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Children's ego-resilience (within-person capacities that facilitate psychological resistance) and irritability (increased proneness to experience negative affective states following environmental stressors) are critical determinants of their mental health. Here, we investigated how ego-resilience engages with irritability when linked to symptoms of anxiety and depression. We analyzed cross-sectional survey data from a combined clinical and nonclinical sample. Overall, 228 German children (M[subscript age] = 12.52, SD[subscript age] = 2.69; 41.7% female) reported on symptoms of depression/anxiety, ego-resilience, and irritability. Moderated hierarchical regression analyses showed that ego-resilience was negatively associated with symptoms of anxiety and depression and that irritability was positively related to heightened symptom levels. Ego-resilience and irritability had overall stronger associations with symptoms of depression than anxiety. Irritability moderated the association between ego-resilience and depression, such that the effects of ego-resilience were stronger among highly irritable children. We discuss our findings within environmental and biological sensitivity frameworks. Future research must substantiate our findings and determine whether sensitivity frameworks help better understand the potentially interrelated impact of ego-resilience with irritability on children's mental health.

Early childhood education [ECE] can foster the social-emotional adjustment and development of young refugee children. Still, the large numbers of newly arriving refugee families challenge the ECE capacities of host countries. In Germany, state authorities have subsidized flexible ECE programs for refugee children in response to this situation. The goal of this study was to examine the implementation and quality of these programs. In the first study phase, we categorized the seemingly heterogeneous ECE programs and assembled measures to assess their ECE quality. In the second study phase, we evaluated the ECE quality of a randomly selected sample of these ECE programs (N = 42) using standardized observation procedures. The ECE programs were implemented differently in temporary setups (caravans, tents), improvised settings (parish rooms, refugee accommodations), or education settings (preschools, elementary schools). To evaluate ECE quality, we created an observation tool for structural quality and coded dimensions from the Classroom Assessment Scoring System Pre-K for process quality. Overall, structural quality was acceptable but differed between implementation settings. Process quality was consistently high, independent of the settings. Our findings suggest that adaptive ECE programs under a flexible childcare policy could support young refugee children after they arrive in host countries. Still, such ECE programs do not compensate for center-based ECE services because of their more vigorous emphasis on children's social-emotional adjustment than pre-academic learning. Further research should consider adaptive assessment tools to assess ECE quality, taking into account heterogeneous program implementation strategies and the specific needs of refugee children.

Research Findings: We assessed socio-emotional behavior, nonverbal reasoning, German receptive language, and motor skills of refugee children attending early childhood development [ECD] programs and of those who did not (N = 207, mean age = 69.4 months). Young refugee children overall demonstrated lower levels of development and more socio-emotional behavior problems. Attendance of preschool-based ECD programs was inconsistently linked to better outcomes. Only moderate improvements in German receptive language skills could be supported across different methodological approaches. Although socio-emotional problems of refugee children attending ECD programs persisted on high levels, those children showed overall fewer problems when compared to non-attenders at the transition to first grade, especially less hyperactivity/inattention and more prosocial behavior. Practice or Policy: Our study supports that refugee experiences during early childhood are linked to lower developmental learning foundations. Specialized ECD programs for refugees can compensate a general shortage in regular ECD services in times of increased demands. Such programs thus increase the chances of refugee children to keep pace academically with their non-refugee peers. However, as specialized programs for refugee children establish a non-inclusive route in the early education sector of Germany, they still have to empirically prove quality and promoting effects on the children's ECD.

Deficits in phonological information processing in upper elementary students with specific learning disabilities in reading or spelling may increase, decrease, or remain stable over time. The authors examined the development of phonological processing longitudinally in 209 students (109 with learning disabilities and 100 typically achieving; n = 127 boys) in Germany, from grade 3 to grade 5 (ages 8-11; mean age at recruitment = 8 years 6.78 months, SD = 5.39 months). Latent change score models revealed that the development of rapid automatized naming was best described as a decreasing deficit, whereas a persistent deficit in phonological awareness was observed. Differences between students with and without learning disabilities regarding the phonological loop increased over time. Further, there were no developmental differences as a function of reading versus spelling deficits. Theoretical and practical implications are discussed.

