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BACKGROUND: Both highly specialized heart centres and less specialized hospitals care for patients with implantable ICDs/CRT-Ds with remote monitoring. OBJECTIVE: To investigate potential differences in patient treatment according to centre's ICD implantation volume. METHODS: Based on their 2012 ICD/CRT-D implantation volume, centres enrolled in the NORDIC ICD trial in Germany were assigned to one of three groups: high- (HV, n = 345), medium- (MV, n = 340) or low-volume (LV, n = 189). RESULTS: The HV-centres had a significant higher CRT-D proportion (41.7%; LV: 36.5%; MV: 23.2%; P 푔푙표푏푎푙 < 0.001), significant shorter median procedure duration (49 min; MV: 58 min; LV: 60 min; P 푔푙표푏푎푙 < 0.001) but significant longer median hospital stay (4 days; MV and LV: 3 days; P 푔푙표푏푎푙 < 0.001) compared to MV- and LV-centres. The X-ray exposure was shorter in MV/HV-centres (MV: 3.4 min; HV: 3.6 min; LV: 5.5 min; P 푔푙표푏푎푙 < 0.001). Only 3.5% (LV: 2.6%; HV: 3.5%; MV: 4.1%) patients received at least one delivered inappropriate shock and 2.5% (HV: 2.0%; LV: 2.6%; MV: 2.9%) patients had withheld inappropriate ICD shocks without subsequent inappropriate shock delivery within 24.5 months of median follow-up. CONCLUSION: Implantation volume-dependent differences were observed in the device selection, procedure duration and x-ray exposure duration. Remote monitoring in combination with adequate response pattern prevented imminent inappropriate shocks in all three groups. [ABSTRACT FROM AUTHOR]

Background: Among the risk factors for nonunion are unchangeable patient factors such as the type of injury and comorbidities, and factors that can be influenced by the surgeon such as fracture treatment and the postoperative course. While there are numerous studies analyzing unchangeable factors, there is poor evidence for factors that can be affected by the physician. This raises the need to fill the existing knowledge gaps and lay the foundations for future prevention and in-depth treatment strategies. Therefore, the goal of this study was to illuminate knowledge about nonunion in general and uncover the possible reasons for their development; Methods: This was a retrospective analysis of 327 patients from 2015 to 2020 from a level I trauma center in Germany. Information about patient characteristics, comorbidities, alcohol and nicotine abuse, fracture classification, type of osteosynthesis, etc., was collected. Matched pair analysis was performed, and statistical testing performed specifically for atrophic long-bone nonunion; Results: The type of osteosynthesis significantly affected the development of nonunion, with plate osteosynthesis being a predictor for nonunion. The use of wire cerclage did not affect the development of nonunion, nor did the use of NSAIDs, smoking, alcohol, osteoporosis and BMI; Conclusion: Knowledge about predictors for nonunion and strategies to avoid them can benefit the medical care of patients, possibly preventing the development of nonunion. [ABSTRACT FROM AUTHOR]

Introduction: Since the introduction of e-scooters in Germany in 2019, they are becoming more and more popular and associated injuries have increased significantly. The aim of this study was to assess the injury patterns after e-scooter accidents. Materials and Methods: From May 2019 to October 2022, all consecutive patients who presented at our emergency department (ED) following e-scooter accidents were included in our study and retrospectively analyzed. Results: A total of 271 patients were included in our study. The mean age was 33 years. 38% of the patients were female and 62% were male. Most common injuries were traumatic brain injuries in 38% of the patients together with fractures affecting the upper limb (17%). An operative treatment was necessary in 40 patients. Most of the patients presented at night and about 30% were under the influence of alcohol. Conclusions: Our study shows one of the largest cohort of patients suffering e-scooter accidents in Europe. Compulsory helmet use, stricter alcohol controls and locking periods could contribute significantly to safety. [ABSTRACT FROM AUTHOR]

