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Purpose: Fear of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and lockdown measures may have an impact on health care utilization particularly for people with chronic diseases. We investigated changes in outpatient utilization behavior in pandemic phases among people with selected chronic diseases in Germany. Methods: The nationwide population-based telephone surveys German Health Update (GEDA) 2019/2020 (April 2019 to September 2020) and GEDA 2021 (July to December 2021) covered 4 out of 7 pandemic phases from the pre-pandemic to the 4th pandemic wave. Data on hypertension, diabetes and major cardiovascular diseases (CVD) in the past 12 months and visiting a general practitioner (GP) or a specialist (excluding dentist) in the past 4 weeks was collected using a standardized questionnaire. Proportions and odds ratios were derived from logistic regression models adjusted for age, sex, education and federal states. Results: Among 27,967 participants aged ≥ 16 years, 8,449, 2,497 and 1,136 individuals had hypertension, diabetes and major CVD. Participants with these chronic diseases visited a GP or specialist significantly more often than the overall study population, irrespective of pandemic phases. Compared to the pre-pandemic phase, a significant reduction in specialist-visiting was found in the first pandemic wave among people with hypertension (34.3% vs 24.1%), diabetes (39.5% vs 25.5%) and major CVD (41.9% vs 25.6%). GP-visiting was lower only among people with hypertension (53.0% vs 46.0%). No difference in GP or specialist visiting was found in the 4th pandemic wave compared to the pre-pandemic phase. Conclusion: The observed decrease particularly in specialist utilization among people with the selected chronic diseases at the beginning of the pandemic was not observed for the second half of 2021 despite the ongoing pandemic. Further studies are required to examine whether the temporary changes in the utilization of ambulatory health care have affected the disease management of people with chronic diseases. [ABSTRACT FROM AUTHOR]

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The well‐known German aversion to inflation has attracted a lot of interest and is often attributed to a specific historical memory: Weimar. Yet we do not know much about why hyperinflation seems to overshadow the Great Depression in German collective economic memory. To answer this question, we study what exactly it is that Germans believe to remember about their past. Using original survey data, we show that many Germans do not distinguish between hyperinflation and the Great Depression, but see them as two dimensions of the same crisis. They conflate Weimar economic history into one big crisis, encompassing both rapidly rising prices and mass unemployment. Additionally, more educated and politically interested Germans are more likely to commit this fallacy. Our finding thus nuances ideational explanations for Germany's economic policy stance in the European Union. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to estimate excess costs of depression in Germany and to examine the influence of sociodemographic and socioeconomic determinants. Methods: Annual excess costs of depression per patient were estimated for the year 2019 by comparing survey data of individuals with and without self-reported medically diagnosed depression, representative for the German population aged 18–79 years. Differences between individuals with depression (n = 223) and without depression (n = 4540) were adjusted using entropy balancing. Excess costs were estimated using generalized linear model regression with a gamma distribution and log-link function. We estimated direct (inpatient, outpatient, medication) and indirect (sick leave, early retirement) excess costs. Subgroup analyses by social determinants were conducted for sex, age, socioeconomic status, first-generation or second-generation migrants, partnership, and social support. Results: Total annual excess costs of depression amounted to €5047 (95% confidence interval [CI] 3214–6880) per patient. Indirect excess costs amounted to €2835 (1566–4103) and were higher than direct excess costs (€2212 [1083–3341]). Outpatient (€498), inpatient (€1345), early retirement (€1686), and sick leave (€1149) excess costs were statistically significant, while medication (€370) excess costs were not. Regarding social determinants, total excess costs were highest in the younger age groups (€7955 for 18–29-year-olds, €9560 for 30–44-year-olds), whereas total excess costs were lowest for the oldest age group (€2168 for 65+) and first-generation or second-generation migrants (€1820). Conclusions: Depression was associated with high excess costs that varied by social determinants. Considerable differences between the socioeconomic and sociodemographic subgroups need further clarification as they point to specific treatment barriers as well as varying treatment needs. [ABSTRACT FROM AUTHOR]

