Search

Teachers' emotional exhaustion is related to various detrimental outcomes, such as work absenteeism, intention to quit, impaired instructional quality, and lower student motivation. Since emotional exhaustion becomes evident as early as teacher training at university, the question is whether it would be possible to identify an individual disposition to this burnout symptom in student teachers. Accordingly, it is important to gain a deeper understanding of the genesis, stability, and trajectories of change of emotional exhaustion. In the present study, we have disentangled different components of longitudinal stability in emotional exhaustion by applying STable, AutoRegressive Trait, and State models to two longitudinal samples of German student teachers (Sample 1: N = 4,510; Sample 2: N = 2,034). Over the timespan of up to 6 years, we found that completely stable sources (Sample 1: 35%; Sample 2: 37%) and slowly changing factors (Sample 1: 46%; Sample 2: 36%) in student teachers' emotional exhaustion accounted for much of the total variance in interindividual differences; occasion-specific factors and measurement error accounted for the remaining variation (Sample 1: 23%; Sample 2: 30%). This variance composition applied equally to male and female students and indicated that student teachers' emotional exhaustion comprises a stable component but is predominantly characterized by malleable parts due to systematically changing and occasion-specific sources of variance. Our findings about the stability of emotional exhaustion contribute to the trait-state debate of psychological characteristics and point out that intervention measures should be employed at an early stage to mitigate the negative consequences of burnout in subsequent career steps.

Students with learning and behavioral problems often face enormous barriers to successful school performance. When the language of instruction is not the students' first language and they are already in secondary school, this is compounded by additional challenges, especially with regard to vocabulary and reading -- subjects that are fundamental to obtaining equal educational opportunities. In addition, difficulties in the language of instruction are often accompanied by declining student motivation. Direct word recognition and vocabulary acquisition are of great importance in language learning contexts. To address these areas, multimodal intervention approaches have proven useful. For this reason, a multimodal storytelling intervention was developed to help this group of students, in particular, to improve significantly in the aforementioned areas. Specifically, a multiple-baseline design across participants (N = 4) was applied to train the sight-word reading and vocabulary of adolescent students with learning and behavioral problems who spoke German as a second language. The training occurred three times a week over a period of five weeks. Results were promising for both variables in a short period of time, suggesting that the storytelling intervention in this form is an appropriate tool for teaching second-language German.

Further and continuing education is not only important for individual employability, but also for regional development. Therefore, improving participation in further and continuing education and removing barriers to participation are key concerns of regional education governance. The present study was conducted in a peripheral region of Rhineland-Palatinate in western Germany, where the annual participation rate in continuing education is relatively low compared to other geographic areas in Germany. This quantitative study was designed to understand: (1) To what extent do adult learners engage in continuing education within their habitual lifelong learning process? (2) Which circumstantial factors influence their participation in continuing education? And (3) What are the barriers hindering their participation? The authors found that for two-thirds of adult learners, a precondition for their enrolment in a continuing education course was the satisfaction of both work-related and private life-related factors. The authors' findings point towards the need for flexible study programmes which learners can fit to the demands of their work and life.

The "transportability" of laboratory findings to other instances than the original implementation entails the robustness of rates of observed behaviors and estimated treatment effects to changes in the specific research setting and in the sample under study. In four studies based on incentivized games of fairness, trust, and reciprocity, we evaluate (1) the sensitivity of laboratory results to locally recruited student-subject pools, (2) the comparability of behavioral data collected online and, under varying anonymity conditions, in the laboratory, (3) the generalizability of student-based results to the broader population, and (4) with a replication at Amazon Mechanical Turk, the stability of laboratory results across research contexts. For the class of laboratory designs using incentivized games as measurement instruments of prosocial behavior, we find that rates of behavior and the exact behavioral differences between decision situations do not transport beyond specific implementations. Most clearly, data obtained from standard participant pools differ significantly from those from the broader population. This undermines the use of empirically motivated laboratory studies to establish descriptive parameters of human behavior. Directions of the behavioral differences between games, in contrast, are remarkably robust to changes in samples and settings. Moreover, we find no evidence for either anonymity effects nor mode effects potentially biasing laboratory measurement. These results underscore the capacity of laboratory experiments to establish generalizable causal effects in theory-driven designs.

