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PubMed1998

[Dog tourism and import: an inquiry in Germany on the extent as well as on the spectrum and preference of countries of residence and origin respectively].

A survey was conducted among practicing veterinarians and at pet clinics in Germany in order to estimate the extent of tourism with dogs and import of dogs and to determine the range and preference of the foreign countries involved. The survey covered the years from 1985 to 1995 and included 5240 dogs, of which 4567 (87.2%) were born in Germany and 673 (12.8%) were born abroad. Among the latter, 263 (39.1%) originated from Mediterranean countries and Portugal, 344 (51.1%) were born in other European countries and 66 (9.8%) were from non-European countries. Of all 5240 dogs surveyed, 2894 (55.2%) had been taken abroad at least once between 1985 and 1995. Of these, 2424 (53.1%) were born in Germany, 470 (69.8%) were born abroad. Of the 2894 dogs taken abroad, 1929 (66.7%) travelled to Mediterranean countries or Portugal and 1152 of these had additional travels to other countries as well. The spectrum of all countries travelled to was very broad, but numerous dogs were taken regularly, repeatedly and exclusively to Austria, Switzerland, Italy, Spain or France. Other countries were visited only once for the majority of dogs. The analysis of the annual survey data revealed a steady increase of dogs along on trips from Germany to other countries, rising from 31.1% in 1990 to 40.8% in 1994. In any of these years, always more than 56% of these dogs were taken to Mediterranean countries.

Africa↗
PubMed1994

[Migration from East to West Germany: intention and realization. A sequential probit model with unobserved heterogeneity controls].

"This study investigated migrations from eastern to western Germany. Using a sequential decision model we first examined which persons expressed the intention of wanting to move from eastern to western Germany. Then, using unobserved heterogeneity controls we determined at the same time which persons of those willing to move actually did so later.... Once the intention to move has been declared...those who are well-qualified, short-time workers and persons who feel threatened by unemployment as well as persons with relatives in western Germany more often than average do in fact realise this intention. Commuters also have a very high rate of realisation." (SUMMARY IN ENG AND FRE AND RUS)

Behavior↗
PubMed1991

Mortality in the two Germanies in 1986 and trends 1976-1986.

"Mortality data of the Federal Republic of Germany and the GDR [German Democratic Republic] are compared by age, sex and cause of death....Within the period from 1976 to 1986 life expectancy has risen in the Federal Republic of Germany, whereas in the GDR it increased to a minor extent only, so that the gap between the two parts of Germany has clearly enlarged. This enlarged gap in life expectancy largely depends on a higher mortality in the GDR due to diseases of the circular system and the respiratory organs, external influences and 'other' causes of death. The last-mentioned two groups also 'contain' the normally [separately] reported causes of death 'cirrhosis of the liver', 'suicide', 'accidents', and some diseases of the digestive system." (SUMMARY IN FRE)

Age Factors↗
PubMed2005

[Animal welfare aspects regarding the raising of breeding ostriches in Germany].

The commercial housing of African Ostriches in Germany for the breed and meat production still represents a disputed topic under the criterion of the animal's welfare. Above all critics state that the frequently wet-cold weather in Germany impairs the well-being and health of the animals. So far however there are just a few scientifically documented data about requirements for housing conditions of ostriches in Central Europe and thus hardly answers whether housing in Germany is possible under the criteria of the animal's welfare. This study tried to evaluate ostrich housing under South German climatic conditions (Rhine level), on the basis of behavioral observations of breeding ostriches. The use of the stable and the influence of different climatic parameters on the behavior were considered. In addition the behavior of 18 adult animals in 5 breeding groups from January to December 2002 was observed. Parallel various climatic data were raised. The housing of the animals took place in open stables with unrestricted pasture possibility. The ostriches reacted in their behavior to different climatic conditions. Particularly at cold weather and adverse soil conditions they used the open stable increasingly as weather protection. In addition, with increased wind velocities the animals spent more time in the stables. The daily amount of precipitation showed no influence on the frequency or duration of the stable use. Rainfall did not animate the animals to look for protection within the stable, but more to set itself on the ground in the external enclosure. The locomotion activity of the animals was strongly in dependence to the reproduction time and the territorial behavior and therefore highest in spring. On cold days the animals performed their reproduction behavior mainly in the stable. For the comfort behaviour distinct weather dependence was seen particularly for sand bathing. Warm temperatures and dry sand were the preconditions for it. Regarding the results it seems, that with the conditions existing on the examined farm, housing of ostriches under respect of animal welfare in Germany is possible. New regulations are to be demanded, adjusted to the newest level of knowledge about ostrich husbandry, with requirements for care, support, accommodation and nutrition of the animals as well as about the qualification of the owners. An occasional hobby animal husbandry limited to few single ostriches is to be rejected. Further scientific investigations at other farms, possibly also under variable climatic conditions are however necessary.

