Eastern Federal States Research Articles

Dynamic archetypes of agricultural land systems in Germany from 1992 to 2019

Grasslands, important agricultural land systems, are undergoing significant shifts such as intensification, abandonment, and conversion to alternative land uses in Europe, leading to biodiversity loss. Despite major efforts, the European Union´s Common Agricultural Policy (CAP) has been unable to halt the decline of grasslands and to appropriately adjust management intensity because implemented policies have not considered the heterogeneity of grassland systems. However, accounting for this heterogeneity is essential to increase the policies´ effectiveness. In this study, we used archetype analysis to identify recurrent patterns in the heterogeneity of farm configurations, using Germany as an example, that can help tailor policy instruments to specific regional conditions. By applying self-organising maps, we reveal nine archetypes integrating 16 farm accountancy indicators. Advancing archetype analysis, we discuss their dynamics (including their emergence, disappearance and persistence) between 1992 and 2019 at the level of federal states and interpret these dynamics in the light of CAP. For example, archetypes in the western federal states are dominated by small crop and dairy farms, while archetypes in the eastern federal states are more diverse, including larger subsidised farms and medium crop farms. Moreover, archetype dynamics in the southern federal states indicate a decline in small dairy farms and an increase in small crop farms, implying the loss of valuable habitats for wild species. Policy instruments tailored to such regional conditions could more appropriately halt this loss. These insights derived from agricultural land systems in Germany can enrich the debate about how to better tailor policy instruments to regional conditions to preserve functional grassland systems in Europe and worldwide.

The Alternative for Germany and the Left Parties in the Eastern States: Transformation of Electoral Preferences

Introduction. The separate existence of East Germany over the years has led to the formation of unique electoral preferences of citizens. In eastern federal states the Left as the heir to the Socialist Unity Party of Germany remained one of the leaders for a long time. However, in recent years its traditional electorate has increasingly begun to choose the Alternative for Germany. The aim of this article is to identify the main reasons for this shift in preferences in East Germany. Materials and Methods. The main materials were the results of the elections to the Bundestag and Landtags. The statistics illustrating the performance of the Left on the national average and separately in East Germany in the national elections since 2009 was processed with the help of comparative analysis, the same was done with regard to the subnational elections since 2009 and 2011. The results of the Alternative for Germany were evaluated from its inception in 2013. Additionally, the data was used on preferences among voters of various age groups, the rating of the National Democratic Party of Germany before and after the advent of the Alternative for Germany, as well as GDP per capita indicators. Results. It is confirmed that it was the Alternative for Germany that mainly occupied the former niche of the Left. The main reasons that comprehensively influenced electoral preferences include the generational change, the unsuccessful adaptation of the left forces to Western values, the unpopularity of anti-capitalist rhetoric, the presence of more influential opponents on key left-wing topics, the demand for conservative and opposition ideology (e.g. in migration policy), as well as the ability of right-wing populists to work with protest voters. Discussion and Conclusion. The decline in the ratings of the left has become a rather stable phenomenon in recent years, while the performance of the right-wing populists strongly depended on the reaction of the party to a particular political crisis. However, this was more about the general popularity of the Alternative for Germany, which did not imply real prerequisites for the return of the electorate to the Left. The results of this paper can be applied in expert-analytical and research activities aimed at explaining electoral processes.

Secular trends and regional variations in pharmacotherapy of attention-deficit/hyperactivity disorder (ADHD) among children and adolescents in Germany

BackgroundThe study aim was to examine the secular trends and regional variations in pharmacotherapy of children and adolescents with attention-deficit/hyperactivity disorder (ADHD) in Germany.MethodsWe used nationwide drug prescription data of outpatient care (2009 to 2016). The study population comprised patients aged between 5 and 14 years with the diagnoses “hyperkinetic disorders” (ICD-10 code F90) (e.g. n = 262,766 in 2016). The examined drugs were methylphenidate, amphetamines, atomoxetine and guanfacine.ResultsOverall, the proportion of patients received any prescription showed a decreasing trend over years (2010, 51%; 2016, 44%). The proportion of methylphenidate prescription was higher in Western than Eastern federal states. However, atomoxetine was more often prescribed in Eastern than Western federal states. The proportion of methylphenidate prescriptions issued by pediatric psychiatrists increased from 28% (2009) to 41% (2016).ConclusionA decreasing trend in use of pharmacotherapy may be explained by prescription restrictions issued by the Federal Joint Committee in recent years.

