State North Rhine-Westphalia Research Articles

Teachers with a refugee background work as educators in Germany

This study's focus is to determine refugee teachers' views regarding their ability to work as teachers in Germany, their initiatives, and the challenges they face. In this context, the study was conducted based on qualitative research methodology. In order to collect data a total of 265 teachers residing in the 16 states of Germany were reached. Upon examining the results, it is observed that the majority of participants express a desire to work as teachers in Germany, while only a few have actually obtained the opportunity to work as teachers in Germany. More than half of the participants who are currently working as teachers reside in the North Rhine-Westphalia state. When analyzing the results, it becomes evident that a significant portion of the participants are strongly inclined to pursue a teaching career in Germany. However, the data reveals that the actual attainment of employment as teacher in Germany remains relatively low among the respondents. Furthermore, it is noteworthy that a majority of the teachers currently employed in the profession are concentrated in the North Rhine-Westphalia state.

Depression symptoms, wellbeing, health-related quality of life, and diabetes-related distress in novel subtypes of recent-onset diabetes in Germany: a 5-year observational follow-up study.

The subjective experiences of individuals living with diabetes is commonly assessed with patient-reported outcomes (PROs; eg, depression symptoms, wellbeing, health-related quality of life [HRQOL], and diabetes-related distress). Cluster analyses have identified novel diabetes subtypes differing in phenotypic and metabolic characteristics. We aimed to investigate associations between these subtypes and PROs and whether subtype predicted PROs 5 years later. Baseline (<12 months after a diabetes diagnosis) and 5-year follow-up data were collected from German Diabetes Study (GDS) participants. Multiple regressions were applied to analyse associations between diabetes subtypes and depression symptoms (Center for Epidemiologic Studies Depression Scale), wellbeing (WHO-5), HRQOL (SF-36), and diabetes-related distress (Problem Areas in Diabetes Scale). Cluster analyses at baseline (n=1391) identified participants with severe autoimmune diabetes (SAID, 417 [30%]), severe insulin-deficient diabetes (SIDD, 33 [2%]), severe insulin-resistant diabetes (SIRD, 150 [11%]), mild obesity-related diabetes (MOD, 354 [25%]), and mild age-related diabetes (MARD, 437 [31%]). At baseline, multiple regression analyses showed that participants with SIRD had higher depression symptoms than participants with MARD and lower physical HRQOL than all other subtypes. Participants with SAID reported higher depression symptoms and lower mental HRQOL than participants with MARD, higher physical HRQOL than participants with MARD and MOD, and higher diabetes-related distress than most other subtypes. At the 5-year follow-up, clustering predicted no statistically significant changes in PROs after adjustment for multiple testing, whereas descriptive analyses demonstrated that individuals with SIRD were more likely to experience clinically relevant depression symptoms (16% vs 6%) and low wellbeing (31% vs 14%), respectively, than individuals with MARD. Diabetes subtypes already differ in PROs at diabetes diagnosis. Our analyses had limited predictive power during follow-up. However, our findings suggest that clustering could predict future changes in depression symptoms. The GDS was initiated and financed by the German Diabetes Center, which is funded by the German Federal Ministry of Health, the Ministry of Culture and Science of the state of North Rhine-Westphalia, and by the German Federal Ministry of Education and Research to the German Center for Diabetes Research. For the German translation of the abstract see Supplementary Materials section.

Attitudes of Nursing Home Managers Regarding Cognitively Stimulating Activities in People With Dementia: A Multicentre Cross-Sectional Study.

Group-based cognitive stimulation has shown short-term benefits for the cognitive outcomes of people with dementia living in nursing homes (NH). However, group participation can be a barrier for people with advanced dementia, bedridden people or isolated people. The CogStim24 project seeks to develop and implement a new psychosocial intervention based on cognitively stimulating (CS) activities integrated into daily nursing care. As part of the intervention development process, this study aimed to survey NH managers' attitudes and describe currently used approaches to CS activities in German NH. We performed a multicentre cross-sectional study between September and December 2021 in randomly recruited NH in the German federal state of North Rhine-Westphalia. NH representatives were asked to fill in a self-developed online questionnaire. We analysed data descriptively, presenting means and standard deviations. For case scenario questions, we used a summative content analysis. We contacted 354 NH and 106 agreed to participate. Representatives of 64 facilities completed the survey. Almost all stated to have implemented CS activities. Cognitive exercises (98%), physical and relaxation exercises (98%) and reminiscence therapy (95%) were most often used. The majority (96%) thought that CS activities could support people with dementia in maintaining their cognitive functions and that nurses should have a key role in the implementation of CS activities. More than half believed that regular CS activities were easy to implement alongside routine nursing care. Results indicate that CS activities are frequently applied in German NH. The positive attitude of NH managers regarding the implementation and effects of CS activities is an important implementation resource. Nursing staff should be more involved in providing CS activities for people with dementia. Training, information, and implementation material must be made available for nursing staff who wish to have an active role in providing CS activities.

