Comparing outpatient oral antibiotic use in Germany and the Netherlands from 2012 to 2016.

PURPOSE: Overuse of antibiotics is of concern, but may differ between European countries. This study compares outpatient use of oral antibiotics between Germany (DE) and the Netherlands (NL). METHODS: For DE, we used the DAPI database with information on dispensings at the expense of the Statutory Health Insurance Funds from > 80% of community pharmacies. For NL, data were obtained from the Dutch Foundation for Pharmaceutical Statistics. Use of oral antibiotics was estimated as defined daily doses per 1000 inhabitants per day (DID), except for age comparisons as packages per 1000 inhabitants annually. National time trends were assessed with linear regression, stratified for the major antibiotic classes, and individual substances. RESULTS: From 2012 to 2016, outpatient antibiotic use was lower in NL than in DE (9.64 vs 14.14 DID in 2016) and non-significantly decreased slightly over time in both countries. In DE, dispensings of oral antibiotics to children were higher compared with NL for the age groups 2 to 5 (2.0-fold in 2016) and 6 to 14 years (2.7-fold in 2016). Use of cephalosporins was very low in NL (0.02 DID in 2016), but the second most frequently dispensed class in DE (2.95 DID in 2016). CONCLUSION: From 2012 to 2016, outpatient use of oral antibiotics was lower in NL than in DE. Differences were primarily observed in the age groups 2 to 5 and 6 to 14 years, although the recommendations of evidence-based guidelines in both countries were in agreement

Quality Appraisal of Ambulatory Oral Cephalosporin and Fluoroquinolone Use in the 16 German Federal States from 2014-2019.

Background: Despite concerns about causing bacterial resistance and serious side effects, oral cephalosporins and fluoroquinolones are still frequently prescribed in Germany. We aimed to test a method for the detection of regional quality differences in the use of oral cephalosporins and fluoroquinolones and to apply this to the German federal states. Methods: Use of antibiotics from 2014–2019 was analyzed using dispensing data from community pharmacies claimed to the statutory health insurance (SHI) funds. Quality of regional antibiotic use in 2019 was assessed by calculating indicators based on defined daily doses per 1000 SHI-insured persons per day (DID). Oral cephalosporin and fluoroquinolone use was followed by linear regression analyses. Results: The method used was suitable to find meaningful quality differences in ambulatory oral cephalosporin and fluoroquinolone use between the German federal states. In 2019, DID varied from 1.62 in Brandenburg to 3.17 in Rhineland-Palatinate for cephalosporins and from 0.47 in Brandenburg to 0.89 in Saarland for fluoroquinolones. The city-states Hamburg, Bremen, and Berlin showed highest quality with the applied indicator set. From 2014–2019, a significant decrease in utilization of oral cephalosporins was found in all federal states. During 2017–2019, all states showed a significant decline of fluoroquinolone us

Inclusion: topical trends of discussion, contradictions and perspectives

Inklusion fokussiert die grundlegende Frage nach dem Umgang mit Verschiedenheit in pädagogischen Kontexten. Damit soll eine enge, allein an Platzierungs- und Förderungsfragen von Kindern und Jugendlichen mit Behinderungen orientierte Sichtweise überwunden werden. Die inklusive Beschulung in einer Schule für (möglichst) alle Schülerinnen und Schüler wird weltweit seit Langem diskutiert und erhält durch die 2009 in Deutschland in Kraft getretene UN-Konvention neue Aufmerksamkeit. In diesem Artikel werden die nationalen und internationalen Herausforderungen von inklusiver Beschulung auf Grundlage relevanter Forschungsergebnisse aufgezeigt. Angelehnt an internationale Diskurse werden die Widersprüche der deutschen Inklusionsbewegung und Perspektiven für inklusive Schulen formuliert. (DIPF/Orig.)Inclusive education focuses on the basic question of how to deal with diversity in educational contexts. Its aim is to overcome the current perception that puts the main emphasis on placement and support of students with special needs. The inclusive schooling of students with and without special needs has been discussed worldwide for a long time. The UN convention which was ratified by Germany in 2009 brought renewed attention to this topic. This article concentrates on the national and international challenges of inclusive schooling, based on relevant research results. Taking the international debate into account, the contradictions of the inclusion movement in Germany and its perspectives for inclusive schools are shown. (DIPF/Orig.

