Dreaming during a pandemic: Low incorporation of COVID-19-specific themes and lucidity in dreams of psychiatric patients and healthy controls

The present study examined the impact of the COVID-19 pandemic on the emotional quality of dreams, the incorporation of pandemic-related themes, and the occurrence of lucid dreaming. Dream reports and lucidity ratings of psychiatric outpatients (n = 30) and healthy controls (n = 81) during two lockdowns in Germany were compared to those of healthy controls (n = 33) before the pandemic. Results confirmed previous reports that pandemic-specific themes were incorporated into dreams. Overall, however, incorporation into dreams was rare. Contrary to expectations, psychiatric outpatients did not differ from controls in the frequency of dream incorporation of pandemic-related content. Moreover, incorporation was independent of psychiatric symptoms and loneliness. Loneliness was, however, associated with threat-related content, suggesting that it represents a risk for bad dreams but not for crisis-specific dream incorporation. Regarding lucid dreaming, both groups had similar scores for its underlying core dimensions, i.e., insight, control, and dissociation, during the two lockdowns. Scores for control and dissociation but not insight were lower compared to the pre-pandemic sample. Our working hypothesis is that REM sleep during lockdowns intensified as a means of increased emotional consolidation, rendering the associated mental state less hybrid and thereby less lucid. (AU)

Anticipated fear and anxiety of Automated Driving Systems: Estimating the prevalence in a national representative survey

Background: Automated Driving Systems (ADS) may reshape mobility. Yet, related fear and anxiety are largely unknown. We estimated the prevalence and risk factors of anticipated anxiety towards ADS. Method: In a nationally representative face-to-face household survey, we assessed anticipated levels of anxiety towards ADS based on DSM-5 specific phobia criteria, using structured diagnostic interviews. We estimated weighted prevalences and conducted adjusted logistic regression models. Results: Of N = 2076 respondents, 40.82% (95%-confidence interval (CI) 37.73–43.98) anticipated experiencing some symptoms of phobia of ADS, 15.22% (CI 13.19–17.51) anticipated subthreshold phobia, and 3.39% (CI 2.42–4.75) anticipated full-blown phobia of ADS. Of subjects anticipating subthreshold phobia, 74.02% showed no strong, enduring fears of driving non-automated cars and 65.07% presented no other specific phobias (full-blown anticipated phobia: 50.37% and 50.03%, respectively). Anticipated phobia highly overlapped with anticipating marked or strong fears of passively encountering ADS in traffic (odds ratio 312.4–1982.2). Conclusion: About 20% of subjects anticipated at least subthreshold and 4% of subjects anticipated full-blown phobia of ADS. It appears to be distinct from fears related to non-automated driving and other specific phobias. Our findings call for prevention and treatment of phobia of ADS as they become increasingly ubiquitous. (AU)

Differential associations of leisure music engagement with resilience: A network analysis

Background/Objective: Several factors associated with resilience as the maintenance of mental health despite stress exposure can be strengthened through participation in leisure time activities. Since many people listen to or make music in their leisure time, the aim of the present study was to provide insights into the architecture of how resilience relates to passive and active music engagement. Method: 511 participants regularly listening to and/or making music completed an online survey on resilient outcomes (i.e., mental health and stressor recovery ability), different resilience factors (e.g., optimism, social support), quantitative music engagement (i.e., time spent with music listening/making) and qualitative music engagement (i.e., use of music listening/making for mood regulation). Results: Bivariate correlations showed that subjects spending more time with music making reported better stressor recovery ability and less mental health problems, while partial correlational network analysis revealed no unique associations for quantitative music engagement. Regarding qualitative music engagement, people using music-based mood regulation reported lower mental health, mindfulness, and optimism, but also higher social support. A more heterogeneous pattern emerged for single music-based mood regulation strategies. Conclusions: Our findings highlight the importance of the individual (mal-)adaptive use of music, painting a more nuanced picture of music engagement and resilience. (AU)

Physical Education Programmes Improve Sportsman's Motivation, Attitude, and Self-Efficacy: A Mixed Methods Study in Germany / Los programas de educación física mejoran la motivación, la actitud y la autoeficacia de los deportistas: un estudio de métodos mixtos en Alemania

Physical education plays a crucial role in the holistic development of students; however, it presents a significant challenge for universities in Germany. In order to achieve this objective, a physical activity programme was developed with the intention of providing individualised assistance to enhance both the quantity and quality of physical education. Additionally, the programme aims to promote improvements in self-efficacy, attitudes, and motivation towards physical education, which are influential factors in enhancing athletic performance. Hence, this study investigates the impact of physical education on motivation, attitude, and self-efficacy in promoting physical activity among university students in Germany. In order to achieve the objectives of this study, a sample of 250 athletes from German universities was selected using a convenient sampling technique. The data collected from this sample was primarily quantitative in nature. Additionally, qualitative data was obtained by conducting 15 interviews. The researcher utilised a mixed-methods approach. The data was subjected to analysis using the Statistical Package for the Social Sciences (SPSS) software, employing pre-test and post-test phases. The results obtained from both qualitative and quantitative analyses unequivocally emphasise the significant advantages of the physical education programme for all individuals involved. Significantly, the anticipated effects were observed in terms of important outcomes such as the reduction of negative attitudes, the increase in desire for exercise, and the enhancement of opinions regarding physical ability. The study provided additional evidence that supports the effectiveness of personalised physical education interventions. These interventions have the potential to improve students' attitudes, motivation, and self-efficacy towards physical activity in school settings. The study's conclusion included a discussion on the limitations of the research and potential avenues for future investigation.(AU)

