"Is organic really organic? " – Why consumers do (not) trust organic food and what they expect from the organic sector. - Results of focus groups -

This paper addresses consumer trust in organic food in order to find out which aspects increase and decrease trust and which trust expectations consumers have. The aim is to strengthen consumer trust on the basis of the findings and to develop trust-building measures. To this end, ten focus groups with German consumers were conducted online in February 2021 and evaluated using content analysis. The results show that there is a predominant lack of trust in organic food. This is based in particular on the fact that organic production is often doubted and there are from the consumer’s point of view too many organic labels. This can be attributed not only to a lack of knowledge on the part of consumers, but also to a lack of transparency within the organic sector and in relation to organic food. Results from the consumer's point of view show that the possibility of control, information and transparency are relevant for trust in organic food and the development of knowledge about organic food can positively influence this trust

Comparison of different strategies to measure medication adherence via claims data in patients with chronic heart failure

Medication adherence correlates with morbidity and mortality in patients with chronic heart failure (CHF), but is difficult to assess. We conducted a retrospective methodological cohort study in 3,808 CHF patients, calculating adherence as proportion of days covered (PDC) utilizing claims data from 2010 to 2015. We aimed to compare different parameters’ influence on the PDC of elderly CHF patients exemplifying a complex chronic disease. Investigated parameters were the assumed prescribed daily dose (PDD), stockpiling, and periods of hospital stay. Thereby, we investigated a new approach using the PDD assigned to different percentiles. The different dose assumptions had the biggest influence on the PDC, with variations from 41.9% to 83.7%. Stockpiling and hospital stays increased the values slightly. These results queries that a reliable PDC can be calculated with an assumed PDD. Hence, results based on an assumed PDD have to be interpreted carefully and should be presented with sensitivity analyses to show the PDC's possible range

„Alles was mit Nachdenken verbunden ist“: Pünktchen und Anton in Buch und Film. Ein Medienvergleich der „Nachdenkereien“ bei Erich Kästner, Thomas Engel und Caroline Link

Erich Kästner’s novel for children, Pünktchen und Anton (1931), has been twice adapted for the screen, first in 1953 by Thomas Engel and then again in 1999 by Caroline Link. Both directors were also responsible for the screenplays which set the action in the present day. Kästner’s novel features 16 so-called “Nachdenkereien,” short passages following each chapter that outline moral principles, virtues, and values. This pedagogical content provides the readers with guidelines for the betterment of their own characters. After considering the genre of children’s literature as well as Erich Kästner’s reputation as an author of children’s books, the thesis focuses on the cinematic adaptation of these “Nachdenkereien.” Each version of Pünktchen und Anton is analyzed in turn with special attention paid to the representation of the moral lessons found in the “Nachdenkereien.” This analysis reveals that the film directors, being unable to reproduce cinematically the specific literary form of Kästner’s “Nachdenkereien,” transmit the content of these lessons by means of plot. Whereas Kästner uses a first-person narrator to explain the “Nachdenkereien” to young readers, the filmmakers introduce events that are not found in Kästner’s novel but which nevertheless convey the ethics present in the “Nachdenkereien.” Engel and Link therefore avoid the use of on- or off-screen narration in favour of incorporating the moral warnings into the plot. Other elements of the films, for example setting and characterization, aid in the transmittal of the story’s ethical messages. The movies leave it to their audiences to extract the moral guidelines contained in the stories, a departure from Kästner’s more direct entreaties to the readers. In either case, the readers/viewers of the stories are ultimately left with the final decision whether to heed the moral imperative presented

Clinical pharmacy services are reimbursed in Germany: challenges of real world implementation remain

Over the last two decades, community pharmacy has experienced major changes as the role of pharmacists is evolving from a product to a service and a patient focus. As part of this change, new and innovative clinical pharmacy services aimed at improving medicines use and patient outcomes have been designed, both nationally and internationally. Since June 2022, five services are reimbursed by all statutory health insurance funds and private insurance companies in Germany: medication review for patients with polymedication; blood pressure control in hypertension; assuring proper inhalation techniques for patients receiving a new device or a device change; medication review including a follow-up for patients taking oral anticancer drugs or immunosuppressants post-transplantation. Beyond reimbursement, the upscaling and sustainable provision of these professional services are now the main challenges. Implementation research will provide important information for the further development of pharmaceutical care programs

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We thank Dr. Kalmanovich and colleagues for their comments on our randomized controlled trial on improving medication adherence and quality of life of heart failure (HF) patients by a pharmacist‐led interdisciplinary approach.1 This study showed that pharmacy care safely improved adherence to HF medications and quality of life. These data extend recent consensus statements of both the Canadian Cardiovascular Society guidelines for the management of HF2 and the German clinical practice guideline on chronic HF3 that acknowledge the available evidence of pharmacist care and interdisciplinary care.4, 5 Topics and tasks include prevention of HF, particularly by improving adherence to antihypertensives, providing medication reviews, assuring appropriate self‐medication, and improving both medication safety and adherence.4 We congratulate Kalmanovich et al. to their research plan. Their study will hopefully provide additional randomized evidence for the effects of interdisciplinary care in patients with HF

'Transformations towards sustainability':Emerging approaches, critical reflections, and a research agenda

