Women In Germany Research Articles

Differences in the Frequency of Use of Epidural Analgesia between Immigrant Women of Turkish Origin and Non-Immigrant Women in Germany - Explanatory Approaches and Conclusions of a Qualitative Study.

Introduction: The starting point of this study was the considerably lower rate of epidural analgesia use among women of Turkish origin in Germany compared to non-immigrant women in the German Research Foundation (DFG)-funded study entitled "Perinatal Health and Migration Berlin". The study aimed to identify possible differences in the women's attitudes towards epidural analgesia. Methods: Exploratory study with semi-structured interviews, interviews lasting 17 minutes on average were conducted with 19 women of Turkish origin and 11 non-immigrant women at a Berlin hospital. The interviews were subjected to a qualitative content analysis. Results: Immigrant women of Turkish origin in Germany more frequently ascribe meaning to the pain associated with vaginal delivery. They more frequently categorically reject the use of epidural analgesia, 1) for fear of long-term complications such as paralysis and back pain and 2) based on the view that vaginal delivery with epidural analgesia is not natural. Information on epidural analgesia is frequently obtained from a variety of sources from their social setting, in particular, by word of mouth. The women in both groups stated that they would take the decision to use epidural analgesia independent of their partner's opinion. Discussion: The differences in epidural analgesia use rates observed correspond to the women's attitudes. For the immigrant women of Turkish origin in Germany, the attitude towards using epidural analgesia is based in part on misinformation. In order to enable the women to make an informed decision, epidural analgesia could receive a stronger focus during childbirth courses.

‘Discipline Your Ladies … So They Become Independent’: A Discourse on the Beginnings of Women’s Skiing in the Black Forest, Germany

The Black Forest is considered to be the cradle of skiing in Germany. In 2016, the 125th anniversary of the beginning of skiing in the Black Forest is being celebrated. Over the decades, skiing developed into a very popular sport for men and women in Germany and spread to the Alps. Presently, the German Ski Federation (Deutscher Skiverband, DSV) has over 500,000 members, about 40% being women. This paper will concentrate on the first decades of women’s skiing in the Black Forest until the First World War. To present a wider picture, in some sections, it will be necessary to relate to other parts of Germany. A special focus will be put on competitive skiing, skiing as a social event and the discourse about women’s ski clothes.

The use of proton pump inhibitors is positively associated with osteoporosis in postmenopausal women in Germany

Objectives: To analyze the association between the use of proton pump inhibitors (PPIs) and osteoporosis in German postmenopausal women.Methods: This study included 3092 women with osteoporosis and 3092 women without osteoporosis. Cases and controls were matched on the basis of age, health insurance, index year, and physician. The main outcome of the study was the risk of osteoporosis dependent on predefined risk factors. Gastrointestinal disorders potentially associated with osteoporosis were determined. The presence of PPIs including the duration of therapy was also assessed. Multivariate logistic regression models were fitted with osteoporosis as a dependent variable.Results: The mean age was 72.3 years; 5.6% of both osteoporosis patients and controls had private health insurance coverage. Gastrointestinal disorders occurred significantly more frequently in osteoporosis patients than in controls. The use of PPI drugs was also significantly more common in osteoporosis patients than in matched controls. Osteoporosis development was found to be associated with disorders of the esophagus (odds ratio (OR) 1.19, p = 0.013) and gastritis/duodenitis (OR 1.14; p = 0.045). Interestingly, the use of PPIs also led to an increase in the risk of developing osteoporosis (OR 1.62; p < 0.001). Finally, the odds of being diagnosed with osteoporosis increased with the duration of PPI therapy from 1.58 for 1 year of therapy or less to 1.72 for at least 5 years of treatment.Conclusions: The use of PPIs was a risk factor for osteoporosis and this risk increased with therapy duration in German women. Esophagus disorders and gastritis/duodenitis also increased the risk of developing this chronic condition.

Bisexual Identities among Women in Germany: A Sociological Approach toward Obstacles and Opportunities

ABSTRACTThis study explores social processes that prevent or delay and processes supporting the adoption of a bisexual identity among women who have been engaged in sexual activities with more than one gender in Germany. Starting from an interactionist perspective on sexual identities, data stemming from 12 qualitative interviews with German participants are analyzed. By citing and interpreting the narratives of interviewees, it is shown (1) how interaction partners affect bisexual labeling, (2) how bisexual identities are enacted in social surroundings, and (3) how drawing boundaries between sexual identities contributes to the process of sexual identification.

