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1.
PLoS One ; 19(3): e0271848, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38466677

RESUMO

Isolating COVID-19 cases and quarantining their close contacts can prevent COVID-19 transmissions but also inflict harm. We analysed isolation and quarantine orders by the local public health agency in Berlin-Reinickendorf (Germany) and their dependence on the recommendations by the Robert Koch Institute, the national public health institute. Between 3 March 2020 and 18 December 2021 the local public health agency ordered 24 603 isolations (9.2 per 100 inhabitants) and 45 014 quarantines (17 per 100 inhabitants) in a population of 266 123. The mean contacts per case was 1.9. More days of quarantine per 100 inhabitants were ordered for children than for adults: 4.1 for children aged 0-6, 5.2 for children aged 7-17, 0.9 for adults aged 18-64 and 0.3 for senior citizens aged 65-110. The mean duration for isolation orders was 10.2 and for quarantine orders 8.2 days. We calculated a delay of 4 days between contact and quarantine order. 3484 contact persons were in quarantine when they developed an infection. This represents 8% of all individuals in quarantine and 14% of those in isolation. Our study quantifies isolation and quarantine orders, shows that children had been ordered to quarantine more than adults and that there were fewer school days lost to isolation or quarantine as compared to school closures. Our results indicate that the recommendations of the Robert Koch Institute had an influence on isolation and quarantine duration as well as contact identification and that the local public health agency was not able to provide rigorous contact tracing, as the mean number of contacts was lower than the mean number of contacts per person known from literature. Additionally, a considerable portion of the population underwent isolation or quarantine, with a notable number of cases emerging during the quarantine period.


Assuntos
COVID-19 , Adulto , Criança , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Quarentena , Berlim , SARS-CoV-2 , Busca de Comunicante/métodos , Alemanha/epidemiologia
2.
4.
Psychother Psychosom Med Psychol ; 74(2): 78-84, 2024 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-38316436

RESUMO

OBJECTIVE: The current study follows the question if psychotherapists with lived experiences of crisis and treatment address these experiences during their processes of self-experience. Further, the conceptual differentiation between self-experience and psychotherapy of this group of staff is explored. METHODS: 108 professionals with psychotherapeutic qualification were surveyed on their training self-experience. Relationships between processing of crisis experiences, crises frequency, and experienced benefit were analyzed using correlation analyses. Conceptual differences between self-experience and psychotherapy were gauged via nine content categories whose importance for self-experience and psychotherapy were rated by the participants. The means of these ratings were compared via t-test. RESULTS: Most participants reported that they had used their self-experience to process lived crisis experiences, and that they benefited from their self-experience, with processing and benefit being correlated significantly and positively. Conceptual differentiation of the two formats appeared to be complex. Participants ascribed biographical and personal categories rather to psychotherapy, and professional categories to self-experience. DISCUSSION: Given the prevalence of stigmatization towards individuals with mental health problems, it was surprising that most of the participants were able to address and process their lived experiences during their self-experience. It was surprising too that personal factors were ascribed to psychotherapy rather than self-experience, as the major importance of the therapeutic relationship and, by extension, personality development is well-known. CONCLUSION: Training self-experience should be a stigma-free setting, where future therapists are able to address their biographical burdens freely and thereby develop their personalities.


Assuntos
Hospitais Psiquiátricos , Psicoterapia , Humanos , Berlim , Psicoterapia/educação , Psicoterapeutas , Personalidade
7.
Gesundheitswesen ; 86(3): 182-191, 2024 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-38242157