Although the decade for Education for Sustainable Development has been well promoted in Germany it still finds itself in a rather marginal position, both in the formal and in the informal educational sector. This is at least partly due to the status it is given in the political debate that leads to different expectations by different actors who operate in different frameworks. Thus teachers in formal education will have to take general requirements of education for citizenship into consideration while NGOs are often focused on improving environments and living conditions. Nonetheless there are numerous efforts for the two to join forces. These efforts can be fruitful, if actors on both sides understand the needs and restrictions the other side faces. In this article we want to explore the opportunities and challenges of cooperation between the formal and informal educational sector with a view of giving partners a chance to better use their often scarce resources.

Children with autism spectrum disorders often exhibit comorbid behavioral problems. These problems have an impact on the severity of the core symptoms, the progression of the disorder as well as on the families' quality of life. We evaluated the effectiveness of the Stepping Stones Triple P group parent training program as a supplementary intervention in the treatment of children with autism spectrum disorder. Therefore, we employed a single group repeated measures design and assessed child variables via parents' and teachers' judgments at four successive time points. The participants were parents of 24 children with autism spectrum disorder aged between 3.6 and 12 years. We found a significant reduction of comorbid behavioral problems in the children, primarily in the parents' judgment at follow-up. Furthermore, a reduction of the autism spectrum disorder core symptoms emerged. The teachers' judgment particularly revealed an improvement in children's social relationships. Effect sizes were large (eta-squared ranging from 0.14 to 0.23). The findings demonstrate the effectiveness of the Stepping Stones Triple P as a supplementary intervention for reducing comorbid behavioral problems in the treatment of children with autism spectrum disorder. Higher parental self-efficacy and parental attributions, including parents' ability to influence child problem behaviors, are discussed as important factors for the effectiveness of Stepping Stones Triple P.

The current field study investigated the weekly use of a reflective electronic (e-)portfolio by 1469 higher education students throughout a term and its effect on exam performance. Students' use of the e-portfolio elements as well as their self-reported use of several learning strategies were documented during a 9-week period. Regression analyses showed that over and above the continuous use and the weekly time spent on the e-portfolio, the reported use of cognitive strategies was a significant predictor for exam grade. Finally, students who used the e-portfolio outperformed their peers without e-portfolio use on the final exam. We discuss results with regard to future implementation and training of the e-portfolio use.

In garden path (GP) jokes, a first dominant interpretation is detected as incoherent and subsequently substituted by a hidden joke interpretation. Two important factors for the processing of GP jokes are salience of the initial interpretation and accessibility of the hidden interpretation. Both factors are assumed to be affected by contextual embedding. We investigated this contextual impact with a priming manipulation in a two self-paced reading experiments (Ns = 45/44). Words that were semantically related to the initial interpretation, to the hidden interpretation, or nonrelated to both served as priming cues before the joke presentation. Only priming semantic content of the hidden interpretation reduced reading times of the final word of the GP joke compared with both other conditions, indicating facilitated detection and revision of the otherwise incoherent discourse. The results highlighted the impact of subtle contextual cues affecting the reinterpretation stage in GP joke comprehension.

A global characteristic of higher education is the opportunity and necessity for students to self-regulate their learning. In contrast to considerable research focusing on self-regulated learning (SRL) from a behavioural perspective, little is known concerning the underlying competencies which enable students to succeed in SRL. A structural model is proposed that differentiates SRL competencies in terms of descriptive, procedural, and conditional knowledge regarding different types of self-regulation strategies in different phases of the learning process. Indications drawn from semi-structured interviews with N?=?108 experts (39 lecturers and 69 as excellent nominated students) from 4 fields of study are in line with core assumptions of the proposed model. Moreover, the results provide a basis to ensure the content validity of assessments of students' SRL competencies and from which to derive standards to judge these competencies.

