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Background In the light of physician shortage and increasing demands of medical services, losing physicians due to early retirement is becoming a significant problem for healthcare systems worldwide. The aim of this study was to investigate retirement plans and the relationship between burnout and retirement planning. Method For the purpose of the current study, a sample of n  = 320 physicians working in patient care was analyzed in 2020 (Baseline) and repeatedly in 2024 (Follow-up). The questionnaire included the Copenhagen Burnout Inventory, measuring overall burnout and sub dimensions (personal, patient- and work-related). One single item assessed retirement planning (earlier vs. later/regular). Mixed-effects generalized linear models with binomial family and logit-link were applied, adjusting for sociodemographic characteristics. Results In terms of retirement planning, 42% of physicians in 2020 and 39% pf physicians in 2024 were planning to retire early. The highest prevalence of burnout was found with regard to personal burnout at both time points. In addition, a significant association between time retirement planning and burnout was found: for a one-unit increase in overall burnout, a 12% increase in the odds of desiring early retirement may be expected when controlling for sociodemographics ( p  = 0.001). Specifically, an increase in work-related burnout was significantly related to a 7.1% higher odds of early retirement intention (p = 0.005) while no relationship was found for personal or patient-related burnout. Conclusion Current analyses indicate that burnout constitutes a significant risk factor for the early retirement of physicians and warrants appropriate attention in workforce planning. In order to avoid negative consequences for the broader healthcare system, it is important to establish interventions that help physicians to cope with high workload. Future studies are needed to better understand decisions regarding retirement among physicians.

Digital health literacy (DHL) has the potential to improve health among older adults by enhancing access to health-related information and health care services. The aim of this study was to analyze the relationship between DHL and technology commitment in adults aged 65 years and older, while also investigating possible gender differences. The analytical sample consisted of 1824 individuals. The analysis included descriptive comparisons in terms of DHL, technology acceptance, competency, support, and internet use. Multivariate regression models (generalized linear models) were applied in order to test the association between DHL and technology commitment, controlling for internet use as well as health-related and sociodemographic characteristics. Male and female participants did not differ in terms of DHL (mean score: 3.5, SD 1.2 [men] and 3.5, SD 1.3 [women]; P=.70); however, male participants reported significantly higher technology acceptance (P<.001) and higher technology competencies (P<.001), but less support with regard to technology use (P<.001). Within regression models, only higher technology acceptance (coefficient=0.023, 95% CI 0.006-0.041; P=.01) and support (coefficient=0.027, 95% CI 0.014-0.040; P<.001) were significantly linked to greater DHL. The subgroup analysis revealed that DHL was significantly associated with technology acceptance among men (coefficient=0.036, 95% CI 0.012-0.060; P=.003) but not women (coefficient=0.024, 95% CI 0.008-0.040; P=.44). According to the current results, DHL is highly related to technology commitment. Gender differences should be taken into account when developing and evaluating appropriate interventions to improve DHL by addressing the acceptance of technologies and optimizing support infrastructures.

Background Currently, the health care system in Germany is facing a serious physician shortage. Previous research reported changes in working hours and a tendency towards a reduction in clinical hours. The aim was to investigate the relationship between changes in working hours and symptoms of burnout in German physicians over two time points. Method In 2020, a random sample of physicians from the Federal State of Saxony (Germany) was drawn. The current analyses are based on data from a longitudinal survey conducted in 2020 and 2024. Overall, a sample of n  = 333 physicians working in both inpatient and outpatient care was investigated using descriptive and regression analyses. In a multivariate analysis predicting burnout symptoms (overall, patient-related, work-related, personal burnout) in 2024, sociodemographic factors such as age, sex and work-related aspects (i.e. medical setting and working hour characteristics), as well as burnout level in 2020, were controlled for. Results Overall, 19.2% ( n  = 64) of the sample reported no changes in working hours over 4 years, whereas 27% ( n  = 90) reported an increase in working hours and 53.8% ( n  = 179) reported a decrease in working hours. In fact, a working hour reduction was significantly linked to lower overall burnout, lower personal burnout and lower work-related burnout at follow-up ( p  < 0.001 for all regression models), while controlling for covariates. No significant association between change in working hours and the third burnout dimension—patient-related burnout at follow-up—was found. Discussion The present findings emphasize that physician burnout remains a critical issue, especially in the context of clinical working hours. Reducing actual working hours and decreasing overwork may help to improve physician well-being. Future efforts should also focus on optimizing working conditions beyond hours alone—such as increasing schedule flexibility and addressing systemic stressors—to sustainably protect physicians’ health and ensure high-quality patient care.

