave of the CoViD-19 pandemic in Germany. The paper finds that during a period where vaccination rates rose from 5 to 40%, seasonality and rapid testing had the largest effect on reducing infection numbers. Frequent large-scale rapid testing should remain part of strategies to contain CoViD-19; it can substitute for many non-pharmaceutical interventions that come at a much larger cost to individuals, society, and the economy. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has made it clear: sharing and exchanging data among research institutions is crucial in order to efficiently respond to global health threats. This can be facilitated by defining health data models based on interoperability standards. In Germany, a national effort is in progress to create common data models using international healthcare IT standards. In this context, collaborative work on a data set module for microbiology is of particular importance as the WHO has declared antimicrobial resistance one of the top global public health threats that humanity is facing. In this article, we describe how we developed a common model for microbiology data in an interdisciplinary collaborative effort and how we make use of the standard HL7 FHIR and terminologies such as SNOMED CT or LOINC to ensure syntactic and semantic interoperability. The use of international healthcare standards qualifies our data model to be adopted beyond the environment where it was first developed and used at an international level. [ABSTRACT FROM AUTHOR]

This article investigates Early Childhood Education and Care (ECEC) leadership during the COVID-19 pandemic. The focus is on ECEC leaders' perceptions of team leadership during the COVID-19 pandemic in Germany. The purpose of the study is to increase understanding of the team-related challenges ECEC leaders have been confronted with, how they have been experienced and mastered. Therefore, two qualitative studies were designed (Hamburg, Leipzig). A total of 55 ECEC leaders from different federal states were surveyed in guideline-based qualitative interviews (Leipzig study: n = 20 ECEC leaders; Hamburg study: n = 35 ECEC leaders) and analysed with a qualitative content analysis. The results show how teamwork changed under the pandemic conditions and what challenges the leaders faced, including a lack of staff (due to e. g. quarantine, disease), structural separation of teams, lack of communication, additional tasks (political regulations), and missing collaboration with parents. The results indicate that not only ECEC leaders are required to organise team development activities on a regular basis or to reflect on the experiences of the pandemic within heterogeneous teams but also setting providers and sectoral policies are called upon to support ECEC centres in crisis according to their needs. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has entered its third year and continues to affect most countries worldwide. Active surveillance, i.e. testing individuals irrespective of symptoms, presents a promising strategy to accurately measure the prevalence of SARS-CoV-2. We aimed to identify the most cost-effective active surveillance strategy for COVID-19 among the four strategies tested in a randomised control trial between 18th November 2020 and 23rd December 2020 in Germany. The four strategies included: (A1) direct testing of individuals; (A2) direct testing of households; (B1) testing conditioned on upstream COVID-19 symptom pre-screening of individuals; and (B2) testing conditioned on upstream COVID-19 symptom pre-screening of households. Methods: We adopted a health system perspective and followed an activity-based approach to costing. Resource consumption data were collected prospectively from a digital individual database, daily time records, key informant interviews and direct observations. Our cost-effectiveness analysis compared each strategy with the status quo and calculated the average cost-effective ratios (ACERs) for one primary outcome (sample tested) and three secondary outcomes (responder recruited, case detected and asymptomatic case detected). Results: Our results showed that A2, with cost per sample tested at 52,89 EURO, had the lowest ACER for the primary outcome, closely followed by A1 (63,33 EURO). This estimate was much higher for both B1 (243,84 EURO) and B2 (181,06 EURO). Conclusion: A2 (direct testing at household level) proved to be the most cost-effective of the four evaluated strategies and should be considered as an option to strengthen the routine surveillance system in Germany and similar settings. [ABSTRACT FROM AUTHOR]

Why did some individuals react to the Covid-19 crisis in a prosocial manner, whereas others withdrew from society? To shed light onto this question, we investigate changing patterns of charitable giving during the pandemic. The study analyzes survey data of 2000 individuals, representative of the populations of Germany and Austria. Logistic regressions reveal that personal affectedness by Covid-19 seems to play a crucial role: those who were personally affected either mentally, financially, or health-wise during the first 12 months of Covid-19 were most likely to have changed their giving behavior. The observed patterns fit psychological explanations of how human beings process existential threats. Our findings indicate that a profound societal crisis in itself mainly leads to changes in charitable giving if individuals are severely affected on a personal level. Thereby, we contribute to a better understanding of the mechanisms underlying individuals' charitable giving behavior in times of crisis. [ABSTRACT FROM AUTHOR]

