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Studies suggest that stalking victimization may have a serious mental health impact. The present article investigates gender differences in mental health and possible mediating effects of stalking victimization in a community sample. The study includes a postal survey of 665 German community residents on the experience of stalking and various mental health indicators. In a majority of mental health scales, women score poorer than men, and a higher percentage of women fulfill criteria for a current mental disorder and used psychotropic medication. However, effects of gender decrease to a nonsignificant level when stalking victimization is entered into the respective models. Furthermore, associations of stalking victimization with poor mental health, psychosocial functioning, and use of medication are largely comparable across gender. (Contains 4 tables.)

Chronic wounds are of high socio-economic importance. Accurate and efficient treatment includes the use of outcomes measures in clinical care and in research. To date, consented standards for documentation of chronic wounds, agreements on interpretation of wound outcomes and harmonisation about standardised goal setting in wound treatment are lacking. Objective (1) To establish a national German consensus group for the definition of standards in outcomes measurement of chronic wounds, (2) to agree on recommendations for practice and research based on a continuous decision process, including implementation of the standards. Methods The national consensus group includes delegates from the German scientific medical societies involved in health care for chronic wounds, the national boards on nursing, and the chairs of regional wound networks. Moreover, the roof organisations of the German health insurances, the German ministry of health and further single wound experts were invited. The consensus work is based on a structured decision process. Results The consensus group consists of 58 representatives and co-representatives of 26 societies and organisations. Since 2012, in the regular bi-annual meetings a Delphi-based workflow has been followed starting with standards for documentation and outcomes measurement in patients with leg ulcers. Additionally, web-based decision processes are conducted and the results are presented for finalisation in the face-to-face meetings. The following application areas of particular interests were defined: clinical routine, health services research, clinical research, and health economics. In the meantime, 245 single decisions have been approved. Conclusions Based on a national joint process involving medical societies, nursing groups, German sickness funds and health politics, a continuous decision process on standards for outcomes measurement and interpretation could be established. The Delphi based decision processes showed high levels of participations, thus providing a valid and robust set of standards. First results are in process of approval by the societies. [ABSTRACT FROM AUTHOR]

The article discusses the contribution of Main-Frankish cloisters to the late Baroque music culture. The author explores not only the Gregorian chants and German church "lieder" contributed by the monasteries but also so-called figural music, that is compositions for soloists, chorus, and orchestra. The contrasting musical contributions of the Cistercian P. Eugen Willkomm and the Benedictine P. Valentine Rathgeber are reviewed.

The article offers information on an exhibition titled "YOUNG CLAY-Ceramics from UK," running at the Keramikmuseum Westerwald in Höhr-Grenzhausen, Germany until May 6, 2014. It explains that the exhibition highlights the work of a group of artists noted for their spontaneous approach to traditional ceramics techniques, many of whom are studying at the Royal College of Art in London, including Yo Thom and Akiko Hirai from Japan, Asraf Hanna from Egypt, and Halima Cassel from Pakistan.

The article presents an obituary for German artist Mary White, who was born as Mary Rollinson.

Background: Electronic medical records are required in ophthalmology clinics to be integrated into digital care networks and efficient clinical registry databases., Aim of the Work: To assess the prevalence and methods of electronic medical recordkeeping in inpatient ophthalmological care in Germany., Material and Methods: An online questionnaire was sent to all German university eye hospitals and ophthalmology departments in June 2021. It included 13 open and closed option questions concerning current practices of digital recordkeeping, including the structure of data storage and the recording of billing-relevant codes in the departments., Results: A total of 44 (44%) out of 100 clinics responded. Patient documentation was completely digital in 15 (34%) clinics and partly digital and paper-based in the remaining 29 (66%). A total of 16 different constellations of documentation programs were specified. The most frequently used programs were Orbis (27%) (Dedalus HealthCare, Bonn, Germany), FIDUS (18%) (Arztservice Wente, Darmstadt, Germany), and SAP/i.s.h.med (16%) (SAP Deutschland, Walldorf, Germany; Cerner Deutschland, Berlin, Germany) and 3 clinics indicated primary use of paper records. Structured documentation of findings was performed in 61% of the departments, while 23% used a semistructured manner and 15% used a nonstructured format. Electronic documents are stored as DICOM (Digital Imaging and Communications in Medicine) documents 20% of the clinics and as PDF (Portable Document Format) files in 34% of the clinics while 23% store scanned printouts., Discussion: Methods of medical record keeping in German eye clinics are heterogeneous, with paper-based documentation continuing to play an important role. This, as well as the high number of different electronic medical record software pose important challenges in terms of interoperability and secondary use of clinical data., (© 2022. The Author(s).)

