Residence In Germany Research Articles

#Stand with Ukraine: Analyzing the links between Germans' emotions and their readiness to protest in response to the Russian invasion of Ukraine

AbstractThe Russian invasion of Ukraine in February 2022 sparked protests around the globe. Most of Europe had – luckily – not seen violent conflict of this scale on their doorstep for more than 30 years. For Germany, the period was even longer. Being confronted with news about the war drove thousands of German citizens to the streets. In passionate protests, they made various demands of their government. Herein, we investigate the links between Germans' emotions and their readiness to engage in such protests. Drawing on collective action research, we predicted that anger and sympathy would correlate positively with Germans' protest readiness. Given the context and public debate, we predicted that fear should also correlate with protest readiness. Two surveys (total N = 905) conducted with residents of Germany – one day after the invasion and at its first anniversary – supported our hypotheses. We consistently found that the more sympathy and anger respondents experienced, the greater their readiness to protest. Fear explained variance beyond sympathy and anger in two cases and in an information‐seeking measure of protest readiness: Greater fear correlated with a higher interest in demonstrations advocating peace negotiations and a lower interest in demonstrations calling for solidarity with Ukraine. These findings underscore the links between sympathy, anger, fear, and the readiness to protest in response to the contemporary crisis that is the war in Ukraine.

Challenges and aspirations of neurosurgery residents in Germany: Insights from a questionnaire-based survey

ObjectiveNeurosurgery residents in Germany face numerous challenges including receiving comprehensive surgical training with adequate learning opportunities, achieving balanced work life equilibrium, maintaining a positive work environment and navigating career prospects. The objectives of this study are to assess overall satisfaction with the training program, identify factors contributing to dissatisfaction, explore various dimensions of the training program, evaluate the psychological well-being of residents, and ascertain their preferences for future subspecialties. MethodsA questionnaire-based survey was conducted anonymously among neurosurgery residents from various training hospitals, nationwide. The survey utilized a quantitative questionnaire as data collection tool. The data collection took place from June 2021 to January 2023. ResultsThe survey encompassed 120 neurosurgery residents, with a gender distribution of 55 % male and 45 % female. The respondents were primarily from university hospitals (53 %), followed by community hospitals (38 %) and private hospitals (9 %). In terms of training program satisfaction, 37 % reported moderate satisfaction, 39 % indicated below-moderate satisfaction, and 28 % experienced above-moderate satisfaction. The predominant causes of dissatisfaction identified were insufficient surgical exposure (reported by 39 % of respondents), suboptimal educational content (38 %), and inadequate research opportunities (32 %). Additionally, 24 % of respondents highlighted psychological stress, and 36 % reported frequent experiences of burnout. A majority (63 %) indicated a workload of 60–80 h weekly. About half of the residents indicated a future specialization interest in neurosurgical oncology. ConclusionThe results of the survey findings provide valuable insights into the challenges and aspirations of neurosurgery trainees in Germany. These results serve as a basis for improving the training system, enhancing the working environment, and guiding future planning in this field. To optimize the training of residents, it is important to address issues such as limited surgical and research opportunities and psychological well-being. The expressed interest in subspecializing offers guidance for shaping the training program’s future direction.

Korean Residents’ Experiences of Racism in Germany During the COVID-19 Pandemic: Association with Life Satisfaction and Sense of Belonging

AbstractSince the outbreak of COVID-19, more incidents of anti-Asian racism have been reported in Europe. Asians in Germany have been directly and indirectly exposed to racism, with potential implications for their well-being and sense of belonging. This study aimed to explore racism experiences among Korean residents in Germany since the outset of the pandemic. It also examines how racism is associated with their life satisfaction and sense of belonging to the host society. Our online survey of 552 Koreans residing in Germany shows that since the beginning of the pandemic nearly 80% of them experienced direct and/or indirect racism mainly in public places, public transportation, social media, and mainstream media. Women, younger people, and temporary visa-holders were more likely to experience racism than other groups. While the experience(s) of racism was associated with lower life satisfaction, a stronger sense of belonging to local communities and German society as a whole appeared to alleviate the negative effect of the racism experience. This study shows the pervasiveness of anti-Asian racism in Germany, and thus urges German society and local communities to commit to creating inclusive and diverse environments alongside anti-racism efforts.

