German Society Research Articles

THE VOCAL HERITAGE OF JOHANNES BRAHMS WITHIN THE CONTEXT OF THE RELIGIOUS AND ETHICAL PRINCIPLES OF 19TH-CENTURY GERMAN CULTURE

The article is devoted to the exploration of spiritual and religious principles in the works of Johannes Brahms and their manifestation in the composer’s vocal and choral opuses. The aim of the study is to reveal the spiritual, ethical, and religious foundations of Brahms’ creative personality and their reflection in the composer’s vocal heritage (using A German Requiem and the vocal cycle Four Serious Songs as examples). The methodology combines intonational, genre-stylistic, etymological, and hermeneutical approaches. The scientific novelty of the study is marked by the introduction into musicology of not only materials concerning the religious worldview of Brahms but also their influence on the formation of the conceptual content inherent in his works, shaped at the intersection of Protestant-Lutheran principles of the German cultural-historical tradition and their metamorphoses during the spiritual quests of the Romantic era. The findings show that the generalization of bibliographic and analytical sources on Brahms’ works, including his vocal heritage, reveals the depth of the spiritual, ethical, and religious principles of his creative personality, which trace back to the German Protestant tradition and the culture formed on its basis. At the same time, these principles were enriched by the spiritual searches of German Romanticism and the Biedermeier period. The appeal to the age-old principles of past national culture and its illustrious representatives, combined with the revival of the “spirit” of the nation and the characteristic Protestant convergence and mutual spiritualization of sacred and secular genres, contributed to the consolidation of German society and its movement towards the unification of Germany. These aspects are also reflected in the poetics of Brahms’ A German Requiem and the vocal cycle Four Serious Songs, which exhibit the tradition’s characteristic focus on eternal themes of life and death in their Protestant interpretation, the use of relevant biblical texts and their authorial re-interpretation, as well as the appeal to the “intonational dictionary” of the Protestant chorale, ranging from direct citation to free compositional realization of broadly interpreted chorality.

The Perils of Privacy and Passivity: Antidemocratic, Racist, and Antisemitic Sentiments in Postwar West Germany

Abstract This article analyzes the affective economy of West Germany's postwar society. After delineating the intellectual history of the Frankfurt Institute for Social Research's “Gruppenexperiment,” which consisted of 137 group interviews with different segments of West German society, my article focuses on one transcript of a 1950 group discussion of young fashion-designer apprentices. Based on a close reading, I study how the younger generation in West Germany constructed a passive and privatist self-image in which they could both articulate their emotional dissociation from National Socialism while clinging to antidemocratic, racist, and antisemitic feelings in metamorphosed form. The micrological focus of the analysis of the group's emotions is balanced by a rereading of both Helmut Schelsky's study about the “skeptical generation” and texts by researchers associated with the Institute for Social Research who came to markedly different conclusions about the West German youth.

Sinunasal surgery as outpatient procedure with special consideration of nasal packing - Position paper of the German Society of Otorhinolaryngology, Head and Neck Surgery, the working group Rhinology/Rhinosurgery (ARHIN) of the German Society of Otorhinolaryngology, Head and Neck Surgery and German Professional Association of Otorhinolaryngologists

Currently, there is an intensive discussion on advancing and expanding outpatient rhinosurgical procedures. Many questions about how to stratify into out- and inpatient procedures are still not sufficiently clarified. Particularly, the use of nasal packing materials is not adequately discussed. Development of a checklist to stratify sinunasal procedures into in- or outpatient procedures with consideration of current scientific literature and risk factors. After comprehensive assessment of the literature and analysis of specific risk factors, a list of sinunasal procedures is presented, which should be performed as inpatient procedures. We present a checklist for in- and outpatient sinunasal procedures, which considers social, medical and surgical factors as well as the use of nasal packing materials. Furthermore, a checklist is added to assess, whether patients are ready for discharge after a planned outpatient procedure.