Purpose The aim of this study was to investigate changes in attitudes of the general public towards bariatric surgery and other interventions that can be part of obesity management, during the last 5 years. Method 1007 participants were randomly selected and interviewed. Apart from socio-demographic data, interviews also included causal reasons for obesity as well as questions regarding treatment methods and their believed effectiveness. Results were compared with data published 5 years ago. Results Surgery is seen as a rather ineffective method to reduce weight in obesity and is recommended less often by the general public compared to the assessment 5 years ago. Conclusions Public health—implications should inform about obesity and benefits of surgery as an intervention to improve individual health conditions.

In the face of rapid global change it is imperative to preserve geodiversity for the overall conservation of biodiversity. Geodiversity is important for understanding complex biogeochemical and physical processes and is directly and indirectly linked to biodiversity on all scales of ecosystem organization. Despite the great importance of geodiversity, there is a lack of suitable monitoring methods. Compared to conventional in-situ techniques, remote sensing (RS) techniques provide a pathway towards cost-effective, increasingly more available, comprehensive, and repeatable, as well as standardized monitoring of continuous geodiversity on the local to global scale. This paper gives an overview of the state-of-the-art approaches for monitoring soil characteristics and soil moisture with unmanned aerial vehicles (UAV) and air- and spaceborne remote sensing techniques. Initially, the definitions for geodiversity along with its five essential characteristics are provided, with an explanation for the latter. Then, the approaches of spectral traits (ST) and spectral trait variations (STV) to record geodiversity using RS are defined. LiDAR (light detection and ranging), thermal and microwave sensors, multispectral, and hyperspectral RS technologies to monitor soil characteristics and soil moisture are also presented. Furthermore, the paper discusses current and future satellite-borne sensors and missions as well as existing data products. Due to the prospects and limitations of the characteristics of different RS sensors, only specific geotraits and geodiversity characteristics can be recorded. The paper provides an overview of those geotraits.

Mental Health Problems and Care Situation in Students with Problem Behaviour from the Autism Spectrum (ASD) at Special Schools for Emotional and Behavioral Disorder (EBD) Children Children and adolescents with ASD often require specific support both inside and outside of school. The majority of these children are educated at special schools for emotional and behavioral disorder (EBD). There is no data available on how often ASD problems occur at EBD special schools, what other emotional and behavioral problems are shown, and how the students are supported. In the study, teachers at EBD special schools were surveyed on their pupils' mental health problems, including ASD, and the use of care services (N = 551). 19.0 % were rated as having problems in the autism spectrum, 16.7 % as having slight problems, and 64.3 % as having no problems in the autism spectrum. Pupils with behavioral problems in the autism spectrum were considered to be more affected by symptoms of depression, anxiety, compulsions and tics, among others. The values for functional impairment and distress were also significantly higher. Furthermore, children with elevated scores in the ASD spectrum receive significantly less psychotherapy and significantly more school support and speech therapy. Pupils with ASD symptoms make slightly more use of support services than other children, despite much higher levels of strain. There seems to be a gap in care that is relevant for the adaptation of conditions in schools and medical- and therapeutic services.Mental Health Problems and Care Situation in Students with Problem Behaviour from the Autism Spectrum (ASD) at Special Schools for Emotional and Behavioral Disorder (EBD) Children Children and adolescents with ASD often require specific support both inside and outside of school. The majority of these children are educated at special schools for emotional and behavioral disorder (EBD). There is no data available on how often ASD problems occur at EBD special schools, what other emotional and behavioral problems are shown, and how the students are supported. In the study, teachers at EBD special schools were surveyed on their pupils' mental health problems, including ASD, and the use of care services (N = 551). 19.0 % were rated as having problems in the autism spectrum, 16.7 % as having slight problems, and 64.3 % as having no problems in the autism spectrum. Pupils with behavioral problems in the autism spectrum were considered to be more affected by symptoms of depression, anxiety, compulsions and tics, among others. The values for functional impairment and distress were also significantly higher. Furthermore, children with elevated scores in the ASD spectrum receive significantly less psychotherapy and significantly more school support and speech therapy. Pupils with ASD symptoms make slightly more use of support services than other children, despite much higher levels of strain. There seems to be a gap in care that is relevant for the adaptation of conditions in schools and medical- and therapeutic services.