Mortality from prostate cancer in the years 2007–2021 in North Rhine-Westphalia, Germany

BackgroundThe crude mortality rate and the lifetime mortality risk from prostate cancer in Germany are above international average. However age-standardised mortality and years of life lost per capita from prostate cancer are declining. This study analyses the mortality-related measures for the federal state of North Rhine-Westphalia (NRW) in Germany.MethodsBased on the cause of death statistics and data from the NRW State Cancer Registry on 45,300 deaths in the years 2007–2021, mortality rates, the lifetime mortality risk from prostate cancer, median age at death and years of life lost are presented. Additionally, the 15 most frequent causes of death of 95,013 patients diagnosed with prostate cancer are reported.ResultsWith a stable lifetime mortality risk from prostate cancer, age-standardised mortality and years of life lost per capita are decreasing while crude mortality and median age at death are increasing in NRW. Less than half of the patients die from their prostate cancer. Cancers of the urinary bladder and other urinary organs also occur more frequently as a cause of death than it would be expected based on the age-specific risk in the total population.ConclusionsMore people in North Rhine-Westphalia are dying of prostate cancer over time due to demographic ageing alone. At the same time, the age-specific mortality risk has not increased and when patients die of prostate cancer, it is at an increasingly older age. However, there is a statistical association with deaths from cancers of the lower urinary tract in patients diagnosed with prostate cancer, which demands further evaluation.

Trends in the incidence of type 1 diabetes and type 2 diabetes in children and adolescents in North Rhine-Westphalia, Germany, from 2002 to 2022

AimsThe objective of this study was to assess overall and segmented trends in the incidence of type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) in children and adolescents younger than 20 years, from 2002 to 2022. MethodsThis study used registry data on physician-diagnosed T1DM or T2DM from primary and secondary sources, covering the German federal state of North Rhine-Westphalia with 18 million inhabitants. The ages at T1DM and T2DM onset ranged from 0 to 19 and 10–19 years, respectively. The main outcomes were direct age- and/or sex-standardized incidence rates per 100,000 person-years (PYs) and trends estimated as annual percentage changes (APCs), both with 95 % confidence intervals. The segmented trends for subperiods were based on joinpoint regression models. ResultsFrom 2002–2022, 17,470 and 819 persons had incident T1DM and T2DM, respectively. The total number of PYs was 73,743,982 for T1DM and 39,210,453 for T2DM, with a mean coverage rate of 98 % for T1DM and 90 % for T2DM. The standardized T1DM incidence increased from 17.6 [16.3;18.9} in 2002 to 33.2 [31.3;35.1] in 2022, with an APC of 2.7 % [2.3 %;3.1 %]. The standardized T2DM incidence increased from 1.3 [0.8;1.7] in 2002 to 2.8 [2.0;3.6] in 2022, with an APC of 6.4 % [4.9 %;8.0 %]. There were four different segmented trends for T1DM and T2DM, with the incidence peaking in 2021 and subsequently declining. ConclusionsThe incidence rates of T1DM and T2DM have increased over the past 20 years, with a wave-like pattern during the Covid-19 pandemic.

Current situation, strengths and problems in intra- and interprofessional collaboration in German nursing homes – A holistic multiple case study

BackgroundThe increasing care complexity of nursing home residents living with dementia requires new care models that strengthen professional collaboration. To contribute to the sustainable implementation of new care models, it is important that they are linked to the care reality. However, little is known about intra- and interprofessional organization and provision of care in German nursing homes. Therefore, the aim of this study was to explore the current care situation, problems and strengths regarding intra- and interprofessional collaboration in the care of residents living with dementia.MethodsWe conducted a holistic multiple case study. The individual care units in which residents living with dementia are cared for were defined as cases. The context was built by the respective nursing homes and their regional affiliation to the federal state of North Rhine-Westphalia. We used qualitative face-to-face interviews, documents and context questionnaires for data collection. The different sources of evidence served to capture complementary perspectives and to validate the findings. First, the collected qualitative data were analyzed using deductive-inductive content analysis. Second, similarities and differences between the cases were identified to elaborate case-specific and cross-case patterns and themes. The reporting followed the EQUATOR reporting guideline for organizational case studies.ResultsWe included four care units comprising 21 professionals (nurses, physicians, social worker, physiotherapist, pharmacist) and 14 relatives of residents living with dementia. The analysis revealed four categories to describe current intra- and interprofessional collaboration in all cases: actors and their roles, service delivery, coordination and governance, and communication channel. Moreover, we identified three categories that relate to the strengths and problems of intra- and interprofessional collaboration in all cases: role understanding, teamwork, and communication and exchange. Although we examined similar care units, we found differences in the realization of professional collaboration and resulting problems and strengths that are connected to the organizational contexts and strategies used.ConclusionsEven though professional collaboration follows given patterns; these patterns do differ context-specifically and are perceived as problematic and fragmentary. Therefore, the identified differences and problems in collaboration need to be addressed in future research to develop and successfully implement tailored innovative care models.