Increased parental stress, poorer mental health, and an increase in the occurrence of child maltreatment (CM) have been reported in earlier phases of the COVID-19 pandemic. However, data from later phases of the pandemic are not yet available. We conducted a cross-sectional, representative survey among 1087 parents (48.8% female; mean age 41.72 years, SD = 9.15) in Germany in December 2021. Data were compared to a previous representative sample, assessed in August 2020 (N = 1024), and to normative scores of the outcome measures. Predictors for the occurrence of CM were analyzed by logistic regression. Pandemic-related stress and general stress were higher and physical and mental health were poorer in the December 2021 sample than in the August 2020 sample. Occurrence rates of CM varied between 5 and 56%. Verbal emotional abuse (n = 607, 56%), witnessing domestic violence (n = 446, 41%), and emotional neglect (n = 435, 40%) were most frequently reported. For these subtypes, parental risk for alcohol abuse (OR 2.1–2.7) and parental recent experience of violence (OR 2.1–5.1) were the strongest predictors. Across all subtypes of CM, parents reporting child maltreatment showed poorer scores on all stress outcomes, with medium–large-effect sizes. Results confirm a high burden within the families, almost 2 years into the pandemic. Occurrence rates of a broad spectrum of CM subtypes raise further concerns for the well-being of children. Family-oriented intervention efforts are needed to stabilize families and provide targeted support. Longitudinal studies are needed for a description of families at risk for poorer outcomes. [ABSTRACT FROM AUTHOR]

Especially in times of crisis, reliable predictions about probable future developments are difficult, but critical for successfully managing business operations. At the same time, it remains unclear what constitutes a good forecasting process during crises. The aim of this study is to analyze whether and how digital transformation can enhance forecasting processes and enable firms to better deal with crises. To do so, we refer to the concept of digital maturity, i.e., the extent to which digital transformation is adopted in internal processes, studied at the practice of forecasting. Specifically, we analyze whether digitally more mature forecasting processes positively influence (1) satisfaction with forecasting during crises, (2) the effectiveness of countermeasures, and (3) the economic situation during crises. We conduct a cross-sectional survey among 195 medium-sized and large companies in Germany to shed light on the forecasting process and its digital maturity as well as on the impact of the COVID-19 economic crisis on companies. Based on ordinary least squares (OLS) regression, we find that digitally more mature forecasts increase satisfaction with forecasting and the effectiveness of countermeasures. Overall, this study provides new insights into relevant aspects of forecasting to support successful crisis management, and it highlights the importance of advancing digital transformation in forecasting, especially to successfully deal with crises. [ABSTRACT FROM AUTHOR]

Introduction: Real-world evidence (RWE) data is increasingly important to generate rapid insights to effectively manage patient populations. Disruptions like the coronavirus disease 2019 (COVID-19) pandemic may negatively impact the choice of medications used for managing chronic diseases such as psoriasis (PSO). Here, we explored the effect of the COVID-19 pandemic on the sales volumes of treatment guideline-based PSO medication in Germany. Methods: Patient-level pharmacy dispensing data from the Permea platform, covering approximately 44% of all community pharmacy dispensing in Germany, were analysed from 2019 through to 2021. Patient demographics and PSO indicated medication sales were assessed specifically before and during the pandemic in Germany. Results: We included 6,865,852 sold PSO related drugs from April 2019 to March 2021. Medication sales increased during the pandemic compared with before the pandemic for treatment classes of first-line biological and second-line drugs. The increase was observed across all age groups, but monthly variations could not be detected. Furthermore, we observed increased sales in first-line biological and second-line medications when comparing low to high COVID-19 incidence state. Conclusion: Throughout the COVID-19 pandemic the PSO indicated medication sales increased for first-line biological and second-line treatment. This shows that despite the pandemic impact, there continues to be an increase in sales volume for biologics. Only German federal states with intermittently very high COVID-19 incidences show a stagnation in sales volume. The reasons for this need to be investigated in further studies to possibly gain a better understanding of the concerns and uncertainties of patients with PSO. [ABSTRACT FROM AUTHOR]

