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Reports that Mondi Fine Paper's division Merebank Paper Mill in KwaZulu-Natal, South Africa has contracted German firm Voith Paper to perform a major rebuild and conversion of its PM 31 paper machine. Conversion of the machine for the production of woodfree paper grades; Speed of August Koehler AG's machine.

Germany's BASF Se has reorganised its paper, water, oilfield and mining businesses within its Performance Chemicals division, in a move which, it says, aims to foster customer and industry focus, and increase competitiveness. [ABSTRACT FROM AUTHOR]

Higher education systems are changing due to trends of funding pressures, increasing social demands and growing numbers of students. Even though teaching and research are still considered as the pivotal functions of universities, other activities such as technology transfer, lifelong learning or social engagement have broadened the scope of their actions. These activities, labelled as third mission, are supposed to strengthen the impact of science in society and epitomize the changing role of universities. In Germany, the federal government and the states announced different programs aiming to foster these activities, e.g. the "Innovative Hochschule" or Real-world Laboratories. In this article, we first want to develop a definition framework of third mission. In two further steps we analyze how politics and policies in Germany have framed the concept in the last few years and how public universities are responding to this in their formal structure. We use approaches of neo-institutional theory according to which organizations such as universities create institutionalized structures and reflect institutional rules in order to maintain legitimacy. As an example of organizational formal structure we analyze mission statements of public universities. Using computer-based qualitative content analysis, we assess to what extent these universities take up the third mission. Our results show that most universities mention the third mission in their mission statements. However, the focus is mainly limited to economic impact and (technical) knowledge transfer. Much less emphasis is put on civic engagement or further education issues.

Up-to-date management of medical emergencies implies primarily that definitive diagnoses and treatment are performed in a timely manner. These claims have been reconfirmed in 2007 by the leading German language medical associations in their 'White Paper on Emergency Treatment'. To actually realize the demands described in this paper a timely, transsectoral and close collaboration of all involved organizations is mandatory. To illustrate this race against cell death the phrase relay of survival is proposed and launched to replace the hitherto used but rigid concept of chain of survival. The tasks of each member of this relay of survival are critically scrutinized one after the other from a patient perspective. The paper presents tangible recommendations for improving the respective individual performance as well as, in particular, the cooperation and coordination between the team members which is comparable to handing over the baton in a relay race. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Our aim was to report the first known incidence of U.S. butter contamination with extremely high levels of polybrominated diphenyl ethers (PBDEs). METHODS: Ten butter samples were individually analyzed for PBDEs. One of the samples and its paper wrapper contained very high levels of higher-brominated PBDEs. Dietary estimates were calculated using the 2007 U.S. Department of Agriculture Loss-Adjusted Food Availability data, excluding the elevated sample. RESULTS: The highly contaminated butter sample had a total upper bound PBDE level of 42,252 pg/g wet weight (ww). Levels of brominated diphenyl ether (BDE)-206, -207, and -209 were 2,000, 2,290, and 37,600 pg/g ww, respectively. Its wrapping paper contained a total upper-bound PBDE concentration of 804,751 pg/g ww, with levels of BDE-206, -207, and -209 of 51,000, 11,700, and 614,000 pg/g, respectively. Total PBDE levels in the remaining nine butter samples ranged from 180 to 1,212 pg/g, with geometric mean of 483 and median of 284 pg/g. Excluding the outlier, total PBDE daily intake from all food was 22,764 pg/day, lower than some previous U.S. dietary intake estimates. CONCLUSION: Higher-brominated PBDE congeners were likely transferred from contaminated wrapping paper to butter. A larger representative survey may help determine how frequently PBDE contamination occurs. Sampling at various stages in food production may identify contamination sources and reduce risk. [ABSTRACT FROM AUTHOR]

The article discusses a curious, unresolved court case in Israel concerning whether Franz Kafka's papers should belong in a German archive or in Israeli's National Library. Arguments for the German side contend that since Kafka wrote in German, the documents should stay in Germany. Jewish proponents claim that because Kafka was Jew and would have been murdered in the Holocaust like his sisters had he lived till then, therefore the papers should stay in Israel.