Involuntary psychiatric hospitalisation – differences and similarities between patients detained under the mental health act and according to the legal guardianship legislation

BackgroundInvoluntary psychiatric hospitalisation occurs under different legal premises. According to German law, detention under the Mental Health Act (MHA) is possible in cases of imminent danger of self-harm or harm to others, while detention according to the legal guardianship legislation (LGL) serves to prevent self-harm if there is considerable but not necessarily imminent danger. This study aims to compare clinical, sociodemographic and environmental socioeconomic differences and similarities between patients hospitalised under either the MHA or LGL.MethodsWe conducted a retrospective health records analysis of all involuntarily hospitalised cases in the four psychiatric hospitals of the city of Cologne, Germany, in 2011. Of the 1,773 cases, 87.3% were detained under the MHA of the federal state of North Rhine-Westphalia and 6.4% were hospitalised according to the federal LGL. Another 6.3% of the cases were originally admitted under the MHA, but the legal basis of detention was converted to LGL during the inpatient psychiatric stay (MHA→LGL cases). We compared sociodemographic, clinical, systemic and environmental socioeconomic (ESED) variables of the three groups by means of descriptive statistics. We also trained and tested a machine learning-based algorithm to predict class membership of the involuntary modes of psychiatric inpatient care.ResultsCases with an admission under the premises of LGL lived less often on their own, and they were more often retired compared to MHA cases. They more often had received previous outpatient or inpatient treatment than MHA cases, they were more often diagnosed with a psychotic disorder and they lived in neighbourhoods that were on average more socially advantaged. MHA→LGL cases were on average older and more often retired than MHA cases. More often, they had a main diagnosis of an organic mental disorder compared to both MHA and LGL cases. Also, they less often received previous psychiatric inpatient treatment compared to LGL cases. The reason for detention (self-harm or harm to others) did not differ between the three groups. The proportion of LGL and MHA cases differed between the four hospitals. Effect sizes were mostly small and the balanced accuracy of the Random Forest was low.ConclusionWe found some plausible differences in patient characteristics depending on the legal foundation of the involuntary psychiatric hospitalisation. The differences relate to clinical, sociodemographic and socioeconomical issues. However, the low effect sizes and the limited accuracy of the machine learning models indicate that the investigated variables do not sufficiently explain the respective choice of the legal framework. In addition, we found some indication for possibly different interpretation and handling of the premises of the law in practice. Our findings pose the need for further research in this field.

Inventory of aqueous and sediment-associated organic pollutants released by the 2021 flood in the Vicht–Inde catchment, Germany

BackgroundThe European flood that occurred between July 13th and 16th 2021, was a natural disaster that caused significant damage in Central European countries, including Germany, Netherlands, Belgium, and Luxembourg. This disaster resulted in the highest number of fatalities from a natural disaster in Germany during the twenty-first century, with over 180 people losing their lives and causing damages exceeding 30 bn€. The flood caused severe destruction in small mountainous river systems such as the Vicht and Inde rivers, particularly in the German state of North Rhine-Westphalia. In addition, the flood caused a significant release of pollutants, including old burdens from the former mining area of Stolberg.ResultsTo assess the extent of pollution caused by the flood in the affected floodplains and urban areas, this study was conducted to inventorize organic contaminants identified through a non-target screening in water and sediment samples taken immediately after the disastrous flood event. In total, 56 individual contaminants were identified from the water samples, including substances derived from urban effluents, such as personal care products, cosmetics, odors, technical additives, pharmaceuticals and surfactants. The analysis of sediment samples revealed different types of environmentally hazardous contaminants, such as petrogenics, urban effluent and wastewater indicators, chlorinated industrial compounds, and pesticides. This diverse range of pollutants and their broad dispersion across various environments in the catchment is attributed to the dynamic nature of the flood.ConclusionThe inventory of identified organic contaminants raises long-term environmental concerns and potential health implications for the flood-affected Vicht–Inde region.