Background: Internationally, potential effects of national SARS-CoV-2-related lockdowns on stillbirth rates have been reported, but data for Germany, including risk factors for fetal pregnancy outcome, are lacking. The aim of this study is to compare the stillbirth rates during the two first lockdown periods in 2020 with previous years from 2010 to 2019 in a large Bavarian cohort. Methods: This study is a secondary analysis of the Bavarian perinatal data from 2010 to 2020, including 349,245 births. Univariate and multivariable regression analyses were performed to investigate the effect of two Bavarian lockdowns on the stillbirth rate in 2020 compared to the corresponding periods from 2010 to 2019. Results: During the first lockdown, the stillbirth rate was significantly higher compared to the reference period (4.04 vs. 3.03 stillbirths per 1000 births; P = 0.03). After adjustment for seasonal and long-term trends, this effect can no longer be observed (P = 0.2). During the second lockdown, the stillbirth rate did not differ in univariate (3.46 vs. 2.93 stillbirths per 1000 births; P = 0.22) as well as in multivariable analyses (P = 0.68), compared to the years 2010 to 2019. Conclusion: After adjustment for known long-term effects, in this study we did not find evidence that the two Bavarian lockdowns had an effect on the rate of stillbirths. [ABSTRACT FROM AUTHOR]

Non-Pharmaceutical Interventions (NPIs) are community mitigation strategies, aimed at reducing the spread of illnesses like the coronavirus pandemic, without relying on pharmaceutical drug treatments. This study aims to evaluate the effectiveness of different NPIs across sixteen states of Germany, for a time period of 21 months of the pandemic. We used a Bayesian hierarchical approach that combines different sub-models and merges information from complementary sources, to estimate the true and unknown number of infections. In this framework, we used data on reported cases, hospitalizations, intensive care unit occupancy, and deaths to estimate the effect of NPIs. The list of NPIs includes: "contact restriction (up to 5 people)", "strict contact restriction", "curfew", "events permitted up to 100 people", "mask requirement in shopping malls", "restaurant closure", "restaurants permitted only with test", "school closure" and "general behavioral changes". We found a considerable reduction in the instantaneous reproduction number by "general behavioral changes", "strict contact restriction", "restaurants permitted only with test", "contact restriction (up to 5 people)", "restaurant closure" and "curfew". No association with school closures could be found. This study suggests that some public health measures, including general behavioral changes, strict contact restrictions, and restaurants permitted only with tests are associated with containing the Covid-19 pandemic. Future research is needed to better understand the effectiveness of NPIs in the context of Covid-19 vaccination. [ABSTRACT FROM AUTHOR]

Purpose: Over the course of COVID-19 pandemic, evidence has accumulated that SARS-CoV-2 infections may affect multiple organs and have serious clinical sequelae, but on-site clinical examinations with non-hospitalized samples are rare. We, therefore, aimed to systematically assess the long-term health status of samples of hospitalized and non-hospitalized SARS-CoV-2 infected individuals from three regions in Germany. Methods: The present paper describes the COVIDOM-study within the population-based cohort platform (POP) which has been established under the auspices of the NAPKON infrastructure (German National Pandemic Cohort Network) of the national Network University Medicine (NUM). Comprehensive health assessments among SARS-CoV-2 infected individuals are conducted at least 6 months after the acute infection at the study sites Kiel, Würzburg and Berlin. Potential participants were identified and contacted via the local public health authorities, irrespective of the severity of the initial infection. A harmonized examination protocol has been implemented, consisting of detailed assessments of medical history, physical examinations, and the collection of multiple biosamples (e.g., serum, plasma, saliva, urine) for future analyses. In addition, patient-reported perception of the impact of local pandemic-related measures and infection on quality-of-life are obtained. Results: As of July 2021, in total 6813 individuals infected in 2020 have been invited into the COVIDOM-study. Of these, about 36% wished to participate and 1295 have already been examined at least once. Conclusion: NAPKON-POP COVIDOM-study complements other Long COVID studies assessing the long-term consequences of an infection with SARS-CoV-2 by providing detailed health data of population-based samples, including individuals with various degrees of disease severity. Trial registration: Registered at the German registry for clinical studies (DRKS00023742). [ABSTRACT FROM AUTHOR]