The article focusses on the recently discovered papers of Clemens von Delbrück (1856-1921), which are held by the Thuringian University and State Library in Jena - a central source for the history of the German Empire and the early Weimar Republic. Delbrück enjoyed a remarkable career, which took him to high positions within the Prussian administration, culminating in his time as a Secretary of State from 1909 to 1916, when he decisively co-determined German domestic policies. In 1918 Delbrück was the last director of the Imperial Civil Cabinet. In 1919 he was among the leading authors of the Weimar Constitution. Since the October 1st. 2009 the Delbrück-papers are being made accessible within a joint project of the Thuringian University and State Library and the Historical Seminar of the Braunschweig University of Technology. The results will be published online. [ABSTRACT FROM AUTHOR]

In scholarly debates, Ludwik Fleck's post-war paper 'Problemy naukoznawstwa [Problems of the Science of Science]', published in 1946, has been taken unanimously to illustrate the epistemology expounded in his monograph Genesis and Development of a Scientific Fact. The paper has also been seen to support parts of the received view of Fleck, notably that he manufactured an anti-typhus vaccine while imprisoned in Buchenwald. However, a different narrative emerges when comparing Fleck's paper with other accounts, also published in 1946 and written by other prisoners alluded to by Fleck in his paper. The situation is further complicated by four papers, published in prestigious scientific journals between 1942 and 1945, by the German medical leader of the typhus studies accounted for by Fleck. In addition, a thus-far neglected paper by Fleck, published in 1946 and summarizing his observations on typhus, discloses his role in the Buchenwald studies. Despite the obvious difficulties with tracing the history behind these works, notably the one on Nazi science, the contention is that what was attempted in Buchenwald in the name of science amounted to pseudoscience. This conclusion is amply supported not only by the accounts given by Fleck's fellow prisoners, but also by his own post-war paper on typhus. Based on the above findings, it is suggested that the mythology about Fleck, established in the 1980s, has been accomplished by a selective reading of his papers and also that the role played by Fleck was more complex than has so far been contemplated. [ABSTRACT FROM AUTHOR]

During their studies to become medical professionals, all students are obliged to become familiar with various aspects of primary care. The aim is to provide all students with a high quality training which ensures the best possible cooperation across all sectors of the medical system. Primary care comprises the primary use of the medical service by an unfiltered set of patients as well as continued patient care--including home-care. This position paper was developed together with representatives of the German Society of University Teachers of General Practice (GHA), the German Society for Ambulatory General Paediatrics (DGAAP), the German Society of General Practice and Family Medicine (DEGAM) and the German Society for Internal Medicine (DGIM). It includes recommendations for teaching in the field of primary care in four different types of internships such as preclinical work experience ("Hospitation"), 4-week clinical traineeships of a casual nature ("Famulatur") and 2-week courses of structured and assessed clinical training ("Blockpraktikum") as well as a broad-based 4-month elective clinical placement in the final year (known as a practical year, "PJ"). The recommendations encompass structural and process criteria for internships in different general practices. In addition, for the first time recommendations for teaching on campus--in the fields of general medicine, paediatrics, numerous cross-sectional areas and other clinical fields, but also for clinical skills training--are set down here. In this position paper the intention is to demonstrate the possible ways in which more aspects of primary care could be integrated into undergraduate medical training.

