Nosocomial infection: A risk factor for a complicated course in children with respiratory syncytial virus infection - Results from a prospective multicenter German surveillance study

BACKGROUND: Nosocomially acquired respiratory syncytial virus infections (RSV-NI) may cause serious problems in hospitalized paediatric patients. Hitherto, prospectively collected representative data on RSV-NI from multicenter studies in Germany are limited. METHODS: The DMS RSV Ped database was designed for the prospective multicenter documentation and analysis of clinically relevant aspects of the management of inpatients with RSV-infection. The study covered six consecutive seasons (1999-2005); the surveillance took place in 14 paediatric hospitals in Germany. RESULTS: Of the 1568 prospectively documented RSV-infections, 6% (n=90) were NI and 94% (n=1478) were community acquired (CA). A significantly higher proportion in the NI group displayed additional risk factors like prematurity, chronic lung disease, mechanical ventilation (med. history), congenital heart disease, and neuromuscular impairment. Of all NI, 55% occurred in preterms (30.6% of all RSV-infections in preterms with severe chronic lung disease of prematurity were NI). Illness severity as well as the total mortality, but not the attributable mortality was significantly higher in the NI group. In the multivariate analysis, NI was significantly associated with the combined outcome 'complicated course of disease'. CONCLUSION: This is the first prospective multicenter study from Germany, which confirms the increased risk of a severe clinical course in nosocomially acquired RSV-infection. Of great concern is the high rate of (preventable) NI in preterms, in particular in those with severe chronic lung disease or with mechanical ventilation due to other reasons.

Gender - an Issue for German Welfare Organisation

During the last months and years the English expression 'gender' has become a well-known word all over Germany, often with the annex 'mainstreaming'. Gender mainstreaming was initiated as a political strategy by the Women's World Conference in Beijing in 1995 and adopted by the European Union in 1997 (COM(96)76 final). It basically means that all actions and initiatives planned have to be tested as to their effects on women and men and should not be taken if they disadvantage either one. But gender is also a category in the discussion about democratic features. Gender democracy means that males and females should be represented equally in the public, political, cultural, social and economic sphere of a society. On this background, this paper traces the gender issue in the field of organizations in the social sector of Germany, in particular the 'welfare organizations'. In this article, 'welfare organizations' is used as a translation of the German word 'Wohlfahrtsverbände'. The reason for this choice is the endeavor to indicate their difference from for instance English 'charitable associations' or French 'associations sociale et sanitaire', because social organizations in the EU-member states differ considerably in regard to their history, function, self-image , financing, political power etc.. The terms 'social non-governmental organizations' (NGOs) or 'social nonprofit organizations' (NPOs ) are used synonymously.

Changes in German sport participation

Sport has become a highly differentiated social phenomenon in recent years. Changes in society, such as individualization, the growing significance of the health and body culture, and changing values, are considered to be generative mechanisms for increasing social importance and the differentiation of modern sport. Although discussions in sport sociology attribute the changes observed in recent decades of sport participation to a socially determined differentiation of sport, this premise has hardly ever been empirically tested. The present study examines to what extent the postulated developments in sport can be observed on the micro level of those engaging in sport, by examining sport behaviour from a contemporary historical perspective. Based on a life-course approach to research, a total of 1739 over 50-year-olds in Germany were asked about their sport participation as part of a retrospective longitudinal study. Results show that the increasing differentiation of sport can be documented by more diversified forms of individual sport careers. During a 30-year observation period the popularity of competitive sport decreased and the variety of ways in which sport was organized increased. A differentiated analysis based on examining three birth cohorts showed that the reported change in sport participation can be attributed to age, cohort and period effects. In addition, the present study examines how specific events in contemporary history are reflected in individual sporting careers. Sport careers in Chemnitz (Eastern Germany) and Braunschweig (Western Germany) differed before German reunification, but these differences have evened out after the political changes and the process of transformation.