Summary Mental Health Problems and Care Situation in Students with Problem Behaviour from the Autism Spectrum (ASD) at Special Schools for Emotional and Behavioral Disorder (EBD) Children Children and adolescents with ASD often require specific support both inside and outside of school. The majority of these children are educated at special schools for emotional and behavioral disorder (EBD). There is no data available on how often ASD problems occur at EBD special schools, what other emotional and behavioral problems are shown, and how the students are supported. In the study, teachers at EBD special schools were surveyed on their pupils’ mental health problems, including ASD, and the use of care services (N = 551). 19.0 % were rated as having problems in the autism spectrum, 16.7 % as having slight problems, and 64.3 % as having no problems in the autism spectrum. Pupils with behavioral problems in the autism spectrum were considered to be more affected by symptoms of depression, anxiety, compulsions and tics, among others. The values for functional impairment and distress were also significantly higher. Furthermore, children with elevated scores in the ASD spectrum receive significantly less psychotherapy and significantly more school support and speech therapy. Pupils with ASD symptoms make slightly more use of support services than other children, despite much higher levels of strain. There seems to be a gap in care that is relevant for the adaptation of conditions in schools and medical- and therapeutic services. Zusammenfassung Kinder und Jugendliche mit Autismus-Spektrum-Storung (ASS) benotigen oft spezifische Hilfsmasnahmen in und auserhalb der Schule. Beschult wird ein Grosteil der Kinder an Forderschulen emotionale und soziale Entwicklung (EsE). Es liegen keine Daten dazu vor, wie haufig Auffalligkeiten im Bereich ASS an Forderschulen EsE auftreten, welche weiteren emotionalen und Verhaltensauffalligkeiten die Schuler:innen zeigen, und wie sie durch Hilfsmasnahmen versorgt sind. In der Studie beurteilten Lehrkrafte an Forderschulen EsE psychische Auffalligkeiten ihrer Schuler:innen (N = 551) unter anderem im Bereich ASS. Auserdem wurde die Inanspruchnahme von Versorgungsleistungen erfragt. 19.0 % wurden als auffallig im Bereich ASS eingeschatzt, 16.7 % als leicht auffallig und 64.3 % als unauffallig. Schuler:innen mit Verhaltensproblemen aus dem Autismus-Spektrum wurden unter anderem in den Bereichen Depression, Angst, und Zwang und Tic als belasteter eingeschatzt. Deutlich ausgepragter sind auch die Werte zu Funktionsbeeintrachtigung und Leidensdruck. In Bezug auf die Versorgungslage zeigte sich, dass die Kinder deutlich weniger Psychotherapie erhalten, und deutlich mehr Schulbegleitung und Logopadie. Die Schuler:innen mit Auffalligkeiten im Bereich ASS nehmen geringfugig mehr Hilfsmasnahmen in Anspruch als andere Kinder, und dies trotz hoherer Belastung. Es zeigt sich eine Versorgungslucke, die relevant fur die Anpassung von Rahmenbedingungen in der Schule und therapeutischer Angebote daruber hinaus ist.