Respiratory interactions with the heart have remained a challenging physiological phenomenon since their discovery more than two hundred and fifty years ago. In the course of translating the seminal publications of Carl Ludwig and his disciple Pavel Petrovich Einbrodt into English, we became aware of some under-appreciated aspects of their work that contain useful insights into the history of the phenomenon now called respiratory arrhythmia. Ludwig observed arrhythmic effects of respiratory movements in experiments on dogs and horses and published his findings in 1847. He subsequently undertook further work on this problem, together with Einbrodt. Already in 1847 Ludwig had mentioned an exciting observation on the possible role of mechanical factors of the respiratory movements on the action of the heart in a dog in whom he had artificially induced bouts of coughing. Einbrodt decided to systematically develop methods to increase or decrease the pressure of the air the animal had to breathe. He observed that this procedure led to a greater or lesser degree of compression or decompression of all the organs in the thoracic cavity without apparently causing harmful consequences during the time of its application. How the mechanical influence of breathing affects cardiac activity during respiratory arrhythmia has been the subject of scientific discussions and controversies over a period of more than 150 years and is still unresolved. Recent publications suggest that cardiac mechano-electrical coupling plays an important role in the emergence of cardio-respiratory interdependence., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Background: The incidence for dysphagia amounts to 44-50% in nursing homes. Dysphagia is one of the main reasons for pneumonia in elderly., Method: Consensus paper., Results and Conclusions: For the advisory board consisting of 2 physicians, 2 pharmacists, a speech therapist, and a respresentative of nursing service it is common understanding that for the ideal maintenance and support of patients with dysphagia an interdisciplinary approach is crucial. Despite high clinical relevance of dysphagia the basic knowledge of this field is often underdeveloped. Specific and validated screening procedures for dysphagia have to be developed and implemented into the relevant guidelines. Specifically in this field an active and discipline spanning risk management should find its way into stationary geriatric care and nursing homes. Just as important is the provision of necessary patient information on the progress of the disease, on therapeutic actions and possible diet forms in a dysphagia pass. Additionally, the mentioned disciplines require an online risk screening (for dysphagia) of the pharmacist concerning the overall medication as well as information of galenic properties like facts regarding the possibility of crushing, portioning or tube feeding of the prescribed medication. In this way health risks due to administration errors concerning the medication can be significantly reduced for this patient group. Adequate oral liquids for adapted application of drugs are missing so far.

In October 2011 the Task Force Therapeutic Drug Monitoring of the Association for Neuropsychopharmacology and Pharmacopsychiatry (AGNP) published an update (Pharmacopsychiatry 2011, 44: 195-235) of the first version of the consensus paper on therapeutic drug monitoring (TDM) published in 2004. This article summarizes the essential statements to make them accessible to a wider readership in German speaking countries.

Objective: The evaluation of medical research performance is a key prerequisite for the systematic advancement of medical faculties, research foci, academic departments, and individual scientists' careers. However, it is often based on vaguely defined aims and questionable methods and can thereby lead to unwanted regulatory effects. The current paper aims at defining the position of German academic medicine toward the aims, methods, and consequences of its evaluation., Methods: During the Berlin Forum of the Association of the Scientific Medical Societies in Germany (AWMF) held on 18 October 2013, international experts presented data on methods for evaluating medical research performance. Subsequent discussions among representatives of relevant scientific organizations and within three ad-hoc writing groups led to a first draft of this article. Further discussions within the AWMF Committee for Evaluation of Performance in Research and Teaching and the AWMF Executive Board resulted in the final consented version presented here., Results: The AWMF recommends modifications to the current system of evaluating medical research performance. Evaluations should follow clearly defined and communicated aims and consist of both summative and formative components. Informed peer reviews are valuable but feasible in longer time intervals only. They can be complemented by objective indicators. However, the Journal Impact Factor is not an appropriate measure for evaluating individual publications or their authors. The scientific "impact" rather requires multidimensional evaluation. Indicators of potential relevance in this context may include, e.g., normalized citation rates of scientific publications, other forms of reception by the scientific community and the public, and activities in scientific organizations, research synthesis and science communication. In addition, differentiated recommendations are made for evaluating the acquisition of third-party funds and the promotion of junior scientists., Conclusions: With the explicit recommendations presented in the current position paper, the AWMF suggests enhancements to the practice of evaluating medical research performance by faculties, ministries and research funding organizations.

