Integration of internationally qualified midwives in obstetric teams

Background: The integration of internationally qualified midwives appears to be one of the strategies implemented to resolve the shortage of midwives in some German federal states. To date, there have been very few studies on the opportunities and limitations of the integration process for midwives. Objectives: Findings from a project on the integration of internationally qualified nurses were transferred to the work of midwives on an experimental basis, thus highlighting the phenomena which need to be investigated more closely in practice. Methodology: In total, 19 interviews were conducted with home managers, nurse managers, ward managers, internationally trained nursing staff and their colleagues in four German residential and outpatient health care services for sick people and elderlies. They were evaluated using grounded theory, and memos from discussions with midwifery teams were used to reflect on transferability. Results: The labour migrants interviewed felt that they were seen more in terms of their shortcomings than their competencies. The existing teams tended to feel overwhelmed by the work integration entailed and to perceive the migrant women as "problematic". Misunderstandings were perceived as language problems. The added work of integration was poorly recognised by the institutions. Conclusion: Integration work must be recognised, thoroughly prepared for and rewarded. The competencies of internationally qualified midwives must be seen as such and must be integrated into the everyday working practice of existing teams.Hintergrund: Die Integration internationaler Hebammen scheint in einigen Bundesländern eine der Strategien zur Lösung des Hebammenmangels zu sein. Chancen und Grenzen des Integrationsprozesses bei Hebammen sind kaum erforscht.Ziele: Erkenntnisse aus einem Projekt zur Integration internationaler Pflegekräfte wurden versuchsweise auf die Tätigkeit von Hebammen übertragen und damit Fragen aufgeworfen, welche Phänomene in der Praxis genauer untersucht werden müssten.Methodik: In vier stationären und ambulanten Kranken- und Altenpflegeeinrichtungen wurden 19 Interviews mit Einrichtungs-, Pflegedienst- und Stationsleitungen sowie mit internationalen Pflegekräften und ihren Kolleg*innen im Stil der Grounded Theory durchgeführt und ausgewertet. Gesprächsnotizen mit Hebammenteams wurden zur Reflexion der Übertragbarkeit genutzt.Ergebnisse: Die interviewten Arbeitsmigrant*innen fühlten sich eher unter dem Aspekt ihrer Defizite gesehen als in ihren Kompetenzen gewürdigt. Die integrierenden Teams fühlten sich von der Integrationsarbeit tendenziell überfordert und nehmen die Arbeitsmigrant*innen eher als "Problemfall" wahr. Missverständnisse wurden als Sprachprobleme wahrgenommen. Die Integrationsarbeit wurde von den Institutionen wenig anerkannt.Schlussfolgerung: Integrationsarbeit muss anerkannt, vorbereitet und honoriert werden. Kompetenzen internationaler Hebammen müssen als solche gesehen und in die Arbeitsroutinen der bestehenden Teams eingebunden werden können

Situation and Perspectives of Public Health in Germany - Research and Teaching Position Paper of the German Public Health Association

Gerlinger T, Babitsch B, Blaettner B, et al. Situation und Perspektiven von Public Health in Deutschland - Forschung und Lehre. Das Gesundheitswesen. 2012;74(11):762-766.This position paper of the German Public Health Association describes current situation and perspectives of public health in Germany with emphasis on research and teaching. It outlines those measures necessary for strengthening of public health research in Germany

Strengthening Public and Global Health in Germany - on Appraisal of the statement "Public Health in Germany "by the German Scientific Academies from June 16th 2015

Gerhardus A, Blaettner B, Bolte G, et al. Public und Global Health in Deutschland stärken – Eine Einordnung der Stellungnahme „Public Health in Deutschland“ der wissenschaftlichen Akademien vom 16.6.2015. Das Gesundheitswesen. 2015;77(8-9):596-599.In June 2015 the scientific academies "Leopoldina" and "acatech" and the union of the German academies of sciences and humanities published a statement on public and global health in Germany. The statement contains many valuable albeit generic and well-known recommendations. The few specific recommendations focus on centralizing research while weakening the role of universities and on the relative increase of research on public health genomics. These recommendations are not based on empirical or theoretical analyses and risk subverting successful developments of the recent past. To actually strengthen public and global health in Germany the existing institutions need to be backed up while designated funding of public and global health needs to be extended

Dynamic change of VOR and otolith function in intratympanic gentamicin treatment for Meniere’s disease: case report and review of the literature,” Case Reports in Otolaryngology,

Intratympanic gentamicin treatment (IGT) is an evidence-based therapeutic option for recurrent vertigo attacks in Ménière's disease (MD). Today, in MD it is possible to monitor changes of vestibular receptor function, induced by IGT, with objective test methods such as the video head impulse test (vHIT) and cervical and ocular vestibular evoked myogenic potentials (cVEMP, oVEMP) in a dynamic, time-and frequency-dependent manner. We report on a 65-year-old female patient with recurrent vertigo attacks in a right-sided MD, where receptor function was followed up before and up to 4 weeks after IGT (time dynamic). Quantitative changes of vestibular function (frequency dynamic) were detected with bithermal calorics and vHIT, with air-conducted sound (ACS) cVEMP and bone-conducted vibration (BCV) oVEMP at 500 Hz. The horizontal vestibuloocular reflex (hVOR) gain in vHIT decreased successively until the 4th week with the appearance of catch-up covert and catch-up overt refixation saccades, and side asymmetry increased in caloric testing. Saccular function was extinguished within 4 weeks, whereas utricular function was diminished after 4 weeks. Monitoring vestibular receptor function with objective test methods provides a quantitative insight into the dynamic activity of vestibular function and is therefore applicable in order to adjust IGT regimen at different therapeutic stages