The poverty of sustainability: behavioral choices of drinking water in Kenya and Germany

Worldwide countries are engaged in technological improvements, changes in legislation, economic incentives, strengthened administrative structures, and political strategies to allocate and distribute water among different sections of the population. These macro measures treat water as an object of social, cultural, and environmental production unit for distribution and allocation, distancing it from the micro behavioral practices of drinking water. The poverty of sustainability stems from the gap between macro instrumental measures and the inner human dimensions that determine the micro practices. This paper explores the disconnect between macro sustainability measures and the micro practice of drinking water choice among individuals and their motives in the city of Nakuru in Kenya and the state of North Rhine-Westphalia in Germany. Both Kenya and Germany have developed top-down policies with a fix-it mindset. Kenya aims to provide drinking water to its population through piped network technology despite being a water-scarce region with inadequate housing and governance. In contrast, Germany, which is rich in water resources with highly regulated governance arrangements, spends billions treating water to attain drinking water quality only for most citizens to buy bottled water to drink. Despite water resources being finite, both of these nations source additional water through instrumental approaches to satisfy the demands of the materialistic world. In this context, the challenge of overcoming the poverty of sustainability remains a topic of debate that can be ameliorated by complementing scientific approaches with nonscientific knowledge and practices.

No net land take policy in practice: Applications and potentials of planning instruments in municipalities. Results of an online survey in North Rhine-Westphalia

In line with the European Commission’s target, land take in Germany has to be reduced to net zero by 2050. This not only presupposes greater inner urban development and more efficient development outside existing settlements, but also puts a greater planning and political focus on renaturation. The aim of this paper is to investigate the implementation of no net land take policy using the example of the highly dense and urbanised federal state of North Rhine-Westphalia in Germany. Based on an online survey, the current and potential use of (planning) instruments to implement this policy in all 396 municipalities in North Rhine-Westphalia was investigated. The findings suggest that the municipalities are not yet in a position to consistently implement no net land take. Particularly in the field of renaturation, this is often due to a lack of experience and uncertainties in the use of the existing (planning) instruments, but also to lacking awareness of the problem and a lack of political and social acceptance for higher housing densities. Since the necessary instruments are defined in current legislation and the concepts for implementation are generally known, it is important to support municipalities in using the available instruments and concepts even without direct pressure to act.

Water Framework Directive micropollutant monitoring mirrors catchment land use: Importance of agricultural and urban sources revealed

River monitoring programs worldwide consistently unveil micropollutant concentrations (pesticide, pharmaceuticals, and industrial chemicals) exceeding regulatory quality targets with deteriorating effects on aquatic communities. However, both the composition and individual concentrations of micropollutants are likely to vary with the catchment land use, in particular regarding urban and agricultural area as the primary sources of micropollutants. In this study, we used a dataset of 109 governmental monitoring sites with micropollutants monitored across the Federal State of North Rhine-Westphalia, Germany, to investigate the relationship between high-resolution catchment land use (distinguishing urban, forested and grassland area as well as 22 different agricultural crop types) and 39 micropollutants using Linear Mixed Models (LMMs). Ecotoxicological risks were indicated for mixtures of pharmaceutical and industrial chemicals for 100 % and for pesticides for 55 % of the sites. The proportion of urban area in the catchment was positively related with concentrations of most pharmaceuticals and industrial chemicals (R2 up to 0.54), whereas the proportions of grassland and forested areas generally showed negative relations. Cropland overall showed weak positive relationships with micropollutant concentrations (R2 up to 0.29). Individual crop types, particularly vegetables and permanent crops, showed higher relations (R2 up to 0.46). The findings suggest that crop type-specific pesticide applications are mirrored in the detected micropollutant concentrations. This highlights the need for high-resolution spatial land use to investigate the magnitude and dynamics of micropollutant exposure and relevant pollution sources, which would remain undetected with highly aggregated land use classifications. Moreover, the findings imply the need for tailored management measures to reduce micropollutant concentrations from different sources and their related ecological effects. Urban point sources, could be managed by advanced wastewater treatment. The reduction of diffuse pollution from agricultural land uses requires additional measures, to prevent pesticides from entering the environment and exceeding regulatory quality targets.

Fatal incidents during the flood of July 2021 in North Rhine-Westphalia, Germany: what can be learnt for future flood risk management?

