Center Of Berlin Research Articles

Care at the centre of the post-pandemic sustainability of grassroots cultural centres and culture-led urban regeneration. A comparison of western and eastern perspectives

ABSTRACT The redevelopment and management of brownfield sites by grassroots cultural organizations have been shown to have a transformative role on communities and cities, implementing bottom-up culture-led urban regeneration rather than top-down models which often lead to gentrification. Based on analyses and interviews with actors from major grassroots cultural centres in Berlin (ufaFabrik) and Bratislava (Nová Cvernovka), this study challenges previous research on cultural brownfields focusing on temporary artistic interventions, arguing instead that long-term commitment, care, participation and cooperation between cultural organizations and local administrations can lead to more sustainable regeneration models in which cultural brownfields operate as commons-based ecosystems of care. The study also offers a unique insight into the “western” vs. “eastern” specifics, highlighting the fact that post-socialist administrations can serve as a barrier to a successful redevelopment through stigmatized public-NGO relationships, where artists and communities are often perceived as a “political opposition”.

Bringing “Religion as Such” to the City: Sacred History and Nation Branding in Contemporary Germany

Abstract This article focuses on a multireligious building project named House of One in contemporary Berlin. Initiated in 2012 by a Protestant community at the center of Berlin, House of One consists of a synagogue, a church, a mosque, and a communal room. My central suggestion is that House of One is invested in a pluralist re-branding of (liberal) Protestantism, a rebranding that underlies the post-unification emergence of a new national German imaginary: out of “soil” marked as historically Christian spreads an “Abrahamic” future that transcends its particularity via its assumed ability to incorporate Islam and Judaism. Liberal, Christian-secularized norms and affects are thus being rearticulated in a language of religious pluralism, so that a normative, Christian-secularized category of religion can be extended to Christianity’s “monotheistic brothers.” Elaborations of this building project’s intended purpose, I argue, are thus animated by a broader question about the appropriate relation between religion and the state, and conjointly, between the self and culture at a moment in time in which hitherto normative, Christian-secularized assumptions concerning this relation are challenged. As such, the discursive representation that sustains the yet-to-be-built House of One is conducive to the making of a new national imaginary: it is driven both by the desire to renounce past evil through a recognition and inclusion of alterity into the body politic, as much as by the simultaneous de-politization and scrutinization of such alterity.

Low-cost system application for policy assessment: a case study from Berlin

Local policies are part of the toolbox available to decision makers to improve air quality but their effectiveness is underevaluated and underreported. We evaluate the impact of the pedestrianization of a street in the city centre of Berlin on the local air pollution. Nitrogen dioxide (NO2) was measured on the street where the policy was implemented and on two parallel streets using low-cost sensor systems supported by periodic calibrations against reference-grade instruments and constrained by passive samplers. Further measurements of NO2 were conducted with a reference-grade instrument mounted on a mobile platform. The concentrations were evaluated against the urban background (UB) to isolate the policy-related signal from natural fluctuations, long-term trends and the COVID-19 lockdown. Our analysis shows that the most likely result of the intervention is a reduced NO2 concentrations to the level of the UB on weekdays for the pedestrian zone. Kerbside NO2 concentrations exhibited substantial differences to the concentrations measured at lampposts highlighting the difficulty for such measurements to capture personal exposure. The results have implications for policy, showing that an intervention on the local traffic patterns can possibly be effective in improving local air quality.

Clinically inapparent mpox virus (MPXV) infections among clients of three anonymous Community Based Voluntary Counselling and Testing centres in Berlin, Germany, 2022–2023