RESUMO

BACKGROUND: The age-standardized application rate for medical rehabilitation services of the German Pension Insurance Association has been declining since 2009. Two of the most frequent reasons for applying for rehabilitation services represent musculoskeletal disorders and mental disorders. The aim of this analysis was to identify factors influencing the utilization of rehabilitation services in the federal states of Berlin and Brandenburg. METHODS: The explorative time series analysis is based on a research dataset of the German Pension Insurance Federation. Insured persons of the German Pension Insurance Federation from the federal states of Berlin and Brandenburg with a diagnosis of musculoskeletal disorders or mental disorders were included. Descriptive differences in targeted and prognostic parameters were calculated using chi-square and t-test statistics. Predictive parameters for the utilization of medical rehabilitation services were calculated using binary, logistic regression analyses. RESULTS: A total of 11,257 insured cases were examined. For the population of insured persons from Berlin, the use of medical rehabilitation services showed significant prognostic variables for gender, age at retirement, marital status, level of education, occupational requirement level, total accumulated earning points, gross pension level, status of a temporary pension, health insurance status, and diagnosis group. For Brandenburg, significant prognostic variables were found for age at retirement, marital status, nationality, education level, occupational requirement level, total accumulated earning points, status of a temporary pension, occupational sector, and diagnosis group. CONCLUSION: In Berlin and Brandenburg mental disorders and sociodemographic parameters are associated with an increased probability of not claiming medical rehabilitation services before the onset of reduced earning capacity. It remains to be investigated which mechanisms cause people with mental disorders to make no use of medical rehabilitation services. Future analyses should examine isolated interaction mechanisms for the utilization of medical rehabilitation services, especially in the case of existing F-diagnoses. In addition, explanations for different influencing variables between states remain to be explored.


Assuntos
Pessoas com Deficiência , Seguro , Doenças Musculoesqueléticas , Humanos , Berlim , Fatores de Tempo , Alemanha/epidemiologia , Pessoas com Deficiência/reabilitação , Pensões
8.
Rofo ; 196(1): 85, 2024 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-38163433

Assuntos
Berlim
10.
Rofo ; 196(1): 86, 2024 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-38163435

Assuntos
Berlim
11.
PLoS One ; 19(1): e0296794, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38265976

RESUMO

Acute type A aortic dissection (ATAAD) is a dramatic emergency exhibiting a mortality of 50% within the first 48 hours if not operated. This study found an absolute value of cosine-like seasonal variation pattern for Germany with significantly fewer ATAAD events (Wilcoxon test) for the warm months of June, July, and August from 2005 to 2015. Many studies suspect a connection between ATAAD events and weather conditions. Using ERA5 reanalysis data and an objective weather type classification in a contingency table approach showed that for Germany, significantly more ATAAD events occurred during lower temperatures (by about 4.8 K), lower water vapor pressure (by about 2.6 hPa), and prevailing wind patterns from the northeast. In addition, we used data from a classification scheme for human-biometeorological weather conditions which was not used before in ATAAD studies. For the German region of Berlin and Brandenburg, for 2006 to 2019, the proportion of days with ATAAD events during weather conditions favoring hypertension (cold air advection, in the center of a cyclone, conditions with cold stress or thermal comfort) was significantly increased by 13% (Chi-squared test for difference of proportions). In contrast, the proportion was decreased by 19% for conditions associated with a higher risk for patients with hypotension and therefore a lower risk for patients with hypertension (warm air advection ahead of warm fronts, conditions with no thermal stress or heat stress, in the center of a cyclone with thermal stress). As many studies have shown that hypertension is a risk factor for ATAAD, our findings support the hypothesized relation between ATAAD and hypertension-favoring weather conditions.


Assuntos
Dissecção Aórtica , Hipertensão , Humanos , Alemanha/epidemiologia , Berlim/epidemiologia , Dissecção Aórtica/epidemiologia , Tempo (Meteorologia)
12.
Viruses ; 16(1)2024 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-38257802

RESUMO

The importance of COVID-19 surveillance from wastewater continues to grow since case-based surveillance in the general population has been scaled back world-wide. In Berlin, Germany, quantitative and genomic wastewater monitoring for SARS-CoV-2 is performed in three wastewater treatment plants (WWTP) covering 84% of the population since December 2021. The SARS-CoV-2 Omicron sublineage JN.1 (B.2.86.1.1), was first identified from wastewater on 22 October 2023 and rapidly became the dominant sublineage. This change was accompanied by a parallel and still ongoing increase in the notification-based 7-day-hospitalization incidence of COVID-19 and COVID-19 ICU utilization, indicating increasing COVID-19 activity in the (hospital-prone) population and a higher strain on the healthcare system. In retrospect, unique mutations of JN.1 could be identified in wastewater as early as September 2023 but were of unknown relevance at the time. The timely detection of new sublineages in wastewater therefore depends on the availability of new sequences from GISAID and updates to Pango lineage definitions and Nextclade. We show that genomic wastewater surveillance provides timely public health evidence on a regional level, complementing the existing indicators.


