Einfluss von Umweltl?rm auf Schlafqualit?t und Schlafst?rungen und Auswirkungen auf die Gesundheit

Environmental noise is a well-known risk factor influencing sleep-wake behavior and sleep quality. Epidemiologic studies have shown that environmental noise is regarded as the most annoying environmental factor. Noise causes modifications in physiologic and mental functions and may result in health outcomes like elevated blood pressure and ischemic heart disease. Reactions to high sound levels during sleep are decreased sleep intensity, arousals, and increased stress hormone secretion. Effects of poor sleep quality are reduced cognitive performance, tiredness, and psychosomatic symptoms. Long-term consequences of recurrent sleep loss due to environmental noise may be heart disease and increased medication intake. Arousals occur especially due to single noise events and intermittent noise. Laboratory and field studies showed no habituation of physiologic parameters to high sound levels. Sleep is especially sensitive to noise; therefore, sound levels during nighttime should be much lower than during daytime.     

Auswirkungen des ?Slacklinings“ auf die Gleichgewichtsf?higkeit von Senioren

Background

Staying independent and active in old age requires the ability to maintain equilibrium in the best possible way. Because of an increasing life expectancy physical fitness in the elderly is gaining more and more attention. The purpose of this randomized controlled trial was to examine whether slackline training for 3?weeks is suited to improve balance control in elderly people aged 60 years and over.

Methods

Thirty-four seniors aged 60?C72 years participated in this study. The participants were randomly assigned to an intervention group (n=17) or a control group (n=17). Subjects in the intervention group participated over a period of 3?weeks twice a week for 20?min in slackline training whereas control group subjects got no training. Baseline and post-intervention measurements included two clinical (functional reach test and balance test according to Wydra) and two biomechanical (posturography on a force platform and the BalensoSenso system) assessments to evaluate dynamic and static equilibration.

Results

Subjects who performed slackline training showed highly significant improvement in maintaining equilibrium under dynamic circumstances. Intervention group subjects also showed highly significant progression in static balance in the balance test according to Wydra and significantly reduced the length of sway in narrow stance on the force platform. All other measurements under static conditions showed no significant rise but tendencies of improvement were recorded. The control group demonstrated no significant changes in the post-measurement at all.

Conclusion

The results suggest that slackline training seems to be suited to improve equilibration in elderly people within a very short period of time.     

Auswirkungen von Multimorbidit?t auf die Inanspruchnahme medizinischer Versorgungsleistungen und die Versorgungskosten

Multiple chronic conditions (multimorbidity) are common among elderly patients; however, little is known about the specific effects of multimorbidity on health care utilization and health care costs. This article reviews empirical studies from the international literature that investigated the relationship between multiple chronic conditions and health care utilization (e.g. ambulatory care, stationary care, pharmacotherapy) and/or health care costs in elderly general populations. Although synthesis of studies was complicated, especially because of ambiguous definitions and measurements of multimorbidity, almost all studies observed a positive association of multimorbidity and utilization and costs. Many studies found that utilization and costs significantly increased with each additional chronic condition. In light of these findings coupled with the fear that current care arrangements may be inappropriate for many multimorbid patients, important implications for research and policy are presented and discussed.     

Wirkung von Nikotin und Amphetamine auf die Regulation des K?rpergewichts

Summary Twice daily s.c. injections of nicotine or amphetamine, for 6 weeks, produced a stabilization of the body weight at a level below that of the controls. This is attained by a transient hypophagia in normal animals and by a brief hyperphagia in animals emaciated prior to the treatment period.These effects confirm the hypothesis of Powley and Keesey (2) that the set-point for body weight is regulated, and not food intake.

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L'effet du nicotine et de l'amphetamine sur la régulation du poids

Résumé Le traîtement de nicotine ou de 1'amphetamine durant 6 semaines, produit une stabilisation du poids corporel à un niveau au dessous de celui des controles. Ceci se passe par une hypophagie passagère chez des animaux normaux et par une hyperphagie temporaire chez des animaux maigris préalablement.Ces effets confirment l'hypothèse de Powley et Keesey (2), disant que le set-point du poids sera régulé et pas la prise de la nourriture.