Background: The German Ophthalmological Society (DOG) regularly records the scientific activities of ophthalmological research institutions in Germany., Objective: With this publication the DOG wants to make the performance of scientific ophthalmology in Germany transparent and increase the options for future research cooperation with facilities of research institutions., Methods: Systematic survey of German research centers in ophthalmology., Results: The current research map records the data from 41 German research centers for the reporting period 2018-2020. Compared to previous editions of the research map, there has been a significant increase in scientific activity. The number of studies reported rose to 496. The number of government funded research projects (n = 121) and projects funded by foundations (n = 108) also increased. Furthermore, the number of scientific publications has almost doubled: while 1919 were published in the period from 2012 to 2014 and 2305 in the period from 2015 to 2017, there were 4215 in the current reporting period. The map also reports on a continuous increase in the number of young scientists in ophthalmology., Conclusion: The research map demonstrates the performance of German scientific ophthalmology. At the same time, the need for research in ophthalmology remains high because many diseases that affect the eyes are not yet or not yet completely curable., (© 2022. The Author(s).)

Objective: Analysis of associations between perceived daily life strain during the COVID-19-crisis and personality aspects with current psychological wellbeing in the general population and comparison of mental health indicators with those from a previous survey in 2018., Methods: Written survey in a random sample from the general population (n = 721) on Corona-related assessments, personality aspects and current mental health (WHO-5, PHQ-D)., Results: Fear for the health of close persons, strain regarding going out restrictions, increased substance use and psychological risk- and resilience factors were independently related to current mental health. Extent and frequencies of mental health symptomatology did not differ between 2018 and 2020., Conclusion: This is a first study in Germany reporting results from a population-based random sample on determinants of mental health during the COVID-19-crisis and a comparison of mental health symptomatology with prepandemic data from the same population., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Background: In 2003, we carried out the first epidemiological study on the frequency and effects of stalking in Germany that was based on a random population sample. We repeated the study with the same design in 2018 in order to assess any potential alterations over time in the frequency of stalking and of psychological problems in the affected persons. As far as we know, this is the first replication study of this kind to be carried out anywhere., Methods: 1000 women and 1000 men were randomly chosen from the residents' registration data of Mannheim, Germany. Each one of them received, by mail, a comprehensive questionnaire about stalking, as well as the WHO-5 Well-Being Index and the German version of the Patient Health Questionnaire (PHQ-D)., Results: In the Mannheim population samples (2003: N = 675; 2018: N = 444), the lifetime prevalence of being stalked was 11.6% in 2003 (95% confidence interval, [9.2; 14.4]) and 10.8% in 2018 [8.1; 13.7]. In both 2003 and 2018, persons who had been stalked had significantly worse mental well-being than unaffected persons (WHO-5 summated score 2003: 11.2 [9.7; 12.6] vs. 15.5 [15.1; 16.0], WHO-5 summated score 2018: 11.8 [10.1; 13.6] vs. 14.5 [13.9; 15.0]). A markedly higher percentage of persons who had been stalked also fulfilled the syndrome criteria for at least one mental disorder (PHQ-D 2003: 50.0% vs. 22.5%; odds ratio [OR]: 3.5 [2.1; 5.6], PHQ-D 2018: 46.5% vs. 24.4%; OR: 2.7 [1.4; 5.1]). In 2018, as in 2003, persons who had been stalked were dissatisfied with, or unaware of, the opportu - nities that they had to get help from the police and the judicial system., Conclusion: Stalking remains a major problem that must be taken seriously. Physicians and psychologists should be well informed about it in order to help affected persons who turn to them for medical and psychological assistance.