Assuntos
COVID-19 , Águas Residuárias , Humanos , Berlim/epidemiologia , RNA Viral/genética , SARS-CoV-2/genética , COVID-19/epidemiologia , Vigilância Epidemiológica Baseada em Águas Residuárias , Alemanha/epidemiologia
13.
Ann Anat ; 253: 152211, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38262544

RESUMO

INTRODUCTION: The dentist's main working area is the head and neck region, which is innervated by the cranial nerves. On a daily basis, dentists must administer local anaesthesia to ensure pain-free treatment and differentiate between dental pain and neuropathies to avoid mistreatment. Therefore, neuroanatomical training, especially on the cranial nerves, is of immense importance for clinical practice. In order to adopt the curriculum, it is essential to constantly evaluate the quality of the training and to investigate whether there is a correlation between the students' performance and the relevance of the subfields to their work. MATERIAL AND METHODS: To address this issue, the results of MC exams in the neuroanatomy course for dental students at Charité-Universitätsmedizin Berlin from winter semester 2014/2015 to winter semester 2019/2020 were analysed. Each question was assigned to a specific subfield of neuroanatomy. We then compared cranial nerves and cranial nerve nuclei (clinically relevant) with the remaining subfields (clinically less/not relevant) to investigate whether students performed better in anatomy subfields that are more aligned with the clinical practice of a dentist. We also conducted an anonymous survey (n=201) of the dental students. RESULTS: From winter semester 2014/2015 to winter semester 2019/2020, students performed significantly (***, p< 0.001) better on the clinically relevant questions of the MC examination than on the less/not clinically relevant questions. However, when looking at each of the eleven semesters separately, only three semesters actually performed significantly better on the clinically relevant questions. Our survey also showed that students perceived the subfield of cranial nerves and cranial nerve nuclei to be the most relevant and studied it more intensively out of their own interest. DISCUSSION: The study showed that students perceived the subfield of cranial nerves and cranial nerve nuclei to be the most relevant. However, there was no direct correlation between student performance and clinically relevant questions. Using student performance alone as an indicator of relevance is not optimal, as factors such as motivation to learn can have a significant impact. CONCLUSION: Greater clinical relevance influences what students learn more intensively out of their own interest, but does not influence the results of the MC examination in favour of the subspecialty. Based on the available evidence, it is recommended that the structure of the neuroanatomy course be reconsidered.


Assuntos
Neuroanatomia , Estudantes de Odontologia , Humanos , Neuroanatomia/educação , Berlim , Currículo , Nervos Cranianos/anatomia & histologia
14.
Contraception ; 130: 110325, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37935352

RESUMO

OBJECTIVES: While abortion is a common medical procedure in Germany, the number of abortion-providing facilities declined by 46% between 2003 and 2022. As existing data do not paint a complete picture of the factors influencing this decline, an understanding into the perspectives of health care professionals (HCPs) is necessary. We set out to examine attitudes of HCPs in Berlin, Germany toward different aspects of abortion to identify barriers that might prevent them from providing abortions. STUDY DESIGN: We used a qualitative research design consisting of in-depth semistructured one-on-one interviews with 14 medical students and four gynecologists. We transcribed interviews verbatim and conducted qualitative content analysis. RESULTS: Many interviewees perceived abortion as a taboo and legally ambiguous intervention. They feared stigmatization when talking about or providing abortions, especially by fellow students or religious family members. Few participants objected to abortion provision on religious grounds. Some medical students underestimated the safety of abortion and overestimated the potential for side effects and complications. Medical students obtained their knowledge about abortion from various sources, such as media, religious school education, or personal experience with abortion; the topic was rarely discussed in their medical education. To decide whether to provide abortions later, many students wished for detailed abortion teaching during medical school and residency. CONCLUSIONS: Fear of stigmatization, misconceptions on abortion, and religious beliefs reduced HCPs' willingness to perform abortions. Abortion education was widely valued by medical students and could address some of the barriers to abortion provision we found in this study. IMPLICATIONS: Universities and teaching hospitals should systematically teach about abortion to counteract misinformation and help normalize abortions among HCPs. Moreover, political decision-makers should take measures in order to destigmatize abortion, like an abortion regulation outside the Criminal Code in line with international public health recommendations.


