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The article proposes a remodeling of Tertiary Language Didactics (TLD) against the backdrop of empirical findings from German-speaking areas and the notions of translanguaging and "compétence plurilingue." TLD as a multilingual didactics approach for the initial stages of L3 learning developed in the 1990s in the field of "German as a foreign language after English" ("DaFnE") as a response to the specificity of L3 learning conditions (age, intellectual development, different domains of prior knowledge in other languages). Later, the approach, with its overarching principle of cognitive learning and teaching, was generalized to other language constellations (Hufeisen & Neuner, 2003; Neuner et al., 2009). By reviewing selected studies from the 1980s up to 2021, our remodeling highlights the importance of transfer not only in L3 reception, but also in L3 production and practice. In order to economize L3 learning, TLD 2.0 proposes to focus on cognates in reception and production (perceived and assumed cross-linguistic similarities) and streamlined grammar teaching (deduction-practice combinations, parallel exercises). Informed by the discourses of translanguaging and "compétence plurilingue," we also discuss the role of less "visible" knowledge stores that bi- or plurilingual L3 learners may have and the possibility of activating skills in previously learned or acquired languages (two-language tasks) in pursuit of education goals beyond L3 learning.

Learning processes that involve cognitive incongruity are closely tied to emotional experiences such as curiosity or confusion. The present study examined how discovering that a confidently held misconception is incorrect influences emotions and in turn the motivation to seek additional information. We asked 275 preservice teachers to judge if common statements about education were true or false and provided feedback about whether these statements were supported by scientific evidence. Following feedback, we assessed study participants' real-time (i.e., state level) epistemic emotions (surprise, curiosity, enjoyment, confusion, frustration, anxiety) and achievement emotions (anger, pride) produced by high-confidence errors (i.e., incorrect answers a person was confident in). We further examined whether providing additional information helped participants to resolve their discrepancy and to what extent emotions promoted participants' subsequent knowledge exploration. Our findings showed that participants were more surprised, curious, confused, and angry in situations where they found out a confidently held misconception was incorrect (i.e., after a high-confidence error) compared to misconceptions held with low confidence. Furthermore, participants reported more enjoyment in situations where they could resolve the discrepancy, and they were frustrated when the resolution of a discrepancy seemed impossible. In contrast to achievement-related anger and pride, participants' surprise, curiosity, confusion, and anxiety were associated with the exploration of knowledge. Finally, we tested whether the intraindividual effects would differ across individuals, but we found no evidence for such interindividual differences. Directions for future research and practical implications are discussed.

Purpose: This article explores the question of what is meant by justice in pedagogical contexts and whether there is a proven pedagogical concept of justice at all, from which the public and scientific controversies about justice in pedagogical contexts can be judged. Design/Approach/Methods: Instead of developing a positive pedagogical concept of justice, this article analyzes pedagogical injustices and assigns them to different levels of the educational system. Findings: The result is a differentiated pedagogical phenomenology of injustices in pedagogical contexts, which at the same time shows starting points for possible changes. Originality/Value: The originality of this article is that an instrumentalization of education in the service of extra-pedagogical norms of justice is avoided and a pragmatic approach is developed, which shows how pedagogical injustices can be reduced. Although the arguments for this are developed on the basis of discourses held in Germany, they are of general and international importance.

The phenomenon of first impression is well researched in social psychology, but less so in the study of OSCEs and the multiple mini interview (MMI). To explore its bearing on the MMI method we included a rating of first impression in the MMI for student selection executed 2012 at the University Medical Center Hamburg-Eppendorf, Germany (196 applicants, 26 pairs of raters) and analyzed how it was related to MMI performance ratings made by (a) the same rater, and (b) a different rater. First impression was assessed immediately after an applicant entered the test room. Each MMI-task took 5 min and was rated subsequently. Internal consistency was [alpha] = 0.71 for first impression and [alpha] = 0.69 for MMI performance. First impression and MMI performance correlated by r = 0.49. Both measures weakly predicted performance in two OSCEs for communication skills, assessed 18 months later. MMI performance did not increment prediction above the contribution of first impression and vice versa. Prediction was independent of whether or not the rater who rated first impression also rated MMI performance. The correlation between first impression and MMI-performance is in line with the results of corresponding social psychological studies, showing that judgements based on minimal information moderately predict behavioral measures. It is also in accordance with the notion that raters often blend their specific assessment task outlined in MMI-instructions with the self-imposed question of whether a candidate would fit the role of a medical doctor.

Background and Context: During online learning, it is essential to provide instructional guidance to support learning. However, guidance can be given in different forms and quantities. Thus, one important challenge is to provide the right amount and type of instructional guidance. Objective: The aim of the study is to investigate types of guidance which are effective for students with heterogenous programming knowledge and skills solving programming tasks in a remote laboratory. Method: We carried out two studies with a single factor pre-post-design with guidance (basic/enhanced) as a between-subjects factor. Findings: In study 1, we implemented enhanced guidance in the form of prompts in the introduction to the tasks. Whereas we found no differences in learning outcome or extraneous cognitive load, students in the enhanced guidance group reported less intrinsic motivation, and logfiles revealed a lower programming performance. In study 2, we implemented enhanced guidance in the form of adaptive just-in-time explanations for error streaks. Enhanced guidance led to a lower extraneous cognitive load, and this way increased learning outcome. Implications: The type and timing of instructional guidance for students in computer science matters. More guidance is not better in each case. Instructional guidance should be tailored to students' needs.

This article proposes a study design developed to disentangle the objective characteristics of a learning situation from individuals' subjective perceptions of that situation. The term objective characteristics refers to the agreement across students, whereas subjective perceptions refers to inter-individual heterogeneity. We describe a novel strategy for assessing and disentangling objective situation characteristics and subjective perceptions thereof, propose methods for analysing the resulting data, and illustrate the procedure with an example of a first study using this design to examine situational interest in 155 university students. Situational interest was assessed nine times per weekly lecture with three measurement time points per person and a rotated multi-group schedule. Assessments took place over the course of an entire semester of ten weeks. One of the advantages of the proposed design is that objective group agreements can be disentangled from subjective deviations from the group's average at each of the nine measurement time points per weekly lecture. Furthermore, the proposed design makes it possible to study the development of both subjective and objective parameters across the time span of one weekly lecture and an entire semester, while the burden for each person is kept relatively low with three beeps per lecture.

The main aim of this study was to assess the criterion validity of the Sedentary Behavior Questionnaire (SBQ) to measure SB in community-dwelling older adults using thigh-measured accelerometry as the criterion method. 801 participants (75.6 ± 6.1 years old, 57.6% females) provided valid thigh-based accelerometer data (activPAL/Axivity) and completed the SBQ. Criterion validity was assessed using Spearman's Rho coefficients. Bland--Altman plots, including 95% limits of agreement and Intraclass Correlation Coefficient (ICC), were used to assess the agreement between self-report and device-measured daily SB time. Strength of the association was examined using multiple linear regression. There was a weak correlation (Rho = 0.25, p < 0.001) between self-reported and device-based SB measures. The SBQ under-estimated daily SB time compared to accelerometry. Our results highlighted an overall weak-to-moderate correlation between measures, with significant differences between each country's version. Researchers should be cautious when using the SBQ to provide an estimation of SB time in older adults.