Life Trajectories of the Russophone Speakers in Germany: 30 Years of Observation

This article presents a multifaceted portrait of immigrants to Germany from the post-Soviet states. The article traces the paths of two families over the course almost of a third of a century after immigration, focusing on language use and integration into the new environment. In-depth interviews conducted at various stages of the integration process and age-appropriate tests served as research material. The content, text, and lexical analyses, as well as a linguistic biography method, were used. The research included four generations of Russian Germans and Jews in each family. Russophones in Germany have not had an easy time integrating but, ultimately, have a positive attitude toward their adoptive country. The results show that the German language became the primary means of communication outside the family and partly within the family where Russian dominates among the second and third generations. The oldest generation (great-grandfathers and great-grandmothers) were fluent in German to some extent; those who moved at the age of 20–40 learned it sufficiently for their jobs; their children studied in German preschools and schools and became completely bilingual; and the great-grandchildren were born in Germany. The younger generations have fully integrated into German society, although strong connections with locals exist among the older generations too. Proficiency in the Russian language is still maintained even among the great-grandchildren’s generation, although not to the same extent as among the generation of young parents.

A Comparative Analysis of International Classification Systems to Predict the Risk of Collapse in Single-Level Osteoporotic Vertebral Fractures.

Various classifications for osteoporotic vertebral fractures (OVFs) have been introduced to enhance patient care and facilitate clinical communication. However, there is limited evidence of their effectiveness in predicting vertebral collapse, and very few studies have compared this association across different classification systems. This study aims to investigate the association between OVF categories, according to the most widely used classification systems, and vertebral collapse. A retrospective single-center study was conducted involving patients diagnosed with acute OVFs at the emergency department of a tertiary-level academic hospital with a minimum follow-up of 6 months. Vertebral fractures were independently classified by two radiologists according to several classification systems, including those proposed by Genant, Sugita, the German Society for Orthopedics and Trauma (DGOU), and the AO Spine. Associations between vertebral collapse and OVF classification systems were analyzed using bivariate and logistic regression analyses. This study included 208 patients (82.7% females; mean age of 72.6 ± 9.2 years). The median follow-up time was 15 months, with L1 being the most common fracture site (47.6%). The most frequent OVF types observed, according to Genant's morphological, Genant's quantitative, Sugita 's, DGOU's, and AO Spine's classifications, were biconcave (50%), grade 0.5 (47.6%), bow-shaped (61.5%), OF2 (74%), and A1 (61.5%), respectively. All classifications, except for Genant's quantitative system, were significantly associated with vertebral collapse in bivariate analyses. Logistic regression analyses showed a significant association (p = 0.002) between the AO Spine classification and vertebral collapse, with 85.7% of A4 fractures developing collapse on follow-up. The AO Spine classification showed the highest predictive capacity for vertebral collapse. Specifically, A4 fracture types showed a very high risk of vertebral collapse, confirming the need for non-conservative management of these fractures. Further multicentric and prospective studies are warranted to confirm these findings.

Report of the German Society of Pathology Working Group on Pediatric and Fetal Pathology

Report of the German Society of Pathology Working Group on Pediatric and Fetal Pathology

Limitations and perspectives of the novel salivary test for endometriosis: an open web-based survey study of German gynecologic healthcare providers.

The description of a salivary miRNA signature for endometriosis has led to the development of a non-invasive diagnostic test. Current healthcare provider practices regarding the test remain uncaptured. The application of this test in practice was examined in a web-based survey, with the aim to provide their opinions on it. We conducted an open web-based survey study between November 2023 and January 2024. Members of the German society of gynecologic endoscopy (Arbeitsgemeinschaft gynäkologische Endoskopie, AGE), society of endometriosis (Arbeitsgemeinschaft Endometriose, AGEM), and the endometriosis research foundation (Stiftung Endometriose Forschung, SEF) were contacted per e-mail twice. Participants' data were anonymized. Differences in responses based on self-reported expertise in the field (basic knowledge, specialized knowledge, expert) were assessed using the χ2-test or Fisher's exact test. Statistical significance was set as p < 0.05. In total 141 of 190 respondents completely responded to the survey (> 75% of the questions of the survey). Twenty-one physicians reported having experience with the test, while most participants had at least specialized knowledge on the field (112/141). In terms of specific questions, more than 90% found the costs high; almost 85% did not believe that the test replaces standard diagnostic tools (histology, clinical examination, and sonography). Eighty-six providers supported the use of the test in adolescents. Gynecologists with basic knowledge had a more positive attitude compared with more experienced ones in terms of usefulness (Fisher's exact test, p < 0.001). Significant differences were demonstrated between expertise groups regarding (not only) applicability in adolescents (Fisher's exact test, p = 0.004), and using the test for screening purposes (χ2-test, p = 0.002). Despite the promising benefits of a salivary test for endometriosis, German healthcare providers would not change current practices. Nevertheless, less experienced colleagues were more positive towards the test.