IntroductionSince the mpox outbreak in 2022, it was unclear if and how often infections with mpox virus (MPXV) were clinically inapparent, i.e. not presenting to clinical care with mpox symptoms. Moreover, it was hypothesized that MPXV circulated in the affected communities before the outbreak was officially detected.MethodsWe retrospectively tested rectal and urethral swabs, and pooled samples for presence of MPXV. Samples were obtained from routine STI testing of three anonymous Community Based Voluntary Counselling and Testing (CBVCT) centres in Berlin, in 2022 and 2023. Testing results were linked to anonymously provided behavioural data.ResultsOverall, 9,053 samples from 6,600 client visits were included. Clinically inapparent MPXV infections were detectable in 1.1% of the samples. We did not find MPXV infections in the month before the first cases appeared in Berlin or between October 2022 and January 2023 when case numbers were low in Germany. However, during the outbreak period in 2022, we found clinically inapparent MPXV infections among 2.2% of the clients and during summer/autumn 2023 among 0.3%. The number of condomless anal/vaginal intercourse partners within the previous 6 months and PrEP use were identified as predictors of clinically inapparent MPXV infection.ConclusionClinically inapparent MPXV infections occurred during the mpox outbreak in Berlin in 2022 and post-outbreak in summer/autumn 2023. Unrecognized MPXV circulation in Berlin before the recognition of the outbreak in May 2022 appears unlikely. However, low-level sustained circulation of clinically inapparent MPXV infections need to be acknowledged in mpox prevention strategies.

Staden i boken

The City in the Book: Materiality and Form in Irina Liebmann’s Documentary Portrayals of Berlin This article considers the relationship between urban materiality and literary form in three documentary portrayals of Berlin by Irina Liebmann: a book of interviews with East German tenants, Berliner Mietshaus (1982), the photo-essay Stille Mitte von Berlin (2002) and the autofictional novel Die Große Hamburger Straße (2020). I use and develop Andreas Mahler’s model for analysis of the “discursive constitution” of urban literature to investigate how various linguistic and formal expressions are used in the texts to represent the material properties of two urban entities: the tenement building and the street. My analysis shows how urban materiality is discursively constituted through referential elements and “material isotopy” (frequent use of materially connotated concepts), as well as through other linguistic means that can be connected to the materiality of the portrayed places such as the structure, layout, typography and interpunctuation of the text. In two of Liebmann’s texts, a further spatio-visual dimension arises through the inclusion of her own photographs of dilapidated buildings, closed-up shops and empty lots in East Berlin in the 1980s. The findings of my investigation demonstrate how Liebmann’s documentary portrayals of Berlin contribute to making visible the fluctuations in how different material circumstances – for example standard of living – are valued in different contexts, as well as to a renegotiation of hegemonic narratives about the city’s historic materiality. Finally, a diachronic comparison between the three texts shows that specific material entities such as streets and buildings in the old center of Berlin have been charged with new meaning after 1989 due to the fundamental alterations to the material conditions of the city through a rapid gentrification process.

“I do not know the advantages of having a general practitioner” - a qualitative study exploring the views of low-acuity emergency patients without a regular general practitioner toward primary care

BackgroundEmergency departments (ED) worldwide have to cope with rising patient numbers. Low-acuity consulters who could receive a more suitable treatment in primary care (PC) increase caseloads, and lack of PC attachment has been discussed as a determinant. This qualitative study explores factors that contribute to non-utilization of general practitioner (GP) care among patients with no current attachment to a GP.MethodQualitative semi-structured telephone interviews were conducted with 32 low-acuity ED consulters with no self-reported attachment to a GP. Participants were recruited from three EDs in the city center of Berlin, Germany. Data were analyzed by qualitative content analysis.ResultsInterviewed patients reported heterogeneous factors contributing to their PC utilization behavior and underlying views and experiences. Participants most prominently voiced a rare need for medical services, a distinct mobility behavior, and a lack of knowledge about the role of a GP and health care options. Views about and experiences with GP care that contribute to non-utilization were predominantly related to little confidence in GP care, preference for directly consulting medical specialists, and negative experiences with GP care in the past. Contrasting their reported utilization behavior, many interviewees still recognized the advantages of GP care continuity.ConclusionUnderstanding reasons of low-acuity ED patients for GP non-utilization can play an important role in the design and implementation of patient-centered care interventions for PC integration. Increasing GP utilization, continuity of care and health literacy might have positive effects on patient decision-making in acute situations and in turn decrease ED burden.Trial registrationGerman Clinical Trials Register: DRKS00023480; date: 2020/11/27.

Reducing trainee mistakes. Better performance with changing to a high-fidelity simulation system?