The need to develop and provide integrated observation systems to better understand and manage global and regional environmental change is one of the major challenges facing Earth system science today. In 2008, the German Helmholtz Association took up this challenge and launched the German research infrastructure TERrestrial ENvironmental Observatories (TERENO). The aim of TERENO is the establishment and maintenance of a network of observatories as a basis for an interdisciplinary and long‐term research program to investigate the effects of global environmental change on terrestrial ecosystems and their socio‐economic consequences. State‐of‐the‐art methods from the field of environmental monitoring, geophysics, remote sensing, and modeling are used to record and analyze states and fluxes in different environmental disciplines from groundwater through the vadose zone, surface water, and biosphere, up to the lower atmosphere. Over the past 15 years we have collectively gained experience in operating a long‐term observing network, thereby overcoming unexpected operational and institutional challenges, exceeding expectations, and facilitating new research. Today, the TERENO network is a key pillar for environmental modeling and forecasting in Germany, an information hub for practitioners and policy stakeholders in agriculture, forestry, and water management at regional to national levels, a nucleus for international collaboration, academic training and scientific outreach, an important anchor for large‐scale experiments, and a trigger for methodological innovation and technological progress. This article describes TERENO's key services and functions, presents the main lessons learned from this 15‐year effort, and emphasizes the need to continue long‐term integrated environmental monitoring programmes in the future. Plain Language Summary: This paper discusses the importance of creating comprehensive environmental observation systems to better understand and address global and regional environmental changes. In 2008, a German research infrastructure named Terrestrial Environmental Observatories (TERENO) was established to build and maintain a network of observatories. The goal is to conduct interdisciplinary, long‐term research on the impacts of global environmental changes on terrestrial ecosystems and their socio‐economic effects. The TERENO network employs advanced methods from environmental monitoring, geophysics, remote sensing, and modeling to study various environmental aspects. Over the past 15 years, four observatories have been part of this network, contributing to valuable experience in overcoming challenges and exceeding expectations. Today, TERENO is a crucial component for environmental modeling and forecasting in Germany, serving as an information hub for practitioners and policymakers. It also fosters international collaboration, supports large‐scale experiments, and drives methodological and technological advancements. The article highlights key lessons learned from this 15‐year effort and emphasizes the importance of continuing such integrated environmental monitoring programs in the future. Key Points: Integrated observatories ensure a holistic Earth Systems perspective, offering data for current and future ecological challengesThe scientific and societal value of observatories is invaluable, but their design, construction and operation require considerable effortFor assured long‐term data collection, research infrastructure must have flexible design for adapting to changing research needs [ABSTRACT FROM AUTHOR]

Consuming media entertainment often challenges recipients' self-control. While past research related self-control almost exclusively to whether individuals engage in media use, it might be equally relevant for the disengagement from media use. Testing core assumptions of the Appraisal of Media Use, Self-Control, and Entertainment (AMUSE) model, the present study investigates the situational interplay of self-control and affective appraisals in predicting disengagement from Netflix use. Preregistered hypotheses were tested based on an event-contingent experience sampling design, in which 205 adult Netflix users in the Netherlands and Germany were tracked and surveyed for two weeks. Results demonstrate that disengagement is contingent upon enjoyment and appreciation and that enjoyment, in turn, can be "spoiled" by feeling guilty. Self-control influenced goal conflict and enjoyment throughout the reception process. We discuss opportunities for modeling disengagement from media use with situational research approaches. [ABSTRACT FROM AUTHOR]

We investigated fluctuations of well-being by using a smartphone-based mobile experience sampling method (real-time and multiple time point measurements in the field using smartphones). Moreover, temperature, longitude, latitude, altitude, wind speed, rainfall, and further environment-based indicators were included as predictors either from smartphone sensors or from open-access Internet databases. Overall, a total of 213 participants reported on their well-being (over 14 days; three measurements per day; 8,000+ well-being judgments). We were able to replicate and refine past research about the dynamics of well-being fluctuations during the day (low in the morning, high in the evening) and over the course of a week (low just before the beginning of the week, highest near the end of the week). We also show what kind of benefits empirical researchers can gain for their research using smartphones and their built-in sensors by combining these measures with data from open-access databases.

Objectives: This study aimed to investigate the impact of post-interventional compression therapy on clinical outcomes after endovenous laser ablation (EVLA) of incompetent saphenous veins. Methods: This prospective, controlled, multicenter study in Germany involved 493 varicose vein patients followed-up for 6 months. Results: Compression therapy significantly reduced symptoms compared to no compression (VCSS: 1.4 ± 1.6 vs 2.2 ± 2.2; p =.007). Post-interventional therapy duration of up to 14 days was found to be most effective for improving patient-reported disease severity (p <.001) and higher quality of life (p =.001). Patient compliance was high (82%), and non-compliance was linked to worse disease severity (VCSS 1.4 ± 1.5 vs 2.1 ± 2.3, p =.009). Conclusion: In conclusion, post-interventional compression therapy is beneficial by reducing symptoms and improving quality of life. High patient compliance with the therapy is observed, and non-compliance is associated with worse disease severity. [ABSTRACT FROM AUTHOR]

Orthogeriatric co-management (OGCM) describes a collaboration of orthopedic surgeons and geriatricians for the treatment of fragility fractures in geriatric patients. While its cost-effectiveness for hip fractures has been widely investigated, research focusing on fractures of the upper extremities is lacking. Thus, we conducted a health economic evaluation of treatment in OGCM hospitals for forearm and humerus fractures. In a retrospective cohort study with nationwide health insurance claims data, we selected the first inpatient stay due to a forearm or humerus fracture in 2014–2018 either treated in hospitals that were able to offer OGCM (OGCM group) or not (non-OGCM group) and applied a 1-year follow-up. We included 31,557 cases with forearm (63.1% OGCM group) and 39,093 cases with humerus fractures (63.9% OGCM group) and balanced relevant covariates using entropy balancing. We investigated costs in different health sectors, length of stay, and cost-effectiveness regarding total cost per life year or fracture-free life year gained. In both fracture cohorts, initial hospital stay, inpatient stay, and total costs were higher in OGCM than in non-OGCM hospitals. For neither cohort nor effectiveness outcome, the probability that treatment in OGCM hospitals was cost-effective exceeded 95% for a willingness-to-pay of up to €150,000. We did not find distinct benefits of treatment in OGCM hospitals. Assigning cases to study groups on hospital-level and using life years and fracture-free life years, which might not adequately reflect the manifold ways these fractures affect the patients' health, as effectiveness outcomes, might have underestimated the effectiveness of treatment in OGCM hospitals. [ABSTRACT FROM AUTHOR]

