Procedures and Criteria for the regulation of innovative non-medicinal technologies into the benefit catalogue of solidly financed health care insurances

Because great interest in an efficient range of effective medicinal innovations and achievements has arisen, many countries have introduced procedures to regulate the adoption of innovative non-medicinal technologies into the benefit catalogue of solidly financed health care insurances. With this as a background, this report will describe procedures for the adoption of innovative non-medicinal technologies by solidly financed health care insurances in Germany, England, Australia and Switzerland. This report was commissioned by the German Agency for Health Technology Assessment at the German Institute for Medical Documentation and Information

Establishing a Sustainable Development Goal for Oceans and Coasts to Face the Challenges of our Future Ocean

Oceans regulate our climate, provide us with natural resources such as food, materials, substances, and energy and are essential for international trade, recreational, and cultural activities. Free access to and availability of ocean resources and services, together with human development, have put strong pressures on marine ecosystems, ranging from overfishing and reckless resource extraction to various channels of careless pollution. International cooperation and negotiations are required to protect the marine environment and use marine resources in a way that the needs of future generations will be met. For that purpose, developing and agreeing on a Sustainable Development Goal (SDG) Oceans and Coasts could be an essential element for sustainable ocean management. The SDGs will build upon the Millennium Development Goals (MDG) and replace them by 2015. Even though ensuring environmental sustainability is one of the eight MDG goals, the ocean is not explicitly included. Furthermore, the creation of a comprehensive underlying set of oceanic sustainability indicators would help assessing the current status of marine systems, diagnose on-going trends, and provide information for forward-locking and sustainable ocean governance

Attracting future civil servants with public values? An experimental study on employer branding

A frequently cited recommendation of public service motivation (PSM) research is to use PSM in the context of HR marketing. However, empirical evidence demonstrating the usefulness of addressing PSM in the recruitment process is limited. Moreover, we know little about the relative importance of PSM for public employers’ attractiveness. We address this gap using an experimental research design to investigate whether public service motivated individuals differ from extrinsically motivated individuals in terms of their attraction to organizations that emphasize either “traditional” public or private values in their employer branding. Our findings indicate that public service motivated individuals are attracted neither to public nor to private values in employer branding. Furthermore, individuals with very high levels of extrinsic motivation are more attracted to private values employer branding than to public values employer branding and to the control group

The Maintenance and Exploitation of ex situ Genebank Collections – Association Mapping for Flowering Time in Wheat

It is estimated that world-wide existing germplasm collections contain about 7.4 million accessions of plant genetic resources. Wheat (Triticum and Aegilops) represents the biggest group with about 900,000 accessions. One of the largest ex situ genebanks worldwide is located at the Leibniz Institute of Plant Genetics and Crop Plant Research in Gatersleben, Germany. This collection comprises wild and primitive forms, landraces as well as old and more recent cultivars of mainly cereals but also other crops. As on the global scale wheat is the largest group having almost 30,000 accessions. Beside the long term storage and frequent regeneration of the material phenotypic characterisation and evaluation data are collected as a prerequisite for gene identification and mapping. We report the outcome of an association-based mapping study to elucidate the genetic basis of flowering time in winter wheat. A core collection of 96 cultivars was subjected to a genome-wide scan using diversity array technology markers. The same set of accessions had been earlier evaluated for flowering time over six consecutive seasons. Some of the resulting marker-trait associations (MTAs) mapped to chromosomal locations in which known major genes affecting flowering time are known to reside. However, most of the MTAs identified genomic locations where no such genes are known to map, so providing new opportunities to exploit genetic variation for flowering time in wheat breeding programmes

Der Zugang zu Satellitenbildern in der Orientierungsstufe: Probleme und Möglichkeiten