Postpartum hemorrhage is a significant cause of both maternal morbidity and mortality worldwide and is increasing in incidence. This study aimed to assess improvement and identify shortcomings in trainee performance in different simulation systems in the management of postpartum hemorrhage. To perform a pilot study evaluating and comparing high- and low-fidelity simulation models, assessing improvement in repeated performance with high-fidelity mode and identifying mistakes made assessed using Objective Structured Assessment of Technical Skills and thereby exploring what aspects of emergency management of postpartum hemorrhage should be prioritized in teaching settings and assessing what simulation setup is most effective in achieving competence. This was a prospective randomized, single-blinded, single-institution trial in a population of 17 junior obstetrical trainees at the Charité University Hospital Obstetric Simulation Center in Berlin. Trainees were randomized into 2 groups, with either initial low-fidelity simulation or high-fidelity simulation, followed by repeated assessment of performance, using the high-fidelity model simulation system. Individual simulation sessions were video-recorded and transcribed, and the timing of interventions was documented. Strandardized Objective Structured Assessment of Technical Skills forms were used as a checklist for performance. There was a statistically significant general improvement in performance (P=.02; 24.7-27.2 of 31.0 points; average of 8.7%) in the second cycle of simulation assessment and a statistically significant training effect (P=.043; 24.4-28.4 of 31.0 points; average of 12.9%) in the group that underwent repeat simulation assessment from the initial low-fidelity system to the high-fidelity system compared with the group using the same high-fidelity setup (P=.276; 25.0-25.8 of 31.0; average of 2.4%). There was an improvement in the performance when trainees underwent a repeated cycle of simulation assessment changing from a low-fidelity system to a high-fidelity system. Simulation assessment can identify mistakes and learning gaps that are important for obstetrical trainees. This study found that trainees make the same mistakes, regardless of which simulation model was initially used.

Sex and Age Characteristics in Acute or Chronic Myocarditis: A Descriptive, Multicenter Cohort Study

BackgroundUnderstanding the clinical features of myocarditis in various age groups is required to identify age-specific disease patterns. ObjectivesThe objective of this study was to examine differences in sex distribution and clinical outcomes in patients with myocarditis of various ages. MethodsPatients with acute or chronic myocarditis in 3 centers in Berlin, Germany from 2005 to 2021 and in the United States (National Inpatient Sample) from 2010 to 2019 were included. Age groups examined included “prepubescent” (below 11 years for females and below 13 years for males), adolescents (11 [female] or 13 [male] to 18 years), young adults (18-35 years), “middle-aged adults” (35-54 years), and older adults (age >54 years). In patients admitted to the hospital, hospital mortality, length of stay, and medical complication rates were examined. ResultsOverall, 6,023 cases in Berlin and 9,079 cases in the U.S. cohort were included. In both cohorts, there were differences in sex distribution among the 5 age categories, and differences in the distribution were most notable in adolescents (69.3% males vs 30.7% females) and in young adults (73.8% males vs 26.3% females). Prepubescent and older adults had the highest rates of in-hospital mortality, hospital length of stay, and medical complications. In the Berlin cohort, prepubescent patients had higher levels of leukocytes (P < 0.001), antistreptolysin antibody (P < 0.001), and NT-proBNP (P < 0.001) when compared to young adults. ConclusionsIn this study, we found that sex differences in myocarditis and clinical features of myocarditis were age-dependent.

Obstetric Care for Gestational Diabetes in Refugee and Immigrant Women in Comparison to Non-Immigrant Women in Berlin: an Analysis of Quantitative Data of the Pregnancy and Obstetric Care for Refugees (PROREF)-study

Are there differences in the frequency of gestational diabetes between women of self-defined refugee status (SDRS), immigrant women, and women born in Germany? Does the perinatal data of women with gestational diabetes (GDM) differ depending on the migration status? For the Pregnancy and Obstetric Care for Refugees (ProRef) study between June 2020 and April 2022, data was collected with the Migrant Friendly Maternity Care Questionnaire (MFMCQ) among women on the postpartum ward in three perinatal centers in Berlin. The data concerning GDM was statistically analyzed. Women of SDRS were tested for GDM (3.2%, p=0.0025) significantly less often than immigrant women (1.4%) or women born in Germany (0.6%). The rate of GDM was higher among immigrant women (19.6%, p=0.001) than among women born in Germany (15.0%) and women of SDRS (14.1%). The rate of GDM varied depending on the country of origin. Vietnam (OR 3.41) and Turkey (OR 2.18) as countries of origin, corrected for age and body mass index, increased the chance of gestational diabetes. The perinatal outcome data among women with GDM did not differ depending on the migration status. As women of SDRS are tested for GDM less frequently, this potentially suggests a supply gap in the health care system. However, the perinatal outcome data does not differ for women of SDRS.