Synovial chondromatosis : Results from the histopathological arthritis register of the German Society for Orthopedic Rheumatology

Synovial chondromatosis, or osteochondromatosis, is arare benign disorder that occurs in joints, tendon sheaths, or bursae, characterized by cartilage proliferations of varying sizes and shapes, often with ossifications. In this study the prevalence, sensitivity, gender predominance, differential diagnoses, and primary localization of synovial chondromatosis are analyzed within the Histopathological Arthritis Registry of the German Society for Orthopedic Rheumatology. All cases of patients diagnosed with "synovial chondromatosis" from the Histopathological Arthritis Registry of the German Society for Orthopedic Rheumatology were retrospectively examined, covering the period from 1 January 2018, to 31 December 2022. Between 1 January 2018, and 31 December 2022, there were 14cases of synovial chondromatosis out of atotal of 13,222 cases in the Histopathological Arthritis Register of the German Society for Orthopedic Rheumatology. The available data include primary localization, and age and gender of the patients. Among the 13,222 cases in the Histopathological Arthritis Register of the German Society for Orthopedic Rheumatology, 14were histopathologically confirmed as synovial chondromatosis. This resulted in aprevalence of 0.1% or 1.13 per 1,000 cases. The correct clinical presumptive diagnosis was made in 5cases, yielding asensitivity of 35.7%, 95% confidence interval (CI) 12.8% to 64.9%. Differential diagnoses for this condition include pigmented villonodular synovitis, tenosynovial giant cell tumor, and chondrosarcoma. Synovial chondromatosis frequently occurs in large joints such as the knee, hip, and the temporomandibular joint. A peak incidence is described in the fifth decade of life. However, the disorder can also occur in children. For the first time, the study was able to provide data for Germany based on alarge sample. Additionally, initial statements regarding the prevalence and sensitivity of synovial chondromatosis could be made. The aim of this work is to raise awareness of this very rare disease to enable faster and more efficient diagnosis. The study also highlights the importance of histopathology in the diagnosis of synovial chondromatosis.

Climate change distress and impairment in Germany.

Climate change has been widely recognized as one of the most challenging problems facing humanity and it imposes serious mental health threats. It is important, however, to differentiate between the affective experience of distress over climate change and the functional impairments associated with climate change. Such a distinction is crucial because not all negative affective states are pathological, and they might even motivate pro-environmental behavior. Functional impairments, like not being able to work or maintaining social relationships, however, might require immediate treatment. This study assesses climate change distress and climate change impairment within the population of Germany using a population-representative sample. The results identify vulnerable subgroups and thereby can help to facilitate the development of target group specific intervention programs. Furthermore, this study explores whether climate change distress and climate change impairment are associated with general health, physical health, mental health, and diverse health behaviors. Study participants were drawn from a panel which is representative of the German-speaking population in Germany with Internet access. Participants answered a series of questionnaires regarding their climate change distress, climate change impairment, general health, physical health, mental health, and diverse health behaviors. To evaluate differences between subgroups, Bayesian independent samples t-tests were calculated. To evaluate associations between constructs, Bayesian correlations were calculated. Especially women, younger people, people from West Germany, and people with a high level of formal education seem to experience higher levels of climate change distress. Regarding climate change impairment, the results suggest that especially women, older people, people from West Germany, people with a low level of formal education, people with a low or middle social status, and people with an inadequate/problematic health literacy seem to experience higher levels of climate change impairment. Furthermore, climate change distress and climate change impairment were weakly and differently associated with general health, physical health, mental health, and diverse health behaviors. Climate change distress and impairment are not evenly distributed within German society. The results of this study provide a starting point for the development of target group specific intervention programs.