Evolution of urban development and regeneration funding programs in German cities

Germany looks back at a rapidly changing developmental period in which the western part of the country experienced economic prosperity during the 1950s, whereas the eastern part experienced a different start. This situation persisted till the German reunification in 1989. After reunification, Germany's policies were similar to those of the post-WWII period—it focused on the most important needs such as social injustice in cities and quarters and too much (eastern federal states) or too little (western federal states) living space. In more recent times, urban development programs have actively promoted sustainability and tackled the risks posed by climate change in accordance with the Leipzig Charter (2007). This paper provides an overview of the increasingly diverse financing programs implemented by German authorities and identifies the specific target of each program, in addition to budget size and regional distribution. The six major funding programs discussed were all active until 2019. They reflect the development of German city planning funding programs and clarify the diversity of the cities' needs. On the downside, this diversity led to a complexity that requires community planning experts to search for the program (s) that best suit their community's individual development concept and project. The paper also summarizes the most recent developments in terms of new programs and a leaner program structure. The German funding system continues to adapt as the conditions change.

The just gender pay gap in Germany revisited: The male breadwinner model and regional differences in gender-specific role ascriptions

Despite recent advances, women still earn less than men, and this gap is considerable. Moreover, even after accounting for differences in education, occupation, experience and performance, many people think that this gap is justified, which leads to a so-called just gender pay gap (JGPG). Research thus far has not been able to explain this JGPG. In this paper, we use a factorial survey experiment conducted with a population-representative sample in Germany (SOEP-Pretest 2008, 1066 persons, 26,650 vignette ratings) to test if the male breadwinner model (MBM)—the belief that fathers should be gainfully employed to provide for the material needs of their family while mothers attend to the unpaid family work—can account for this JGPG. Based on the MBM explanation, we expect that the JGPG is larger if there are children in a family. To account for the multistep rating process of the factorial survey in the SOEP-Pretest 2008, we develop and implement a new, highly flexible factorial survey model: the generalized Craggit model. Our results clearly indicate that the MBM is a critical factor driving the JGPG in Germany. While respondents think that childless women and men should be paid equally, they consider it just if men with children earn approximately 8 % more than women with children or childless persons earn. Moreover, our analyses based on the generalized Craggit model demonstrate a lower JGPG and less relevance of the MBM in the eastern federal states than in the western federal states.

Trends and regional distribution of outpatient claims for asthma, 2009-2016, Germany.

ObjectiveTo investigate asthma morbidity in Germany by calculating current prevalence, examining its temporal and spatial trends and estimating the total number of asthmatics in Germany and calculating age-, sex- and residence-specific risk.MethodsWe used claims data reported by physicians during 2009–2016, including outpatient diagnoses of all statutory health insured individuals, comprising 85.3% (70 416 019/82 521 653) of the total population in Germany in 2016. We performed a spatial analysis of asthma prevalence according to administrative district by calculating Global and Local Moran’s I. We assessed the risk of asthma by sex, age, type of residence (rural versus urban) and federal state (East versus West) using a multilevel parametric survival regression.FindingsWe estimated that 4.7 million individuals were affected by asthma in 2016, including 0.8 million children and 3.9 million adults. We observed a slightly higher prevalence (with an increasing trend) among adults (5.85%; 3 408 622/58 246 299) compared to children (5.13%; 624 899/12 169 720), and calculated an age-standardized prevalence of 5.76% (95% confidence interval, CI: 5.76–5.77). We found evidence of a strong spatial autocorrelation (Global Moran’s I: 0.50, P < 0.0001), and identified local spatial clusters with higher levels of prevalence. Living in the western (versus eastern) federal states and living in densely populated large urban municipalities (versus rural area) were independently associated with an increased risk of asthma, with hazard ratios of 1.33 (95% CI: 1.32–1.34) and 1.32 (95% CI: 1.31–1.32), respectively.ConclusionOur insights into the spatial distribution of asthma morbidity may inform public health interventions, including region-specific prevention programmes and control.