Simple Summary: Intraoperative consultation is frequently used in clinical practice to establish the initial diagnosis of lung cancer when preoperative histological confirmation fails. The ability to distinguish benign and malignant lesions established frozen sections as the gold standard to guide surgical procedures. Ex vivo fluorescence confocal microscopy is a novel fully digital microimaging technique that enables timely examinations of fresh tissue without loss. The method proved to be an effective and safe method for diagnosing and subtyping lung cancer in our study and is therefore a promising alternative to frozen sections. It preserved the tissue as native material for subsequent examinations, which is an advantage in the diagnosis of small tumors and for biobanking. The acquired digital image data in cross-platform formats formed a suitable basis for telepathological procedures, e.g., second opinions by external specialists. Background: Intraoperative frozen sections (FS) are frequently used to establish the diagnosis of lung cancer when preoperative examinations are not conclusive. The downside of FS is its resource-intensive nature and the risk of tissue depletion when small lesions are assessed. Ex vivo fluorescence confocal microscopy (FCM) is a novel microimaging method for loss-free examinations of native materials. We tested its suitability for the intraoperative diagnosis of lung tumors. Methods: Samples from 59 lung resection specimens containing 45 carcinomas were examined in the FCM. The diagnostic performance in the evaluation of malignancy and histological typing of lung tumors was evaluated in comparison with FS and the final diagnosis. Results: A total of 44/45 (98%) carcinomas were correctly identified as malignant in the FCM. A total of 33/44 (75%) carcinomas were correctly subtyped, which was comparable with the results of FS and conventional histology. Our tests documented the excellent visualization of cytological features of normal tissues and tumors. Compared to FS, FCM was technically less demanding and less personnel intensive. Conclusions: The ex vivo FCM is a fast, effective, and safe method for diagnosing and subtyping lung cancer and is, therefore, a promising alternative to FS. The method preserves the tissue without loss for subsequent examinations, which is an advantage in the diagnosis of small tumors and for biobanking. [ABSTRACT FROM AUTHOR]

In the context of the COVID-19 pandemic, there has been a scarcity of resources with various effects on the care of cancer patients. This paper provides an English summary of a German guideline on prioritization and resource allocation for colorectal and pancreatic cancer in the context of the pandemic. Based on a selective literature review as well as empirical and ethical analyses, the research team of the CancerCOVID Consortium drafted recommendations for prioritizing diagnostic and treatment measures for both entities. The final version of the guideline received consent from the executive boards of nine societies of the Association of Scientific Medical Societies in Germany (AWMF), 20 further professional organizations and 22 other experts from various disciplines as well as patient representatives. The guiding principle for the prioritization of decisions is the minimization of harm. Prioritization decisions to fulfill this overall goal should be guided by (1) the urgency relevant to avoid or reduce harm, (2) the likelihood of success of the diagnostic or therapeutic measure advised, and (3) the availability of alternative treatment options. In the event of a relevant risk of harm as a result of prioritization, these decisions should be made by means of a team approach. Gender, age, disability, ethnicity, origin, and other social characteristics, such as social or insurance status, as well as the vehemence of a patient's treatment request and SARS-CoV-2 vaccination status should not be used as prioritization criteria. The guideline provides concrete recommendations for (1) diagnostic procedures, (2) surgical procedures for cancer, and (3) systemic treatment and radiotherapy in patients with colorectal or pancreatic cancer within the context of the German healthcare system. [ABSTRACT FROM AUTHOR]

There are few long-term studies in which the development of vocational education and training (VET) is placed in a larger societal framework. Consequently, there is limited understanding as to why VET has evolved quite differently even in countries with similar economic and social development. In his reflections on a possible theoretical framework for analyzing the historical development of European VET systems, Wolf-Dietrich Greinert takes a three-step approach searching for common principles of the various systems. VET is firstly embedded in national work cultures manifest in labor law. It is the work cultures which form the basis of specific VET regimes. Work cultures and VET regimes in turn come with leading ideas, which legitimatize a certain didactic orientation. Based on a diachronic analysis from the Industrial Revolution onwards, three general types of VET systems are identified: the liberal market economy model in Britain, the state-regulated bureaucratic model in France and the dual-corporate model in Germany.

Purpose: The Kyleena™ Satisfaction Study (KYSS) provided the first data on 19.5 mg levonorgestrel-releasing intrauterine system (LNG-IUS-19.5 mg) use in routine clinical practice. Here we report results from the German participants in KYSS. Methods: This prospective, observational, single-arm cohort study recruited women who independently chose to use LNG-IUS-19.5 mg during routine counseling in Germany. Overall satisfaction and bleeding profile satisfaction, continuation rates, and safety profile were evaluated at 12 months or premature end of observation (EoO). Results: In the German study population, LNG-IUS-19.5 mg placement was attempted in 508 women and successful in 506 women. Mean age was 32.3 years, and 60.0% (n = 305/508) were parous. Placement was considered easy and associated with no more than mild pain, even in younger and nulliparous participants. Of those with satisfaction data available, 87.6% (n = 388/443) were satisfied with LNG-IUS-19.5 mg at 12 months/EoO. Satisfaction was similar for parous (86.9%, n = 238/274) and nulliparous (88.8%, n = 150/169) women, and was independent of age, prior contraceptive method, or reason for choosing LNG-IUS-19.5 mg. Most participants (73.6%, n = 299/406) were also satisfied with their bleeding profile at 12 months/EoO, independent of parity, age, prior contraceptive method, presence of amenorrhea or dysmenorrhea severity. The 12-month continuation rate was 84.1% (n = 427/508). Most discontinuations were due to loss to follow-up (8.5%, n = 43/508) or treatment-emergent adverse events (TEAEs) (4.7%, n = 24/508). TEAEs were reported in 12.6% (n = 64) of participants, with 9.3% (n = 47) considered to have an LNG-IUS-19.5 mg-related TEAE. Conclusion: Our real-world findings on LNG-IUS-19.5 mg use in German KYSS participants reflected its suitability for a broad population, including young and nulliparous women. Clinical trial registration: NCT03182140 (date of registration: June 2017). [ABSTRACT FROM AUTHOR]

Background: Information about follow‐up care in blood cancer survivors is limited. The questionnaire‐based "Aftercare in Blood Cancer Survivors" (ABC) study aimed to identify patterns of follow‐up care in Germany and compare different types of follow‐up institutions. Methods: The study's 18‐month prospective part compared the follow‐up institutions identified in the preceding retrospective part (academic oncologists, community oncologists, primary care physicians). The questionnaires were completed by the follow‐up physicians. Results: Of 1070 physicians named by 1479 blood‐cancer survivors, 478 (44.7%) consented to participate. For provision of care, most oncologists relied on published guidelines, while most primary care physicians depended on information from other physicians. Survivors with a history of allogeneic transplantation or indolent lymphoma were mainly seen by academic oncologists, whereas survivors with monoclonal gammopathy, multiple myeloma, or myeloproliferative disorders were often seen by community oncologists, and survivors with a history of aggressive lymphoma or acute leukemia by primary care physicians. Detection of relapse and secondary diseases was consistently viewed as the most important follow‐up goal. Follow‐up visits were most extensively documented by academic oncologists (574 of 1045 survivors cared for, 54.9%), followed by community oncologists (90/231, 39.0%) and primary care physicians (51/203, 25.1%). Relapse and secondary disease detection rates and the patients' quality of life were similar at the three institutions. Laboratory tests were most often ordered by academic oncologists, and imaging by primary care physicians. Psychosocial issues and preventive care were more often addressed by primary care physicians than by oncologists. Conclusions: Patients at high risk of relapse or late complications were preferentially treated by academic oncologists, while patients in stable condition requiring continuous monitoring were also seen by community oncologists, and patients with curable diseases in long‐term remission by primary care physicians. For the latter, transfer of follow‐up care from oncologists to well‐informed primary care providers appears feasible. [ABSTRACT FROM AUTHOR]

