[A survey of Local Physicians and Psychotherapists on Cooperation in Regional Networks for Early Child Interventions in Saxony-Anhalt]. / Befragung von niedergelassenen Ärzten/innen und Psychotherapeuten/innen zur Kooperation in regionalen Netzwerken der Frühen Hilfen in Sachsen-Anhalt.

BACKGROUND: Early childhood interventions positively contribute to health related child development. For these interventions, networks are a necessary prerequisite as they promote interdisciplinary and interprofessional cooperation. This holds especially true for the integration of health system protagonists. METHODS: In a cross-sectional survey local paediatrists, gynaecologists, general practitioners, and psychotherapists were asked about their knowledge, experiences, desires, and reservations regarding cooperation in early childhood intervention networks. RESULTS: 64 out of 1747 (3.7%) eligible clinicians answered the survey. On average they estimated that 10.1% of the families they are treating would benefit from early childhood interventions. Participants rated themselves as competent to offer appropriate early childhood interventions. The youth welfare service was judged as the most important institution for their own professional practice by 84.4%. Additionally to an applicable agenda, a fair group moderation of network meetings was seen as a substantial requirement in order to take part in network meetings. CONCLUSION: Health professionals are important protagonists in early childhood interventions. Clinicians should assess relevant problems in families and offer appropriate support on a regular basis. Alongside clearly defined regional contacts, interprofessional continuing education seems mandatory.

[Appraisal of Educational Programmes and Qualifications of Health Occupations/Professions: A European Comparison - Main Results and Conclusions]. / Bestandsaufnahme der Ausbildung in den Gesundheitsfachberufen im europäischen Vergleich (GesinE) - zentrale Ergebnisse und Schlussfolgerungen.

INTRODUCTION: This is about some results of a study called "Appraisal of the educational programmes and qualifications of health professions: a European Comparison" (in short: GesinE). It was carried out in the years 2009-2013, commissioned by the BMBF and supported by the BIBB. It is focussed on Germany, France, Great Britain, the Netherlands and Austria. The objectives have been (i) an inventory and comparative international synoptic presentation of education programmes of 16 health professions, (ii) a comparative international qualification analysis for the professions of radiographer, physiotherapist and nurse and (iii) the exposure of key aspects of the health-care and education systems in the compared countries. METHODS: This is a comparative multi-sectional study for which a mixed methods approach with qualitative and quantitative elements was used. RESULTS: According to the results of this study it is necessary that current qualification paths and competence profiles of the health professions are developed continuously in Germany. In this process the German education and the secondary education sector should not be underrated. At the same time the results suggest that there are advantages in some aspects in the academic education (which is the norm for most of the analysed professions in the surveyed countries) compared to the existing education programmes in the secondary sector. This in particular applies to the competence for finding and transferring scientific knowledge into practice and for implementing reflected processes for decision making. CONCLUSIONS: The results improve the basis of the current debate in Germany about the development and reorganisation of the profiles of health professions and their qualification in a European context.

[Project "FrühStart"--family midwives in Saxony-Anhalt. Their networking with other health care and child welfare professionals and subjective view of the families]. / Modellprojekt FrühStart--Evaluation der Familienhebammen in Sachsen-Anhalt. Vernetzung, Sichtweise der Klientinnen und Verankerung im Netzwerk Früher Hilfen.

The project "Family midwives in Saxony-Anhalt" was evaluated by a multidimensional approach in order to document the subjective perspective of the mothers as well as the networking of health care and child welfare professionals, while caring for highly vulnerable families. The documentation of 734 cases and quantitative data of 33 family midwives were analyzed. Ten mothers were interviewed and problem-focused expert interviews were carried out with 39 health care and child welfare professionals. The method of coding the interview texts was both open and guided by the research questions. After finishing the qualification course and while caring for highly vulnerable families, the networking of family midwives with child welfare professionals significantly increased. Besides the family midwives and the youth welfare office, the antenatal counseling centers were important "gatekeepers". An important ingredient for constructive networking and care for families is trust which draws on client-oriented care, availability, and advocacy by the family midwives. While the family midwives are respected as partners by the professionals of the child welfare system, networking with obstetricians and hospitals is unsatisfactory. In order to improve this, the latter must be a future goal.

[Midwife attendance during labour and its relation to interventions and outcome of birth]. / Zusammenhänge zwischen Anwesenheit der Hebamme, Interventionen und dem Outcome der Geburt.

BACKGROUND: Continuity of midwifery care during labour is beneficial. We investigated the relationship between midwife presence, interventions and outcome. PATIENTS AND METHODS: From the overall sample of singleton pregnancies in cephalic presentation (n=4 438) we selected 541 prospectively documented hospital-based birth processes occurring at term without antenatal risks and spontaneous mode of birth. Univariate and multivariate analyses were performed. RESULTS: Midwives were present for up to six hours in 66% of 247 births to primiparae, and for up to three hours in 61% of 294 births to multiparae. Midwives were present for more than 75% of the overall labour duration in 62% of all births in nulliparae and 63% in multiparae. Midwife presence for more than 75% of the total birth duration correlated positively to immersion in water (p<0.02), up to two CTG tracings (p<0.001), and up to three vaginal examinations (p<0.04). Midwives working in hospitals which contributed more than 50% of their eligible births were present for longer during labour than midwives in units with a lower participation rate (p<0.002). Multivariate regression revealed that up to two CTG tracings (p<0.001) and a participation rate of more than 50% (p<0.002) were significantly related to midwife presence. DISCUSSION: Intensive intrapartum midwife presence during spontaneous birth was associated neither with fetal outcome nor with interventions, except for up to two CTG tracings. This might be due to shorter labour or the later commencement of care. CONCLUSIONS: Intrapartum midwife presence covers a large portion of the birth process, but continues to be poorly understood.