DNA-aided identification of Culex mosquitoes (Diptera: Culicidae) reveals unexpected diversity in underground cavities in Austria

Subterranean cavities serve as resting places and hibernation shelters for mosquitoes. In Europe, members of the genus Culex are often the most abundant insects on cave walls. Culex pipiens L., the common house mosquito, exists in two physically very similar, yet genetically and ecologically distinct biotypes (or forms, ‘f.’), namely Cx. pipiens f. pipiens and Cx. pipiens f. molestus. Autogeny and stenogamy of the latter form have been interpreted as adaptations to underground habitats. The epigean occurrence of the two biotypes and their hybrids was recently examined in Eastern Austria, but the hypogean distribution of the Cx. pipiens complex and morphologically similar non-members such as Cx. torrentium is unknown. Considering the key role of Culex mosquitoes in the epidemiology of certain zoonotic pathogens, the general paucity of data on species composition and relative abundance in subterranean shelters appears unfortunate.For a first pertinent investigation in Austria, we collected mosquitoes in four eastern federal states. Based on analyses of the ACE2 gene and the CQ11 microsatellite locus, 150 female and three male mosquitoes of the genus Culex, two females of the genus Culiseta and a single female of the genus Anopheles were determined to species level or below. In our catches, Cx. pipiens f. pipiens exceeded the apparent abundance of the purportedly cave-adapted Cx. pipiens f. molestus many times over. Records of Cx. hortensis and Cx. territans, two species rarely collected in Austria, lead us to infer that underground habitats host a higher diversity of culicine mosquitoes than previously thought.

Marked Underreporting of Pertussis Requiring Hospitalization in Infants as Estimated by Capture-Recapture Methodology, Germany, 2013-2015.

In Germany, pertussis became notifiable in eastern federal states in 2002 and nationwide in March 2013. Infants are at greatest risk for severe disease, with a high proportion requiring hospitalization. We implemented enhanced hospital-based surveillance to estimate the incidence of pertussis requiring hospitalization among infants in Germany and to determine the proportion of infants hospitalized with pertussis too young to have been vaccinated. Enhanced surveillance was implemented within a nationwide hospital surveillance network (ESPED). We defined cases as children less than 1 year of age hospitalized due to laboratory-confirmed pertussis with disease onset from 01/07/2013-30/06/2015. We matched cases to those ascertained in the national statutory notification system, and estimated incidence using capture-recapture methodology. The estimated annual incidence of pertussis requiring hospitalization in infants was 52/100,000 infants (95% confidence interval [CI] 48-57/100,000), with 39% under-reporting to the national notification system. During the two epidemiologic years under-reporting decreased from 46% to 32% and was lower in eastern than western federal states (21% vs. 40%). Within ESPED, 154 of 240 infants (64%) were younger than or still at the age recommended for the first vaccine dose; 55 (23%) could have received one or more vaccine doses. Median length of hospitalization was 9 days (IQR 5-13 days) and 18% required intensive care treatment. Our study revealed a high burden of pertussis in infants with marked under-reporting, especially in western federal states where notification was only recently established. Strategies for the prevention of severe pertussis.

Migrants’ Participation in Tertiary and Vocational Education: A Comparison of Germany’s Federal States

First, the present study investigates, whether inequality between people with and without a migrant background in the participation in tertiary and vocational education varies across Germany’s federal states and if these differences are due to composition effects of the migrant groups. Second, the impact of general secondary school education on the participation in tertiary and vocational education is compared between federal states. The results show that inequality is quite heterogeneous across federal states. A large part of this heterogeneity can be explained by the differing levels of general secondary school education that the inhabitants of the federal states have reached on average. However, when considering these differences in multivariate analyses inequality is still larger in Berlin and other eastern federal states and smaller in Hamburg or Schleswig-Holstein. This finding leads to the conclusion that the differences in the tertiary and vocational education systems between the federal states have an impact on young people in transition to the tertiary and vocational education systems. Die Teilnahme von Migrierten an tertiärer und beruflicher Ausbildung: Ein Vergleich der deutschen Bundesländer Dieser Beitrag beschäftigt sich zum einen mit der Frage, ob das Ausmaß ethnischer Ungleichheit in der Beteiligung an beruflicher Bildung zwischen den Bundesländern Deutschlands variiert und ob diese Variation auf die Zusammensetzung der Migrantengruppen zurückzuführen ist. Zum anderen wird analysiert, ob der allgemeine Schulabschluss in manchen Bundesländern wichtiger für die Teilnahme an beruflicher Bildung ist als in anderen. Die Ergebnisse zeigen, dass das Ausmaß ethnischer Ungleichheit tatsächlich zwischen den Bundesländern variiert. Ein großer Teil dieser Variation ist darauf zurückzuführen, dass die Bundesländer sich in der Zusammensetzung des Niveaus allgemeiner Schulbildungszertifikate unterscheiden. Aber auch wenn man diesen Unterschied berücksichtigt, bleiben einige Unterschiede im Ausmaß der ethnischen Ungleichheit zwischen den Bundesländern bestehen: die ethnische Ungleichheit ist größer in Berlin und den östlichen Bundesländern und relativ klein in Hamburg und Schleswig-Holstein. Dieser Befund führt zu der Annahme, dass Unterschiede in der Ausgestaltung des beruflichen Bildungssystems zwischen den Bundesländern zu unterschiedlichen Niveaus ethnischer Ungleichheit in der Teilnahme an beruflicher Bildung führen könnten. JEL–Klassifizierung: I24, J15

