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Weiträumige Kontaktnetzwerke sorgen für Verbreitung und Transfer von Wissen und Gütern sowie von kulturellen Werten. Der Transport von Lasten und Menschen kann als einer der wichtigsten Eckpfeiler solcher Austauschsysteme gesehen werden. Daher dürften die Suche nach Transportmöglichkeiten und die Entwicklung geeigneter Vehikel in der menschlichen Gedankenwelt seit jeher fest verankert sein. Die hier vorliegenden Beiträge basieren auf den Vorträgen der Tagung „Transporte, Transportwege und Transportstrukturen“ der Arbeitsgemeinschaft Bronzezeit und des Sonderforschungsbereiches 1070 RessourcenKulturen. Sie fassen im archäologischen Befund der Bronzezeit vorhandene Evidenzen zu Transportwegen und -fahrzeugen sowie Aussagen zu Infrastruktur nicht nur zusammen, sondern ergänzen diese um zahlreiche wissenswerte Aspekte. Was können diese Befunde über die Transportvehikel und ihre Bedeutung aussagen? Welche Eigenschaften wiesen diese auf? Handelt es sich bei den Fundstücken um abgenutzte oder mutwillig zerstörte Fahrzeuge bzw. Teile von solchen? Welche Implikationen auf technologischer und sozialer Ebene lassen sich mit den Befunden verbinden? Wie muss man sich die bronzezeitliche Infrastruktur in unterschiedlichen Regionen vorstellen? Inwiefern bildeten Verkehrswege und Austausch eine Ressource? Der detaillierten Beantwortung dieser Fragen ist dieser Band gewidmet, woraus eine übergreifende Zusammenschau von Funden, Befunden und Theorien entstanden ist.
Purpose: The treatment with a cochlear implant (CI) is the gold standard in therapy of patients with profound hearing loss or deafness. Successful hearing rehabilitation with a CI is a complex, multi-stage process. In medicine, “Clinical Practice Guidelines” (CPG) are widely accepted for the standardization of such processes. These are supplemented by medical registries in which data regarding the treatment can be collected and evaluated. The aim of this paper is to identify currently existing CI-related CPGs and registries in Europe.
Methods: Between 01/2021 and 06/2021, 42 countries on the European continent, including the United Kingdom, Russia and Turkey, were screened using an internet search (search engine: Google) and a key word search in the Pubmed database. Search terms were the respective country name combined with the following terms: “Cochlear Implant”, “CI”, “Cochlear implant clinical practice guideline”, “CI Guideline”, “Cochlear Implant Registry”, “CI Registry”, “Ear nose throat society”. The internet search was conducted in English as well as in the corresponding national language. The objective was to identify a CI-related CPG or registry.
Results: A CPG was found in 16 of 42 (38%) countries. In terms of population, this accounts for 645 million out of 838 million people (77%). A registry existed in 4 of the 42 (10%) countries assessed. This corresponds to 102 million out of 838 million (12%) people. In total, 4 out of 42 countries (10%) had both a CPG and a registry.
Conclusion: Our work shows numerous efforts in Europe to standardize CI care at the national level. While most people in Europe already live in countries with a CPG, this is not the case for CI registries. European-wide consensus on CPGs or registries does not yet exist. The present study thus provides a first assessment of the distribution of CI-related CPGs and registries.
Purpose: The coronavirus disease 2019 (COVID-19) poses major challenges to health-care systems worldwide. This pandemic demonstrates the importance of timely access to intensive care and, therefore, this study aims to explore the accessibility of intensive care beds in 14 European countries and its impact on the COVID-19 case fatality ratio (CFR).
Methods: We examined access to intensive care beds by deriving (1) a regional ratio of intensive care beds to 100,000 population capita (accessibility index, AI) and (2) the distance to the closest intensive care unit. The cross-sectional analysis was performed at a 5-by-5 km spatial resolution and results were summarized nationally for 14 European countries. The relationship between AI and CFR was analyzed at the regional level.
Results: We found national-level differences in the levels of access to intensive care beds. The AI was highest in Germany (AI = 35.3), followed by Estonia (AI = 33.5) and Austria (AI = 26.4), and lowest in Sweden (AI = 5) and Denmark (AI = 6.4). The average travel distance to the closest hospital was highest in Croatia (25.3 min by car) and lowest in Luxembourg (9.1 min). Subnational results illustrate that capacity was associated with population density and national-level inventories. The correlation analysis revealed a negative correlation of ICU accessibility and COVID-19 CFR (r = − 0.57; p < 0.001).