     

Macht uns die Stadt krank? Wirkung von Stadtstress auf Emotionen,Verhalten und psychische Gesundheit

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Stadtleben geht mit einem erhöhten Risiko für eine Reihe an psychischen Erkrankungen einher. Dabei scheint ein...     

Gesetzesänderungen und ihre Auswirkungen auf die Arbeitsmedizin

German legislation with respect to occupational health during recent years is reviewed. Discussed is the occupational safety law and related legislation as the hazardous substances act and the biological hazard act, the occupational health and safety act and the social act VII. Most improvements of occupational standards in Germany are induced by regulations of the European Union. Furthermore initiatives of the federal government and the federal states according to an amendment of the social act VII and the occupational health and safety act, which would induce a reduction of social standards, are discussed. The role of occupational medicine in companies by some of the above mentioned laws is improved. On the other hand the situation of occupational physicians in companies, universities and other agencies is characterized by budget cuts, reduction of occupational standards and loss of importance.     

Die Gesundheit arbeitsloser Frauen und Männer

Unemployment has material and psychosocial consequences that can also have an adverse effect on health. According to the Telephone Health Survey 2003, unemployed women and men suffer more frequently from many diseases and complaints. Their assessment of their own state of health is also more negative, and they say more often that their quality of life is restricted by their health. In the case of men, health problems are especially common among the long-term unemployed (>1 year), whereas women can suffer equally (or even more) serious effects on their health as a result of short-term unemployment. On the other hand, the analysis clearly indicates that poor health heightens a person's risk of becoming unemployed. However, no conclusive statement can be made on the direction of causality between unemployment and health, since this requires more longitudinal data.     

Evaluation der Auswirkungen des Mammographie-Screening-Programms auf die Brustkrebsmortalität

Background

In the German Mammography Screening Program (MSP), women aged 50–69 years are offered X-ray-based mammography for the early detection of breast cancer (BC) every 2nd year. To maintain the licensing of the MSP, evidence of a positive benefit–risk assessment of the radiation-related health risk has to be provided. Therefore, long-term effects of the program have to be shown by evaluating the BC mortality reduction based on the MSP. A current feasibility study attempts to develop different data flow models to evaluate whether, based on current legislations on data confidentiality, secondary data routinely available in the German health system can be linked in such a way that they can be used for epidemiological evaluation studies. We present the“NRW model,” which builds on procedures developed and evaluated in the Epidemiological Cancer Registry of North Rhine-Westphalia (EKR-NRW).

Methods

Data of the Association of Statutory Health Physicians in Westfalen-Lippe (KVWL) are used to enumerate the cohort of women in WL who are entitled to MSP participation and their use of curative mammography outside of the MSP. The EKR-NRW provides epidemiological and medical data on all BC cases in WL, on cohort mortality, and on causes of death. The central MSP database MaSc offers the screening history of all MSP participants. The established uniform encryption methods employed in the EKR-NRW are used for linking records from the three data sources in one data-merging center (DZS). To this end, data are first captured in standardized formats, variably aggregated and transferred in an encrypted format, checked for anonymity and diversity level in an encrypted form, and eventually stored in a factually anonymized manner in the evaluation center (ES). Researchers can obtain data sets with plain text epidemiological–medical data from the ES for analyses.     

Einfluss von Naturräumen auf die Gesundheit – Evidenzlage und Konsequenzen für Wissenschaft und Praxis

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Naturräumen und insbesondere urbanen Grünräumen (Stadtgrün) und Gewässern (Stadtblau) wird seit Langem...     

Der Einfluss von Hirnfunktionsst?rungen auf die Entwicklung des Kindes

Summary In childhood and adolescence two forms of so-called "psychoorganic syndrome" are distinguished. The early form, in the English and American literature called minimal brain dysfunction, impairs the entire development of the personality in its somatic and psychic aspects. It requires extensive therapeutic efforts. Early diagnosis therefore is of great preventive importance.The infantile psychoorganic syndrome which is acquired later in childhood can be distinguished from the early form by the fact that the impairment is usually only temporary, the etiology is understood and therefore understanding for the child is present.Minimal brain dysfunction when it continues into adolescence is called juvenile psychoorganic syndrome. The emotional lability and irritability which characterises the pubescent period are intensified in the early adolescent with juvenile psychoorganic syndrome and therefore stand out.The brain damage acquired in adolescence resembles the one acquired in adulthood. It is characterised however by the problems of this agegroup (identity, vocational decisions, social sexual maturations etc).