Enhancing ultrasound education in obstetrics and gynecology in Germany: insights and innovations from postgraduate training

BackgroundUltrasound (US) has become integral to obstetrics and gynecology (Ob/Gyn), necessitating proficient training during residency. Despite its clinical importance, there is a perceived gap in the quality and structure of postgraduate ultrasound education in Germany.MethodsA cross-sectional survey was conducted among Ob/Gyn residents in Germany from October 2023 to March 2024, using the LimeSurvey platform. The survey, distributed via email, social media, and physical flyers, garnered 211 participants, with 115 completing all sections. The questionnaire covered demographic details, US training experiences, and the perceived importance of US in clinical practice.ResultsAlthough US was highly valued by respondents, with an average of 26.1% of their clinical activity devoted to it, there was significant dissatisfaction with the training quality. Key issues included inadequate supervision, the necessity of self-training, and low participation in certification courses. Despite 93.0% awareness of professional US organizations like the German Society for Ultrasound in Medicine (DEGUM), engagement with structured training programs was minimal.DiscussionThe study highlights a critical need for standardized US training protocols and curricular reform in Ob/Gyn residencies in Germany. The discrepancy between the recognized importance of US and the quality of training indicates a pressing need for improvements. Addressing these gaps through comprehensive, structured educational reforms could significantly enhance the proficiency and confidence of future Ob/Gyn specialists, ultimately improving patient care.

Frequency Of Psychological Stress And Barriers To Accessing Mental Health Services For Leipzig Citizens Of Afghan And Iraqi Citizenship

Aim of the study was to report evidence on mental health needs and access to mental health and psychosocial support for Leipzig citizens of Afghan and Iraqi citizenship in the presence of mental stress and, above all, to identify barriers to access to care. All adults in Leipzig with Iraqi or Afghan citizenship, who were not born in Germany were contacted. Various instruments (PHQ-9, GAD-7, SSS-8, PCL-5/LEC-5) to screen for symptoms of depression, anxiety, somatization disorder or PTSD and one item for self-reported emotional problems were used. Questions on health care utilization and barriers to care followed. 51.4% screened positive in at least one of the tests and self-reported emotional problems. 38.2% of those in need of treatment did not seek help. Frequent reasons for not seeking help were, that the people wanted to solve the problem on their own or that the problem did not bother them very much. A lack of trust and understanding regarding the healthcare system and fear of discrimination and stigmatisation were also perceived as additional barriers to care. The study revealed a high percentage of mental health needs. This could be due to the high number of traumatic events and post-migration stressors. A longer period of residence in Germany and easier access to the public health system through the health insurance card could have encouraged the health care utilization. The treatment gap was caused by barriers to care such as a lack of knowledge or trust of the German health care system and fear of stigmatisation and discrimination. More information about access to care structures and more low-threshold services need to be implemented. These should be organised on an interdisciplinary basis and focus on culturally and racially sensitive care. Mental health awareness should be strengthened and under no circumstances should the access to care be restricted any further.

Knowledge and competences in hematological malignancies amongst radiation oncology residents in Germany-results from anational survey.

Radiation oncology is apivotal modality in the treatment of hematologic malignancies. To enable state-of-the-art patient care, structured education during residency is essential. However, given the lack of detailed data, the scope of educational opportunities available to trainees remains elusive. This prompted our group to perform anational survey amongst radiation oncology residents in Germany assessing the status quo of competences in the treatment of lymphoma and leukemia patients. Furthermore, areas of potential improvement were identified to further the goal of competence-based education for residents. Asurvey-based analysis was conducted to assess the knowledge and competence of radiation oncology residents in Germany regarding hematological malignancies. Adecisive questionnaire covering demographics, self-assessment of competences, and areas for improvement was developed in adaption of asurvey by the Association of Residents in Radiation Oncology and distributed amongst 1439 members of the German Society of Radiation Oncology. Responses were collected anonymously via an online survey tool and analyzed using descriptive statistics and chi-square tests. Atotal of 59complete and 22partial responses were collected, yielding a5.6% response rate. Participants' competence varied, with notable experience gaps in pediatric cases, proton therapy, and large-field techniques like total-skin irradiation or pediatric total body irradiation. While participants felt confident in treatment planning and patient counseling, they showed deficiencies in the definition of the planning target volume for modern involved site radiotherapy. Resources for education included national and international guidelines, scientific reviews, and textbooks. Board-certified radiation oncologists and physicians from specialized lymphoma centers demonstrated higher overall competence levels. This survey highlights the diversity of resident education regarding hematological malignancies in German radiation oncology programs. Knowledge gaps exist in key areas, including pediatric cases and specialized techniques. Competence-based education, interactive teaching formats, and rotations to specialized centers are potential strategies to address these gaps. The study contributes to the understanding of the federal educational landscape, underscoring the need for standardized and comprehensive training to ensure optimal patient care in hematological malignancies within the context of radiation oncology. Further research and collaborations are warranted to enhance training and expertise in this critical domain.