Conclusion: Geographical access to intensive care beds varies significantly across European countries and low ICU accessibility was associated with a higher proportion of COVID-19 deaths to cases (CFR). Important differences in access are due to the sizes of national resource inventories and the distribution of health-care facilities relative to the human population. Our findings provide a resource for officials planning public health responses beyond the current COVID-19 pandemic, such as identifying potential locations suitable for temporary facilities or establishing logistical plans for moving severely ill patients to facilities with available beds.
APPEAL‐1: A pan‐European survey of patient/caregiver perceptions of peanut allergy management
(2020)
Background: Peanut allergy (PA) is associated with marked quality‐of‐life (QoL) impairment. However, data are lacking on the experience and impact of living with PA from the perspectives of persons with PA (PwPA) and their caregivers. Allergy to Peanuts imPacting Emotions And Life study 1 (APPEAL‐1) was a pan‐European survey investigating these perspectives. This first of two articles reports clinical characteristics of PwPA and PA management practices.
Methods: APPEAL‐1 was a quantitative, online survey conducted in eight European countries, developed by eight representatives of patient advocacy groups and five healthcare professionals and researchers. Eligible participants included adults with PA and parents/caregivers of PwPA who responded by self‐report and provided proxy‐report for the PwPA under their care. Data were summarized using nonweighted descriptive statistics.
Results: Of 1846 completed/analysed questionnaires, 528 were from adults with PA (self‐report); 437 by proxy for children with PA (34 aged 0‐3 years, 287 aged 4‐12 years, 116 aged 13‐17 years) and 881 from parents/caregivers (self‐report). Of PwPA (N = 965), 95% reported diagnosis by healthcare professionals, mostly by clinical history and peanut‐specific allergy testing. Rates of allergic rhinitis, asthma and other food allergies in PwPA were 50%, 42% and 79%, respectively. Only 31% of PwPA received HCP advice/support following their worst allergic reaction, and 28% had not been prescribed an adrenaline auto‐injector. Results were similar by country but varied by age group.
Conclusions: The APPEAL‐1 findings contribute to greater understanding of PA impact on PwPA, caregivers and family members and the need for improved PA management across Europe.
With a growing Muslim population, many European countries need to integrate Muslims into their societies. One aspect that can hinder successful integration are substantial differences in human values. This is because such values are consequential for attitudes as well as behavior. We compare basic human values between Muslim immigrants and non-Muslim natives in four European countries with distinct immigration histories and integration politics: Belgium, France, Germany, and Sweden. For most insightful comparisons, we contrast values of Muslim immigrants with those of Christian natives as well as those of non-religious natives. We employ data of more than 50,000 individuals based on the first eight waves of the European Social Survey. Our findings reveal significant differences in value priorities between Muslims, Christians and non-religious individuals in all four countries. Amongst other things, Muslim immigrants score particularly high in conservation values (security and tradition/conformity). At the same time, they also score higher in self-transcendence values (benevolence as well as universalism). While many of these findings are in line with theory and previous research, the higher score in universalism is unexpected. A potential explanation is the combination of religious traditionalism and discrimination experiences. In other words, religious traditions are associated with more conservative views, but being subject to marginalization can still result in an appreciation of equal opportunities. We find only limited support for differences in hedonism. Religiosity correlates with values of tradition/conformity for Muslim immigrants as well as for Christian natives. Thus, accounting for religiosity renders differences in these values between Muslims and other groups statistically insignificant. While most of these findings hold in all countries, differences are most pronounced in Sweden and lower in the other three countries, which is also true after accounting for differences in socio-economic status and religiosity between the three groups. This suggests that a combination of a country's history of diversity and national integration policies either encourages the convergence of values or leads to a solidification of value differences between groups. We discuss these political and social implications of our findings.
Uncertainty is a central theme in the illness experiences of older cancer patients throughout their illness trajectory. Mishel’s popular theory on uncertainty during illness approaches uncertainty as an outcome and is characterized by the patient’s inability to find meaning in illness events. This study used the concepts of liminality and subjunctivity to explore uncertainty throughout the illness trajectory of cancer patients. We interviewed 18 older (age range = 57–92 years) patients with breast cancer or gastro-intestinal cancer 3 to 4 years post diagnosis. Our analysis is based on the QUAGOL guide that draws on elements of grounded theory such as constant comparison. We found that liminality and subjunctivity provide a useful frame for understanding uncertainty with a specific focus on its productive potential and meaning making. Health care professionals should be open to acquiring a complete picture of patients’ diverse and dynamic experiences of uncertainty in the different stages of their illness trajectory.