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Résumé Il convient donc de distinguer chez l'enfant le syndrome psychoorganique précoce du syndrome psychoorganique plus tardivement acquis. Le syndrome psychoorganique précoce remonte généralement à la grossesse, à l'accouchement ou aux premiers mois de la vie, alors que le syndrome psychoorganique acquis plus tardivement est la conséquence d'une lésion (traumatisme, méningo-encéphalite, tumeur cérébrale etc.) survenue après la première année. Le syndrome psychoorganique précoce met en cause tout le dévelopement de l'enfant et provoque notamment en plus des troubles moteurs et du langage parlé, une perturbation de sa fonction visuomotrice. Il en résulte fréquemment une dyslexie et une dysorthographie secondaire. L'enfant atteint d'un syndrome psychoorganique précoce doit bénéficier d'un traitement combiné comprenant aussi bien des mesures pédagogiques et médicamenteuses.Chez l'enfant ayant subi une atteinte encéphalique tardive on note que les fonctions acquises ne sont généralement que peu ou pas touchées par l'affection cérébrale. Ceci vaut par exemple pour le langage et pour la fonction visuo-motrice. Par contre, on constate à la suite d'une attaque cérébrale diffuse le syndrome bien connu comprenant des troubles de l'attention et de la concentration et de la mémoire de fixation. La fatigabilité augmentée, la tendance à la persévération et les troubles de la mémoire d'évocation ont une influence néfaste sur le rendement scolaire et/ou professionel.Sur le plan affectif on note classiquement une labilité augmentée entrainant souvent une tendance à des réactions pathologiques. Les syndromes psychoorganiques de la puberté et de l'adolescence se rapprochent cliniquement de celui de l'adulte, tout en présentant une teinte particulière due à la phase de dévelopment.Il est important de retenir que la récupération même dans une atteinte légère ou moyenne peut s'étendre sur plusieurs mois ou plus. Durant la longue période de convalescence et de réhabilitation il convient d'éviter au grand enfant ou à l'adolescent tout effort scolaire exagéré, tout en lui apportant les aides nécessaires sur les plans médicamenteux et psychothérapiques et au besoin, dans le domaine de la rééducation.

     

Psychische Belastungen und m?gliche Pr?vention bei Polizeibeamten

Background

In a longitudinal study the influence of physical and mental stress and the method of coping with stress on the health status of police officers in Saxony-Anhalt as well as the success of individual health-supporting measures were assessed. Special focus was set on the change of stress coping strategies based on individually suggested health-supporting measures and on changes of the physical and mental exposure.

Material and Methods

A total of 35 police officers (mean age 47.5±5.3 years) were questioned on job stress over a period of 5 years. Several questionnaires were used in this study.

Results

Improvements in the stress and exposure situations were observed in the recreation and exposure status as well as in the Freiburg personality inventory (FPI). Individually applied preventive measures did not show any significant positive effects on coping with stress.

Conclusion

The results show that there is a necessity for offering additional courses in stress coping and acquired stress coping techniques should be regularly applied.     

Perinatale Einflussfaktoren auf die spätere Gesundheit

KIGGS is a health survey on 17,641 children and adolescents in 167 communities representative for Germany, conducted between May 2003 and May 2006. Of the perinatal indicators, only a small proportion of data important for long-term outcomes was available for statistical analysis, and is presented here. In the past 20 years the mean weight gain during pregnancy has increased significantly by 2 kg, the mean birth weight has increased significantly by an average of 50 g, there has been no significant time trend for smoking and alcohol consumption in pregnancy. Birth weight and pregnancy weight gain of the mother correlate significantly. Pregnancy weight gain explains 5% of the birth weight in first-born infants. 17-18% of the mothers smoked during pregnancy, 4 times as many in the lower than the upper social class. 14% of the mothers consumed alcohol in pregnancy, but only 1% regularly. Only 5% of the migrants, but 3 times as many of the non-migrants consumed alcohol in pregnancy, and 2 1/2 times as many of the upper class compared to the lower class. With respect to smoking and alcohol consumption during pregnancy there seems to be an urgent need for political action.     