Nationwide but still inhomogeneous distribution ofcertified chest pain units across Germany : Need to strengthen rural regions.

The purpose of this work was to analyze structure, distribution, and bed capacities of certified German chest pain units (CPUs) to unveil potential gaps despite nationwide certification of 230 units till the end of 2015. Analysis of number and structure of CPUs per state, resident count, and population density by standardized telephone interview, online research, and data collection from the registry of the Federal Statistical Office for all certified German CPUs. Nationwide, German health facilities provided amean of 1CPU bed within acertified unit per 65,000 inhabitants. Bremen, Hamburg, Hesse, and Rhineland-Palatinate provided more than 1bed per 50,000 inhabitants. Most CPUs (49%) were located in the emergency room. All university hospitals in Germany provided acertified CPU. Most units were found in academic teaching hospitals (146 CPUs). Only 42CPUs were found in nonacademic providers of primary health care. The absolute necessary number of CPUs to reach full nationwide coverage is still unknown. The current analysis shows ahigh number of CPUs and bed capacities within the cities and industrial areas without relevant gaps, but also demonstrates acertain undersupply in more rural areas as well as in some of the former eastern federal states of Germany.

Regional differences in the prevalence of cardiovascular risk factors in men and women in Germany

More than half of all cardiovascular diseases are caused by eight, mostly preventable risk factors. In view of the considerable differences in the prevalence and mortality of cardiovascular diseases between the 16German federal states, the regional distribution of cardiovascular risk factors was analyzed stratified for men and women, using population-based data. Pooled data (n= 62,606) from the national, telephone health surveys "German Health Update" from 2009, 2010 and 2012 were used to estimate the prevalence of physical inactivity, risky alcohol consumption, smoking, low fruit and vegetable consumption, obesity and diagnosed hypertension, diabetes and dyslipidemia and the accumulated number of risk factors stratified for men and women in the federal states. Furthermore, we analyzed the influence of age and social status on prevalence differences. At the national level, 36.0% of men and 26.6% of women had three or more risk factors. Large differences between men and women were found for risky alcohol consumption (32.8% versus 21.7%), low fruit and vegetable consumption (20.6% versus 10.4%) and current smoking (32.6% versus 24.9%). The prevalence of all eight risk factors differed considerably between federal states. The highest prevalence of physical inactivity, obesity, hypertension and diabetes in both sexes as well as risky alcohol consumption in men were observed in the Eastern federal states (except for Berlin). Sachsen-Anhalt was the only federal state with the highest prevalence for two risk factors. Current smoking was most prevalent in the three federal city states Berlin, Hamburg and Bremen. Saarland had the highest prevalence of low fruit and vegetable consumption in both sexes. Regional differences remained after adjustment for age and social status. There is evidence for regional differences in cardiovascular risk factor levels in Germany that resemble variations in the prevalence and mortality of cardiovascular diseases between federal states with amore unfavorable situation in the East (except for Berlin). Overall, this study shows aconsiderable need for the prevention of mostly modifiable risk factors for cardiovascular diseases in men and women in Germany.