Background: Good vision highly depends on the transparency of the cornea, which is the "windscreen" of the eye. In fact, corneal blindness due to transparency loss is the second most common cause of blindness worldwide, and corneal transplantation is the main cure. Importantly, the cornea is normally avascular but can secondarily be invaded by pathological (blood and lymphatic) vessels due to severe inflammation, and the survival prognosis of a corneal graft mainly depends on the preoperative vascular condition of the recipient's cornea. Whereas transplants placed into avascular recipient beds enjoy long-term survival rates of > 90%, survival rates significantly decrease in pathologically pre-vascularized, so-called high-risk recipients, which account for around 10% of all performed transplants in Germany and > 75% in lower and middle-income countries worldwide. Methods: This parallel-grouped, open-randomized, multicenter, prospective controlled exploratory investigator-initiated trial (IIT) intends to improve graft survival by preconditioning pathologically vascularized recipient corneas by (lymph)angioregressive treatment before high-risk corneal transplantation. For this purpose, corneal crosslinking (CXL) will be used, which has been shown to potently regress corneal blood and lymphatic vessels. Prior to transplantation, patients will be randomized into 2 groups: (1) CXL (intervention) or (2) no pretreatment (control). CXL will be repeated once if insufficient reduction of corneal neovascularization should be observed. All patients (both groups) will then undergo corneal transplantation. In the intervention group, remaining blood vessels will be additionally regressed using fine needle diathermy (on the day of transplantation). Afterwards, the incidence of graft rejection episodes will be evaluated for 24 months (primary endpoint). Overall graft survival, as well as regression of corneal vessels and/or recurrence, among other factors, will be analyzed (secondary endpoints). Discussion: Based on preclinical and early pilot clinical evidence, we want to test the novel concept of temporary (lymph)angioregressive pretreatment of high-risk eyes by CXL to promote subsequent corneal graft survival. So far, there is no evidence-based approach to reliably improve graft survival in the high-risk corneal transplantation setting available in clinical routine. If successful, this approach will be the first to promote graft survival in high-risk transplants. It will significantly improve vision and quality of life in patients suffering from corneal blindness. Trial registration: ClinicalTrials.gov NCT05870566. Registered on 22 May 2023. [ABSTRACT FROM AUTHOR]

With the nationwide introduction of wastewater treatment the overall water quality improved significantly, but challenges remain, including diffuse pollution, historical sediment contamination and the presence of a multitude of anthropogenic chemical species. The implementation of several EU directives in the twenty-first century led to a stronger focus on improving water and sediment quality and the sustainable management of sediments at river basin scale. Hence, in the last 25 years, not only have the regulatory frameworks significantly changed, but also the scientific backbone of our products, delivered to Germany's federal ministries, practitioners from the German Waterways and Shipping Administration, German federal states and the public. In this respect, approaches such as non-target screening, multi-element analysis, effect-based methods, novel approaches in microplastic and nanoparticle analysis and the benefits from the increase in digitalization and automation are key methods and processes to face future challenges, especially those connected to the global climate crisis. [ABSTRACT FROM AUTHOR]

In-service teacher development programs are perceived as a common way to foster school improvement. Nevertheless, program evaluation to date ends with the assessment of acquired knowledge, skills, and motivation, frequently disregarding the actual learning transfer and its conditions. This study aimed to investigate how individual and situational factors interact and contribute to learning transfer in an in-service teacher development program. We tested a transfer model derived from human resources development research. One hundred and twenty-nine teachers aged 25-62 years (87% female), participating in an in-service development program, were surveyed three times during the program. Results of path analyses suggest that not only especially individual factors are critical for learning transfer in the context of school improvement, but also that program and environmental factors have important effects. They moderated the effects of the individual factors.

Sepsis is a common life-threatening disease caused by dysregulated immune response and metabolic acidosis which lead to organ failure. An abnormal expression of aquaporins plays an important role in organ failure. Additionally, genetic variants in aquaporins impact on the outcome in sepsis. Thus, we investigated the polymorphism (rs17553719) and expression of aquaporin-3 (AQP3) and correlated these measurements with the survival of sepsis patients. Accordingly, we collected blood samples on several days (plus clinical data) from 265 sepsis patients who stayed in different ICUs in Germany. Serum plasma, DNA, and RNA were then separated to detect the promotor genotypes of AQP3 mRNA expression of AQP3 and several cytokines. The results showed that the homozygote CC genotype exhibited a significant decrease in 30-day survival (38.9%) compared to the CT (66.15%) and TT genotypes (76.3%) (p = 0.003). Moreover, AQP3 mRNA expression was significantly higher and nearly doubled in the CC compared to the CT (p = 0.0044) and TT genotypes (p = 0.018) on the day of study inclusion. This was accompanied by an increased IL-33 concentration in the CC genotype (day 0: p = 0.0026 and day 3: p = 0.008). In summary, the C allele of the AQP3 polymorphism (rs17553719) shows an association with increased AQP3 expression and IL-33 concentration accompanied by decreased survival in patients with sepsis. [ABSTRACT FROM AUTHOR]

Background: Compounding in German is a frequent and highly productive word formation strategy. Monolingual children begin to form compound words in regular language acquisition at around the age of two. There is individual evidence in the literature of early phases of non-target language production in the form of inversions, i.e., exchange of compound components. For bilingual language acquisition, pilot study results show that such inversions still occur at the age of seven to eight or after three to four years of exposure to German (Scherger & Kliemke, 2021). Method In the present study, inversions in the comprehension and production of neologistic compound nouns were investigated in 19 bilingual school-age children (n = 11 with German as L2 and n = 8 with 2L1 acquisition) in a quasi-experimental design using picture naming and word-picture matching tasks. These children were compared with two control groups of monolingual children: an age-matched group (n = 9, mean age = 7;2) and a group that was compared with the groups of bilingual children in terms of contact time with German (n = 7, mean age = 3;11). Results: There are differences between children with German as L2 and the age-matched control group of monolingual children and between children with L2 and monolingual children matched according to their length of exposure in the comprehension task. In addition, children with 2L1 show better comprehension performance than children with L2. Conclusion! Since composition is one of the most important word formation strategies in German, especially in the context of academic language, its comprehension and production should be monitored particularly in children with German as an L2 and - if necessary - promoted. Doing so, the resources for cross-linguistic comparisons and multilingual learning based on knowledge of the structures in the respective heritage language may be integrated positively. [ABSTRACT FROM AUTHOR]

