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Background: Even now the further training in surgery faces considerable challenges. The planned hospital structural reform will result in new bureaucratic and organizational hurdles, which could lead to a considerable loss of quality in advanced surgical training across all disciplines. Objective: The aim of this position paper is to describe the current and future challenges for advanced surgical training and to identify possible approaches and opportunities for the further development against the background of the planned hospital structural reform. Material and methods: For the development of this position paper a committee of representatives of the Young Forums of the German surgical societies identified and critically discussed current problems and challenges of the present residency training system and formulated a list of demands for a sustainable residency training concept. Results: The planned shift to outpatient treatment and centralization were identified as central challenges for surgical residency training. Surgical training must be considered consistently and from the outset in all political reform efforts. In addition to a transparent and cost-appropriate financing of residency training, we call for the involvement of all German surgical societies in the reform process. Furthermore, the social framework conditions for junior surgeons should be considered. Conclusion: The structural change in the hospital landscape in Germany, which is being forced by politicians, harbors the risk of a further loss of quality and experience in surgical treatment and training. At the same time, the planned hospital reform offers a unique opportunity to address existing problems and challenges in surgical training and to consider them as a starting point for structural changes which are fit for the future. [ABSTRACT FROM AUTHOR]

Background: With reference to the United Nations Convention on the Rights of Persons with Disabilities (UN CRPD), a fundamental change in psychiatric care in Germany was proposed in 2019 by Zinkler and von Peter, supported by a legal perspective from Kammeier, which has since led to controversial debates. Essentially, the aim is not only to reduce coercion in psychiatry to a minimum, but also to fundamentally exclude it in a psychiatry that only provides care. The function as an agent of social control is to be returned from psychiatry to state institutions. Psychiatric hospitals will only admit patients with their consent; patients who refuse therapy will not be admitted regardless of their capacity for self-determination and will remain untreated or, if they have committed a criminal offence or threaten to commit a criminal offence, they will be taken into custody or imprisoned in accordance with the legal regulations applicable to all people. There they will receive psychiatric care if they so wish. Aim of the paper: The paper outlines the background of this concept, including international sources, traces the discussion in German specialist literature and takes a critical look at it. Results: The criticism is primarily directed against the fact that responsibility for a relevant proportion of psychiatric patients would be handed over to the police and judiciary and that, as a result, two realities of care would be established that would considerably differ in terms of quality. Conclusion: Arguments are put forward in favor of retaining the function of social control and considerations are suggested as to how caring coercion can be largely minimized. [ABSTRACT FROM AUTHOR]

Background: The healthcare sector is responsible for 5.2% of CO2 emissions in Germany. The prescribing of medicines is a significant contributor. Among the prescribed medicines, metered dose inhalers (MDIs) play a decisive role due to the propellant gases they contain. A relevant reduction in emissions is possible by switching to dry powder inhalation systems (DPI). Aim: The guideline "Climate-conscious prescribing of inhalants" is intended to provide assistance in the prescribing of inhaled medicines by summarising the available evidence on the decision between DPI and MDI and explicitly addressing the aspect of climate damage caused by propellants. It addresses everyone involved in prescribing and counselling those affected. Materials and methods: The S2k guideline was drawn up under the joint leadership of DEGAM (German College of General Practitioners and Family Physicians) and the German Society for Pneumology and Respiratory Medicine (DGP) under moderation of the AWMF (Association of the Scientific Medical Societies in Germany). The main contents from a practical perspective are presented in this paper. Results: Overall, MDIs account for a high proportion of inhaler prescriptions in Germany. The aspects of climate damage should be considered when prescribing MDIs. In order to facilitate implementation in practice, several decision aids were developed. Conclusion: The guideline is the first to address the importance of prescribing a group of medicines in relation to climate change. The degree of implementation of the guideline recommendations can be determined by future analyses of prescription data. A planned practical test is required to check the acceptance of the decision aids. [ABSTRACT FROM AUTHOR]

The article "President's Greeting" reports on the position paper on equal opportunities and diversity of the German Mathematical Society (DMV). The DMV presidency emphasizes the importance of a diverse, respectful, and inclusive community. It is mentioned that the discussion about a possible renaming of the DMV has resurfaced, but no name change has taken place so far. The presidency has established a specialist group for gender, diversity, and sustainability in mathematics and proposes a participatory process to shape the discussion about the name of the DMV. Furthermore, reference is made to a paper adopted by various mathematical and scientific societies, condemning antidemocratic and nationalist approaches in Germany. It is emphasized that science requires openness, international cooperation, democracy, and the rule of law. [Extracted from the article]