Assuntos
Aborto Induzido , Estudantes de Medicina , Gravidez , Feminino , Humanos , Ginecologista , Aborto Legal , Berlim , Atitude do Pessoal de Saúde , Aborto Induzido/educação , Alemanha , Pesquisa Qualitativa
15.
J Ment Health ; 33(1): 66-74, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36880330

RESUMO

BACKGROUND: Although mental health professionals' mental health problems are gaining increased attention, there is little systematic research on this topic. AIMS: This study investigated the frequency of crisis experiences among mental health professionals and examined how they approach these experiences in terms of their personal and social identities. METHODS: An online survey was conducted among mental health professionals in 18 psychiatric hospital departments in the German federal states of Berlin and Brandenburg (N = 215), containing questions about personal crisis experiences, help sought, service use, meaningfulness of lived experiences, causal beliefs of mental illness and psychotherapeutic orientation. Social identification was assessed via semantic differential scales derived from preliminary interview studies. To investigate relationships between the variables, explorative correlation analyses were calculated. RESULTS: Results showed a high frequency rate of crisis experiences, substantial rates of suicidal ideation and incapacity to work and high service use. Most participants regarded their experiences as meaningful for their personal identity. Meaningfulness was positively related to a psychosocial causation model of mental illness, to psychodynamic psychotherapeutic orientation and to a high degree of disidentification with users and crisis experienced colleagues. CONCLUSION: The (paradoxical) disintegration of personal and social identity of may be understood as a strategy to avoid stigmatization. A more challenging coping style among professionals is discussed.


Assuntos
Transtornos Mentais , Saúde Mental , Humanos , Berlim , Estigma Social , Transtornos Mentais/psicologia , Estereotipagem
17.
HNO ; 72(2): 90-101, 2024 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-38117331

RESUMO

BACKGROUND: The impact of the COVID-19 pandemic on potential limitations to the diagnosis and treatment of patients with head and neck tumours has not yet been adequately investigated. There are contradictory data on this subject. Data from larger patient collectives do not exist for Germany so far. OBJECTIVE: The aim of the survey was to clarify in a large cohort whether the COVID-19 pandemic had an influence on the diagnosis and treatment of patients with head and neck tumours. METHODS: A retrospective data analysis of the reporting data of the Clinical and Epidemiological Cancer Registry of Brandenburg and Berlin (Klinisch-epidemiologischen Krebsregisters Brandenburg-Berlin, KKRBB) of 4831 cases with head and neck tumours from 2018 to 2020 was performed. The period before April 01, 2020, was evaluated as a prepandemic cohort and compared with the cases of the pandemic cohort from April 1, 2020, until December 31, 2020, in terms of patient-related baseline data, tumour location, tumour stage, tumour board and treatments administered. RESULTS: No differences were observed between the prepandemic and pandemic cohorts with regard to patient-related baseline data, tumour localisation and tumour stage. Likewise, no temporal delay in diagnosis, tumour board and treatment was evident during the pandemic period. On the contrary, the time interval between diagnosis and start of therapy was shortened by an average of 2.7 days in the pandemic phase. Tumours with T4 stage were more frequently treated surgically during the pandemic compared to the period before (20.8% vs. 29.6%), whereas primary radio(chemo)therapy decreased during the pandemic (53.3% vs. 40.4%). For all other tumour stages and entities, there were no differences in treatment. CONCLUSION: Contrary to initial speculation that the COVID-19 pandemic may have led to a decrease in tumour cases, larger tumour stages at initial presentation and a delay in diagnosis and treatment, the cohort studied for Brandenburg and Berlin showed neither a delay in tumour treatment nor an increase in tumour size and stage at initial presentation. The treatments performed, however, were subject to a change in favour of surgery and it remains to be seen whether this trend will be maintained in the long term.


Assuntos
COVID-19 , Neoplasias de Cabeça e Pescoço , Humanos , Pandemias , Estudos Retrospectivos , Berlim/epidemiologia , COVID-19/epidemiologia , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/epidemiologia , Neoplasias de Cabeça e Pescoço/terapia , Teste para COVID-19
18.
Int J Public Health ; 68: 1606096, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38045993