Animal Welfare↗
PubMed2000

Political change and course of schizophrenia in East Germany, 1984-1994.

BACKGROUND: We tested the hypothesis that the political change occurring in East Germany after the fall of the Berlin Wall in November 1989 affected patients with long-term schizophrenia, resulting in more and longer hospitalisations. METHODS: In two samples in East Germany (120 patients in East Berlin, 70 patients in Chemnitz) and in a control group from West Berlin (40 patients), hospitalisations for each month between November 1984 and October 1994 were assessed. Each sample included all schizophrenia patients who were in continuous treatment in the given community mental health centre throughout the full observation period. RESULTS: Hospitalisation indices were not higher after November 1989 than before in any of the groups. CONCLUSIONS: There is no evidence that political change in East Germany negatively affected the course of longterm schizophrenia as assessed by hospitalisations. If consistent medical care is provided, characteristics of the political system may have less impact on the course of schizophrenia than is sometimes assumed.

Adult↗
PubMed2005

Seroprevalence of herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) in former East and West Germany, 1997-1998.

The aim of this study was to investigate the seroprevalence of herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) in representative samples of the total former East German (FEG) and total former West German (FWG) populations. Type-specific testing with the HSV-1 (gG1) and HSV-2 (gG2) indirect ELISA was performed on an age- and sex-stratified random subsample of 3,792 sera collected during the 1997-1998 German National Health Survey. Weighted seroprevalence estimates were calculated for the total FEG and FWG populations. The overall age-standardised seroprevalence of HSV-1 was 82.6% in Germany, 85.5% (95%CI, 83.4-87.3%) in FEG and 81.8% (95%CI, 79.9-83.6%) in FWG. The overall seroprevalence of HSV-2 was 13.3% (95%CI, 11.8-14.9) in Germany, 16.5% (95%CI, 14.1-18.9) in FEG and 12.6% (95%CI, 10.7-14.5%) in FWG. The difference between FEG and FWG was largely due to the significantly higher age-adjusted seroprevalence of HSV-1 and HSV-2 in women (but not men) in FEG as compared to FWG. The HSV seroprevalence estimates in this study are consistent with results of previous less representative seroprevalence studies in Germany. Differences in HSV-2 seroprevalence between FEG and FWG suggest differences in sexual behaviour that warrant further investigation.

Adolescent↗
PubMed2003

Post-diagnostic abortion in Germany: reproduction gone awry, again?

Routine use of prenatal diagnostic technologies (PDTs) such as ultrasound and amniocentesis result in the detection of a small percentage of fetal anomalies. For those women faced with the diagnosis of fetal disability, a decision must be made to continue or terminate the pregnancy. When the diagnosis is merely hypothetical, the discursive specter of post-diagnostic abortion is shaped by social and historical contexts in which interested discourses (regional, political, ethical, and religious) weigh in with varying degrees of authority and influence. However, when the diagnosis is actual, in this sample population of women, an estimated minimum of 90% opt to terminate their pregnancies. Data collected at two German hospitals-one in former East Germany, one in former West Germany-illuminate rates of PDT use and provide data with which to discuss the specter of post-diagnostic abortion in relation to mainstream medical discourses, Germany's divided history, abortion politics, feminism, disability activism, and religion. These data demonstrate how reproductive discourses are shaped by ideological and historical contingencies, even when women's ultimate reproductive decisions are not.

