Advance care planning and the parental geographical background in pediatric palliative home care: a retrospective chart review.

The relevance to acknowledge the parental migration history in pediatric palliative care is widely recognized. However, its influence on integral parts of advance care planning (ACP) is unknown. In this non-interventional cohort study, we aimed at identifying systematic differences between pediatric palliative patients with varying parental countries of origin regarding medical orders for life-sustaining treatment and the location of patients' death. Two hundred eighty-eight pediatric cases in an ambulant pediatric palliative care setting in Germany were retrospectively analyzed using multinomial logistic regression models. Agreements on medical orders for life-sustaining treatment (MOLST) differed significantly between patients with varying parental countries of origin. Full code orders for life-sustaining treatment were made more often in Turkish families than in German families. There were no significant associations between the patients' location of death and the parental countries of origin. However, confounder-analysis revealed a strong association between the patients' underlying disease and the orders for life-sustaining treatment as well as the location of death.Conclusions: Even this study indicates that the parental geographical background as an important sociocultural aspect might have an impact on ACP decisions for children and adolescents with life-limiting conditions, other factors as the patients' underlying disease can be more crucial for decision making in pediatric palliative care. The reason for the differences found might lay in cultural preferences or barriers to appropriate care. The inclusion of sociocultural aspects in decision-making is crucial to guarantee culture-sensitive, patient-centered pediatric palliative care.

Nobel Prize nominees hundred years ago: Abraham Jacobi (1830-1919) and Otto Heubner (1843-1926).

Pediatrics directly and indirectly played an important role in the history of the Nobel Prize in physiology or medicine. However, the history of the Nobel Prize and pediatrics goes beyond the actual laureates. Based on original files in the archive of the Nobel committee of physiology or medicine at the Karolinska Institute in Sweden, this overview aims to shed new light on why the international pioneers of pediatrics Abraham Jacobi (1830-1919) and Otto Heubner (1843-1926) were nominated but never received the prize in 1918. Moreover, Clemens von Pirquet (1874-1929), one of the founders of this journal in 1910 (previously known as Zeitschrift für Kinderheilkunde), also appears in the Nobel records during the first decades of the twentieth century, nominated by Heubner and others. CONCLUSION: We argue that studies of Nobel nominations give new opportunities to study not only the selection process for Nobel laureates, but also to explore which pioneers were seen as the most outstanding at a particular point in time and why. What is known? • Recent historical research suggests that Nobel Prize nominations can help to reconstruct trends in medicine over time. What is new? • This paper takes a new approach on the history of pediatrics and shows why the internationally famous pediatricians Abraham Jacobi, New York, and Otto Heubner, Berlin, were runners-up for the Nobel Prize hundred years ago.

,,Wir wollen mit den ersten Heften nicht gleich Sigerist und die Amerikaner verärgern! "

Drawing on scattered archival records this article explores the circumstances allowing the new release of the German medico-historical journal "Sudhoffs Archiv" in 1952. The article focuses on the paralyzing conditions of the publishing trade in post-1945 Germany due to a tremendous lack of resources, a growing political East-West-antagonism and the Nazi background of both authors and publishers. The article examines how academics competed for influence in the newly-structured field of German Medical History which, in the 1950s, underwent a generational change. However, former students' loyalties to their teachers remained very close resulting in a search for continuity. This became visible when, in 1952, the first postwar volume of "Sudhoffs Archiv" appeared, joining together a first part comprising of articles authored and submitted to the editors in 1943 and a second part consisting of articles submitted for the 1952 re-launch, epitomizing the missed chance for a new beginning. The examined correspondences of the new editors shed light on the protagonists' political opportunism vis-à-vis readers outside Germany and their struggle both for quality assurance in a discipline, which was deprived of its most progressive exponents as a consequence of emigration during the Nazi period, and for recognition in the international scientific community. In this complex field of conflicting interests, the journal missed a substantial and methodological reorientation in the 1950s.