Wie lässt sich die Eliminierung von Hepatitis B,C und D in Deutschland messen? Ergebnisse eines interdisziplinären Arbeitstreffens

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Die Weltgesundheitsorganisation (WHO) hat 2016 eine Strategie zur Eliminierung von Hepatitis-B-, -C- und -D-Virusinfektionen...     

Die Ergebnisse des Kinder- und Jugendgesundheitssurveys (KiGGS) – eine einzigartige Datensammlung zur Gesundheit der heranwachsenden Bevölkerung in Deutschland

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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...     

Bedeutung von Multicenterstudiengruppen für die klinische Forschung in der Hämatologie und Onkologie

During the past 25 years a highly effective infrastructure for clinical trials was developed in hematology. Following initial funding by the BMFT (Ministry for Research and Technology) a number of large multicenter study groups for leukemia and lymphoma were developed. Treatment results from these studies often represent the“gold standard”. However, since no standard therapy is defined for these diseases, the study groups aim to treat all patients within treatment optimization trials (TOT) to combine research and care. They contribute considerably to quality control in therapy and diagnostics, e.g., by establishing central reference laboratories. The regulatory requirements for clinical trials were extended considerably after the activation of the 12th drug law and TOTs now have to fulfill requirements similar to registration trials in the pharmaceutical industry. Due to the considerable bureaucratic effort and increased costs, only few large multicenter trials could thereafter be initiated and a substantial disadvantage for independent academic research becomes clearly evident.     

Umsetzung des Infektionsschutzgesetzes (IfSG) – Aufgaben für die Arbeitsmedizin?Zur Kooperation von Gesundheitsämtern und Betriebsärzten

As announced in the Federal Law Gazette (July 2000), the Infection Protection Act (IfSG) replaced the Federal Law for Control of Infectious Diseases (BSeuchG) on the first of January, 2001, ending its reign for the past forty years. Incorporating some of the tried and tested rules from the BSeuchG, the Infection Protection Act contains new rules on case reporting procedures, hospital hygiene, communal establishments and food handling enterprises, which will gradually be implemented through administrative channels, jurisdiction, professional editorials and academic publications. In place of requiring physical examinations, x-rays and stool specimens from employees in communal establishments and food handling enterprises according to the BSeuchG, the Infection Protection Act holds informative talks with workers in these fields on infectious diseases, on favourable conditions for spreading the disease, and on how agents contaminate certain products in food handling enterprises that can cause consumers to become ill. These informative talks with both employees and visitors in communal establishments and with employees in food handling enterprises (see further §§ 34/35 and 42/43 IfSG) are based on the general rules of the Infection Protection Act (§ 1 Para. 2 and § 3), which adhere to the guidelines found in the leaflets “Prevention by information and education” and “Fostering personal responsibility in communal establishments and enterprises”. On the basis of school legislation, public health law and the rules stated in § 34 of the Infection Protection Act, community health services must fulfil the duties of a occupational health physician in schools and other communal institutions. Because of the need to repeat training sessions for employees in these institutions every two years, the work load of public health officials has increased sharply. Training sessions are oral and entail handing out leaflets. Depending on the degree of expertise, these sessions can be quite time consuming. However, quality must not be sacrificed in order to ease the work load. Consequently, general practitioners in occupational health are expected to cooperate with public health services and take over these training sessions. The initial informative talk with the employees in food handling enterprises is, in accordance with § 43 Para 1 of The Infection Protection Act, both oral and written and is administered by the community health service. Further instructional sessions on diarrhoea, typhus, hepatitis A, suppurating skin diseases, among others (see § 42 IfSG) should be held annually in the respective enterprises. While the employer is responsible for holding these meetings, their medicinal nature requires the competence of a doctor. In 1999, Charlottenburg, a district in Berlin, issued 8,650 certificates; Frankfurt am Main issued around 6,600 the same year. These examples show clearly how much time is required for the initial and following instructions. In order to reach the goal of having employees who are both informed and responsible, a mutual understanding and good communications between the public health service and occupational health are of utmost importance. Dispensing of the required stool specimen in accordance with §§ 17/18 of the BSeuchG has been heavily criticised, for fear that an undetected carrier could endanger the purity of a product. However, the prevalence of positive stool specimen ranged between 0,3 and 0,7 percent in the 90 s and any relationship between the examination and infectious epidemiological insight of infections due to food contamination could not be proven. Surely, this shows that the best way to prevent infections is by informing and instructing people about the dangers.     

Inanspruchnahme von Maßnahmen der betrieblichen Gesundheitsförderung in Deutschland – Ergebnisse der Studie „Gesundheit in Deutschland aktuell“ (GEDA 2014/2015-EHIS)

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Maßnahmen der betrieblichen Gesundheitsförderung (BGF) sollen die Arbeitsorganisation und die Arbeitsbedingungen...     