Report of the German Society of Pathology Thoracic Pathology Working Group

Report of the German Society of Pathology Thoracic Pathology Working Group

Report of the German Society of Pathology Working Group on Bone, Joint, and Soft Tissue Pathology

Report of the German Society of Pathology Working Group on Bone, Joint, and Soft Tissue Pathology

Report of the German Society of Pathology Working Group on Uropathology

Report of the German Society of Pathology Working Group on Uropathology

Definition and diagnosis of Parkinson's disease: guideline "Parkinson's disease" of the German Society of Neurology.

Accurate definition and operational criteria for diagnosing Parkinson's disease (PD) are crucial for evidence-based, patient-centered care. To offer evidence-based recommendations for defining and diagnosing PD, incorporating contemporary clinical, imaging, biomarker, and genetic insights. The guideline development began with the steering committee establishing key PICO (patient, intervention, comparison, outcome) questions, which were refined by the coauthors. Systematic literature searches identified relevant studies, reviews, and meta-analyses. Recommendations were drafted, evaluated, optimized, and voted upon by the German Parkinson's Guideline Group. Parkinson's disease (PD) is now understood to encompass a broader spectrum of etiologies than previously recognized. Advances in molecular pathogenesis, neuroimaging, and early clinical phenotypes suggest that PD is not a uniform disease entity and is often not idiopathic. This necessitates an updated framework for PD definition and diagnosis. The German Society for Neurology now endorses a broader concept of PD, incorporating both idiopathic and hereditary forms, as opposed to the previously narrower concept of "idiopathic Parkinson syndrome." The revised guidelines recommend using the 2015 Movement Disorders Society diagnostic criteria, emphasize the importance of long-term clinical follow-up for improved diagnostic accuracy, and highlight the significance of non-motor symptoms in clinical diagnosis. Specific recommendations are provided for the use of imaging and fluid biomarkers and genetic testing to support the clinical diagnosis. The updated guidelines from the German Society for Neurology enhance diagnostic accuracy for PD, promoting optimized clinical care.

Development and Validation of a High-Performance Liquid Chromatography-Ultraviolet Spectrometry Method for Ampicillin and its Application in Routine Therapeutic Drug Monitoring of Intensive Care Patients.

Ampicillin/sulbactam, a combination of a β-lactam and β-lactamase inhibitor, is widely used in clinical settings. However, therapeutic drug monitoring (TDM) of ampicillin is not commonly performed, particularly in intensive care units (ICUs). The purpose of this study was to develop and validate a rapid and cost-effective high-performance liquid chromatography (HPLC)-ultraviolet spectrometry method to quantify ampicillin in human serum and evaluate its clinical application in ICU patients. Sample cleanup included a protein precipitation protocol, followed by chromatographic separation on a C18 reverse-phase HPLC column within 12.5 minutes using gradient elution of the mobile phase. The assay was validated according to the German Society of Toxicology and Forensic Chemistry criteria. Clinical applications involved the retrospective analysis of TDM data from ICU patients receiving continuous infusion of ampicillin/sulbactam, including the attainment of target ranges and individual predicted and observed pharmacokinetics. The method was robust, with linear relations between the peak area responses and drug concentrations in the range of 2-128 mg/L. The coefficient of variation for precision and the bias for accuracy (both interday and intraday) were less than 10%. Clinical application revealed variable pharmacokinetics of ampicillin in ICU patients (clearance of 0.5-31.2 L/h). TDM-guided dose adjustments achieved good therapeutic drug exposure, with 92.9% of the samples being within the optimal (16-32 mg/L) or quasioptimal (8-48 mg/L) range. This method provides a practical solution for the routine TDM of ampicillin, facilitating individualized dosing strategies to ensure adequate therapeutic drug exposure. Given its simplicity, cost-effectiveness, and clinical relevance, HPLC-ultraviolet spectrometry holds promise for broad implementation in hospital pharmacies and clinical laboratories.