The intricate geographies of gender ideologies in Germany

Due to Germany’s recent history, the country represents a case that is unparalleled worldwide for regional differentiations of gender ideologies. The 40-year separation into one capitalist and one socialist state until 1990 is reflected in different wage-work policies toward women in the former GDR and FRG, which are mirrored by more conservative gender role attitudes in the western federal states and more liberal attitudes in the eastern federal states. Furthermore, this order is destabilized by an urban/rural differentiation that becomes apparent in an urbanized western part and a rural and sparsely populated eastern part. In international rural studies, such pastoral regions are coupled with a rural ideology of gender conservatism. The paper analyzes the present regional differentiation of gender ideologies in Germany with respect to this supposed intersection between socialist wage-work policies of including women in the labor force and conservative rural ideologies in the East and conservative male breadwinner policies and liberal urban ideologies in the West. The findings show, first, that the attitudinal dimension of gender ideologies is more moderate in the eastern federal states but that the behavioral dimension of work in the household is not. Second, for the urbanized western federal states, a rural ideology of gender conservatism is crucial, and it expresses itself in an imagined rurality. In the western federal states the self-description of the place of residence as rural has a significant effect on gender ideologies. Clearly, beyond the official categorization of the place of domicile as urban, suburban, or rural, only the imagining of rural living is able to predict conservative gender ideologies in the western part of Germany. Third, in terms of imagined rurality, the finding is interpreted as a structure of feeling that induces a transition of social experiences and attitudes from generation to generation and explains the still existing gap between the eastern and the western parts of Germany.

Modelling the epidemiological impact of rotavirus vaccination in Germany – A Bayesian approach

BackgroundRotavirus (RV) infection is the primary cause of severe gastroenteritis in children aged <5 years in Germany and worldwide. In 2013 the German Standing Committee on Vaccination (STIKO) developed a national recommendation for routine RV-immunization of infants. To support informed decision-making we predicted the epidemiological impact of routine RV-vaccination in Germany using statistical modelling. MethodsWe developed a population-based model for the dynamic transmission of RV-infection in a vaccination setting. Using data from the communicable disease reporting system and survey records on the vaccination coverage from the eastern federal states, where the vaccine was widely used before recommended at national level, we first estimated RV vaccine effectiveness (VE) within a Bayesian framework utilizing adaptive Markov Chain Monte Carlo inference. The calibrated model was then used to compute the predictive distribution of RV-incidence after achieving high vaccination coverage with the introduction of routine vaccination. ResultsOur model estimated that RV-vaccination provides high protection against symptomatic RV-infection (VE=96%; 95% credibility interval (CI): 91–99%) that remains at its maximum level for three years (95% CI: 1.43–5.80 years) and is fully waned after twelve years. At population level, routine vaccination at 90% coverage is predicted to reduce symptomatic RV-incidence among children aged <5 years by 84% (95% prediction interval (PI): 71–90%) including a 2.5% decrease due to herd protection. Ten years after vaccine introduction an increase in RV incidences of 12% (95% PI: −16 to 85%) among persons aged 5–59 years and 14% (95% PI: −6 to 109%) within the age-group >60 years was predicted. ConclusionRoutine infant RV-vaccination is predicted to considerably reduce RV-incidence in Germany among children <5 years. Our work generated estimates of RV VE in the field and predicted the population-level impact, while adequately addressing the role of model and prediction uncertainty when making statements about the future.

Cross-sectional study on factors associated with influenza vaccine uptake and pertussis vaccination status among pregnant women in Germany

Pregnant women and their newborns are at increased risk for influenza-related complications; the latter also have an increased risk for pertussis-related complications. In Germany, seasonal influenza vaccination is recommended for pregnant women since 2010. A dose of pertussis-containing vaccine has been recommended since 2004 for women of childbearing age if they have not been vaccinated within the past 10 years. We conducted a nationwide cross-sectional survey among pregnant women in February/March 2013 to assess knowledge, attitudes, and practices related to influenza vaccination during pregnancy and to identify factors associated with their pertussis vaccination status. In total, 1025 pregnant women participated and provided information through a self-administered questionnaire. Of these, 23.2% were vaccinated against seasonal influenza during the 2012/13 season; 15.9% during their pregnancy. Major reasons for being unvaccinated (n=686 respondents) were lack of confidence in the vaccine (60.4%) and the perception that vaccination was not necessary (40.3%). Influenza vaccination during pregnancy was independently associated with having received influenza vaccine in the previous season, having received a recommendation from a physician, a high level of vaccine-related knowledge and of perceived disease severity. In contrast, knowledge of the recommendation for regular hand-washing to prevent influenza and the perception that vaccine-related side effects were likely to occur or likely to be severe were negatively associated with vaccine uptake. Receipt of a pertussis vaccine in the past 10 years was reported by 22.5% of participants. Pertussis vaccine uptake was independently associated with living in the Eastern federal states and receiving seasonal influenza vaccination annually, while a migration background was associated with a lower uptake. To enhance vaccine uptake in pregnant women and women of childbearing age, special efforts must be undertaken to improve knowledge of both recommendations and the benefits of vaccination. Gynecologists could serve as important facilitators.