Auswirkungen des demografischen Wandels auf die Fachkräftesituation im Pflegebereich in Mitteldeutschland

This article provides a detailed analysis of the current state of the labor market for long-term carers in the Federal States of Saxony, Saxony-Anhalt, and Thuringia and uses model calculations to derive trends until the year 2025. Examining the current situation, we look at the ratio of unemployed persons to registered job vacancies, the duration of the vacancy, the short-term and long-term employment trend, the replacement demand, and the job-specific unemployment rates. In addition, wages are discussed as the central clearing mechanism between labor demand and labor supply. Employment bottlenecks are evident for nurses and social workers, which will be exacerbated in the future owing to a strong demographic change. On the one hand, demand for long-term care will grow along with the increase of elderly people. On the other hand, the labor force potential and hence the supply of long-term carers will decrease. Model calculations show that in these three Federal States, between 18,100 and 31,700 long-term carers (in full-time employment) will additionally be needed for the elderly. Employers in this field will face grave challenges in meeting these needs.     

L?rm und Gesundheit

Zusammenfassung Es wird eine kurze phänomenologische Betrachtung über das Wesen des Lärmes angestellt bezüglich seiner Bedeutung für die Gesundheit, sein Aggressions- und Streßcharakter betont und seine Schädlichkeit nach drei unterschiedlichen Dimensionen diskutiert: das akustische Trauma, der Lärm als Faktor der Zivilisationskrankheiten, der Lärm als Kulturkrankheit. In der Bejahung einer zunehmenden Schädlichkeit gründet der Ruf nach energischer Lärmprophylaxe.

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Résumé La notion du bruit est soumise à une courte analyse phénoménologique, son caractère d'aggression et de «stress» est souligné et son importance pathogénétique est discuté sous les trois angles du traumatisme acoustique, du bruit comme facteur des «maladies de civilisation», du bruit comme «maladie culturelle». L'importance nocive croissante du bruit réclame une campagne prophylactique énergique contre celui-ci.

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Nach einem Kurzvortrag an einem von der Bernischen Liga gegen den Lärm am 19. November 1956 veranstalteten öffentlichen Vortragsabend.     

Medizinische Rehabilitation im europäischen Vergleich und Auswirkungen des europäischen Rechts auf die deutsche Rehabilitation

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Die Versorgungspraxis der medizinischen Rehabilitation unterscheidet sich in den europäischen Ländern deutlich. In den...     

Einfluss von k?rperlicher Aktivit?t und Sport auf die Knochengesundheit im Lebenslauf

Physical activity and exercise are important determinants for metabolic and cardiovascular health. They also play an important role for bone health in childhood, adolescence, and adulthood. This review summarizes results from observational and intervention studies which evaluated the association between physical activity/exercise and bone health in different life course stages. In childhood and adolescence, physical activity and exercise induce improved bone accrual. In adulthood, mainly in postmenopausal women, long-term exercise programs reduce age-related bone loss. Especially weight-bearing activities seem to have an important osteogenic effect. Children and adolescent show a higher bone accrual until 5 years after cessation of an exercise program compared to their peers, who do not participate in an exercise program. In contrast, adults who quit exercising have a higher decrease in bone stiffness compared to adults who never exercised. This effect was particularly seen in postmenopausal women. Continuous physical activity and exercise over the life course and the implementation of exercise programs in schools and community-based intervention programs can help prevent or even reduce osteoporosis and osteoporosis-related fractures. Due to the lack of prospective longitudinal studies, the supposed long-term sustainable protective effect of physical activity and exercise in childhood and adolescent on bone health in later adulthood is not well established.     

Stillen und mögliche Geschmacksprägung

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Muttermilch bietet neben spezifischen nutritiven und funktionellen Vorteilen auch eine größere sensorische...