Colaboración hispano-alemana en Bioquímica mantenida por miembros de la Real Academia Nacional de Farmacia y por otros bioquímicos españoles / Spanish-German collaboration in Biochemistry maintained by members of the Royal Academy National of Pharmacy and by other Spanish biochemists

Considerada la Bioquímica alemana como la pionera en el mundo, ya en la etapa inicial de la misma, hacia 1872, se estableció la primera vinculación entre el Profesor alemán fundador de esta disciplina, Felix von Hoppe-Seyler, y el Catedrático español de Química Orgánica Laureano Calderón Arana. Después, algunos de los Catedráticos de la recién establecida asignatura de Química Biológica, cuya enseñanza se impartía únicamente en la Facultad de Farmacia madrileña para los alumnos de Doctorado (común a Farmacia, Medicina y Ciencias), mantuvieron esta relación, aunque menos intensa, con sus colegas germanos. Pero, a partir de 1928, el que sería Premio Nobel, Dr. Severo Ochoa, trabajó durante largos periodos en prestigiosos Departamentos de Berlín y Heidelberg. Y ya en época reciente, bioquímicos pertenecientes a la Real Academia Nacional de Farmacia (RANF) han continuado esta vinculación colaborando en diversos Departamentos alemanes. Por otro lado, bioquímicos germanos han impartido conferencias en Universidades españolas, invitados por sus colegas hispanos, además de hacerlo en congresos o simposios en España. Asimismo, algunos de ellos han sido miembros de la RANF. (AU)

German can be considered as world pioneer in the development of Biochemistry. Its founder, Prof. Felix von Hoppe-Seyler, established contacts with the Spanish Professor of Organic Chemistry, Laureano Calderón Arana, since the onset of this subject around 1872. Later, some other Professors of the newly created Química Biológica, which was taught only at the Faculty of Pharmacy in Madrid as a subject common to doctoral students in Pharmacy, Medicine and Science, maintained a connection, albeit minor, with their German colleagues. From 1928, Dr. Severo Ochoa, who would subsequently win a Nobel Prize, worked for long periods in the prestigious Departments at Berlin and Heidelberg. More recently, other biochemists, members of the Royal Academy National of Pharmacy (RANF), have followed this connection with several German Departments. Furthermore, German biochemists have delivered lectures in Spanish Universities invited by their Spanish colleagues, in addition to their participation in Spanish symposia. Moreover, several German biochemists have been RANF members. (AU)

Indicadores técnicos de desempenho para comparação de equipes de sucesso e não sucesso na Bundesliga / Indicadores de rendimiento técnico para comparar equipos exitosos y no exitosos en la Bundesliga / Technical performance indicators for comparing successful and unsuccessful teams in the Bundesliga

Objetivo: Este estudo propôs comparar e identificar variáveis técnicas capazes de diferenciar as equipes de melhor desempenho das demais equipes que disputaram a Bundesliga nas últimas cinco temporadas. Método: Foram coletados dados de nove variáveis técnicas de 1530 jogos da Bundesliga entre as temporadas 2014-15 e 2018-19 através do site público “whoscored.com”. As equipes presentes na tabela da Bundesliga nas últimas cinco temporadas foram divididas em grupos de três. Após a coleta, utilizou-se o teste de Shapiro-Wilk para a determinação da distribuição dessas variáveis. Para os dados cuja distribuição é normal foi utilizado o teste T de amostras independente e para os dados cuja distribuição não foi normal, utilizou-se o teste de Mann-Whitney. Resultado: Os resultados mostraram que as equipes do Grupo 1 apresentaram melhores índices nas variáveis chute de dentro da área, chute de fora da área, passe para setor de meio, passe para setor de ataque e desarme pelo tempo de posse de bola adversária. Conclusão: O estudo se mostrou satisfatório pois cumpriu com seu objetivo ao identificar variáveis técnicas que discriminam equipes vencedoras das outras equipes, além de proporcionar aos treinadores informações para definir objetivos para equipe e jogadores nas sessões de treinamento.(AU)