Background: Patients with breast cancer (BC) show strong interest in complementary and alternative medicine (CAM), particularly for adverse effects of adjuvant endocrine treatment - e.g., with letrozole. Letrozole often induces myalgia/limb pain and arthralgia, with potential noncompliance and treatment termination. This analysis investigated whether CAM before aromatase inhibitor (AI) therapy is associated with pain development and the intensity of AI-induced musculoskeletal syndrome (AIMSS) during the first year of treatment., Patients and Methods: The multicenter phase IV PreFace study evaluated letrozole therapy in postmenopausal, hormone receptor-positive patients with early BC. Patients were asked about CAM use before, 6 months after, and 12 months after treatment started. They recorded pain every month for 1 year in a diary including questions about pain and numeric pain rating scales. Data were analyzed for patients who provided pain information for all time points., Results: Of 1396 patients included, 901 (64.5%) had used CAM before AI treatment. Throughout the observation period, patients with CAM before AI treatment had higher pain values, for both myalgia/limb pain and arthralgia, than non-users. Pain increased significantly in both groups over time, with the largest increase during the first 6 months. No significant difference of pain increase was noted regarding CAM use., Conclusions: CAM use does not prevent or improve the development of AIMSS. Pain intensity was generally greater in the CAM group. Therefore, because of the risk of non-compliance and treatment discontinuation due to the development of higher pain levels, special attention must be paid to patient education and aftercare in these patients., Competing Interests: Declaration of competing interest S·Y.B. has received honoraria from Pfizer and Novartis. W.J. has received honoraria and research grants from Novartis. A.D.H. has received honoraria from AstraZeneca, Genomic Health, Roche, Novartis, Celgene, and Pfizer. R.W. has received honoraria and research funds from Novartis. S.K. has received honoraria from Roche, Celgene, Amgen, and AstraZeneca and funding support from Roche. C.T. has received honoraria from Novartis, Pfizer, and AstraZeneca. M.P.L. has participated on advisory boards for AstraZeneca, MSD, Novartis, Pfizer, Genomic Health, and Roche and has received honoraria for lectures from Lilly, Roche, Novartis, Pfizer, Genomic Health, AstraZeneca, medac, and Eisai. P.G. has received honoraria from Novartis and financial support for symposia from Novartis, Roche, and PharmaMar. H.-C.K. has received honoraria from Carl Zeiss meditec, TEVA, Theraclion, Novartis, Amgen, Astra Zeneca, Pfizer, Janssen-Cilag, GSK, LIV Pharma, Roche, and Genomic Health. D.S.-B. has received honoraria from Novartis. M.W.B.‘s institution has received research grants from Novartis. T.F. has received honoraria from Pfizer, Novartis, Roche, and Amgen. P.A.F. has received honoraria from Roche, Pfizer, Novartis, and Celgene. His institution conducts research for Novartis. N.N. has received honoraria from Janssen-Cilag, Novartis and Teva. All of the remaining authors have declared that they have no conflicts of interest., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: In 2003 the German diagnosis-related groups (G-DRG) were introduced for reimbursement of inpatient treatment. The aim of this study was to analyze the development of G-DRGs in ophthalmology in Germany (MDC02) from 2004 to 2012 by means of data from the Institute for the Reimbursement System in Hospitals (InEK)., Methods: The data regarding costs, cost weighting and mean length of stay (LOS) from the G-DRG reports of the InEK from 2004 to 2012 in 9 representative surgical and non-surgical ophthalmological treatment case groups were analyzed. Differences in the coding system as well as alterations between the G-DRGs over the course of time were taken into consideration. The cost weightings were calculated taking the year 2004 as the baseline and are presented in the form of graphs., Results: The selected cases cover 54% of all G-DRG cases used by the InEK for G-DRG calculations. For 6 out of the 9 case groups there was a cost/reimbursement reduction by nearly one third of the calculated costs by InEK from 2004 to 2012. Only one case group showed an increase in costs by 23% which can be explained by alterations in graft costs in this case group. The mean LOS decreased over the time period in the 9 groups investigated by up to 40% and on average by -22.3%., Conclusions: The annually calculated costs of the InEK directly influence the calculation of the cost weightings and reimbursement and are therefore important for every hospital. During the time period analyzed a high reduction in costs and LOS in the majority of the analyzed case groups were found.

