[Young Respiratory Physicians in Germany - Current Situation and Future Perspectives]. / Pneumologischer Nachwuchs in Deutschland.

BACKGROUND: Demographic changes in the society and among doctors, as well as changing attitudes towards and norms of how living should be structured are creating challenges regarding the organization of work environment in the hospital. In addition, organization of medical training is increasingly being influenced by economic considerations as well as a high level of medical specialization. We asked young respiratory physicians how they assessed their current situation with respect to quality of medical training and organization of their work environment. METHODS: From September to November 2019, we performed an online survey adressing young respiratory physicians in Germany. Participants were recruited via three emails (baseline and reminders after 2 and 6 weeks) sent by the German Respiratory Society (DGP) and the German Union of Pulmonologists (BdP). The questionnaire consisted of a maximum of 62 questions. Apart from own questions that had been aligned with other questionnaires from similar surveys in other medical specialties, we also assessed the effort-reward ratio (ER ratio) based on the short version of the effort-reward imbalance questionnaire (16 questions). RESULTS: We recuited n = 224 participants (33.8 ±â€Š4.5 years, 5.4 ±â€Š2.9 years of medical training, 54.4 % female , 86.8 % with German nationality). A little under half of the interviewees (n = 103, 46 %) reported to be very or generally satisfied with their working conditions, while n = 60 (27 %) were unsure. The main reasons for not being satisfied were long working hours and high work-load, as well as a lack of streamlining the work environment in the hospital to the specific needs of doctors. Despite the fact that many participants were satisfied, a large majority (n = 166, 88.2 %) depicted an unfavorable effort-reward ratio imbalance (adjusted mean 1.89 ±â€Š2.18). CONCLUSION: Compared to many other European countries and internationally, the German healthcare system offers high-quality patient care and a well-equipped work environment. Increasing demands in the health care sector, however, are leading to a gratification crisis that not only harms the health and work performance of doctors but is also leading to reduced attractiveness of the job that might possibly lead to the search for new fields of activity or migration. Respiratory medicine is a discipline of growing interest and motivating young doctors to secure the promotion of this discipline is increasingly important. Factors harming the growth of this discipline should be immediately addressed. The results of this survey might help leaders in the field to restructure the work environment and medical education according to the actual needs.

[Recommended actions: Reinforcing clinicians' resilience and supporting second victims during the COVID-19 pandemic to maintain capacity in the healthcare system]. / Handlungsempfehlung: Stärkung der Resilienz von Behandelnden und Umgang mit Second Victims im Rahmen der COVID-19-Pandemie zur Sicherung der Leistungsfähigkeit des Gesundheitswesens.

The term second victim describes a person involved in patient care who, due to an extraordinary patient care situation, also becomes traumatized. This phenomenon is largely unknown to the general public, although it is widespread, and is being exacerbated by the COVID-19 pandemic. Pronounced psychological strain among clinicians entails the risk of increasing pressure on the healthcare system even further. The ensuing threat to the safety of both patients and staff needs to be taken seriously. The second victim phenomenon is extensively researched and requires a two-pronged strategy. Second victims need fast, personal and confidential support within a comprehensive, easily accessible, stratified system and reinforcing clinicians' resilience is crucial. Leadership and appropriate crisis communication can sustainably support clinicians' resilience, and thus their ability to function effectively in the long term. Consequently, management can make both a short-term as well as a sustainable contribution to patient safety and therefore increasing the chances of survival for many patients during and after the COVID-19 pandemic.

[Career Prospects for Young Physicians in Infectious Diseases]. / Perspektiven für junge Ärztinnen und Ärzte in der Infektiologie.

Infectious Diseases are a cross-sectional area connected to various medical disciplines and offer interested physicians multiple working opportunities. The spectrum of infectious diseases covers both out- and inpatient care as well as basic, clinical and epidemiological research. The need for infectious diseases specialists is increasing, thus career prospects are promising. Working conditions in infectious diseases are comparatively family-friendly. With this article we intend to arouse interest for working in the fascinating fields of infectious diseases and provide information on career opportunities. Data from a recently conducted survey among members of the German Society of Infectious Diseases deliver insight, how infectious disease specialists work today.

[Work and training conditions of residents in urology in Germany : Results of a 2015 nationwide survey by the German Society of Residents in Urology]. / Weiterbildungs- und Arbeitsbedingungen urologischer Assistenzärzte in Deutschland : Ergebnisse einer GeSRU-Umfrage von 2015.

BACKGROUND: High-quality urologic residency training programs are crucial to secure both the future of our specialty and patient care. However, little is known about the current training and working conditions among German urology residents. OBJECTIVES: To comprehensively assess the training- and working conditions among urologic residents in Germany. MATERIALS AND METHODS: The GeSRU invited all German urologic residents to complete an online survey on training- and work conditions. Furthermore, the model of effort-reward imbalance (ERI) was applied to measure psychosocial strain at work. RESULTS: A total of 476 urologic residents participated in the survey. Workdays are characterized by high pace and workload and economic considerations. This comes at the cost of professional training, research and family time. Due to these circumstances, a relevant part of residents draws or at least considers consequences. Psychosocial strain among participants is high and conveys a risk for physicians' health and patients' quality of care. CONCLUSION: Our findings call for an adjustment of urologic working and training conditions to preserve high-quality medical treatment and to ensure an attractive working environment.

Skeleton Graph Matching vs. Maximum Weight Cliques aorta registration techniques.

Vascular diseases are one of the most challenging health problems in developed countries. Past as well as ongoing research activities often focus on efficient, robust and fast aorta segmentation, and registration techniques. According to this needs our study targets an abdominal aorta registration method. The investigated algorithms make it possible to efficiently segment and register abdominal aorta in pre- and post-operative Computed Tomography (CT) data. In more detail, a registration technique using the Path Similarity Skeleton Graph Matching (PSSGM), as well as Maximum Weight Cliques (MWCs) are employed to realise the matching based on Computed Tomography data. The presented approaches make it possible to match characteristic voxels belonging to the aorta from different Computed Tomography (CT) series. It is particularly useful in the assessment of the abdominal aortic aneurysm treatment by visualising the correspondence between the pre- and post-operative CT data. The registration results have been tested on the database of 18 contrast-enhanced CT series, where the cross-registration analysis has been performed producing 153 matching examples. All the registration results achieved with our system have been verified by an expert. The carried out analysis has highlighted the advantage of the MWCs technique over the PSSGM method. The verification phase proves the efficiency of the MWCs approach and encourages to further develop this methods.

Skeleton-based abdominal aorta registration technique.

Vascular diseases are the most challenging health problems in developed countries. The vascular segmentation as well as registration techniques are the topics of past and ongoing research activities. In this work we target an abdominal aorta registration technique. The developed methodology is useful in the assessment of abdominal aortic aneurysm treatment by visualizing the correspondence between pre- and postoperative Computed Tomography (CT) data. The presented approach makes it possible to match all voxels belonging to the aorta from different CT series. It is based on aorta lumen segmentation and graph matching method. To segment the lumen area a hybrid level-set active contour approach is used. The matching step is performed based on a path similarity skeleton graph matching procedure. The registration results have been tested on the database of 8 patients, for which two different contrast-enhanced CT series were acquired. All registration results achieved with our system and verified by an expert prove the efficiency of the approach and encourage to further develop this method.