During the severe flooding in July 2021 189 people lost their lives in Germany, which is the highest number of flood-related fatalities since 1962. 49 people died in the densely populated state of North Rhine-Westphalia (NRW), whose flood risk management has, however, often been regarded as pioneering in Germany. To further improve flood risk management in NRW, the causes and circumstances of all 49 flood-related deaths were analyzed. Based on official files a structured document analysis was performed and a new coding scheme was developed that relates accident locations and victims’ activities to accident dynamics and causes of death. Circumstances and causes of death differed significantly between in-/outdoor incidents, age groups, and areas with different event magnitudes. Elderly people (&gt;60 years) were particularly at risk; they account for two thirds of the dead. Eight of the 25 people who died in a building were surprised by water entry into basements or ground-floor apartments. In addition, there are indications that nine of 24 people who died outdoors were surprised and caught by water on their way home or when trying to leave the flooded zone. It is assumed that a lack of warning played a role in these cases. In most of the remaining cases, hazards were underestimated pinpointing to insufficient awareness and weaknesses of crisis and risk communication. 14 people died in their basements while attempting to inspect equipment (e.g., pumps) or to inspect, minimize, or repair damage. Since property-level adaptation has been emphasized in flood risk communication, life-threatening situations during fast onset-flooding and the priority to be safe have to be emphasized in future communications. It has to be acknowledged that the official hazard maps indicated no risk from flooding at around half of the 49 accident locations illustrating the exceptional event magnitude. Still, warning levels and flood hazard maps should be better linked to identify hazard zones and to enable appropriate behavior including (self-)evacuation.

Gambling as Work: A Study of German Poker Players

The study addresses the question whether professional gamblers can be considered an occupational group from a sociological perspective. It combines survey data on poker players from the German state North Rhine-Westphalia with sociological theory in order to explain the oxymoron of professional gambling. The descriptive analysis of the survey data is supplemented by ego-centric network data of the poker players to analyze whether hobby and professional players maintain different forms of social relationships. Even when semiprofessionals and professional players are grouped together for the purpose of comparative analysis, they fulfill the criteria of occupational groups according to Salaman’s major work on the topic. The study points to the fact that more research on occupational groups outside of the common fields is needed and bridges the gap between the literature on serious leisure and sociological research on professions and professionalization.

Analysis of type 2 diabetes heterogeneity with a tree-like representation: insights from the prospective German Diabetes Study and the LURIC cohort

Heterogeneity in type 2 diabetes can be represented by a tree-like graph structure by use of reversed graph-embedded dimensionality reduction. We aimed to examine whether this approach can be used to stratify key pathophysiological components and diabetes-related complications during longitudinal follow-up of individuals with recent-onset type 2 diabetes. For this cohort analysis, 927 participants aged 18-69 years from the German Diabetes Study (GDS) with recent-onset type 2 diabetes were mapped onto a previously developed two-dimensional tree based on nine simple clinical and laboratory variables, residualised for age and sex. Insulin sensitivity was assessed by a hyperinsulinaemic-euglycaemic clamp, insulin secretion was assessed by intravenous glucose tolerance test, hepatic lipid content was assessed by 1 H magnetic resonance spectroscopy, serum interleukin (IL)-6 and IL-18 were assessed by ELISA, and peripheral and autonomic neuropathy were assessed by functional and clinical measures. Participants were followed up for up to 16 years. We also investigated heart failure and all-cause mortality in 794 individuals with type 2 diabetes undergoing invasive coronary diagnostics from the Ludwigshafen Risk and Cardiovascular Health (LURIC) cohort. There were gradients of clamp-measured insulin sensitivity (both dimensions: p<0·0001) and insulin secretion (pdim1<0·0001, pdim2=0·00097) across the tree. Individuals in the region with the lowest insulin sensitivity had the highest hepatic lipid content (n=205, pdim1<0·0001, pdim2=0·037), pro-inflammatory biomarkers (IL-6: n=348, pdim1<0·0001, pdim2=0·013; IL-18: n=350, pdim1<0·0001, pdim2=0·38), and elevated cardiovascular risk (nevents=143, pdim1=0·14, pdim2<0·00081), whereas individuals positioned in the branch with the lowest insulin secretion were more prone to require insulin therapy (nevents=85, pdim1=0·032, pdim2=0·12) and had the highest risk of diabetic sensorimotor polyneuropathy (nevents=184, pdim1=0·012, pdim2=0·044) and cardiac autonomic neuropathy (nevents=118, pdim1=0·0094, pdim2=0·06). In the LURIC cohort, all-cause mortality was highest in the tree branch showing insulin resistance (nevents=488, pdim1=0·12, pdim2=0·0032). Significant gradients differentiated individuals having heart failure with preserved ejection fraction from those who had heart failure with reduced ejection fraction. These data define the pathophysiological underpinnings of the tree structure, which has the potential to stratify diabetes-related complications on the basis of routinely available variables and thereby expand the toolbox of precision diabetes diagnosis. German Diabetes Center, German Federal Ministry of Health, Ministry of Culture and Science of the state of North Rhine-Westphalia, German Federal Ministry of Education and Research, German Diabetes Association, German Center for Diabetes Research, European Community, German Research Foundation, and Schmutzler Stiftung.