Identity fusion is a relatively unexplored form of alignment with groups that entails a visceral feeling of oneness with the group. This feeling is associated with unusually porous, highly permeable borders between the personal and social self. These porous borders encourage people to channel their personal agency into group behavior, raising the possibility that the personal and social self will combine synergistically to motivate pro-group behavior. Furthermore, the strong personal as well as social identities possessed by highly fused persons cause them to recognize other group members not merely as members of the group but also as unique individuals, prompting the development of strong relational as well as collective ties within the group. In "local fusion", people develop relational ties to members of relatively small groups (e.g., families or work teams) with whom they have personal relationships. In "extended fusion", people project relational ties onto relatively large collectives composed of many individuals with whom they may have no personal relationships. The research literature indicates that measures of fusion are exceptionally strong predictors of extreme pro-group behavior. Moreover, fusion effects are amplified by augmenting individual agency, either directly (by increasing physiological arousal) or indirectly (by activating personal or social identities). The effects of fusion on pro-group actions are mediated by perceptions of arousal and invulnerability. Possible causes of identity fusion--ranging from relatively distal, evolutionary, and cultural influences to more proximal, contextual influences--are discussed. Finally, implications and future directions are considered. (Contains 6 footnotes and 2 figures.)

The Sidney Heitman Germans from Russia Collection at the Colorado State University Libraries is named in honor of the late Dr. Heitman's years of research and teaching about Colorado's second largest ethnic group. Created to support his Germans from Russia in Colorado Study Project, active at the university in the late 1970s, the collection's centerpiece is the oral histories generated by the project. This article provides information on the collection and describes a digital project supported by an Institute of Museum and Library Services (IMLS) grant through the Colorado Digitization Project (CDP) to make a selection of the oral histories, transcripts, photos, project documentation, and the finding aid available online to researchers. In addition to providing access to more than 1,500 digital objects, project staff developed important metadata for their discovery, retrieval, and management using the "Western States Dublin Core Metadata Best Practices" and Encoded Archival Description (EAD). (Contains 6 figures and 20 notes.)

• Proportion of beech affects beta diversity more than alpha diversity. • The effect of proportion of beech on diversity is taxa dependent. • Availability of light, humus layer and microhabitats are affecting diversity. • Forest conversion leads to diverse communities and prevents species homogenization. The conversion from pure coniferous stands to mixed forests is a major goal of forest management strategies in the light of climate change. However, the effects of forest conversion on the associated species diversity and the factors driving diversity changes remain poorly understood. To investigate these effects, we established 54 plots in a managed forest in southern Germany, where large areas have been converted from pure spruce to mixed spruce-beech stands since the middle of the 20th century. Our sampling plots consisted of three different age classes and increasing proportions of beech, measured by the number of stems. We sampled fungi, plants, invertebrates, and birds and combined classical methods (identification by specialists) and metabarcoding for species identification. Furthermore, important forest structure and site parameters were recorded to test their influence on species alpha and beta diversity. Alpha diversity of embryophytes, and therein tracheophytes, increased with increasing availability of light, whereas fungi decreased. With increasing humus thickness alpha diversity of insects, especially dipterans and hymenopterans increased, whereas embryophytes, tracheophytes and fungi decreased. Increasing numbers of habitat trees increased the alpha diversity overall, especially in tracheophytes and hymenopterans. The proportion of beech determined the alpha diversity of one out of 12 taxa and influenced the beta diversity of 10 from 12 taxa. However, factors influencing the diversity are taxa dependent. Our study indicates that the proportion of beech had less impact on alpha diversity but impacts beta diversity. Changes in forest structures and environmental conditions occurring during forest conversion are as important as the introduction of beech for alpha and beta diversity. [ABSTRACT FROM AUTHOR]

Cognitive ability plays a prominent role among individual characteristics favorable for success in life. The extent to which endowments for cognitive ability can be realized is an important aspect of unequal life chances in a society. Social origin is considered particularly relevant for realizing cognitive genetic potentials, but related empirical findings are mixed. This paper examines whether there are differences in the interactions between genetic variation and social origin across distinct parental resources and whether the patterns of interactions are (non)linear for three different cohorts of twins (late childhood, adolescents, young adults). Our results showed inconsistent interaction patterns across cohorts and parental resources. A pattern following the Scarr-Rowe Interaction (SRI) was observed only for the younger twins (late childhood) and only for parental occupational status. There were (for the most) no interaction patterns for the adolescent twins. For the young adult twins, patterns partly followed a "reverse" SRI. Taken together, the results suggested that, first of all, parental occupational status and household income moderate either genetic or environmental contributions to cognitive ability in Germany, however, not consistently as a Scarr-Rowe interaction. Using composite measures would have obscured these differential effects of social origin. The interaction patterns are mostly not in line with an SRI but can be approximated using a linear approach in many cases. • In most cases, results do not align with a Scarr-Rowe Interaction (SRI). • Occupational status influenced genetic contributions to cognitive ability. • Household income affected the contribution of shared environments. • Interaction patterns were more often linear than with marked thresholds. • For adolescent twins, a "reversed" SRI was partly observed. [ABSTRACT FROM AUTHOR]