Quality of Life of Residents in Seniors' Homes in Poland and Germany.

Homes for the elderly and care facilities are not only a place of treatment, but also a place of permanent residence for older people. It is assumed that older adults' quality of life in the centres may not be sufficient for their long well-being. The purpose of this study was to determine the level of quality of life among nursing home residents in Poland and Germany and the impact of disability on functioning in their major life domains. This study was carried out using the WHOQOL-BREF questionnaire (abridged version) on 1000 people-500 residents of the centre in Poland and 500 residents in Germany. The quality of life of Polish and German residents is at an average level and is closely related to their degree of independence. People with greater independence assessed their quality of life higher. The degree of disability affects one's own health and the quality of life of the residents. Therefore, to improve older adults' quality of life, certain steps should be taken, including supporting them in maintaining their health and independence on a daily basis.

‚Back‘ costs 11.6 billion euros per year

The Health Atlas editions of the Scientific Institute of the AOK (WIdO), which have been published annually since 2019, make the health situation of all residents in Germany‘s 400 districts and cities transparent. The current edition of the Health Atlas, published at the end of 2023, focuses on the topic of back pain and its prevalence in the German population. The report also focuses on causes, consequences, prevention options and consequences for the healthcare system.

Sarcopenia, physical activity and sedentary behavior among nursing home residents in Germany

Residents in nursing homes show a high prevalence of the musculoskeletal syndrome sarcopenia and tend not to achieve current physical activity recommendations. The aim of this study is to identify differences in physical activity and sedentary behavior of sarcopenic residents compared with nonsarcopenic and presarcopenic residents. Sarcopenia assessment was performed among 63nursing home residents in Baden-Wuerttemberg (D) using the European Working Group on Sarcopenia in Older People2 specifications. Structured activity sessions (per week), accelerometer-based physical activity (steps/day), and sedentary behavior (percentual/day) were examined. The group comparisons were determined with Kruskal-Wallis tests and Dunn-Bonferroni post hoc tests. Significant differences were found for number of steps (p = 0.005) and percentual sedentary behavior (p = 0.019). Moreover, steps per day presented significant results in group comparison for no sarcopenia (2824.4 [423-14275]) with probable sarcopenia (1703.9 [118-5663]) and confirmed/severe sarcopenia (1571.2 [240-2392]) (both p = 0.022; |r| = 0.34). Sedentary behavior demonstrated significant differences in groups with no sarcopenia (87.9% [69.1-94.3]) and with probable sarcopenia (91.7% [80.4-9835]) (p = 0.018; |r| = 0.35). Nonsarcopenic residents demonstrated ahigher number of steps and lower sedentary behavior compared with presarcopenic and sarcopenic residents. Increasing steps, reducing sedentary behavior and promoting activities of daily living can contribute to the prevention and treatment of sarcopenia in the nursing home setting.

Effect of area-level socioeconomic deprivation on mental and physical health: A longitudinal natural experiment among refugees in Germany