Current status of lung cancer care in Germany in the context of treatment centralization and lack of personnel

Lung cancer is the malignancy with the highest mortality rate worldwide. In January 2025, the German public healthcare system will introduce a new regulation according to which a centre can offer surgery for lung cancer only if it carries out a minimum number of lung resections. The purpose of this directive is to reduce the number of centres offering surgical treatment for primary lung cancer, thus centralising and improving lung cancer care. It is expected that the introduction of this regulation will lead to a significant shift in the staffing of thoracic units. The purpose of this survey was to examine the current occupational structures behind the units of thoracic surgery and respiratory medicine. We performed an online survey through the German Society for Thoracic Surgery and the Association of Respiratory Physicians. The responding centres were divided in two groups, centres that were certified by the German Cancer Society or the Society for Thoracic Surgery and centres which were not certified. The response rate was 29.3% (respiratory physicians) and 31.9% (thoracic surgeons); 67% of the participating colleagues answered that their unit was an independent department. The majority of the participants reported having to share the on-call duty of the trainees with other departments in order to be able to cover the required shifts. 35% of the respiratory physicians and 57% of the thoracic surgeons reported having vacant job posts in their units. The introduction of the minimum quantity regulation will have significant consequences for the treatment of lung cancer in Germany. The current staff shortage in healthcare will lead to both medical and nursing staff needing to be redistributed in order to meet the needs that will arise in 2025. Operating lists, theatre days, and operative equipment will need to be redistributed as well, not only within hospitals but probably on a nationwide level. A negative impact of the new regulation is to be expected on research and academic activities since most university hospitals are not expected to reach the minimum number of lung resections that is required in order keep performing lung cancer surgery.

Conservative nonsurgical knowledge of German orthopedic and trauma surgeons-Present state of affairs.

After the fusion of the fields of orthopedics and trauma surgery in 2006 the educational content significantly increased. The acquisition of non-surgical diagnostic and treatment skills seems to fall behind in the classical operatively focused residency programs. This study presents astatus quo of the non-surgical education and knowledge in the field of orthopedics and traumatology in Germany. An online-based voluntary and anonymous questionnaire was conducted between June and August 2023. The questionnaire was distributed through the email lists of the German Society for Orthopedics and Traumatology (DGOU) and the German Professional Association for Orthopedics and Traumatology (BVOU). Atotal of 486 German orthopedic and trauma surgeons answered the online questionnaire (77.9% male; mean age50.2 ± 11.8 years) and 11.5% were residents. Only 27.1% spent part of the residency training in the outpatient sector. In total 84.2% wish for an increased focus on non-operative treatment options during further education, 81.1% agreed that they have agood general understanding of non-operative treatment options and 81.0% felt confident to apply them in the daily clinical routine (residents 35.4% and 41.7%, respectively). The highest self-assessed competences were knowledge on the application of splints and casts and physiotherapy, ergotherapy and sports therapy, the lowest were knowledge on acupuncture, magnetic field therapy and nutritional aspects after trauma. In total, 77.7% stated non-surgical research projects are not supported at their institution. Orthopedic and trauma surgeons in Germany subjectively have solid knowledge on treatment options while resident physicians still need to strengthen their skills. Rotation into the outpatient sector and rehabilitation facilities as well as supporting research in the field could further improve the non-surgical skills.

Balancing family and career for female physicians in Germany: insights from asurvey of female urologists

The shortage of skilled labor in medicine is one of the most pressing challenges in healthcare. The increasing number of women in medicine, particularly in the field of urology, raises questions about the compatibility of family and career, especially concerning the work environment and working time models. The aim of this study is to capture the impact of motherhood on the professional lives of female physicians and scientists in the field of urology in Germany. Specific challenges in this surgical specialty and the compatibility of family and career will be highlighted. The working group "Female Physicians and Scientists in Urology" of the German Society of Urology (DGU) surveyed its 1343female members regarding demographic data, professional status, and aspects of work-life balance. Among 487female urologists in Germany, 53.4% had children. Mothers tended to be older, less frequently in training, less often in inpatient settings, and less frequently engaged in surgical activities. Notably, the proportion of full-time working mothers (36.2%) was significantly lower compared to female urologists without children (92.4%). Among female urologists with children, 32.3% reported having changed their workplace because of their children, while 10.7% indicated that their responsibilities had changed at least once after pregnancy. Additionally, 76.9% of mothers had reduced their weekly working hours due to family commitments. Multivariate analysis showed an influence of motherhood on professional status and parttime work. The fact that starting afamily for women in urology in Germany is associated with areduction in working hours and the end of clinical careers suggests aneed for optimizing the compatibility of family and career in Germany. The increasing feminization of the medical profession exacerbates the existing shortage of skilled workers due to the exit of mothers from professional life. To meet the needs of working parents, particularly mothers, urgent adjustments in the work environment are necessary. Promoting flexible working time models and creating supportive conditions are crucial to preventing the loss of skilled professionals and maintaining job satisfaction in this field.