The followup study of approximately 150 adolescent rural German learning disabled girls, who left before completing a special vocational training course, yielded findings such as that few school leavers obtained jobs or training, and that vocational interest and motivation were above average but mitigated by a tendency to quick resignation. (Author/MC)

This paper uses a twin-based approach to examine the extent to which institutional differences in school systems that relate to tracking across German states moderate the role of genes and environment in explaining children's attendance at upper secondary school. The results show moderation effects for two of the three indicators included: teacher recommendations and rigidness of tracking. Contrary to expectations, binding recommendations do not reduce the relevance of environmental influences. Similarly, differences in the timing of tracking do not lead to changes in the relevance of genetic and environmental influences on track attendance. Overall, the results provide little evidence that any of the tracking systems distinguished here for Germany offer significant advantages over others when it comes to providing students with better opportunities to reach their full potential. However, this is true only for the indicators considered here. [ABSTRACT FROM AUTHOR]

As transport is one of the big sources of carbon dioxide emissions, it is natural to seek for solutions reducing the carbon dioxide emissions in transport as well. Replacing cars powered by a combustion engine by battery electric vehicles may be one measure to achieve this goal, at least as long as the electricity consumed by these cars is produced carbon neutral or in a low-carbon manner. In Germany, the Federal Government aims at a stock of one million electric vehicles in the year 2020. This goal is very ambitious, since customers are reluctant to buy battery electric cars, probably most of all due to their limited range. A possible solution to the limited range problem is the use of Plug-in Hybrid Electric Vehicles or Extended Range Electric Vehicles (EREV), combining an electric battery with a combustion engine or a generator. These solutions overcome the range limitations while at the same time allowing driving on electric power for the majority of the total mileage. In this paper, we analyse the effects of an increased use of EREVs and battery electric vehicles using the travel demand model mobiTopp. For three scenarios with different rates of market penetration of electric vehicles, the travel demand and car usage is simulated over a simulation period of one week. The results show, that for 65 up to 70 percent of the mileage, EREVs can be driven in battery-only mode, demonstrating the usefulness of the EREV concept and indicating a substantial potential for the reduction of carbon dioxide emissions. The results, however, also show that with an uncontrolled charging strategy, i. e. every car recharges immediately after accessing a charging location, the peaks of electricity demand for charging the electric cars occurs when the general electricity demand is already high. During these periods, additional electricity demand is typically covered by gas-fuelled power plants, thus using fossil fuels. Therefore, the concept of introducing electric vehicles in order to reduce total carbon dioxide emissions can only succeed if combined with intelligent charging strategies. [ABSTRACT FROM AUTHOR]

The Pirate Party organisations in North Rhine-Westphalia and in Berlin use the Internet to implement intraparty Liquid Democracy. Their aim is to give as many party members as possible the opportunity to participate in the party's decision making processes. At the same time they want to tie decisions of the regional executive board and the regional parliamentary party to the political intent of the party base. LiquidFeedback is the key digital tool to achieve these goals. A selected number of case studies reveals, however, a rather great discrepancy between ambition and reality. Despite the rather low thresholds of digital participation fewer party members participate in intraparty decision making by way of the Internet than by party conventions. Furthermore, decisions made by way of digital participation within the Pirate Party have little, if not to say no influence on the final decisions taken by the executive board or the parliamentary party in the state legislatures. Against this background the claim of the Pirate Party to represent a new model of intraparty participation by using the tools of LiquidFeedback must be questioned. [ABSTRACT FROM AUTHOR]