Background: Over the last decade inpatient treatment has been reduced in favor of outpatient care or markedly shortened inpatient stays in most organ-specific surgical specialties such as ophthalmology in Germany., Methods: Data from the federal statistics agency on the international classification of disease (ICD), diagnosis-related groups (DRG) and performed operations and procedures from 2000 to 2010 as well as data from the Institute for Reimbursements of Hospitals (InEK) on average costs per DRG in every German DRG (G-DRG) version from 2004 to 2010 were analyzed for ophthalmology., Results: From 2000 to 2010, the number of cases with a main ophthalmological diagnosis decreased (-19 %), which was mostly due to a reduction in the number of cataract inpatients (-56 %). All subspecialties such as glaucoma (+82 %) and retina (+68 %) with the exception of primary strabismus diagnoses (-15 %) gained in number of cases. Inpatient cataract surgery was the most common surgery in 2004 but numbers decreased to 2010 (-9 %). The most often performed inpatient procedure was vitreoretinal surgery in 2007 and 2010 (increase 2004-2010 + 46 %). Average hospital stay decreased between 2005 and 2010 from 3.9 to 3.4 days and the average cost per case increased by 3.6 % overall and by 13.4 % for surgical cases., Conclusion: Ophthalmic healthcare provided as inpatient services decreased with a trend towards more complex cases being treated as inpatients from 2000 to 2010.

Aims: The present study was designed to to investigate lifetime prevalence and types of stalking victimization in a sample of psychiatric in-patients., Methods: 300 consecutively admitted patients of the psychiatric clinic of the Central Institute of Mental Health were included and examined with a standardized stalking victimisation questionnaire., Results: The cohort of psychiatric in-patients had a lifetime prevalence of being a stalking victim of 21.3 % . The percentage of men and women affected was equal. The course of stalking was more difficult to handle and more violent compared to a representative cohort of the general population of Mannheim. In most cases, the psychiatric disorder had been present before the stalking victimization started. The attending psychiatrists were only aware of the stalking victimization in four cases., Conclusions: Stalking seems to be a relevant problem in psychiatric patients. The results indicate that there is urgent need for advanced educational programs for patients and psychiatrists., (Georg Thieme Verlag KG Stuttgart. New York.)

Objective: To compare the prevalence rates of problematic alcohol consumption in students and in the general population., Methods: A sample of students (n=1 115) and a population sample (n=631) were assessed with the Patient Health Questionnaire (PHQ). The PHQ probes for problematic alcohol consumption with five questions. An "alcohol syndrome" is suspected if at least one of these indicators is present., Results: The alcohol syndrome was present more frequently among students than in the population sample (30,1% versus 8,1%). The odds ratio, adjusted for age, gender and education, was OR=3,7. However, when the five indicators were analysed separately, only two of them were significantly more frequent in students than in the comparison sample. Both indicate a neglect of duties as a consequence of alcohol consumption., Conclusions: Intervention strategies aimed at students' alcohol consumption should focus on binge drinking and the risks associated with this problematic form of alcohol consumption.

Certain professionals, such as health care personnel, have a higher risk of stalking victimization because of their professional activities. This study analyzed the lifetime prevalence of stalking victimization for journalists because they belong to a professional group that often works in public, demonstrates personal attitudes and opinions, and thus may easily become objects for positive or negative transferences. Four hundred and ninety-three journalists answered a standardized Internet questionnaire on stalking victimization. Twelve percent of respondents reported common stalking due to nonprofessional reasons, and an additional 2.2% reported apparently job-related stalking. In contrast to common stalking, job-related stalking victims were mostly male and took the perpetration less seriously, although they had the same risk of suffering violence and aggressive attacks. Since stalking can cause severe psychological distress in victims and some cases are at high risk for aggressive violence, better information for this professional group is necessary. Primary and secondary preventive strategies should be considered.