Existing studies on contextual health effects struggle to account for compositional bias, limiting causal interpretation. We use refugee dispersal in Germany as a natural experiment to study the effect of area-level socioeconomic deprivation on mental and physical health, while considering the potential mediating role of neighbourhood characteristics. Refugees subject to dispersal (n = 1466) are selected from a nation-wide longitudinal refugee study (IAB-SOEP-BAMF Panel; 2016–2018). Multi-level linear regression models, adjusted for age, sex, education, country of origin, federal state, asylum status and length of residence in Germany, are fitted to the change in mental and physical health subscales of the SF-12 depending on quintiles (Q1 – Q5) of commune-level socioeconomic deprivation (German Index of Socioeconomic Deprivation, GISD). This is followed by sensitivity analyses and mediation analyses for housing, social cohesion, proportion of non-citizens in the neighbourhood, access to green space, population density and primary care physician density. Residency in districts with moderate-high deprivation (Q4) has a negative impact on physical health (coef.: -2.2, 95%CI: -4.1;-0.2) compared to lowest deprivation (Q1). Moderate-high deprivation (Q4) has a positive impact on mental health, but the effect is statistically insignificant (coef.: 1.6, 95%CI: -0.7; 3.9). Comparisons with other deprivation quintiles are statistically insignificant. Sensitivity analyses confirm results of the final models, while no mediating factors show a substantial impact on the observed relationship. The results point to gaps in health and social service provision for refugees living in the most deprived regions, but further research is required to understand the precise mechanisms behind the observed relationships. Further research using longer timeframes and larger sample sizes are required to confirm results.

Evaluation of easy-to-implement anti-stress interventions in a series of N-of-1 trials: study protocol of the anti-stress intervention among physicians study.

Adverse effects of chronically high levels of stress on physical and mental health are well established. In physicians, the effects of elevated stress levels exceed the individual level and include treatment errors and reduced quality of patient-doctor relationships. Breathing and mindfulness-based exercises have been shown to reduce stress and could serve as an immediate and easy-to-implement anti-stress intervention among physicians. Due to the heterogeneity of their effect on stress, we aim to evaluate the intervention effect of performing a short daily breathwork-based or mindfulness-based intervention on the everyday level of perceived stress in physicians in residence in Germany in a series of N-of-1 trials. Study participants will choose between two short interventions, box breathing, and one guided more complex mindfulness-based breathing exercise. Each participant subsequently will be randomly allocated to a sequence of 1-week intervention (A) and control (B, everyday life) phases. Each N-of-1 trial consists of two two-week cycles (AB or BA), resulting in a total trial duration of 4 weeks (ABAB or BABA). Perceived levels of stress will be assessed daily via the StudyU App on the participant's smartphone. Additionally, participants will be asked to complete a questionnaire at baseline and three months after completion of the study that contains questions about basic participant characteristics, lifestyle factors, individual living situations, and validated psychological questionnaires. Intervention effects will be estimated by Bayesian multi-level random effects models on the individual and population level. This study contributes to the development of short-term solutions to reduce work-related stress for physicians in residence. This is expected to benefit the individual and increase the quality of overall healthcare due to a reduction in treatment errors and an increase in the quality of doctor-patient relationships. ClinicalTrials.gov, identifier NCT05745545.

The role of external factors on the reactivation of the heritage language of Turkish-German returnees.

This study investigates the heritage language performance of Turkish-German returnees upon their reintegration into Turkey and explores the impact of external factors on their proficiency in the (re-)activated heritage language (HL). Data collection involved the participation of 28 Turkish heritage speakers and a control group of 28 monolingual speakers. The language proficiency of both groups was assessed through a cloze test and an error correction task with a focus on converbial constructions, evidentiality and direct object case marking in Turkish. A sociolinguistic background questionnaire was used to obtain information about their language experiences. The study focused on understanding the individual and group differences in returnee's heritage language performance. Additionally, random forest analysis was employed to investigate the relative influence of external factors on individual variability within the returnee group. The analysis of results revealed notable group differences between the returnees and the control group, emphasizing the unique linguistic challenges faced by those who returned to Turkey. Within the returnee group, there was considerable individual variability in heritage language performance. The subsequent exploration of individual variation highlighted the significant role of external factors. Notably, the length of residence in Germany, the age at which participants returned to Turkey, and the frequency of Turkish language use in their migration context emerged as significant predictors of the returnee participants' proficiency in their (re-)activated HL. Surprisingly, formal contact with the dominant German language did not exert a substantial impact on the returnees' language proficiency, suggesting the nuanced influence of various external factors on heritage language development.

Improving Mild to Moderate Depression With an App-Based Self-Guided Intervention: Protocol for a Randomized Controlled Trial.