Background: The rapid progress of psychosomatic research in cardiology and also the increasing impact of psychosocial issues in the clinical daily routine have prompted the Clinical Commission of the German Heart Society (DGK) to agree to an update of the first state of the art paper on this issue which was originally released in 2008., Methods: The circle of experts was increased, general aspects were implemented and the state of the art was updated. Particular emphasis was dedicated to coronary heart diseases (CHD), heart rhythm diseases and heart failure because to date the evidence-based clinical knowledge is most advanced in these particular areas. Differences between men and women and over the life span were considered in the recommendations as were influences of cognitive capability and the interactive and synergistic impact of classical somatic risk factors on the affective comorbidity in heart disease patients., Results: A IA recommendation (recommendation grade I and evidence grade A) was given for the need to consider psychosocial risk factors in the estimation of coronary risks as etiological and prognostic risk factors. Furthermore, for the recommendation to routinely integrate psychosocial patient management into the care of heart surgery patients because in these patients, comorbid affective disorders (e.g. depression, anxiety and post-traumatic stress disorder) are highly prevalent and often have a malignant prognosis. A IB recommendation was given for the treatment of psychosocial risk factors aiming to prevent the onset of CHD, particularly if the psychosocial risk factor is harmful in itself (e.g. depression) or constrains the treatment of the somatic risk factors. Patients with acute and chronic CHD should be offered anti-depressive medication if these patients suffer from medium to severe states of depression and in this case medication with selective reuptake inhibitors should be given. In the long-term course of treatment with implanted cardioverter defibrillators (ICDs) a subjective health technology assessment is warranted. In particular, the likelihood of affective comorbidities and the onset of psychological crises should be carefully considered., Conclusions: The present state of the art paper presents an update of current empirical evidence in psychocardiology. The paper provides evidence-based recommendations for the integration of psychosocial factors into cardiological practice and highlights areas of high priority. The evidence for estimating the efficiency for psychotherapeutic and psychopharmacological interventions has increased substantially since the first release of the policy document but is, however, still weak. There remains an urgent need to establish curricula for physician competence in psychodiagnosis, communication and referral to ensure that current psychocardiac knowledge is translated into the daily routine.

This consensus paper introduces a classification of headache care facilities on behalf of the German Migraine and Headache Society. This classification is based on the recommendations of the International Association for the Study of Pain (IASP) and the European Headache Federation (EHF) and was adapted to reflect the specific situation of headache care in Germany. It defines three levels of headache care: headache practitioner (level 1), headache outpatient clinic (level 2) and headache centers (level 3). The objective of the publication is to define and establish reliable criteria in the field of headache care in Germany.

Diagnosis and treatment of sleep disordered breathing (SDB) undergo substantial changes, both in terms of increasing scientific knowledge and also in terms of patient provision and socio-economic aspects. Increasing evidence shows the relevance of SDB on morbidity and mortality of affected patients. The precise differentiation of different phenotypes of SDBs has improved substantially in recent years. These proceedings influence the approach to the patients suspected of suffering from SDB. The scientific advances on the one hand are facing intentions to simplify diagnostical processes and treatment initiation and intentions to translate duties of physicians to non-medical personnel on the other hand. This consensus paper presents the principals of diagnosis, treatment initiation and provision, including the role of different participants of the healthcare system, and compares different treatment options. Major aspects include the differentiation of the diagnostical process in screening, affirmation of diagnosis and differential diagnosis. In addition, it focusses on the relevance of the pretest probability and describes a therapeutical algorithm., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: Dementia is an increasing challenge for care providers in nursing homes and hospitals. Since the 1980s, special acute care units in nursing homes have developed rapidly. In Germany, the first unit in a hospital opened in 1990. In 2013, there were 22 units., Materials and Methods: In the following paper, the German Geriatric Society ("Deutsche Gesellschaft für Geriatrie e. V.") recommends basic standards for these wards., Results: The basic standards for these wards include the following: a maximum of 20 beds, an area physically separated from the geriatric hospital department, their own dayroom and therapy room, a structured daily routine suitable for patients with dementia, the selection of permanent staff on a voluntary basis, specialized training, extended geriatric assessment, and special consideration of the background and social situation of the patients.

Sleep related breathing disorders (SRBD) impair quality of live, morbidity and mortality of affected patients seriously. Moreover, due to their high prevalence, they have a huge impact on health care systems and national economics. The members of the German Respiratory Society, the German Society of Sleep Research and Sleep Medicine, the Association of Pneumological Clinics and the Association of Pneumologists focus strongly on the diagnosis and treatment of SRBD in their daily work. Prevailing developments in the provision of patients with SRBD, have strong impact on the quality of diagnosis and treatment, on the supply of devices, on the follow-up care and on the role and duties of the physician. Therefore, the societies estimate it essential, to publish this common position paper based on the evaluation and discussion of the scientific literature, the clinical practice and a consensus process of an expert group which is published in more detail (Randerath et al., Pneumologie 2/2014, Somnologie 1/2014)., (© Georg Thieme Verlag KG Stuttgart · New York.)