Objetivo: Este estudio propuso comparar e identificar variables técnicas capaces de diferenciar los equipos con mejor desempeño de los demás equipos que compitieron en la Bundesliga en las últimas cinco temporadas. Método: Fueron recogidos datos sobre nueve variables técnicas de 1530 partidos de la Bundesliga entre las temporadas 2014-15 y 2018-19 a través del sitio Web público "whoscored.com". Los equipos presentes en la tabla de la Bundesliga en las últimas cinco temporadas se dividieron en grupos de tres. A continuación se utilizó usó la prueba de Shapiro-Wilk para determinar la distribución de estas variables. Para los datos cuya distribución es normal, se utilizó la prueba T de muestras independientes y para los datos cuya distribución no fue normal, se utilizó la prueba de Mann-Whitney. Resultado: Los resultados mostraron que los equipos del Grupo 1 tuvieron mejores índices en las variables remate desde dentro del área, remate desde fuera del área, pase al sector medio, pase al sector de ataque y desarme por el tiempo de posesión del balón del oponente. Conclusión: El estudio demostró ser satisfactorio porque cumplió su objetivo mediante la identificación de variables técnicas que discriminan a los equipos ganadores de otros equipos, además de proporcionar a los entrenadores información para definir objetivos para el equipo y los jugadores en las sesiones de entrenamiento.(AU)

Objective: The aim of the current study is to compare and identify specific technical indicators that discriminate the successful and unsuccessful team that played in the Bundesliga in the last five seasons. Method: Data of nine technical variables of 1530 games in Bundesliga between the seasons 2014-15 and 2018-19 were collected through the public website “whoscored.com”. The teams that played in the Bundesliga in the last five seasons were divided in groups of three. The Shapiro-Wil Test was used to determine the distribution of these variables. For data whose distribution is normal, the T test of independent samples was used and for data whose distribution was not normal, the Mann-Whitney test was used. Results: The results showed the teams on Group 1 had better ratio in variables such Six Yard Box Shot, Out of Box Shot, Passes to Midfield Area, Passes to Attacking Area, Tackles related to Opponent’s Possession Time. Conclusion: In conclusion, this study presents values finding technical indicators that discriminate successful and unsuccessful team that can be used by coaches to design individual and group strategies in training sessions.(AU)

The early days of electrodermal activity / Los primeros días de la actividad electrodérmica

This paper emphazises main steps of the discovery of one of the most salient autonomic markers of mind expressions, the electrodermal activity (EDA). The contribution of French and German schools of physiology, aimed by clinical needs and the desire to know further about physiological mechanisms, constitutes the very early roots of such activity. In this frame, Féré and Tarchanoff, respectively a French and a Russian discoverers, established the link between mind activity and the EDA on the one hand and laid the methodological foundations of modern utilisation of this neuromarker on the other hand. This heritage, associated with central neural measures, is promised to an expanding future in neuropsychology, psychopathology, neurology, criminology and in cognitive and affective neuroscience.(AU)

Este artículo enfatiza las etapas principales del descubrimiento de uno de los marcadores autonómos más destacados de las expresiones mentales, la actividad electrodérmica (EDA). La contribución de las escuelas de fisiología francesa y alemana, orientada por las necesidades clínicas y el deseo de conocer más sobre los mecanismos fisiológicos, constituyen las primeras raíces de dicha actividad. En este marco, Féré y Tarchanoff, descubridores franceses y rusos respectivamente, establecieron el vínculo entre la actividad mental y la EDA, por un lado, y sentaron las bases metodológicas de la utilización moderna de este neuromarcador, por el otro. Este legado, asociado con medidas neuronales centrales, promete un futuro en expansión en neuropsicología, psicopatología, neurología, criminología y en neurociencia cognitiva y afectiva.(AU)

Eficacia de las medidas de minimización de riesgos del ácido valproico: estudio de utilización del fármaco en Europa, análisis de datos de España / Effectiveness of risk minimisation measures for valproate: a drug utilisation study in Europe, analysis of data from Spain

Introducción: En 2015 se aplicaron en España distintas medidas para la minimización de los riesgos (MMR) del ácido valproico. Objetivo: El objetivo de este estudio es evaluar la eficacia de las MMR del ácido valproico en España, con el fin de reducir el uso de ácido valproico como terapia de primera línea y evaluar los patrones de prescripción de ácido valproico en las mujeres, incluidas las mujeres en edad fértil (MEF), en los períodos previos y posteriores a la implementación de las MMR. Materiales y métodos: Los patrones de prescripción del ácido valproico en mujeres y MEF antes y después de la implementación de las MMR se examinaron utilizando la base de datos longitudinales de pacientes (longitudinal patient data, LPD por sus siglas en inglés), que incluye información de pacientes de dos paneles: médicos de atención primaria (MAP) y neurólogos/psiquiatras. El criterio principal de valoración fue la proporción de prescripciones iniciales de ácido valproico con al menos un medicamento relacionado con indicaciones de ácido valproico antes de la fecha de inicio del ácido valproico. Resultados: La proporción de prescripciones de ácido valproico secundarias con uso previo de medicamentos relacionados con indicaciones de ácido valproico fue del 78% –intervalo de confianza (IC) al 95%: 73,9-81,5%– y del 78,2% (IC al 95%: 74,5-81,4%) en los períodos principales previo y posterior a la implementación en el panel de MAP. Las cifras correspondientes a MEF fueron del 79,6% (IC al 95%: 73,6-84,5%) y del 75,5% (IC al 95%: 69,7-80,6%), respectivamente. La tasa de incidencia de embarazos expuestos al ácido valproico (por 1.000 personas-años) en MEF disminuyó de 17,4 en el período completo previo a la implementación a 8,5 en el período completo posterior a la implementación...(AU)

