[Violence Against Staff in Delivery Rooms - Results of an Online-Survey and Structured Interviews in Obstetric Clinics in Berlin]. / Gewalt gegen Kreißsaalpersonal ­ Ergebnisse einer Online-Befragung und von Leitfadeninterviews an Berliner Geburtskliniken.

INTRODUCTION: Violence against medical staff is a known problem in emergency departments. Nevertheless, there is little empirical data about physical and verbal violence against staff members in delivery rooms in Germany. METHODS: This study comprises both quantitative and qualitative analyses. For the quantitative part, midwives and doctors working in delivery rooms in Berlin were asked to fill out a questionnaire about their experiences with violence within the last 6 months; this survey was completed between 15 November 2019 and 15 February 2020. For the qualitative part, structured interviews were conducted to investigate individual experiences of violence in more detail. RESULTS: Out of 173 participants in total, 148 (86%) reported to have experienced verbal violence and 82 (47%) reported to have experienced physical violence. Midwives and younger staff seem to be more often affected by violence. 70% of the participants did not feel sufficiently prepared for situations of violence. In a total of 36 interviews, the participants specifically named communicative problems, too high expectations of the pregnant women and their companion, as well as language barrier and cultural differences as reasons for furthering violence. CONCLUSION: Violence against staff is a relevant problem in delivery rooms in Berlin. Participants would welcome training to deal with violence and professional help for coming to terms with experiences of violence. Improved information about pregnancy and delivery, institutionalized translation, and more staff could possibly help to decrease frequency of violence.

The role of education and migration background in explaining differences in folic acid supplementation intake in pregnancy: results from a German birth cohort study.

OBJECTIVE: Official German recommendations advise women to start taking folic acid supplementation (FAS) before conception and continue during the first pregnancy trimester to lower the risk of birth defects. Women from lower socio-economic background and ethnic minorities tend to be less likely to take FAS in other European countries. As little is known about the determinants of FAS in Germany, we aimed to investigate the association between FAS and formal education and migration background, adjusting for demographic factors. DESIGN: We used data (2013-2016) on nutrition and socio-economic and migration background from the baseline questionnaire of the BaBi cohort study. We performed multivariate regressions and mediation analyses. SETTING: Bielefeld, Germany. PARTICIPANTS: Nine-hundred forty-seven women (pregnant or who had given birth in the past 2 months). RESULTS: 16.7% of the participants (158/947) did not use FAS. Migration-related variables (e.g. language, length of stay) were not associated with FAS in the adjusted models. FAS was lower in women with lower level of formal education and in unplanned pregnancies. Reasons given by women for not taking FAS were unplanned pregnancy and lack of knowledge of FAS. CONCLUSIONS: Health practitioners may be inclined to see migrant women as an inherently at-risk group for failed intake of FAS. However, it is primarily women who did not plan their pregnancy, and women of lower formal education level, who are at risk. Different public health strategies to counter low supplementation rates should be supported, those addressing the social determinants of health (i.e. education) and those more focused on family planning.

General practitioners using complementary and alternative medicine differ from general practitioners using conventional medicine in their view of the risks of electromagnetic fields: a postal survey from Germany.

OBJECTIVE: General practitioners (GPs) play a key role in consulting patients worried about health effects of electromagnetic fields (EMF). We compared GPs using conventional medicine (COM) with GPs using complementary and alternative medicine (CAM) concerning their perception of EMF risks. Moreover, we assessed whether the kind of alternative medicine has an influence on the results. METHODS: A total of 2795 GPs drawn randomly from lists of German GPs were sent an either long or short self-administered postal questionnaire on EMF-related topics. Adjusted logistic regression models were fitted to assess the association of an education in alternative medicine with various aspects of perceiving EMF risks. RESULTS: Concern about EMF, misconceptions about EMF, and distrust toward scientific organizations are more prevalent in CAM-GPs. CAM-GPs more often falsely believed that mobile phone use can lead to head warming of more than 1°C (odds ratio [OR] = 2.2, 95% confidence interval [CI] = 1.5-3.3), more often distrusted the Federal Office for Radiation Protection (OR = 2.2, 95% CI = 1.4-3.6), were more often concerned about mobile phone base stations (OR = 2.4, 95% CI = 1.6-3.6), more often attributed own health complaints to EMF (OR = 3.2, 95% CI = 1.8-5.6), and more often reported at least 1 EMF consultation (OR = 2.5, 95% CI = 1.6-3.9). GPs using homeopathy perceived EMF as more risky than GPs using acupuncture or naturopathic treatment. CONCLUSION: Concern about common EMF sources is highly prevalent among German GPs. CAM-GPs perceive stronger associations between EMF and health problems than COM-GPs. There is a need for evidence-based information about EMF risks for GPs and particularly for CAM-GPs. This is the precondition that GPs can inform patients about EMF and health in line with current scientific knowledge.

The views of primary care physicians on health risks from electromagnetic fields.

BACKGROUND: The aim of this study was to find out what primary care physicians in Germany think about the possible health risks of electromagnetic fields (EMF) and how they deal with this topic in discussions with patients. METHODS: Questionnaires were mailed to a nationwide, representative sample drawn from the regional associations of statutory health insurance physicians in Germany, consisting of 2795 primary care physicians (7% random sample of the total number in the country). 435 of them returned four-page questionnaires (response rate, 23.3%), and 456 returned a one-page questionnaire (response rate, 49.1%). They were asked about their views on the health risks of electromagnetic fields and about their experience with patients on this topic. RESULTS: 61.4% of the primary care physicians reported having discussed the possible health risks of electromagnetic fields with at least one patient. In 73.4% of these discussions, the patient raised the subject first and presumed that such risks do, in fact, exist. Among all discussions in which the patient expressed this concern, the physician considered the association to be plausible only 24.1% of the time. In half of all consultations in which EMF was discussed as a possible danger, the physician recommended some type of protective measure. The most frequent recommendation was to remove electrical equipment; the second most frequent, to move to another location. The physicians' answers to the questionnaires revealed a poor knowledge of the properties and risks of electromagnetic fields. CONCLUSION: Primary care physicians often discuss the putative health risks of electromagnetic fields with their patients, yet their recommendations very often are not evidence-based and might have major consequences in their patients' lives.