Career and Family - Are They Compatible?: Results of a Survey of Male and Female Gynaecologists in Germany.

Purpose: Nowadays, most gynaecologists are female and the compatibility of job-related career and family life is an upcoming issue. The working group "Gender and Career" of the German Society for Gynaecology and Obstetrics (DGGG) designed a survey to reflect the present situation with a focus on the compatibility of career and family. Material and Methods: A web-based 74-item survey was filled out by members of the DGGG. In total, there were 1037 replies, 75 % female (n = 775) and 25 % male (n = 261) gynaecologists. Results: 62 % of the female and 80 % of the male respondents had already finished their doctoral theses and 2 % female and 13 % male had finished their PhD. Mean number of children was 1.06 (SD 1.08) in female and 1.68 (SD 1.34) in male gynaecologists. The majority of females desired day care for their children, but only 5 to 13 % of employers offer any day care. 88 % of the female and 72 % of the male physicians think that job-related career and family are not compatible. Conclusion: The majority of female gynaecologists wished to have professional child care, but most employers or other institutions do not offer this. This might be one of the reasons why career and family appear incompatible.

[Organization of methodological support and cross-project research activities in multicenter research programmes - experiences of the centers for methodological support within the "rehabilitation science" research network]. / Organisation methodischer Beratung und projektübergreifender Forschungsaktivitäten in multizentrischen Forschungsprogrammen - Erfahrungen der Methodenzentren im Verbundforschungsprogramm Rehabilitationswissenschaften.

On completion of the funding period of six years within the federal programme for research in medical rehabilitation, an evaluative summary is given of the work performed and the experiences made in the cross-sectional projects offering methodological support. While specific research profiles had prevailed in each of the eight regional research networks, two institutions had been implemented with similar task assignments within all networks; i. e., (i) a central office, and (ii) a center for methodological support (CMS) had been available in order to enhance methodological research infrastructure and research quality of the clinical projects. This article outlines the support offered as well as further tasks of the CMS. Further, it is argued that organized, scientifically based methodological support and consultation should be part of any research network. Finally, a number of important aspects are discussed which should be taken into account to enhance research quality in medical rehabilitation in the future.

[Sensitivity to change of questionnaires measuring subjective health--results of a prospective comparative study]. / Anderungssensitivität von Fragebogen zur Erfassung der subjektiven Gesundheit--Ergebnisse einer prospektiven vergleichenden Studie.

PURPOSE: Questionnaires measuring patients' subjective health or health-related quality of life are indispensable tools for the evaluation of effects revealed by intervention studies in the field of medical rehabilitation. These patient-reported outcomes should appropriately reflect change over time. Unfortunately, "sensitivity to change" has so far not been adequately examined for German health-related quality of life questionnaires, especially not in a comparative way. Therefore, indices of sensitivity to change for three widespread generic assessment tools have been determined: IRES-3, SF-36, scales of the SCL-90-R. METHODS: A prospective comparative study was conducted in n = 1145 inpatients with orthopaedic/rheumatologic and cardiac diseases from 16 rehabilitation clinics. All patients received usual care. Their subjective health-status was assessed at two to four weeks before admission (t0), admission (t1), discharge (t2), and three months after discharge (t3). At each time point, they completed the IRES-3, SF-36, and relevant scales of the SCL-90-R. For the time interval t1-t2, Guyatt's responsiveness index (GRI) was calculated and compared across scales and instruments. RESULTS: Virtually all GRI coefficients for scales and aggregated scores, respectively, reached statistical significance. With respect to the GRI distributions of the diagnostic groups, most coefficients were located in a middle to upper range. While the results for the scales do not clearly indicate which assessment instrument should be preferred, GRI coefficients for higher aggregated scores suggest the IRES-3 to be most sensitive to change. CONCLUSION: These results can be helpful in selecting a health-related quality of life instrument or certain subscales for evaluation studies in the field of medical rehabilitation.

[Sensitivity to change]. / Anderungssensitivität.

In rehabilitation research patient questionnaires are widely used for evaluative purposes, i. e. to measure improvements or deteriorations over time. This is only possible if the questionnaires applied appropriately reflect "true" change over time, i. e. they have to be sensitive to change. The aim of this paper is to point out the importance of the "sensitivity to change" concept for evaluative assessment tools and evaluative studies, respectively, considering quality of life research as an example. Various qualitative aspects, e. g. scaling of response options of assessment tools, are covered as well as quantitative methods, i. e. study designs and indices. Furthermore, recommendations for interpretation are given.

[Comparison of mammography and automated sonography in 700 patients]. / Vergleich von Mammographie und automatisierter Sonographie an 700 Patienten.

700 patients underwent routinely x-ray mammography and breast ultrasound with an automated grey-scale breast scanner. The parenchymal pattern of the ultrasound B-scan was morphological identical to the x-ray film. The echogram gave further informations about the topographic localisation of pathologic lesions to the chest wall including the pectoral muscles. The sonogram was of no value in 10 percent due to diffuse reflection of the breast. In cystic disease the diagnostic accuracy of the ultrasound was with about 100 percent superior to that of x-ray mammography. On the contrary the accuracy of the x-ray mammography was higher than that of ultrasound in the diagnosis of benign or malignant solids. Benign adenoma smaller than 1 cm could not be definetively recognised as carcinoma of this size. The diagnostic accuracy of the sonogram was 70 percent by 40 histologically proved carcinomas. The only use of the automated scanner in the diagnostics of the breast seams to be not justified, even not as a screening method, especially because small tumors with good prognosis are not recognized, however, the ultrasound gives additional important informations in the differential diagnosis of benign and malignant lesions of the female breast.

[Sonographic determination of thyroid volume. Comparison with other methods (author's transl)]. / Sonographische Volumenbestimmung der Schilddrüse. Vergleich mit anderen Methoden.

Using ultrasound it is possible to determine the thyroid volume with a maximal error of 12%. The method is based on the electronic planimetry of a sequence of transverse ultrasound scans of the thyroid. Following this, the "slices" are added using a small computer. On 101 patients five commonly used methods of volume determination were compared with this reference technique. The volume estimation by palpation and interpretation of the scintigram as well as the volume calculation from the scintigram area or from an ellipsoid model gave maximal errors between plus or minus 82% and plus or minus 90%. The combination of scintigram area or scintigraphically determined length and width of a single thyroid lobe and the sonographically measured thickness reduced the maximal error to plus or minus 35% and plus or minus 37%. In 10 patients teh reproducibility of the reference technique was excellent and the absolute maximal error was 4.6%, even when the patients were differently positioned.