Summary: Orthogeriatric co-management (OGCM) may provide benefits for geriatric fragility fracture patients in terms of more frequent osteoporosis treatment and fewer re-fractures. Yet, we did not find higher costs in OGCM hospitals for re-fractures or antiosteoporotic medication for most fracture sites within 12 months, although antiosteoporotic medication was more often prescribed. Purpose: Evidence suggests benefits of orthogeriatric co-management (OGCM) for hip fracture patients. Yet, evidence for other fractures is rare. The aim of our study was to conduct an evaluation of economic and health outcomes after the German OGCM for geriatric fragility fracture patients. Methods: This retrospective cohort study was based on German health and long-term care insurance data. Individuals were 80 years and older, sustained a fragility fracture in 2014–2018, and were treated in hospitals certified for OGCM (ATZ group), providing OGCM without certification (OGCM group) or usual care (control group). Healthcare costs from payer perspective, prescribed medications, and re-fractures were investigated within 6 and 12 months. We used weighted gamma and two-part models and applied entropy balancing to account for the lack of randomization. All analyses were stratified per fracture site. Results: We observed 206,273 patients within 12-month follow-up, of whom 14,100 were treated in ATZ, 133,353 in OGCM, and 58,820 in other hospitals. Total average inpatient costs per patient were significantly higher in the OGCM and particularly ATZ group for all fracture sites, compared to control group. We did not find significant differences in costs for re-fractures or antiosteoporotic medication for most fracture sites, although antiosteoporotic medication was significantly more often observed in the OGCM and particularly ATZ group for hip, pelvic, and humerus fractures. Conclusion: The observed healthcare costs were higher in ATZ and OGCM hospitals within 12 months. Antiosteoporotic medication was prescribed more often in both groups for most fracture sites, although the corresponding medication costs did not increase. [ABSTRACT FROM AUTHOR]

Little is known about changes in the personal living conditions of long-term blood cancer survivors in Germany. To gather information about social relationships, work life, overall well-being, and religion, we performed a questionnaire-based retrospective study on 1551 survivors who had been on follow-up for ≥ 3 years (median, 9 years). Most survivors reported that marital status and relationships with relatives and friends remained constant before and after blood cancer. Vocational activities were temporarily impaired for 47.5%, with a median time of 11 months to return to work. More than a third of the patients (35.6%) discontinued work permanently, with disability and retirement pension rates of 7.9% and 38.1%, respectively, at the time of the survey. Financial problems due to reduced income were reported by 26.2%, in particular after relapse or allogeneic transplantation. Patient reports addressing their quality of life showed large variations. It was best in acute leukemia survivors without a history of allogeneic transplantation and worst in patients with myeloproliferative disorders. Religion tended to become more important after blood cancer. In conclusion, vocational impairment and financial problems are frequent among German blood cancer survivors. Efforts should be made at an early stage to reestablish the patients' ability to work. [ABSTRACT FROM AUTHOR]

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The aim of the present study was to introduce a general theoretical model of scientific competencies in higher education and to adapt it to three social sciences, namely psychology, sociology, and political science, by providing evidence from expert interviews and program regulations. Within our general model, we distinguished and specified four building blocks of scientific competencies: input, operations, and output, as well as personal characteristics. We defined "input" as content students are exposed to in their respective domains, "operations" as cognitive processes stated by Anderson et al. (2001), and "output" as content students create as a result of applying operations on input. We considered scientific competencies to be the constructive use of operations on input and the creation of output thereby. Furthermore, we considered personal characteristics that are relevant for competency acquisition and for working in a scientifically competent manner. In the present article we provide main results for the four building blocks of scientific competencies in psychology, sociology, and political science. Furthermore, we discuss limitations of our current model such as the necessity to determine criteria to further clarify what the constructive use of operations on input looks like in the different cycles of higher education.

An evidence-based consensus meeting was held with urologists, a pharmacist and a cardiologist to perform a structured benefit-risk analysis of reclassifying tadalafil, a phosphodiesterase type 5 (PDE5) inhibitor for treatment of erectile dysfunction (ED), to be available without prescription in Germany. As per the Brass process endorsed by regulatory authorities, an evidence-based Brass value tree was developed, which identified the incremental benefits and risks that should be considered above the safety and efficacy evidence required for prescription medicines. During the Group Delphi consensus meeting, the expert panel rated the likelihood and clinical impact of each benefit and risk on a scale of 0 (none) to 3 (high). Overall attribute scores were calculated from the product of the mean likelihood and mean clinical impact scores giving a possible score of 0–9. The overall benefit attribute scores ranged from 2.8 to 5.4. The overall risk attribute scores ranged from 0.2 to 2.2 though most were 1.0 or less (3 or more is generally considered to be of concern). On balance, the independent meeting scored the benefits of reclassification of tadalafil higher than the risks and considered the risk mitigation strategies of the packaging label and patient information leaflet (PIL) sufficient. [ABSTRACT FROM AUTHOR]

The migratory behaviour of Ospreys (Pandion haliaetus) has been well studied using satellite telemetry, but studies on their behaviour in the breeding area are scarce. We caught and fitted 17 adult Ospreys with solar-powered GPS-enhanced satellite transmitters in northeast Germany and tracked them for up to 7 years. There was a high variation in home range size depending on sex, nesting site and breeding success. The home ranges of successfully breeding males (median 33.4 km2, 95% kernel density estimations) were significantly larger than those of females (median 4.6 km2) and varied in extent and shape between individuals. Some females made long excursions and sometimes spent the night at great distances to their nests after the juveniles had fledged but they also returned to the nesting area before they left for migration. The males' home range areas were consistent during the breeding period. The proportion of water surfaces on the home range areas of males ranged between 9.6 and 29%. The overnight roosts were found in distances up to 7.83 km (median 980 m) for successfully breeding males and up to 105 km (median 568 m) for successfully breeding females. The correlation between overnight roost-nest distance and the corresponding home range area was significant for females but not for males. The overlap in the home ranges of individual males that occupied the same nests in different years varied between 37.3 and 54.7% of the mutual home ranges. Males partly included the same waterbodies in their home ranges, but they also visited different lakes. In the incubation and nestling phases, females are closely bound to the nest, whereas their mates can range over vast areas. [ABSTRACT FROM AUTHOR]

Copyright of Anaesthesiologie & Intensivmedizin is the property of DGAI e.V. - Deutsche Gesellschaft fur Anasthesiologie und Intensivmedizin e.V. 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.)