Kernfrage der Studie: Ist Satellitenbildeinsatz im Erdkundeunterricht der Orientierungsstufe möglich und sinnvoll? Dazu wurden Schüler der Orientierungsstufe einer Realschule und eines Gymnasiums zu drei ausgewählten Satellitenbildern befragt. Die Studie gibt Auskunft über das Farbverständnis, das genutzte Vorwissen, das Verständnis von unterschiedlichen Skalen und die Wertschätzung dieser Schüler. Insgesamt ist ein Verständnis möglich, jedoch zeigten sich signifikante Unterschiede zwischen diesen ausgewählten Schülern des Gymnasiums und der Realschule, die sich jedoch auch als studienspezifisch interpretieren ließen. Neben einer hohen Wertschätzung zeigte sich für den Einsatz das Farbverständnis als besonders interessant für weiterführende Überlegungen

Entwicklung eines Bewertungsverfahrens zur erfolgreichen Anwendung einer Kalzitaufspülung für die interne Restaurierung eutropher Baggerseen in Baden-Württemberg

Zusammenfassung Laboruntersuchungen haben gezeigt, daß Kalzit grundsätzlich zur Phosphat-Fixierung und Phosphat-Retention in eutrophierten Seesedimenten geeignet ist. Freilanduntersuchungen im Kirchentellinsfurter Baggersee bei Tübingen (Epplesee) machten jedoch deutlich, daß die Barrierewirkung einer Kalzitschicht durch biologische und hydrodynamische Parameter drastisch herabgesetzt werden kann. Dies wurde in Ergebnissen von Laboruntersuchungen bestätigt, die zeigten, daß die Intaktheit der Schicht eine wesentliche Voraussetzung für die längerfristige Effizienz einer Kalzitbarriere zur Seenrestaurierung ist. Hinsichtlich der Erarbeitung objektiver Bewertungskriterien zur Nachhaltigkeit des Verfahrens wurden Laborversuche durchgeführt, um die Einflußparameter Bioturbation und Resuspension auf die Stabilität der Kalzitbarriere am Beispiel des Epplesees zu quantifizieren. Es konnte gezeigt werden, daß in einem Fall eine Kalzitbarriere mit einer Mächtigkeit von 1 cm innerhalb von drei bis vier Monaten durch die Bioturbation der Larven von Chironomus plumosus bei einer Larvendichte, die den natürlichen Verhältnissen im Baggersee entspricht, fast vollständig ins Sediment eingearbeitet wird. Auch eine höhere Kalzitauflage von 2,5 cm wurde im anderen Fall in einer etwas größeren Zeitspanne von sechs Monaten in das Oberflächensediment eingemischt. In flachen Seen besteht zusätzlich die Gefahr, daß die Kalzitschicht durch windinduzierte Wellen erodiert werden kann. Die kritischen Schubspannungen von drei potentiellen Barrierematerialien wie Socal® U1-R, Kalzitmehl und Quarzsand K12 betragen 0.16 N/m2, 0.31 N/m2 bzw. 0.32 N/m2, so daß die Auflagen z. B. im durchschnittlich 4 m tiefen Epplesee nach einer Modellrechnung erst ab kritischen Windgeschwindigkeiten von ca. 15 m/s, 31 m/s bzw. 32 m/s verdriftet werden könnten. Bei entsprechender Morphometrie (Oberfläche/Tiefen-Verhältnis) und Windexposition kann jedoch eine windinduzierte Resuspension einer Kalzitbarriere in Flachseen nicht ausgeschlossen werden. The Development of Instrumental Valuation Criteria for a Successful Application of Calcite as an Internal Restoration Method for Eutrophic Gravel-pit Lakes in Baden-Württemberg (BWC 20002) Summary Laboratory experiments showed that calcite is in principle suitable for phosphorus fixation and phosphorus retention in eutrophic lake sediments. However, field studies in the gravel-pit lake of Kirchentellinsfurt near Tübingen (Epplesee) clearly pointed to the fact that the efficiency of a calcite barrier can be dramatically reduced by biological and hydrodynamic influences. This was confirmed in laboratory tests, which showed that the completeness of the calcite layer is essential to achieve a successful lake restoration over a longer time range. In view of the elaboration of objective valuation criteria for the sustainability of the method, laboratory investigations were carried out to quantify the influence of bioturbation and resuspension on the stability of the calcite barrier in Lake Epplesee. The experiments showed that a calcite barrier of 1 cm thickness in one case was almost entirely burrowed within 3 to 4 months by the bioturbation of the larvae of Chironomus plumosus. The number of the larvae corresponded to the natural occurrence in the gravel-pit lake. Even a thicker calcite layer of 2.5 cm in the other case was nearly completely mixed into the deeper sediment in a slightly longer time period of about 6 months. Wind-generated waves can erode the calcite layer, especially in shallow lakes. Therefore, the critical shear stress of three potential barrier materials (Socal® U1-R, calcite powder and sand K12) was measured. In shallow lakes like Epplesee with a mean depth of 4 m, the calculated critical wind velocities by about 16 m/s, 31 m/s and 32 m/s exceed the critical shear stresses of the barrier materials (0.15 N/m2, 0.31 N/m2 and 0.32 N/m2, respectively) and can cause erosion of these layers. According to morphometry (ratio surface/depth) and wind exposition of shallow lakes wind-induced resuspension cannot be excluded