In energy modelling, open data and open source code can help enhance traceability and reproducibility of model exercises which contribute to facilitate controversial debates and improve policy advice. While the availability of open power plant databases increased in recent years, they often differ considerably from each other and their data quality has not been systematically compared to proprietary sources yet. Here, we introduce the python-based ‘powerplantmatching’ (PPM), an open source toolset for cleaning, standardizing and combining multiple power plant databases. We apply it once only with open databases and once with an additional proprietary database in order to discuss and elaborate the issue of data quality, by analysing capacities, countries, fuel types, geographic coordinates and commissioning years for conventional power plants. We find that a derived dataset purely based on open data is not yet on a par with one in which a proprietary database has been added to the matching, even though the statistical values for capacity matched to a large degree with both datasets. When commissioning years are needed for modelling purposes in the final dataset, the proprietary database helps crucially to increase the quality of the derived dataset.
This essay discusses the current Europeanization of national museums in different European countries and considers it against the background of media theories and feminist epistemologies. Taking the example of the European Solidarity Centre Gdansk, the Deutsches Historisches Museum Berlin and the Musée des civilisations de l’Europe et de la Méditerranée Marseille, it suggests two approaches to the dynamics of travel and locatedness in the museum. Firstly, using the concept of what I call “Europoeic media” this essay shows how “Europe” as a travelling memory is shaped by and in media. Secondly, I argue that the locatedness both of memories and the memory researcher are not detrimental but instead produce “situated knowledges”. Thus, in combining media-sensitivity and standpoint-reflexivity, the paper proposes new ways of taking into account the travels and locatedness of both memories and memory research.
Within the last decades, western democracies have experienced a rise of inequality, with the gap between lower and upper class citizens steadily increasing and a widespread sentiment of growing inequalities also in the political sphere. Against this background, and in the context of the current “crisis of democracy”, democratic innovations such as direct democratic instruments are discussed as a very popular means to bring citizens back in. However, research on direct democracy has produced rather inconsistent results with regard to the question of which effects referenda and initiatives have on equality. Studies in this field are often limited to single countries and certain aspects of equality. Moreover, most existing studies look at the mere availability of direct democratic instruments instead of actual bills that are put to a vote. This paper aims to take a first step to fill these gaps by giving an explorative overview of the outputs of direct democratic bills on multiple equality dimensions, analyzing all national referenda and initiatives in European democracies between 1990 and 2015. How many pro- and contra-equality bills have been put to a vote, how many of those succeeded at the ballot, and are there differences between country groups? Our findings show that a majority of direct democratic bills was not related to equality at all. Regarding the successful bills, we detect some regional differences along with the general tendency that there are more pro- than contra-equality bills. Our paper sheds new light on the question if direct democracy can serve as an appropriate means to complement representative democracy and to shape democratic institutions in the future. The potential of direct democracy in fostering or impeding equality should be an important criterion for the assessment of claims to extend decision-making by citizens.
A twentieth century-long coupled atmosphere-ocean regional climate simulation with COSMO-CLM (Consortium for Small-Scale Modeling, Climate Limited-area Model) and NEMO (Nucleus for European Modelling of the Ocean) is studied here to evaluate the added value of coupled marginal seas over continental regions. The interactive coupling of the marginal seas, namely the Mediterranean, the North and the Baltic Seas, to the atmosphere in the European region gives a comprehensive modelling system. It is expected to be able to describe the climatological features of this geographically complex area even more precisely than an atmosphere-only climate model. The investigated variables are precipitation and 2 m temperature. Sensitivity studies are used to assess the impact of SST (sea surface temperature) changes over land areas. The different SST values affect the continental precipitation more than the 2 m temperature. The simulated variables are compared to the CRU (Climatic Research Unit) observational data, and also to the HOAPS/GPCC (Hamburg Ocean Atmosphere Parameters and Fluxes from Satellite Data, Global Precipitation Climatology Centre) data. In the coupled simulation, added skill is found primarily during winter over the eastern part of Europe. Our analysis shows that, over this region, the coupled system is dryer than the uncoupled system, both in terms of precipitation and soil moisture, which means a decrease in the bias of the system. Thus, the coupling improves the simulation of precipitation over the eastern part of Europe, due to cooler SST values and in consequence, drier soil.