To assess changes in treatment modalities for supracondylar humerus fractures (SCHFs) at a large pediatric university hospital, we analyzed patient data from 2014 to 2022. A total of 233 SCHFs treated surgically at our hospital were included. To evaluate postoperative outcome and quality of life, DASH and EuroQol-5D-Y questionnaires were sent to patients. In addition to a significant fluctuation in fracture severity, we found an increase in training interventions (more surgeries were performed by trainees) and a significant decrease in surgery times after 2016. From 2020, there was a significant shift in the type of surgical method away from closed reduction with elastic stable intramedullary nailing (ESIN) and towards closed reduction and crossed K-wire osteosynthesis (CRK). Surgeries performed in the morning and evening hours increased, while those performed in the afternoon and after midnight decreased. After a mean follow-up of 4 years, there was no difference in elbow function between ESIN and open reduction and K-wires (ORK). Treatment with ESIN was equivalent to ORK in terms of function, at least in the medium-term follow-up. In summary, the combination of shifting treatment from SCHF to daytime hours, increasing trainee participation and using cross K-wire fixation instead of ESIN had no negative impact on surgery times. In our setting, these measures have reduced resource utilization and increased efficiency without compromising patient care. [ABSTRACT FROM AUTHOR]

Copyright of GAIA: Ecological Perspectives for Science & Society is the property of Oekom Verlag GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hand and forearm injuries are the most frequent reason for consultations in German emergency departments. Therefore, full recovery has a high social and economic relevance. In this study, data on surgically treated hand injuries in a regional German trauma centre between 01.01.2019 and 31.01.2021 were collected using the new German HandTraumaRegister of the German Society for Hand Surgery. These data were retrospectively analysed and correlated with mobility data of the Bavarian population, the 7-day incidence of Covid-19 infections in Germany and the number of elective hand surgeries. We found that a fall from standing height with consecutive distal radius fracture was the most common injury in women, whereas mechanism of injury and diagnosis were more diverse in men. The populations' mobility correlated well with the number of accidents, which in turn was reciprocal to the 7-day-incidence of Covid-19 infections. The number of elective hand surgeries expectedly dropped significantly during the state-imposed lockdowns. Knowing that mainly young men and elderly women suffer from hand injuries, tailored prevention measures may be elaborated. In order to reduce socioeconomic burden, care for hand injuries and elective hand surgeries must be guaranteed according to the frequency of their occurrence. [ABSTRACT FROM AUTHOR]

Purpose: Mobility patterns of western societies have been changing due to ongoing demographic change. Therefore, continuously updated epidemiological data on fracture morphology and treatment strategies are needed. Methods: This retrospective single-center study included all tibial plateau fractures (TPF) between January 2011 and December 2020 in a level-I trauma center in Central Europe. Epidemiology, trauma mechanism and fracture morphology were analyzed. Age- and sex-specific differences regarding fracture classification (Schatzker, AO/OTA, Moore) and changes during the study period are highlighted. Results: A total of 607 patients (55.2% women, 44.8% men, mean age 52.9 years (± 17.9)) were included in the study, 462 (76.1%) thereof having undergone surgical treatment. Over the decade, an increase in mean age (+ 7.4 years; p = 0.10), incidence (+ 68%; p < 0.05) and low-energy trauma was observed, with the highest peak in elderly women. Within classifications, AO/OTA 41-B3 (24.9%), Schatzker II (26.8%) and Moore V (46.6%) fractures were the most common. Conclusion: Incidence (+ 68%), mean age and fractures with signs of knee dislocation of tibial plateau fracture increased over the last decade and low-energy trauma mechanism are more frequent. As the increase in incidence is mainly seen in older women, the comorbidities and need for immediate postoperative full weight-bearing have to be considered in treatment strategies. [ABSTRACT FROM AUTHOR]

