Objectives: Asylum seekers in Germany represent a highly vulnerable group from a health perspective. Furthermore, their access to healthcare is restricted. While the introduction of the Electronic Health Insurance Card (EHIC) for asylum seekers instead of healthcare-vouchers is discussed controversially using politico-economic reasons, there is hardly any empirical evidence regarding its actual impact on the use of medical services. The aim of the study is to examine this impact on the use of medical services by asylum seekers as measured by their consultation rate of ambulant physicians (CR). Study Design: For this purpose, a standardized survey was conducted with 260 asylum seekers in different municipalities, some of which have introduced the EHIC for asylum seekers, while others have not. Methods: The period prevalence was compared between the groups “with EHIC” and “without EHIC” using a two-sided t-test. Multivariate analysis was done using a linear OLS regression model. Results: Asylum seekers in possession of the EHIC are significantly more likely to seek ambulant medical care than those receiving healthcare-vouchers. Conclusions: The results of this study suggest that having to ask for healthcare-vouchers at the social security office could be a relevant barrier for asylum seekers.

Objective As the digitization of the working world progresses, the demands on employees change. Not least, this is true for the setting of public administrations in Germany, which is currently affected by the transformation to E-Government. This study aims to identify and describe a risk cluster of digitally stressed employees in public administrations. Methods An online sample of 710 employees from three public administrations in North Rhine-Westphalia were surveyed about digital stress (7 items) and several potential risk factors (19 items) derived from the current research. In the first step, a hierarchical agglomerative cluster analysis is used to detect the risk cluster. This is followed by a comparison to the group of the remaining employees regarding their risk profiles. Results The analysis states that the digitally stressed cluster accounts for approximately ten percent of the public administration’s employees of the total sample. Employees in the risk cluster are less satisfied with on-site work overall, experience less collegial support on-site, experience less collegial support in the home office, resign more often, are more likely to feel overwhelmed, are less educated, are older in age and more often have relatives in need of care. Conclusion This work was able to identify and describe a group of digitally stressed rather than left-behind employees in public administrations to bring awareness to potentially destructive factors in the digital transformation process but eventually to social inequalities. The findings offer the basis for interventions to arise and evoke potential for further research.

Background: The initial and intermediate-term access of refugees to healthcare in Germany is limited. A previous study showed that the obligation to request healthcare vouchers at the social security offices decreases the asylum seekers’ consultation rate of ambulant physicians. The introduction of the Electronic Health Insurance Card (EHIC) for asylum seekers is considered skeptically by some municipalities and federal states, among other reasons due to the fear of an overuse of health care services by asylum seekers. The aim of this study is to further evaluate the data of the authors’ initial study with a new focus on inpatient care as well as a differentiation of the ambulant consultation rate into general practitioners and outpatient specialists. Methods: The now-differentiated consultation rate of the initial study as well as the asylum seekers’ use of inpatient care are compared to the values of the sex- and age-corrected autochthonous population as given by the German Health Interview and Examination Survey for Adults (DEGS1). A mean difference test (student’s t-test) is used for comparison and significance testing. Results: Asylum seekers who were in possession of the EHIC were significantly less likely to visit their ambulant general practitioners and specialists than the German autochthonous population. Simultaneously, this difference is partly compensated for by their more frequent use of impatient care. Conclusions: There is no indication that the EHIC leads to an overuse of healthcare services.

Background With the increasing digitalization of the working environment, the demands on managers are changing fundamentally to the point of an emerging field of research in digital leadership. Municipal administrations are particularly affected by the digital transformation processes. Therefore, a score to measure the construct of digital leadership competence in the context of virtual-based workstation was developed and tested. Methods Based on an online survey with n = 546 employees at virtual-based workstations in municipal administrations in 2020, the instrument is tested regarding selectivity (coefficients), dimensionality (principal component analysis), homogeneity (inter-product-moment correlations), reliability (Cronbach’s α) and construct validity (correlation with general leadership skills). Results The instrument can be considered selective, one-dimensional, homogeneous, reliable and constructively valid in the sense of the formulated hypotheses. By integrating the employees’ perspective, the instrument aims to be one of the first of its kind to initiate a scientific further discourse. Among other things, the categorization of the co-determination component as either traditional or digital leadership can be discussed. Conclusions The developed instrument for measuring digital leadership performs well concerning the aspects of discriminatory power, one-dimensionality, homogeneity, reliability as well as construct validity. It aims to induce further research and a scientific discourse on the topic of health-oriented leadership within the world of work 4.0.

Chemical eye burns present an avoidable, but frequent, occupational injury with potentially detrimental consequences for the quality of life and occupational rehabilitation of the injured. A periodical review of guidelines is required to assure the optimal emergency management. We reviewed the literature with emphasis on current German guidelines, primarily MEDLINE. If the crucial first-line measure, the injury prevention has failed and an eye burn has been sustained, the immediate and copious rinsing of the eye is the pivotal emergency treatment modality. Whereas the immediacy and sufficiency of the emergency rinsing are largely unanimous, there is an ongoing debate about the benefits and risks of specific rinsing solutions, and regular updates on guidelines and recommendations for the emergency treatment are warranted. The easiest and readily available rinsing solution is tap water, which fulfils the crucial criteria conveniently in most industrialized countries: purity, sterility, and neutral pH. Other rinsing solutions are proposing higher osmolality to stabilize the physiological pH, because of their superior buffering capacity. However, there is no compelling evidence for a substantial benefit, and some reports suggest that there could be unwanted side effects. In combination with the substantially increased expenditure and a more complex handling procedure, currently a general recommendation of any other solution than tap water is not warranted.