Bayesian parameter inference for dynamic infectious disease modelling: rotavirus in Germany

Understanding infectious disease dynamics using epidemic models based on ordinary differential equations requires the calibration of model parameters from data. A commonly used approach in practice to simplify this task is to fix many parameters on the basis of expert or literature information. However, this not only leaves the corresponding uncertainty unexamined but often also leads to biased inference for the remaining parameters because of dependence structures inherent in any given model. In the present work, we develop a Bayesian inference framework that lessens the reliance on such external parameter quantifications by pursuing a more data-driven calibration approach. This includes a novel focus on residual autocorrelation combined with model averaging techniques in order to reduce these estimates' dependence on the underlying model structure. We applied our methods to the modelling of age-stratified weekly rotavirus incidence data in Germany from 2001 to 2008 using a complex susceptible-infectious-susceptible-type model complemented by the stochastic reporting of new cases. As a result, we found the detection rate in the eastern federal states to be more than four times higher compared with that of the western federal states (19.0% vs 4.3%), and also the infectiousness of symptomatically infected individuals was estimated to be more than 10 times higher than that of asymptomatically infected individuals (95% credibility interval: 8.1–19.6). Not only do these findings give valuable epidemiological insight into the transmission processes, we were also able to examine the considerable impact on the model-predicted transmission dynamics when fixing parameters beforehand.

Hot Spot: Epidemiologie der Masern und Röteln in Deutschland und Europa

The elimination of measles and rubella by 2015 is an important goal set by the World Health Organization European Region (WHO/Europa). Since 1991, the incidence of measles in WHO/Europa declined owing to routine childhood vaccination and supplementary immunization activities in the region. However, in many countries of Western Europe elimination of measles and rubella remains a challenge, and every year there are outbreaks with partly long-lasting transmission chains and dissemination of the virus internationally. In Germany, outbreaks occur because of the high proportion of susceptible individuals in specific population groups. In 2011, over 1,600 cases were reported (19.7 per 1,000,000 inhabitants, data from the Robert Koch Institute) whereas in 2012 only 167 cases were reported to the Robert Koch Institute (2 per 1,000,000 inhabitants). It is unclear whether the declining trend will continue in the following years due to improved vaccination coverage or whether number of cases will rise again because of the accumulation of susceptible groups. In Germany, there are currently no representative, country-wide data on rubella; however, data from the eastern federal states provide important epidemiological insights. Outbreaks are seldom reported, but statutory notification of rubella and congenital rubella syndrome was implemented in March 2013. As a result, it will be possible to better assess the epidemiology of rubella in Germany, although a considerable underreporting of rubella cases is anticipated.

Mumps epidemiology in Germany 2007-11

In Germany, mumps has been notifiable until 2013 only in the five Eastern federal states (EFS) of former East Germany. Due to different immunisation policies until 1990 and varying vaccination coverages thereafter, mumps incidences cannot be extrapolated to the 11 Western federal states (WFS). We studied mumps-related International Classification of Diseases (ICD-10) code diagnoses claimed through statutory health insurances between 2007 and 2011 to estimate countrywide mumps incidences in the outpatient sector, and compared them with case numbers from ambulatory notification data. Overall, 32,330 outpatient mumps cases were claimed. Annual incidence ranged between 9.3/100,000 and 11.8/100,000 and showed a significant decreasing trend. Compared with EFS, mumps incidence in WFS was higher and indicated a shift towards older age groups. Notified outpatient case numbers in EFS were 13-fold lower and from voluntary surveillance during an outbreak in the WFS Bavaria 8-fold lower than from insurance data (n=316 versus n=4,217 and n=238 versus 1,995, respectively). Of all notified cases with available information, 75.4% (EFS) and 57.6% (Bavaria) were unvaccinated; 6.8% (EFS) and 19.3% (Bavaria) required hospitalisation. In Germany, mumps is still endemic despite decades of vaccination, with considerable underreporting in the established notification systems.