Closing the loop between integrated assessment and climate risk research – rapid climate risk emulation

Climate model emulation has long been and is increasingly applied to the results of integrated assessment modelling (IAM)models (IAMs), to determine the climate outcomes, primarily global mean surface temperature (GMST), of emissions pathways. Originally provided at the global level, more recently approaches have been developed to reproduce a growing number of climate variables, also with spatial, even gridded, resolution. Here we build on these approaches to demonstrate a workflow and post-processing package, that takes the GMST trajectory, e.g. from a simple climate model (SCM) and calculates a range of climate impacts and exposure indicators based on the GMST trajectory. To do this, we built a database of post-processed climate impacts from global climate [WM1] CMIP6 & ISIMIP-3 GCMs and impacts [WM2] models, and also calculated population and land area exposure to the indicators through time and for spatial units, e.g. countries. Indicators include temperature and precipitation extremes, heatwaves, degree days, drought intensity, water stress, and indicators of hydrological variability. Using a high-resolution temperature time timeslice approach, GMST trajectories are then mapped to the impact and exposure indicators to produce gridded maps of climate impacts through time, and trajectories of climate exposure by spatial unit. Using this approach we demonstrate the rapid post-processing of SCM [WM3] results such that ensembles of global IAM [WM4] mitigation pathways, such as those from AR6, can be accompanied by a new suite of climate impacts and risk information – and discuss related uncertainties and avenues for further research to incorporate vulnerabilities

Analysis of O.Oeni proteome

Comunicaciones a congreso

PKAN neurodegeneration and residual PANK2 activities in patient erythrocytes

Objective: Pantothenate kinase 2-associated neurodegeneration (PKAN) is a rare neurodegenerative disease caused by mutations in the pantothenate kinase 2 (PANK2) gene. PKAN is associated with iron deposition in the basal ganglia and, occasionally, with the occurrence of misshaped erythrocytes (acanthocytes). The aim of this study was to assess residual activity of PANK2 in erythrocytes of PKAN patients and to correlate these data with the type of PANK2 mutations and the progression of neurodegeneration. Methods: Residual PANK2 activities in erythrocytes of 14 PKAN patients and 14 related carriers were assessed by a radiometric assay. Clinical data on neurodegeneration included the Barry-Albright Dystonia Scale (BAD-Scale) besides further general patient features. A molecular visualization and analysis program was used to rationalize the influence of the PKAN causing mutations on a molecular level. Results: Erythrocytes of PKAN patients had markedly reduced or no PANK2 activity. However, patients with at least one allele of the c.1583C > T (T528M) or the c.833G > T (R278L) variant exhibited 12-56% of residual PANK2 activity. In line, molecular modeling indicated only minor effects on enzyme structure for these point mutations. On average, these patients with c.1583C > T or c.833G > T variant had lower BAD scores corresponding to lower symptom severity than patients with other PANK2 point mutations. Interpretation: Residual erythrocyte PANK2 activity could be a predictor for the progression of neurodegeneration in PKAN patients. Erythrocytes are an interesting patient-derived cell system with still underestimated diagnostic potential

Leistung und Inklusion: Eine Einladung zur Reflexionspause

Der Beitrag dient als Einführung in das Themenheft. Nach einer inhaltlichen Hinführung werden die zugrunde gelegten Begriffsverständnisse von inklusiver Bildung und Leistung erläutert. Dabei wird das Verhältnis zwischen den beiden Begriffen als ein – aus divergierenden programmatischen Logiken resultierendes – spannungsreiches entworfen. Es folgt eine Vorstellung des BMBF-Verbundprojektes Reflexion, Leistung & Inklusion (ReLInk), aus dem heraus das Themenheft entstanden ist. Dieses Projekt ist durch ein Forschungs- und Entwicklungsdesign charakterisiert. Bezugnehmend auf einen Schwerpunkt der Forschungen werden ausgewählte Aspekte (z.B. Leistung als Frage individueller und institutioneller Erwartungen, Fragen zur Differenzierung von Aufgaben, Differenz in der Leistungsbewertung etc.) zu der Bandbreite der mit Leistung und Inklusion im schulischen Alltag verbundenen Fragen und Herausforderungen dargestellt. Diesen Beitrag schließt ein Überblick über die Beiträge im Themenheft