Background: The SARS-CoV-2 pandemic presented major challenges to the health sector in 2020. The burden of disease arising from COVID-19 can be expressed as the number of years of life lost to disease or death. For example, death at age 40 involves a loss of far more years of life than death at age 80. Methods: The disability-adjusted life years (DALY) lost to COVID-19 were calculated as the sum of the years of life lost through death (YLL) and the number of years lived with disability (YLD), on the basis of laboratory-confirmed notifiable cases of SARS-CoV-2 infection in Germany in 2020 (documented as of 18 January 2021). The methodology was based on that used in the Global Burden of Disease Study. Pre-existing diseases do not enter into the determination of YLL; rather, the residual life expectancy that is applied in this calculation corresponds to a mean age-specific level of morbidity. Results: 305 641 years of life were lost to COVID-19 in Germany in 2020. The percentage of DALY lost by persons under 70 was 34.8% in men and 21.0% in women. 99.3% of the COVID-19 disease burden was accounted for by death (YLL). The daily average years of life lost due to death was lower for COVID-19 than for the major non-communicable diseases. Persons who died of COVID-19 lost a mean of 9.6 years of life; those who were under 70 when they died lost a mean of 25.2 years of life. Men lost more years of life than women (11.0 vs. 8.1 years). Conclusion: The effects of COVID-19 on public health can be expressed through the burden of disease indicators. This method yields additional information that should be put to use early in the course of future outbreaks. [ABSTRACT FROM AUTHOR]

Background: Knowing which diseases and causes of death account for most of the years of life lost (YLL) can help to better target appropriate prevention and intervention measures. The YLL in Germany for specific causes of death were estimated as part of the BURDEN 2020 project at the Robert Koch Institute. Methods: Data from cause-of-death statistics were used for the analysis. ICD codes were grouped into causes of death categories at different levels of disaggregation. The YLL were estimated by combining each cause of death with the remaining life expectancy at the age of death. Deaths and YLL were compared by sex, age category, and regional distribution. Results: Approximately 11.6 million years were estimated to be lost in Germany in 2017, of which 42.8% were lost by women and 57.2% by men. The largest number of YLL were due to (malignant) neoplasms (35.2%), followed by cardiovascular diseases (27.6%), gastrointestinal diseases (5.8%), and neurological diseases (5.7%). Deaths at younger ages had a greater impact on population health if expressed in YLL: the death share of persons under age 65 was 14.7%, but the years of life lost in this age group amounted to 38.3% of all YLL. The most common causes of death in this group include accidents, self-injury and violence, malignant neoplasms, and alcohol-related diseases. Conclusion: A large proportion of YLL is borne by young and middle-aged persons. These findings emphasize the need to introduce preventive strategies early in life to reduce the YLL at younger ages, as well as to prevent risk factors for diseases in older ages. [ABSTRACT FROM AUTHOR]

Background: Dimensions of social location such as socioeconomic position or sex/gender are often associated with low response rates in epidemiological studies. We applied an intersectionality-informed approach to analyze non-response among population strata defined by combinations of multiple dimensions of social location and subjective health in a health survey in Germany. Methods: We used data from the cross-sectional sample of the German Health Interview and Examination Survey for Adults (DEGS1) conducted between 2008 and 2011. Information about non-responders was available from a mailed non-responder questionnaire. Intersectional strata were constructed by combining all categories of age, sex/gender, marital status, and level of education in scenario 1. Subjective health was additionally used to construct intersectional strata in scenario 2. We applied multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) to calculate measures of discriminatory accuracy, proportions of non-responders among intersectional strata, as well as stratum-specific total interaction effects (intersectional effects). Markov chain Monte Carlo methods were used to estimate multilevel logistic regression models. Results: Data was available for 6,534 individuals of whom 36% were non-responders. In scenario 2, we found weak discriminatory accuracy (variance partition coefficient = 3.6%) of intersectional strata, while predicted proportions of non-response ranged from 20.6% (95% credible interval (CI) 17.0%-24.9%) to 57.5% (95% CI 48.8%-66.5%) among intersectional strata. No evidence for intersectional effects was found. These results did not differ substantially between scenarios 1 and 2. Conclusions: MAIHDA revealed that proportions of non-response varied widely between intersectional strata. However, poor discriminatory accuracy of intersectional strata and no evidence for intersectional effects indicate that there is no justification to exclusively target specific intersectional strata in order to increase response, but that a combination of targeted and population-based measures might be appropriate to achieve more equal representation. [ABSTRACT FROM AUTHOR]

