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With the co-operation of a further 13 institutes and as a continuation of our own epidemiological-statistical survey, we recorded the total and relative distribution (frequency profile) of the blood alcohol concentration of car drivers for the 3rd quarter 1990 and the 1st quarter 1991. The participating institutes recorded almost 27,000 blood samples and compared them with results of the first part of the study (1989). The survey dealt separately with sex-, age- and time of day-distribution of drivers involved and not involved in road accidents. One of our repeatedly presented field research into the problem of "alcohol and road safety", once again, provided to be a useful method in the run-up to the unprejudiced alcohol test which we are striving for. We noticed characteristic changes in the frequency profiles of the old and the new counties (Bundesländer) in Germany in the 1st (1989) and the 2nd (1990/91) report of the study. The results of Police supervisory operations in the administrative district of Cologne have basically given useful indications as to their epidemiological-statistical value as evidence.

Mortality from ischemic heart disease (ICD 410-414) is changing. Remarkable decreases have been observed in the age groups from 35-64 years, while overall mortality (all age groups) has remained approximately stable. In Switzerland this has meant a gain of some 4700 life years in the period 1988 to 1993 in the working population (35-64 years). The object of this study was to assess the associated change in indirect costs (productivity losses) due to premature death, using the human capital approach. The indirect costs were CHF 519 million (CHF 7.5 million per 100,000 population) in 1993. This represents approximately half of all indirect costs (and 25% of the total costs generated by the disease). Compared with the year 1988, a decrease in productivity losses due to premature death was observed amounting to CHF 46 million (-11%) in constant Swiss francs. Society benefits from this decrease in indirect costs, a desirable development hardly ever mentioned.

The first to create a "needle-free injector" was the American anesthetist Robert A. Hingson, 65 year ago. Since that time those devices underwent a changeful history. In 1986 an outbreak of hepatitis B among patients receiving injections from a needle-free multiple-use-nozzle injector was documented and related to the use of the injector device. Due to such risk of transmission of infection with these reusable devices, their application has been restricted. In 1998 the WHO recommended that only conventional needles and syringes should be used for immunization until safe needle-free injectors are identified through independent safety testing. Since needle-free injection has shown numerous advantages in comparison to conventional injection, new systems were developed that combine the advantages of needle-free injection with sufficient safety in mass vaccination programs. As an alternative to this early injector type, the disposable-cartridge injectors were developed. The newest research field in the area of the needle-free injection systems opened with the development of powder injectors, in which the drug preparation is no longer a suspension or solution, but a powdered solid. This injector type using powder formulations shows a number of advantages in comparison with the conventional needle/syringe injection technique as well as towards the liquid jet injectors. Due to this new kind of injectors the comeback of the needle-free injection technique in large-scale vaccination programs of the WHO seems reasonable and within reach.

Der vorliegende Beitrag gibt einen detailreichen historischen Einblick in die Geschichte und Stellung der Erwachsenenbildung in der Weltgesellschaft – allen voran im Rahmen der Vereinten Nationen und ihrer Sonderorganisationen. Der Autor ist selbst seit vielen Jahrzehnten an der Entwicklung von bedeutsamen internationalen Papieren und Empfehlungen sowie an der Planung und Durchführung von Konferenzen – z.B. der CONFINTEA, der von der UNESCO organisierten Weltkonferenz für Erwachsenenbildung – beteiligt. Aus dieser Perspektive verwebt sich der Rückblick auf fast ein halbes Jahrhundert bewegte (Berufs-)Biografie mit der Entwicklung eines Projekts einer Erwachsenenbildung für die Weltgemeinschaft, die an der Zielvorstellung von Frieden und Menschenrechten ausgerichtet ist. Das alles bestimmende Motiv: der Erwachsenenbildung und dem Lebenslangen Lernen einen angemessenen Platz in den internationalen Erklärungen der Weltgemeinschaft sichern. Der Beitrag schildert Erreichtes und Rückschläge, und am Ende steht: ein unbeirrt positiver Blick in die Zukunft, denn „die nächste CONFINTEA ist just around the corner“. (DIPF/Orig.) This article provides a detailed historical look at the development and position of adult education in global society – above all as part of the United Nations and its agencies. For many decades, the author has participated in the development of important international papers and recommendations as well as the planning and carrying out of conferences – for example CONFINTEA, the International Conferences on Adult Education organized by UNESCO. From this perspective, the review of nearly half a century of eventful (professional) biography is interwoven with the development of a project on adult education for the global community which is oriented towards the goal of peace and human rights. The motif that defines everything: Guaranteeing that there is a suitable place for adult education and lifelong learning in the international declarations of the world community. The article describes achievements and setbacks, and at the end concludes with an unwaveringly positive look into the future, for „the next CONFINTEA is just around the corner“. (DIPF/Orig.)

