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Background: Berlin offers a variety of delivery facilities: maternity clinics, birth centres, obstetrical practices and ambulant working midwives for the various options and kinds of delivery. To select an individual service is a difficult task for most women. In this process of decision-making the gynaecologist plays an important part. This raised the question as to how established gynaecologists appraise the available services, which delivery sites they recommend, and what criteria are decisive for their recommendation., Methods: A postal survey of all the 523 gynaecologists of Berlin was conducted anonymously, 273 (52.2 %) of whom completed the questionnaire., Results: The results of the study demonstrated that the most important aspects for the recommendation of a delivery place are the technological equipment and qualification of the staff. However, characteristics of good care and support and an atmosphere of kindness and mutual trust are equally important. According to these goals, criticism has been expressed especially in the area of care and kindness, larger obstetrical divisions having more defaults in this regard., Conclusions: Future developments in delivery units of hospitals should take into consideration that both safety and optimal care are expected.

A model for forecasting mortality developed by Lee and Carter is applied to data of West Germany. The logs of the age-specific death rates are modeled as a linear function of an unobserved mortality index using the singular value decomposition method. The forecasts are based on projections of all individual trends of the mortality rates. Applied to life expectancy at birth between 1969 and 1992 the model implies an increase of 2.2 years in life expectancy for men and 2.4 years for women in 2002.

The temporal bone collection of the ENT Department of the Charité Hospital in Berlin contains 128 cases from 1924 to 1941 of fatal complications of acute otitis media and cholesteatoma. In 1927 alone, one patient died on average every 2 weeks at Charité Hospital from fatal otitic disease. Lesions include labyrinthitis, meningitis, sinus thrombosis and brain abscess. Each case is documented by clinical history, autopsy findings and temporal bone sections. The reasons for the various features of each illness are briefly discussed.

Due to extensive government funding, public health research in Germany presently goes through times of revival and relative prosperity. The multiprofessionality of its background, its nearly disrupted scientific tradition in Germany, and the idiosyncrasies in their understanding of "health" among different professions impede the development of a common scientific identity. This paper underscores the importance of semantic precision and the avoidance of pretentious, overstrained theories in favour of pragmatic scientific approaches. Complementary to its action-oriented rationale, the German public health community should more than ever devote itself to health objectives and outcomes.

Objectives or targets for health have been presented by the World Health Organisation as well as a number of national health administrations. Health objectives are intended as guidelines attracting the commitment of decision makers and health professionals. As a "normative health indicator" a health objective should quantify the desired progress and give the time by which it could be attained. The article discusses general and methodical aspects which are thought to be relevant in identifying and quantifying health objectives for a population.

The article gives algorithms to calculate mean ages at death for specific causes, based on life table models. Parameters of interest are death due to a specific cause, dying after the "elimination" of the specific cause, or the transition into a "new" structure of mortality when a specific cause of death vanishes. The setbacks of widely used calculations are discussed in this context. These different approaches are demonstrated by means of data pertaining to accident and cardiovascular mortality of the male population of Berlin (West). The estimated impact on life expectancy varies according to both the mathematical model and the specific cause of death: differences are negligible in mortality due to accidents, whereas the results differ considerably in cardiovascular causes of death. The algorithm suggested allows to constrain the calculations to specific age groups. Topics such as "avoidable death" and "health objectives" have to be aware of these different methods.

The formal mathematical steps of direct and indirect standardisation are deduced and it is pointed out that standardisation is an analytical concept for processing data within the framework of structurised populations to enable correct interpretation of these data in a manner modified according to specific problems. In particular, this concept is not confined to transforming age-structured mortality data of a population to the age distribution of the members of a larger population by means of a rule of three. Standardisation is in fact a model of the macrolevel (population). It makes no demands on the modalities of structuring. The structure selected as standard is arbitrarily set. With time series, standardisation usually modifies only the levels of the figures and not the frequencies. The results of standardisation are in every case valid only if the standard is also stated. A rule of thumb is: In retrospective analysis it is meaningful to standardise on the structure at the beginning or end of the time series; in extrapolations standardisation should be performed on the last structure that had been determined, whereas for comparisons a median structure should be standardised. The standardisation approach can be used in case of weighted arithmetic, geometric or harmonic means. Before effecting standardisation, the type of connection between the employed data should be examined. The examples of concepts of direct standardisation refer to cardiovascular and accident mortality in West Berlin from 1963 to 1991, whereas those of indirect standardisation are based on the accident mortality in West Berlin in 1987 structured according to city districts.

Following a long-term decline, death rates due to infectious diseases in West-Berlin men have dramatically increased since 1983. The Berlin mortality statistics introduced AIDS as a specific cause of death only in 1989. However, opportunistic infections, a negligible quantity until 1983, and pointing to AIDS as the underlying cause, show a steep increase in the mid and late eighties. In terms of Potential Years of Life Lost, AIDS-related mortality amounts to 8 percent of total mortality in West-Berlin men in 1989/1990.