Migrant voices addressing social work: listening to Italian women in Germany

The research presented here aimed to give voice to Italian women who emigrated to Germany in the 1960s by giving an authentic account of their experiences and their coping abilities through participatory research approaches and the analysis of in-depth biographic interviews conducted 2012/2013 in the South of Germany. This type of interviewing itself often enabled the women, for the first time to reflect on their migration story, on their attachment to ‘Italy’, on their relationship with the host country, its language and culture. They usually realised late in life that an originally provisional project had become permanent. Their thinking in ‘habitual patterns’ is not to be taken as a sign of failed integration but reveals a differentiated strategy of managing the ‘in-between situation’. The higher quality of services in the host country is invariably a key factor in the decision to stay. The results indicate the benefits of recognising individual strengths in personal modes of adapting to multiple and often conflicting demands in the negotiation of multi-layered value structures. Differentiated listening skills to such voices and sensitive support strategies have far-reaching implications for both research and intervention methods in social work, and not just with migrants.

Outsourcing of Housework and the Transition to a Second Birth in Germany

The struggle that women face in reconciling their work and family roles is one of the main explanations proposed for the rapid decline in fertility rates in some developed countries. This study examines the role of the outsourcing of housework in reducing such role incompatibility and in increasing fertility among women in Germany—a country with below-replacement fertility rates, which enacted a series of large-scale schemes from the beginning of the 1990s that give incentives to households to outsource housework. Based on Goode’s role strain theory and by using data from the German Socio-Economic Panel, this study analyzed whether women who outsourced housework after the birth of their first child had a higher probability of having a second child. A survival analysis of 3990 person years demonstrates that, controlling for observables, the outsourcing of domestic labor is positively associated with a higher probability of a subsequent second birth in German women.

Education, ethnicity and gender. Educational biographies of ‘Roma and Sinti’ women in Germany

This article explores the experiences of ‘Sinti and Roma’ women in Germany with regard to their educational biographies. It draws on first results of an ongoing research project (in the context of a PhD) that brings into focus that ‘Sinti and Roma’ women in particular experience various levels of discrimination. The project tries to understand and to reconstruct how biographies of ‘Sinti and Roma’ women are shaped, taking formal and especially informal learning settings into consideration. The study will also offer some first ideas on how support for these women can be effectively organized and discrimination can be reduced. First results show that ‘Sinti and Roma’ women are facing not only specific forms of discrimination by the majority of society but are also dealing with expectations from their own families which are hard to fulfil. Nevertheless, women are often developing strategies to handle discrimination and stigmatization [Goffman, E. (1975). Stigma. Über Techniken der Bewältigung beschädigter Identität. Frankfurt am Main: Suhrkamp] and find creative ways of combining their own vision of life with life scripts imposed on them. While there is empirical evidence of processes of social exclusion, especially in the field of education, the analysis also shows the women's manifold strategies of resistance and self-realization. Especially, self-organized groups of civic engagement offer encouraging and strengthening experiences.

Potential Parenthood and Career Progression of Men and Women: A Simultaneous Hazards Approach

We analyze individual career transitions of men and women in Germany. Our particular focus is on the association of upward, downward and horizontal job changes with individual fertility. In contrast to most of the literature, we focus on potential rather than realized fertility. Based on mixed multivariate proportional hazard models with competing risks, we find a significant negative relationship between the contemporaneous probability of having a child and horizontal career transitions for women, and a positive significant association of the hazard of parenthood with upward career transitions for men. These effects persist if we apply fixed effects panel data models allowing for correlation of individual parenthood hazards with unobserved individual characteristics. Independent of their sources, our results suggest clear gender differences in the relationship between career patterns and potential fertility.

