Bund-Länder-Arbeitsgruppe Arzneimittelfälschungen

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Im Jahr 2014 wurde eine große Anzahl an Fälschungen von Arzneimitteln italienischen Ursprungs bekannt. Der Umfang der...     

Bildung, ausgewählte Ernährungseinstellungen und Ernährungsverhalten

Background

Social inequalities in nutrition are observed, but the causes still have to be clarified. This study focuses on nutrition attitudes as mediator. We investigate whether there are social inequalities in selected nutrition attitudes in men and women and whether these contribute to social inequalities in nutrition behaviour.

Material and methods

Data are derived from the prospective population based Heinz Nixdorf Recall Study. Information on education, nutrition attitudes and behaviour of 4,157 men and women aged 50–80 years are stratified and analyzed using binary logistic regressions separately for men and women. Attitudes refer mainly to the relevance of healthy nutrition for chronic diseases. Behaviour is measured by consumption of vegetables, cereals and olive oil.

Results

We observe social inequalities in selected nutrition attitudes in study participants. However, social differences in nutrition behaviour are not explained by this.

Conclusion

Important attitudes regarding healthy nutrition are underrepresented in low education groups. It should continue to be an issue of health promotion that is sensitive towards socioeconomic status and gender.     

Ernährungswissen und Ernährungsverhalten

Background

Unfavourable nutritional behaviour is common among students in Germany, indeed in the whole German population. Intervention studies to investigate the effects of imparting nutritional knowledge to nutritional behaviour used diverse methods. Moreover the period of investigation was short and studies of this type have provided inconsistent results.

Objective

A controlled intervention study was conducted to analyze the long-term effects of nutrition-related studies on nutritional knowledge and the nutritional behaviour of female university students.

Materials and methods

Female students at the University of Education in Schwäbisch Gmünd were divided by course at the beginning of their studies: nutrition-related courses (intervention group: IG, n = 55), other courses of studies (control group: CG, n = 22). Theory- and practice-orientated nutritional knowledge and nutritional behaviour (food intake, Indicator Food Index) were assessed using a standardized questionnaire at the beginning and after two years of studies. Intervention effects were analyzed by two-way repeated measures analysis of variance.

Results

The theory- and practice-orientated nutritional knowledge of the IG increased compared to the CG (both: p < 0.001). Changes in food intake were an increased vegetable intake (p < 0.01) and a decreased fast food consumption (p < 0.01) within the IG compared to CG. The Indicator Food Index did not change.

Conclusions

Although nutrition-related studies are accompanied by a significant increase in nutritional knowledge, effects on nutritional behaviour are sparse. It can be speculated that acquired nutritional knowledge could be implemented into every day action although with a delay. Furthermore, the results show that long-term interventions have a certain health-promoting potential in sensitive phases of life.

     

50 Jahre Ernährungsaufklärung

Zusammenfassung 50 Jahre Ernährungsaufklärung haben ihr Ziel nicht erreicht. Ernährungsabhängige Krankheiten, Übergewicht und Verunsicherung steigen weiterhin an. Die kognitive Information über Ernährung bewirkt kaum eine Veränderung des überwiegend emotional regulierten Essverhaltens. Das bessere Ernährungswissen der Verbraucher aktiviert höchstens das schlechte Gewissen, wenn das eigene Essverhalten beurteilt wird. Präventionskampagnen, die nach den Prinzipien des sozialen Marketings die Bedürfnisse der Verbraucher reflektieren, aber auch verhältnispräventiven Maßnahmen wird für die Zukunft eine bessere Wirksamkeit beigemessen.     

Kardiovaskuläre Hochrisikokonstellationen in der primärärztlichen Versorgung

DETECT is a nationwide epidemiological cross-sectional and longitudinal study program in a random probability sample of 3,795 primary care settings (response rate: 60.2%). Based on a target day total assessment of n=55,518 consecutive patients (RR 93.5%) in these settings all patients underwent standardized diagnostic assessment, using self-reporting, clinical interview and laboratory measures. DETECT aims at describing the point prevalence and comorbidity of coronary heart disease (CHD), hyperlipidaemia, arterial hypertension and diabetes mellitus and at identifying the behavioural, clinical, laboratory and psychological risk factors associated with these conditions. A random subset of patients (n=7,519) also completed an extensive standardized laboratory screening program and a 12-month follow-up investigation. Findings reveal a high prevalence of hypertension (36.3%), dyslipidaemia (29.1%), diabetes mellitus (14.6%) and CHD (12.4%) in primary care as well as their close association among each other. The study describes for the first time in greater detail the prevalence of specific disorders and the frequency of high-risk constellations in primary care and allows for the evaluation of various risk scores.     