Summary: Osteoporosis is a skeletal disease that may result in low-trauma fracture if untreated. Among men and women ≥ 70 years untreated for osteoporosis, 30% (43,514) sustained at least one post-index fracture. Care for patients with osteoporosis diagnosis directly contributed to a cost burden of €786 million. Introduction: Osteoporosis is a skeletal disease that manifests as bone mineral density loss and low-trauma fractures. This database analysis describes the characteristics of untreated osteoporosis patients, and their rate of fractures, health resource utilization, and cost burden. Methods: From the InGef database (2011–2016), eligible patients (≥ 70 years) untreated for osteoporosis were identified via a recorded diagnosis of osteoporosis (ICD-10 codes M80/M81) or an initial fragility fracture (index point). All patients were followed up for fractures post index. Direct costs included inpatient, outpatient, pharmacy, and ancillary care costs. Results: A total of 144,752 patients (mean age 79 years; 73% female, median follow-up of 3.2 years) met the eligibility criteria; 23% had a history of fractures. Forty-eight percent of patients had cardiac diseases, 32% diabetes, and 27% cerebrovascular disease. Thirty percent (43,514) of patients had at least one post-index fracture; two or more post-index fractures were experienced in 7% (10,262) of patients. Median time from index date to first fracture was 145.5 days. Bisphosphonates were the most prescribed osteoporosis treatment following a first fracture post-index (n = 4102, 9.2%). There was a total of 107,055 patients (74.0%) who had at least one all-cause hospital stay. The total number of fracture-related admissions was 63,595 and that of outpatient visits was 323,460. A total of 34,764 (24%) patients died during follow-up. Costs for fracture-related care for patients directly contributed to a cost burden of €786 million. Conclusions: Osteoporosis patients and patients who sustain a fragility fracture remain undertreated for osteoporosis, increasing their risk of future fractures. Diagnosing and treating this group of patients should remain a priority to alleviate the clinical and economic burden of osteoporosis-related fractures. [ABSTRACT FROM AUTHOR]

Summary: This retrospective study investigated the incidence of fracture in 4420 type 1 diabetes (T1DM) patients. Our findings indicate that patients with T1DM have an increased incidence of fractures. Further studies and preventive measures are urgently needed. Introduction: The aim of this study was to investigate the incidence of fracture in patients with type 1 diabetes mellitus (T1DM). Methods: This study is based on the German Disease Analyzer database and included 4258 adult individuals with a T1DM diagnosis documented between January 2000 and December 2015 in 1203 general practices in Germany. Individual matching of T1DM and non-diabetic patients was performed. The cumulative incidence of new fractures was shown for up to 10 years after the index date using Kaplan-Meier curves. Cox proportional hazard models (dependent variable: incident fracture) were used to estimate the effect of T1DM on fracture incidence, as well as the effect of predefined variables on fracture incidence. Results: After 10 years of follow-up, the cumulative fracture incidence was 18.4% for T1DM patients and 9.9% for non-diabetic patients (p < 0.001). A strong association between T1DM and fractures was found (HR, 2.01 (95% CI, 1.70–2.38) p < 0.001) in both female and male patients. Significant differences between T1DM and non-diabetes patients were found in lower leg/ankle, foot and toe, shoulder/upper arm, and rib(s), sternum and thoracic spine fractures. A significant association between higher age and fracture incidence was observed in T1DM patients. Conclusions: In summary, we found that patients with T1DM have a twofold increased fracture rate compared with healthy controls. Furthermore, fractures were associated with increased age and high HbA1c values. [ABSTRACT FROM AUTHOR]

Background: Peripheral nerve injury in the upper extremity is linked to high socioeconomic burden, yet cost-analyses are rare and from small cohorts. The objective of this study was to determine the costs and long-term socioeconomic effects of peripheral nerve injuries in the upper extremity in Germany. Methods: We analyzed data of 250 patients with 268 work-related upper extremity nerve injuries from acute treatment to long-term follow-up on rehabilitation, sick-leave and disability-pension. Results: Patients were on average 39.9±14.2 years old, male (85%) and mean inpatient treatment was 7±6 days. Location of nerve was 8% (N = 19) proximal to the wrist, 26% (N = 65) at the wrist and metacarpus, and 66% (N = 166) at phalangeal level. Acute in-patient treatment for (single) median nerve injury accounted for 66% with hospital reimbursement of 3.570€, ulnar nerve injury for 24% and 2.650€ and radial nerve injury for 10% and 3.166€, all including finger nerve injuries. The remaining were combined nerve injuries, with significantly higher costs, especially if combined with tendon 5.086€ or vascular injury 4.886€. Based on location, nerve injuries proximal to the wrist averaged 5.360±6.429€, at the wrist and metacarpus 3.534±2.710€ and at the phalangeal level 3.418±3.330€. 16% required rehabilitation with average costs of 5.842€ and stay of 41±21 days. Sick leave was between 11–1109 days with an average of 147 days with socioeconomic costs of 197€/day, equaling on average 17.640€. 30% received a mean yearly disability pension of 3.187€, that would account to 102.167€ per lifetime. Conclusion: This large German patient sample indicates that nerve injury has a major impact on function and employment, resulting in significant health care costs. Both proximal and distal nerve injuries led to long-term disability, subsequent sick-leave and in 30% to permanent disability pension. These data are determined to support future studies and health economical work on prevention, treatment and rehabilitation of these often small injuries with great consequences. [ABSTRACT FROM AUTHOR]

