Marriage strategies and social prestige of barber-surgeons in 19th-century Württemberg: a quantitative evaluation of marriage- and probate inventories

Im 19. Jahrhundert leisteten Wundärzte einen wichtigen Beitrag zur medizinischen Versorgung. Die soziale und ökonomische Stellung der letzten Generationen von Wundärzten im Königreich Württemberg im Zeitraum 1800-1899 wird untersucht. Dazu werden 510 Hochzeits- und Testamentsinventuren von Wundärzten und ihren Ehefrauen ausgewertet. Es zeigt sich, daß der Hochzeitstermin mit dem der Meisterprüfung zusammenfiel. Die Mehrheit der Ehepartner kam aus dem Handwerkermilieu. Die getrennten Auswertungen der Vermögenswerte beider Ehepartner ergeben, daß die Aussteuer der Frau im Durchschnitt doppelt so hoch war wie die des Mannes. So wird deutlich, wie die Wundärzte durch die Heirat mit einer wohlhabenderen Partnerin eine höhere soziale Stellung erwarben. Dieses Heiratsverhalten wird als Beispiel für 'soziale Heterogamie' betrachtet. (prf)'Although barber-surgeons made an essential contribution to the medical treatment in 19th-century Germany, there is an evident lack of literature about their living conditions. This article examines the social estimation of the last generations of barber-surgeons in the Kingdom of Württemberg. For this, 510 marriage- and probate inventories of the so-called Wundärzte and their wives were evaluated. It could be proven that the majority of the marriage partners came from craftsman's milieu. Separate evaluations of the assets of both the husbands and their wives led to remarkable results: on the average, the wives' marriage portions turned out to be more than twice as high as their husbands'. Supposing that dowry and decent of the wives are related to the social estimation of their partners, we have to conclude that contemporary barber-surgeons still enjoyed quite a high prestige. Most of them succeeded in marrying upwards - at least in economical respect. Thus, the barbers' practice of marriage has to be looked upon as an example for social heterogamy.' (author's abstract

Just two Sides of the Same Coin? Ethical Issues and Discourses on COVID-19 and Ebola: A Comparative Literature Analysis

Infectious diseases pose a continuing threat to human life. In the case of pandemics, they can also grow into massive challenges for society as a whole - not only from a medical but also from an ethical perspective. This article takes the current COVID-19 pandemic as the occasion for an empirical medico-ethical analysis. It explores the ethical dimensions and discourses on COVID-19 and the Ebola epidemics (West Africa, Democratic Republic of Congo). Additional attention is paid to the question whether and to what extent the ethical issues raised differ and how the possible disparities can be explained. Using a methodological two-step approach (systematic literature review; qualitative content analysis), we were able to identify nine categories that map the ethical dimensions of recent outbreaks of these two diseases: (1) Prioritization of health, (2) Equitable access to resources, (3) Adequate information, (4) Health worker vulnerability, (5) Stigma and discrimination, (6) Research ethics, (7) Measures restricting freedom, (8) Global health justice, (9) Environmental ethics

Pilot project "Patient-Safety" in Medical Education

Since the summer term 2009 the study project „Patientensicherheit – Der klinische Umgang mit Patienten- und Eingriffsverwechslungen sowie Medikationsfehlern“ (Patient Safety – the clinical handling of patients – and mistaking of procedures as well as medication errors) is offered within the Modellstudiengang Medizin. Seminars on patient safety in Germany so far mainly address trained doctors and health economists. In contrast, this study project on patient safety should at an early stage contribute to a “culture of discussing and preventing mistakes” – an aspect that is little established in clinical medicine, but also in medical training. For this purpose, a broad variety of courses was developed, which – relying on problem-oriented learning – enables the students to analyse so-called adverse events (AE) and develop adequate prevention measures on the basis of the insights gained by this analysis. Therefore, theoretical lessons are complemented by discussing prototypical clinical cases. These discussions are moderated by experienced clinicians. After completing the seminar, students showed a significant increase (comparison of means) in the self-assessed qualifications „Wissen zu Patientensicherheit“ (Knowledge of Patient Safety) and „Wahrnehmung von Risikosituationen“ (Appreciation of Risk Situations). All in all, the students rated their training success with a grade of 1.5 (good)

Identification of semester-specific teaching contents for dental ethics: development, testing and validation of a questionnaire

Background Although medical ethics is an indispensable part of dental education, it has not played a relevant role in the dental curriculum thus far. This study is aimed at developing and validating a questionnaire that identifies semester-specific ethical issues, in order to develop longitudinal ethic modules. Methods March 2018 a workshop on item generation was coordinated, using Delphi method; followed by a cognitive testing with students (2nd, 4th, 10th semesters, n = 12). A pilot test was carried out with students from different semesters (n = 60). The distribution of response frequencies and missing values were determined. The questionnaire used for validation consisted of three dimensions: ethical knowledge, dealing with ethical issues, expectations in terms of teaching. The psychometric examination was carried out by preclinical students (n = 105) and clinical semesters (n = 110) January 2019. Results After cognitive testing and piloting, some items were reformulated, so that a questionnaire with 127 items was used for validation. The individual dimensions were assigned to various factors with excellent to acceptable internal consistency (Cronbach's α 0.72-0.96). Conclusion The questionnaire has an acceptable to excellent consistency and suggests that the different dimensions are conclusive. With this questionnaire, ethical issues in dentistry can be mapped and teaching contents identified