Nudging is increasingly used in public health interventions in Western societies to produced health-promoting behavior changes; however, there is lack of clarity as to what constitutes a nudge, scant knowledge of the effectiveness of nudging techniques in public health lifestyle interventions and a number of ethical and value-based concerns. The aim of this review is to address these research lacunae and identify the characteristics of nudges in empirical research on public health interventions intended to induce healthy lifestyle changes, including whether they are effective. We conducted systematic searches for relevant articles published between January 2008 and April 2019 in three databases, PubMed, CINAHL and PsycINFO, and combined this with a metasynthesis to construct interpretative explanations. A total of 66 original studies met the inclusion criteria. The findings of the systematic review showed that most nudging interventions involved diet/nutrition, most were carried out as single experiments, and the majority had the intended effects. Specific nudging techniques were identified with respect to the broader nudging categories of accessibility, presentation, using messages and pictures, technology-supported information, financial incentives, affecting the senses, and cognitive loading; several studies included more than one nudging technique. Although many nudging techniques had the intended effects, it is unclear whether they would work outside the study setting. The synthesis revealed that the studies lacked critical reflection on the assumptions about health that were implicit in nudging interventions, the cultural acceptability of nudges, the context-free assumptions of nudging theory, and the implications of these aspects for the public health context.

In 2010 1.1 million pupils took private lessons in Germany, with 25% of all German children by the age of 17 having attended paid private lessons at some point in their school career (Klemm & Klemm, 2010). The high demand for support for learning curricular content led us to consider an integrated solution that speeds up both the design of mobile learning games as well as their implementation and adaption. This paper describes the iterative development of a game development framework for touch-based mobile learning games. The framework focuses on touch-controlled interaction due to the fact that in 2014 more than 87% of German teenagers possess a smart phone with touch input (Feierabend, Plankenhorn, Rathgeb, 2014) as well as the possibility to engage in short bursts of learning experiences during their idle time, e.g. when commuting. The framework consists of a conceptual component that specifies five different game modes for casual mobile learning games. The technical part of the framework builds on the Unity game engine and offers an architecture that mirrors the game modes and objects from the conceptual part as well as a layer of service building blocks that cover generic functionality like logging, high score management or social media integration. The development of the framework is iterative and cyclic in that each produced game enriches the framework, which in turn accelerates the prototyping and development of further games. Additionally the games themselves are developed and tested iteratively, both concerning usability/user-experience and transfer, which is described in this paper.

Purpose: We describe the natural auditory environment of people with cochlear implants (CIs), how it changes across the life span, and how it varies between individuals. Method: We performed a retrospective cross-sectional analysis of Cochlear Nucleus 6 CI sound-processor data logs. The logs were obtained from 1,501 people with CIs (ages 0-96 years). They covered over 2.4 million hr of implant use and indicated how much time the CI users had spent in various acoustical environments. We investigated exposure to spoken language, noise, music, and quiet, and analyzed variation between age groups, users, and countries. Results: CI users spent a substantial part of their daily life in noisy environments. As a consequence, most speech was presented in background noise. We found significant differences between age groups for all auditory scenes. Yet even within the same age group and country, variability between individuals was substantial. Conclusions: Regardless of their age, people with CIs face challenging acoustical environments in their daily life. Our results underline the importance of supporting them with assistive listening technology. Moreover, we found large differences between individuals' auditory diets that might contribute to differences in rehabilitation outcomes. Their causes and effects should be investigated further. From learning language in a noisy nursery to tea time at the retirement home, different stages of life are characterized by different environments. Each of these comes with particular learning tasks and social interactions. For 360 million people with hearing loss (World Health Organization, 2015), the environment also provides acoustical challenges that can jeopardize learning and social participation. This holds true for those who perceive sounds through a cochlear implant (CI).

The present study examines the association between various facets of generativity, that is, cultural demand for generativity, generative concern, and generative action, with the satisfaction of the needs for relatedness, competence, and autonomy in samples of elderly from Cameroon, China (Hong Kong), the Czech Republic, and Germany. Participants provided information on self-transcendence values (internalized cultural demand), generative concern and action, and need satisfaction. Results suggest, first, that internalized cultural demand affects generative action indirectly through generative concern, second, that generative concern has a positive direct effect on need satisfaction, but that, third, there is also an indirect effect of generative concern on need satisfaction through generative action, which, fourth, is positive for the needs for relatedness and competence but negative for the need for autonomy. These findings were culture-invariant in our study, suggesting generalizability to other cultures. They are discussed with respect to the role of values in generativity and a possible trade-off of generative action for the satisfaction of needs at least in the elderly.