Background: In Germany, patients are consulting general practitioners increasingly frequently, resulting in a high burden on the healthcare system. This study aimed to identify factors associated with frequent primary care attendance in the German healthcare system. Methods: The German Health Interview and Examination Survey for Adults (DEGS) is part of Germany's national health monitoring, and includes a large representative sample of the German population aged 18–79 years. We defined the 10% of participants with the highest number of general practitioner contacts in the preceding 12 months as frequent attenders of primary care services. Binary logistic regression models with average marginal effects were used to identify potential determinants for frequent use of primary care services. Results: The sample comprised 7956 participants. Significant effects on frequent use of primary care were observed for low socioeconomic status, stressful life events, factors related to medical need for care such as medically diagnosed chronic conditions and for subjective health. In the full model, the number of non-communicable diseases and subjective health status had the strongest effect on frequent primary care use. We found an interaction effect suggesting that the association between subjective health status and frequent attendance vanishes with a higher number of non-communicable diseases. Conclusions: We observed strong associations between frequent primary care attendance and medical need for care as well as subjective health-related factors. These findings suggest that better coordination of care may be a preferred method to manage health services utilization and to avoid redundant examinations and uncoordinated clinical pathways. Further research is needed to clarify moderating and mediating factors contributing to high utilization of primary care services. [ABSTRACT FROM AUTHOR]

Recent studies cast doubt on the ability of abstract experiments to predict decision‐making in the field. Thus, scholars have argued for more 'realism' by introducing context to field experiments. Yet, such realism may work against the induced values of monetary incentives in economic experiments. It is an open question whether contextual framing works best with or without inducing values, through methods such as the use of monetary incentives. Using a sample of 146 German farmers, we compare experimentally the predictive power of a framed lottery in an agricultural context vs. using an abstract version. For one half of the sample, lotteries are incentivised; for the other half, they are hypothetical. Although risk preferences differ between treatments, all four lottery tasks correlate poorly with farmers' real‐world use of risk management instruments such as harvest or hail insurance. Subjects who start with an agricultural framing are willing to take significantly greater risks in the lotteries. More generally, our findings cast doubt on the ability of lottery tasks to predict risk‐taking in the field. [ABSTRACT FROM AUTHOR]

Degrowth activists and scholars have questioned society's current levels of material throughput and energy use. The energy sector is at the core of any modern economy, and Germany serves as an international showcase for the transition of a large industrialized economy to a low-carbon energy system. Diverse actors, organizational models, and technologies have contributed to the initiation of Germany's energy transition through a wide range of community renewable energy projects. The think piece investigates how far these diverse actors embrace the aims of the Degrowth movement. It also provides a critical account of on-the-ground realities through six hypotheses and contrasts them with claims made by the Degrowth movement. It is suggested that community renewable energy projects are at a crossroads. While many projects have familiarized thousands of people with alternative economic models, there is little evidence of a general change in attitudes towards technology, consumption, or equity. In conclusion, a major effort is needed to open initiatives to less affluent actors, oppose recent trends of commodification, and prevent community renewable energy projects from being engrossed by the dominant political and economic system. [ABSTRACT FROM AUTHOR]

In Germany, like in other European countries, one can observe the recent rise of right wing movements, referred to by some authors as the New Right (Bruns, Glösel and Strobel 2016). During the last years those tendencies were able to create and establish closed pictures of national identities, and promote these quite successfully through populist discourses (Speit 2016, 314). Since the so called 'Refugee-crisis,' they gained even more approval throughout German society and established the 'Muslim' as contrary to German habitus. On the contrary there are also civic movements that show explicit solidarity with refugees and offer their help to the newcomers, which was labelled as 'welcome-culture.' Since this polarisation of attitudes towards refugees is so obvious, the question that is addressed in this article concerns the motives and structural circumstances of this division of orientations throughout German society, and hints at questions of identity and habitus. [ABSTRACT FROM AUTHOR]