We aim to contribute to a more informed discussion of the economic and environmental effects of a glyphosate ban in European agriculture. As real-world observations of weed control under a glyphosate ban are not available, we develop a normative modelling approach based on damage abatement functions considering production risk and farmers' risk preferences. Different sources of risk are included by incorporating uncertainty of both attainable yield level and weed pressure. Results for a case study of silage maize cultivation in 377 municipalities in North Rhine-Westphalia, Germany, show that a glyphosate ban causes a shift towards more mechanical weed control, but not to more pronounced use of selective herbicides. The ban slightly reduces net profits and yields, leads to a significant reduction of the overall toxicity of pesticide use, but increases energy consumption of the agricultural system. The magnitude of these effects is found to be critically dependent on output price levels and yield expectations. [ABSTRACT FROM AUTHOR]

Private households in ageing societies increasingly employ live-in migrant carers (LIMCs) to care for relatives in need of 24/7 care and supervision. Whilst LIMC arrangements are a common practice in Germany, they are only recently emerging in the Netherlands. Taking this development as a starting point, this study uses the countries' different long-term care (LTC) regimes as the analytical framework to explore and compare the motivations and justifications of German and Dutch family carers who opt for an LIMC arrangment. Findings show that Dutch and German LTC regimes impact differently the decision-making processes of families, as well as on patterns of justification, through a combination of policies and social norms and their related expectations towards care and care work in old age. [ABSTRACT FROM AUTHOR]

The article presents a new section of "Journal of Marketing" which focuses on marketing developments around the world. The focus of this particular article is development in Germany. Because of economic reasons, marketing problems were not particularly an issue in German companies until the mid 1960s. Marketing as a field of study emerged from German universities in 1970, accompanied by marketing literature. To gain an understanding of marketing in Germany, the author looks at some of the literature that has surfaced since that time. Some of the topics covered in the article include consumer behavior, quantitative marketing, marketing management, and societal aspects of marketing.

Background: Osteoporosis-associated fractures are of increasing importance in trauma surgery. Systematic diagnostics and treatment of osteoporosis during a hospital stay, however, remain inadequate. Therefore, a specific algorithm for diagnosing and treating osteoporosis in trauma surgery patients was developed based on the DVO (German Osteology Society) guideline for osteoporosis from 2014. Methods: In a first step, the individuals' age and risk profile for osteoporosis is identified considering specific fractures indicating osteoporosis and risk factors assessed by a specific questionnaire. In addition, physical activity, risk of falls, dietary habits and the individuals' medication are considered. Basic osteoporosis laboratory tests, a bone densitometry by dual-energy X-ray absorptiometry (DXA) and, if needed, X-rays of the spine are carried out to identify prevalent vertebral body fractures. Results: Based on the treatment algorithm adapted to the new guidelines for osteoporosis in the majority of proximal femoral fractures, treatment of osteoporosis could already be indicated without prior DXA. In case of preexisting glucocorticoid therapy, a history of previous fractures or other risk factors according to the risk questionnaire, the threshold of treatment has to be adjusted given the table of T-scores. Conclusions: The treatment algorithm for diagnosing and treating osteoporosis in in-patient trauma surgery patients can help identify high-risk patients systematically and efficiently. As a result, osteoporosis-associated fractures or failure of osteosynthesis could be reduced, yet a prospective validation of the algorithm has to be completed. [ABSTRACT FROM AUTHOR]