Diagnosing student achievement in a formative way is a crucial skill for planning and carrying out effective mathematics lessons. This study takes a subject-specific view and aims at investigating diagnostic competence in the field of mathematical functions at secondary level and how to improve it. Following three evidence-based design principles, a Continuous Professional Development (CPD) unit has been designed for a statewide official in-service teacher program of the Ministry for Education in Baden-Württemberg, Germany. The workshops of this CPD unit are presented in this paper and were investigated in a first pilot study (N = 26). To this end, we qualitatively analyzed the participants' diagnostic competence before and after the training. We can report different diagnostic profiles of teachers that contain increased application of pedagogical content knowledge through the training in the field of functions. A number of teachers carried out increasingly profound diagnostic judgments after the training and shifted from a corrective to a descriptive or analytical view on student achievement. We furthermore report on steps to implement the unit on a statewide scale as part of a facilitators' training and adjustments of the training's content and methods based on our results of the pilot study.

Human behavior is directed by an implicit and an explicit motivational system. The intrinsic form of the implicit achievement motive has been demonstrated to predict the experience of flow. Thus, this achievement flow motive can be considered an integral component of the autotelic personality, posited in Flow Theory as dispositional difference in the propensity to experience flow. As implicit motivation predicts long-term behavioral trends and flow predicts quality of performance, the achievement flow motive should be predictive of a long-term goal pursuit such as educational attainment. This hypothesis is tested cross-culturally to shed some light on the universality of flow: Participants from Cameroon, Costa Rica, and Germany were asked about the level of education they attained. To assess their achievement flow motive, the Operant Motive Test was employed. After measurement equivalence was established, analyses revealed that, across all three cultures, the achievement flow motive explained variance in educational attainment independent of achievement values as measured by a scale of the Schwartz Value Survey. Consequently, as would be expected of an element of the autotelic personality, the achievement flow motive predicts long-term academic success.

In 2 separate studies, the idea is tested that the positive association between self-regulatory capacities and well-being is partly explained by the positive effect self-regulation has on the successful resolution of developmental crises in Eriksonian terms. In Study 1, attentional control, intimacy, and subjective well-being are assessed in 177 young adults. Results show that attentional control fosters intimacy, which in turn is beneficial to subjective well-being. Study 2 has a longitudinal design: Action control, generativity, purpose in life, and Machiavellianism are measured in 163 adults with an interval of 18 months between the 2 testing occasions. Action control is found to promote the development of generative concern, which in turn increases purpose in life. The latter association, however, is further qualified by Machiavellian attitudes. Results are discussed with respect to the role of self-regulation in development and to belief in the species, which Erikson postulated to be active in the development of generativity. (Contains 1 figure, 5 tables, and 1 footnote.)

Little is known about whether ego identity statuses have the same developmental concomitants in different cultural contexts. Thus, 159 German and 158 Cameroonian Nso adolescents aged 15-18 were recruited to test if associations between identity and generativity (i.e. the desire to create a positive legacy) and prosocial behavior (i.e. helpful and supportive behavior), respectively, are comparable. In both cultural samples, only identity achievement was positively linked with generative concern and prosocial tendencies. Integrating these and previous findings on the association between prosocial behavior and generativity, a partial mediation of the relation between identity achievement and generative concern through prosocial tendencies was hypothesized and confirmed for both cultural groups. Thus, there is an equivalent association between identity achievement, prosocial behavior, and generative concern in adolescents with widely different cultural background. (Contains 4 tables.)

This article presents an analysis of a short customer-vendor dialogue between a German couple and a Polish vendor at a food bazaar on the Polish border with Germany. In this situation, interactants have to negotiate and construct framings of hospitality abroad, customer-vendor relations, as well as intercultural relations. It is assumed that individuals hold their own subjective concepts of these three variables. Using tools from ethnomethodology's membership categorization analysis, this paper will delineate aspects of this constructionist process in which participants make use of concurrent and alternative framings to steer the interaction to a positive end for themselves. (Contains 1 figure.)

While previous research discussed populism as a phenomenon of declining trust, we investigated the predictive value of populist attitudes for citizens’ trust, attitudes, and behaviors during the COVID-19 pandemic. Moreover, we tested the role of trust in several institutions simultaneously. As preregistered, the cross-sectional (N = 1,090) and longitudinal (n = 216) data collected (April to June, 2020) in Germany (n = 617) and Poland (n = 473) showed that stronger populist attitudes predicted higher trust in (a) alternative news media but less trust in (b) mainstream news media, (c) political institutions, and (d) scientific institutions. Moreover, we found negative effects of populist attitudes on acceptance and compliance, mediated via trust in political and scientific institutions (but not news media). [ABSTRACT FROM AUTHOR]