Abortion, Eugenic↗
PubMed2002

What is palliative care in Germany? Results from a representative survey.

The recent development of palliative care inpatient units in Germany has been impressive. As a first step for quality assurance, a core documentation form was developed in 1996. The core documentation form consisted of 4 pages with 35 items documenting physical and psychosocial symptoms at the time of admission, diagnostic and therapeutic procedures before and during inpatient treatment, and outcome of physical and psychosocial dimensions. Checklists were used for most items and free text entries could be added. Of the 65 palliative inpatient units in Germany, 44 participated in the second phase of the evaluation of the core documentation in 2000. Eight units were affiliated with anesthesiology departments, 31 with internal medicine, two with radiotherapy, 1 with a surgical department, and 2 units were not affiliated with a department of the hospital. A total of 1087 patients were assessed in the 44 units during a period of up to 3 months. There was a high variability between units in all checklist items of the core documentation. Compared to units affiliated with internal medicine departments, units affiliated with anesthesiology departments performed less chemotherapy, but more immunotherapy; gave fewer infusions and blood transfusions but more skin and wound care, and more lymphatic drainage and massage; and documented psychosocial interventions more frequently for patients as well as for relatives. In one-third of the patients, a consent for omission of therapeutic options was documented. Inpatient treatment ended with the death of the patient in 45.3% of patients and with discharge in 51.6% (not documented 3.1%). The efficacy of inpatient treatment was rated very high by the staff. In conclusion, we found large variation in the documentation pertaining to palliative care patients at the time of admission, as well as for inpatient treatment, among palliative care units in Germany. This was related to the affiliation of the units at least to some degree, but also to differences in interests and documentation discipline. We suggest that training procedures for documentation should be included in crossectional surveys, as the results may not be comparable otherwise. However, common documentation instruments may be the first step towards an interdisciplinary discussion on aims and methods in palliative care.

Data Collection↗
PubMed1991

Healthcare for a new Germany: the West and East German health systems and their unification process.

One of the new Germany's many challenges will be merging a socialist, centralized healthcare system with a decentralized network much like our own. Both Germanys' health services have clear pluses and minuses, and while preserving the best of each may not be completely possible, it is not as remote a goal as one might think. With a summary of the pre-unification East and West health systems, the authors map out Germany's healthcare options.

Delivery of Health Care↗
PubMed2000

Permanent pacemaker therapy before and after the reunification of Germany: 16 years of experience at an East German regional pacing center.

The reunification of Germany had a significant influence on the management of patients with bradyarrhythmias. The current study was performed in a regional pacing center located in the former German Democratic Republic. It compares the situation of patients with critical bradyarrhythmias before and after the reunification of Germany in 1990 focusing on (1) indication for pacemaker implantation, (2) pacemaker modalities and function, (3) type of leads, (4) frequency of reintervention, and (5) early and late complications. The study covers 9 years before and 7 years after the reunification. A total of 1,125 patients were included, and the database was formed by the patients' files and the protocols of implantation. The situation before reunification was characterized by a nonavailability of modern physiological pacing devices and insufficient diagnostic equipment. Between 1981 and 1990, 384 patients underwent pacemaker implantation solely receiving single chamber devices with no or only minimal feasibility of programming. Between 1990 and 1996, 741 patients were treated, and they all received modern pacemakers having the capability of multiprogramming and telemetry. Regarding complications of pacemaker therapy, lead related problems significantly decreased after the reunification (dislocation, 5.3% vs 1.7%, P < 0.05; exit block, 6.7% vs 1.4%, P < 0.05) opposite to pacemaker infections, which significantly increasing after dual chamber pacemakers were implanted (2.2% vs 6.0%, P < 0.05). The reunification of Germany dramatically improved the situation of patients with critical bradyarrhythmias leading to free access to high-tech pacing equipment within a few months. However, the abrupt change from antiquated to modern pacemaker therapy created some new problems, especially regarding application and handling of modern physiological pacing devices.

Equipment Design↗
PubMed1995

Drug-resistant tuberculosis in northern Germany: a retrospective hospital-based study of 1,055 patients from 1984 until 1993.