Heterologous DNA-prime/protein-boost immunization with a monomeric SARS-CoV-2 spike antigen redundantizes the trimeric receptor-binding domain structure to induce neutralizing antibodies in old mice

A multitude of alterations in the old immune system impair its functional integrity. Closely related, older individuals show, for example, a reduced responsiveness to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccines. However, systematic strategies to specifically improve the efficacy of vaccines in the old are missing or limited to simple approaches like increasing the antigen concentration or injection frequencies. We here asked whether the intrinsic, trimeric structure of the SARS-CoV-2 spike (S) antigen and/or a DNA- or protein-based antigen delivery platform affects priming of functional antibody responses particularly in old mice. The used S-antigens were primarily defined by the presence/absence of the membrane-anchoring TM domain and the closely interlinked formation/non-formation of a trimeric structure of the receptor binding domain (S-RBD). Among others, we generated vectors expressing prefusion-stabilized, cell-associated (TM+) trimeric “S2-P” or secreted (TM−) monomeric “S6-PΔTM” antigens. These proteins were produced from vector-transfected HEK-293T cells under mild conditions by Strep-tag purification, revealing that cell-associated but not secreted S proteins tightly bound Hsp73 and Grp78 chaperones. We showed that both, TM-deficient S6-PΔTM and full-length S2-P antigens elicited very similar S-RBD-specific antibody titers and pseudovirus neutralization activities in young (2–3 months) mice through homologous DNA-prime/DNA-boost or protein-prime/protein-boost vaccination. The trimeric S2-P antigen induced high S-RBD-specific antibody responses in old (23-24 months) mice through DNA-prime/DNA-boost vaccination. Unexpectedly, the monomeric S6-PΔTM antigen induced very low S-RBD-specific antibody titers in old mice through homologous DNA-prime/DNA-boost or protein-prime/protein-boost vaccination. However, old mice efficiently elicited an S-RBD-specific antibody response after heterologous DNA-prime/protein-boost immunization with the S6-PΔTM antigen, and antibody titers even reached similar levels and neutralizing activities as in young mice and also cross-reacted with different S-variants of concern. The old immune system thus distinguished between trimeric and monomeric S protein conformations: it remained antigen responsive to the trimeric S2-P antigen, and a simple change in the vaccine delivery regimen was sufficient to unleash its reactivity to the monomeric S6-PΔTM antigen. This clearly shows that both the antigen structure and the delivery platform are crucial to efficiently prime humoral immune responses in old mice and might be relevant for designing “age-adapted” vaccine strategies

Sex differences in long-term effects of collagen-induced arthritis in middle-aged mice

Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory disorder with high prevalence among middle-aged women. Collagen-induced arthritis (CIA) is the most widely used animal model of RA, however, sex differences and long-term effects of CIA in mice are poorly described in the literature.Aim: Therefore, the present study aimed to analyze the long-term effects of CIA on the joints of middle-aged mice of both sexes and to describe potential sex differences.Materials and methods: CIA was induced in middle-aged DBA/1J mice by immunization with bovine type II collagen and complete Freund’s adjuvant. Saline was administered to control mice. Arthritis score assessment, plethysmometry, and thermal imaging of the joints were performed weekly for 15 weeks. Locomotor activity, micro-computed tomography, joint histology and biochemical analyses were performed at the end of the experiment.Results: Our results indicate a similar prevalence of arthritis in both sexes of mice—67% (8/12) of females and 89% (8/9) males with an earlier onset in males (day 14 vs. day 35). After the arthritis scores peaked on day 56 for males and day 63 for females, they steadily declined until the end of the experiment on day 105. A similar dynamics was observed in paw volume and temperature analyzing different aspects of joint inflammation. Long-term consequences including higher proteinuria (by 116%), loss of bone density (by 33.5%) and joint damage in terms of synovial hyperplasia as well as bone and cartilage erosions were more severe in CIA males compared to CIA females. There were no significant differences in locomotor activity between CIA mice and CTRL mice of any sex.Conclusion: This is the first study to describe the long-term effects of the CIA model in terms of sex differences in DBA/1J mice. Our results indicate sex differences in the dynamics, but not in the extent of arthritis. An earlier onset of arthritis and more severe consequences on joints, bones and kidneys were found in males. The underlying immune pathomechanisms responsible for the limited duration of the arthritis symptoms and the opposite sex difference in comparison to RA patients require further investigation