Over the last two decades researchers have come to understand much about the global challenges confronting human society (e.g. climate change; biodiversity loss; water, energy and food insecurity; poverty and widening social inequality). However, the extent to which research and policy efforts are succeeding in steering human societies towards more sustainable and just futures is unclear. Attention is increasingly turning towards better understanding how to navigate processes of social and institutional transformation to bring about more desirable trajectories of change in various sectors of human society. A major knowledge gap concerns understanding how transformations towards sustainability are conceptualised, understood and analysed. Limited existing scholarship on this topic is fragmented, sometimes overly deterministic, and weak in its capacity to critically analyse transformation processes which are inherently political and contested. This paper aims to advance understanding of transformations towards sustainability, recognising it as both a normative and an analytical concept. We firstly review existing concepts of transformation in global environmental change literature, and the role of governance in relation to it. We then propose a framework for understanding and critically analysing transformations towards sustainability based on the existing ‘Earth System Governance’ framework (Biermann et al., 2009). We then outline a research agenda, and argue that transdisciplinary research approaches and a key role for early career researchers are vital for pursuing this agenda. Finally, we argue that critical reflexivity among global environmental change scholars, both individually and collectively, will be important for developing innovative research on transformations towards sustainability to meaningfully contribute to policy and action over time

Modulation of G-protein activation, calcium currents and opioid receptor phosphorylation by the pH-dependent antinociceptive agonist NFEPP

N-(3-fluoro-1-phenethylpiperidine-4-yl)-N-phenyl propionamide is a newly-designed pain killer selectively activating G-protein-coupled mu-opioid receptors (MOR) in acidic injured tissues, and therefore devoid of central side effects which are typically elicited at normal pH values in healthy tissues. However, the neuronal mechanisms underlying NFEPP's antinociceptive effects were not examined in detail so far. Voltage-dependent Ca2+ channels (VDCCs) in nociceptive neurons play a major role in the generation and inhibition of pain. In this study, we focused on the effects of NFEPP on calcium currents in rat dorsal root ganglion (DRG) neurons. The inhibitory role of the G-protein subunits G(i/o) and G beta gamma on VDCCs was investigated using the blockers pertussis toxin and gallein, respectively. GTP gamma S binding, calcium signals and MOR phosphorylation were also investigated. All experiments were performed at acidic and normal pH values using NFEPP in comparison to the conventional opioid agonist fentanyl. At low pH, NFEPP produced more efficient G-protein activation in transfected HEK293 cells and significantly reduced VDCCs in depolarized DRG neurons. The latter effect was mediated by G beta gamma subunits, and NFEPP-mediated MOR phosphorylation was pH-dependent. Fentanyl's responses were not affected by pH changes. Our data indicate that NFEPP-induced MOR signaling is more effective at low pH and that the inhibition of calcium channels in DRG neurons underlies NFEPP's antinociceptive actions

Resistance of Enterococcus spp. in Dust From Farm Animal Houses: A Retrospective Study

In a retrospective study, the antimicrobial susceptibility of Enterococcus spp. isolated from stored sedimentation dust samples from cattle, pig and poultry barns to 16 antibiotics was determined using a microdilution test. The resistance phenotypes of 70 isolates from different timespans (8 from the 1980s, 15 from the 1990s, 43 from the 2000s and 4 from 2015) were determined. Resistant enterococci were detected in samples from all time periods. Resistances to three or more antibiotics occurred in 69 percent of all isolates. The oldest multidrug resistant isolate was an Enterococcus faecium obtained from a 35-year-old pig barn dust sample. No correlations (ρ = 0.16, p = 0.187) were found between the age of isolates and the number of resistances. Instead, the number of resistances was associated with the origin of the isolates. An exact logistic conditional regression analysis showed significant differences in resistance to ciprofloxacin, erythromycin, penicillin and tylosin between isolates from different animal groups. Interestingly, we isolated ciprofloxacin-resistant E. faecium from pig barn dust before fluoroquinolones were introduced into the market for use in animal husbandry. In conclusion, dust from farm animal houses is a reservoir and carrier of multidrug-resistant Enterococcus spp. People working in barns are unavoidably exposed to these bacteria. Furthermore, it can be hypothesized that emissions from barns of intensive livestock farming contaminate the environment with multidrug resistant enterococci

MicroRNA 200a as a histologically independent marker for meningioma recurrence : Results of a four microRNA panel analysis in meningiomas

Introduction: Meningiomas are mostly benign neoplasms of the central nervous system. Nevertheless there are recurrences in about 20% after surgical resection. Previous studies could reveal several predictors of meningioma recurrence. Tumor progression often is associated with a specific pattern of chromosome losses. Our study investigated the potential function of selected microRNAs as markers of tumor progression. Methods: By real-time polymerase chain reaction the expressions of microRNA 21-3p, 34a-3p, 200a-3p, and 409-3p were analyzed in solid tumor and in blood samples of 51 meningioma patients as well as in blood samples of 20 healthy individuals. Additionally, aberrations of parts of chromosomes 1, 14, 18, and 22 were analyzed by FISH. Tumor and blood samples were statistically analyzed, using Spearman's rank correlation coefficient as well as Mann–Whitney U- and Kruskal–Wallis-Test. Results: MicroRNA 200a showed significantly lower expressions in recurrent meningiomas than in newly diagnosed ones. MicroRNA 409 in meningiomas was correlated significantly with tumor volume and showed a significant negative correlation with patient age. Significance was found between the expression patterns of microRNAs 34a and 200a with the respective aberrations of chromosome 1p and the microRNA 409 with aberration of chromosome 14. In the male cohort the expression of microRNA 200a in blood was significantly upregulated in patients compared to healthy volunteers. By our research the function of microRNA 200a was proved to detect meningioma patients by liquid biopsy. Conclusion: We detected microRNA 200a as a new biomarker to indicate meningioma recurrences. Future transferability to blood could be important for patient follow-up