Introduction: The prevalence of osteoporosis in female patients over 75 years of age is 59.2 %. In Germany ~6.3-7.8 million patients are affected by osteoporosis. In 77 % of german patients osteoporosis is not treated adequately. Even after fragility fractures only 16-21 % of female patients and 3 % of male patients are supplied with a specific osteoporosis therapy. Establishing a Fracture Liaison Services (FLS) is a possible addition to co-management for an efficient treatment of osteoporosis in orthogeriatric patients. Materials and methods: According to a treatment algorithm adapted to the DVO guideline 2014, data of 251 (77 male, 173 female) patients were collected over 3 months. For the assessment specific and standardized questionnaires were used. There was also a basic laboratory testing for osteoporosis done. Results: The average age of female patients was 76.1 years, in male patients 76.6 years. Thirty-seven patients had vertebral fractures, 25 patients proximal humerus fractures, 18 distal radius fractures and a total of 78 proximal femur fractures were recorded. Eighteen percent of the 251 patients have already been treated with a basic and 11 % with a specific osteoporosis medication. Approximately 40 % of the orthogeriatric patients were diagnosed with osteoporosis for the first time in our clinic. Less than 1 % of the patients had a vitamin D level over 40 ng/ml and 32 % had a vitamin D level under 10 ng/ml. Sixty-five percent of the discharged patients received a basic osteoporosis therapy and 25 % an additional specific therapy. Discussion: Due to the demographic development osteoporosis-associated fractures steadily increase. In addition to the surgical treatment of fractures, osteological diagnosis and treatment are essential components of successful treatment and critical to the prevention of further fractures. A combination of orthogeriatric center and fracture liaison service allows a more efficient treatment of osteoporosis by close supervision of orthogeriatric patients by the physicians involved. [ABSTRACT FROM AUTHOR]

Background: the incidence and prevalence of patients with advanced heart failure is increasing worldwide and the number of cardiac transplantations remains limited. Aims: it was the aim of the study to describe our experience with the increasing number of available medical, interventional and cardiac surgery options, and to assess heart failure survival score predictability in an academic heart failure center within a 1-year follow-up. Methods and Results: in all patients who were referred for cardiac transplant evaluation within a 12-month period between April 1998 and March 1999 at our Interdisciplinary Heart Failure and Transplant Program, our team assessed all medical interventions as well as interventional and surgical treatment options that were available, based on the clinical profile on initial presentation. In 92% of the 120 patients referred for cardiac transplantation evaluation, drug therapy could be optimized. A considerable number of patients could be subjected to an organ-preserving intervention or surgery, either PTCA (n=11), CABG (n=4), valve repair (n=7), multisite pacing (n=7), or partial ventricular resection (n=5). Only a small group of patients with the worst heart failure survival score were listed for heart transplantation (n=17) or received a ventricular assist device (n=3). Conclusions: within a contemporary cohort of advanced heart failure patients, only a small number of patients will undergo cardiac transplantation, which is predictable by the heart failure survival score. Most patients will undergo optimized medical therapy and a considerable number will be subjected to interventional or surgical treatment options. [Copyright &y& Elsevier]

Background: The aim of this study was to review the role of the pathologist in mammography screening. Patients and Methods: The first German mammography screening project was undertaken in Bremen in June 2001. Women between the ages of 50 and 69 were offered mammographic assessment. Suspicious findings were followed up by a stereotactic core biopsy or vacuum-assisted core biopsy. The tissue was examined at the Department of Pathology in Bremen as well as at the Section of Breast Pathology at the University Münster. Each case was discussed in a multidisciplinary board. The core biopsies were classified according to the 5-point scale of the internationial guidelines. Results: Biopsies were obtained from 402 women within the first 2 years of the screening project. Of these, 47% were assigned to group B5 (malignant), 44% were categorized in group B2 (benign) while 1% was classified in group B1 (regular breast tissue, unsatisfactory) and 8% were assigned to the group B3/B4 (lesion of uncertain malignant potential / suspicious for malignancy). The discrepancies in 10% of the cases centered on papillary lesions, flat epithelial atypia (FEA) and atypical ductal hyperplasia (ADH). Conclusion: In clearly defined lesions the agreement of the histological findings of independent pathologists is very high. In unclear lesions it should be raised. In addition, close cooperation between clinicians, radiologists and pathologists is critical. [ABSTRACT FROM AUTHOR]

Copyright of Journal of International Migration & Integration is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Investigates the optimized control concepts used to minimize the number of additional tanks for the Wuppertal-Buchenhofen wastewater treatment plant in the catchment basin of the River Wupper in Germany. Description of the control concept for nitrification; Application spectrum of spectral absorption coefficient and SS measurement.