Long-term anticoagulation treatment in proximal femoral fractures as obstacle to surgery in the 24h time window? : Results of an analysis of Quality Assurance data on 32,252 treatment courses with osteosynthesis

Both in Germany and internationally there is avehement controversy about the appropriate time for care of proximal femoral fractures in older patients. The effort to achieve high quality and uniform standards of care culminated in the German healthcare system in the strict requirement of delay-free surgery within 24 h. Until now, in view of their high vulnerability patients who were severely injured were too often operated on late with the reference to ageneral medical condition that could be improved preoperatively. In particular, the fear of complications due to apre-existing long-term anticoagulation treatment was repeatedly emphasized. The present study is dedicated to the question of whether adelay in surgery of anticoagulated patients with proximal femoral fractures already during the inpatient course has adetrimental effect on the complication statistics and the mortality of the patients. The extent to which external quality assurance data are suitable for rebutting any objections to an operation as soon as possible are examined. The study is based on treatment data from the external inpatient quality assurance procedure of the federal state of North Rhine-Westphalia from the years 2018-2020. Patients with aproximal femoral fracture were considered. This includes femoral neck fractures and fractures in the area of the pertrochanteric to subtrochanteric region. Only cases with joint-preserving fracture care were selected. The data sets were analyzed using suitable statistical software. More general complications and deaths have been observed in anticoagulated patients. The trend of delayed fracture treatment under anticoagulant medication continues to be clearly visible. Apositive association between longer preoperative waiting time and undesirable courses can be confirmed. With respect to fracture care when taking anticoagulants, it must be critically examined to what extent arapid normalization of the coagulation situation is necessary and this actually improves the chances of low complication courses. Should the elimination of the anticoagulant effect by substitution or antidote appear necessary, this should not prevent early care.

Estimating regional unemployment with mobile network data for Functional Urban Areas in Germany

The ongoing growth of cities due to better job opportunities is leading to increased labour-related commuter flows in several countries. On the one hand, an increasing number of people commute and move to the cities, but on the other hand, the labour market indicates higher unemployment rates in urban areas than in the surrounding areas. We investigate this phenomenon on regional level by an alternative definition of unemployment rates in which commuting behaviour is integrated. We combine data from the Labour Force Survey with dynamic mobile network data by small area models for the federal state North Rhine-Westphalia in Germany. From a methodical perspective, we use a transformed Fay–Herriot model with bias correction for the estimation of unemployment rates and propose a parametric bootstrap for the mean squared error estimation that includes the bias correction. The performance of the proposed methodology is evaluated in a case study based on official data and in model-based simulations. The results in the application show that unemployment rates (adjusted by commuters) in German cities are lower than traditional official unemployment rates indicate.

Seasonal soil moisture and crop yield prediction with fifth-generation seasonal forecasting system (SEAS5) long-range meteorological forecasts in a land surface modelling approach

Abstract. Long-range weather forecasts provide predictions of atmospheric, ocean and land surface conditions that can potentially be used in land surface and hydrological models to predict the water and energy status of the land surface or in crop growth models to predict yield for water resources or agricultural planning. However, the coarse spatial and temporal resolutions of available forecast products have hindered their widespread use in such modelling applications, which usually require high-resolution input data. In this study, we applied sub-seasonal (up to 4 months) and seasonal (7 months) weather forecasts from the latest European Centre for Medium-Range Weather Forecasts (ECMWF) seasonal forecasting system (SEAS5) in a land surface modelling approach using the Community Land Model version 5.0 (CLM5). Simulations were conducted for 2017–2020 forced with sub-seasonal and seasonal weather forecasts over two different domains with contrasting climate and cropping conditions: the German state of North Rhine-Westphalia (DE-NRW) and the Australian state of Victoria (AUS-VIC). We found that, after pre-processing of the forecast products (i.e. temporal downscaling of precipitation and incoming short-wave radiation), the simulations forced with seasonal and sub-seasonal forecasts were able to provide a model output that was very close to the reference simulation results forced by reanalysis data (the mean annual crop yield showed maximum differences of 0.28 and 0.36 t ha−1 for AUS-VIC and DE-NRW respectively). Differences between seasonal and sub-seasonal experiments were insignificant. The forecast experiments were able to satisfactorily capture recorded inter-annual variations of crop yield. In addition, they also reproduced the generally higher inter-annual differences in crop yield across the AUS-VIC domain (approximately 50 % inter-annual differences in recorded yields and up to 17 % inter-annual differences in simulated yields) compared to the DE-NRW domain (approximately 15 % inter-annual differences in recorded yields and up to 5 % in simulated yields). The high- and low-yield seasons (2020 and 2018) among the 4 simulated years were clearly reproduced in the forecast simulation results. Furthermore, sub-seasonal and seasonal simulations reflected the early harvest in the drought year of 2018 in the DE-NRW domain. However, simulated inter-annual yield variability was lower in all simulations compared to the official statistics. While general soil moisture trends, such as the European drought in 2018, were captured by the seasonal experiments, we found systematic overestimations and underestimations in both the forecast and reference simulations compared to the Soil Moisture Active Passive Level-3 soil moisture product (SMAP L3) and the Soil Moisture Climate Change Initiative Combined dataset from the European Space Agency (ESA CCI). These observed biases of soil moisture and the low inter-annual differences in simulated crop yield indicate the need to improve the representation of these variables in CLM5 to increase the model sensitivity to drought stress and other crop stressors.