• First longitudinal data analyses on sports activity patterns and health. • Long-standing sports activity engagement improves cardio-metabolic health. • Starting regular sports activity reduces cardio-metabolic risk factor occurrence. • Relapse from regular sports activity increases cardio-metabolic disease incidence. Physical activity is favorable for health, and vigorous sports activity is particularly beneficial. This study investigates the association between changes in sports participation patterns over time and cardio-metabolic and self-perceived health outcomes. Data from 3752 adults (18–79 years of age) who participated in 2 national health interview and examination surveys in 1997–1999 and 2008–2011 were included, with a mean follow-up time of about 12 years. A change in self-reported sports activity was analyzed with respect to the incidence of type 2 diabetes, coronary heart disease (CHD), hypertension, obesity, dyslipidemia, metabolic syndrome, and poor self-perceived health. Participants with pre-existing disease or risk factor of interest at baseline were excluded from the analysis. Being sufficiently active in sports was specified as doing sports for at least 1–2 h per week, and 4 activity categories were defined: 1) inactive at both time points (inactive–inactive), 2) inactive at baseline and active at follow-up (inactive–active), 3) active at baseline and inactive at follow-up (active–inactive), and 4) active at both time points (active–active). Associations between sports activity engagement and health outcomes were estimated by logistic regression models with different stages of adjustments. Not engaging in any regular sports activity at both time points (inactive–inactive) was associated with higher rates of type 2 diabetes (odds ratio (OR) = 1.82, 95% confidence interval (95%CI): 1.08–3.08), CHD (OR = 1.82, 95%CI: 1.16–2.84), hypertension (OR = 1.36, 95%CI: 1.03–1.81), metabolic syndrome (OR = 1.58, 95%CI: 1.08–2.32), and poor self-perceived health (OR = 2.54, 95%CI: 1.83–3.53) compared to doing regular sports for a minimum of 1–2 h per week over time (active–active). In case of change from inactivity to any regular sports activity (inactive–active), the rate of risk factor occurrence was not statistically different from the active–active reference group except for poor self-perceived health, but it was higher for type 2 diabetes (OR = 2.15, 95%CI: 1.12–4.14) and CHD (OR = 1.77, 95%CI: 1.03–3.03). Being active at baseline but inactive at follow-up (active–inactive) was not associated with higher disease incidence of type 2 diabetes (OR = 0.70, 95%CI: 0.25–1.97) or CHD (OR = 1.20, 95%CI: 0.49–2.99), but was associated with higher rates of hypertension (OR = 1.61, 95%CI: 1.11–2.34), obesity (OR = 2.34, 95%CI: 1.53–3.57), metabolic syndrome (OR = 1.70, 95%CI: 1.11–2.63), and poor self-perceived health (OR = 2.16, 95%CI: 1.53–3.07) at follow-up. Even a low weekly quantity (1–2 h) of regular sports activity is partly associated with health benefits. Being formerly but not currently active was not associated with an increased disease incidence, but was associated with a higher risk-factor development compared to the reference group (active–active). Becoming active was preventive for risk-factor development but was not preventive for disease incidence, which probably means that the health benefits from sports activity are not sustainable and disease incidence is only shifted to a later period in life. For this reason, the promotion of and commitment to regular sports activity should be addressed as early as possible over the lifespan to achieve the best health benefits. [Display omitted] [ABSTRACT FROM AUTHOR]