Ambulatory rehabilitation concepts for women with psychosomatic disorders and with pre-school children are rare and moreover not yet assessed. An economic concept for the evaluation of indirect costs and (patient) time costs is being developed in this article and applied to an ongoing ambulatory rehabilitation programme for mothers at the Hanover Medical School. In health economic evaluations time cost is expressed by loss and reduction of working time, time for housework, and leisure time. These are indirect cost items (working time) and direct non-medical costs (housework and leisure time). To estimate the loss of working time (and hence production loss) the human capital approach and the frictional cost approach can be applied. Loss of time due to housework can be estimated either by the production of goods and services or by the opportunity costs of the equivalent working time. Loss of leisure time can be partial or total whereas a total loss and a loss of working time are considered to be analogous. The health economic evaluation of the ambulatory rehabilitation programme for mothers is designed as a randomised controlled study with repeated data collection. The parameters of indirect and direct non-medical costs are measured at the beginning of the rehabilitation programme and until twelve months later by means of questionnaires, face-to-face and telephone interviews. So far, results of the evaluation show that the actual time cost of the rehabilitation programme is DM 6,162 for each mother and the time cost because of the utilisation of the health care system is DM 996 per four weeks. Therefore, the patient costs are obviously higher than the direct medical costs for the programme which makes it clear that taking into account the costs of the patient (especially the time costs) can make a decisive difference in the evaluation of alternative treatment programmes and may possibly reverse the advantages of an alternative.

Während in Asien und den USA der asiatische und insbesondere der chinesische Energiehunger bereits Mitte der 1990er Jahre auf der politischen Tagesordnung der Regierungen sowie vieler Diskussionen und Konferenzen war, blieb die Problematik in Europa fast unbeachtet. Im Glauben an die Allheilkräfte eines sich selbst regulierenden globalen Marktes von Angebot und Nachfrage galt die Analyse der asiatischen Energiemärkte und der chinesischen Energiepolitik als weitgehend entbehrlich. Darüber hinaus wurden mögliche Auswirkungen auf die Außen- und Sicherheitspolitik, das regionale Krisen- und Konfliktmanagement oder die globale Ordnungspolitik fast völlig ignoriert. So ist die Tatsache der rapide steigenden Energienachfrage aus China, Indien und anderen asiatischen Staaten sowie ihre globalen Auswirkungen in Deutschland bis Mitte 2004 kaum zur Kenntnis genommen worden. China aktuell, China aktuell - 1/2007

A retrospective study was undertaken to determine whether the degree of alcohol intoxication has an effect on the driving performance with regards to both the quantity and quality. A total of 625 accidents caused by drivers who were under the influence of alcohol were reviewed. They were divided into three groups according to the blood alcohol concentration (BAC):0.30 - 1.09 g/kg, 1.10 - 1.99 g/kg and > 2.00 g/kg. In order to exclude the influence of factors unrelated to alcohol, the groups were matched for age, sex, location of accident and the light and road conditions. This resulted in a total of 85 accidents in each group. The accidents were classified with reference to the "Register of causes of accidents" used in road accident statistics. The three groups differed significantly in their causes of accidents (p < 0.025), although those due to speeding dominated in each group. In the group with low BAC, the next most common accidents were the ones caused by failure to give way. In the group with medium BAC, rear-end collisions and accidents occurring during low speed manoeuvres were the second most common. In the group with highest BAC, the next most common causes of accidents were the leaving of the correct traffic lane unassociated with speeding.