A content analysis of The Washington Post and the Frankfurter Allegemeine Zeitung revealed that both papers relied on official sources, but the German paper provided far less coverage of the conflict. [ABSTRACT FROM AUTHOR]

A discussion paper was developed by a panel of experts of the German Federal Environment Agency (UBA) contributing to the on-going debate on the identification, assessment and management of endocrine disruptors with a view to protect wildlife according to the EU substance legislation (plant protection products, biocides, industrial chemicals). Based on a critical synthesis of the state-of-the-art regarding regulatory requirements, testing methods, assessment schemes, decision-making criteria and risk management options, we advise an appropriate and consistent implementation of this important subject into existing chemicals legislation in Europe. Our proposal for a balanced risk management of endocrine disruptors essentially advocates transparent regulatory decision making based on a scientifically robust weight of evidence approach and an adequate risk management consistent across different legislations. With respect to the latter, a more explicit consideration of the principle of proportionality of regulatory decision making and socio-economic benefits in the on-going debate is further encouraged., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Reports that the German firm Voith Paper signed an agreement to provide Austrian firm Papierfabrik Hamburger Spremberg GmbH & Co. KG with preventive maintenance and quality control services.

Invites producers, converters, suppliers and retailers of the European tissue sector to offer papers for presentation at the 4th Paper Technology Specialists Tissue Symposium in Munich, Germany. Deadline for abstract submission; Availability of additional information online.

Karen Gubb's (2013) review focuses on contemporary developments in psychoanalytic theory and practice in relation to psychosomatics, starting with some historical remarks, and Paris School with the Attachment approach. This paper examines the question of how the German scene fits into the issues raised in Gubb's discussion. From a historical point of view, psychosomatic thinking had already come into existence at the beginning of the twentieth century in internal medicine, influenced not only by Freud's ideas, but also by holistic philosophical approaches, anthropology, and semiotic systems theory as well. Psychosomatics is still under the influence of psychodynamic thinking, but as a required subject for all medical students, it is currently more involved in inpatient treatment settings than in psychoanalyses in the classical couch setting. Research projects using standardized questionnaires, neuroimaging, and other empirical methods have also proved that these treatments are as effective as therapy based on psychoanalytic concepts like alexithymia or the Attachment approach. In addition, qualitative methods have been implemented to grasp the fine-grained conscious and unconscious processes in the inner life of patients and in the verbal and nonverbal interaction phenomena of therapies. To sum up: Recent developments in psychoanalytic theory, which begin to overcome the differences among psychoanalytic schools in favor of re-erecting a common psychoanalytic understanding like that demonstrated in Gubb's article, fit together in bridging the gap between insights from classical psychoanalyses and results from empirical research. [ABSTRACT FROM AUTHOR]

The article reports on the contracts of Toscotec to complete the rebuilding of the PM 5 paper machine in Marsberg-Giershagen, Germany. The machine was substantially rebuilt by Toscotec into a Crescent Former.

The article focuses on the European Commission's guidance paper (GP) and the relevance and effectiveness of reforming Article 82 through a soft-law tool, and whether the GP demonstrates an effective means of compliance for Germany. The EU aspires to launch GP's features that will analyze concepts such as consumer welfare, anti-competitive foreclosure, and consumer harm. It discusses how the GP could be professed from the viewpoint of German competition law and policy, and the kind of transitional regime required for an effective completion of its main analytical concepts. It notes that it is therefore important to come up an overall balance between both the efficiencies and competitive-harm policy when enforcing Article 82 despite all the criticism.