Depression is one of the most prevalent mental disorders and frequently co-occurs with other mental disorders. Despite the high direct and indirect costs to both individuals and society, more than 80% of those diagnosed with depression remain with their primary care physician and do not receive specialized treatment. Self-guided digital interventions have been shown to improve depression and, due to their scalability, have a large potential public health impact. Current digital interventions often focus on specific disorders, while recent research suggests that transdiagnostic approaches are more suitable. This paper presents the protocol for a study that aims to assess the efficacy of a self-guided transdiagnostic app-based self-management intervention in patients with mild or moderate depression with and without comorbid mental disorders. Specifically, we are investigating the impact of the intervention on symptoms of depression, quality of life, anxiety symptoms, and mental health-related patient empowerment and self-management skills. The intervention under investigation, MindDoc with Prescription, is a self-guided digital intervention aimed at supporting individuals with mild to moderate mental disorders from the internalizing spectrum, including depression. The app can be used as a low-threshold psychosocial intervention. Up to 570 adult patients will be randomized to either receive the intervention in addition to care as usual or only care as usual. We are including adults with a permanent residency in Germany and mild or moderate depression according to International Classification of Diseases, 10th Revision, criteria (F32.0, F32.1, F33.0, and F33.1). Clinical interviews will be conducted to confirm the diagnosis. Data will be collected at baseline as well as 8 weeks and 6 months after randomization. The primary outcome will be depression symptom severity after 8 weeks. Secondary outcomes will be quality of life, anxiety symptom severity, and patient empowerment and self-management behaviors. Data will be analyzed using multiple imputations, using the intention-to-treat principle, while sensitivity analyses will be based on additional imputation strategies and a per-protocol analysis. Recruitment for the trial started on February 7, 2023, and the first participant was randomized on February 14, 2023. As of September 5, 2023, 275 participants have been included in the trial and 176 have provided the primary outcome. The rate of missing values in the primary outcome is approximately 20%. Data from this efficacy trial will be used to establish whether access to the intervention is associated with an improvement in depression symptoms in individuals diagnosed with mild or moderate depression. The study will contribute to expanding the evidence base on transdiagnostic digital interventions. German Registry of Clinical Trials DRKS00030852; https://drks.de/search/de/trial/DRKS00030852. DERR1-10.2196/46651.

«Американская лихорадка»: попытка массовой эмиграции немецкого населения из Советского Союза в конце 1920-х годов

The article examines the case of the mass emigration of Germans from the Soviet Union to Europe and America in the late 1920s, referred to as the “American fever”. Based on unpublished archival materials from the collections of RGASPI (Russian State Archive of Social-Political History) and GARF (State Archive of the Russian Federation), as well as documentary collections, German periodicals of the era, and contemporary research, the study presents a comprehensive account of the alterations in the conditions of departure from the USSR for Soviet citizens of German nationality, encompassing both reunification with relatives and resettlement for permanent residence in Germany, Canada, and other countries. Throughout the first half of the 1920s, Germans were granted relatively unrestricted travel as a means of eliminating “internal enemies” and “declassified elements”. Later, the Soviet government made decisions to restrict and ultimately prohibit mass emigration from the USSR. The underlying factors and reasons for the expulsion of the German-speaking Mennonite community from the USSR, which possessed a prominent anti-Bolshevik stance, and the subsequent prohibitions on their emigration are scrutinized. The primary factors that sparked emigration sentiments in the German countryside were collectivization, the struggle against religion, hunger, and oppression. The aforementioned “American fever” garnered significant international attention and resonance in the Western media. In response, the Soviet leadership implemented “preventative measures” to eradicate the emigration movement. A flurry of raids, arrests and repression swept through German villages and the Sovietization of the German countryside intensified. German peasants who had gathered near Moscow were forcibly evicted back. Only 5,671 German nationals were able to leave the USSR, while most of the emigrants were forcibly returned, and all of them were placed under supervision, or detained by the OGPU. The Soviet government was unprepared for mass emigration from the USSR as a non-violent form of resistance. The mass nature of the emigration movement as well as the appeal of the Germans to a foreign state, in this case to Germany, for help, clearly showed the Bolshevik government a low degree of loyalty, both of the refugees themselves and their local supporters.