Zusammenfassung Einleitung Männer nutzen seltener psychosoziale Unterstützung als Frauen, auch wenn sie psychisch belastet sind. Ziel war, verschiedene Maßnahmen zu entwickeln, die Männern die Inanspruchnahme der Angebote von Krebsberatungsstellen erleichtern sollen. Dieser Beitrag gibt die Erfahrungen aus der Praxis wieder, die wir im Rahmen der Studie WAG-ES! gewinnen konnten. Methode Ein Maßnahmenpaket wurde in vier Schritten entwickelt, dabei auf Praxistauglichkeit und Umsetzbarkeit geprüft und zu einem Katalog zusammengefasst. Anschließend wurde es in einer mehrmonatigen Pilotierungs- und Interventionsphase in sieben Krebsberatungsstellen umgesetzt und an die jeweiligen Gegebenheiten adaptiert. Ergebnisse Das Maßnahmenpaket besteht aus vier Säulen: Öffentlichkeitsarbeit, Schnittstellen & Zuweisende, strukturelle Veränderungen und männerspezifische Aktivitäten. Ziel der Öffentlichkeitsarbeit ist, Zuweisende über das Beratungsangebot und männerspezifische Angebote zu informieren und mögliche Fehlvorstellungen über psychosoziale Beratung zu korrigieren. Die Zuweisenden wurden gezielt angesprochen und hatten eine Schlüsselfunktion. Strukturelle Veränderungen, zum Beispiel eine Abendsprechstunde, konnten leicht umgesetzt werden. Besonders wichtig waren männerspezifische Angebote. Dabei wurde die körperliche Aktivität oder Informationsvermittlung an erste Stelle gesetzt. Später, wenn sich eine Vertrautheit entwickelt hatte, konnten auch emotional oder schambesetzte Themen angesprochen und bearbeitet werden. Schlussfolgerung Das erarbeitete Maßnahmenpaket ist praxistauglich und kann in der Breite eingesetzt werden.

EinleitungMänner nutzen seltener psychosoziale Unterstützung als Frauen, auch wenn sie psychisch belastet sind. Ziel war, verschiedene Maßnahmen zu entwickeln, die Männern die Inanspruchnahme der Angebote von Krebsberatungsstellen erleichtern sollen. Dieser Beitrag gibt die Erfahrungen aus der Praxis wieder, die wir im Rahmen der Studie WAG-ES! gewinnen konnten.MethodeEin Maßnahmenpaket wurde in vier Schritten entwickelt, dabei auf Praxistauglichkeit und Umsetzbarkeit geprüft und zu einem Katalog zusammengefasst. Anschließend wurde es in einer mehrmonatigen Pilotierungs- und Interventionsphase in sieben Krebsberatungsstellen umgesetzt und an die jeweiligen Gegebenheiten adaptiert.ErgebnisseDas Maßnahmenpaket besteht aus vier Säulen: Öffentlichkeitsarbeit, Schnittstellen & Zuweisende, strukturelle Veränderungen und männerspezifische Aktivitäten. Ziel der Öffentlichkeitsarbeit ist, Zuweisende über das Beratungsangebot und männerspezifische Angebote zu informieren und mögliche Fehlvorstellungen über psychosoziale Beratung zu korrigieren. Die Zuweisenden wurden gezielt angesprochen und hatten eine Schlüsselfunktion. Strukturelle Veränderungen, zum Beispiel eine Abendsprechstunde, konnten leicht umgesetzt werden. Besonders wichtig waren männerspezifische Angebote. Dabei wurde die körperliche Aktivität oder Informationsvermittlung an erste Stelle gesetzt. Später, wenn sich eine Vertrautheit entwickelt hatte, konnten auch emotional oder schambesetzte Themen angesprochen und bearbeitet werden.SchlussfolgerungDas erarbeitete Maßnahmenpaket ist praxistauglich und kann in der Breite eingesetzt werden.

Most sRNA biogenesis mechanisms involve either RNAseIII cleavage or ping-pong amplification by different Piwi proteins harboring slicer activity. Here, we follow thequestion why the mechanism of transgene-induced silencing in the ciliate Paramecium needs both Dicer activity and two Ptiwi proteins. This pathway involves primary siRNAs produced from non-translatable transgenes and secondary siRNAs from endogenous remote loci. Our data does not indicate any signatures from ping-pongamplification but Dicer cleavage of long dsRNA. We show that Ptiwi13 and 14 have different preferences for primary and secondary siRNAs but do not load them mutually exclusive. Both Piwis enrich for antisense RNAs and Ptiwi14 loaded siRNAs show a 5′-U signature. Both Ptiwis show in addition a general preference for Uridine-rich sRNAs along the entire sRNA length. Our data indicates both Ptiwis and 2′-O-methylation to contribute to strand selection of Dicer cleaved siRNAs. This unexpected function of two distinct vegetative Piwis extends the increasing knowledge of the diversity of Piwi functions in diverse silencing pathways. As both Ptiwis show differential subcellular localization, Ptiwi13 in the cytoplasm and Ptiwi14 in thevegetative macronucleus, we conclude that cytosolic and nuclear silencing factors are necessary for efficient chromatin silencing. Competing Interest Statement The authors have declared no competing interest.