Dogs and cats use human emotional information directed to an unfamiliar situation to guide their behavior, known as social referencing. It is not clear whether other domestic species show similar socio-cognitive abilities in interacting with humans. We investigated whether horses (n = 46) use human emotional information to adjust their behavior to a novel object and whether the behavior of horses differed depending on breed type. Horses were randomly assigned to one of two groups: an experimenter positioned in the middle of a test arena directed gaze and voice towards the novel object with either (a) a positive or (b) a negative emotional expression. The duration of subjects’ position to the experimenter and the object in the arena, frequency of gazing behavior, and physical interactions (with either object or experimenter) were analyzed. Horses in the positive condition spent more time between the experimenter and object compared to horses in the negative condition, indicating less avoidance behavior towards the object. Horses in the negative condition gazed more often towards the object than horses in the positive condition, indicating increased vigilance behavior. Breed types differed in their behavior: thoroughbreds showed less human-directed behavior than warmbloods and ponies. Our results provide evidence that horses use emotional cues from humans to guide their behavior towards novel objects.

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.

Independent from initial severity, many patients develop persistent symptoms after infection with SARS-CoV-2, described as long COVID syndrome. Most of these patients are treated by general practitioners (GPs). As evidence-based treatment recommendations are still sparse, GPs must make their therapy decisions under uncertainty. We investigated (1) the most frequently observed long COVID symptoms in general practices and (2) GPs' applied treatment and rehabilitation plans for these symptoms. In total, 143 German GPs participated in an online-based survey between 05/2021 and 07/2021. We found that each GP practice was treating on average 12 patients with long COVID symptoms. Most frequently seen symptoms were fatigue and reduced performance. Current therapy options were rated as poor and loss of smell and taste, fatigue, or lack of concentration were perceived to be especially difficult to treat. The use of drug and non-drug therapies and specialist referrals focused primarily on physiological and less on psychosomatic/psychological rehabilitation and followed guidelines of similar conditions. Our results provide first insights into how GPs approach a newly emerging condition in the absence of guidelines, evidence-based recommendations, or approved therapies, and might inform about GP preparedness in future pandemics. Our results also emphasize a gap between the current knowledge of the long COVID manifestation and knowledge about effective rehabilitation.

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.

The COVID-19 pandemic affected regular health care for patients with chronic diseases. However, the impact of the pandemic on primary care for patients with coronary artery disease (CAD) who are enrolled in a structured disease management program (DMP) in Germany is not clear. We investigated whether the pandemic affected primary care and health outcomes of DMP-CAD patients (n = 750) by using a questionnaire assessing patients' utilization of medical care, CAD symptoms, as well as health behavior and mental health since March 2020. We found that out of concern about getting infected with COVID-19, 9.1% of the patients did not consult a medical practitioner despite having CAD symptoms. Perceived own influence on infection risk was lower and anxiety was higher in these patients compared to symptomatic CAD patients who consulted a physician. Among the patients who reported chest pain lasting longer than 30 min, one third did not consult a medical practitioner subsequently. These patients were generally more worried about COVID-19. Patients with at least one worsening CAD symptom (chest pain, dyspnea, perspiration, or nausea without apparent reason) since the pandemic showed more depressive symptoms, higher anxiety scores, and were less likely to consult a doctor despite having CAD symptoms out of fear of infection. Our results provide evidence that the majority of patients received sufficient medical care during the COVID-19 pandemic in Germany. However, one in ten patients could be considered particularly at risk for medical undersupply and adverse health outcomes. The perceived infection risk with COVID-19 might have facilitated the decision not to consult a medical doctor.

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.