Methods for assessment of innovative medical technologies during early stages of development

Conventional Health Technology Assessment (HTA) is usually conducted at a point in time at which the development of the respective technology may no longer be influenced. By this time developers and/or purchasers may have misinvested resources. Thus the demand for Technology Assessment (TA) which incorporates appropriate methods during early development stages of a technology becomes apparent. Against this health political background, the present report describes methods for a development-accompanying assessment of innovative medical technologies. Furthermore, international research programmes set out to identify or apply such methods will be outlined. A systematic literature search as well as an extensive manual literature search are carried out in order to obtain literature and information. The greatest units of the identified methods consist of assessment concepts, decision support methods, modelling approaches and methods focusing on users and their knowledge. Additionally, several general-purpose concepts have been identified. The identified research programmes INNO-HTA and MATCH (Multidisciplinary-Assessment-of-Technology-Centre-for-Healthcare) are to be seen as pilot projects which so far have not been able to generate final results. MATCH focuses almost entirely on the incorporation of the user-perspective regarding the development of non-pharmaceutical technologies, whereas INNO-HTA is basically concerned with the identification and possible advancement of methods for the early, socially-oriented technology assessment. Most references offer only very vague descriptions of the respective method and the application of greatly differing methods seldom exceeds the character of a pilot implementation. A standardisation much less an institutionalisation of development-accompanying assessment cannot be recognized. It must be noted that there is no singular method with which development-accompanying assessment should be carried out. Instead, a technology and evaluation specific method selection seem to be necessary as medical innovations are diverse and none of the methods are exhaustive. Because of a variety of issues (e. g. ideal time of evaluation, lack of data and uncertainty of data) a development-accompanying assessment should not replace a comprehensive HTA, but rather form a possible preceding step in a multi-staged HTA-process. A final appraisal of the methods for development-accompanying assessment cannot be made based on the available sources. However, the present review may serve as a starting point for further development and application of these methods as well as further examination of the concept of development-accompanying assessment. There is a substantial need for further research concerning the application, validation and comparison of the various methods for development-accompanying assessment

Transstadial Transmission and Replication Kinetics of West Nile Virus Lineage 1 in Laboratory Reared Ixodes ricinus Ticks

West Nile virus (WNV) is a mosquito-borne agent that has also been isolated from several tick species. Vector competence of Ixodes ricinus, one of the most common tick species in Europe, has been poorly investigated for WNV to date. As such, to evaluate the vector competence, laboratory reared Ixodes ricinus nymphs were in vitro fed with WNV lineage 1 infectious blood, allowed to molt, and the resulting females artificially fed to study the virus transmission. Furthermore, we studied the kinetics of WNV replication in ticks after infecting nymphs using an automatic injector. Active replication of WNV was detected in injected nymphs from day 7 post-infection until 28 dpi. In the nymphs infected by artificial feeding, the transstadial transmission of WNV was confirmed molecularly in 46.7% of males, while virus transmission during in vitro feeding of I. ricinus females originating from infected nymphs was not registered. The long persistence of WNV in I. ricinus ticks did not correlate with the transmission of the virus and it is unlikely that I. ricinus represents a competent vector. However, there is a potential reservoir role that this tick species can play, with hosts potentially acquiring the viral agent after ingesting the infected ticks