Sexualpädagogik und Gewaltprävention

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Die Prävention von sexualisierter Gewalt gegen Kinder und Jugendliche hat in pädagogischen Kontexten hohe...     

Qualitätssicherung und Qualitätsmanagement in der stationären Altenpflege

Quality, quality assurance, and quality management have been important topics in residential care homes for several years. However, only as a result of reform processes in the German legislation (long-term care insurance, care quality assurance) is a systematic discussion taking place. Furthermore, initiatives and holistic model projects, which deal with the assessment and improvement of service quality, were developed in the field of care for the elderly. The present article gives a critical overview of essential developments. Different comprehensive approaches such as the implementation of quality management systems, nationwide expert-based initiatives, and developments towards professionalizing care are discussed. Empirically based approaches, especially those emphasizing the assessment of outcome quality, are focused on in this work. Overall, the authors conclude that in the past few years comprehensive efforts have been made to improve the quality of care. However, the current situation still requires much work to establish a nationwide launch and implementation of evidence-based quality assurance and quality management.     

Lärmschäden und Lärmschutz Erfahrungen bei 2415 Lärmarbeitern der Deutschen Bundesbahn

Ohne ZusammenfassungMit 25 TextabbildungenHerrn Chefarzt der Deutschen Bundesbahn Dr. Karl Dunker zum 65. Geburtstag gewidmet.     

Zur Qualität der Qualitätssicherung

Ohne Zusammenfassung     

Qualitätsentwicklung in der vertragsärztlichen Versorgung: ein Baukasten mit vielfältigen Ansätzen

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Welche Unterstützungsangebote und freiwilligen Initiativen gibt es im vertragsärztlichen Bereich in Bezug auf...     

Betriebsärztliche Betreuung von Lehrkräften

Background

The health of teachers is of individual, economic, and social interest. Implementing effective and efficient health protection for teachers and pupils in the school environment is possible. Fundamental health protection is based on the implementation of the occupational health and safety law. This paper describes the implementation of occupational health care in Saxony in addition to the relevant principles of the law, which are also presented because the procedure is different in the other federal states of Germany.

Methods

Based on the data of the occupational health care of 2,361 teachers in Saxony, differences in various types of schools are described, including gender- and age-related results of individual occupational health care regarding health behavior, cardiovascular risk, subjective symptoms and diseases, burnout, and the effort–reward ratio compared with the general population.

Results

The health status of teachers must be evaluated in a differentiated manner. With the exception of blood pressure, the investigated Saxon teachers have a more favorable health status on average compared to the general population. However, some teachers face serious health problems. With increasing age, the health status of individual teachers varies significantly more.

Conclusions

Preventive occupational medical health care can contribute to the early detection and influencing work-related health conditions, to a school-related and individual prevention and to the effective and long-term collection of data on work ability and health. The results of health analyses form the basis for determining the need for action.

     

Lärmbedingte Belästigung und Erkrankungsrisiko

Traffic noise (road, train and flight noise, and the noise of parking cars), is the dominant source of annoyance in the living environment of many European countries. This is followed by neighbourhood noise (neighbouring apartments, staircases and noise within the apartment). The subjective experience of noise stress can, through central nervous processes, lead to an inadequate neuro-endocrine reaction and finally to regulation diseases. Within the context of the LARES-survey, noise annoyance within the everyday living environment was collected and evaluated in connection with medically diagnosed illnesses. Adults who indicated chronically strong annoyance due to neighbourhood noise were found to have an increased health risk in the cardiovascular system, the movement apparatus as well as depression and migraine. For adults with chronically strong annoyance caused by traffic noise, the risks to the respiratory system also increased. In older people, both neighbourhood and traffic noise indicated, in general, a lower risk of noise annoyance induced illness than in adults. It can be assumed that the effects of noise induced annoyance in older people is concealed by the physical consequences of age (with a strong increase in illnesses). With children, the effects of noise induced annoyance from traffic as well as neighbourhood noise is evident in the respiratory system. The increased illness risks in the respiratory system in children do not seem to be caused primarily by air pollutants but rather, as with case of neighbourhood noise, though emotional stress.     