Wood has always been an indispensable material in human society throughout history. Its efficient utilization is even more crucial today in achieving the Sustainable Development Goals (SDGs). However, its production, trade, use, and recycling are seldom systematically assessed, with Germany being an exception due to the extensive work conducted by the University of Hamburg and the Thünen Institute over the years. To provide a more precise account of wood use, this study employs oven-dry metric tonne as the reference unit to construct a static wood flow based on the material flow analysis and wood resource balance in Germany in 2020. The Sankey diagrams comprehensively visualize the flow and stock of wood in various sectors, including forests, sawmills, pulp mills, buildings, energy, and waste. Results showed that forest felling volume exceeded growth due to significant wood demand and export, while forest carbon sinks increased because more hardwood was retained in German forests. The building and construction sector was the largest consumer of primary wood products, accounting for 52.1 % of the total, followed by furniture (29.5 %) and packaging (14.0 %). All waste paper was used to produce recycled fiber pulp, whereas only 14 % of waste wood was employed in particle board production. The woody biomass energy, amounting to 142.4 TWh, provided approximately 4.4 % of Germany's primary energy consumption, with around half of it used in private households. In addition to apparent data, this study also uses resource allocation, carbon storage, and cascade potential as examples to demonstrate that wood flow is applicable for further in-depth analysis, supporting wood efficient utilization. It can even be applied to any country and period with sufficient data and conversion factors, but here, they also prevented this study from comprehensively describing past and future wood flows. [Display omitted] [ABSTRACT FROM AUTHOR]

The German engineer H.A. Janssen gave one of the first accounts of the often peculiar behavior of granular material in a paper published in German in 1895. From simple experiments with corn he inferred the saturation of pressure with height in a granular system. Subsequently, Janssen derived the equivalent of the barometric formula for granular material from the main assumption that the walls carry part of the weight. The following is a translation of this article. The wording is chosen as close as possible to the original. While drawings are copied from the original, figures displaying data are redone for better readability. The translation is complemented by some bibliographical notes and an assessment of earlier work, wherein Hagen predicted the saturation of pressure with depth in 1852, and Huber-Burnand demonstrated that saturation qualitatively as early as in 1829. We conclude with a brief discussion of more recent developments resting on Janssen's work. [ABSTRACT FROM AUTHOR]

This comment is meant to reiterate two warnings: One applies to the uncritical use of ready-made (openly available) program packages, and one to the estimation of trends in serially correlated time series. Both warnings apply to the recent publication of Lischeid et al. about lake-level trends in Germany. [ABSTRACT FROM AUTHOR]

Custom-made mandibular advancement devices are an effective treatment option for snoring, upper airway resistance syndrome, and obstructive sleep apnea (OSA). Evidence-based data indicates their efficacy, and international sleep societies recommend oral appliance (OA) therapy for patients with sleep-related breathing disorders. The following position paper by the German Society of Dental Sleep Medicine (DGZS) is to guide the interdisciplinary team (sleep physician and sleep disorder dentist) in detail when to prescribe oral appliances. This position paper supports the responsible use of OA as an effective treatment option for patients with sleep-related breathing disorders. The paper advises of proper indication regarding OSA severity, body mass index (BMI), and dentition. It emphasizes the interdisciplinary approach of oral appliance therapy and suggests treatment under the guidance of dentists trained in dental sleep medicine.

The German Standing Committee on Vaccination (STIKO) recommends seasonal influenza vaccination for children and adolescents with chronic medical conditions that put them at risk for severe influenza illness. In addition to trivalent inactivated influenza vaccines (TIV), a trivalent live-attenuated influenza vaccine (LAIV) was licensed for children and adolescents aged 2-17 years in the European Union in 2011. Employing the methodology of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group, we examined the evidence for efficacy and safety of LAIV relative to TIV to guide STIKO's decision on whether LAIV should be preferentially recommended for at-risk children. In our meta-analysis of data from two randomized trials directly comparing LAIV and TIV in children aged ≤ 6 years, the protective efficacy of LAIV against laboratory-confirmed influenza was 53 % [95 % confidence interval (CI): 45-61 %] higher than that of TIV. A similar study in individuals aged 6-17 years showed a 32 % (95 % CI: 3-52 %) higher efficacy of LAIV. The quality of the evidence for a superior protective efficacy of LAIV against all relevant clinical outcomes was rated 'moderate' for children aged 2-6 years and 'low' for the age group 7-17 years. Regarding safety outcomes, the available data suggest no significant differences between LAIV and TIV. Based on these results, STIKO recommends that LAIV should be used preferentially for influenza vaccination of at-risk children aged 2-6 years. In children and adolescents aged 7-17 years, either LAIV or TIV may be used without specific preference. Possible contraindications and the vaccinee's and his/her guardians' preferences should be taken into account.