Klebsiella (K.) pneumoniae is a ubiquitous Gram-negative bacterium and a common coloniser of animals and humans. Today, K. pneumoniae is one of the most persistent nosocomial pathogens worldwide and poses a severe threat/burden to public health by causing urinary tract infections, pneumonia and bloodstream infections. Infections mainly affect immunocompromised individuals and hospitalised patients. In recent years, a new type of K. pneumoniae has emerged associated with community-acquired infections such as pyogenic liver abscess in otherwise healthy individuals and is therefore termed hypervirulent K. pneumoniae (hv Kp). The aim of this study was the characterisation of K. pneumoniae isolates with properties of hypervirulence from Germany. A set of 62 potentially hypervirulent K. pneumoniae isolates from human patients was compiled. Inclusion criteria were the presence of at least one determinant that has been previously associated with hypervirulence: (I) clinical manifestation, (II) a positive string test as a marker for hypermucoviscosity, and (III) presence of virulence associated genes rmpA and/or rmpA2 and/or magA. Phenotypic characterisation of the isolates included antimicrobial resistance testing by broth microdilution. Whole genome sequencing (WGS) was performed using Illumina® MiSeq/NextSeq to investigate the genetic repertoire such as multi-locus sequence types (ST), capsule types (K), further virulence associated genes and resistance genes of the collected isolates. For selected isolates long-read sequencing was applied and plasmid sequences with resistance and virulence determinants were compared. WGS analyses confirmed presence of several signature genes for hv Kp. Among them, the most prevalent were the siderophore loci iuc and ybt and the capsule regulator genes rmpA and rmpA2. The most dominant ST among the hv Kp isolates were ST395 capsule type K2 and ST395 capsule type K5; both have been described previously and were confirmed by our data as multidrug-resistant (MDR) isolates. ST23 capsule type K1 was the second most abundant ST in this study; this ST has been described as commonly associated with hypervirulence. In general, resistance to beta-lactams caused by the production of extended-spectrum beta-lactamases (ESBL) and carbapenemases was observed frequently in our isolates, confirming the threatening rise of MDR-hv Kp strains. Our study results show that K. pneumoniae strains that carry several determinants of hypervirulence are present for many years in Germany. The detection of carbapenemase genes and hypervirulence associated genes on the same plasmid is highly problematic and requires intensified screening and molecular surveillance. However, the non-uniform definition of hv Kp complicates their detection. Testing for hypermucoviscosity alone is not specific enough to identify hv Kp. Thus, we suggest that the classification of hv Kp should be applied to isolates that not only fulfil phenotypical criteria (severe clinical manifestations, hypermucoviscosity) but also (I) the presence of at least two virulence loci e.g. iuc and ybt , and (II) the presence of rmpA and/or rmpA2. [ABSTRACT FROM AUTHOR]

The article discusses an article focused on court-to-court communication in cross-border insolvencies, which has been reprinted from an article published in German in the journal "Neue Zeitschrift für Insolvenzrecht." Topics discussed include how insolvency systems of Canada and the U.S. differ from that of Germany, approaches taken by civil law and common law jurisdictions regarding court-to-court communications, and limited jurisdiction of locals courts in criminal and civil proceedings.

The article examines ideological problems and contradictions of economic policy in the German Democratic Republic. The author compares practical politics in this field with theoretical statements and proposals regarding subject made by German Communist philosopher Karl Marx and subsequent Marxist theorists. Topics discussed include the relationship between socialism and communism, state ownership of industry and business enterprises, and Stalinist conceptions of the laws of economics and central economic planning.

Abstract: Legal requirements in context of the EU Marine Strategy Framework Directive require increased trans-national cooperation on environmental effects induced by marine uses to achieve Good Environmental Status by 2020. Interactions between offshore wind farms and seabirds represent a valuable example of how a changed spatial perspective might influence the assessment of environmental impacts. This paper addresses the potential consequences of offshore wind farm development at the North Sea scale on selected seabird species with high relevance in context of national approval procedures. It provides a new methodology to estimate the cumulative habitat loss due to ongoing and planned offshore wind farm construction activities within the North Sea''s exclusive economic zones of Germany, the Netherlands, Belgium and the United Kingdom. In addition to providing information on the seasonal distribution of important species and initial estimates of potential seabird habitat exclusion due to offshore wind farming, this study highlights the need for increased trans-national cooperation among riparian states and harmonization of conservation approaches to successfully implement the Marine Strategy Framework Directive. [Copyright &y& Elsevier]

Building on a recent study by Schultheiss, Liening, and Schad (2008), we examined the internal consistency, retest reliability, sample-level profile stability, and ipsative stability of a Picture Story Exercise (PSE) measure for implicit achievement, affiliation, and power motive. While Schultheiss et al. (2008) examined these indices by administering eight picture cues to students with 2 weeks between assessment occasions, in the present study adult samples from Germany (n = 129) and Cameroon (n = 122) provided data on five picture cues at two assessment times 18 months apart. Despite these differences, reliability indices are comparable to those presented by Schultheiss and colleagues: Internal consistency is low, but retest reliability and ipsative stability are in the expected range. The reliability of the PSE is also discussed and compared to the refiability of self-report and other non-self-report measures. [ABSTRACT FROM AUTHOR]

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The article develops from a talk Die Orgeln der Väter: Erbe oder Last? given by organ expert Hemann J. Busch the 4 February 2010 conference of organists, organ-builders, and organ experts in Meißen, Germany, about the situation of organ-builders in Germany, especially in Saxony. In particular, it discusses the predominance of organs built during the post-World War II period across Germany, and the peculiarities of the situation in Saxony specifically.