Corporate stewardship holds great promise for the improvement of shareholder engagement and the encouragement of more responsible and long-term oriented value creation. This is particularly true since the outbreak of the global COVID-19 pandemic. Many countries have long adopted a best practice code for the stewardship role of institutional investors and asset managers, but Germany has so far refused to follow that trend. This paper explores the reasons for this reluctance, as well as whether the adoption of a Stewardship Code would still make sense in the regulatory framework of Germany today. Despite the increased presence of shareholder engagement (and even activism), several reasons may be put forward for why lawmakers have refused to adopt a stewardship code. This paper argues that the main political reason for this reluctance lies in the limited geographical reach of such a code, which would primarily be restricted to the (limited) domestic fund industry and would thus be unable to prescribe any meaningful principles to foreign-based asset managers. Still, I argue that the adoption of a code in the German context may make sense, for example to define expectations and to clarify the obligations of investee companies. Most importantly, it would benefit domestic investors that are typically 'home biased' and thereby frequently disproportionately invested in domestic funds. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has made it clear: sharing and exchanging data among research institutions is crucial in order to efficiently respond to global health threats. This can be facilitated by defining health data models based on interoperability standards. In Germany, a national effort is in progress to create common data models using international healthcare IT standards. In this context, collaborative work on a data set module for microbiology is of particular importance as the WHO has declared antimicrobial resistance one of the top global public health threats that humanity is facing. In this article, we describe how we developed a common model for microbiology data in an interdisciplinary collaborative effort and how we make use of the standard HL7 FHIR and terminologies such as SNOMED CT or LOINC to ensure syntactic and semantic interoperability. The use of international healthcare standards qualifies our data model to be adopted beyond the environment where it was first developed and used at an international level. [ABSTRACT FROM AUTHOR]

Using unique (bi)monthly panel data (IAB-HOPP) covering the immediate postlockdown period from June to August 2020, as well as the subsequent period up until the second lockdown in January/February 2021, we investigate opposing claims of widening/closing the gender gap in parental childcare during the Covid-19 pandemic in Germany. We consider prepandemic division as a reference point and provide dynamics rather than snapshots. Our results suggest a slight initial shift toward a more egalitarian division that, however, faded out in subsequent months. Starting from a fairly "traditional" prepandemic childcare division, the lockdown stimulus was not nearly strong enough to level the playing field. Subgroup analysis differentiating between individual lockdown-specific work arrangements shows that the drivers of the observed shift were mothers with relatively intense labor market participation who cannot work from home. Fathers' work arrangement instead did not play a significant role. We conclude that the shift emerged out of necessity rather than opportunity, which makes it likely to fade once the necessity vanishes. Further, a shift is observed only if fathers were to some extent involved in childcare prepandemic, which points to the crucial role of initial conditions. [ABSTRACT FROM AUTHOR]

Introduction: During the SARS-CoV-2 pandemic, the training of medical students was severely disrupted. Government authorities imposed a second national lockdown, which lasted from December 2020 to May 2021, forcing medical schools to adapt their teaching strategies. Several surveys have assessed students' perspectives, but there is limited data available to objectively assess and compare different strategies between medical faculties. The aim of this study was to evaluate the lecturer-based perspective to assess the impact on the theoretical and practical education of medical students before and during the second lockdown. Methods: We developed a questionnaire focusing on theoretical and practical training during pandemic before and during the second lockdown. The questionnaire was sent by personal invitation in January 2021 to all responsible lecturers of gastroenterology and hepatology departments at university hospitals in Germany. Results: The complete response rate was obtained from 52.5% (21/40) teaching centres representative of all regions in Germany. While the majority of respondents (62%) reported a limited impact of the lockdown on theoretical training, 90.5% reported a significant impact on practical training during the SARS-CoV-2 pandemic response. Several centres adapted virtual or hybrid education early during the pandemic, bedside teaching was down to 38.1% (8/21), particularly for students in the early phase of education, suggesting a substantial long-term impact on students' skills. Conclusion: Our questionnaire-based data provide one of the first systematic evaluation of faculty-based assessments of the potential impact of the pandemic during lockdown on medical education. We observed considerable heterogeneity in strategies for maintaining teaching activities during the SARS-CoV-2 pandemic in Germany. [ABSTRACT FROM AUTHOR]