For the past decade, there have been no data on the time course of drug resistant tuberculosis and on risk factors for drug resistance in former West Germany. We reviewed the medical records of all patients with positive cultures for Mycobacterium tuberculosis from 1984 until 1993 in a hospital near Hamburg. Drug-susceptibility testing was performed for isoniazid, rifampicin, ethambutol, and streptomycin, using the modified proportion method. Of 1,055 patients, 9.6% had isolates resistant to one or more drugs. Of the isolates, 5.8% showed resistance to isoniazid or rifampicin and 1.8% to both isoniazid and rifampicin. There was no significant change of the resistance rate during the study period. Twenty six percent of 89 patients from South America, Africa or Asia had isolates resistant to one or more drugs, compared with 7.6% of 799 patients born in Germany (odds ratio (OR) 4.2; 95% confidence interval (95% CI) 2.5-7.3). Among patients born in Germany, 32% of 101 patients with a history of prior anti-tuberculosis drug therapy had resistant organisms, versus 4.2% of 698 patients without prior therapy (OR 10.7; 95% CI 6.1-18.7). Resistance rates for 35 patients, who had been treated within the last 5 yrs, and for 65 patients, who had been treated more than 5 yrs ago, were 57 and 17%, respectively (OR 6.6; 95% CI 2.9-16.6). Our results suggest that there is no increase in the proportion of drug-resistant tuberculosis in our hospital, and that patients with a recent history of antituberculosis drug therapy and patients from South America, Africa, or Asia are at high risk for drug resistance.

Adult↗
PubMedDate not supplied

Nutritional behaviour differences in Germany.

East- and west-German health inequalities that emerged in the 1960s and 1970s centered not only on cardiovascular mortality but also on lifestyle-dependent risk factors, thus a question that should be addressed is whether different dietary behaviours existed in the two sections of Germany. To answer this question, we examined two random-sample population surveys--MONICA in the east and VERA in the west--that were carried out during the late 1980s. In the eastern section of Germany, the consumption of milk, vegetable oil and fat, fresh vegetables and tropical fruits was much lower than that in the west, whereas the intake of sausages and butter was much higher. Consequently, the calorie intake in the east was higher for fat and lower for carbohydrates before reunification. Changes in dietary habits were anticipated in East Germany after reunification because of important changes in the food supply. Analysis of an east-German dietary survey that was carried out after the wall came down revealed that the improved food supply to the east, with more choices for planning a healthy diet, led to a favourable development in both macro- and micro-nutrient intake, more carbohydrates, vitamins, calcium, and potassium were consumed.

Adult↗
PubMedDate not supplied

The epidemiology of atopic diseases in Germany: an east-west comparison.

This review summarizes studies comparing the epidemiology of asthma, allergic rhinitis, and atopic dermatitis in eastern versus western German populations. These studies clearly revealed that the prevalence of physician-diagnosed allergic rhinitis was higher in western Germany than in eastern Germany. The rate for asthma also tended to be higher in western than in eastern populations, whereas a tendency for less atopic dermatitis was found in western German children. When sensitization rates, as measured by RAST and skin-prick tests, were compared, a clear increase was found in western versus eastern young-adult German populations. This phenomenon may be related to exposure to different allergens, such as those associated with nutritional patterns or pet ownership, as well as to different environmental factors, such as outdoor and indoor pollutants. If lifestyle or environmental factors play a role in developing allergic sensitization, then one would expect the rates of sensitization in eastern and western Germany to converge as the two societies become more similar.

Adolescent↗
PubMed1999

Trends in allergies among children in a region of former East Germany between 1992-1993 and 1995-1996.