A multidisciplinary German expert group met in 2012 to discuss the current status and prospects of health care of geriatric patients with urinary incontinence in Germany. The purpose of this position paper is to raise awareness among health care providers for the challenges associated with adequate management of urinary incontinence in frail elderly. The experts agree that a multidisciplinary collaboration is essential for the successful treatment of urinary incontinence symptoms which are often associated with loss of autonomy and social isolation. For most geriatric patients, usually the general practitioner is the first contact when seeking help. Hence, the general practitioner plays a crucial role in the coordination of diagnosis and treatment. The involved health care providers should have adequate education and training in their respective disciplines and should be networked allowing quick turnaround times. Non-pharmacological treatments (e.g. behavioural interventions) should have been tried before any pharmacotherapy is initiated. If pharmacological treatment of urinary incontinence involves the use of anticholinergic agents, cognitive performance should be monitored regularly. If indicated, anticholinergic agents with a documented efficacy and safety profile, explicitly assessed in the elderly population, should be preferred.

Two rotavirus (RV) vaccines were introduced to the European market in 2006. To support the decision-making process of the German Standing Committee on Vaccination ("Ständige Impfkommission", STIKO) regarding adoption of routine RV vaccination into the national vaccination schedule in Germany relevant scientific background was reviewed. According to STIKO’s Standard Operating Procedures for the development of evidence-based vaccination recommendations, a set of key questions was addressed and systematic reviews were performed with a focus on the efficacy, effectiveness, impact and safety of RV vaccines. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was applied to assess the quality of available evidence. Data from 5 randomized controlled trials demonstrated a high efficacy of RV vaccines in preventing severe RV-associated gastroenteritis (91%) and hospitalization (92%) in settings comparable to Germany. Post-marketing observational studies confirmed these findings. In several countries, impact studies suggest that age groups not eligible for vaccination might also benefit from herd effects and demonstrated a decrease in the number of nosocomial RV infections after RV vaccine introduction. The vaccines were considered safe, except for a slightly increased risk of intussusception shortly after the first dose, corresponding to 1-2 additional cases per 100,000 infants vaccinated (relative risk =1.21, 95% confidence interval [CI] 0.68-2.14). RV case-fatality is extremely low in Germany. However, RV incidence among children aged <5 years is high (reported 8-14 cases per 1000 children annually), and of these almost half require hositalization. In view of the available evidence and expected benefits, STIKO recommends routine rotavirus vaccination of children under the age of 6 months with the main goal of preventing RV-associated hospitalizations in Germany, especially among infants and young children.

The German graduate medical education system is going through an important phase of changes. Besides the ongoing reform of the national guidelines for graduate medical education (Musterweiterbildungsordnung), other factors like societal and demographic changes, health and research policy reforms also play a central role for the future and competitiveness of graduate medical education. With this position paper, the committee on graduate medical education of the Society for Medical Education (GMA) would like to point out some central questions for this process and support the current discourse. As an interprofessional and interdisciplinary scientific society, the GMA has the resources to contribute in a meaningful way to an evidence-based and future-oriented graduate medical education strategy. In this position paper, we use four key questions with regards to educational goals, quality assurance, teaching competence and policy requirements to address the core issues for the future of graduate medical education in Germany. The GMA sees its task in contributing to the necessary reform processes as the only German speaking scientific society in the field of medical education.

The treatment of the severely injured is, just as the injury severity and combinations, often highly complex and leaves little leeway for delay, dissent or even error. In order to reduce this to a minimum, trained emergency room teams in addition to optimal technical and structural prerequisites are necessary. This must function in an interdisciplinary fashion according to fixed consensus algorithms which are known to all team members and have been agreed by all participants. The White Paper on treatment of the severely injured of the German Society of Trauma Surgery (DGU) and the recently published S3 guidelines offer evidence-based recommendations on the structural, technical, organizational and personnel prerequisites.