During COVID-19, a large proportion of employees have been able to work from home (WFH) in order to prevent from contagion. With a downturn of the pandemic, firms have recently announced a return to the onsite offices for their employees, at least for some days of the week. In order for firms to smoothen the transition from full-time remote work to (part-time) onsite work, the determinants of employee preferences for working at the onsite office versus WFH are of crucial importance. This study investigates six work-related factors and their relation to employees' preferences of working at the onsite office versus WFH: job involvement, planning autonomy, team psychological safety, team direction, social contact and workload. In doing so, data from 182 employees of generation Y in Germany are analyzed using multiple regression analyses. Results revealed that social contact and a clear direction of a team's collective action are significant positively related to preferences of working at the onsite office. Implications for future research and limitations of the research are discussed alongside the results of the study. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic has pushed many hospitals to their capacity limits. Therefore, a triage of patients has been discussed controversially primarily through an ethical perspective. The term triage contains many aspects such as urgency of treatment, severity of the disease and pre-existing conditions, access to critical care, or the classification of patients regarding subsequent clinical pathways starting from the emergency department. The determination of the pathways is important not only for patient care, but also for capacity planning in hospitals. We examine the performance of a human-made triage algorithm for clinical pathways which is considered a guideline for emergency departments in Germany based on a large multicenter dataset with over 4,000 European Covid-19 patients from the LEOSS registry. We find an accuracy of 28 percent and approximately 15 percent sensitivity for the ward class. The results serve as a benchmark for our extensions including an additional category of palliative care as a new label, analytics, AI, XAI, and interactive techniques. We find significant potential of analytics and AI in Covid-19 triage regarding accuracy, sensitivity, and other performance metrics whilst our interactive human-AI algorithm shows superior performance with approximately 73 percent accuracy and up to 76 percent sensitivity. The results are independent of the data preparation process regarding the imputation of missing values or grouping of comorbidities. In addition, we find that the consideration of an additional label palliative care does not improve the results. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and the measures to prevent its spread have had a negative impact on substance use behaviour. It is likely that social distancing and lockdown measures have also altered gambling behaviour, for instance shifting from land-based to online gambling. We used large-scale web scraping to analyse posting behaviour on a major German online gambling forum, gathering a database of more than 200k posts. We examined the usage of different subforums, i.e. terrestrial, online gambling and problem gambling sections, and changes in posting behaviour related to the casino closures that were part of the nationwide restrictions in Germany in 2020. There was a marked increase in newly registered users during the first lockdown compared to the preceding weeks, an increase in the number of posts in the online gambling subforum and concurrent decrease in the terrestrial gambling subforum. Further, the number of short-latency replies was higher during the first lockdown compared to the preceding weeks. Many users who posted in both the online and terrestrial forum contributed at least once to the problem gambling subforum, implying that the topic of problem gambling is widely discussed. Our findings may indicate a shift from terrestrial to online gambling during lockdown, and mirror the general increase in screen time and usage of online platforms after the onset of the COVID-19 pandemic. The analyses help to identify lockdown-related effects on gambling behaviour. These potentially detrimental effects pose a special threat for individuals at risk and may require monitoring and special public health measures. [ABSTRACT FROM AUTHOR]