Highlights: [•] German EEG increases biomass production with negative impacts on ecosystem services. [•] Steering effects of many legal instruments are too weak to secure sustainability. [•] Privilege of agriculture and “good farming practices” set no safe minimum standards. [•] Sustainability and minimum standards need to be specified at the local level. [•] EEG extended by regional/spatial planning improves energy crop cultivation. [Copyright &y& Elsevier]

Abstract: This paper analyses the consequences and effects of management towards more naturalness and wilderness, using the case of the Müritz National Park as an example. Planned management actions for enhancing naturalness and providing space for wilderness are examined. The scenic qualities of the national park landscape are analysed in terms of the management objectives and with the appropriate tools. For open landscapes, we applied the Delphi survey method to forecast their appearances in 2020 and 2035. A forest growth simulator was used to describe the change in forest tree species composition over the coming decades, and well into the 22nd century. These forecasts are compared with the goals set in the National Park Plan. [Copyright &y& Elsevier]

In recent years, many countries have begun to develop national security strategies, employing innovative methods and applying institutional design. In Germany, the question whether an explicit security strategy is needed remains controversial. This article analyses the experiences of important partner countries in Europe and across the Atlantic in order to examine whether a set of best practices in the development of national security strategies can be identified. It concludes that a pattern of designing and implementing strategy has emerged in Europe and the US which could serve as a useful basis of information for experts and decision-makers in Germany, as they further explore the option of a national security strategy. [ABSTRACT FROM AUTHOR]

The paper aims at discussing the issue of governance in respect to creative scenes, a central structural element of the creative economy, exemplifying the case of Berlin. Berlin has a fast growing creative industry that has become the object of the city's development policies and place marketing. The core question is: What are the spatial-organizational driving forces of creativity in Berlin - can they be steered by public administration? I am using Berlin as a reference case to articulate the gap between 'state-led planning' on the one hand and the organisational practices of self-governed creative scenes on the other. I attempt to demonstrate why a perspective change in terms of re-scaling is necessary, in order to respond to the particular practices of emerging industries and their societal form 'scenes'. By re-scaling I mean the conceptualization of governance in different nonhierarchical organisational as well as spatial scales, based on the observation that scenes are considered to be a central element of the functionality of creative industries. [ABSTRACT FROM AUTHOR]

The article presents a profile of the life, education, and works of the stained glass painter Franz Pauli, from Cologne, Germany. The author discusses how his family background and the experience of being affected by traumatic events of World War II, influenced his work, which was concentrated mostly in church buildings in areas near Cologne. In particular the article discusses his work in the bishopric of the city of Hildesheim, including wall paintings, liturgical objects, and stained glass windows.

Abstract: A framework for landscape monitoring based on a functional approach is presented. Landscape monitoring is defined as regular, long-term surveillance of landscapes. Suitable monitoring resulting in the early recognition of crucial changes in the environment is a prerequisite if timely counteractions are to be carried out. Such monitoring provides spatially and temporally homogeneous data sets, and allows for adjustment to and validation of ecological models. The peculiarities of the framework presented are as follows. Landscape functions, and ecological conditions and processes are scrutinized from a strong human perspective. The procedure employs various methods based on models, balances, calculations and estimations. Thus, far-reaching data integration is possible, which allows for the drawing of conclusions which are important for human society. The landscape monitoring proposed also follows a differentiated scale-dependent approach (at local, sub-regional and regional levels) with a stepwise integration of data. Data sampling and analysis are organized according to a scale-dependent set of assumptions allowing a problem-oriented approach. The framework is exemplified by changes in soils in a small (16.1km2) floodplain in Saxony (Germany). The assessment proposed also takes into account historical data. Essential changes in soils have been established, e.g. losses in humus, deposition of soils by excavation matter and peat degradation. It was found that the percentage of arable land increased, and the groundwater level decreased in several areas. This finds expression in several physical and chemical parameters, e.g. in reduced field and sorption capacities. Therefore, the performances of soil protection functions and of production functions became worse. [Copyright &y& Elsevier]

Focuses on research activities undertaken by the German Institute for Polymers (DKI), a non-profit research institution. Areas in which the institute conducts research and development projects; Responsibilities of the institute's chemistry department; Association of DKI with the Technical University of Darmstadt in Germany.