Dementia mindset of caregivers providing residential care for older persons: study protocol for a replication study on the validation of the Dementia Mindset Scale

IntroductionProfessional caregivers’ perspectives on dementia and on people living with dementia (PlwD) can influence their feelings, judgements and behaviours in work situations, for example, how they think about symptoms, disease...

Hand Surgery Training Structure in Germany - Evaluation of an Online Questionnaire

The duration of the training for hand surgery in Germany was reduced from three to two years in 2020, while other European Countries introduced hand surgery as a separate surgical specialty. Therefore, the structure of hand surgery training in Germany is under intense, ongoing discussion. This study aimed to evaluate the current situation of hand surgery training in Germany. Two separate online questionnaires were developed for self-assessment of residents and teachers in German hand surgery services. The questionnaire contained 29 questions for residents and 24 questions for teachers. Demographic data, educational tools, surgical training parameters and satisfaction were assessed from May to July 2023. The survey was based on the former training time of three years. The online questionnaire was sent to the members and associate members of the German Society for Hand Surgery via email. 148 participants answered the questionnaire, including 54 residents and 94 teachers. Overall, more female residents were assessed, whereas the majority of teachers was male. Hand surgery training is mostly conducted in high-level hospitals (tertiary care p=0.012, quaternary care p<0.001). Residents use digital teaching media significantly more often than teachers do (p<0.001). In contrast, teachers use journals (p=0.006) and clinical visits (p=0.024) significantly more often for their training than residents do. Trainers and trainees mostly agreed about time points of surgical milestones during surgical training that should be performed independently. Both trainers and trainees were largely satisfied with the practical and theoretical training in hand surgery. The importance of digital media in hand surgery training will increase in the near future. Therefore, digital media should be more frequently included in hand surgery training protocols. The study revealed that the majority of residents as well as teachers would appreciate the introduction of an independent hand surgery specialty, which would most likely improve the hand surgery competence in Germany.

The Effect of Individual Attitude toward Healthy Nutrition on Adherence to a High-UFA and High-Protein Diet: Results of a Randomized Controlled Trial.

502 subjects were randomized to an intervention group (IG; dietary pattern focused on high intake of unsaturated fatty acids (UFA), plant protein and fiber) or control group (CG; dietary recommendation in accordance with the German Society of Nutrition) within a 36-month dietary intervention trial. Sum scores for effectiveness, appreciation and practice of healthy nutrition were assessed using ATHN questionnaire during the trial (n = 344). Linear regression models were used to investigate associations between ATHN and dietary patterns at baseline and at month 12. Retirement, higher education level, age and lower body mass index (BMI) were associated with higher ATHN sum scores. ATHN was similar in CG and IG. Higher baseline intake of polyunsaturated fatty acids (PUFA) and fiber as well as lower intake in saturated fatty acids (SFA) were associated with higher scores in practice in both groups. The intervention resulted in a stronger increase of UFA, protein and fiber in the IG after 12 months, while intake of SFA declined (p < 0.01). Higher scores in appreciation were significantly associated with higher intake of fiber and lower intake of SFA in the CG at month 12, whereas no associations between ATHN and macronutrient intake were observed in the IG after 12 months. While ATHN appeared to play a role in general dietary behavior, ATHN did not affect the success of the specific dietary intervention in the IG at month 12. Thus, the dietary intervention achieved a substantial modification of dietary pattern in the IG and was effective to override the impact of the individual ATHN on dietary behavior.