Esther and Mary: The Uneasy Jewish/Catholic Dynamic in the Work and Life of Edith Stein

The second woman in Germany to earn a doctorate in philosophy, Edith Stein, born in 1891 into a Jewish family, became a Roman Catholic in 1922, a Carmelite nun in 1933, and was killed in Auschwitz in 1942. In October 1998, she was canonized as Saint Teresa Benedicta of the Cross. From her youth, she identified as an ardent feminist, an identity she sustained throughout her life. In her prodigious postconversion philosophical and theological writings, Stein grappled with gender theories and pioneered a progressive Christian feminism that anticipated ideas articulated by Christian feminists during recent decades. Especially evident in her reverence for both biblical Esther and Virgin Mary, Stein’s writings reveal her struggle to affirm her dual Jewish and Christian identities and to integrate her phenomenological analysis of gender with her theological convictions. The resulting dilemmas highlight the creative as well as time-rooted facets of Stein’s thought.

Prevalence of uterine myomas in women in Germany: data of an epidemiological study.

Currently, no reliable data are available concerning the prevalence of uterine myomas in Germany. In this prospective study, we examined the prevalence of myomas in women older than 30years by means of vaginal ultrasound. 2296 women, who consented to the procedure, were examined by means of vaginal ultrasound for the presence of myomas in seven gynaecological outpatient departments in Germany. myomas were detected in 41.6% of all women. Age dependence: With increasing age, the prevalence of uterine myomas rose from 21.3% (30-35years) to 62.8% (46-50years). Later, the number of myomas decreased again from 56.1% (51-55years) to 29.4% in women older than 55years. Menarche/BMI: no correlation could be found between the age at first menstrual period or the body mass index and the occurrence of myomas. Parity: since the group of nulliparous women and the group of women with more than four deliveries stand out by increased occurrence of myomas, a non-linear correlation seems to exist, necessitating more in-depth discussion with regard to age dependency. The results of this study suggest that more than 40% of women over 30years of age suffered from myomas and more than 50% of all women in Germany may develop uterine myomas at some time in their life.

Laparoscopic Supracervical Hysterectomy or Myomectomy With Power Morcellation: Risk of Uterine Leiomyosarcomas. A Retrospective Trial Including 35.161 Women in Germany.

Laparoscopic Supracervical Hysterectomy or Myomectomy With Power Morcellation: Risk of Uterine Leiomyosarcomas. A Retrospective Trial Including 35.161 Women in Germany.

P08.36 Chlamydia trachomatisinfection in women in germany, 2008–2014

Background Chlamydia trachomatis (CT) infections are not reportable in Germany and limited data on CT-prevalence among women is available. In 2008 an opportunistic CT-screening programme for women Methods In September 2010 voluntary laboratory-based sentinel surveillance system was implemented and is collecting retrospective (from 2008) and prospective data on CT-tests together with information on age and test reason (TR). We calculated positivity rates (PR) by age-group and TR over years. We used Chi2 and two-sample t-test, accordingly. We estimated coverage of OCS by extrapolating the proportion of CT-tests attributable to OCS to the respective German population. Results As of 10.04.2015 data from 24 laboratories were available for analysis. Overall 93% (3,440,131) of all tests (3,701,288) were among women. Among those 24% were attributable to OCS, 36% to screening in pregnancy, 25% to diagnostic testing, and in 15% the TR was unknown. The coverage of OCS increased over time from 8% in 2008 to 11% in 2009, and 12% in 2014. PR was highest in age-groups 15–19 (6.75%) and 20–24 (5.93%) years compared to age-groups Conclusion The proportion of young women testing positive for CT is high despite gradual but slight decrease in PR among 15–24 years old women. OCS coverage in Germany is low and did not increase substantially in the last years. OCS should be promoted among the target population and physicians. Awareness campaigns for young women should be implemented. Respective regulations should be expanded and remuneration for counselling to physicians for OCS offered. Disclosure of interest statement Chlamydia trachomatis laboratory sentinel is funded by German Federal ministry of health. No conflicts of interest.