Multiscale and Multiphysical Numerical Simulations of Solid Oxide Cell (SOC)

Electrochemical applications play a key role for the topic of “green hydrogen” for the de-carbonization of the energy and mobility sectors. Electrochemical systems and processes, including fuel cells and electrolysers, have witnessed several benefits over conventional combustion-based technologies currently being widely used in power plants and vehicles. The ceramic high-temperature technologies by means of SOC exhibits high efficiencies, with a thermoelectric conversion efficiency as high as 60% and a total efficiency of up to 90% in fuel cell operation and even higher in electrolysis mode. The SOC technology, therefore, sees a promising future in the production of green hydrogen and electricity.Providing high operating temperature, over 600 oC, the SOC system shows the capability to operate with diverse types of gas mixtures, for example, hydrogen, ammonia, and carbon-containing mixtures such as methane (CH4), carbon monoxide (CO) in fuel cell operation (SOFC) and steam and/or carbon dioxide (CO2) in electrolysis operation (SOEC). The design of the SOC stack enables a reversible operation (rSOC) between fuel cell and electrolysis modes. It indicates the SOC system can perform with high efficiencies in both operating modes, which also widens the scope of possible applications.Challenges remain when it comes to commercialization of the SOC technology, in both the investment costs (CAPEX) and operating costs (OPEX) aspects. From the technological and scientific point of view, the physical transport phenomena in SOCs need to be understood which can be done by the help of experimental and numerical investigations. Cheaper and long-lasting material alternatives may be found for the cell, stack and system development afterwards.Detailed experimental investigations usually require a lot of effort in time and data analysis. To promote the scientific and technological studies on the SOC technology, numerical investigations by using multiscale and multiphysical models are carried out in this work. The models include an in-house designed/written phase field model (PFM) 1, and an open-source based computational fluid dynamics (CFD) model, openFuelCell2 2 (based on OpenFOAM). The former accounts for the microstructure evolution of the Ni/YSZ composition. The latter addresses the multiphysical transport processes in different phases, i.e., ionic transfer in YSZ, electronic transfer in Ni, and the gas diffusion in the gas phase.The figure below shows the computational domain and different phases in the numerical simulations. The evolution of Ni/YSZ composition can be predicted by the PFM. It is supposed to reproduce the Ni agglomeration that has been observed in SOFC long-term experiments 3. The simulation result shown at the left-most is obtained by performing the PFM simulation (with 96 x 96 x 96 voxels) representing the microstructure change for a certain time duration. The computational domain (192 x 192 x 192 voxels) consists of three phases, namely, YSZ, Ni, and gas, as shown in the middle and on the right side. It is refined in each direction to better capture the triple phase regions (lower right) shared by the three phases, which refers to the active sites that enable the electrochemical reaction to be conducted. By applying different governing equations on these phases, the CFD model, openFuelCell2, can describe the transport phenomena numerically. Hence, the performance degradation of a SOFC due to Ni agglomeration can be captured by carrying out the simulations for different time durations. The effective properties may be derived as well so that they can be used in numerical simulations with larger scales.AcknowledgementThe authors would like to thank their colleagues at Forschungszentrum Jülich GmbH for their great support and the Helmholtz Society, the German Federal Ministry of Education and Research as well as the Ministry of Culture and Science of the Federal State of North Rhine-Westphalia for financing these activities as part of the Living Lab Energy Campus.References Q. Li, L. Liang, K. Gerdes, and L.-Q. Chen, Appl. Phys. Lett., 101, 033909 (2012). S. Zhang, S. Hess, H. Marschall, U. Reimer, S. B. Beale, and W. Lehnert, Computer Physics Communications, to be submitted (2023). C. E. Frey, Q. Fang, D. Sebold, L. Blum, and N. H. Menzler, J. Electrochem. Soc., 165, F357 (2018). Figure 1

