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Berlin, Germany

Muller-Mahn D.,University of Bonn | Beckedorf A.-S.,Auswartiges Amt
Geographische Rundschau | Year: 2014

After three decades of political inertia and economic mismanagement in Egypt, civil society movements of the so called 'Arab Spring' enforced the fall of Hosni Mubarak in February 2011. Old and new media played an important role in the struggle for public space. The Tahrir square in the centre of Cairo particularly reflects this development. Here, opposition groups organized protest camps which demonstrated against Mubarak and Mursi and which distributed images and messages across the globe. However, since the beginning, both the Muslim brotherhood and the military government aimed at implementing their particular interests. As a consequence, Egypt's current political geography is shaped by growing divisions of society and by an alarming escalation of violence. The latest military coup and the violent persecution of Islamist groups demonstrate that despite any changes, the "deep state" has survived.

Boecken G.,Auswartiges Amt | Sunderkotter C.,Universitatsklinikum Munster | Bogdan C.,Friedrich - Alexander - University, Erlangen - Nuremberg | Weitzel T.,University for Development | And 15 more authors.
JDDG - Journal of the German Society of Dermatology | Year: 2011

The incidence of cutaneous and mucocutaneous Leishmaniasis (CL/MCL) is increasing globally, also in Germany, although the cases are imported and still low in number. The current evidence for the different therapies has many limitations due to lack of sufficient studies on the different Leishmania species with differing virulence. So far there is no international gold standard for the optimal management. The aim of the German joint working group on Leishmaniasis, formed by the societies of Tropical Medicine (DTG), Chemotherapy (PEG) and Dermatology (DDG), was to establish a guideline for the diagnosis and treatment of CL and MCL in Germany, based on evidence (Medline search yielded 400 articles) and, where lacking, on consensus of the experts. As the clinical features do not necessarily reflect the involved Leishmania species and, as different parasite species and even geographically distinct strains of the same species may require different treatments or varying dosagesor durations of therapy, the guidelines suggest for Germany to identify the underlying parasite prior to treatment. Because of relevant differences in prognosis and ensuing therapy species should be identified in i) New World CL/MCL (NWCL/ MCL) to distinguish between L. mexicana-complex and subgenus Viannia, ii) in suspected infections with L. mexicana-complex to distinguish from L. amazonensis, and iii) in Old World CL (OWCL) to distinguish between L. infantum and L. major, L. tropica, or L. aethiopica. A state-of-the-art diagnostic algorithm is presented. For recommendations on localized and systemic drug treatment and physical procedures, data from the accessible literature were adjusted according to the involved parasite species and a clinical differentiation into uncomplicated or complex lesions. Systemic therapy was strictly recommended for i) complex lesions (e. g. > 3 infected lesions, infections in functionally or cosmetically critical areas such as face or hands, presence of lymphangitis), ii) lesions refractory to therapy, iii) NWCL by the subgenus Viannia or by L. amazonensis, iv) in MCL and v) in recalcitrant, or disseminating or diffuse cutaneous courses. In e. g. infection with L. major it encompasses miltefosine, fluconazole and ketoconazole, while antimony or allopurinol were here considered second choice. Local therapy was considered appropriate for i) uncomplicated lesions of OWCL, ii) L. mexicana-complex and iii) pregnant women. In e. g. infection with L. major it encompasses perilesional antimony, combined with cryotherapy, paromomycin 15 %/in methylbenzethoniumchlorid 12 % and thermotherapy. The group also stated that there is an urgent need for improving the design and the way of publishing of clinical trials in leishmaniasis. © 2011 The Authors.

The German population is becoming ever heavier, a trend that also affects the German workplace. Fifteen percent of children and teenagers are overweight, while 4-8% are obese (Federal Centre for Health Education - BZgA 2007). Weight problems increase with advancing age: some 65% of adult men and 50% of adult women are overweight (Robert Koch Institute 2005). The proportion of the population which is severely overweight has grown steadily in recent years, making workplace obesity prevention efforts ever more important. The Federal Ministry of Food, Agriculture and Consumer Protection (BMELV) has targeted this problem with the "IN FORM" campaign, a nationwide initiative to promote exercise and healthy eating which began in 2008. This initiative served as the inspiration for the new occupational health offering described in this article, which was conducted at a Federal Ministry and harnessed social group dynamics to strengthen interventions for overweight employees, which had previously been tailored only to individuals.

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