Ergebnisse der qualitativen WPP Studie der Charité – Universitätsmedizin Berlin

Introduction: University medicine in Germany is a highly hierarchically regulated system due to complex processes as well as the different powers of the status groups and their professional socialization. Sexual harassment in the social and historical context of power and inequality is inherent in hierarchical structures, which is evidenced by the high prevalence in clinics of international/national studies. From the limited international data situation it can be concluded that hierarchy, power relations, stress burden and corporate culture play a significant role in medicine and care. For this reason, culture-specific protection and prevention concepts are indispensable for the employees in the hospital environment, until now the topic has been re-searched only to a limited time internationally/nationally. Methods: As part of the WPP study on the study of sexual harassment in a clinical en-vironment, data on a) incidence b) prevention c) implementation were generated in order to comprehensively address the multigroup phenomenon. In the qualitative part of the study, protection prevention strategies were investigated using semi-structured guide interviews with 15 doctors and 15 nurses. The qualitative method provided in-sights as well as recommendations for action from the clinical environment, which are reflected in the professional reality of the interviewees. Results: From the perspective of the interviewees, findings and recommendations for action on protection and prevention options could be analysed at an individual strategic and structural level The Management Board should be committed to a zero-tolerance strategy and appropriate institutional prevention strategies. Especially personnel-responsible managers of the clinics/departments/institutes have the responsibility in the case of incidents of sexual harassment in the case of intervention. Managers serve as role models for a respectful and appreciative working atmosphere and should reflect the diversity of employees. Both professions cite intervention and relief techniques for self-protection in Patient_innen and family settings. At nuisance events at the horizontal level, situational strategies from over-ignored to direct response of practitioners were applied. Conclusion: The results presented show that due to the high prevalence of sexual harassment in the clinical environment, the need for protection and prevention measures is essential at all levels of the company. In order to protect sexual harassment, combinations of individualised interventions and in-depth prevention options were mentioned in the organisational structures. A culturally specific company agreement that is customary to the company provides a necessary basis for proactive handling of institutional prevention events.Einführung: Die Universitätsmedizin in Deutschland ist aufgrund von komplexen Abläufen sowie der unterschiedlichen Machtbefugnisse der Statusgruppen und deren Berufssozialisation ein stark hierarchisch reglementiertes System. Aus der limitierten internationalen Datenlage lässt sich schlussfolgern, dass Hierarchie, Machtverhältnis-se, Stressbelastung und Unternehmenskultur in der Medizin und Pflege eine erhebliche Rolle spielen. Sexuelle Belästigung im Kontext von Macht und (Geschlechter-) Ungleichverteilung ist hierarchischen Strukturen inhärent, welches durch die hohe Prävalenz in Kliniken internationalen/nationalen Studien belegt wird. Daher sind Schutz- und Präventionskonzepte für die Beschäftigten im Klinikambiente unerlässlich, bis dato wurde die Thematik international/national nur limitiert erforscht. Methodik: In Rahmen der dargestellten WPP-Studie zur Erforschung von sexueller Belästigung im klinischen Ambiente wurden Daten zur a) Inzidenz b) Prävention c) Implementierung generiert, um dem multifraktionellen Phänomen umfassend zu begegnen. Im qualitativen Studienteil wurden Schutz- und Präventionsstrategien anhand von semistrukturierten Leitfadeninterviews mit 15 Ärztinnen und 15 Pflegekräften unter-sucht. Die qualitative Methode lieferte dabei Erkenntnisse sowie Handlungsempfehlungen aus dem klinischen Umfeld, die sich an der beruflichen Realität der Interviewten abbilden. Die Auswertung des transkribierten Interviewmaterials erfolgte mit der strukturierten Inhaltsanalyse nach Philipp Mayring. Das zentrale Vorgehen bildet dabei die Analyse anhand der deduktiven und induktiven Kategorienbildung. Ergebnisse: Aus der Perspektive der Interviewten konnten Erkenntnisse und Hand-lungsempfehlungen zum Schutz und Präventionsoptionen auf individueller strategischer und struktureller Ebene analysiert werden. Beide Berufsgruppen nennen Interventions- und Entlastungstechniken zum Selbstschutz in Patient_innen- und Angehörigensettings. Auf Belästigungsereignisse auf horizontaler Ebene werden situativ Strategien von Überhören bis direktes Ansprechen der Ausübenden angewandt. Die Berufsgruppen benennen die Null-Toleranz-Strategie des Management-Boards mit entspre¬chenden institutionellen Präventionsstrategien zur Unterstützung der Strategie. Personalverantwortliche Führungskräfte der Kliniken/Abteilungen/Institute haben eine Vorbildfunktion im Interventionsgeschehen sowie für eine respektvolle und wertschätzende Arbeitsatmosphäre und sollen der Diversität der Beschäftigten gerecht werden. Schlussfolgerungen: Die dargestellten Ergebnisse zeigen auf, dass aufgrund der hohen Prävalenz von sexueller Belästigung im klinischen Umfeld die Notwendigkeit von Schutz- und Präventionsmaßnahmen, auf allen Unternehmensebenen unerlässlich sind. Zum Schutz vor sexueller Belästigung wurden Kombinationen von individualisierten Interventionen sowie in die Organisationsstrukturen eingehende Präventionsoptionen genannt. Kulturspezifische, dem Unternehmen angepasste Maßnahmen stellen dabei eine notwendige Grundlage zum proaktiven Umgang im institutionellen Präventionsgeschehen dar