A lower prevalence of asthma and allergies has been reported among children and adults living in the area of former East Germany compared with those living in West Germany. After German reunification in 1990, the East German population rapidly adopted a western lifestyle. Therefore, this study examined if the prevalence rates of allergic diseases, symptoms, and sensitisation and asthma have increased among East German children since German reunification. - Children aged 5 to 7 years living in the region of Sachsen-Anhalt, East Germany were examined in two cross-sectional studies during 1992-93 (n = 769, response rate 84.0%) and 1995-96 (n = 725, response rate 74.6%). Sensitisation was assessed by specific immunoglobulin E measurements against five common aeroallergens using the CAP-FEIA technique. After adjustment for sex, parental education, season of examination, day care attendance, breast feeding, environmental tobacco smoke exposure, cat dander exposure, and several indoor factors, an increase in the prevalence of self-reported, physician-diagnosed allergies (OR 1.44, 95% CI 1.01-2. 06), but not in allergic sensitisation (OR 0.85, 95% CI 0.62-1.16) was found. The only evidence of an increase in allergies of the self-reported increase in the prevalence of physician-diagnosed allergies is likely due to changes in physician diagnostic patterns and the heightened public awareness of allergic diseases. - In conclusion, there were no significant changes in the prevalence of asthma, allergic rhinitis, or self-reported symptoms of allergic diseases.

Adult↗
PubMed1999

Lung cancer risk in male workers occupationally exposed to diesel motor emissions in Germany.

BACKGROUND: Although in several epidemiological studies exposure to diesel motor emissions (DME) shows an elevated lung cancer risk, it is still controversial whether DME is a human carcinogen. METHODS: In a pooled analysis of two case-control studies on lung cancer in Germany a total of 3498 male cases with histologically or cytologically ascertained lung cancer and 3541 male population controls were included. Information about lifelong occupational and smoking history was obtained by questionnaire. Drivers of lorries, buses, taxies, diesel locomotives and forklift trucks, bulldozers, graders, excavators, and tractors, were considered as exposed to DME and their cumulative exposure was estimated. All odds ratios were adjusted for smoking and asbestos exposure. RESULTS: The evaluation of lung cancer risk for all jobs with DME-exposure combined showed an odds ratio of OR=1.43 (95%-CI: 1.23-1.67). Most pronounced was the increase in lung cancer risk in heavy equipment operators (OR=2. 31 95%-CI: 1.44-3.70). The risk of tractor drivers increased with length of employment and reached statistical significance for exposures longer than 30 years (OR=6.81, 95%-CI: 1.17-39.51). The group of professional drivers (e.g., trucks, buses, and taxies), showed an increased risk only in West Germany (OR=1.44, 95%-CI: 1. 18-1.76), but not in East Germany (OR=0.83, 95%-CI: 0.60-1.14). DME-exposure in other traffic related jobs (e.g., diesel engine locomotive drivers, switchmen, forklift operators) was associated with an odds ratio of OR=1.53 (95%-CI: 1.04-2.24). CONCLUSIONS: The study provides further evidence that occupational exposure to diesel motor emissions is associated with an increased lung cancer risk.

Aged↗
PubMed1996

Immigrants, Germans and national identity in the new Germany: some policy issues.

"This paper considers how the role and status of Germany's diverse immigrant population has been affected by its new geopolitical situation, in particular unification, since 1989.... The paper shows how the integration prospects for Germany's older immigrant populations have been dented by the combination of economic restructuring and a huge upsurge in new types of immigration. Prominent among the latter are ethnic German resettlers (or Aussiedler), and the paper examines how these immigrants find themselves in a weak position.... The paper concludes that, although there would appear to be no major labour shortages within the economy, Germany has to develop a more extensive range of migration policies to cater for the huge demand for economically motivated migration. The alternative will inevitably be a further growth in illegal migration, which would not be helpful to the position of established immigrant populations."

Acculturation↗
PubMed2000

Patterns of care for patients with primary differentiated carcinoma of the thyroid gland treated in Germany during 1996. U.S. and German Thyroid Cancer Group.