Aktives Monitoring kleinräumiger Krebshäufungen

Background

Cancer registries often receive inquiries on possible cancer clusters. In 2010, the Cancer Registry of Lower Saxony reported on a spatial leukemia accumulation in the community of Asse. As a result, the Cancer Registry was engaged in developing an approach for a regional cancer monitoring program by the federal government. The modular approach involves a two-stage process. First, all regional monitoring areas are under surveillance, and in the second phase, noticeable areas only are observed further. A positive confirmation test is regarded as an initial concern and may lead to further investigations.

Methods

The standardized incidence ratio (SIR) is used in the first stage. For confirmation, the Sequential Probability Ratio Test (SPRT) is applied in the second stage. All new observations are tested at a given time. The SPRT tests the null hypothesis (no increase) and an alternative hypothesis (increase) leading to three possible conclusions: warning, all-clear, or further surveillance necessary.

Results

A high false alarm rate due to clustering by chance is to be considered with multiple statistical testing. The number of false alarms depends on the number of tested areas, diagnoses, subgroup analyses, and time periods. Preliminary considerations comprise 400 spatial areas, three diagnosis groups, no subgroup analyses, and a biannual first-stage testing. Guidelines for the level of significance and for detecting an increase in incidence will be necessary for the assessment of the monitoring parameters.

Discussion

Before running the monitoring program, a number of questions have to handled politically; e.g., how many false alarms can be handled, the impact on the population involved, and existing risk communication structures.     

Berufliche Tätigkeit und Arbeitsunfähigkeit

The use of sickness absence data of the health insurance funds for health reporting and health research has a long tradition in Germany. The data are especially used for work-related health monitoring. Work-related health reporting describes sickness absenteeism with respect to selected occupational populations and exposures and thereby provides valuable information pointing to needs in worksite prevention and health promotion. However, despite the routine use, different standards for the keeping, selection and evaluation of data have become established. Furthermore, in Germany there are a great number of statutory health insurances which traditionally were open to certain occupations only. A nationwide work-related health reporting therefore requires methods to account for these differences and to adjust for selective memberships in health insurance institutions. The BKK health report has established a specific standardisation approach which allows analysis with respect to occupations adjusted for economic sectors and vice versa.     

Die Häufigkeit der Unterbringung älterer Menschen in stationären Pflegeeinrichtungen

Scientific studies often exclude institutionalized people. Thus, there is insufficient information about the percentage of older people, who are living in nursing homes. Furthermore, when they move to a care facility, it is questionable whether their new address is officially registered. This is a major prerequisite for their accessibility in studies. By using a standardized questionnaire, the number of nursing home residents in Dortmund was anonymously recorded. Their percentage of the population was determined separately for gender and age. This information was then compared to the official registry. Of those 65 years and older, 5.0% of women and 1.8% of men lived in long-term nursing homes. The percentage of institutionalized people of both genders increases with age; however, the correlation is stronger for women. Overall, 79.5% of the residents are female. To some extent, there were large differences between the information from the care facilities and the official registry concerning the number of residents.     

Arzneimittelfälschungen

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Arzneimittelfälschungen sind variantenreich und von hoher krimineller Energie getrieben. Die Risiken für die Gesundheit...     

Präimplantationsdiagnostik

Preimplantation genetic diagnosis (PGD) undertakes an examination of an embryo outside the mother's womb subsequent to artificial insemination in order to identify a potential genetic and chromosomal impairment of that embryo. PGD is not being practiced in the Federal Republic of Germany since it cannot be reconciled with the provisions of the Embryo Protection Law. Objections have been raised against PGD based on ethical, religious and feminist arguments as well as on the grounds of legal framework policy. The essence of those objections relates to the fact that this method relativises the inviolability of the embryo in its early stages. Even human dignity itself is considered in danger. However, those objections have themselves caused demur. A variety of ethical reasons make it appear conceivable to allow PGD under narrowly defined conditions in medically founded cases. PGD can be used to the benefit of the health of both the pregnant mother and the expected children. In case PGD should be permitted, it would have to be within the framework of medical and sociopsychological counselling.