Layout and Experimental Results of an 10/40 Kw rSOC Demonstration System

Scientific Approach Within the last years, the development work on reversible solid oxide cell (rSOC) systems has been intensified. This is mainly because this technology can deliver a valuable contribution to carbon-neutral energy supply by storing surplus electrical power into hydrogen and converting it again if necessary. Motivated by this application, in 2018 research by Frank et al. [1] suggests that a round trip efficiency of 50% is possible for a pressurized storage at 70 bars. Based on these results, Forschungszentrum Jülich developed an rSOC demonstration system whose design point is 10 kWAC in fuel cell mode and 40 kWAC in electrolysis mode. The system layout and the evaluation of balance of plant components (BoP) are described by Peters et al. [2].Figure below shows on the left side the core components of the demonstrator system including the Integrated Module (IM). This IM consists of four 20-layer sub-stacks in the mark H20-design by Forschungszentrum Jülich. The fuel and air heaters are located at the top and bottom of the module. The system can be heated up by in total five heating plates which are arranged on top and below each sub-stack. These plates are also used to maintain the temperature management of the stacks during the endothermic electrolysis operation. In order to ensure the most compact system design, the BoP components are suitably arranged in the vicinity of the IM. The right side of Figure shows the core system installed in the laboratory test environment including the full thermal insulation. This environment provides the necessary media supply and disposal as well as the supporting safety equipment and control units.The system was set into operation on the first of June in 2021. The operation started with stationary operating points in fuel cell and electrolysis mode, after passing the commissioning phase. The performance and efficiency data achieved during this operating phase are shown below.An overall power range from 1.7 kWAC to 13 kWAC was achieved in fuel cell mode. At an output power of 10.4 kWAC and a fuel utilization of 98 %, a system efficiency of 63.3 % could be achieved. During the electrolysis mode, an efficiency of 71.1 % could be achieved with an input power of -49.6 kWel and a steam utilization of 80 %. An analysis of the loss mechanisms showed that in the fuel cell mode about 75 % of the losses are caused by the heat production of the stack itself. In the electrolysis mode, the largest share of about 65 % is caused by the power consumption of the steam generator. The system efficiency can be further increased by a skillful heat recovery from the fuel side off-gas into the steam generation process. Outlook In future work new methods of stack temperature control based on artificial neural networks will be investigated on basis of the presented system. Afterwards it is planned to apply realistic load profiles to the system while investigating the performance, temperature and degradation behavior. Furthermore, electricity and gas storage as well as heat decoupling for district heating application will be studied. Acknowledgement The authors would like to thank their colleagues at Forschungszentrum Jülich GmbH for their great support and the Helmholtz Society, the German Federal Ministry of Education and Research as well as the Ministry of Culture and Science of the Federal State of North Rhine-Westphalia for financing these activities as part of the Living Lab Energy Campus.

Testing a single item screener to support family doctors in identifying patients with limited health literacy: convergent validity of the SILS and the HLS-EU-Q16

BackgroundLow health literacy (HL) is associated with reduced disease self-management skills, worse health outcomes, an increased number of hospitalizations, more frequent use of the emergency room and less utilization of preventive services. To support patients with low HL it is crucial to identify affected patients. HL is a multidimensional construct, which covers different skills and abilities to make informed health decisions. Validated brief screening tools to assess health-literacy-related skills or abilities in primary care settings are currently not available in German. This study aimed to validate a single item screener developed in the US for the German primary care setting.MethodsOur study used cross-sectional data from a survey among mainly chronically ill patients (n = 346) conducted in family practices in the state of North Rhine-Westphalia. We explored the convergent validity between a single item literacy screener (SILS) and the HLS-EU-Q16. The SILS measures functional HL by asking patients about their need for help when reading information materials. The HLS-EU-Q16 is a multidimensional HL measure frequently used for research purposes in Germany. Associations between the two instruments were examined using Spearman’s correlations and regression analyses. The diagnostic performance of the SILS relative to the HLS-EU-Q16 was assessed using receiver operator curves (ROC).ResultsThe SILS had a statistically significant correlation with the HLS-EU-Q16 (Spearman ρ: 0.35) and explained 26% of its total variance. Stratified analyses of the convergent validity between both instruments by age, sex, migration background, education level and chronic disease status showed moderate statistically significant correlations in all subgroups (range: 0.223 to 0.428). With an area under the curve of 0.66, the receiver operator curve indicated a satisfactory diagnostic performance of the SILS relative to the HLS-EU-Q16.ConclusionsThe SILS provided an acceptable initial assessment of HL limitations among a heterogeneous population of mainly chronically ill patients in a primary care setting. With only one item, the SILS can be a short and effective tool for routine use in primary care and specialized care settings. Future research should test the SILS in other populations and pilot applications of the SILS in routine care.