Severe historical floods on the river Roda, Thuringia: from reconstruction to implications for flood management

Using the Roda river (Thuringia) as an example, we present methods for and results of historical flood research in Germany. The Roda river is one of the tributaries of the Saale river with a length of approximately 33 km. Although the watershed only covers around 262 km², the Roda is very vulnerable to flooding. The river caused damages of catastrophic dimensions within the urban area of Stadtroda (until 1925 “Roda”). These damages were especially devastating after heavy rainfall events during the late spring and early summer seasons of June 1582, April 1654, June 1827, June 1871 and June 1876. This article discusses how the flood history of the Roda river and human response to the associated natural hazards can be analysed by a combination of archive and field work. By means of the available material (e.g. printed, handwritten and physical sources as well as maps, engravings and historical photos), the history of severe floods was reconstructed for several centuries. This specifically refers to 1) the genesis, magnitude, frequency and length of floods, 2) the extent of damages and losses, 3) the risk perception and evaluation by municipal and national administrations and 4) the planning and implementation of protective measures and their impacts. Interestingly, the analysis of the disastrous floods of 1871 and 1876 shows striking similarities to the current discussion (e.g. regarding the influence of land use changes). Furthermore, the combined historical accounts are an important basis for the derivation of future flood risk assessments for the Roda river. Going beyond the specific basin of the Roda, the findings also reveal important insights regarding the impacts of increases in heavy regionalized rainfall for small watersheds, which is predicted to occur more frequently in such watersheds in the state of Thuringia

Analyse aktueller Einflussfaktoren und Motive im Zusammenhang mit der Entscheidung für oder gegen eine Karriere als Facharzt für Allgemeinmedizin auf der Basis quantitativer und qualitativer Methoden

Vor dem Hintergrund eines zunehmenden Hausärztemangels in Deutschland und zahlreichen anderen Staaten untersucht die vorliegende Arbeit mit Hilfe quantitativer und qualitativer Methoden aktuelle Einflussfaktoren und Motive im Zusammenhang mit der Entscheidung junger Mediziner für oder gegen eine Karriere als Facharzt für Allgemeinmedizin. Die Untersuchung kombiniert dabei im Studienverlauf erhobene Daten zur Teilnahme Medizinstudierender an definierten allgemeinmedizinischen Lehrveranstaltungen mit Daten einer späteren Absolventenbefragung (n = 659). Die Ergebnisse der quantitativen Analysen tragen zur Evidenz hinsichtlich aktueller Einflussfaktoren auf die Berufswahl Allgemeinmedizin bei und unterstützen die Annahme, dass ein praxisorientiertes allgemeinmedizinisches Curriculum, sowohl in frühen als auch in späten Stadien des Medizinstudiums, die Nachwuchsgewinnung im Fach befördern kann. Die Ergebnisse der qualitativen Analysen geben einen weitreichenden Überblick über aktuell ausschlaggebende Gründe sowohl für, als auch gegen eine Karriere als Hausarzt. Implikationen im Hinblick auf die Entwicklung effektiver Strategien gegen die drohende Unterversorgung werden diskutiert

Early community-based family practice elective positively influences medical students’ career considerations – a Pre-post-comparison

BACKGROUND: Demographic change and recruitment problems in family practice are increasingly threatening an adequate primary care workforce in many countries. Thus, it is important to attract young physicians to the field. The purpose of the present study was to examine the effect of an early community-based 28-h family practice elective with one-to-one mentoring on medical students’ consideration of family practice as a career option, their interest in working office-based, and several perceptions with regard to specific aspects of a family physician’s work. METHODS: First- and second-year medical students completed questionnaires before and after a short community-based family practice elective, consisting of a preparatory course and a community-based practical experience with one-to-one mentoring by trained family physicians. RESULTS: We found a significantly higher rate of students favoring family practice as a career option after the elective (32.7% vs. 26.0%, p = 0.039). Furthermore, the ranking of family practice among other considered career options improved (p = 0.002). Considerations to work office-based in the future did not change significantly. Perceptions regarding a family physician’s job changed positively with regard to the possibility of long-term doctor-patient relationships and treatment of complex disease patterns. The majority of the students described identification with the respective family physician tutor as a professional role model and an increased interest in the specialty. CONCLUSIONS: Our results indicate that a short community-based family practice elective early in medical education may positively influence medical students’ considerations of a career in family practice. Furthermore, perceptions regarding the specialty with significant impact on its attractiveness may be positively adjusted. Further research is needed to evaluate the influence of different components of a family practice curriculum on the de facto career decisions of young physicians after graduation

