The roles of spatial and environmental variables in the appearance of a globally invasive Physa acuta in water bodies created due to human activity.

Anthropogenic pollution of freshwater environments is a subject of serious international concern since they affect freshwater and land environments. The disturbances in the functioning of ecosystems that result from various forms of human activity permit them to be settled by alien species. Research was carried out in 84 anthropogenic water bodies using quantitative methods for sampling, laboratory analysis and multivariate statistical methods. The appearance of P. acuta in these water bodies seems to depend on their water chemistry. Physa acuta primarily occurred in waters with a very low content of ammonia, medium salinity and hardness, and in waters with a higher pH. The density of P. acuta decreased along with its dominance index, which indicates that in water bodies in which its density was low, the other snail species achieved higher densities. This suggest competitive displacement of native species at high densities of P. acuta. Cluster analysis showed that water bodies in which P. acuta was abundant were similar in the snail community composition in contrast to water bodies in which it wasn't present. Research on colonisation of freshwater habitats by alien species in freshwater habitats is important because in the future, the number of alien species is likely to increase as a result of climate change and their ability to overcome the existing barriers as well as with the progressive colonisation of new areas outside of their native range.

[Atrial fibrillation in Germany: A prospective cost of illness study]. / Vorhofflimmern in Deutschland--eine prospektive Krankheitskostenstudie.

BACKGROUND: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in clinical practice and associated with a high risk of stroke, heart failure and hospitalization. This study examines the indication-specific costs of illness of AF patients in Germany. METHODS: The study was conducted nationwide with 54 general practitioners and internists, as well as 12 practicing cardiologists. The observational period per patient was one year. Costs were calculated from the perspective of the German statutory health insurance. The study collected the annual direct indication-specific costs and additional patient relevant outcomes. RESULTS: Indication-specific services of 361 patients (age: 75, male: 55%) documented by general practitioners and internists cause average costs of 582 € per patient. The highest cost are caused by hospitalization (289 €), followed by outpatient treatment costs (151 €) and costs of anticoagulation with 52 € per patient. Additional consulting of a cardiologist (115 patients) causes average costs of 81 €. Assuming that a patient with AF is treated once a year by a resident cardiologist, the average annual cost amounted to 664 €. CONCLUSION: The results of this prospectively cost of illness analysis for AF patients under real life conditions in Germany indicate a high socio-economic burden of AF.

[Treatment recommendations for alcohol dependence--comparison of German and international guidelines]. / Behandlungsempfehlungen zur Alkoholabhängigkeit. Ein Vergleich deutscher und internationaler Leitlinien.

In order to identify relevant recommendations for the treatment of alcohol dependent adults a systematic guideline research was conducted on national and international guideline providers. The research showed differences between German and international guidelines in terms of the treatment goal and the resulting treatment recommendations. In Germany, abstinence is the only accepted treatment goal. An alcohol reduction in terms of harm reduction is recommended by one guideline as an intermediate goal. The recommended treatment options include intensive inpatient measures such as detoxification and alcohol withdrawal. Further outpatient treatment of alcohol dependency is not recommended by German guidelines. International guidelines also recommend abstinence as the goal for all patients. Beyond, the reduction of alcohol consumption is recommended as a possible treatment goal under certain conditions if abstinence not (yet) is possible. Thereby the treatment goal should be set individually considering the patient's feasibility and wishes. Besides abstinence also the reduction of alcohol consumption leads to an improvement of health. Therefore patients aiming for this goal should also be supported. Furthermore, the inclusion of patient's wishes in the goal setting leads to better treatment outcomes. Therefore, an extension of goal setting and treatment recommendations towards the reduction of alcohol consumption seems reasonable for Germany. Furthermore, the adaption to the state of international guidelines seems reasonable.