Working Pensioners in Germany and the UK: Quantitative and Qualitative Evidence on Gender, Marital Status, and the Reasons for Working

Taking paid work among men and women beyond pension age as an example, the contribution examines the interrelationship between life courses, gendered welfare regimes, and later-life employment outcomes. Using both quantitative and qualitative data, the article focuses on the role of inequalities, gender and marital status for working despite receiving a pension, and on the subjective reasons for this employment. The quantitative analyses are based on the English Longitudinal Study of Ageing (ELSA) and the German Ageing Survey (DEAS), and the qualitative evidence on semi-structured interviews with working pensioners in Germany and the UK. Gender differences in working can be traced back in part to differences in educational qualification and in pre-retirement class. Although no general gender differences in the reasons for paid employment can be found, financial reasons are mentioned much more often by divorced women in Germany and widowed women in the UK than by men and by married women. The qualitative data underlines the special role earned income plays for divorced women and, more generally, the variety of reasons which motivate pensioners to work for pay. Furthermore, pension age is less meaningful for mothers because of their patchier careers. All in all, (poor) labour market chances and household dynamics in old age are interrelated in gendered patterns of old age employment, and accompanied by specific interpretations of this work.

The Treatment of Primary Breast Cancer in Older Women With Adjuvant Therapy: A Retrospective Analysis of Data From Over 3000 Patients From the PATH Biobank, With Two-Year Follow-up.

Breast cancer is the most common cancer in women in Germany. Mortality from breast cancer has declined over the past 15 years, but less so in women aged 70 or older than in younger women. The discrepancy might be explained by age-related differences in treatment. Data from the Patients' Tumor Bank of Hope (PATH) database of women who underwent adjuvant treatment for the treatment of an invasive primary tumor without distant metastases (year of diagnosis, 2006-2011) were retrospectively analyzed. The clinical and tumor-biological findings and treatment data over two years of follow-up were compared across three age groups (under age 50, ages 50 to 69, and ages 70 and up). Chi-square tests were carried out to reveal significant differences, and post-hoc multiple comparisons were performed with and without Bonferroni correction. Treatment data were adjusted for staging and grading and tested for age-dependence with logistic regression. Follow-up data were available for 3257 (65% ) of 4981 women, of whom 61% were in the middle age group and 22% in the oldest. Compared to women aged 50 to 69, those aged 70 and up less commonly received breast-conserving treatment (68.8% vs. 86.4% ), chemotherapy (27.5% vs. 44.1% ), radiotherapy (81.8% vs. 92.4% ), and trastuzumab (52.9% vs. 79.3% ; p<0.001 for all differences). All differences remained significant after stastistical adjustment. The cause of these age-related differences is unclear. It cannot be determined from these data whether concomitant disease, the older patients' individual decisions, or other factors were responsible for their not receiving treatment as often as the younger patients did.

Does a decision aid improve informed choice in mammography screening? Study protocol for a randomized controlled trial.

BackgroundWhen invited for the first time at age 50, most women in Germany have to decide whether they wish to participate in the German mammography screening programme. For ethical reasons, screening decisions should be informed choices, but this is rarely the case with mammography screening. Decision aids are interventions with the potential to support informed choice by improving the following factors: knowledge, clarity of personal attitude, and implementation of an intention. Currently, no systematically evaluated decision aid exists for the German mammography screening programme. Therefore, the objective of this randomized controlled trial is to assess the effectiveness of a decision aid for first-time mammography screening programme invitees.Methods/DesignWe have developed a decision aid for women invited to the mammography screening programme for the first time based on the criteria of the International Patient Decision Aids Standards Collaboration. The effectiveness of the decision aid will be evaluated in a randomized controlled trial with a 3-month follow-up. We will invite 7400 women aged 50 years from the district of Westfalen-Lippe, Germany, to participate. This sample will be drawn from registration office data. The primary outcome will be informed choice. The secondary outcomes will be the components of informed choice (knowledge, attitude, decision/implementation). Decisional conflict, decision regret, eHealth literacy, health behaviours, perceived behavioural control, subjective norms, invitation status, and demographic variables will be assessed. Data will be collected online at baseline, post-intervention, and at the 3-month follow-up. Participants will be randomized to receive either the decision aid or usual care (invitation and standard leaflet of the mammography screening programme).DiscussionThis paper describes the evaluation of a decision aid for the German mammography screening programme in a randomized controlled trial. If the decision aid proves to be an effective tool to enhance the rate of informed choice, it will be made accessible to the public and the use of this decision aid for first-time invitees will be recommended. The long-term effect could be an improvement in informed choices in women invited to the mammography screening programme.Trial registrationGerman Clinical Trials Register DRKS00005176.Electronic supplementary materialThe online version of this article (doi:10.1186/s12905-015-0210-5) contains supplementary material, which is available to authorized users.