Dyslexia, the Amsterdam Way.

The current aim is to illustrate our research on dyslexia conducted at the Developmental Psychology section of the Department of Psychology, University of Amsterdam, in collaboration with the nationwide IWAL institute for learning disabilities (now RID). The collaborative efforts are institutionalized in the Rudolf Berlin Center. The first series of studies aimed at furthering the understanding of dyslexia using a gamified tool based on an artificial script. Behavioral measures were augmented with diffusion modeling in one study, and indices derived from the electroencephalogram were used in others. Next, we illustrated a series of studies aiming to assess individuals who struggle with reading and spelling using similar research strategies. In one study, we used methodology derived from the machine learning literature. The third series of studies involved intervention targeting the phonics of language. These studies included a network analysis that is now rapidly gaining prominence in the psychopathology literature. Collectively, the studies demonstrate the importance of letter-speech sound mapping and word decoding in the acquisition of reading. It was demonstrated that focusing on these abilities may inform the prediction, classification, and intervention of reading difficulties and their neural underpinnings. A final section examined dyslexia, conceived as a neurobiological disorder. This analysis converged on the conclusion that recent developments in the psychopathology literature inspired by the focus on research domain criteria and network analysis might further the field by staying away from longstanding debates in the dyslexia literature (single vs. a multiple deficit, category vs. dimension, disorder vs. lack of skill).

Investigating the impact of stop network designs on DRT operation

Modern on-demand mobility concepts have the potential to drive the mobility transition. Increasing attention is being paid to DRT (Demand Responsive Transportation) services that enable the bundling of trips with the help of dynamic routing algorithms. Many providers use a stop-based operating concept for this purpose. The transport between so-called virtual stops promises a higher fraction of shared trips and shorter vehicle detours. The aim of this paper is to investigate multiple stop network designs and their impacts on the efficiency of the operation. For this purpose, three stop network generation approaches were derived from literature and applied to the simulation environment MATSim. A scenario in the city center of Berlin is simulated, where all inner car trips are replaced by DRT. Comparing the stop network design against a door-to-door service, the results suggest a trade-off between a reduction of vehicle kilometers (up to 18%) and increased walking distances (up to 250 meters on average).

Reliability and validity of the Vietnamese menopause rating scale

The menopause rating scale (MRS) has been proven to be a reliable tool for quantifying the impact of menopausal symptoms and aiding clinicians in prescribing appropriate treatments worldwide. However, the Vietnamese-MRS (VN-MRS) has not been developed. This research aimed to evaluate the reliability and validity of the VN-MRS, and identify factors that are associated with menopausal symptoms in women aged 50 to 59. A cross-sectional study was conducted on a sample of 200 women aged 50 - 59 years in Vietnam from February 2020 to June 2020. The MRS was translated into Vietnamese following the procedure from the Berlin Center for Epidemiology and Health Research and adjusted to fit the local culture. Reliability was assessed by using Cronbach’s alpha coefficients and repeatability (using Intra-class Correlation Coefficient (ICC) at 2-week intervals). Validity was assessed by concurrent validity and construct validity. Cronbach’s alpha for the total score was 0.89. Repeatability (test-retest) was valued as “very good” (ICC = 0.991). The fit indices for construct validity, after adjustment, were: χ2 (39) = 67.78 with p = 0.003; SRMR = 0.042; TLI = 0.971; CFI = 0.979; RMSEA = 0.061 90% confidence interval (CI) (0.035 – 0.084). Concurrent validity demonstrated an inverse correlation with the SF-36 survey (r = - 0.87; p&lt;0.001). Age, education, and menopausal period were contributed to the menopausal score. The VN-MRS has good reliability and validity, making it suitable for assessing the severity of menopausal symptoms in middle-aged Vietnamese women.