The article discusses the awarding of German composer Hans Erich Pfitzner with the Goethe-Prize of the city of Frankfurt, Germany in 1934 and his alleged role in the National Socialist (Nazi) regime. Other topics discussed were the role of Pfitzner´s opera "Palestrina" in the eye of Nazi music and ideology, Pfitzner´s alleged relationships with high Nazi officials such as Alfred Rosenberg, and the overall role of Pfitzner in the Nazi cultural policy.

The article discusses the German currency union that officially occurred on July 1, 1990, and which created a common credit, currency, money, and coinage system for reunified Germany. The author analyzes the action's impact on German monetary policy, as well as the political and economic preconditions for and consequences of the switchover from the East German mark to the Federal Republic's Deutschmark. The currency move is seen as an irreversible symbol of German political unity and the start of the fulfillment of the East Germans' longing for West German living standards. Impacts on both German regions are reviewed.

Abstract: The Münster Cretaceous Basin is a synclinal structure containing Upper Cretaceous sediments of local thickness exceeding 1700m, partially covered by Cenozoic deposits. The underlying basement consists of deep Carboniferous strata with interbedded hard coal seams. The Cretaceous sequence can be subdivided into the Cenomanian–Turonian-Complex, representing a brine aquifer, and the overlying ‘Emscher Mergel’ (clayey marl), separating the brine from shallow freshwater aquifers. This geological setting potentially offers favourable conditions for geological storage of CO2 by physical sorption in the coal seams below the ‘Emscher Mergel’ cap rock formation. This storage option could be combined with the production of coalbed methane (CBM), by means of application of a CO2-enhanced coalbed methane (ECBM) strategy. A potential storage area of 820km2 has been identified by considering local geological, hydrogeological and tectonic settings. This regional study was complemented by the analysis of carbon isotope signatures of CH4 and CO2 in shallow aquifers and concentration profiles of methane-in-place. Using the Coal Inventory Calculation Model (KVB-model) of the Geological Survey (GD) of North Rhine-Westphalia, Germany, coal volumes within the study area have been estimated to amount to 37.5×109 metric tons. High-pressure CO2 sorption isotherms measured on a selected coal sample at different temperatures were used to estimate the sorptive storage capacity of this coal at the pressure and temperature conditions in the seams. Assuming an accessibility of 40% of the total coal as well as a methane-in-place recovery efficiency of 80%, a maximum CO2 storage potential of 160million metric tons of CO2 was estimated for the coal seams down to a depth of 3000m. However, the application of ECBM is restricted due to the low permeabilities and large depth of the coal deposits. [Copyright &y& Elsevier]

The reception of Borges in the Federal Republic of Germany began unusually late and was slow to gather momentum. It commenced only in 1959 with the first German translation of a selection of short stories. The article discusses reasons for this delay and chronicles the increasing selection of Borges' work made available in German. [ABSTRACT FROM AUTHOR]

Abstract: The dietary intake of arsenic, selenium and mercury was studied for children living on the North Sea island Amrum, Germany. Altogether, 98 duplicate portions were collected from 14 children (age 1.5–5.5 years) in April and May 1995 over a sampling period of 7 days, respectively. The element concentrations in duplicate samples were measured by atomic absorption spectrometry. The weekly As and Hg intake (median and range) was 2.31 and 0.89–6.75 μg/(kgbw · week) for As and 0.13 and 0.060–0.62 μg/(kgbw · week) for Hg. Compared with the provisional tolerable weekly intake (PTWI) for As and Hg as proposed by the WHO, German children from coastal areas reveal no health risks due to As and Hg dietary intake. The daily Se intake (median and range) was 19 and 6–160 μg/day. The appropriate Se intake of 10–40 μg/day, as recommended by the Austrian, German, and Swiss Nutrition Councils for 1–4 years-old children, was not reached in 8 out of 49 cases (16.3%), whereas the recommended Se intake, fixed at 15–45 μg/day for the 4–7 years-old children, was not reached in 15 out of 48 cases (31.3%). [Copyright &y& Elsevier]

The article offers a report from the 2012 Frankfurter Buchmesse book fair in Frankfurt, Germany. The author discusses the study of library science and information science in response to the introduction of the bachelor degree into the German university system, the social and educational roles of libraries, and the impact of the internet and technology on library science.