Determinants of mammography screening participation among Turkish immigrant women in Germany--a qualitative study reflecting key informants' and women's perspectives.

Mammography screening programmes aiming to reduce mortality from breast cancer are implemented in most European countries. Immigrant women are less likely to participate than women of the respective autochthonous populations in several European countries but not in Germany. Qualitative, semi-structured interviews were conducted with 16 key informants and 10 Turkish immigrant women aged 50-69 years to analyse the factors influencing their screening participation in Germany. Interviews were analysed using summarising content analysis. The Theory of Planned Behaviour was used for structuring the results. Key informants stated poor German language skills and insufficient knowledge about breast cancer and screening as factors influencing screening participation. Immigrant women demonstrated basic knowledge about screening, but their attitudes towards screening varied. Information from the invitation letter of the screening programme was often filtered by family members. Key informants tended to emphasise barriers and system-related factors while the Turkish women focused more on factors on the individual level. Contrasting both perspectives is helpful for health professionals to critically assess their own views. Measures to improve screening participation need to address not only barriers but also take women's attitudes and norms into account, thus helping women to make an informed decision.

Surgical Methods for the Treatment of Uterine Fibroids - Risk of Uterine Sarcoma and Problems of Morcellation: Position Paper of the DGGG.

The appropriate surgical technique to treat patients with uterine fibroids is still a matter of debate as is the potential risk of incorrect treatment if histological examination detects a uterine sarcoma instead of uterine fibroids. The published epidemiology for uterine sarcoma is set against the incidence of accidental findings during surgery for uterine fibroids. International comments on this topic are discussed and are incorporated into the assessment by the German Society for Gynecology and Obstetrics (DGGG). The ICD-O-3 version of 2003 was used for the anatomical and topographical coding of uterine sarcomas, and the "Operations- und Prozedurenschlüssel" (OPS) 2014, the German standard for process codes and interventions, was used to determine surgical extirpation methods. Categorical qualifiers were defined to analyze the data provided by the Robert Koch Institute (RKI), the German Federal Bureau of Statistics (DESTATIS; Hospital and Causes of Death Statistics), the population-based Cancer Register of Bavaria. A systematic search was done of the MEDLINE database and the Cochrane collaboration, covering the period from 1966 until November 2014. The incidence of uterine sarcoma and uterine fibroids in uterine surgery was compared to the literature and with the different registries. The incidence of uterine sarcoma in 2010, standardized for age, was 1.53 for Bavaria, or 1.30 for every 100 000 women, respectively, averaged for the years 2002-2011, and 1.30 for every 100 000 women in Germany. The mean incidence collated from various surveys was 2.02 for every 100 000 women (0.35-7.02; standard deviation 2.01). The numbers of inpatient surgical procedures such as myoma enucleation, morcellation, hysterectomy or cervical stump removal to treat the indication "uterine myoma" have steadily declined in Germany across all age groups (an absolute decrease of 17 % in 2012 compared to 2007). There has been a shift in the preferred method of surgical access from an abdominal/vaginal approach to endoscopic or endoscopically assisted procedures to treat uterine fibroids, with the use of morcellation increasing by almost 11 000 coded procedures in 2012. Based on international statements (AAGL, ACOG, ESGE, FDA, SGO) on the risk of uterine sarcoma as an coincidental finding during uterine fibroid surgery and the associated risk of a deterioration of prognosis (in the case of morcellation procedures), this overview presents the opinion of the DGGG in the form of four Statements, five Recommendation and four Demands.

Disability-adjusted life years lost due to diabetes in France, Italy, Germany, Spain, and the United Kingdom: a burden of illness study.