Background: This study aimed to describe the characteristics and mortality of two cohorts of patients with chronic coronary syndrome (CCS) recruited with identical study designs in the same rehabilitation clinics but approximately 10 years apart. Methods: The KAROLA cohorts included patients with CCS participating in an inpatient cardiac rehabilitation programme in Germany (KAROLA-I: years 1999/2000, KAROLA-II: 2009–2011). Blood samples and information on sociodemographic factors, lifestyle, and medical treatment were collected at baseline, at the end of rehabilitation, and after one year of follow-up. A biomarker-based risk model (ABC-CHD model) and Cox regression analysis were used to evaluate cardiovascular (CV) and non-CV mortality risk. Results: We included 1130 patients from KAROLA-I (mean age 58.7 years, 84.4% men) and 860 from KAROLA-II (mean age 60.4 years, 83.4% men). Patients in the KAROLA-I cohort had significantly higher concentrations of CV biomarkers and fewer patients were taking CV medications, except for statins. The biomarker-based ABC-CHD model provided a higher estimate of CV death risk for patients in the KAROLA-I cohort (median 3-year risk, 3.8%) than for patients in the KAROLA-II cohort (median 3-year risk, 2.7%, p-value for difference < 0.001). After 10 years of follow-up, 91 (8.1%) patients in KAROLA-I and 45 (5.2%) in KAROLA-II had died from a CV event. Conclusions: Advances in disease management over the past 20 years may have led to modest improvements in pharmacological treatment during cardiac rehabilitation and long-term outpatient care for patients with CCS. However, modifiable risk factors such as obesity have increased in the more recent cohort and should be targeted to further improve the prognosis of these patients. [ABSTRACT FROM AUTHOR]

Most odontogenic and intraoral abscesses can be treated on an outpatient basis with local anesthesia. However, severe disease progression may require an incision under general anesthesia (GA) with postoperative inpatient treatment. This study aimed to evaluate the first "COVID-19 year" in Germany and compare the first "COVID-19 year" with the two previous years. All consecutive cases with odontogenic or intraoral abscesses treated in an outpatient or inpatient setting between 2018 and 2021 were included in this study. Data were collected, including the type of anesthesia, length of hospital stay, and healthcare costs. Despite the lower total number of abscess treatments in the first year of COVID-19 (n = 298 patients) than that in the two previous years (n = 663 patients), the number of advanced abscesses requiring intervention under GA was significantly higher (p < 0.001). This increased burden of care was also reflected in increased healthcare costs. The measures taken against the COVID-19 pandemic had an impact on the course of other diseases, for example, odontogenic and intraoral abscesses. The results showed an emerging conflict in patient care during the pandemic crisis that should be considered in possible future pandemics. [ABSTRACT FROM AUTHOR]

Background: Due to Covid-19, elective medical procedures were partly postponed to reduce the burden on the medical system. The impact of these effects in bariatric surgery and their individual consequences remain unknown. Materials/Methods: In a retrospective monocentric analysis, all bariatric patients at our centre between 01/2020 and 12/2021 were investigated. All patients with postponed surgery due to pandemic were analysed regarding weight change and metabolic parameters. In addition, we performed a nationwide cohort study of all bariatric patients in 2020 using billing data provided by the Federal Statistical Office. Population adjusted procedure rates of 2020 were compared to 2018/2019. Results: Seventy-four patients (42.5%) out of 174 scheduled for bariatric surgery were postponed due to pandemic-related limitations, and 47 (63.5%) patients waited longer than 3 months. Mean postponement was 147.7 days. Apart from outliers (6.8% of all patients), mean weight (+0.9 kg) and body mass index (+0.3 kg/m2) remained stable. HbA1c increased significantly in patients with a postponement longer than 6 months (p = 0.024) and in diabetic patients (+0.18% vs −0.11 in non-diabetic, p = 0.042). In the Germany-wide cohort, the overall reduction of bariatric procedures in the first lockdown (04-06/2020) was −13.4% (p = 0.589). In the second lockdown (10-12/2020), there was no nationwide detectable reduction (+3.5%, p = 0.843) but inter-state differences. There was a catch-up in the interim months (+24.9%, p = 0.002). Conclusion: For future lockdowns or other healthcare bottleneck circumstances, the impact of postponement in bariatric patients has to be addressed and prioritization of vulnerable patients (e.g. diabetics) should be considered. [ABSTRACT FROM AUTHOR]

Individual initiative is required to successfully master career transitions in adolescence, and also parents play an important role in this process. Past research largely omitted co-agency in transition-related activities between adolescents and their parents, which could be described in terms of self- and other-regulation. The present pilot study examined adolescents' and mothers' career-specific regulatory behaviors as perceived from both agents' perspectives. 38 German adolescents rated importance and engagement in one transition-related personal goal and reported on intensity of career exploration activities. Furthermore, they reported on their perceptions of mothers' career-related behaviors and confidence in their offspring's transition management. All measures were also assessed from the mothers' point of view. Results revealed associations within and across family members' ratings that showed similarities as well as differences in perceptions of how behaviors associate. Partial correlation analyses showed that specific maternal behavior not contingent upon her general warmth associated with child behavior. (Contains 2 tables.)

The study examines school and parental influences on adolescents' occupational exploration. Analyses of data from 859 6th, 8th, and 10th graders attending high- and lower-track high schools in the German federal state of Thuringia suggested more extensive exploration among students closer to the school-to-work transition. Besides cross-sectional effects of parenting and achievement orientation at school, acceptance and openness students experienced in class predicted increases of their exploratory behaviors. Multilevel analyses showed, however, that school effects operated on the level of subjective perceptions (individual level), but not on the level of intersubjective reality (classroom level). Implications for attempts to foster and facilitate exploration are discussed. (Contains 3 tables.)

Are the central pedagogical concepts and practices of the Humboldtian university, with "Bildung" as the overarching goal, only part of an elitist history of the university in the past or may they still be of relevance for the 21st century? What processes are involved in fostering "Bildung" then and now? This article investigates such questions, with a special focus on seminar pedagogy. A brief account is given of the major pedagogical consequences of the Bologna-related Quality Reform in Norway and the problems of Bologna adaptation in Germany. Although both countries used the Bologna Process to solve internal problems in higher education, pedagogical improvements were more visible in Norway, but "Bildung" as a concept has been nearly absent from the debate until 2009. In Germany, however, Humboldtian ideals are still a reference point and ongoing large-scale pedagogical experiments have aimed at modernising these in the face of mass education. This may prove a source of innovation for post Bologna re-reform.

Internationally, the question of how to qualify the workforce seems to be of increasing importance for competitive economies. How can politics govern the quantity and quality of employment structures and optimise both? In this article a theoretical framework is outlined that has been developed for the analysis of institutional constructs serving workforce qualification. Its most important elements and mechanisms are explained in a model and a typology--both based on a European/German perspective. (Contains 1 note.)

Parents are major partners in helping adolescents prepare for a career choice. Although several studies have examined links between general aspects of the parent-adolescent relationship and adolescents' career development, little research has addressed the mechanisms involved. This study aimed to validate a three-dimensional instrument for the assessment of parental career-related behaviors and to examine their associations with career exploration and decision-making difficulties. After testing the dimensional structure of the instrument, we examined the relationship between parents' behaviors and adolescents' career development by using data from 359 German adolescents who reported the amount of perceived parental career-related behaviors and their career exploration and decision-making difficulties. The results of structural equation modeling confirmed the hypothesized dimensional structure (support, interference, lack of engagement). While parental support associated positively with career exploration, interference and lack of engagement associated with decision-making difficulties. Furthermore, interference and lack of engagement moderated the relationship between support and exploration. Support moderated the association between interference and decision-making difficulties. (Contains 3 tables and 2 figures.)