With RheMIT rheumatology centers can participate in the German national database-Expansion of the long-term rheumatological documentation

The national database (NDB) of the German regional collaborative rheumatology centers was switched to the RheMIT documentation software last year. Rheumatology centers that already use RheMIT for care contracts or other research projects can therefore use the software to also participate in the NDB. Experiences from ahospital, amedical care center and aspecialist practice show how the changeover to RheMIT from an existing documentation system or anew participation in the NDB with RheMIT can be implemented. The NDB team at the German Rheumatism Research Center in Berlin (DRFZ) welcomes new participating rheumatology centers.

Two German Perspectives on a German Discussion

This contribution results from a place of serious discomfort regarding recent public and academic discussions in Germany, where Holocaust memory and its political instrumentalization have seemed to produce a growing dogmatism, harming academic freedom. Because we both direct university research centers in Berlin and Los Angeles dedicated to the study of the Holocaust, we have decided to join forces and share our particular German perspectives on this debate. Our views are in part generational, in part personal.

Associations between physical and mental health and the utilization of ambulatory and emergency healthcare among asylum-seekers: results from a cross-sectional survey in Berlin, Germany

BackgroundDespite a high burden of chronic and mental illness, asylum-seekers show low utilization of ambulatory specialist healthcare. Forgoing timely healthcare when facing access barriers may direct them toward emergency care. This paper examines interrelations of physical and mental health and utilization of ambulatory and emergency care, and explicitly addresses associations between the different types of care.MethodsA structural equation model was applied to a sample of n = 136 asylum-seekers living in accommodation centers in Berlin, Germany. Utilization patterns of emergency care (outcome) and physical and mental ambulatory care (endogenous predictors) were estimated, while controlling for age, gender, chronic conditions, bodily pain, depression, anxiety, length of stay in Germany (exogenous predictors) and self-rated health (endogenous predictor).ResultsAssociations were observed between ambulatory care utilization and poor self-rated health (0.207, CI: 0.05; 0.364), chronic illness (0.096, CI: 0.017; 0.175) and bodily pain (0.019, CI: 0.002; 0.036); between mental healthcare utilization and anxiety (0.202, CI: 0.051; 0.352); and between emergency care utilization and poor self-rated health (0.621, CI: 0.059; 1.183), chronic illness (0.287, CI: 0.012; 0.563), mental healthcare utilization (0.842, CI: 0.148; 1.535) and anxiety (0.790, CI: 0.141; 1.438) (values in parentheses show estimated regression coefficients and 95% confidence intervals). We found no associations between the utilization of ambulatory and emergency care.ConclusionsOur study generates mixed results concerning associations between healthcare needs and ambulatory and emergency care utilization among asylum-seekers. We found no evidence that low utilization of ambulatory care contributes to emergency care utilization; neither did we find evidence that ambulatory treatment obviates the need to seek emergency care. Our results indicate that higher physical healthcare needs and anxiety are associated with more utilization of both ambulatory and emergency care; whereas healthcare needs related to depression tend to remain unmet. Both the undirected and under-utilization of health services may reflect navigation and accessibility issues. To facilitate more needs-based and effective healthcare utilization and thus contribute to health equity, support services such as interpretation and care navigation as well as outreach are warranted.

Development's Inaugural Outstanding Paper Prize.

Development's Inaugural Outstanding Paper Prize.

Exploring the views of low-acuity emergency department consulters on an educational intervention and general practitioner appointment service: a qualitative study in Berlin, Germany

ObjectivesLow-acuity patients presenting to emergency departments (EDs) frequently have unmet ambulatory care needs. This qualitative study explores the patients’ views of an intervention aimed at education about care options and...

Management, risk factors and prognostic impact of checkpoint-inhibitor pneumonitis (CIP) in lung cancer – A multicenter observational analysis