AimsTo compare the burden of disease (BoD) attributable to diabetes expressed in disability-adjusted life years (DALYs) for five European countries in 2010.MethodsDALYs lost to diabetes as the sum of years of life lost and years lived with disability were estimated by sex and age using country-specific epidemiological data and global disability weights. Data from various secondary sources were combined to estimate health loss due to diabetes for France, Germany, Italy, Spain, and the UK. National statistical databases were used and if necessary, community studies were used to derive the prevalence of diabetes by sex and age group, which were weighted proportionately for a national population burden of disease estimate. All identified data were adapted to the Global Burden of Disease methodology (2010) to calculate the burden attributable to diabetes. No age weighting and discounting was applied. Sensitivity to different sources of variation was examined. Germany and Italy lost the largest number of DALYs due to diabetes, with 5.9 and 5.8 per 1,000 inhabitants, respectively, followed by Spain (4.4), France (3.7), and the UK (2.9). The highest burden was caused by mortality due to diabetes, with the exception of the UK, for which the burden due to disability of diabetes was higher. Mean DALYs lost were higher for women in Germany, Italy, and Spain and shown to increase with age for all countries. Sensitivity analysis in variation in disability weights and uncertainty in epidemiological data were shown to have effects on DALYs lost.ConclusionIn spite of data limitations, the estimates reported here show that DALY loss due to diabetes imposes a substantial burden on countries. Cross-national variation in disease epidemiology was the largest source of variation in the burden of diabetes between countries.

Living longer, working longer: the need for a comprehensive approach to labour market reform in response to demographic changes.

Increases in life expectancy over the last decades have been among the most salient reflections of changes in the quality of life in the developed world. In Germany, in 1990, the average life expectancy for men and women was, respectively, 72 and 79, while in Italy men could expect to live 74 years and women 80. By 2012, these numbers changed by about 6 years for men and 4 years for women in Germany and by 6 and 5 years in Italy. Substantial increases in life expectancy have been recorded in all EU countries, from Portugal to Estonia and from Cyprus to Norway. This growth reflects unequivocal success of medicine and health care provision and fundamental changes in the quality of life and lifestyle, and offers new opportunities for the growing groups of older populations. However, when set against very low birth rates and low levels of economic growth, the increases have also called into question the financial sustainability of social security and public health care systems, and the potential generosity of welfare support for large groups of the population. It has long been recognised that increases in life expectancy, and the slower but equally important growth of healthy life expectancy, must be matched by adaptations of eligibility for public retirement pensions and by extended labour market activity. Continued economic development requires that increased proportions of the 50, 60 and 70 year olds be involved in the labour market, and that living longer be accompanied by working longer. There seems to be broad agreement that the process of extending working lives needs to involve all of the key stakeholders, i.e. both workers and their employers with an important supportive role of the government in areas of potential market failures. It also requires a comprehensive approach that combines labour market and retirement policies with tax policy and public health and welfare reforms. The demographic changes that are occurring before our very eyes offer new opportunities for older individuals, insofar as many of them continue to enjoy healthy and active lives. At the same time these changes also present substantial challenges for many individuals who find themselves faced with new requirements at the workplace and difficult choices concerning care duties for older family members or support expectations among younger generations. It seems clear that as the proportion of the 50? in the population grows, it becomes ever more important to understand the mechanisms which affect the quality of life of these groups of the population and which drive individual decisions in different areas of life, including activity in the labour market. Fortunately, as new survey and administrative data on older populations become available at national and international levels, researchers can examine the causes behind observed variation in different outcomes and they can address increasing number of key questions of academic and policy relevance. The labour market activity of older people is the focus of the special section in this issue of the European Journal of Ageing, with each of the four articles in the section making its contribution to the current debate on increasing working lives. As argued by Sonnet et al. (2014), for example, this debate, apart from reforming retirement systems, has to address such areas as rewarding work, changing employer practises and improving employability of workers. The four papers in the special section fit well within this framework. Dal Bianco et al. (2014) and Achdut et al. (2014) examine different factors behind retirement Responsible editor: H. Litwin.

Changes in Variability and Flexibility of Individual Travel in Germany

Are daily life and daily travel behavior in Germany more flexible today than it was 10 to 15 years ago? Against the background of an increasing use of information and communication technologies (ICT) and the question of that impact on daily life, this paper analyzes changes in the variability of travel behavior. The paper examines the data from individual travel diaries of a whole week covering a longitudinal perspective over 15 years. These two dimensions of information allow for more detailed evaluation of variability profiles. The analyses were based on traditional key values of daily travel as well as new customized measures of individual variability in travel behavior in the course of a whole week. The paper investigated the temporal development by sociodemographic group. The results show that travel behavior patterns of young men and woman in Germany are becoming more similar. The young age group drives several trends, including multimodality. However, at the same time, young men are shifting their leisure habits toward more home-located activities; this effect is possibly partly induced by the influence of ICT.