Purpose: The content, provided in learning management systems (LMS), is often text oriented as in a usual textbook, extended by some animations and links. Hands on activities and experiments are not possible. The paper aims to give an overview about the concept to couple smart simulation and assessment tools with an LMS to provide a more explorative approach to the learning content. Design/methodology/approach: Interactive components, such as smart design tools and online laboratories are added to an LMS that allow exploring the learned content additionally to text parts interactively. The objective of this teaching concept is to empower the students to solve complex design tasks for digital systems and to validate the results. This requires on the one hand site knowledge about the mathematical background of the algorithms used by design tools, and on the other hand, experience from as much as possible examples. Commercial tools are too complex for teaching purposes and hide mostly the algorithms they use for the several design steps. That is why we have developed smart special tailored tools for each single design step that should be learned during a lesson. Findings: These smart tools are very useful to support the process of understanding and learning by doing. Learners can explore the several design steps with own examples and get immediately feedback about the correct solutions. Practical implications: The connection to an LMS allows us to record all students' relevant actions in the design process and to evaluate the student or to give individual tailored hints. Originality/value: The paper introduces a new teaching concept that allows exploring the learned content interactively additionally to text parts.

Purpose: The purpose of this paper is to evaluate the health-promoting and stigma-reducing effect of the German school-based programme "Crazy? So what!". Design/methodology/approach: A quasi-experimental longitudinal control-study was carried out with assessments one week prior to the school programme, immediately after it and three months later. A total of 210 Year 9 and 10 students (aged 13-18 years) were surveyed in four schools in Saxony, Germany. Data analysis was done descriptively based on frequency distributions. Random effects regression models for unbalanced panel data were used to estimate the change of the outcome variables over time. Findings: At baseline, only 5.2 per cent of the intervention group would talk with their teacher about a mental health problem. Immediately after the programme, this number increased to 10.6 per cent and after three months to 17.9 per cent. There was also a positive, short-term effect on students' social distance, i.e. an increase in positive attitudes towards those with a mental illness, but this was not sustained over time. By contrast, self-efficacy proved resistant to change. Originality/value: This school programme is successful in that the "experts on their own behalf" (young people, who have gone through mental illness) were able to encourage and reassure others on how to face a mental health crisis with more confidence, which also contributes to strengthening students' resilience. The results of this study indicate the importance of sensitising children and youth, but also teachers and other adults to mental health. (Contains 3 tables, 2 figures and 2 notes.)

Traditionally, the higher education sector in Germany has been research oriented. During their studies of ten to thirteen semesters, students have had close contact with research and have been motivated by new findings they have discovered themselves. Introducing a bachelor's- and master's-style structure into the current system means in many cases losing this close contact at the bachelor's level. Only a few programs developed professionally maintain this link.

The use of extracorporeal membrane oxygenation (ECMO) is discussed to improve patients' outcome in severe COVID-19 with respiratory failure, but data on ECMO remains controversial. The aim of the study was to determine the characteristics of patients under invasive mechanical ventilation (IMV) with or without veno-venous ECMO support and to evaluate outcome parameters. Ventilated patients with COVID-19 with and without additional ECMO support were analyzed in a retrospective multicenter study regarding clinical characteristics, respiratory and laboratory parameters in day-to-day follow-up. Recruitment of patients was conducted during the first three COVID-19 waves at four German university hospitals of the Ruhr University Bochum, located in the Middle Ruhr Region. From March 1, 2020 to August 31, 2021, the charts of 149 patients who were ventilated for COVID-19 infection, were included (63.8% male, median age 67 years). Fifty patients (33.6%) received additional ECMO support. On average, ECMO therapy was initiated 15.6 ± 9.4 days after symptom onset, 10.6 ± 7.1 days after hospital admission, and 4.8 ± 6.4 days after the start of IMV. Male sex and higher SOFA and RESP scores were observed significantly more often in the high-volume ECMO center. Pre-medication with antidepressants was more often detected in survivors (22.0% vs. 6.5%; p = 0.006). ECMO patients were 14 years younger and presented a lower rate of concomitant cardiovascular diseases (18.0% vs. 47.5%; p = 0.0004). Additionally, cytokine-adsorption (46.0% vs. 13.1%; p < 0.0001) and renal replacement therapy (76.0% vs. 43.4%; p = 0.0001) were carried out more frequently; in ECMO patients thrombocytes were transfused 12-fold more often related to more than fourfold higher bleeding complications. Undulating C-reactive protein (CRP) and massive increase in bilirubin levels (at terminal stage) could be observed in deceased ECMO patients. In-hospital mortality was high (Overall: 72.5%, ECMO: 80.0%, ns). Regardless of ECMO therapy half of the study population deceased within 30 days after hospital admission. Despite being younger and with less comorbidities ECMO therapy did not improve survival in severely ill COVID-19 patients. Undulating CRP levels, a massive increase of bilirubin level and a high use of cytokine-adsorption were associated with worse outcomes. In conclusion, ECMO support might be helpful in selected severe cases of COVID-19. [ABSTRACT FROM AUTHOR]

Purpose: In Germany, colorectal robot-assisted surgery (RAS) has found its way and is currently used as primary technique in colorectal resections at our clinic. We investigated whether RAS can be extensively combined with enhanced recovery after surgery (ERAS®) in a large prospective patient group. Methods: Using the DaVinci Xi surgical robot, all colorectal RAS from 09/2020 to 01/2022 were incorporated into our ERAS® program. Perioperative data were prospectively recorded using a data documentation system. The extent of resection, duration of the operation, intraoperative blood loss, conversion rate, and postoperative short-term results were analyzed. We documented the postoperative duration of Intermediate Care Unit (IMC) stay and major and minor complications according to the Clavien–Dindo classification, anastomotic leak rate, reoperation rate, hospital-stay length, and ERAS® guideline adherence. Results: One hundred patients (65 colon and 35 rectal resections) were included (median age: 69 years). The median durations of surgery were 167 min (colon resection) and 246 min (rectal resection). Postoperatively, four patients were IMC-treated (median stay: 1 day). In 92.5% of the colon and 88.6% of the rectum resections, no or minor complications occurred postoperatively. The anastomotic leak rate was 3.1% in colon and 5.7% in rectal resection. The reoperation rate was 7.7% (colon resection) and 11.4% (rectal resection). The hospital stay length was 5 days (colon resection) and 6.5 days (rectal resection). The ERAS® guideline adherence rate was 88% (colon resection) and 82.6% (rectal resection). Conclusion: Patient perioperative therapy per the multimodal ERAS® concept is possible without any problems in colorectal RAS, leading to low morbidity and short hospital stays. [ABSTRACT FROM AUTHOR]