A correction is presented to the article "Fractures in untreated patients with osteoporosis in Germany: an InGef healthcare insurance database analysis."

Osteoporosis (OP) is a skeletal disease that manifests as bone mineral density loss and low-trauma fractures. In this representative cohort (5%) of German patients untreated for OP, the total cost burden of OP care and fragility fractures was €300 million. [Extracted from the article]

In Germany, wolves live in a human-dominated landscape. The return of the wolf to Germany more than 20 years ago is a prime example of successful nature conservation; however, it has also led to conflict due to the high degree of landscape fragmentation and the feeding habits of the wolf. Here, the wolf diet composition was studied based on an analysis of 11,225 scats. Wolves in Germany mainly feed on wild ungulates, which comprise more than 94% of their diet. The predominant species are roe deer and wild boar, whereby in most territories roe deer dominate the diet composition. Depending on availability, red deer and fallow deer may also make up a high proportion of the diet. Seasonal and territorial variation in diet composition has been noted even in directly neighboring territories. Wolves preferentially hunt juveniles of the main prey species. With the exception of the mouflon, which has all but disappeared locally, no other ungulate species has vanished from the wolf's diet. This study provides an overview of the varied diet of wolves in Germany since recolonization more than 20 years ago. [ABSTRACT FROM AUTHOR]

This article describes and analyses the availability of outpatient, inpatient and community-based psychiatric care in Saxony-Anhalt, one of the federal states in the eastern part of Germany. The European Services Mapping Schedule was used to classify 365 institutions. Outpatient care was provided by an average of four private practice psychiatrists per 100 000 inhabitants, which is low when compared to the German average. Ten secure beds (fo-rensic), 48 acute beds, 13 elective beds and 13 day hospital places per 100 000 inhabitants were available for inpatient care. Non-acute non-hospital residential services with indefinite stay and with 24 h support amounted to 240 places per 100 000, with regional differences ranging from less than 100 to more than 1000. Other facilities offering paid work or work-related activities were scarce and some services providing structured activity or social contact were available only in urban agglomerations. Overall, psychiatric care in Saxony-Anhalt is fragmented as regards providers and funding. [Copyright &y& Elsevier]

This study evaluates the organofacies and petroleum generation potential of kerogen of Early Cretaceous Wealden Shales in the Lower Saxony Basin, Germany. Methods applied include open-system-and Curie-point-pyrolysis, attenuated total reflectance infrared spectroscopy, x-ray diffraction and x-ray fluorescence spectroscopy. The geochemical results give a comprehensive elemental characterization of the Wealden source rocks and indicate an anoxic to oxygen-depleted lacustrine depositional setting in a rather warm climate. The kerogen composition is characterized by high abundance of aliphatic compounds with many alkylated low molecular weight oxygen-bearing compounds, but only a minor aromatic contribution. Differences between organic matter-rich lamalginite facies A and Botryococcus -bearing, less organic matter-rich facies B occur. For both facies, the total hydrocarbon generation potential (Rock-Eval HI) of facies A is higher than that of facies B. TOC-normalized cumulative hydrocarbon gas yields generated during pyrolysis-GC are similar for both facies and account for only 8–16% of the total hydrocarbon generation potential. In contrast, the cumulative yield of molecular hydrogen generated during open-system pyrolysis of facies B is twice as high than for facies A. Overall Wealden Shales generate 55 mg HC per g rock on average, they generate roughly 6 mg H 2 per g TOC. Although these H 2 yields are rather low compared to other organic-rich rocks or coals with aromatic kerogen structures, this study shows that detecting H 2 during open-system-pyrolysis is important for the understanding of kerogen transformation processes during pyrolysis in both natural and laboratory settings. • Advanced, detailed geochemical characterization of the Wealden Shale. • An anoxic-suboxic lacustrine depositional environment and warm paleo-climate persisted. • Kerogen composed mainly of aliphatic and alkylated oxygen compounds. • GOR of Wealden shales pyrolysates range from 0.05 to 0.16. • H 2 yields demonstrate that geological HC yields are underestimated by up to 6 mg H 2 per g TOC. [ABSTRACT FROM AUTHOR]