Increasing the share of renewable energies requires an extension of grid capacity and additional storage possibilities. Although load shifting has been identified as a key instrument to relieve an overloaded grid, technologies that enable the decentralization of load shifting have hardly penetrated the electricity market. In this paper, a discrete choice experiment is applied to investigate preferences and willingness to pay values for micro-cogeneration, a technology that has huge potential to enhance load shifting, and at the same time reduce costs and CO 2 emissions for heating. Our study includes homeowners as well as tenants to capture the overall market potential. Drawing from a sample of 412 adult Germans, several drivers of willingness to pay for micro-cogeneration are identified such as cost and CO 2 saving potential, contract specifics and a feed-in tariff. The results show that most people would be willing to invest in micro-cogeneration technologies but non-monetary obstacles, such as limited institutional support, hinder investment on a larger scale. Several sources of preference heterogeneity are identified, giving rise to the development of a large variety of products and incentive structures. [ABSTRACT FROM AUTHOR]

Aims: Coronary artery disease accounts for the majority of sudden cardiac deaths (SCD) in the older population whereas cardiomyopathies and arrhythmogenic abnormalities predominate in younger SCD victims (<35 years) with a significant genetic component. The elucidation of the pathogenetic cause of death might be relevant for the prevention of further deaths within affected families. Aim of this study was to determine the portion of underlying genetic heart diseases among unexplained putative SCD cases from a large German forensic department.Methods and Results: We included 10 forensic cases of sudden unexplained death (SUD) victims aged 19-40 years, who died by SCD due to forensic autopsy. DNA was analysed by next generation panel sequencing of 174 candidate genes for channelopathies and cardiomyopathies. Cardiological examinations, genetic counselling, and subsequent genetic testing were offered to all affected families. We identified within 1 year 10 cases of SUD among 172 forensic cases. Evidence for a genetic disposition was found in 8 of 10 (80%) cases, with pathogenic mutations in 3 and variants of uncertain significance in 5 of SCD cases. Subsequent selective screening of family members revealed two additional mutation carriers.Conclusion: The study provides strong evidence that molecular genetics improves the post mortem diagnosis of fatal genetic heart diseases among SUD victims. Molecular genetics should be integrated in forensic and pathological routine practice. [ABSTRACT FROM AUTHOR]

Economic experiments are increasingly conducted with field populations for whom comprehension of instructions may be more difficult to achieve. We investigate how framing experimental instructions in a familiar context and incentivizing the experimental task may affect comprehension. Based on an experiment with 146 German farmers, we compare four different versions of a Holt-and-Laury multiple price list. We find that incentives have a small positive effect on comprehension, as measured by the probability of making inconsistent choices and subjects’ self-assessment. In the absence of incentives, framing negatively affects comprehension. Comprehension is enhanced for farmers who score high on a numeracy test. We conclude that contextual framing might confuse subjects, whereas incentives can help to facilitate comprehension of experimental instructions. [ABSTRACT FROM PUBLISHER]

Background. Physical therapy is included in many clinical guidelines and is a commonly used health service. However, access to its benefits should not strongly depend on social or demographic factors. Objective. The present study used the Andersen model to explain to what extent physical therapy utilization in Germany depends on factors beyond medical need. Methods. The German Health Interview and Examination Survey for Adults (DEGS, 2008-2011; target population, 18-79 years) is part of the German health-monitoring system. Two-stage stratified cluster sampling resulted in a sample of 8152 participants. Data were matched with district-related information on social structures and service supply. Following Andersen's Behavioral Model of Health Services Use, this study identified predisposing, enabling, and need factors for physical therapy utilization using multilevel logistic regression analyses. Results. Physical therapy was used by 23.4% (95% CI: 22.0-24.8) of the German population within one year, with a higher proportion of females (26.8%; 95% CI: 25.1-28.6) than males (19.9%; 95% CI: 18.1-21.8) and an increase with age. Beyond medical need, physical therapy utilization depended on higher education, migrant background, nonsmoking (predisposing), social support, higher income, private health insurance, and gatekeeping service contact (enabling). Variation among districts partly reflected regional supply. Limitations. Because the present study was cross-sectional, its findings provide representative information on physical therapy use but do not establish final causal links or identify whether utilization or supply in certain districts or population groups is adequate. Conclusions. Whether certain regions are under- or overserved and whether further regulations are needed is of political interest. Physicians and therapists should develop strategies to improve both adherence of hard-to-reach groups and supply in low-supply regions. [ABSTRACT FROM AUTHOR]