Hidradenitis suppurativa (HS) is a chronic skin disease that is often associated with metabolic disorders. Diabetes mellitus (DM) is a frequent comorbidity in HS. There is currently no established screening for DM in HS patients. The aim of our study was to identify high-risk groups of HS patients that develop DM and to assess the frequency of different types of DM present in HS patients. To do so, we conducted a monocentric study in 99 patients with HS. All patients underwent detailed clinical and laboratory assessments, including the determination of glycated hemoglobin. Among the 20.2% of patients that presented with DM, type 2 was by far the most prevalent (19 out of 20 patients). Moreover, male gender, age, BMI, Hurley stage, modified Hidradenitis Suppurativa Score (mHSS), DLQI and hypertension all correlated with the glycated hemoglobin levels in the HS patients. In the multivariable analysis, Hurley stage III, older age, and higher BMI were significantly associated with DM. Specifically, patients at Hurley stage III were at a 5.3-fold increased risk of having DM type II compared to patients at earlier Hurley stages. Since many of the HS patients had not been diagnosed, our study reveals shortcomings in the screening for DM and suggest that this should be routinely performed in HS patients at high risk to avoid secondary complications. [ABSTRACT FROM AUTHOR]

Background: Many authors have described a significant mental health burden on children and adolescents during the COVID-19 pandemic, possibly moderated by social disparities. This analysis explores whether pre-pandemic family circumstances might be related to different aspects of child health during the pandemic. Methods: We analyzed trajectories of health-related outcomes in children aged 5 to 9 years (T7 to T11) using the Ulm SPATZ Health study, a population based birth cohort study (baseline 04/2012–05/2013) conducted in the South of Germany. Outcomes were children's mental health, quality of life, and lifestyle, such as screen time and physical activity. We conducted descriptive statistics of maternal and child characteristics before and throughout the pandemic. We defined three different groups of pre-pandemic family situations and used adjusted mixed models to estimate differences in means associated with the time during the pandemic vs. before the pandemic in (a) all children and in (b) children belonging to specific pre-pandemic family situations. Results: We analyzed data from n = 588 children from whom at least one questionnaire was completed between T7 and T11. When not considering the pre-pandemic family situation, adjusted mixed models showed statistically significant lower mean scores of health-related quality of life among girls during vs. before the COVID-19 pandemic (difference in means (b): − 3.9 (95% confidence interval (CI): − 6.4, − 1.4). There were no substantial differences in mental health, screen time, or physical activity in boys or girls. When considering pre-pandemic family situations, boys with mothers having symptoms of depression or anxiety showed a substantial loss of health-related quality of life on the subscale of friends (b: − 10.5 (95% CI: − 19.7, − 1.4)). Among girls in this group, 60% of the 15 assessed outcomes were negatively associated with a remarkable loss in health-related quality of life (e.g., KINDL-physical well-being difference in means: − 12.2 (95% CI: − 18.9, − 5.4)). Furthermore, a substantial increase in screen time was found (+ 2.9 h (95% CI: 0.3, 5.6)). Conclusion: Our results suggest that the health (and behavior) of primary school-aged children is possibly impacted by the COVID-19 pandemic, with adverse consequences differing by gender and very likely by the pre-pandemic family situation. Especially in girls having a mother with depression or anxiety symptoms, the adverse consequences of the pandemic on mental health seem to be aggregated. Boys showed fewer adverse trajectories, and it needs to be further assessed which factors exactly are behind the (socio-economic) factors, such as maternal working habits and limited living space, when analyzing the effect of the pandemic on children's health. [ABSTRACT FROM AUTHOR]

Bladder dysfunction is physically and mentally stressful. Long‐term catheterization is indicated as conservative therapy for chronic urinary retention as well as urinary incontinence; although an indwelling, transurethral catheter still represents a risk factor for ascending urinary tract infection and urosepsis. The primary outcome of this study was the impact of the DFree ultrasonic sensor on the subjectively perceived quality of life and satisfaction of patients. The secondary outcomes evaluated were usefulness, ease of use (user‐friendliness), quality of care, and self‐reported degree of autonomy. In this pilot study, 18 urological patients with various kind of bladder dysfunction were treated with an ultrasonic sensor for at least 12 h a day over a 3‐month period. Assessment was conducted using the Kings Health Questionnaire (KHQ) and the German version of the Client Satisfaction Questionnaire (ZUF‐8) (quantitative data) and guided interviews (qualitative data). Eighteen participants were included in this study. Participants highly appreciated the ideas and concepts of the device. A change in KHQ after treatment could not be statistically confirmed; however, the average value in ZUF‐8 showed satisfaction with Dfree. However, no significant improvement was observed in the quantitative data. During the interviews at the end of the testing phase, the participants provided positive feedback with specific suggestions to improve device usability. The application was described as helpful and easy to use. Data triangulation illustrates that an improvement in technical implementation could increase device usefulness. This would imply higher patient satisfaction when using the device for bladder dysfunction. [ABSTRACT FROM AUTHOR]

Stable isotopes of water are ideal tracers to integrate into process‐based models, advancing ecohydrological understanding. Current tracer‐aided ecohydrological modeling is mostly conducted in relatively small‐scale catchments, due to limited tracer data availability and often highly damped stream isotope signals in larger catchments (>100 km2). Recent model developments have prioritized better spatial representation, offering new potential for advancing upscaling in tracer‐aided modeling. Here, we adapted the fully distributed EcH2O‐iso model to the Selke catchment (456 km2, Germany), incorporating monthly sampled isotopes from seven sites between 2012 and 2017. Parameter sensitivity analysis indicated that the information content of isotope data was generally complementary to discharge and more sensitive to runoff partitioning, soil water and energy dynamics. Multi‐criteria calibrations revealed that inclusion of isotopes could significantly improve discharge performance during validations and isotope simulations, resulting in more reasonable estimates of the seasonality of stream water ages. However, capturing isotopic signals of highly non‐linear near‐surface processes remained challenging for the upscaled model, but still allowed for plausible simulation of water ages reflecting non‐stationarity in transport and mixing. The detailed modeling also helped unravel spatio‐temporally varying patterns of water storage‐flux‐age interactions and their interplay under severe drought conditions. Embracing the upscaling challenges, this study demonstrated that even coarsely sampled isotope data can be of value in aiding ecohydrological modeling and consequent process representation in larger catchments. The derived innovative insights into ecohydrological functioning at scales commensurate with management decision making, are of particular importance for guiding science‐based measures for tackling environmental changes. Key Points: Process‐based tracer‐aided ecohydrological modeling is upscaled to >100 km2 catchments using stable water isotopesIsotopes benefit large‐scale modeling in substantially improving model robustness and reliability of water age estimatesLarger‐scale water partitioning and drought responses are controlled by heterogeneity in catchment organization [ABSTRACT FROM AUTHOR]

Summarizes the Konstanz Training Model (KTM), a German primary and secondary preventive program that increases teacher self-competence and social competence in dealing with aggressive and disruptive student behaviors. Emphasizes KTM's focus on systemic aspects, cognitive level, and behavioral level approaches. Describes KTM Compact, a short term training program. (CAJ)