The aim was to investigate the attitude towards and perceived stress from emergency remote teaching (ERT) among teachers during the COVID-19 pandemic. A Germany-wide online survey was conducted among teachers from all school types in March 2021. Data from 31,089 teachers entered analysis. ANOVAs or Welch's t-tests with post-hoc analyses were performed to determine sociodemographic and work-related group differences in teachers' attitude towards and perceived stress from ERT. The mean attitude towards ERT was 3.47 (±.84) out of 5 and the mean perceived stress was 5.03 (±.62) out of 6. Regarding the attitude towards ERT, we revealed significant differences for gender, age groups, number of children, occupational group, school management membership, and employment status (p <.05). Regarding perceived stress, significant differences were obtained for gender, age groups, and employment status (p <.05). A more positive attitude towards ERT seems to be associated with lower stress levels. Being female, a higher age, a higher number of children living in the own household as well as working full-time might hinder an effective implementation of remote teaching in school settings in Germany. Policy-makers and schools should think of strategies to improve the attitude towards and decrease perceived stress from remote teaching. This could include subgroup-specific training on the use of digital media, adapted to the work environment. [ABSTRACT FROM AUTHOR]

Purpose: The severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) has caused substantial mortality worldwide. We investigated clinical and demographic features of COVID-19-related deaths that occurred between March 2020 and January 2022 in Regensburg, Germany. Methods: We compared data across four consecutive time periods: March 2020 to September 2020 (period 1), October 2020 to February 2021 (period 2), March 2021 to August 2021 (period 3), and September 2021 to January 2022 (period 4). Results: Overall, 405 deaths in relation to COVID-19 were reported. The raw case fatality ratio (CFR) was 0.92. In periods 1 to 4, the CFRs were 1.70%, 2.67%, 1.06%, and 0.36%. The age-specific CFR and mortality were highest in persons aged ≥ 80 years in period 2 while mortality in younger cases increased with time. The median age at death was 84 years and it varied slightly across periods. Around 50% of cases of death were previously hospitalized. In all time periods, the cause of death was mostly attributed to COVID-19. Over the four periods, we did not find significant changes in the distribution of sex and risk factors for severe disease. The most frequent risk factor was cardio-circulatory disease. Conclusion: In conclusion, the CFR decreased over time, most prominently for period 4. Mortality was considerable and younger cases were increasingly at risk. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic is associated with crucial changes in children's daily life including their physical activity (PA) and screen time (ST). Among preschool children, the family represents an important factor for sufficient PA levels by being the gatekeeper for PA. Thus, the aim of this study was to investigate the influence of the family environment, specifically SES, parental support, and having siblings on COVID-19-related changes of PA and ST behavior in 317 (170 boys, 147 girls) German preschool children using longitudinal data. Our results indicate a decline in total amount of sports-related PA, an increase in outdoor play, as well as an increase in leisure ST in preschool children. The changes in total amount of PA differed between children with different levels of parental support as well as in dependence on having siblings. Furthermore, levels of outdoor play and ST in preschool children were influenced by environmental factors like having access to their own garden. We conclude that the family environment (parental support as well as physical environment) is highly relevant for PA and ST levels in preschool children. To provide every child with PA opportunities during potential future lockdowns, restriction policies should be adapted and parents need sophisticated information about the importance of their support and thus the PA levels of their children. [ABSTRACT FROM AUTHOR]

The highly dynamic nature of the COVID-19 crisis poses an unprecedented challenge to policy makers around the world to take appropriate income-stabilizing countermeasures. To properly design such policy measures, it is important to quantify their effects in real-time. However, data on the relevant outcomes at the micro level is usually only available with considerable time lags. In this paper, we propose a novel method to assess the distributional consequences of macroeconomic shocks and policy responses in real-time and provide the first application to Germany in the context of the COVID-19 pandemic. Specifically, our approach combines different economic models estimated on firm- and household-level data: a VAR-model for output expectations, a structural labor demand model, and a tax-benefit microsimulation model. Our findings show that as of September 2020 the COVID-19 shock translates into a noticeable reduction in gross labor income across the entire income distribution. However, the tax benefit system and discretionary policy responses to the crisis act as important income stabilizers, since the effect on the distribution of disposable household incomes turns progressive: the bottom two deciles actually gain income, the middle deciles are hardly affected, and only the upper deciles lose income. [ABSTRACT FROM AUTHOR]