Consumers can choose from a wide range of electricity supply contracts, including green power options. Electricity produced from renewable energy involves information asymmetries. With a sample of more than 2,000 German electricity consumers, we tested the proposition of a “lemon market” for renewable energy in a discrete choice experiment. Specifically, we found that, compared to investor-owned firms, additional willingness-to-pay for renewable energy is approximately double when offered by cooperatives or municipally-owned electricity utilities. Consumers who are experienced with switching suppliers have an additional willingness-to-pay of one Eurocent per kilowatt hour for cooperatives and two Eurocents for public enterprises. The results demonstrate that organizational transformation in dynamically-changing electricity markets is not only driven by political initiatives but also by consumers' choices on the market. Public policy may reduce information asymmetries by promoting government labeling of green energy products. [ABSTRACT FROM AUTHOR]

Background: Socially disadvantaged people have an increased need for medical care due to a higher burden of health problems and chronic diseases. In Germany, outpatient care is chiefly provided by office-based general practitioners and specialists in private practice. People are free to choose the physician they prefer. In this study, national data were used to examine differences in the use of outpatient medical care by socioeconomic status (SES). Methods: The analyses were based on data from 6,754 participants in the Robert Koch Institute’s German Health Interview and Examination Survey for Adults (DEGS1) aged between 18 and 69 years. The number of outpatient physician visits during the past twelve months was assessed for several medical specializations. SES was determined based on education, occupation, and income. Associations between SES and physician visits were analysed using logistic regression and zero-truncated negative binomial regression for count data. Results: After adjusting for sociodemographic factors and health indicators, outpatients with low SES had more contacts with general practitioners than outpatients with high SES (men: incidence rate ratio [IRR] = 1.25; 95% confidence interval [CI] = 1.08–1.46; women: IRR = 1.20; 95% CI = 1.07–1.34). The use of specialists was lower in people with low SES than in those with high SES when sociodemographic factors and health indicators were adjusted for (men: odds ratio [OR] = 0.68; 95% CI = 0.51–0.91; women: OR = 0.56; 95% CI = 0.41–0.77). This applied particularly to specialists in internal medicine, dermatology, and gynaecology. The associations remained after additional adjustment for the type of health insurance and the regional density of office-based physicians. Conclusion: The findings suggest that socially disadvantaged people are seen by general practitioners more often than the socially better-off, who are more likely to visit a medical specialist. These differences may be due to differences in patient preferences, physician factors, physician-patient interaction, and potential barriers to accessing specialist care. [ABSTRACT FROM AUTHOR]

B Correction: Arch Public Health 79, 86 (2021) b B https://doi.org/10.1186/s13690-021-00609-0 b Following publication of the original article [[1]], the authors reported the second author affiliation needed to be added. Reference 1 Starker A, Hövener C, Rommel A. Utilization of preventive care among migrants and non-migrants in Germany: results from the representative cross-sectional study 'German health interview and examination survey for adults (DEGS1)'. [Extracted from the article]

