Anne Schrimpf

Background/Objectives: Effective communication between medical practices and community pharmacists is essential for safe and efficient outpatient care, yet quantitative evidence from the perspective of community pharmacies regarding the frequency, content, and efficiency of routine pharmacist–physician communication in Germany is limited. This study aimed to investigate, from the perspective of community pharmacies, the reasons for and outcomes of initiating contact with medical practices following the submission of patient prescriptions in routine outpatient care. Methods: In this observational study, 45 community pharmacies in Leipzig and the surrounding region (Germany) documented simultaneously all contacts with medical practices related to prescriptions over a 14-day period (November 2023) using a standardized documentation form. Data included reasons for contact, communication channels, number of contact attempts, outcomes, satisfaction ratings, and case duration. Multivariable linear regression was used to identify factors associated with satisfaction with contact outcomes, and ordinal regression to examine determinants of case duration. Results: In total, 498 documented contacts were analyzed. The most frequent reasons for contact were drug availability issues and formal or content-related prescription errors. Consultations related to drug interactions or contraindications were rare. Overall satisfaction with contact outcomes was high, but lower satisfaction was associated with repeated contact attempts, non-acceptance of pharmacists’ recommendations, and contacts related to formal prescription errors. Case resolution was faster when fewer contact attempts were required and when communicating with general practices rather than specialist practices. Conclusions: Pharmacy-initiated communication with medical practices in outpatient care is largely driven by administrative and logistical issues rather than clinical consultations. Improving prescription quality, enhancing transparency of drug availability, and strengthening efficient communication pathways may reduce workload and increase satisfaction.

Introduction: The prognosis for patients admitted to emergency departments (ED) after drowning or diving accidents is often uncertain. In this study, we evaluated a range of clinical and laboratory parameters as potential indicators of survival. Many of these markers have previously been investigated in the context of survival prediction in both trauma-related and non-trauma-related clinical scenarios. Methods: We conducted a retrospective analysis of 25 patients aged >17 years who were admitted to the ED of the University Hospital Leipzig after drowning or diving accidents between 2012 and 2024. Clinical and laboratory parameters were compared between survivors and non-survivors, with survival defined as discharge from the hospital. Results: Of all cases analyzed—comprising 19 drowning and six diving incidents—10 patients (40%) survived, while 15 (60%) did not. Age, sex, or etiology of the accident were not statistically associated with survival. Compared to survivors, non-survivors were significantly more likely to have received prehospital cardiopulmonary resuscitation (CPR; 20% vs. 86.7%) and to have exhibited lower Glasgow Coma Scale scores and lower pH values (7.4 vs. 6.7). They were also more likely to have shown increased levels of lactate (4.3 mmol/L vs. 14.8 mmol/L), CK-MB quotient (9.7% vs. 51.8%), myoglobin (188.9 µg/L vs. 1930.9 µg/L), and blood glucose (6.6 mmol/L vs. 14.3 mmol/L). Conclusions: The need for CPR appears to be the most significant risk factor for not surviving a drowning or diving accident. Furthermore, certain laboratory parameters, such as pH and lactate, may provide supportive information regarding the severity of hypoxia and could be cautiously considered as indicators of survival likelihood in these patients. Our findings offer a rationale for future prospective studies, aiming to incorporate additional clinical and biochemical markers and potentially develop new prognostic scoring systems for patients following drowning or diving accidents. This study examines the association between clinical and laboratory parameters and survival in patients following drowning and diving accidents. A total of 25 cases from 2012 to 2024 were retrospectively analyzed. The results showed that patients who required CPR had significantly poorer outcomes. Certain laboratory markers; such as pH and lactate levels; were closely related to survival status in this patient group.

