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ZusammenfassungUS-amerikanische Schwarze Feminist*innen entwickelten den Begriff Birth Justice, um strukturell verankerte Ungleichheits- und Gewaltverhältnisse rund um Schwangerschaft, Geburt und frühe Elternschaft sichtbar zu machen (Oparah 2015). Birth Justice verortet sich im Kontext des Konzeptes von Reproductive Justice und ist durch eine menschenrechtsbasierte, intersektionale Analyse reproduktiver Ungleichheitsverhältnisse gekennzeichnet (Oparah 2015; Ross und Solinger 2017).Die individuellen Erfahrungen Schwangerer* und Gebärender* werden geprägt durch die vielfältigen Wechselwirkungen zwischen Merkmalen wie geschlechtlicher Identität, Race/Ethnizität/Nationalität, Klasse, Alter, sog. Behinderung und sexueller Orientierung (ebd.). Subjektive Erfahrungen wirken sich auf Zufriedenheit mit der gesundheitlichen Versorgung aus und beeinflussen zukünftige Gesundheitsentscheidungen (Ohlbrecht 2016). Dadurch können Ungleichheiten fortgeschrieben werden.Zufriedenstellende intersektional orientierte quantitative und qualitative Studien zu peripartalen Outcomes sowie zum Erleben der gesundheitlichen Versorgung stehen im deutschsprachigen Raum aus. Quantitative Erhebungen zu Outcomes Gebärender* mit Migrationshintergrund in Deutschland sind sehr begrenzt und kritisch zu betrachten, da sie nicht auf der Grundlage differenzierter Antidiskriminierungsdaten durchgeführt wurden. Qualitative Studien zu Erfahrungen marginalisierter/minorisierter Personen mit peripartaler Betreuung gibt es nur sehr unzureichend in Quantität und Qualität. Ergebnisse zu Diskriminierungserfahrungen sind bisher noch nicht publiziert.Um menschenrechtsbasierte, respektvolle Betreuung als Qualitätsmerkmal der Gesundheitsversorgung Realität werden zu lassen und gesundheitliche Ungleichheiten abzubauen, braucht es verlässliche Erhebungen zu Erfahrungen mit der peripartalen Versorgung insbesondere von marginalisierten und minorisierten Personen. Diese sollten in ihrem Design intersektional reflektiert und diskriminierungssensibel angelegt sein. Intersektionalität und ihre Auswirkung auf den Zugang und die Qualität der peripartalen Begleitung sollten in die theoretische als auch praktische Ausbildung im Gesundheitswesen aufgenommen und Bewusstsein durch Fortbildungen gefördert werden.

Graefe's archive for clinical and experimental ophthalmology 259(8), 2251-2257 (2021). doi:10.1007/s00417-021-05235-8, Published by Springer, Heidelberg

Background Providing care for someone with a disease or chronic condition can have a negative psychological, physical, social, and economic impact upon informal caregivers. Despite the socio-economic relevance and more than three decades of caregiver intervention research only very few translational efforts of successful interventions are reported. Still less of these interventions have been implemented into routine services. The aim of the ReDiCare study (German acronym BerTA) is to evaluate the effectiveness of a stepped counselling approach for burdened caregivers delivered by care counsellors of two long-term care insurances and registered psychotherapists. Methods/ design A pragmatic randomised controlled trial with 572 caregivers of older adults (≥ 60 years) receiving benefits of one of the two participating long-term care insurances. Participants are assigned (t0) to either the ReDiCare intervention or a control group receiving routine care and counselling. Data are collected at baseline (-t1), 3-month (t1), 9-month (t2) and 15-month (t3). The 9-month post-intervention assessment (t2) is the primary endpoint to evaluate the results on the primary and secondary outcomes, measured by self-reported questionnaires. Depressive symptoms measured with the CES-D are the primary outcome. The main secondary outcomes are physical complaints, utilization of psychosocial resources, caregiver self-efficacy and burden, positive aspects of caregiving and perceived care quality. A process evaluation, including audio tapes, self-report questionnaires and documentation will be conducted to examine internal and external validity of the intervention. Data on direct and indirect costs are collected for the (health) economic evaluation, using a health care perspective and a societal perspective. Discussion While comparable previous caregiver interventions have been developed and evaluated for specific caregiver groups (e.g. dementia caregivers, stroke caregivers), the ReDiCare study will indicate whether a stepped approach will be effective also in a broader group of caregivers. The intervention is one of the very few translational studies in caregiver intervention research and will provide valuable insights into relevant factors for training, intervention protocol adherence, effectiveness, and costs for future implementation steps. Trial registration Deutsches Register Klinischer Studien (German Clinical Trials Register), DRKS00014593 (www.drks.de, registered 14 May 2018) and International Clinical Trials Registry Platform, DRKS00014593 (https://apps.who.int/trialsearch/).