Unintentional injuries cause much of the global mortality burden, with the workplace being a common accident setting. Even in high-income economies, occupational injury figures remain remarkably high. Because risk factors for occupational injuries are prone to confounding, the present research takes a comprehensive approach. To better understand the occurrence of occupational injuries, sociodemographic factors and work- and health-related factors are tested simultaneously. Thus, the present analysis aims to develop a comprehensive epidemiological model that facilitates the explanation of varying injury rates in the workplace. The representative phone survey German Health Update 2010 provides information on medically treated occupational injuries sustained in the year prior to the interview. Data were collected on sociodemographics, occupation, working conditions, health-related behaviors, and chronic diseases. For the economically active population (18–70 years, n = 14,041), the 12-month prevalence of occupational injuries was calculated with a 95% confidence interval (CI). Blockwise multiple logistic regression was applied to successively include different groups of variables. Overall, 2.8% (95% CI 2.4–3.2) of the gainfully employed population report at least one occupational injury (women: 0.9%; 95% CI 0.7–1.2; men: 4.3%; 95% CI 3.7–5.0). In the fully adjusted model, male gender (OR 3.16) and age 18–29 (OR 1.54), as well as agricultural (OR 5.40), technical (OR 3.41), skilled service (OR 4.24) or manual (OR 5.12), and unskilled service (OR 3.13) or manual (OR 4.97) occupations are associated with higher chances of occupational injuries. The same holds for frequent stressors such as heavy carrying (OR 1.78), working in awkward postures (OR 1.46), environmental stress (OR 1.48), and working under pressure (OR 1.41). Among health-related variables, physical inactivity (OR 1.47) and obesity (OR 1.73) present a significantly higher chance of occupational injuries. While the odds for most work-related factors were as expected, the associations for health-related factors such as smoking, drinking, and chronic diseases were rather weak. In part, this may be due to context-specific factors such as safety and workplace regulations in high-income countries like Germany. This assumption could guide further research, taking a multi-level approach to international comparisons. [ABSTRACT FROM AUTHOR]

The aim of the BURDEN 2020 project is to calculate the Burden of Disease for Germany at the national and regional level. Based on the methods of the Global Burden of Disease study, the results will assess the impact of diseases on population health thus providing a freely accessible information basis for policy making and health care planning. How can the transfer from science to society take place on a lowthreshold basis? We will talk about our strategy reaching out to decision-makers within health care planning in Germany and Europe. In addition, it will be examined how we wanted our results to be accessible, which possibilities of publication we choose beyond scientific articles and what options we had when talking about research marketing. We will also have a closer look on our demands for data visualization and transparency. In an ongoing process, two things were at stake: how do we define our target groups and how we address them. It has been proven to be a good strategy to continuously build up (international) networks, to share our knowledge and implement feedback. When publishing scientific results, it has turned out to be helpful for the project to approach a wellknown bi-lingual journal with a wide range of coverage. We aimed to present the pilot project online with an appealing data visualization and graphic formats. This type of presentation made it easier to approach members of the press. Also, the inclusion of current topics such as COVID-19 helped to increase the media response. There are plans to include the use of the data in media formats such as webinars. Burden of Disease assessments can be challenging in implementation and communication. Before the start, the use of the metrics for Germany had to be thoroughly explained to national stakeholders. Within the project, we had to discuss how our data should be communicated to the public, to explain strength and weaknesses, and to produce publication formats that suit different target groups. [ABSTRACT FROM AUTHOR]

The Social Democrats together with the Greens gained only a slight majority in the state elections. Both parties succeeded a ten year duration of the conservative and liberal government coalition on state level. SPD and the Greens received a total of 46.3 per cent of the vote while CDU and FDP gained only 45.9 per cent. With this result, the new coalition government holds only one seat more in parliament than the opposition parties. The new Left and the small Pirate Party fell below the five per cent hurdle which results in four parties being represented in the state parliament. The electoral participation increased modestly and reached a level comparable to the turnout in other state elections. The very short "winter campaigning" was dominated by national political issues. Among the very few state-oriented political concerns were the educational, the labour market and the family programs of the competing political parties. The electoral behaviour of social groups fulfils all expectations and predictions of contemporary electoral research. Only one among the nine ministers of the new coalition has political experience in governing on state level. [ABSTRACT FROM AUTHOR]