Introduction: Risk minimisation measures for valproate were implemented in Spain in 2015.Objective: The objective of this study is to assess the effectiveness of valproate risk minimisation measures in Spain intended to decrease the use of valproate as a first-line therapy, and to evaluate the prescribing patterns of valproate in women, including women of childbearing potential, in the pre- and post-implementation risk minimisation measures periods. Materials and methods: The prescribing patterns of valproate in females and women of childbearing potential before and after risk minimisation measures implementation were examined using the longitudinal patient data database, which includes patient information from two panels: primary care physicians and neurologists/psychiatrists. Primary endpoint was the proportion of initial valproate prescriptions with at least one medication related to the valproate indications before the valproate initiation date. Results: The proportion of incident valproate prescriptions with previous use of medication related to valproate indications was 78.0% (95% CI, 73.9%; 81.5%), and 78.2% (74.5%; 81.4%) in the main pre-and post-implementation periods in the primary care physician panel. The corresponding figures for women of childbearing potential were 79.6% (73.6%; 84.5%) and 75.5% (69.7%; 80.6%), respectively. The incidence rate of pregnancies exposed to valproate (per 1,000 person-years) in women of childbearing potential decreased from 17.4 the entire pre-implementation to 8.5 in the entire post-implementation periods. Conclusion: After the implementation of risk minimisation measures for valproate in Spain, no meaningful change in prescribing was observed regarding the proportion of valproate initiations preceded by prior medication related to valproate indications. The preventative measures recommended for use of valproate in women of childbearing potential should be considered.(AU)

El papel de la atención primaria en la pandemia COVID-19: Una mirada hacia Europa / The role of primary care during COVID-19 pandemic: A European overview

Describimos el papel de la atención primaria (AP) en 12 países europeos con relación a la COVID-19. No existe información oficial a nivel europeo sobre la actividad de AP. Los hallazgos fueron: Todos los países informaron mediante web y línea telefónica OVID-19 a sus ciudadanos. El rastreo se realizó a través de Salud Pública mayoritariamente, salvo España, Irlanda y Portugal. La tarea de vigilancia epidemiológica se ha solapado con la asistencial sobrecargando la AP. Las pruebas de detección de infección aguda (PDIA) se realizaron en AP de forma exclusiva en España. En el resto se derivaron a laboratorios externos. El seguimiento de pacientes ha sido realizado por AP, mayoritariamente no presencial. La cobertura sanitaria a población vulnerable y a residencias de mayores se ha regulado en todos los países. Es necesario un plan estratégico para AP en Europa que dé respuesta a los retos planteados.(AU)

We describe the role of primary care (PC) in 12 European countries in relation to the COVID-19 pandemic. There is no official information at European level on the activity of PC. The findings were: All countries provided COVID-19 information through telephone lines and websites to their citizens. Contact tracing was mainly carried out by Public Health except for Ireland, Portugal and Spain. The epidemiological surveillance task has overlapped with the PC assistance. Active Infection Diagnostic Tests (AIDT) were performed in PC exclusively in Spain. The other countries performed them in external laboratories. Patients were followed-up in PC mostly by remote assessment. Health coverage for vulnerable populations and nursing homes has been regulated in all countries. There is a need for a strategic plan for PC in Europe that responds to the challenges posed.(AU)

Suprarrenalectomía retroperitoneoscópica por vía posterior. Recomendaciones para la implementación de esta técnica / Posterior retroperitoneoscopic adrenalectomy: recommendations to implement this approach

Introducción: El abordaje retroperitoneoscópico posterior es una técnica poco extendida en España para la suprarrenalectomía a pesar de que, según algunos autores, ofrece ventajas respecto al acceso laparoscópico anterior o lateral. El objetivo del estudio fue identificar aquellas características que permitieran seleccionar los casos más favorables para iniciarse en esta técnica. Métodos: Estudio observacional de una cohorte de 50 pacientes intervenidos mediante suprarrenalectomía retroperitoneoscópica posterior (SRP) en un único centro. Se evaluó: sexo, edad e índice de masa corporal (IMC), tiempo operatorio, lateralidad, tamaño y características anatomopatológicas de las lesiones, tasa de conversión, complicaciones y estancia hospitalaria. Resultados: Se intervinieron 25 (50%) mujeres y 25 (50%) hombres con un tiempo operatorio mediano de 80 minutos (45-180). Se observó un tiempo operatorio significativamente menor en mujeres (p = 0,002) y en adenomas (p = 0,002). En cambio, no se observó correlación entre el tiempo quirúrgico e IMC, lateralidad o tamaño de la lesión. No hubo ningún caso de conversión. Las complicaciones fueron del 14% y la mayoría fueron leves, según la Escala de Clavien Dindo (i). La estancia hospitalaria mediana fue de dos días. Conclusiones: La suprarrenalectomía retroperitoneoscópica por vía posterior es una técnica segura, reproducible y con muy buenos resultados. Los casos más favorables para iniciar la implantación de este abordaje son mujeres con adenomas suprarrenales. (AU)