Stress and how individuals cope with it can have substantial implications for health. As the socio-cultural environment influences individual perceptions of stress and coping behavior, differences between cultural groups may have different effects on physical and mental health. Using qualitative interviews and questionnaires, this study examined cultural differences in stress coping and their interplay with perceived stress (Perceived Stress Questionnaire, Trier Inventory for Chronic Stress), BMI (normal-weight, obesity), and depressive symptoms (Beck Depression Inventory Short Form) in young adults from Germany (individualistic society, n = 120) and American Samoa (collectivistic society, n = 56). Stress coping strategies were assessed through interviews, after which the data were quantified as problem-focused, emotion-focused, or avoidance coping. Group differences in coping strategies were analyzed using Gamma generalized linear models, group differences in perceived stress and depressive symptoms were analyzed using univariate ANCOVAs. The results showed that the German group used more problem-focused coping, while the Samoan group used more avoidance coping. The use of avoidance coping was associated with higher perceived stress in the German group but with lower perceived stress in the Samoan group. In general, depressive symptoms were higher among participants from the Samoan than the German group. However, Samoan individuals with obesity who used avoidance coping had lower depressive symptoms than Samoan individuals with obesity who did not. This difference was not observed in the German group. Irrespective of cultural background, individuals with obesity tended to use more avoidance and less emotion-focused coping, and to report eating more during stress compared to individuals with normal-weight. On the one hand, our findings may contribute to a better understanding of how the cultural environment influences stress coping and its potential adaptive effects on perceived stress and depressive symptoms, highlighting the need for culturally appropriate stress management interventions. On the other hand, the association between weight status and avoidance coping might be relatively stable across cultures, offering opportunities for intervention.

Introduction: The prognosis for patients admitted to emergency departments (ED) after drowning or diving accidents is often uncertain. In this study, we evaluated a range of clinical and laboratory parameters as potential predictors of survival. Many of these markers have previously been investigated in the context of survival prediction in both trauma-related and non-trauma-related clinical scenarios. Methods: We conducted a retrospective analysis of 25 patients aged >17 years who were admitted to the ED of the University Hospital Leipzig after drowning or diving accidents between 2012 and 2024. Clinical and laboratory parameters were compared between survivors and nonsurvivors, with survival defined as discharge from the hospital. Results: Of all cases analyzed—comprising 19 drowning and six diving incidents—10 patients (40%) survived, while 15 (60%) did not. Age, sex, or etiology of the accident were not statistically associated with survival. Compared to survivors, nonsurvivors were significantly more likely to have received prehospital cardiopulmonary resuscitation (CPR; 20% vs. 86.7%) and to have exhibited lower Glasgow Coma Scale scores and lower pH values (7.4 vs. 6.7). They were also more likely to have shown increased levels of lactate (4.3 mmol/l vs. 14.8 mmol/l), CK-MB quotient (9.7% vs. 51.8%), myoglobin (188.9 µg/l vs. 1930.9 µg/l), and blood sugar (6.6 mmol/l vs. 14.3 mmol/l). Conclusions: The need for CPR appears to be the most significant risk factor for not surviving a drowning or diving accident. Furthermore, selected laboratory parameters, such as pH and lactate, may serve as tools for predicting survival in these patients. Early decision-making regarding the continuation of CPR remains a critical and routine challenge for ED teams. Our findings offer a rationale for future prospective studies, aiming to incorporate additional clinical and biochemical markers and potentially develop new prognostic scoring systems for patients following drowning or diving accidents.

The landscape of general practice has experienced notable transformations in recent decades, profoundly influencing the working conditions of general practitioners (GPs). This study aimed to examine the most salient changes affecting GPs' daily practices. Through semi-structured qualitative interviews with 15 end-of-career GPs, the study explored how these changes affected work organization, equipment, working hours, work-life balance, job satisfaction, training, patient relationships, and reputation. The interviews revealed that these changes were perceived as barriers, opportunities, or a complex interplay of both for general practice. While the interviewed GPs valued technological advancements and reported positive developments in working conditions, challenges included a gradual reduction in the range of tasks, growing administrative burdens, and less practical training for young physicians. Other changes, such as new doctor-patient dynamics, the transition from single to group practice, and differing professional expectations of the younger generation, were seen as both challenging and strengthening for general practice. By combining these factors and trade-offs observed by end-of-career GPs in our study over the past few decades with general societal changes, we provide ideas for the design of future framework conditions in general practice that might enhance the attractiveness of the profession. These insights offer key considerations that can guide future strategies for general practice and medical education.