Background: Patients with peritoneal metastases of gastric cancer have a poor prognosis with a median survival of 7 months. A benefit of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) could be shown in several selected patient cohorts but remains controversial. The aim of this study was, to reflect the results of a national German HIPEC registry initiated by the German Society of General and Visceral Surgery (DGAV)., Methods: The DGAV HIPEC registry StuDoQ|Peritoneum documents patients with peritoneal malignancy contributed from 52 hospitals. All consecutive documented patients from 2011 until 2016 (n = 3078) were treated with CRS and HIPEC and were analysed. A total of 315 (10%) suffered from gastric cancer and were analysed., Results: A complete data set of 235 patients was available for this study, including 113 male (48.1%) and 122 female (51.9%) patients with a median age of 53.4 years (SD ± 11.9). The median PCI was 8.0 (range 1-30). A complete cytoreduction was achieved in 121 patients (71.6%). Postoperative complications (Clavien-Dindo grades 3-4) occurred in 40 patients (17%). The median overall survival (OS) time was 13 months. The 5-year survival rate was 6%. According to the PCI from 0-6 (n = 74); 7-15 (n  = 70) and 16-39 (n = 24) the median OS differs significantly (18 months vs. 12 months vs. 5 months; p = 0.002)., Conclusions: CRS and HIPEC in selected patients with gastric cancer and peritoneal spread can improve survival when they are treated in centers. An accurate staging and patient selection are of major importance to achieve long-term survival.

Laparoscopic pancreatic surgery is not common practice in Germany and is only carried out in approximately 20 clinics but with an increasing trend. The reasons for this are manifold, such as the current selection of patients and both skills in laparoscopic and pancreatic surgery are necessary to perform this operation safely. In 2008 a registry called "Laparoscopic pancreatic surgery" was implemented to collect enough data in Germany to find out whether the resection is safe, feasible and beneficial for the patient.For further development of new laparoscopic techniques new data is needed. A group of experts performing laparoscopic pancreatic surgery in Germany supplied their data for the German registry for laparoscopic pancreatic resection and a consensus conference about the indications became necessary. This consensus conference discussed in particular the indications for laparoscopic pancreatic resection. A consensus was found by all members of the conference utilizing currently available evidence-based data.It was suggested that all data of laparoscopic pancreatic surgery should be evaluated in the German Registry. A consensus was made which diseases were either suitable for laparoscopic resection or not suitable or suitable in selected cases.

Background & Aims: Tailored organ-sparing procedures have been shown to alleviate pain and are potentially superior in terms of preservation of endocrine and exocrine function as compared with standard resection (Whipple) for chronic pancreatitis with inflammatory pancreatic head tumor. Long-term results comparing these 2 procedures have not been published so far. The aim of this study was to report on long-term results of a randomized trial comparing a classical resective procedure (pylorus-preserving Whipple) with an extended drainage procedure (Frey) for chronic pancreatitis., Methods: All patients who participated in a previously published randomized trial on the perioperative course comparing both procedures were contacted with a standardized, validated, quality of life and pain questionnaire. Additionally, patients were seen in the outpatient clinic to assess endocrine and exocrine pancreatic function by an oral glucose tolerance test and fecal chymotrypsin test., Results: There were no differences between both groups regarding quality of life, pain control, or other somatic parameters after a median of 7 years postoperatively. Correlations among continuous alcohol consumption, endocrine or exocrine pancreatic function, and pain were not found., Conclusions: Both procedures provide adequate pain relief and quality of life after long-term follow-up with no differences regarding exocrine and endocrine function. However, short-term results favor the organ-sparing procedure.

Objective: To give an up-to-date profile of nephropathy and the involvement of risk factors in a large, prospective cohort of patients with type 1 diabetes and largely pediatric and adolescent onset of disease., Research Design and Methods: A total of 27,805 patients from the nationwide, prospective German Diabetes Documentation System survey were included in the present analysis. Inclusion criteria were at least two documented urine analyses with identical classification. Urine analyses, treatment regimens, diabetes complications, and risk factors were recorded prospectively. Baseline characteristics were age at diagnosis 9.94 years (median [interquartile range 5.8-14.3]), age at last visit 16.34 years (12.5-22.2), and follow-up time 2.5 years (0.43-5.3). Cumulative incidence of nephropathy was tested by Kaplan-Meier analysis and association with risk factors by logistic regression., Results: Nephropathy was classified as normal in 26,605, microalbuminuric in 919, macroalbuminuric in 78, and end-stage renal disease (ESRD) in 203 patients. After calculated diabetes duration of 40 years, 25.4% (95% CI 22.3-28.3) had microalbuminuria and 9.4% (8.3-11.4) had macroalbuminuria or ESRD. Risk factors for microalbuminuria were diabetes duration (odds ratio 1.033, P < 0.0001), A1C (1.13, P < 0.0001), LDL cholesterol (1.003, P < 0.0074), and blood pressure (1.008, P < 0.0074), while childhood diabetes onset (1.011, P < 0.0001) was protective. Male sex was associated with the development of macroalbuminuria., Conclusions: Diabetes duration, A1C, dyslipidemia, blood pressure, and male sex were identified as risk factors for nephropathy. Therefore, besides the best possible metabolic control, early diagnosis and prompt treatment of dyslipidemia and hypertension is mandatory in patients with type 1 diabetes.