Introduction: The posterior retroperitoneoscopic approach (PRA) is seldom used in our country to perform adrenalectomies, although it offers possible advantages over laparoscopic anterior or lateral access, according to some authors. The aim of this study was to identify those features that determine the most suitable cases to start the implementation of this technique. Methods: A prospective observational study was performed with a 50 patients cohort. All the cases were operated using the PRA. Sex, age, body mass index (BMI), operative time, left or right side, size and anatomopathological characteristics of the lesion, conversion rates, complications and hospital stay were analyzed. Results: 25 (50%) women and 25 (50%) men underwent surgery, with a median operative time of 80 minutes (45-180). A significantly shorter operative time (p = 0.002) was observed in women and in adenomas (p = 0.002). However, no correlation was observed between surgical time and BMI, lesion side or lesion size. There were no conversions. The complication rate was 14%, and most of the complications were grade i in Clavien Dindo's Scale. Median hospital stay was two days. Conclusions: Retroperitoneoscopic adrenalectomy by posterior approach is a safe and reproducible procedure, with very good outcomes. The most suitable cases to implement this technique would be female patients with adrenal adenomas. (AU)

Primary healthcare policy and vision for community pharmacy and pharmacists in Germany

Germany is the highest populated country in Europe with a population of 82.3 million in 2019. As in many other developed countries, it has an aging population. Approximately 10% of the gross domestic product is spent on healthcare. The healthcare system is characterized by its accessibility. Patients are generally free to choose their primary care physicians, both family doctors and specialists, pharmacy, dentist, or emergency service. Up to a certain income, health insurance is mandatory with the statutory health insurance (SHI) system, covering 88% of the population. Major challenges are the lack of cooperation and integration between the different sectors and healthcare providers. This is expected to change with the introduction of a telematic infrastructure that is currently being implemented. It will not only connect all providers in primary and secondary care in a secure network but will also enable access to patients' electronic record/medical data and at the same time switch from paper to electronic prescriptions. Approximately 52,000 of the 67,000 pharmacists are working in approximately 19,000 community pharmacies. These pharmacies are owner-operated by a pharmacist. Pharmacists may own up to three subsidiaries nearby to their main pharmacy. Community pharmacy practice mainly consists of dispensing drugs, counselling patients on drug therapy and safety, and giving advice on lifestyle and healthy living. Many cognitive pharmaceutical services have been developed and evaluated in the past 20 years. Discussions within the profession and with stakeholders on the national level on the roles and responsibilities of pharmacists have resulted in nationally agreed guidelines, curricula, and services. However, cognitive services remunerated by the SHI funds on the national level remain to be negotiated and sustainably implemented. A law passed in November 2020 by parliament will regulate the remuneration of pharmaceutical services by the SHI funds with an annual budget of EUR 150 million. The type of services and their remuneration remain to be negotiated in 2021. The profession has to continue on all levels to advocate for a change in pharmacy practice by introducing pharmacy services into routine care

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Colaboración hispano-alemana en Bioquímica mantenida por miembros de la Real Academia Nacional de Farmacia y por otros bioquímicos españoles / Spanish-German collaboration in Biochemistry maintained by members of the Royal Academy National of Pharmacy and by other Spanish biochemists

Considerada la Bioquímica alemana como la pionera en el mundo, ya en la etapa inicial de la misma, hacia 1872, se estableció la primera vinculación entre el Profesor alemán fundador de esta disciplina, Felix von Hoppe-Seyler, y el Catedrático español de Química Orgánica Laureano Calderón Arana. Después, algunos de los Catedráticos de la recién establecida asignatura de Química Biológica, cuya enseñanza se impartía únicamente en la Facultad de Farmacia madrileña para los alumnos de Doctorado (común a Farmacia, Medicina y Ciencias), mantuvieron esta relación, aunque menos intensa, con sus colegas germanos. Pero, a partir de 1928, el que sería Premio Nobel, Dr. Severo Ochoa, trabajó durante largos periodos en prestigiosos Departamentos de Berlín y Heidelberg. Y ya en época reciente, bioquímicos pertenecientes a la Real Academia Nacional de Farmacia (RANF) han continuado esta vinculación colaborando en diversos Departamentos alemanes. Por otro lado, bioquímicos germanos han impartido conferencias en Universidades españolas, invitados por sus colegas hispanos, además de hacerlo en congresos o simposios en España. Asimismo, algunos de ellos han sido miembros de la RANF

German can be considered as world pioneer in the development of Biochemistry. Its founder, Prof. Felix von Hoppe-Seyler, established contacts with the Spanish Professor of Organic Chemistry, Laureano Calderón Arana, since the onset of this subject around 1872. Later, some other Professors of the newly created Química Biológica, which was taught only at the Faculty of Pharmacy in Madrid as a subject common to doctoral students in Pharmacy, Medicine and Science, maintained a connection, albeit minor, with their German colleagues. From 1928, Dr. Severo Ochoa, who would subsequently win a Nobel Prize, worked for long periods in the prestigious Departments at Berlin and Heidelberg. More recently, other biochemists, members of the Royal Academy National of Pharmacy (RANF), have followed this connection with several German Departments. Furthermore, German biochemists have delivered lectures in Spanish Universities invited by their Spanish colleagues, in addition to their participation in Spanish symposia. Moreover, several German biochemists have been RANF members