Ritual plants of Muslim graveyards in northern Israel

This article surveys the botanical composition of 40 Muslim graveyards in northern Israel, accompanied by an ethnobotanical study of the folkloristic traditions of the use of these plants in cemeteries. Three groups of plants were found to be repeated systematically and were also recognized for their ritual importance: aromatics herbs (especially Salvia fruticosa and Rosmarinus officinalis), white flowered plants (mainly Narcissus tazetta, Urginea maritima, Iris spp. and Pancratium spp.) and Cupressus sempervirens as the leading cemetery tree. As endemic use we can indicate the essential role of S. fruticosa as the main plant used in all human rites of passage symbolizing the human life cycle. The rosemary is of European origin while the use of basil is of Indian influence. The use of white flowers as cemeteries plants reflects an old European influence and almost the same species are used or their congeners. Most of the trees and shrubs that are planted in Muslim cemeteries in Israel have the same use in ancient as well in modern European cultures. In conclusion, our findings on the occurrence of plants in graveyards reflect the geographic situation of Israel as a crossroads in the cultural arena between Asia and Europe. Most of the traditions are common to the whole Middle East showing high relatedness to the classical world as well as to the present-day Europe

The Influence of Number and Timing of Pregnancies on Breast Cancer Risk for Women With BRCA1 or BRCA2 Mutations

Background: Full-term pregnancy (FTP) is associated with a reduced breast cancer (BC) risk over time, but women are at increased BC risk in the immediate years following an FTP. No large prospective studies, however, have examined whether the number and timing of pregnancies are associated with BC risk for BRCA1 and BRCA2 mutation carriers. Methods: Using weighted and time-varying Cox proportional hazards models, we investigated whether reproductive events are associated with BC risk for mutation carriers using a retrospective cohort (5707 BRCA1 and 3525 BRCA2 mutation carriers) and a prospective cohort (2276 BRCA1 and 1610 BRCA2 mutation carriers), separately for each cohort and the combined prospective and retrospective cohort. Results: For BRCA1 mutation carriers, there was no overall association with parity compared with nulliparity (combined hazard ratio [HRc] ¼ 0.99, 95% confidence interval [CI] ¼ 0.83 to 1.18). Relative to being uniparous, an increased number of FTPs was associated with decreased BC risk (HRc¼ 0.79, 95% CI ¼ 0.69 to 0.91; HRc¼ 0.70, 95% CI ¼ 0.59 to 0.82; HRc¼ 0.50, 95% CI ¼ 0.40 to 0.63, for 2, 3, and 4 FTPs, respectively, Ptrend < .0001) and increasing duration of breastfeeding was associated with decreased BC risk (combined cohort Ptrend ¼ .0003). Relative to being nulliparous, uniparous BRCA1 mutation carriers were at increased BC risk in the prospective analysis (prospective hazard ration [HRp] ¼ 1.69, 95% CI ¼ 1.09 to 2.62). For BRCA2 mutation carriers, being parous was associated with a 30% increase in BC risk (HRc ¼ 1.33, 95% CI ¼ 1.05 to 1.69), and there was no apparent decrease in risk associated with multiparity except for having at least 4 FTPs vs. 1 FTP (HRc¼ 0.72, 95% CI ¼ 0.54 to 0.98). Conclusions: These findings suggest differential associations with parity between BRCA1 and BRCA2 mutation carriers with higher risk for uniparous BRCA1 carriers and parous BRCA2 carriers