Moral Distress in Radiation Oncology: Insights From Residents in Germany

Being challenged by circumstances that force one to act in discordance with one's moral compass can lead to moral distress. The phenomenon has been widely investigated among nurses. This study was designed to shed some light on the situation of resident physicians in radiation oncology. To gain insight into moral distress among residents in radiation oncology, a web-based questionnaire was developed and distributed throughout Germany. Participants were asked to evaluate possible burdensome situations and different options for relief. To outline the main issues of moral distress, an exploratory factor analysis was conducted. Relief options were examined by frequencies. The factor analysis yielded lack of time, contradiction between patient request and indication, nonmedical interests, and decisions between curative treatment and best supportive care as main issues for the 84 participants. Support from supervisors and senior physicians, as well as exchanges with resident colleagues were indicated as forms of relief. Professional support, such as ethics consultations, structured conversation groups (Balint), or psychological case supervisions, were rated as less helpful, although most participants reported a lack of experience with these. The results are in accordance with existing assumptions that moral distress among physicians is mainly due to uncertainty. Regarding radiation oncology residents in particular, moral distress seems to be related to uncertainty in decisions and conflicts about treatment options. Although senior physicians and supervisors present important role models in dealing with moral distress, professional services such as ethics consultations offer an opportunity for relief that can still be expanded.

The role of qualification and quality management in the prescription of antipsychotics and potentially inappropriate medication (PIM) in nursing home residents in Germany: results of the HIOPP-3-iTBX study.

Nursing home residents (NHR) show high rates of polypharmacy. The HIOPP-3-iTBX study is the first cRCT on medication optimization in nursing homes (NH) in Germany. The intervention did not result in a reduction of PIM and/or antipsychotics. This analysis looks at structure quality in the HIOPP-3-iTBX study participants. Evaluation of structure quality as part of a cluster-randomized controlled intervention study. Structure quality in multiprofessional teams from n = 44 NH (n = 44 NH directors, n = 91 family doctors (FD), and n = 52 pharmacies with n = 62 pharmacists) was assessed using self-designed questionnaires at baseline. Main aspects of the questionnaires related to the qualification of participants, quality management, the medication process and size of the facilities. All completed questionnaires were included. number of PIM/antipsychotics was drawn from the baseline medication analysis in 692 NHR. Data were analyzed by descriptive statistics and mixed model logistic regression. The presence of a nurse with one of the additional qualifications pain nurse or Zertifiziertes Curriculum (Zercur) Geriatrie in the participating NH was associated with a lower risk for the prescription of PIM/antipsychotics. No association between any characteristic in the other participants at baseline was observed. The results support the known role of nursing qualification in the quality and safety of care. Further studies need to look more closely at how use is made of the additional qualifications within the multiprofessional teams. Perspectively, the results can contribute to the development of quality standards in NH in Germany.

Perspectives of nursing home executives on collaboration with GPs and specialist palliative care teams.

Background: Nursing home (NH) staff, general practitioners (GPs) and specialist outpatient palliative care teams are expected to cooperate to ensure adequate palliative care for NH residents in Germany. Aim: The aim of this study was to investigate the perspective of NH executives concerning collaboration with GPs and specialist outpatient palliative care teams. Methods: We conducted semi-structured telephone interviews with executives of NHs in the federal state of Baden-Wuerttemberg, Germany. Interviews were analysed by means of structured content analyses. Results: Executives of 20 NHs participated in the study, eight NHs cooperate with specialist outpatient palliative care teams. Content analysis resulted in two main categories: 'general palliative care by primary carers' and 'collaboration with SAPV in NHs', each with three first-order subcategories. The main barriers to adequate palliative care were reported to be lack of palliative care knowledge in GPs and NH staff, refusal of some GPs to cooperate with specialist outpatient palliative care teams and staff shortage in NHs. Specialist palliative care involvement was described to result in improved palliative care. Conclusion: Solutions seem obvious, e.g., further education in palliative care or round tables to discuss collaboration. However, studies show that even comprehensive educational and management interventions to implement palliative care do not always result in long-term effects and further research is needed.

Actual Duration of Postgraduate Training of Medical Residents in Germany: Results of the KarMed Study Ten Years After Physician Licensure

Professional qualification as a doctor of medicine includes completion of medical studies and residency. Data on the real duration of residency are currently not assessed systematically in Germany. Our study aimed to analyze data on the real length of residency under consideration of area of expertise (specialization), part-time working, grades after school and medical studies, gender, and parenthood of the physicians in residency. The KarMed Study's database consists of annual postal surveys throughout the entire residency of medical students, beginning with their "Practical Year" in 2008/2009 until 2019. The study analyzed data six and ten years within this residency period. The majority of the residents was capable of finishing their residency within the minimal time. One significant effect on actual duration of residency was the subject choice. One-third of the female residents had not yet finished their residency after ten years. Partenhood had a significant effect on female residents, but not on male residents. A regression analysis showed (R²corr=0.03, p<0.001) that the duration of residency was associated with the grade received after studying (β=0.30). Male residents were more satisfied with the overall residency then female residents. Structural improvement in postgraduate training needs to be adjusted in terms of parental status. Prospective studies should take the selection process of universities into account and examine its association with the time required to complete residency.