Smallpox vaccination in the German Empire. Vaccination between biopolitics and moral economy / La vacuna contra la viruela en el imperio alemán. La vacunación entre biopolítica y economía moral

After a smallpox epidemic in Germany in the early 1870s in the wake of the Franco-German War, smallpox vaccination became compulsory by Imperial Law in 1874. The act was hotly debated in parliament and in public and earlier resistance against vaccination developed into a political anti-vaccination movement. For this reason, the German government adopted a number of safety measures. The current article describes, firstly, vaccination practices, regulations and policies in the German states up to the 1870s and the biopolitical developments that led to the Imperial Law on compulsory smallpox vaccination in 1874. Secondly, the article sketches the public debate and critique regarding vaccination asking why compulsory vaccination succeeded in Germany. The article describes the measures implemented by the German government to promote compulsory vaccination and acceptance of the Imperial Law: initially, smallpox vaccines were manufactured by state-run production sites and supervised by local authori­ties. Empire-wide statistics were collated documenting the success of vaccination as well as related side-effects. From a government perspective, these precautions could be interpreted as a technology of trust

Después de una epidemia de viruela en Alemania a principios de la década de 1870 a raíz de la guerra francoalemana, la vacuna antivariólica se hizo obligatoria por Ley Imperial en 1874. La ley se debatió acaloradamente en el parlamento y en pú­blico, y la resistencia ya existente contra la vacunación se convirtió en un movimiento político antivacunas. Por ello, el gobierno alemán adoptó una serie de medidas de seguridad. El artículo actual describe, en primer lugar, las prácticas, regulaciones y políti­cas de vacunación en los estados alemanes hasta la década de 1870, y los desarrollos biopolíticos que llevaron a la Ley Imperial sobre la vacunación antivariólica obligatoria en 1874. En segundo lugar, se esbozan el debate público y la crítica sobre la vacunación, preguntando por qué la vacunación obligatoria tuvo éxito en Alemania. Se describen las medidas aplicadas por el gobierno alemán para promover la vacunación obligatoria y la aceptación de la Ley Imperial: inicialmente, las vacunas contra la viruela se fabricaban por centros de producción estatales supervisados por las autoridades locales. Se recopilaban estadísticas de todo el imperio que documentaban el éxito de la vacunación, así como los efectos secundarios relacionados. Desde la perspectiva del gobierno, estas precauciones podrían interpretarse como una tecnología de confianza

La mascarilla (que tanto necesitamos es la que hubiéramos necesitado) / The mask (which we need so much is the one we would have needed)

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Nimuendajú, a Senhorita Doutora e os 'etnógrafos berlineses': rede de conhecimento e espaços de circulaçâo na configuraçâo da etnologia alemâ na Amazônia no início do século XX / Nimuendajú, Fräulein Doktor and the 'berliner ethnographers': network of knowledge and spaces of circulation in the configuration of German ethnology in the Amazon in the early 20th Century

O artigo analisa a participação da zoóloga alemã Emília Snethlage (1868-1929), pesquisadora e depois diretora do Museu Goeldi, em Belém, Brasil, na rede de conhecimento que se estabeleceu no início do século XX na região amazônica, destinada à investigação etnológica e à coleta de artefatos indígenas, e que teve, entre seus mais conhecidos atores, os alemães Theodor Koch-Grünberg (1872-1924) e Curt Nimuendajú (1883-1945). Ambos são reconhecidos pelo trabalho em prol dos povos indígenas do Brasil e pelo legado científico nos campos da antropologia, arqueologia e linguística. Menos conhecida, Snethlage teve, entretanto, decisiva participação na inserção de Nimuendajú no meio científico. A partir de uma extensa pesquisa em fontes documentais localizadas no Brasil e na Alemanha, demonstra-se que, no primeiro período em que Nimuendajú esteve vinculado ao Museu Goeldi, entre 1913 e 1921, Snethlage viabilizou suas primeiras expedições e publicações científicas, além de articular suas relações com museus e etnólogos alemães, incluindo aquele que viria a ser seu dileto amigo e interlocutor, Koch-Grünberg, de maneira a lhe permitir trabalhar também como coletor profissional

The article analyses the participation of the German zoologist Emilia Snethlage (1868-1929), researcher and later director of the Goeldi Museum, in Belém, Brazil, in the network of knowledge that was established in the early 20th century in the Amazonian region, aimed at ethnological research and to the collection of indigenous artifacts, and among its best known actors were Germans Theodor Koch-Grünberg (1872-1924) and Curt Nimuendajú (1883-1945). Both are recognized for working for the indigenous peoples of Brazil and for the scientific legacy in the fields of anthropology, archaeology and linguistics. Less well-known, Snethlage had, however, decisive participation in the insertion of Nimuendajú in the scientific environment. From an extensive research on documentary sources located in Brazil and Germany, it is shown that in the first period when Nimuendajú was linked to the Goeldi Museum between 1913 and 1921, Snethlage made possible his first expeditions and scientific publications, in addition to articulating his relations with German museums and ethnologists, including the one who would become his beloved friend and interlocutor, Koch-Grünberg, in order to allow him to work as a professional collector