IntroductionCheckpoint-inhibitor pneumonitis (CIP) represents a major immune-related adverse event (irAE) in patients with lung cancer. We aimed for the clinical characterization, diagnostics, risk factors, treatment and outcome in a large cohort of patients from everyday clinical practice. Patients and methodsFor this retrospective analysis, 1,376 patients having received checkpoint inhibitors (CPI) in any line of therapy from June 2015 until February 2020 from three large-volume lung cancer centers in Berlin, Germany were included and analyzed. ResultsWith a median follow-up of 35 months, all-grade, high-grade (CTCAE ≥ 3) and fatal CIP were observed in 83 (6.0%), 37 (2.7%) and 12 (0.9%) patients, respectively, with a median onset 4 months after initiation of CPI therapy. The most common radiologic patterns were organizing pneumonia (OP) and non-specific interstitial pneumonia (NSIP) (37% and 31%). All except 7 patients with G1-2 CIP interrupted treatment. Corticosteroids were administered to 74 patients with a median starting dose of 0.75 mg/kg. After complete restitution (n = 67), re-exposure to CPI (n = 14) led to additional irAE in 43% of the cases. Thoracic radiotherapy targeting the lung was the only independent risk factor for CIP (odds ratio 2.8, p < 0.001) and pretherapeutic diffusing capacity for carbon monoxide inversely correlated with CIP severity. Compared with patients without CIP and non-CIP irAE, CIP was associated with impaired overall survival (hazard ratios 1.23, p = 0.24 and 2.01, p = 0.005). ConclusionsHigh-grade CIP accounts for almost half of all CIP cases in an allcomer lung cancer population. A continuous vigilance, rapid diagnostics and adequate treatment are key to prevent disease progression associated with impaired survival.

The Berlin-Buch respiration chamber for energy expenditure measurements

PurposeWe present a methodological overview of a respiration chamber at the Experimental and Clinical Research Center in Berlin, Germany. Since 2010, we investigated 750 healthy subjects and patients with various diseases. We routinely measure resting energy expenditure (REE), dietary-induced thermogenesis, and activity energy expenditure.MethodsThe chamber is a pull calorimeter with a total volume of 11,000 L. The majority of measurements is done with a flow rate of 120 L/min, yielding a favorable time constant of 1.53 h. The gas analysis system consists of two paramagnetic O2 sensors and two infrared CO2 sensors, one for incoming and one for outgoing air samples. O2 and CO2 sensors are calibrated simultaneously before each measurement with a 6 min calibration routine. To verify the accuracy of the whole the calorimetric system, it is validated every 2 weeks by 2 h acetone burning tests.ResultsValidation factors (calculated/measured) of 20 representative 2 h acetone burning tests were 1.03 ± 0.03 for dot{V}{text{O}}_{2}, 1.02 ± 0.02 for dot{V}{text{CO}}_{{2}}, 0.99 ± 0.02 for RER, and 1.03 ± 0.03 for EE. Four repeated 60 min REE measurements of a healthy woman showed variabilities of 231.9 ± 4.8 ml/min for dot{V}{text{O}}_{2} (CV 2.1%), 166.0 ± 6.3 ml/min for dot{V}{text{CO}}_{{2}} (CV 3.8%), 0.73 ± 0.03 for RER (CV 4.6%), and 4.55 ± 0.07 kJ/min for EE (CV 1.6%).ConclusionsThe data presented show that our respiration chamber produces precise and valid EE measurements with an exceptionally fast responsiveness.Graphical

Monument protection as a limiting factor for large scale vertical greening system implementation to counteract indoor heat stress – a GIS-based analysis for Berlin, Germany

Vertical greening systems (VGS), as proven strategy for adaptation to heat stress, are prohibited for monument-protected buildings and façades. To what extent monument protection effectively limits the implementation of VGS in heat stress affected city centers has not been quantified yet. In this study, the ratio of buildings under monument protection was quantified for Berlin, Germany, using a GIS analysis. It was then compared to a map of potential heat stress. This was done for the entire city and the inner-city area on block-scale.Therefore, maps of the Berlin buildings, monuments and blocks were processed. The ratio of buildings under monument protection was calculated for each block of Berlin. To not deform the outcome, urban green areas were cut out of the maps. Inside the 80 km2 city center of Berlin, which is severely affected by heat stress, the range of monument protection prohibiting VGS in the individual blocks ranges from 0 % to 100 %. However, 25.42 % of the building façades in the city center and 16.20 % for whole of Berlin are protected on average and therefore cannot be greened. Compared to other restricting factors, monument protection does not generally hinder large scale implementation of VGS in Berlin. Nonetheless, 102 potentially heat stress exposed blocks inhabited by 48,122 people cannot be greened due to monument protection. This demonstrates that VGS should be discussed as exception from monument protection that can be justified by a predominant public interest. It also points to the need of minimal invasive and mobile greenery technologies, which would enable heritage-protection conform greening.