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Background: Within an ongoing birth cohort study (LISA) the cytokine production of cord blood T cells was compared between neonates from Leipzig (East Germany) and Munich (West Germany). The aim of this study was to analyse regional differences and influencing factors of the immune status., Methods: Cytokine production was measured in a randomly selected subgroup of 158 children from the LISA (Life style - Immune system - Allergy) cohort by intracellular cytokine staining. Information on family "atopy" history (FAH) and home characteristics was obtained from questionnaires., Results: Reduced numbers of interferon-gamma (IFN-gamma) and tumor necrosis factor-alpha (TNF-alpha) producing T cells were found in association with biparental FAH and housing renovation during pregnancy. In addition, cytokine production was influenced by season. In Munich, the frequency of biparental FAH and of renovation measures during pregnancy was significantly higher as compared to Leipzig. Neonates from Munich showed significantly decreased amounts of IFN-gamma and TNF-alpha and elevated levels of interleukin-4 (IL-4) producing T cells. Differences in cytokine production between Munich and Leipzig were influenced by season (IL-4) and housing renovation (IFN-gamma, TNF-alpha)., Conclusions: Since differences in the T cell cytokine production of neonates in Munich and Leipzig are independent from FAH our findings may provide evidence for the impact of environmental factors upon the fetal immune system.

The author analyzes results from a 1990 survey of family and social networks in the former Federal Republic of Germany. "Our project...focuses on the question as to what extent the changes in the observed demographic factors do affect and modify the system of the family with its various acts of assistance and support (financial help, emotional support, rendering of services)." The questionnaire used is provided, and survey methods are described., (excerpt)

From 1976 to 1985 151 recurrent carcinomas of the uterine cervix were diagnosed and in 118 cases they have been treated at the Gynaecological Centre of the University of Freiburg. The recurrences were divided according to the localisation scheme of Munnell and Bonney. 55 patients (47%) received radiotherapy, 22 (19%) surgery, 12 (10%) combined therapy of surgery and radiotherapy and 13 women (11%) chemotherapy or hormone therapy. 16 patients (13%) received a different type of therapy. We found most of the recurrences three or four years after the primary therapy. There was no correlation between the point of time of diagnosis of the recurrences and the prognosis. The distribution of the histology was no parameter for the OAS. The operative procedure demonstrates better results than the radiotherapy at recurrences in the centre of the pelvis--but there is no significance. The radiotherapy achieves significant better results than the operative treatment when we have large recurrences in the whole pelvis. If there is an answer of the tumour to the therapy, the OAS gets better--in these cases we should use, in spite of the risk of more side effects, the whole therapeutic range.

Performance priorities for high quality care, multiprofessional team care and deinstitutionalization of patients among mental health services in England and West Germany were found to be significantly influenced by management practices fostering goal congruence, peer review and staff participation in decision making.

Physicians are moving into organized settings where their autonomy is more constrained and where management has more responsibility for physician satisfaction. The relationship of management practices to physician autonomy and satisfaction was explored in a survey of 185 psychiatrists in the State of Hessen in the Federal Republic of Germany (FRG). Analysis revealed that controlling for physician and institutional characteristics, management practices in relationship to participative activities, supportive communication, and peer review activities were the most important predictors both of perceived clinical autonomy and of work satisfaction. Gender was also a factor in that male physicians experienced greater perceived autonomy. Perceived clinical autonomy was an important factor in explaining satisfaction, whereas a few other physician and institutional characteristics were significant in predicting satisfaction. Unexpectedly, there was more perceived clinical autonomy among psychiatrists in larger, less well funded, more managerially constrained, state institutions than in smaller, community general hospitals and private organizations. Implications for further research are discussed.