Discusses the classification of landscape from a physico-geographical context in Saxony, Germany. Holistic regional planning; Suitability of natural landscape units for human activities; Holistic approach in landscape ecology.

Purpose: To evaluate the possible association between bladder tumor location and the laterality of positive lymph nodes (LN) in a prospectively collected multi-institutional radical cystectomy (RC) series., Methods: The study population included 148 node-positive bladder cancer (BC) patients undergoing RC and pelvic lymph node dissection in 2011 without neoadjuvant chemotherapy and without distant metastasis. Tumor location was classified as right, left or bilateral and compared to the laterality of positive pelvic LN. A logistic regression model was used to identify predictors of ipsilaterality of lymphatic spread. Using multivariate Cox regression analyses (median follow-up: 25 months), the effect of the laterality of positive LN on cancer-specific mortality (CSM) was estimated., Results: Overall, median 18.5 LN [interquartile range (IQR), 11-27] were removed and 3 LN (IQR 1-5) were positive. There was concordance of tumor location and laterality of positive LN in 82% [95% confidence interval (CI), 76-89]. Patients with unilateral tumors (n = 78) harbored exclusively ipsilateral positive LN in 67% (95% CI 56-77). No criteria were found to predict ipsilateral positive LN in patients with unilateral tumors. CSM after 3 years in patients with ipsilateral, contralateral, and bilateral LN metastasis was 41, 67, and 100%, respectively (p = 0.042). However, no significant effect of the laterality of positive pelvic LN on CSM could be confirmed in multivariate analyses., Conclusions: Our prospective cohort showed a concordance of tumor location and laterality of LN metastasis in BC at RC without any predictive criteria and without any influence on CSM. It is debatable, whether these findings may contribute to a more individualized patient management.

Aim: The outcome of patients with urothelial carcinoma of the bladder (UCB) after radical cystectomy (RC) shows remarkable variability. We evaluated the ability of artificial neural networks (ANN) to perform risk stratification in UCB patients based on common parameters available at the time of RC., Methods: Data from 2111 UCB patients that underwent RC in eight centers were analysed; the median follow-up was 30 months (IQR: 12-60). Age, gender, tumour stage and grade (TURB/RC), carcinoma in situ (TURB/RC), lymph node status, and lymphovascular invasion were used as input data for the ANN. Endpoints were tumour recurrence, cancer-specific mortality (CSM) and all-cause death (ACD). Additionally, the predictive accuracies (PA) of the ANNs were compared with the PA of Cox proportional hazards regression models., Results: The recurrence-, CSM-, and ACD- rates after 5 years were 36%, 33%, and 46%, respectively. The best ANN had 74%, 76% and 69% accuracy for tumour recurrence, CSM and ACD, respectively. Lymph node status was one of the most important factors for the network's decision. The PA of the ANNs for recurrence, CSM and ACD were improved by 1.6% (p = 0.247), 4.7% (p < 0.001) and 3.5% (p = 0.007), respectively, in comparison to the Cox models., Conclusions: ANN predicted tumour recurrence, CSM, and ACD in UCB patients after RC with reasonable accuracy. In this study, ANN significantly outperformed the Cox models regarding prediction of CSM and ACD using the same patients and variables. ANNs are a promising approach for individual risk stratification and may optimize individual treatment planning., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Background: The therapeutic gold standard of muscle-invasive tumour stages is radical cystectomy (RC), but there are still conflicting reports about associated morbidity and mortality and the oncologic benefit of RC in elderly patients. The aim of the present study was the comparison of overall (OS) and cancer-specific survival (CSS) in patients <75 and >75 years of age (median follow-up was 42 months)., Patients and Methods: Clinical and histopathological data of 2,483 patients with urothelial carcinoma and consecutive RC were collated. The study group was dichotomized by the age of 75 years at RC. Statistical analyses comprising an assessment of postoperative mortality within 90 days, OS and CSS were assessed. Multivariate logistic regression and survival analyses were performed., Results: The 402 patients (16.2%) with an age of ≥75 years at RC showed a significantly higher local tumour stage (pT3/4 and/or pN+) (58 vs 51%; p=0.01), higher tumour grade (73 vs 65%; p=0.003) and higher rates of upstaging in the RC specimen (55 vs 48%; p=0.032). Elderly patients received significantly less often adjuvant chemotherapy (8 vs 15%; p<0.001). The 90-day mortality was significantly higher in patients ≥75 years (6.2 vs 3.7%; p=0.026). When adjusted for different variables (gender, tumour stage, adjuvant chemotherapy, time period of RC), only in male patients and locally advanced tumour stages was an association with 90-day mortality noticed. The multivariate analysis showed that patients ≥75 years of age have a significantly worse OS (HR=1.42; p<0.001) and CSS (HR=1.27; p=0.018)., Conclusions: An age of ≥75 years at RC is associated with a worse outcome. Prospective analyses including an assessment of the role of comorbidity and possibly age-dependent tumour biology are warranted.