Blood glucose measurements are generally accepted components of a modern diabetes self-management. The value of self-monitoring of blood glucose (SMBG) is, however, discussed controversially and only a few studies addressed the efficacy of SMBG under real-life conditions so far. In order to investigate whether the frequency of SMBG is related to long-term metabolic control, data from the DPV-Wiss-database, a standardized,prospective, computer-based documentation of diabetes care and outcome, were analyzed for patients with type 1(n = 19,491) and type 2 (n = 5,009) diabetes from 191 centers in Germany and Austria. Local HbA1c reference ranges were mathematically adjusted to the DCCT reference. For each patient, data from the most recent year of diabetes care were used. On average,patients with type 1 diabetes performed 4.4 blood glucose measurements/day. Corrected for age, gender, diabetes duration,on intensified (>or=4 daily injections or CSII) therapy (HbA1c reduction of 0.32% for one additional SMBG/day) compared to patients on conventional (1-3 daily injections) therapy(HbA1c-reduction of 0.16% for one additional SMBG/day). In 2,021 patients with insulin-treated type 2 diabetes (2.7 measurements/day), more frequent SMBG was associated with better metabolic control (HbA1c-reduction of 0.16% for one additionalSMBG/day, p < 0.0001), while in 2,988 patients on OAD or diet alone (2.0 measurements/day), more frequent blood glucose measurements were associated with higher HbA1c-levels(HbA1c-increase of 0.14% for one additional SMBG/day,p < 0.0001). These data indicate that more frequent SMBG are associated with better metabolic control in both, patients with type 1 and insulin-treated type 2 diabetes. Since no benefit ofSMBG on metabolic control was found in patients with type 2 diabetes on OAD or diet alone, SMBG should primarily be recommended for those patients with suboptimal metabolic control whereas the benefit of SHBG in non-insulin-treated patients with adequate HbA1c-levels remains uncertain.insulin therapy and center difference, the SMBG frequency was associated with better metabolic control (HbA1c-reduction of0.26% for one additional SMBG/day, p < 0.0001). HbA1c-reduction with higher frequency of SMBG was more pronounced in patients Blood glucose measurements are generally accepted components of a modern diabetes self-management. The value of self-monitoring of blood glucose (SMBG) is, however, discussed controversially and only a few studies addressed the efficacy of SMBG under real-life conditions so far. In order to investigate whether the frequency of SMBG is related to long-term metabolic control, data from the DPV-Wiss-database, a standardized,prospective, computer-based documentation of diabetes care and outcome, were analyzed for patients with type 1(n = 19,491) and type 2 (n = 5,009) diabetes from 191 centers in Germany and Austria. Local HbA1c reference ranges were mathematically adjusted to the DCCT reference. For each patient, data from the most recent year of diabetes care were used. On average,patients with type 1 diabetes performed 4.4 blood glucose measurements/day. Corrected for age, gender, diabetes duration,insulin therapy and center difference, the SMBG frequency wasassociated with better metabolic control (HbA1c-reduction of 0.26% for one additional SMBG/day, p < 0.0001). HbA1c-reduction with higher frequency of SMBG was more pronounced in patients on intensified (>or= 4 daily injections or CSII) therapy (HbA1c reduction of 0.32% for one additional SMBG/day) compared to patients on conventional (1-3 daily injections) therapy(HbA1c-reduction of 0.16% for one additional SMBG/day). In 2,021 patients with insulin-treated type 2 diabetes (2.7 measurements/day), more frequent SMBG was associated with better metabolic control (HbA1c-reduction of 0.16% for one additionalSMBG/day, p < 0.0001), while in 2,988 patients on OAD or diet alone (2.0 measurements/day), more frequent blood glucose measurements were associated with higher HbA1c-levels(HbA1c-increase of 0.14% for one additional SMBG/day, p < 0.0001). These data indicate that more frequent SMBG are associated with better metabolic control in both, patients with type 1 and insulin-treated type 2 diabetes. Since no benefit of SMBG on metabolic control was found in patients with type 2 diabetes on OAD or diet alone, SMBG should primarily be recommended for those patients with suboptimal metabolic control whereas the benefit of SHBG in non-insulin-treated patients with adequate HbA1c-levels remains uncertain.