Purpose: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is currently the major threat for immunocompromised individuals. The course of COVID-19 in lung transplant recipients in the Omicron era remains unknown. The aim of the study was to assess outcome and associated factors in lung transplant recipients in a German-wide multicenter approach. Methods: All affected individuals from January 1st to March 20th, 2022 from 8 German centers during the Omicron wave were collected. Baseline characteristics and antiviral measures were associated with outcome. Results: Of 218 patients with PCR-proven SARS-CoV-2 infection 166 patients (76%) received any early (< 7 days) antiviral therapy median 2 (interquartile range 1–4) days after symptom onset. Most patients received sotrovimab (57%), followed by remdesivir (21%) and molnupiravir (21%). An early combination therapy was applied in 45 patients (21%). Thirty-four patients (16%) developed a severe or critical disease severity according to the WHO scale. In total, 14 patients (6.4%) died subsequently associated with COVID-19. Neither vaccination and antibody status, nor applied treatments were associated with outcome. Only age and glomerular filtration rate < 30 ml/min/1.73m2 were independent risk factors for a severe or critical COVID-19. Conclusion: COVID-19 due to Omicron remains an important threat for lung transplant recipients. In particular, elderly patients and patients with impaired kidney function are at risk for worse outcome. Prophylaxis and therapy in highly immunocompromised individuals need further improvement. [ABSTRACT FROM AUTHOR]

Bail-out, bail-in, or restructuring? In this article, we argue that restructuring has its rightful place in macro crises, such as the Covid pandemic. A policy that primarily focuses on insolvency avoidance and bail-outs is misled as it creates unwanted risk incentives, distorts market selection and resource allocation, and reduces beneficial transformative pressure. As a crisis typically goes hand in hand with new and fundamental developments, the changing environment should be met by competitive innovation. Bail-outs which tend to preserve the status-quo may be justified as part of a comprehensive emergency strategy and to overcome temporary market dysfunction. Such a response strategy, however should always be designed in concert with restructuring options. We propose amendments to the German insolvency and restructuring laws to address the shortcomings of restructuring/insolvency uncovered during the Covid pandemic. The goal is to improve the restructuring/insolvency regime so that it can better deal with the specific challenges of macro crises. [ABSTRACT FROM AUTHOR]

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Secondary transports of patients from one hospital to another are indicated for medical reasons or to address local constraints in capacity. In particular, interhospital transports of critically ill infectious patients present a logistical challenge and can be key in the effective management of pandemic situations. The state of Saxony in Germany has two characteristics that allow for an extensive evaluation of secondary transports in the pandemic year 2020/2021. First, all secondary transports are centrally coordinated by a single institution. Second, Saxony had the highest SARS-CoV-2 infection rates and the highest COVID-19 associated mortality in Germany. This study evaluates secondary interhospital transports from March 2019 to February 2021 in Saxony with a detailed analysis of transport behaviour during the pandemic phase March 2020 to February 2021. Our analysis includes secondary transports of SARS-CoV-2 patients and compares them to secondary transports of non-infectious patients. In addition, our data show differences in demographics, SARS-CoV-2- incidences, ICU occupancy of COVID-19 patients, and COVID-19 associated mortality in all three regional health clusters in Saxony. In total, 12,282 secondary transports were analysed between March 1st, 2020 and February 28th, 2021, of which 632 were associated with SARS-CoV-2 (5.1%) The total number of secondary transports changed slightly during the study period March 2020 to February 2021. Transport capacities for non-infectious patients were reduced due to in-hospital and out-of-hospital measures and could be used for transport of SARS-CoV-2 patients. Infectious transfers lasted longer despite shorter distance, occurred more frequently on weekends and transported patients were older. Primary transport vehicles were emergency ambulances, transport ambulances and intensive care transport vehicles. Data analysis based on hospital structures showed that secondary transports in correlation to weekly case numbers depend on the hospital type. Maximum care hospitals and specialized hospitals show a maximum of infectious transports approximately 4 weeks after the highest incidences. In contrast, standard care hospitals transfer their patients at the time of highest SARS-CoV-2 case numbers. Two incidence peaks were accompanied by two peaks of increased secondary transport. Our findings show that interhospital transfers of SARS-CoV-2 and non-SARS-CoV-2 patients differ and that different hospital care levels initiated secondary transports at different times during the pandemic. [ABSTRACT FROM AUTHOR]