Inanspruchnahme zahnmedizinischer Versorgung von Erwachsenen mit und ohne Beeinträchtigungen und Behinderungen – Ergebnisse der Studie GEDA 2014/2015-EHIS

ZusammenfassungHintergrundBeeinträchtigungen und Behinderungen können sich nachteilig auf die Mundgesundheit auswirken. Studien zur Mundgesundheit von Menschen mit Beeinträchtigungen und Behinderungen gibt es jedoch nur wenige. Dieser Beitrag untersucht die 12-Monats-Prävalenz der Inanspruchnahme zahnmedizinischer Versorgung von Erwachsenen mit und ohne Beeinträchtigungen und Behinderungen in Deutschland.MethodenDie Analysen basieren auf Daten von 23.372 Personen ab 18 Jahren mit ständigem Wohnsitz in Deutschland der Studie GEDA 2014/2015-EHIS. Die Teilnehmenden wurden gefragt, wann sie zuletzt bei einem Zahnarzt, Kieferorthopäden oder einem anderen zahnmedizinischen Spezialisten waren, um sich selbst beraten, untersuchen oder behandeln zu lassen – „vor weniger als 6 Monaten“, „vor 6 bis weniger als 12 Monaten“, „vor 12 Monaten oder länger“ oder „nie“. Für die Analysen wurden die ersten und letzten beiden Antwortoptionen zusammengefasst, um die 12-Monats-Prävalenz der Inanspruchnahme zahnmedizinischer Leistungen zu erhalten.ErgebnisseErwachsene mit Beeinträchtigungen und Behinderungen haben im Jahr vor der Befragung etwas häufiger keine zahnmedizinische Praxis aufgesucht als Erwachsene ohne Beeinträchtigungen und Behinderungen (21,5 % vs. 18,4 %; p = 0,002). Der Zusammenhang zwischen dem Vorliegen von Beeinträchtigungen und Behinderungen und einer geringeren Inanspruchnahme zahnmedizinischer Versorgung blieb aber nach Kontrolle für Alter, Geschlecht, Partnerschaft und sozioökonomischen Status nicht bestehen.DiskussionEs zeigen sich kaum Unterschiede in der Inanspruchnahme zahnmedizinischer Leistungen zwischen Personen mit und ohne Beeinträchtigungen und Behinderungen. Dennoch ist aufgrund ihrer im Mittel schlechteren Mundgesundheit zu überlegen, wie die zahnmedizinische Versorgung dieser sehr heterogenen Gruppe weiter verbessert werden kann. Die Auswertungen zeigen Versorgungsbedarfe und Präventionspotenziale auf.

Hepatitis A seroprevalence, vaccination status and demographic determinants in children and adolescents in Germany, 2014–2017, a population-based study

Children play an important role in hepatitis A virus (HAV) transmission but, due to frequent asymptomatic or mild courses, these infections are underrecognized in routine surveillance. Here, we analyzed hepatitis A (HA) seroprevalence, vaccination status and demographic determinants and estimated previous HAV infections in a cross-sectional population-based study of children and adolescents with residence in Germany 2014–2017, performing weighted univariable and multivariable logistic regression. Of 3567 participants aged 3–17 years, serological results were available for 3013 (84.5%), vaccination records for 3214 (90.1%) and both for 2721 (76.3%). Of 2721 with complete results, 467 (17.2%) were seropositive, thereof 412 (15.1%) with and 55 (2.0%) without previous HA vaccination, indicating previous HAV infection. Seropositivity was associated with age, residence in Eastern states, high socioeconomic status and migration background with personal migration experience. Participants with migration background and personal migration experience also had the highest odds ratios for previous HAV infection. Germany remains a country with very low HA endemicity. The current vaccination recommendations focusing on individuals with a high risk for HAV exposure (e.g. travelers to endemic countries) or severe disease appear appropriate. Migration and travel patterns as well as the endemicity in other countries influence the domestic situation, warranting further monitoring.