This study provides new organic geochemical, organic petrological and isotope data on the Berriasian Wealden Shales, northwest Germany as well as new kinetic data on petroleum generation determined both for kerogen concentrates and whole rock samples. The kinetics were applied in numerical petroleum system models for two wells: one in the western Lower Saxony Basin (LSB) and the other one in the Pompeckj Block further north. The study increases the understanding on rate, conversion and timing of petroleum generation and is consistent with oil fields and prospects in the area, which was not the case in previous studies. The first facies of the Wealden 3–4 members is partly very rich in organic matter (TOC up to 21.85 wt%), the organic matter being composed almost exclusively of thin lamalginites. The second organic facies is characterized by lower TOC values (3.86–10.73 wt%) containing both Botryococcus algae and lamalginites. High atomic H/C and C/S ratios as well as the occurrence of Botryococcus algae prove a brackish–freshwater depositional environment with high HI values, which are typical of type I or type II kerogen. Broad n -alkane distributions without odd-even predominance are surprising in view of vitrinite reflectance, HI and T max data, which are typical of immature or early mature kerogen. Several biomarker indices indicate dysoxic/anoxic bottom water conditions and possibly water stratification, while the low steranes/terpanes ratio suggests a significant bacterial contribution to the organic matter. Low δ13C values (−28.5 to −34.5‰) are in line with previously obtained data for the Wealden and support the presence of microbial-derived kerogen. Low Pristane/Phytane, low Pristane/nC 17 and Phytane/nC 18 ratios and the absent odd-even predominance are regarded as a result of kerogen being derived from microbial rather than algal biomass; it is not related to thermal maturation. Lamalginite is in this case probably derived from microbial mats producing no chlorophyll and little sterane precursors. Deeper in the water or in the sediments, denitrification of the bacterial biomass took place leading to extraordinarily low nitrogen/carbon ratios and extraordinarily high ẟ15N values. The occurrence of H 2 S in the lower water column resulted in excellent organic matter preservation leading to very high TOC values (up to 21.8 wt%). Abundant framboidal pyrites indicate a microbial pyrite origin. The burial, thermal and maturity history calibrated by Easy%RoDL reveals that more erosion is required than assumed in previous studies to explain the present-day maturation in the western LSB and Pompeckj Block. In both wells (A, B), the Wealden source rocks experienced sufficient temperatures for hydrocarbon generation and primary migration. Kinetics obtained from kerogen concentrates indicate earlier generation (i.e. at slightly lower temperatures) than those from whole rock samples. The Botryococcus algae facies reveals lower transformation ratios at a given temperature history, suggesting that most of the oil was generated by the lamalginite facies. Significant and late (~40 million years ago; Lutetian) kerogen-to-oil conversion in the northern part of the study area lowers the charge risk in future conventional oil exploration. • Unusual organic geochemistry of organic rich Wealden shales, e.g. low pristane and phytane. • Extraordinarily high ẟ15N and low ẟ13C values prove unusual origin of organic matter. • New hydrocarbon generation kinetic data for lacustrine kerogen are presented. • The hydrocarbon generation history matches the known oil accumulations in the region. [ABSTRACT FROM AUTHOR]

Recently, the importance of psychiatric day hospital treatment is increasing in German psychiatry, as the regionalization and community-orientation of care advance and catchment areas become smaller. When a psychiatric department of a local general hospital is within easy reach of the patient's residence, the means for intensive treatment, as is available in a hospital, can be utilized during the day, while the patient spends a considerable amount of time (in fact, two thirds) in the familiar surroundings of his/her own home. This is applicable for many psychiatric conditions, including neuroses, personality disorders and psychosomatic diseases. As compared to conventional individual outpatient psychotherapy on the one hand and a distinct limited stay in a psychosomatic sanatorium far from home on the other hand, psychotherapy in a day hospital offers a promising additional way to provide effective and lasting professional help early and with a low threshold. The article summarizes the experience gained in a newly founded department of psychiatry and psychotherapy at a general hospital in one district of eastern Germany, where the staff is struggling to meet the needs of the catchment area in spite of a too small number of hospital beds.