Riparian zones fulfill diverse ecological and economic functions. Sustainable management requires detailed spatial information about vegetation and hydromorphological properties. In this study, we propose a machine learning classification workflow to map classes of the thematic levels Basic surface types (BA), Vegetation units (VE), Dominant stands (DO) and Substrate types (SU) based on multispectral imagery from an unmanned aerial system (UAS). A case study was carried out in Emmericher Ward on the river Rhine, Germany. The results showed that: (I) In terms of overall accuracy, classification results decreased with increasing detail of classes from BA (88.9%) and VE (88.4%) to DO (74.8%) or SU (62%), respectively. (II) The use of Support Vector Machines and Extreme Gradient Boost algorithms did not increase classification performance in comparison to Random Forest. (III) Based on probability maps, classification performance was lower in areas of shaded vegetation and in the transition zones. (IV) In order to cover larger areas, a gyrocopter can be used applying the same workflow and achieving comparable results as by UAS for thematic levels BA, VE and homogeneous classes covering larger areas. The generated classification maps are a valuable tool for ecologically integrated water management. [ABSTRACT FROM AUTHOR]

We measured the motivation and interest of medical students in oral and maxillofacial surgery at a German university. After a detailed cost-benefit analysis of a course that used an ex-vivo animal model and active participation in the operating theatre, we measured changes in the students’ interest in taking up a surgical specialty in the future. We found that practical experience could lower the expenses of the course by almost 70%. Twenty per cent of students chose oral and maxillofacial surgery as an elective in their final year. These students could be residents one day. [ABSTRACT FROM AUTHOR]

The article presents a research investigating the organizational structure and ideology of Green Party, a political party in Germany. The data elements show that the ideological composition of the said group's program is self-help and social services. Moreover, though the formal organizational structure of the said party is designed to counter elite-directed participation that leads to oligarchy, bureaucracy and the professionalism of leadership are considered vital to the system.

This article is concerned with the relationship between the supporters of new social movements (peace, ecology, arid anti-nuclear power) and the Green Party in contemporary Germany. In theoretical terms the research interest lies in the question of the extent to which the new social movements in Germany are responsible for a change in the nature of the party system. Particular attention is given to the historical and electoral ties as well as the value system and the ideological orientation of the Green voters and the followers of new social movements. Their over-all impact on future party system is still controversial: on the one hand, the Greens could prepare the way for a dealignment, and on the other hand they could determine the process of realignment within the German party system. [ABSTRACT FROM AUTHOR]

Background: Right ventricular (RV) function is a known predictor of adverse events in heart failure and following acute myocardial infarction (AMI). While right atrial (RA) involvement is well characterized in pulmonary arterial hypertension, its relative contributions to adverse events following AMI especially in patients with heart failure and congestion need further evaluation. Methods: In this cardiovascular magnetic resonance (CMR)-substudy of AIDA STEMI and TATORT NSTEMI, 1235 AMI patients underwent CMR after primary percutaneous coronary intervention (PCI) in 15 centers across Germany (n = 795 with ST-elevation myocardial infarction and 440 with non-ST-elevation MI). Right atrial (RA) performance was evaluated using CMR myocardial feature tracking (CMR-FT) for the assessment of RA reservoir (total strain εs), conduit (passive strain εe), booster pump function (active strain εa), and associated strain rates (SR) in a blinded core-laboratory. The primary endpoint was the occurrence of major adverse cardiac events (MACE) 12 months post AMI. Results: RA reservoir (εsp = 0.061, SRs p = 0.049) and conduit functions (εep = 0.006, SRe p = 0.030) were impaired in patients with MACE as opposed to RA booster pump (εap = 0.579, SRa p = 0.118) and RA volume index (p = 0.866). RA conduit function was associated with the clinical onset of heart failure and MACE independently of RV systolic function and atrial fibrillation (AF) (multivariable analysis hazard ratio 0.95, 95% confidence interval 0.92 to 0.99, p = 0.009), while RV systolic function and AF were not independent prognosticators. Furthermore, RA conduit strain identified low- and high-risk groups within patients with reduced RV systolic function (p = 0.019 on log rank testing). Conclusions: RA impairment is a distinct feature and independent risk factor in patients following AMI and can be easily assessed using CMR-FT-derived quantification of RA strain. [ABSTRACT FROM AUTHOR]