The Probiotic Compound VSL#3 Modulates Mucosal, Peripheral, and Systemic Immunity Following Murine Broad-Spectrum Antibiotic Treatment

There is compelling evidence linking the commensal intestinal microbiota with host health and, in turn, antibiotic induced perturbations of microbiota composition with distinct pathologies. Despite the attractiveness of probiotic therapy as a tool to beneficially alter the intestinal microbiota, its immunological effects are still incompletely understood. The aim of the present study was to assess the efficacy of the probiotic formulation VSL#3 consisting of eight distinct bacterial species (including Streptococcus thermophilus, Bifidobacterium breve, B. longum, B. infantis, Lactobacillus acidophilus, L. plantarum, L. paracasei, and L. delbrueckii subsp. Bulgaricus) in reversing immunological effects of microbiota depletion as compared to reassociation with a complex murine microbiota. To address this, conventional mice were subjected to broad-spectrum antibiotic therapy for 8 weeks and perorally reassociated with either VSL#3 bacteria or a complex murine microbiota. VSL#3 recolonization resulted in restored CD4+ and CD8+ cell numbers in the small and large intestinal lamina propria as well as in B220+ cell numbers in the former, whereas probiotic intervention was not sufficient to reverse the antibiotic induced changes of respective cell populations in the spleen. However, VSL#3 application was as efficient as complex microbiota reassociation to attenuate the frequencies of regulatory T cells, activated dendritic cells and memory/effector T cells in the small intestine, colon, mesenteric lymph nodes, and spleen. Whereas broad-spectrum antibiotic treatment resulted in decreased production of cytokines such as IFN-γ, IL-17, IL-22, and IL-10 by CD4+ cells in respective immunological compartments, VSL#3 recolonization was sufficient to completely recover the expression of the anti-inflammatory cytokine IL-10 without affecting pro-inflammatory mediators. In summary, the probiotic compound VSL#3 has an extensive impact on mucosal, peripheral, and systemic innate as well as adaptive immunity, exerting beneficial anti-inflammatory effects in intestinal as well as systemic compartments. Hence, VSL#3 might be considered a therapeutic immunomodulatory tool following antibiotic therapy

Applying time series analyses on continuous accelerometry data—A clinical example in older adults with and without cognitive impairment

Introduction: Many clinical studies reporting accelerometry data use sum score measures such as percentage of time spent in moderate to vigorous activity which do not provide insight into differences in activity patterns over 24 hours, and thus do not adequately depict circadian activity patterns. Here, we present an improved functional data analysis approach to model activity patterns and circadian rhythms from accelerometer data. As a use case, we demonstrated its application in patients with mild cognitive impairment (MCI) and age-matched healthy older volunteers (HOV). Methods: Data of two studies were pooled for this analysis. Following baseline cognitive assessment participants were provided with accelerometers for seven consecutive days. A function on scalar regression (FoSR) approach was used to analyze 24 hours accelerometer data. Results: Information on 48 HOV (mean age 65 SD 6 years) and 18 patients with MCI (mean age 70, SD 8 years) were available for this analysis. MCI patients displayed slightly lower activity in the morning hours (minimum relative activity at 6:05 am: -41.3%, 95% CI -64.7 to -2.5%, p = 0.031) and in the evening (minimum relative activity at 21:40 am: -48.4%, 95% CI -68.5 to 15.4%, p = 0.001) as compared to HOV after adjusting for age and sex. Discussion: Using a novel approach of FoSR, we found timeframes with lower activity levels in MCI patients compared to HOV which were not evident if sum scores of amount of activity were used, possibly indicating that changes in circadian rhythmicity in neurodegenerative disease are detectable using easy-to-administer accelerometry. Clinical trials: Effects of Brain Stimulation During Nocturnal Sleep on Memory Consolidation in Patients With Mild Cognitive Impairments, ClinicalTrial.gov identifier: NCT01782391. Effects of Brain Stimulation During a Daytime Nap on Memory Consolidation in Patients With Mild Cognitive Impairment, ClinicalTrial.gov identifier: NCT01782365