Die Epidemiologie des idiopathischen Parkinson-Syndroms und assoziierter Demenz und Depression in Dresden

Parkinson's disease (PD) is frequently compounded by dementia and depression. Yet local total estimates on the prevalence of PD with dementia/depression are still lacking. These are socioeconomically important, especially for the eastern federal states in Germany due to the demographic structures. We conducted a two-staged total estimation in the area of Dresden. First, all local office-based neurologists, hospitals and retirement homes were asked to list their patients/residents with PD on a single study day. Then a random sample of patients/home residents was neuropsycholoigcally examined, including the Mini-mental-state exam and the Montgomery-Asberg Depression rating scale. Dementia was diagnosed according to DSM-IV criteria. Overall, 886 PD cases (95 % CI: 809 - 926) were estimated, of which 252 (95 % CI: 226 - 279) suffered from dementia and 216 (95 % CI: 191 - 242) from depression. Dementia rates increased by age with 13.8 % (≤ 65 years) to 40.2 % (≥ 76 years). Depression rates ranged from 23.3 % to 28.0 %. Overall, 20.6 % of all ambulatory treated PD patients and 85.7 % of all home residents with PD had dementia. The prevalence of PD in Dresden dovetails with previous reported estimates. Dementia and depression are frequent complications in outpatients as well as home residents with PD.

Impact of rotavirus vaccination in regions with low and moderate vaccine uptake in Germany

In Germany, routine RV-vaccination is not adopted into the national immunization schedule as of 2012. Because RV-vaccines were already on the market since 2006, in 2010 a moderate (58%) and low (22%) vaccine uptake was observed in the 5 eastern federal states (EFS) and the 11 western federal states (WFS), respectively. To assess the impact of RV-vaccination, we compared the incidence rates (IR) of RV-related hospitalizations before (2004‒2006) and in seasons after (2008/09–2010/11) RV-vaccine introduction in Germany by utilizing data from the national mandatory disease reporting system. In the EFS, the IR was significantly reduced in age-groups < 18 mo in 2008/09 and in age-groups < 24 mo in 2009/10–2010/11. In the WFS an IR-reduction was observed only in age-groups < 12 mo in 2008/09 and in age-groups < 18 mo in 2009/10–2010/11. Overall IR-reduction in age-groups < 24 mo comparing 2008–11 with 2004–06 was 36% and 25% in EFS and WFS, respectively. In addition, we computed IR-ratios (IRR) in the seasons after mid-2006 with negative binomial regression. The effect of vaccination was independent from the geographic region. Vaccination was associated with a significant reduction in RV-related hospitalizations in the age-groups 6–23 mo. Most prominently, vaccination of 50% of infants led to an estimated decrease in age group 6–11 mo by 42%. No significant reduction was observed in age-groups ≥ 24 mo. In conclusion, in the German setting with low to moderate vaccine uptake, RV-related hospitalization incidence decreased substantially depending on the achieved vaccination coverage, but only in the first two years of life.

Potentials and impacts of short-rotation coppice plantation with aspen in Eastern Germany under conditions of climate change

Woody biomass generated in short-rotation coppice (SRC) plantations with aspen (Populus tremula L.) has good properties for bioenergy crop production: annual yields are high, labour input per year is low, and it is ecologically valuable because of the multi-year rotation periods. Eastern Germany has a special advantage in producing bioenergy crops: the former “agricultural cooperatives” built up quite large farms with, compared to Western Germany, comparatively large fields. Therefore, a modelling study of the potential and the impacts of aspen SRC plantations in the five eastern federal states of Germany under the recent climate and future climate projections was conducted. The ecophysiological forest growth model 4C was used to simulate the growth of aspen SRC plantations and their impacts on carbon in soils, and groundwater recharge, on selected suitable areas currently under crops but with marginal site conditions for cropping. A clear signal to enhanced growth condition over the whole area can be seen in the simulation of the mean annual woody biomass yield under conditions of climate change, which increased from 7.47 t DW ha−1 a−1 under the recent climate to 9.26 t DW ha−1 a−1 at the end of the considered future period 2034–2055 under climate change. The mean soil carbon sequestration rate was 0.81 t C ha−1 a−1 under the recent climate and could rise up to 0.93 t C ha−1 a−1 under the assumption of climate change. On the other hand, the mean annual percolation rate, used as an indicator of impacts on the regional water budget, will diminish under future climatic conditions. The results suggest that aspen SRC plantations are a suitable contribution to regional CO2 mitigation and carbon sequestration under possible change of climate, but that negative impacts on the regional water budget are possible.