Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz最新文献

Abortion continues to be a highly contentious issue. This article provides an overview of the historical, ethical, and legal aspects of the abortion debate in Germany with a focus on the developments since the reunification. It delves into the background of the 1995 reform of the German abortion law, which centers around mandatory counseling before having an abortion. Furthermore, it outlines the implications of the medical indication for abortion and legal areas of tension. In light of the emerging shift in the status of abortion from a prohibited act under criminal law to a reproductive right, the article presents various legal viewpoints and practical considerations in the ongoing discussion.

Person-centered care is a fundamental principle of healthcare in Germany. The concept focuses on the preferences, needs, and values of individuals in the healthcare system. Studies show that unintentionally pregnant women seeking to terminate their pregnancy may encounter legal regulations, stigmatization, and ethical and moral concerns from healthcare providers. In Germany, the implementation of person-centered care in the care of unintentionally pregnant women has been scarcely researched. The goals of the CarePreg study (running from November 2020 to July 2024) were to evaluate person-centered care in psychosocial and medical care (1) from the perspective of healthcare providers as well as (2) from the perspective of women experiencing an unintended pregnancy and abortion, and (3) to derive recommendations for the current care situation. A mixed-methods approach was chosen for the study.This article presents the methodology of the CarePreg study and reports on the findings from two workshops involving 18 experts as part of the first study phase. Participants in the workshops were professionals from psychosocial and medical services for individuals with unintended pregnancies. They considered person-centered care highly relevant to abortion services, emphasizing dimensions such as "access to care," "personalized information," and "equal collaboration and involvement in decision-making." Barriers to person-centered care discussed included the stigmatization of abortion and those providing related services as well as the current legal framework.

The Institute for Quality and Efficiency in Health Care (IQWiG) was commissioned by the Federal Ministry of Health to provide support for the further development of the S2k guideline on first-trimester abortion into an S3 guideline. To this end, the responsible guideline group formulated research questions that were answered in IQWiG evidence reports. One of the questions to be addressed was the evidence regarding the psychological consequences of an abortion in the first trimester compared to no abortion in the first trimester in pregnant women who wish to have an abortion. A systematic search identified one relevant prospective comparative cohort study that reported results on the outcomes of clinically diagnosed depression and clinically diagnosed anxiety disorders. The evidence was evaluated in accordance with the methodological requirements of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group, as specified by the IQWiG methods. No significant differences were observed between the study groups with regard to the outcomes mentioned. The certainty of the evidence was rated as very low and downgraded due to study limitations and imprecision of the effects. Prospective comparative cohort studies that approach the research question under investigation should, inter alia, have adequate control for relevant confounders, a sufficient number of participants, and a carefully planned collection of data on relevant outcomes.

Introduction: Despite the social and political importance of abortion, little quantitative research has been done on the individual circumstances of women who have had abortions in Germany. This article takes an empirical and descriptive look at the individual, economic, and partnership conditions under which such decisions are made.

Methods: Data from the first 13 waves (2008-2021) of the German Family Panel (pairfam) were analyzed. Data from women who had an abortion were compared with those who carried the pregnancy to term in terms of individual characteristics, economic, and partnership circumstances. The sample consists of 1511 observations from 1082 respondents, including 216 abortions and 1295 births. The data were analyzed by means of descriptive analysis.

Results: Abortions are associated with several individual, economic, and partnership characteristics. Abortions are relatively less frequent when women are in good health and more frequent when they already have two or more children. In addition, the financial situation of women who have an abortion is comparatively worse. They are also more likely to be single or dissatisfied with their partnership.

Discussion: The findings suggest that the decision to terminate a pregnancy by abortion is made in the context of specific life circumstances. This article highlights the need for further research into the complexities involved.

In January 2023, the "S2k guideline on abortion in the first trimester" of the Association of Scientific Medical Societies ("Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e. V.", AWMF) was published, which was commissioned by the Federal Ministry of Health ("Bundesministerium für Gesundheit", BMG). The guideline deals with surgical and medical abortion after counseling, with criminological or medical indication in the first 14 weeks of pregnancy, based to the last menstrual period. In this review article, based on this guideline, the procedures for medical and surgical abortion are compared as well as the advantages and disadvantages of the two methods. Clinical and practical aspects of preparation and implementation, complication management, and immediate aftercare for abortion are presented.

In acute crises such as the COVID-19 pandemic, scientific questions need to be addressed quickly in order to protect the health of the population and to maintain the function of the healthcare system. The prevailing urgency and the large number of issues to be addressed, combined with the limitation of time, personnel, or monetary resources make prioritization indispensable. In the COVID-19 Evidence Ecosystem (CEOsys) project initiated by the University Medicine Network (NUM), a procedure for the rapid prioritization of questions was used specifically for evidence syntheses and clinical guideline recommendations, which was further developed in the follow-up project PREparedness and Pandemic Response in Germany (PREPARED).The result is a concept paper on the prioritization of research questions and topics with a more generic orientation. The content of the concept is presented in this article. The core subjects are basic principles of successful prioritization as well as an explicit seven-step process with information on organizational framework conditions and the procedure. The concept offers possibilities for adaptation, as research prioritization is highly context-dependent.The application of such a systematic, transparent prioritization process contributes to comprehensible and informed decisions about which research questions are relevant and urgent, in which order they should be processed, and which issues are not critically urgent or have to be postponed.

Background: Digital information sources provide adolescents with quick access to health-related information. Schools are ideal for promoting digital health literacy and enabling students to handle such information safely. The aim of this paper is to present initial results from a representative study on learning digital health literacy in schools, with a focus on sociodemographic and socioeconomic differences.

Methods: The cross-sectional study was conducted in Germany with 1448 students (aged 9 to 18 years) as part of the DURCHBLICKT!

Project: Bivariate and multivariate analyses were used to examine differences and relationships in the learning of digital health literacy in school and gender, age, migration background, and subjective social status.

Results: Approximately 50% of students reported that they had not (or only to a limited extent) learned digital health literacy in school. The chi-square test reveals significant differences in terms of gender, age, migration background, and social status. Regression analyses indicate that age and subjective social status are significant factors for acquiring digital health literacy.

Discussion: The high number of students who do not learn digital health literacy in school is concerning, especially given their often low levels of digital health literacy. The results highlight the need for targeted educational strategies-especially those tailored to gender and socioeconomic status-to promote digital health literacy and reduce social inequalities.

Children can only grow up healthy on a healthy planet. Climate change threatens their health through rising temperatures and extreme weather events. In Germany, average temperatures have risen, leading to more frequent and intense heatwaves. This development particularly endangers children, whose thermoregulation is not yet fully developed. UV exposure increases the risk of skin cancer and eye damage. Extreme weather also negatively impacts children's mental health.Childcare, educational, and recreational facilities play a key role in managing the psychological and physical burdens of climate change. Resilient systems and facilities can promote stability and resilience and have a preventive effect. However, the adaptation of children's personal living context to climate change is still inadequate. It is essential to enhance the climate competence of those responsible in these environments through practical informational materials that enable them to not only be aware but also to actively establish protective measures. Health insurance companies can also play a crucial role in prevention by advising and supporting climate-friendly and health-promoting activities.Health promotion in environments with children has great potential to encourage climate-protective and climate-adaptive behavior and to establish it long term among children and families. Bringing about the necessary changes requires cross-sector collaboration between institutions, providers, authorities, health insurance companies, and civil society as well as between federal, state, and local governments.