The lifetime prevalence of stalking is about 12% in the general population. The risk to become a stalking victim is increased for psychiatrists and psychologists. However, there are no studies with regard to other professions. The present study analyses the lifetime prevalence of stalking victimization for journalists, because some professional tasks may also put members of this professional group at a higher risk to become a stalking victim. 493 journalists answered an internet questionnaire. 12% of the journalists reported stalking victimization due to private or other non-professional reasons. This is nearly exactly the same lifetime prevalence that was found in a German community sample. However, 2.2% of the journalists reported stalking victimization that was related to their professional work. This is the first empirical study on this issue. Due to methodological problems no other studies have been published on this topic so far. The reported data of this study have to be interpreted cautiously, because the data are not based on a representative sample. However, comparisons with community-based epidemiological studies render our data a valid basis for starting a discussion of a so far neglected research issue. Our preliminary data suggest that journalists may be at higher risk to become a stalking victim because of their professional activities. Since stalking may cause severe psychological distress in the victims and, in some cases, puts them in severe risk of aggressive violence, preventive strategies should be considered.

Stalking is a widespread phenomenon describing a pattern of intrusive and threatening behaviour that leads to the victim's perception of being harassed and of him or her being rendered fearful. Physical assault and even homicide may occur in the context of stalking. Anglo-Saxon studies have revealed a lifetime prevalence of being a victim of stalking ranging from 4-7% in men and 12-17% in women. Recently, these rates have been confirmed by the first community based study carried out in Germany. As a stalker can have a number of victims during his or her lifetime, the prevalence of stalkers may be less than this, although at present data for this are lacking. Although the phenomenology of stalking appears to be rather homogenous, fairly distinct stalker typologies and perpetrator-victim relationships have to be considered. Requests for psychiatric and forensic assessment of stalkers are increasing. According to the German penal code, psychiatrists must provide expert opinion on criminal responsibility and the placement of stalkers. So far, all typologies of stalkers refer to the Anglo-Saxon cultural background and do not consider the special needs of German forensic psychiatry. In particular, the psychopathological dimension is widely neglected in common typologies. The present paper proposes a multiaxial typology of stalking that considers the psychopathological dimension, the relationship between stalker and victim and motivational aspects. Consequences for the forensic psychiatric assessment according to section 20, 21 StGB are outlined. It should be pointed out that stalking is not a new diagnostic category, but only involves, at a descriptive level, deviation from a normal behavioural pattern. The central components of the forensic psychiatric assessment remain the known diagnostic categories, the effects of which on behaviour can be analysed.

Purpose: Population-based studies on the relationship between stalking and mental health outcomes in victims are scarce. The aim of the present study was to assess associations between stalking victimization and specific DSM-IV mental disorders in a community sample., Method: A postal survey was conducted in a middle-sized German city (sample size=675). Lifetime stalking victims and non-victims were compared regarding rates of any mental disorder, comorbid mental disorders, and specific disorders assessed by the Patient Health Questionnaire (PHQ)., Results: Victims had a higher incidence of mental disorders and comorbid mental disorders. Sex- and age-adjusted rates of specific disorders were increased, with the most robust associations identified for major depression (OR 4.8, 95% CI 1.8-12.8) and panic disorder (OR 4.1, 95% CI 1.1-14.9). Victims also reported higher current use of psychotropic medication (20.8% versus 5.6%)., Conclusions: Our study indicates substantial associations between stalking victimization and impaired mental health that can be quantified at diagnostic levels in the general population. To confirm these findings, larger community studies are needed, which also include an assessment of lifetime psychopathology and of factors potentially mediating the associations between stalking victimization and mental health.

There is a lack of community-based studies on prevalence rates of stalking and the impact of stalking on victims in continental European countries. The authors published the first community-based epidemiological study on stalking in Germany. The purpose of this paper is to discuss possible implications of these epidemiological data for the mental health system, forensic psychiatry and legal regulations in Germany. For these reasons some data of our epidemiological study are outlined and reanalyzed. To examine lifetime and point prevalence rates of stalking, behavioural and psychological consequences for victims and the impact of stalking on current psychological well-being in a German community sample, a postal survey was conducted with 2000 inhabitants randomly selected from Mannheim (response rate 34.2%, n=679). The survey included a stalking questionnaire and the WHO-5 well-being scale. Almost 12% of the respondents reported having been stalked. This study identified a high lifetime prevalence of stalking in the community. Effects on victims' psychological health were significant and there was a high rate of physical (31%) and sexual (19%) violence in the context of stalking. Our data suggest that the phenomenon deserves more attention in future forensic psychiatric research and practice. Implications for forensic psychiatric assessment and treatment of stalkers as well as for management of stalking victims are discussed.