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Medication dispensing, additional therapeutic recommendations, and pricing practices for acute diarrhoea by community pharmacies in Germany: a simulated patient study

Background: In Germany over-the-counter medications (OTC) - which since 2004 are no longer subject to binding prices - can only be purchased in pharmacies. Pharmacy owners and their staff therefore have a special responsibility when dispensing, advising on and setting the prices of medications. Objective: The aim of this study was to assess medication dispensing, additional therapeutic recommendations and pricing practices for acute diarrhoea in adults and to evaluate the role of the patient's approach (symptom-based versus medication-based request) in determining the outcome of these aspects. Methods: A cross-sectional study was conducted from 1 May to 31 July 2017 in all 21 community pharmacies in a medium-sized German city. Symptom-based and medication-based scenarios related to self-medication of acute diarrhoea were developed and used by five simulated patients (SPs) in all of the pharmacies (a total of 84 visits). Differentiating between the different test scenarios in terms of the commercial and active ingredient names and also the prices of the medications dispensed, the SPs recorded on collection forms whether the scenario involved generic products or original preparations as well as whether recommendations were made during the test purchases regarding an additional intake of fluids. Results: In each of the 84 test purchases one preparation was dispensed. However, a preparation for oral rehydration was not sold in a single test purchase. On the other hand, in 74/84 (88%) of test purchases, medications with the active ingredient loperamide were dispensed. In only 35/84 (42%) of test purchases, the patient was also recommended to ensure an 'adequate intake of fluids' in addition to being dispensed a medication. In symptom-based scenarios significantly more expensive medications were dispensed compared to the medication-based scenarios (Wilcoxon signed rank test: z = -4.784, p < 0.001, r = 0.738). Also within the different scenarios there were enormous price differences identified - for example, in the medication-based scenarios, even for comparable loperamide generics the cheapest preparation cost EUR 1.99 and the most expensive preparation cost EUR 4.53. Conclusions: Oral rehydration was not dispensed and only occasionally was an adequate intake of fluids recommended. There were also enormous price differences both between and within the scenarios investigated

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Residential crowding and asthma in preschool children, a cross-sectional study

Background: Asthma is the most common chronic disease in children, and associations with crowding have been reported. The aim of this study was to explore possible associations of crowding with asthma in children. Methods: Seven cross-sectional surveys with preschool children were conducted within the framework of the health monitoring units in Bavaria, Germany, from 2004 to 2014. Residential crowding was defined as habitation of more than one person per room or less than 20m2 living space per person. Logistic regression models examined temporal changes in crowding, applying the first survey as reference. The relationship between crowding and physician-diagnosed asthma, asthma defined by the International Study of Asthma and Allergies in Childhood (ISAAC) and asthma symptoms were analyzed. Results: Analyzing temporal changes of crowding rates did not reveal any differences over the years. However, the stratified descriptive analysis indicated a crowding increase in time in urban households where parents had a low education level (47.9% in 2004/05, 55.8% in 2014/15). No association was found between crowding and the variables "physician-diagnosed asthma" in 2014/15, "asthma defined by ISAAC" in 2014/15, or "wheezing" in 2014/15. A positive association with cough was identified in 2014/15 after adjusting for confounders (aOR = 1.42 [95% CI: 1.20-1.69]). Conclusions: In general, residential crowding did not change from 2004 to 2014; however, there seems to be a small upsurge for children with low-educated parents, living in urban areas over the years. A statistically significant association between crowding and cough was only found in the survey from 2014/15

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German Ethics Council's Opinion: intervening in the human germline

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Mental Health of Spanish Immigrants in Germany and the UK in Comparison to Non-Immigrants and Migration Protective Factors / La salud mental de los españoles inmigrantes en Alemania y Reino Unido en comparación con los españoles no inmigrantes y sus factores protectores

The global economic crisis of the previous decade has accelerated internal mobility in the European Union. The main objective was to analyse perceived stress and mental health among Spanish immigrants and non-immigrants, as well as gender differences, and to examine the mediation role of perceived stress in the relationship between migration protective factors and mental health. A convenience sample (N = 941) was obtained by snowball sampling, contacting with social networks during 2014 and 2015. Spanish immigrants (n = 719) living in Germany or United Kingdom and non-immigrants (n = 222) living in Spain answered an online survey with a questionnaire about socio-demographic and migration variables (immigrants) as well as PSS-14 and GQH-28. The low level of perceived stress and mental health symptoms found were similar in Spanish immigrants and non-immigrants. Women immigrants presented slightly higher rates of prevalence of somatisation and anxiety/insomnia and higher perceived stress. A parsimonious structural equation model with two protective migration factors was obtained (R2 = .58), which had direct and indirect effects on mental health through perceived stress. The migration process was not related to poorer mental health in the European context, and gender differences were small. These findings could be explained by the privileged migration conditions of Spanish immigrants