Prevention Strategies for Sexual Harassment in Academic Medicine: A Qualitative Study

Jenner SC, Djermester P, Oertelt-Prigione S. Prevention Strategies for Sexual Harassment in Academic Medicine: A Qualitative Study. Journal of Interpersonal Violence. 2020: 088626052090313.Sexual harassment and gendered discrimination in the workplace are global issues that can affect anyone regardless of their age, gender, job title, or field of employment. The medical field is also relevantly concerned, yet effective prevention measures are scarce. The purpose of this study was to explore preventive options for sexual harassment in an academic medical context from the employees’ perspective and to develop transferable strategies. We conducted semi-structured interviews with 15 female physicians and 15 female nurses working at a tertiary referral center in Berlin, Germany, in the months of April to November 2015. The one-on-one interviews addressed the perception of sexual harassment and available and desirable preventive measures. Data were analyzed by qualitative content analysis. The participants outlined preventive measures at two levels: individual and institutional. Individual options included personal safety measures and individual protection strategies against patients, peers, and superiors. Institutional strategies included guidelines and workplace policies, structured complaint and reporting procedures, formal training options, and organizational development and leadership strategies. The current study highlights how the prevention of sexual harassment hinges on a combination of individualized and system-wide measures to capture the personal as well as the organizational dimension of sexual harassment. Only a concerted effort addressing both aspects will sensitize the workforce, support the victims, and prevent sexual harassment in medical institutions

Barriers to Active Inquiry About Intimate Partner Violence Among German Physicians Participating in a Mandatory Training

Jenner SC, Etzold SS, Oesterhelweg L, et al. Barriers to Active Inquiry About Intimate Partner Violence Among German Physicians Participating in a Mandatory Training. Journal of Family Violence. 2016;31(1):109-117

Discrimination and sexual harassment - Results from the largest German medical university

Ludwig S, Jenner S, Berger R, et al. Discrimination and sexual harassment - Results from the largest German medical university. European Journal of Public Health. 2022;32(Suppl. 3): ckac131.276

ILC Reference Design Report Volume 1 - Executive Summary

The International Linear Collider (ILC) is a 200-500 GeV center-of-mass high-luminosity linear electron-positron collider, based on 1.3 GHz superconducting radio-frequency (SCRF) accelerating cavities. The ILC has a total footprint of about 31 km and is designed for a peak luminosity of 2x10^34 cm^-2s^-1. This report is the Executive Summary (Volume I) of the four volume Reference Design Report. It gives an overview of the physics at the ILC, the accelerator design and value estimate, the detector concepts, and the next steps towards project realization.The International Linear Collider (ILC) is a 200-500 GeV center-of-mass high-luminosity linear electron-positron collider, based on 1.3 GHz superconducting radio-frequency (SCRF) accelerating cavities. The ILC has a total footprint of about 31 km and is designed for a peak luminosity of 2x10^34 cm^-2s^-1. This report is the Executive Summary (Volume I) of the four volume Reference Design Report. It gives an overview of the physics at the ILC, the accelerator design and value estimate, the detector concepts, and the next steps towards project realization