Stalking is a widespread phenomenon, which for the stalked person is associated with a not inconsiderable risk of becoming the victim of an act of violence. Furthermore, stalked persons may develop significant psychological problems, and therefore often seek out a doctor as their first contact. Another reason for this is the still unsatisfactory legal situation and widespread ignorance of the stalking problem on the part of the police and the courts. In the light of the above, it is of great importance that the physician should thoroughly familiarize himself with the problems associated with stalking.

Background: The objective of the study was to illustrate the effect of the extensive changes of the German DRG System on reimbursement of clinical ophthalmology during the years 2003, 2004 and 2005., Methods: All ophthalmologic patients treated as in-patients at the Department of Ophthalmology at the University Munich during the year 2003 served as a reference data basis. By means of appropriate software those cases were then re-grouped according to the G-DRG classification of the years 2003, 2004 and 2005. This resulted in different reimbursements caused only by system changes for an exemplary hospital of maximum medical care. In addition, the same calculations were performed for four virtual, typical clinics based on the calculation data of the "Institut für Entgeltsysteme (InEK)". For those four clinics it was assumed that 80 % of the cases came from one of the subspecialties retina, glaucoma, cataract or strabismus surgery., Results: Changes in the G-DRG system caused the sample hospital of maximum care to loose 8.5 % case mix index (CMI) during the period of 2003 to 2005. For three of the four virtual, typical ophthalmological clinics the theoretic reimbursement conditions also deteriorated: retina surgery -- 10.6 %, glaucoma surgery - 15.8 % and cataract surgery -- 17.9 % CMI. Only strabismus surgery showed an increase of + 5.6 % in CMI during the period examined., Conclusion: Over the years 2003 to 2005 the CMI clearly deteriorated for many ophthalmological subspecialties given otherwise identical conditions. To calculate the changes specifically for an individual hospital, the individual base rates have to be considered.

Aims: To provide an overview on the psychiatric significance of stalking and the implications for the health care system., Results: Stalking is a widespread phenomenon and can result in significant health care problems., Conclusion: In the future physicians will have to deal with this problem in a professional manner.

Background: There is a lack of community-based studies on prevalence rates of stalking and the impact of stalking on victims in European countries., Aims: To examine lifetime and point prevalence rates of stalking, behavioural and psychological consequences for victims, and the impact of stalking on current psychological well-being in a German community sample., Method: A postal survey was conducted with a sample randomly selected from the population of a middle-sized German city; 679 people (400 women, 279 men) responded. The survey included a stalking questionnaire and the WHO-5 well-being scale., Results: Almost 12% of the respondents (n=78, 68 women, 10 men) reported having been stalked. A multiple regression analysis revealed a significant effect of victimisation on psychological well-being., Conclusions: This study identified a high lifetime prevalence of stalking in the community. Effects on victims' psychological health are significant, suggesting that the phenomenon deserves more attention in future community mental health research.

Aims: The present study aimed at gathering information on the lifetime prevalence and impact of stalking on victims in a German community., Methods: A postal survey was sent to 1000 men and 1000 women who were sampled randomly from the inhabitant register., Results: The lifetime prevalence of being a stalking victim was at 11.6 %. Compared to non-victims, stalking victims scored significantly poorer on the WHO-5 well-being index., Conclusions: Stalking seems to be a relevant problem in Germany. Physicians have to become experts in this issue since victims frequently ask them for help.

Background: Since the year 2004 hospitals in Germany are obliged to participate in a payment system based on diagnosis-related groups (DRG), which bases hospital reimbursement on the diagnosis and treatment of patients. The aim of this study was to analyze the data of the first German national hospital cost data calculation for their homogeneity., Methods: The cases at the LMU hospital in Munich were calculated analogous to the national hospital cost data calculation for a period of 7 months. These exemplary data were then analyzed in detail for homogeneity., Results: For many DRGs, the numbers of cases in the analysis were within a range similar to those in the official nationwide calculation. The costs and lengths of stay were similar to those of the official national calculation., Conclusions: Many ophthalmologic DRGs are quite inhomogeneous necessitating regrouping to avoid false incentives. For cases with high complexity the current system may lead to cost deficits especially for hospitals providing maximum care.