Quantum Control of the Hyperfine Spin of a Cs Atom Ensemble

We demonstrate quantum control of a large spin-angular momentum associated with the F=3 hyperfine ground state of 133Cs. A combination of time dependent magnetic fields and a static tensor light shift is used to implement near-optimal controls and map a fiducial state to a broad range of target states, with yields in the range 0.8-0.9. Squeezed states are produced also by an adiabatic scheme that is more robust against errors. Universal control facilitates the encoding and manipulation of qubits and qudits in atomic ground states, and may lead to improvement of some precision measurements.Comment: 4 pages, 4 figures (color

Reality bites:An analysis of corona deniers in Germany over time

The COVID-19 pandemic resulted in unprecedented government interventions in many people's lives. Opposition to these measures was not only based on policy disagreements but for some founded in an outright denial of basic facts surrounding the pandemic, challenging social cohesion. Conspiracy beliefs have been prolific within various protest groups and require attention, as such attitudes have been shown to be associated with lower rule compliance. Several studies have shown that the characteristics linked to holding COVID-19 conspiracy beliefs are complex and manifold; however, those insights usually rest on cross-sectional studies only. We have less knowledge on whether these cross-sectional correlates also reveal which parts of the population have been newly convinced by conspiracy theories or have dropped their support for them as the pandemic evolved. Using a unique panel data set from Germany, this paper explores a wide range of characteristics and compares the insights gained from cross-sectional associations on the one hand and links to the ways in which people change their views on the other hand. The findings show that cross-sectional analyses miss out on nuanced differences between different groups of temporary and more consistent conspiracy supporters. Specifically, this paper identifies major differences in the profiles of people who have been denying COVID-19 consistently compared to those who changed their minds on the question and those who assessed the reality correctly throughout. In doing so, socio-political and perception-based dimensions are differentiated and distinctions between respondents from East and West Germany explored

Identifying patients with psychosocial problems in general practice: a scoping review protocol

Introduction: Psychosocial problems (PSPs) are common issues associated with negative health outcomes. Since general practitioners are the first point of contact for any health-related concern, understanding their options to recognise patients with PSPs plays an important role as it is essential for early intervention and can prevent serious conditions. The objective of our scoping review is to map published evidence on the usage of instruments to identify patients with PSPs in general practice. Methods and analysis: We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist and the Joanna Briggs Institute Reviewer’s Manual on scoping reviews. A systematic search of four electronic databases (Medline (Ovid), Web of Science Core Collection, PsycInfo, Cochrane Library) will be conducted for quantitative and qualitative studies published in English, Spanish, French and German. Main study characteristics as well as information on identification instruments will be extracted and visualised in structured tables to map the available evidence. The protocol has been registered with Open Science Framework, https://osfio/c2m6z. Ethics and dissemination: This study does not require ethical approval as we will not collect personal data. Dissemination will consist of publications, presentations and other knowledge translation activities

Global Efforts to Address Severe Acute Malnutrition.

Detailed description on the two formats presented, proBAM (S1A) and proBed (S1B). (XLSX 46 kb

The Impact of the COVID-19 Pandemic on Avoidance of Health Care, Symptom Severity, and Mental Well-Being in Patients With Coronary Artery Disease

The COVID-19 pandemic affected regular health care for patients with chronic diseases. However, the impact of the pandemic on primary care for patients with coronary artery disease (CAD) who are enrolled in a structured disease management program (DMP) in Germany is not clear. We investigated whether the pandemic affected primary care and health outcomes of DMP-CAD patients (n = 750) by using a questionnaire assessing patients’ utilization of medical care, CAD symptoms, as well as health behavior and mental health since March 2020. We found that out of concern about getting infected with COVID-19, 9.1% of the patients did not consult a medical practitioner despite having CAD symptoms. Perceived own influence on infection risk was lower and anxiety was higher in these patients compared to symptomatic CAD patients who consulted a physician. Among the patients who reported chest pain lasting longer than 30 min, one third did not consult a medical practitioner subsequently. These patients were generally more worried about COVID-19. Patients with at least one worsening CAD symptom (chest pain, dyspnea, perspiration, or nausea without apparent reason) since the pandemic showed more depressive symptoms, higher anxiety scores, and were less likely to consult a doctor despite having CAD symptoms out of fear of infection. Our results provide evidence that the majority of patients received sufficient medical care during the COVID-19 pandemic in Germany. However, one in ten patients could be considered particularly at risk for medical undersupply and adverse health outcomes. The perceived infection risk with COVID-19 might have facilitated the decision not to consult a medical doctor