Background: Few and partially contradictory data are available regarding the prognostic signature of downstaging of muscle-invasive clinical tumour stages in patients treated with radical cystectomy., Materials and Methods: Clinicopathological parameters of 1,643 patients (study group, SG) treated with radical cystectomy due to muscle-invasive urothelial bladder cancer were summarized in a multi-institutional database. Patients of the SG fulfilled the following conditions: clinical tumour stage T2 N0 M0 and no administration of neoadjuvant radiation or chemotherapy. Cancer-specific survival (CSS) rates were calculated referring to pathological tumour stages in cystectomy specimens (pT2) (mean follow-up: 51 months). Furthermore, a multivariable model integrating clinical information was developed in order to predict the probability of downstaging., Results: A total of 173 patients (10.5%) of the SG presented with downstaging in pathological tumour stages (pT0: 4.8%, pTa: 0.4%, pTis: 1.3%, pT1: 4.1%); 12 of these patients had positive lymph nodes (7%, in comparison with 21% pN+ of pT2 tumours and 43% of >pT2 tumours). Patients with tumour stages pT2 had CSS rates after 5 years of 89, 69 and 46%, respectively (p<0.001). In a multivariable Cox model the presence of pathological downstaging resulted in a significant reduction of cancer-specific mortality (HR 0.30; 95% CI 0.18-0.50). By logistic regression analysis the date of TURB (benefit for more recent operations) was identified as the only independent predictor for downstaging of muscle-invasive clinical tumour stages. Age, gender, grading and associated Tis in the TURB did not reveal any significant influence., Conclusion: Patients with muscle-invasive clinical tumour stages and downstaging in cystectomy specimens represent a subgroup with significantly enhanced CSS rates. Further trials that integrate the parameters tumour size, stages cT2a vs cT2b and focality are required in order to define the independent prognostic signature of downstaging of tumour stages more precisely.

Introduction and Objectives: The purpose of this study was to examine the outcome of the "Mainz Pouch II" urinary diversion at two different centers (the Klinik und Poliklinik für Urologie, Bonn and the Ospedale "San Salvadore", Pesaro, Italy) in terms of different techniques of ureteral implantation., Materials and Methods: Between March 1995 and February 2003, the procedure was performed on 83 patients with 165 renal units (RU). Ureteral implantation with the Goodwin-Hohenfellner technique was performed in 57 RU, with the Abol-Enein modification in 23 RU and the Le-Duc procedure in 85 RU. Follow-up was available for 71 patients (85%) with a period of 1 to 82 months (mean 19.5 months, median 12 months). A non-validated questionnaire was used in the Bonn series to determine specific urinary diversion items., Results: Early complications occurred in 12%, three requiring surgical intervention. Two patients died within the first 30 days after initial surgery. Pyelonephritis occurred in 12 RU (14% of the patients, 8.5% of the RU). Ureteral stenosis requiring reimplantation was found in two RU. The continence rate was 100% during daytime in the Bonn series; all but one patient had to get up for urination at night. A total of 63% of the patients were able to distinguish between stool and urine., Conclusion: Mainz pouch II is a quick, safe and easy to perform urinary diversion which serves as a satisfying alternative to other forms of continent diversion. Follow-up shows a low complication rate with good results in terms of continence; however, long term results have to be evaluated. There are no significant differences in complication rates for the different ureteral implantation techniques.