Purpose To test if an encircling band improves outcomes in vitrectomy for pseudophakic retinal detachment (PRD) with inferior or with multiple (4 or more) breaks. Methods Subgroup analysis of a prospective randomized controlled multicenter trial in patients with uncomplicated PRD assigned either to 20 G vitrectomy plus encircling band (group E1), or 20 G vitrectomy without any buckle (group C), or 23/25 G vitrectomy without any buckle (group E2). The primary endpoint was defined as no indication for any retina reattaching procedure during the review period of 6 months. One hundred out of 257 patients were identified with inferior breaks and 63 patients had 4 or more breaks. Results In patients with retinal breaks between 5:00 and 7:00, treatment was successful in 77.4% (24/31, treatment arm E1) versus 57.1% (16/28, treatment arm C) (p = 0.301, odds ratio (OR) 1.83, 95% confidence interval (CI) 0.48 to 7.17). In patients with multiple breaks, success rates were 68.2% (15/22, E1) versus. 72.4% (21/29, C, p = 0.46, OR 0.52, CI 0.08–3.65). Conclusion Combining an encircling band with vitrectomy in patients with pseudophakic retinal detachment and inferior or multiple breaks does not significantly improve primary anatomical success in comparison to treatment with 20 G or 23/25 G vitrectomy alone.

Blue–yellow visual-evoked potentials (BY-VEPs) may be used for diagnostics of functional ganglion cell damage in glaucoma and other ocular diseases. In this study we investigated the impact of lenticular opacities on BY- and standard pattern reversal VEPs by examining patients before and after cataract surgery. Eighteen patients with moderate cataract were included in a prospective study. Transient on/off isoluminant blue–yellow 2° checks were used for short-wavelength stimulation (BY-VEP), transient large 1° (M1) and small 0.25° (M2) black-white checks for standard pattern reversal VEPs. VEPs were acquired before (24 ± 30 days) and after cataract surgery (14 ± 16 days). The contralateral eye was used as a control. Amplitude and latency of M1 and M2 peaks did not change significantly from before to after surgery. The amplitude of the BY-VEPs did not change significantly after cataract surgery (pre-surgery, −7.42 ± 3.43 μV, post-surgery, −7.93 ± 3.65 μV, p = 0.42), yet the latency of the main negative peak showed a significant decrease (pre-surgery, 143.9 ± 12.9 ms, post-surgery, 133.2 ± 7.7 ms, p = 0.0006). The BCVA improvement was significant from before to after cataract surgery (pre-surgery, 0.344 ± 0.125 LogMAR, post-surgery, 0.224 ± 0.179 LogMAR, p = 0.013) yet not correlated to the absolute decrease in latency of the BY-VEP after surgery (r = 0.309, p = 0.22). No significant changes were found in the contralateral eye. The BY-VEP is sensitive to lenticular opacities of the human lens, presumably due to the increased short-wavelength absorption in the aging eye. This fact should be considered when applying BY-VEPs for diagnostics.

Thermosize effects have been proposed in literature by considering the quantum size effects (QSE) induced by the wave character of particles. These effects appear only if nano and macro domains are connected to each other when they are under a temperature gradient. QSE are noticeable in nano domain while they are almost negligible in macro domain. This difference causes thermosize effects, which may be called quantum thermosize effects (QTSE) because of their pure quantum origin. On the other hand, also classical thermosize effects (CTSE) appear as a result of different transport regimes in nano and macro domains, and they can be noticeable even if QTSE are negligible. As long as the mean free path (l) is much greater than the mean de Broglie wave length of particles (λ), which is almost the case in practice λ/l < 1, the principal effects are CTSE. QSE cause only small corrections on CTSE when the scale is down to nanoscale. On the other hand, in literature, QTSE and CTSE have been examined individually although it is not possible to observe QTSE alone in practice except for the extreme case of $${\lambda /l \gg 1}$$ . Furthermore, the constant pressure assumption and the Knudsen law have been used during the derivations of QTSE and CTSE, respectively, although the proper assumption at nanoscale is the modified Knudsen law, which considers QSE. In this study, QSE on CTSE are considered and the modified Knudsen law is derived and used to obtain the more realistic results for thermosize coefficients. The results can be used for a possible experimental verification of thermosize effects as well as to design some new devices based on these effects.

To introduce a method for improvement of multifocal VEP (mfVEP) recordings by prediction of waveforms at multiple positions on the surface of the skull. Fifteen healthy participants (mean age 24 ± 3.8 years) underwent mfVEP recordings from 3 surface positions. Two methods of a best-of-mfVEP approach were used and compared. In the first, a standard procedure, further data from 3 calculated channels were used. In the second approach, mfVEPs were obtained by using data derived from 40 virtual electrode positions on the basis of predictions from dipole source calculations. The mean signal-to-noise ratios (SNRs) of the best-of-mfVEPs of both methods were compared. The SNR was significantly higher for mfVEP data using additional virtual recordings revealed by dipole source determination (2.87 vs. 3.36; P < 0.035). We conclude that multichannel prediction of mfVEP responses based on dipole source calculation significantly improves the quality of the examination results compared with the currently prevalent standard method.