RESUMO

Objectives: This paper presents the study design of the Berlin-Brandenburg Air study (BEAR-study). We measure air quality in Berlin and Brandenburg before and after the relocation of aircraft (AC) traffic from Tegel (TXL) airport to the new Berlin-Brandenburg airport (BER) and investigate the association of AC-related ultrafine particles (UFP) with health outcomes in schoolchildren. Methods: The BEAR-study is a natural experiment examining schoolchildren attending schools near TXL and BER airports, and in control areas (CA) away from both airports and associated air corridors. Each child undergoes repeated school-based health-examinations. Total particle number concentration (PNC) and meteorological parameters are continuously monitored. Submicrometer particle number size distribution, equivalent black carbon, and gas-phase pollutants are collected from long-term air quality monitoring stations. Daily source-specific UFP concentrations are modeled. We will analyze short-term effects of UFP on respiratory, cardiovascular, and neurocognitive outcomes, as well as medium and long-term effects on lung growth and cognitive development. Results: We examined 1,070 children (as of 30 November 2022) from 16 schools in Berlin and Brandenburg. Conclusion: The BEAR study increases the understanding of how AC-related UFP affect children's health.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Criança , Humanos , Poluentes Atmosféricos/efeitos adversos , Poluentes Atmosféricos/análise , Aeroportos , Berlim , Material Particulado/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Monitoramento Ambiental
19.
Euro Surveill ; 28(48)2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-38037727

RESUMO

BackgroundWest Nile virus (WNV), found in Berlin in birds since 2018 and humans since 2019, is a mosquito-borne virus that can manifest in humans as West Nile fever (WNF) or neuroinvasive disease (WNND). However, human WNV infections and associated disease are likely underdiagnosed.AimWe aimed to identify and genetically characterise WNV infections in humans and mosquitoes in Berlin.MethodsWe investigated acute WNV infection cases reported to the State Office for Health and Social Affairs Berlin in 2021 and analysed cerebrospinal fluid (CSF) samples from patients with encephalitis of unknown aetiology (n = 489) for the presence of WNV. Mosquitoes were trapped at identified potential exposure sites of cases and examined for WNV infection.ResultsWest Nile virus was isolated and sequenced from a blood donor with WNF, a symptomatic patient with WNND and a WNND case retrospectively identified from testing CSF. All cases occurred in 2021 and had no history of travel 14 days prior to symptom onset (incubation period of the disease). We detected WNV in Culex pipiens mosquitoes sampled at the exposure site of one case in 2021, and in 2022. Genome analyses revealed a monophyletic Berlin-specific virus clade in which two enzootic mosquito-associated variants can be delineated based on tree topology and presence of single nucleotide variants. Both variants have highly identical counterparts in human cases indicating local acquisition of infection.ConclusionOur study provides evidence that autochthonous WNV lineage 2 infections occurred in Berlin and the virus has established an endemic maintenance cycle.


Assuntos
Culex , Culicidae , Febre do Nilo Ocidental , Vírus do Nilo Ocidental , Animais , Humanos , Vírus do Nilo Ocidental/genética , Febre do Nilo Ocidental/epidemiologia , Febre do Nilo Ocidental/veterinária , Berlim/epidemiologia , Estudos Retrospectivos , Europa (Continente) , Alemanha/epidemiologia
20.
Gesundheitswesen ; 85(12): 1115-1123, 2023 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-38081173

RESUMO

INTRODUCTION: The delegation of tasks and responsibilities from general practitioners (GPs) to medical practice assistants (MPAs) can contribute to ensuring primary care in Germany. The aim of the study was to collect and analyze attitudes and procedures of GPs and MPAs regarding the delegation of physician-related tasks and activities. METHODOLOGY: A self-designed, piloted questionnaire was sent to all GPs listed within the regional Associations of Statutory Health Insurance Physicians (KV) in Thuringia, Berlin, and Brandenburg (n=5,516) and their MPAs. Participants were asked to indicate which physician-related activities were already delegated and on which occasions further delegations could be considered. RESULTS: 890 GPs (response rate: 16.1%) and 566 MPAs participated in the written survey. The participants were predominantly female and most of them worked in urban areas. Numerous activities, such as medical history taking, triage, Disease Management Program (DMP) controls, vaccinations and home visits, have already been delegated. The willingness to delegate further tasks (e. g., follow-up prescriptions and referrals, independent takeover of simple consultations, assessing the necessity of physician consultation) was high. CONCLUSION: The survey showed a high level of willingness of both occupational groups to delegate physician-related activities to MFAs. An expansion seems possible under certain conditions. Many activities have already been delegated to MPAs in primary care practices. Our survey provides suggestions regarding further tasks suitable for delegation, some of which go beyond the delegation agreement valid in Germany.


Assuntos
Clínicos Gerais , Humanos , Feminino , Masculino , Berlim , Alemanha , Inquéritos e Questionários , Atitude do Pessoal de Saúde
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