Entwicklung des Sächsischen Gesundheitsziels „Aktives Altern – Altern in Gesundheit, Autonomie und Mitverantwortlichkeit“

In Saxony, the consequences of demographic aging are observable already today. To manage the implications on the health sector, the Saxon Health Targets Steering Committee decided in March 2008 to develop a health target “Active Aging – Aging in Health, Autonomy, and Participation”. Target development was based on a 7-level approach (fields of action, main goals, target areas, targets, strategies, intervention measures, indicators for evaluation). A quantitative content analysis was used to reveal 10 potential relevant fields of action, three of which were selected for target development. Targets were developed by 53 stakeholders in multiprofessional working groups. Criteria-based analyses were performed to assure appropriate scientific evidence and feasibility of targets and intervention measures. Over a period of 9 months, 24 targets were defined referring to the main goals “needs-based health care structures”, “multiprofessional qualification”, “self-rated health” and “intergenerational solidarity”. Thirteen targets were developed into recommendations for specific intervention measures. Most of the proposed interventions aim to modify health-related structures or psychosocial determinants of health in the elderly. The best recommendations for intervention measures shall be implemented in cooperation with interested decision-makers.     

Mortalitäts-Follow-up der Studie zur Gesundheit Erwachsener in Deutschland (DEGS)

Objectives

Within the framework of the German Health Interview and Examination Survey for Adults (DEGS), the Robert Koch Institute (RKI) conducted a nationwide mortality follow-up study. As there is no national mortality register in Germany, mortality and causes of death were investigated individually and under observance of state-specific data protection conditions.

Methods

The German Health Interview and Examination Survey 1998 (GNHIES98) provided the database including 7,124 participants aged 18–79 years. A total of 6,979 participants of GNHIES98 (98?%) who consented to be re-contacted were invited between October 2008 and October 2011 to also participate in the first data collection wave of DEGS (DEGS1). In this context, the vital status and the causes of death for deceased participants were assessed. Age- and sex-specific probabilities of survival and death rates were calculated and grouped by main causes of death according to ICD-10 groups.

Results

A total of 671 individuals (285 women, 386 men) died between the two survey contacts. For all deceased persons the date of death and for 539 (80.3?%) the causes of death could be determined. With a median follow-up time of 12.0 years, 8,0742.5 person years were available for survival analysis. The crude overall death rate amounted to 8.3 per 1,000 persons-years (women: 7.2; men: 9.5). Among 539 persons with available information on causes of death, 209 (38.8?%) were attributable to cardiovascular diseases, 188 (34.9?%) to cancer, 135 (25.0?%) to other causes, and seven (1.3?%) could not be unambiguously assigned.

Conclusions

A mortality follow-up was successfully integrated in the longitudinal component of DEGS as part of the national health monitoring at the RKI. Death rates and cause-specific mortality in relation to highly prevalent chronic diseases and risk factors provide essential information for assessing the potential of prevention and quality of care among adults in Germany. This requires a regular and complete conduction of mortality follow-ups.     

Falldefinitionen des Robert Koch-Instituts zur Übermittlung von Erkrankungs- oder Todesfällen und Nachweisen von Krankheitserregern§ 4 (2) des Gesetzes zur Verhütung und Bekämpfung von Infektionskrankheiten beim Menschen (Infektionsschutzgesetz – IfSG)

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Daten zur sexuellen Gesundheit von Anbietern und Kunden sexueller Dienste bei in Deutschland lebenden Männern,die Sex mit Männern haben

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Über die sexuelle Gesundheit von männlichen Anbietern und Kunden sexueller Dienstleistungen in Deutschland ist wenig...     

Prävalenz und Inzidenz von Atemwegserkrankungen und Allergien bei Schulkindern. Ergebnisse einer dreijährigen Kohortenstudie in Südwestdeutschland

Prevalence and incidence of respiratory diseases and allergies in schoolchildren were assessed during a longitudinal study in the years 1990 to 1993 in southwestern Germany. In the beginning of the study, the average age of the children was 7.3 years. In the years 1990 to 1992 each survey involved a questionnaire and a skin prick test with seven inhalative allergens. In spring 1993 the data collection was finished with a final questionnaire. Basically 1 812 subjects took part, from which 1 082 participated in all surveys. Questions regarding asthma, asthmatic symptoms, hay fever and eczema were analyzed, taking local and sex-specific conditions into account. We found a higher prevalence of asthma, asthmatic symptoms, hay fever and hay fever associated symptoms among males, and a higher prevalence of eczema among females. Male subjects more often reacted positively in the skin prick tests. A not significantly higher prevalence of asthma and most of the asthmatic symptoms occured in Kehl. Consistent local differences regarding hay fever, eczema or positive skin prick test results could not be demonstrated. During the three surveys the prevalence of positive skin prick test reactions to the aeroallergens increased. Incidences of asthma and positive skin prick test results were higher in male than in female subjects