BACKGROUND: To determine current patterns of care and disease characteristics for patients with thyroid carcinoma, a Patient Care Evaluation Study was initiated in 1996 in the U.S. and Germany. This project addresses ongoing concerns with respect to the diagnostic evaluation and treatment of patients diagnosed with thyroid carcinoma and raises questions concerning how physicians are interpreting current standards and acting on the basis of these recommendations. METHODS: Patients with primary thyroid carcinoma were entered into a prospective multicenter observational study with free choice of treatment (no control group) between January 1, 1996 and December 31, 1996 in Germany. This resulted in a total of 2537 cases under observation and analysis; 1685 patients had papillary carcinoma (66.4%), 691 had follicular carcinoma (27.2%), 70 had medullary carcinoma (2.8%), and 91 had anaplastic carcinoma (3.6%). The 2376 patients with carcinoma of either papillary or follicular histology were included in the current analysis. RESULTS: The major symptoms reported for patients with papillary and follicular thyroid carcinoma was neck mass (reported in 76% and 79%, respectively) followed by dysphagia (reported in 25% and 27%, respectively), stridor (reported in 9% and 14%, respectively), and neck pain (reported in 7% and 8%, respectively). Greater than 50% of the patients with papillary thyroid carcinoma were reported to have American Joint Committee on Cancer/International Union Against Cancer Stage I disease. Between 37-39% of the follicular carcinoma patients had Stage I and Stage II disease. Only slight differences in the diagnostic approach to patients with papillary or follicular carcinoma were noted. The majority of patients underwent an ultrasound of the thyroid region (78.1%), which was suggestive of carcinoma in only 39% of the cases. A thyroid scan was performed on 76.6% of patients, and the results were suggestive of carcinoma in 44.8% of the individuals. In contrast, fine-needle aspiration biopsy of the thyroid is highly recommended in the current Clinical Practice Guidelines (CPG) but results were obtained in only 27.4% of the patients. Total thyroidectomy without lymph node dissection was the most commonly used surgical procedure in the treatment of patients with papillary and follicular thyroid carcinoma. Only approximately 2% of patients at low risk in the group with Stage I disease were treated with a lobectomy. In 80% of the patients with Stage I papillary thyroid carcinoma and approximately 90% of those patients diagnosed with Stage II, III, and IV disease treating physicians chose to utilize radioiodine as adjuvant treatment after disease-directed surgery. External beam radiation was added to the treatment regimen for many patients diagnosed with Stage III and IV disease (30% in patients with papillary thyroid carcinoma and 33% in patients with follicular thyroid carcinoma). CONCLUSIONS: To the authors' knowledge no single effective diagnostic test for thyroid carcinoma currently is available and in the majority of cases a combination of ultrasound, thyroid scan, or fine-needle aspiration biopsy together with the clinical findings (e.g., thyroid mass) led to a diagnosis of carcinoma. The authors suspect that the high prevalence of concomitant pathologic findings such as goiter, even in the healthy population in Germany, reduces the accuracy of all diagnostic test methods and may account for the frequent use of imaging techniques. The majority of patients underwent a total or near-total thyroidectomy. Total thyroidectomy with radical lymph node dissection was used very frequently in those patients with papillary thyroid carcinoma (22%). German physicians tend to surgically treat early stage thyroid carcinoma somewhat more radically than recommended in the CPG. With respect to other treatment options employed as part of the first course of treatment, radioiodine appears to play the most important role. [See commentary o

Adenocarcinoma, Follicular↗
PubMed2001

Prevalence of eating disorders and weight control practices in Germany in 1990 and 1997.

OBJECTIVE: To investigate whether the prevalence of bulimic behaviors and weight control practices changed between 1990 and 1997. METHOD: In November 1997, we surveyed a representative sample of 2,130 adult subjects in West Germany and 2,155 subjects in East Germany. We asked subjects about binge eating, vomiting, use of laxatives, appetite suppressants and diuretics, and about dieting, weighing, and exercise. As the same questions had been used in a representative survey (N = 1,773) in autumn 1990 in West Germany, trend comparisons for prevalence between 1990 and 1997 are possible. RESULTS: The prevalence of severe eating binges twice a week dropped nonsignificantly between 1997 and 1990 from 3.1% to 2.4% in men and from 2.3% to 1.3% in women. In men, the prevalence of binge eating disorder dropped nonsignificantly from 2.4% to 1.5%, the prevalence of bulimia nervosa from 2.1% to 1.1%. In women, the prevalence of binge eating disorder dropped nonsignificantly from 1.5% to 0.7% and that of bulimia nervosa from 2.4% to 1.1%. CONCLUSION: The prevalence of bulimic behaviors decreased slightly during 1990 and 1997 in the West German population.

Adolescent↗