This study explores the geospatial relationship between the invasive crayfish species Faxonius limosus and the native Austropotamobius bihariensis and A. torrentium crayfish populations in Eastern Europe, identifying the environmental factors which influence the invasion. We used species distribution modelling based on several climatic, geophysical and water quality variables and crayfish distributional data to predict sectors suitable for each species within the river network. Thus, we identified the sectors potentially connecting invasive and native population clusters and quantified the degree of proximity between competing species. These sectors were then extensively surveyed with trapping and hand searching, doubled by eDNA methods, in order to assess whether any crayfish or the crayfish plague pathogen Aphanomyces astaci are present. The predictive models exhibited excellent performance and successfully distinguished between the analysed crayfish species. The expansion of F. limosus in streams was found to be limited by flash-flood potential, resulting in a range that is constrained to lowland rivers. Field surveys found neither crayfish nor pathogen presence in the connective sectors. Another interesting finding derived from the screening efforts, which are among the most extensive carried out across native, apparently healthy crayfish populations, was the existence of a latent infection with an A. astaci strain identified as A-haplogroup. Our results provide realistic insights for the long-term conservation of native Austropotamobius species, which appear to be naturally protected from F. limosus expansion. Conservation efforts can thus focus on other relevant aspects, such as ark-sites establishment for preventing the spread of more dangerous invasive crayfish species and of virulent crayfish plague pathogen strains, even in locations without direct contact between crayfish hosts.

Introduction: The reluctance to be vaccinated against COVID-19 has significantly curbed vaccine uptake. Unlike mass vaccination centers, general practitioners (GPs) might be able to address some of the patients’ concerns through their long-term doctor-patient relationship. This study compared vaccination reasons, concerns and skepticism about vaccination, and perceived importance of the vaccine and its hypothetical value between vaccination centers and GP practices. Methods: A survey was distributed (07/2021-10/2021) among newly vaccinated individuals in ten GP practices (n = 364) and two vaccine centers (n = 474). Results: Participants in vaccine centers stated more prosocial and benefit-oriented reasons for vaccination, whereas participants in GP practices more often stated the GP’s recommendation as the reason. Perceived importance of the vaccine in combating the pandemic was rated higher among individuals at vaccine centers and with higher health awareness and self-efficacy. Participants at both types of sites who preferred a GP for vaccination expressed more vaccination skepticism, which was also related to older age, more health risk concerns related to COVID-19 vaccines, and lower perceived importance of the vaccine. Conclusion: Our results indicate opportunities for framing future vaccination campaigns that include vaccination centers. Additionally, a rapid GP involvement in future mass vaccinations might be crucial for overcoming attitudinal barriers and achieving higher vaccine uptake.

General practitioners (GPs), already in a profession with a high workload, have been at the frontline of providing COVID-19-related healthcare in addition to routine care. Our study examined the impact of pandemic-related consultations and changes in practice organization on GPs’ current workload and provision of healthcare in summer 2021 (May 2021–July 2021) and early 2022 (January 2022–February 2022). In total, 143 German GPs participated in an online survey in the summer of 2021. Of these, 51 GPs participated in the follow-up survey in 2022. Most GPs perceived an increase in consultation frequency, consultation times, and workload since the pandemic outbreak. Increased consultation times were related to the reduced provision of medical care to other patients with chronic diseases. More SARS-CoV-2 vaccination consultations were associated with reduced home visits, acute consultation times, and cancer screenings. A quarter of GPs considered leaving their job. Pandemic-related bureaucracy, restricted access to therapy and rehabilitation services specialized on COVID-19, unreliable vaccine deliveries, mandatory telematics-infrastructure implementation, and frequent changes in official regulations were the main reasons reported for dissatisfaction. Our results provide insights into how the pandemic continues to burden GPs’ work routines and how better working conditions in times of high demand could be achieved in future pandemics.

In the European Union, SARS-CoV-2 vaccines became available in December 2020. The vaccination campaign in Germany was initially implemented through mass vaccination centers and later joined by general practitioners (GPs) in spring 2021. This study compared population characteristics, perceived access barriers, and satisfaction with the vaccination procedure between vaccination centers and GP practices. A paper-based survey was distributed (07/2021–10/2021) among newly vaccinated individuals in ten GP practices (n = 364) and two vaccine centers (n = 474). Participants in vaccine centers were younger compared to participants in GP practices. GP preference was higher in older participants and those with pre-existing illnesses. Wait time at vaccination site was longer in GP practices, whereas travel distance to site was longer for participants in vaccine centers. However, satisfaction with patient education and recommendation of site were more likely with increasing comprehensibility of the vaccination procedure and physicians’ information as well as perceived sufficiency of patient education duration, factors that can be easily modified by all vaccination sites. Our results demonstrate that both types of vaccination sites complement each other in terms of accessibility and target population and that satisfaction with the vaccination procedure can be promoted at all sites by an easy-to-understand process.