Making Open Access Viable Economically

The Editors-in-Chief have decided that we will provide our much-cherished readers with an editorial every so often as a way of sharing insights from the “machine room” where so much of the thinking and work is done to publish the German Law Journal. We want to let you in on the ideas that are on our minds, share with you our observations, and include you in the conversations we are having that might be of interest to you. We begin this tradition with this issue, Volume 21 – Number 6. Andrew Hyde, a member of the editorial team with which the Journal has partnered at Cambridge University Press, as well as Russell A. Miller and Emanuel V. Towfigh, two of the Journal’s co-Editors-in-Chief, open our From the Headquarters Essay with a piece on the Journal’s experiences with and its further plans for making open-access (OA) publishing economically viable. Related to that theme, we also want to share news with you about the introduction of a voluntary article processing charge this fall. Finally, we want to draw your attention to a videos and podcasts service we will start to produce to accompany the scholarship published in the Journal as a way of promoting our authors’ work and expanding access to their ideas. If you are interested only in these latter initiatives, you can also read the short section in the GLJ Instructions for Authors

First experience with a new negative pressure incision management system on surgical incisions after cardiac surgery in high risk patients

<p>Abstract</p> <p>Background</p> <p>Sternal wound infection remains a serious potential complication after cardiac surgery. A recent development for preventing wound complications after surgery is the adjunctive treatment of closed incisions with negative pressure wound therapy. Suggested mechanisms of preventive action are improving the local blood flow, removing fluids and components in these fluids, helping keep the incision edges together, protecting the wound from external contamination and promoting incision healing. This work reports on our initial evaluation and clinical experience with the Prevena™Incision Management System, a recently introduced new negative pressure wound therapy system specifically developed for treating closed surgical incisions and helping prevent potential complications. We evaluated the new treatment on sternal surgical incisions in patients with multiple co-morbidities and consequently a high risk for wound complications.</p> <p>Methods</p> <p>The Prevena™incision management system was used in 10 patients with a mean Fowler risk score of 15.1 [Range 8-30]. The negative pressure dressing was applied immediately after surgery and left in place for 5 days with a continuous application of -125 mmHg negative pressure. Wounds and surrounding skin were inspected immediately after removal of the Prevena™ incision management system and at day 30 after surgery.</p> <p>Results</p> <p>Wounds and surrounding skin showed complete wound healing with the absence of skin lesions due to the negative pressure after removal of the Prevena™ dressing. No device-related complications were observed. No wound complications occurred in this high risk group of patients until at least 30 days after surgery.</p> <p>Conclusions</p> <p>The Prevena™system appears to be safe, easy to use and may help achieve uncomplicated wound healing in patients at risk of developing wound complications after cardiothoracic surgery.</p

Effects of self-monitoring of glucose in non-insulin treated patients with type 2 diabetes: design of the IN CONTROL-trial

<p>Abstract</p> <p>Background</p> <p>Diabetes specific emotional problems interfere with the demanding daily management of living with type 2 diabetes mellitus (T2DM). Possibly, offering direct feedback on diabetes management may diminish the presence of diabetes specific emotional problems and might enhance the patients' belief they are able to manage their illness. It is hypothesized that self-monitoring of glucose in combination with an algorithm how and when to act will motivate T2DM patients to become more active participants in their own care leading to a decrease in diabetes related distress and an increased self-efficacy.</p> <p>Methods and design</p> <p>Six hundred patients with T2DM (45 ≤ 75 years) who receive care in a structured diabetes care system, HbA1c ≥ 7.0%, and not using insulin will be recruited and randomized into 3 groups; Self-monitoring of Blood Glucose (SMBG), Self-monitoring of Urine Glucose (SMUG) and usual care (n = 200 per group). Participants are eligible if they have a known disease duration of over 1 year and have used SMBG or SMUG less than 3 times in the previous year. All 3 groups will receive standardized diabetes care. The intervention groups will receive additional instructions on how to perform self-monitoring of glucose and how to interpret the results. Main outcome measures are changes in diabetes specific emotional distress and self-efficacy. Secondary outcome measures include difference in HbA1c, patient satisfaction, occurrence of hypoglycaemia, physical activity, costs of direct and indirect healthcare and changes in illness beliefs.</p> <p>Discussion</p> <p>The IN CONTROL-trial is designed to explore whether feedback from self-monitoring of glucose in T2DM patients who do not require insulin can affect diabetes specific emotional distress and increase self-efficacy. Based on the self-regulation model it is hypothesized that glucose self-monitoring feedback changes illness perceptions, guiding the patient to reduce emotional responses to experienced threats, and influences the patients ability to perform and maintain self-management skills.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN84568563</p

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10&nbsp;years; 78.2% included were male with a median age of 37&nbsp;years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Geschicktes Glücksspiel. Die Sportwette als Grenzfall des Glücksspielrechts

Das Glücksspielrecht hat in Deutschland zurzeit Konjunktur. Nicht zuletzt weil der Glücksspielstaatsvertrag bis 2011 befristet ist, wird über neue Regelungsmodelle diskutiert. Nach geltendem Recht hängt alles an der Unterscheidung zwischen Glücksspielen und Geschicklichkeitsspielen. Geschicklichkeitsspiele sind kaum reguliert. Glücksspiele sind nahezu vollständig in staatlicher Hand. Wenn man diese dogmatische Unterscheidung beim Wort nimmt, kommt es auf eine empirische Frage an: wie viel Geschick braucht man, um bei dem jeweiligen Spiel Erfolg zu haben? Diese Frage ist vor allem bei Sportwetten lebhaft umstritten: Sind Sportwetten entgegen der derzeit herrschenden Auffassung vielleicht nicht als Glücks-, sondern als Geschicklichkeitsspiel einzustufen und folglich aus der Regulierung des Glücksspielrechts herauszulösen? An der Entscheidung des Streits hängt, ob private Anbieter in den Markt eintreten dürfen. Der vorliegende Beitrag untersucht empirisch, ob Sportwetten als Glücks- oder als Geschicklichkeitsspiel einzustufen sind und ob vor dem Hintergrund der empirischen Befunde die Differenzierung zwischen Glücks- und Geschicklichkeitsspiel mit Blick auf die Regelungszwecke des Glücksspielrechts - vor allem dem Schutz vor der Sucht und der Ausnutzung der menschlichen Spielleidenschaft - sinnvoll ist. Dazu wird zunächst kurz in die Thematik eingeführt (dazu I.), sodann wird die Forschungsfrage präzisiert (dazu II.) und erörtert, mit welchen Methoden dieser Frage nachzugehen ist (dazu III.). Es folgt eine überblicksartige Darstellung der empirischen Ergebnisse (dazu IV.), bevor abschließend die juristischen Implikationen für die Qualifikation der Sportwette und für die Dogmatik des Glücksspielrechts dargelegt werden (dazu V. und IV). Abschließend wird ein möglicher Alternativweg zur gegenwärtigen Dogmatik skizziert (VII.)