En la última década la crisis económica global ha acelerado la movilidad interna dentro de la Unión Europea. El objetivo principal de este estudio ha sido analizar el estrés percibido y la salud mental de los españoles inmigrantes en comparación con los no inmigrantes, atendiendo a las diferencias de género. Un objetivo complementario era examinar el papel mediacional del estrés percibido en la relación entre los factores protectores migratorios y la salud mental. Se obtuvo una muestra de conveniencia (N = 941) a través del muestreo de bola de nieve contactando con redes sociales en el periodo 2014-2015. Españoles inmigrantes (719 residentes en Alemania o Reino Unido) y no inmigrantes (n = 222) respondieron en internet a un cuestionario sobre variables sociodemográficas y migratorias (inmigrantes), así como a los instrumentos PSS-14 y GHQ-28. Los bajos niveles de estrés percibido y los síntomas de salud mental encontrados fueron similares en la población española inmigrante y no inmigrante. Las mujeres inmigrantes presentaban tasas de prevalencia ligeramente más elevadas en somatización, ansiedad e insomnio que los hombres inmigrantes. Se obtuvo un modelo de ecuaciones estructurales parsimonioso que incluía dos factores migratorios protectores (R2 = .58), con efecto directo e indirecto en la salud mental a través del estrés percibido. El proceso migratorio estudiado no se relaciona con peor salud mental en el contexto europeo y las diferencias en función del sexo son muy pequeñas. Estos resultados pueden explicarse por las condiciones privilegiadas migratorias de la población española en otros países de la Unión Europea

Exploring the training and scope of practice of GPs in England, Germany and Spain / Análisis de la formación y el ámbito de práctica de los médicos de atención primaria en Inglaterra, Alemania y España

Objective: To explore general practitioner (GP) training, continuing professional development, scope of practice, ethical issues and challenges in the working environment in three European countries. Method: Qualitative study of 35 GPs from England, Germany and Spain working in urban primary care practices. Participants were recruited using convenience and snowball sampling techniques. Semi-structured interviews were recorded, transcribed and analysed by four independent researchers adopting a thematic approach. Results: Entrance to and length of GP training differ between the three countries, while continuing professional development is required in all three, although with different characteristics. Key variations in the scope of practice include whether there is a gatekeeping role, whether GPs work in multidisciplinary teams or singlehandedly, the existence of appraisal processes, and the balance between administrative and clinical tasks. However, similar challenges, including the need to adapt to an ageing population, end-of-life care, ethical dilemmas, the impact of austerity measures, limited time for patients and gaps in coordination between primary and secondary care are experienced by GPs in all three countries. Conclusion: Primary health care variations have strong historical roots, derived from the different national experiences and the range of clinical services delivered by GPs. There is a need for an accessible source of information for GPs themselves and those responsible for safety and quality standards of the healthcare workforce. This paper maps out the current situation before Brexit is being implemented in the UK which could see many of the current EU arrangements and legislation to assure professional mobility between the UK and the rest of Europe dismantled

Objetivo: Analizar la formación, el desarrollo profesional continuado, el ámbito de práctica, las cuestiones éticas y los retos en el entorno laboral de los médicos de atención primaria en tres países europeos. Método: Estudio cualitativo de 35 médicos de atención primaria de Inglaterra, Alemania y España que trabajan en centros urbanos de atención primaria. Se reclutó a los participantes utilizando técnicas de muestreo de oportunidad y con efecto multiplicador. Se registraron, transcribieron y analizaron entrevistas semiestructuradas realizadas por cuatro investigadores independientes, quienes adoptaron un enfoque temático. Resultados: El acceso y la duración de la formación del médico de atención primaria difieren entre los tres países, mientras que se requiere desarrollo profesional continuado en los tres, aunque con características diferentes. Las variaciones clave en el ámbito de la práctica incluyen la existencia de un papel curativo, si el trabajo de médico de atención primaria se realiza en equipos multidisciplinarios o de manera individual, la existencia de procesos de valoración, y el equilibrio entre las tareas administrativas y clínicas. Sin embargo, los médicos de atención primaria en los tres países se enfrentan a retos similares, que incluyen la necesidad de adaptarse al envejecimiento de la población, la atención al final de la vida, el impacto de las medidas de austeridad, la limitación del tiempo de dedicación al paciente, y las brechas en cuanto a coordinación entre la atención primaria y secundaria. Conclusión: Las variaciones de la atención primaria tienen fuertes raíces históricas, que se derivan de las diferentes experiencias nacionales y el rango de los servicios clínicos proporcionados por los médicos de atención primaria. Existe una necesidad de fuentes de información accesibles para dichos médicos, y aquellos responsables de los estándares de seguridad y calidad del personal sanitario. Este trabajo esboza la situación actual que está siendo implementada en el Reino Unido con anterioridad al Brexit, que podría vislumbrar muchos de los acuerdos y legislaciones actuales de la UE para garantizar la movilidad profesional entre el Reino Unido y el resto de la Europa desmantelada