Rahmenbedingungen für die palliative Versorgung in Deutschland und Entwicklung von Public-Health-Zielen

To provide adequate end-of-life care is a substantial task of the health care system. However, it has been largely disregarded. For public health research, important activities include analysing the societal requirements as well as the health system-related possibilities and framework. Therefore, a study, funded by the German Research Foundation, for the first time (1) examines the viewpoints of a wide range of stakeholders that operate on different levels of the German health system, and (2) develops broadly based public health targets for palliative care in Germany. This article presents the conceptual framework, design and methods of the study.     

Wie werden die Impfempfehlungen gegen saisonale Influenza und gegen humane Papillomaviren in gynäkologischen Praxen umgesetzt?

In Germany, seasonal influenza vaccination has been recommended for pregnant women since 2010 and human papillomavirus (HPV) vaccination for girls since 2007. Gynecologists play an important role in the communication and vaccination of these two target groups. Moreover, seasonal influenza vaccination is also recommended for healthcare workers, as well as adults aged ≥?60 years and individuals with underlying chronic diseases. The aim of this study was to gain first insights into the acceptance and implementation of the seasonal influenza und HPV vaccination recommendations in gynecological practices. In the context of the national influenza immunization campaign—which is jointly carried out by the Robert Koch Institute (RKI) and the Federal Centre for Health Education (BZgA)—a questionnaire was sent together with influenza information kits to 7477 gynecologists in September 2014. Data from 1469 (20?%) gynecologists were included in the analysis. 72?% of respondents reported that they themselves received a seasonal influenza shot each year. The majority of gynecologists recommended seasonal influenza vaccination for pregnant women (93?%) and HPV vaccination for girls (97?%). The most commonly stated reasons against influenza vaccination were safety concerns. Those against HPV vaccination were effectiveness concerns. Additionally, for both vaccinations the provision of vaccine-related information to the patient was considered too time consuming.The high acceptance of seasonal influenza and HPV vaccination among gynecologists is discordant with the available vaccination coverage figures in Germany. Gynecologists must be reminded of their important role in the prevention of vaccine-preventable diseases in adolescents and adult women. Immunization and communication skills should be considered more strongly as an integral part of medical education and further training for gynecologists.     

Falldefinitionen für die Surveillance meldepflichtiger Infektionskrankheiten in Deutschland, Ausgabe 2007

The revised case definitions established by the Robert Koch Institute will become effective on 1 January 2007. The case definitions provide criteria for the reporting of mandatory notifiable infectious diseases according to the German infectious disease control act. The new case definitions take into account recent developments in laboratory methods. Furthermore in the new edition the criteria were updated and clarified if necessary. For each case definition a paragraph 'reference definition' is introduced and explained. If applicable additional information (e.g., vaccination history) to be reported was added. In this article, the major changes of the revised case definitions are described.     

Falldefinitionen für die Surveillance meldepflichtiger Infektionskrankheiten in Deutschland,Ausgabe 2015

Case definitions ensure standardised criteria for the surveillance of infectious diseases in Germany. Since its last revision in 2007, an update of the complete case definition edition became necessary due to new scientific insights, changes in legislature, terminology and classification systems. At the same time, the case definition should be further standardised and work at local public health authorities should be simplified. The department for infectious disease epidemiology at the Robert Koch Institute (RKI) coordinated the revision of the case definitions. During several feedback sessions, internal RKI experts and external experts from different levels of the German public health system, as well as from medical associations and laboratories, were involved in the revision process. The new edition and an annotated version are published on the RKI website (www.rki.de/falldefinitionen). The new case definitions will become effective on 1st January 2015. The most important changes are summarised in this article.     

Präventionspotenziale für Darm- und Brustkrebs in Deutschland

Population attributable fractions (PAFs) for the risk factors alcohol intake and overweight in the German population were calculated to estimate the preventability of colorectal and breast cancer attributable to these risk factors. Estimates were based on national alcohol consumption and overweight prevalence data in the German population. Comparative analyses were used to evaluate the variation of PAF estimates according to changes in the calculation parameters. PAFs quantify the preventive potential that could result from removing or reducing the risk factor exposure, respectively. Postmenopausal breast cancer was estimated to be preventable by 13–23% if the population were normal weight. Among German men, 10–25% of colon cancers were attributable to alcohol consumption and 7–13% of colorectal cancers to overweight. The comparative analyses demonstrated that preventability estimates vary considerably with the chosen data (risk estimates, reference categories) for PAF calculation and can differ by up to 50%. Thus, data selection should be evidence based, for example, based on meta-analyses, in order to increase the validity of preventability estimates.     

Einflussfaktoren für Asthma bronchiale bei Kindern und Jugendlichen in Deutschland

In this study, associations between current asthma and possible determinants were studied using data of the German Health Interview and Examination Survey for Children and Adolescents ("Studie zur Gesundheit von Kindern und Jugendlichen in Deutschland," KiGGS). In this nationwide cross-sectional survey, 17,461 subjects aged 0-17?years were examined between 2003 and 2006. Data collection included a medical examination of the child, an interview of the parents, and written questionnaires. Apart from prevalence estimates, multivariate logistic regression analyses were performed. Increasing age and male sex, previous atopic diseases of the child, a positive family history of allergic diseases and low birth weight were significant risk factors of asthma, as were overweight and moldy walls in the residence. Breast feeding was not associated with a reduced risk of asthma. Low age at delivery of the mother and living in rural or provincial regions were shown to be protected. Overall, this study suggests that allergies of the parents and previous atopic disease of the child are the strongest determinants of asthma. However, environmental factors (mold on walls, living in rural and provincial towns) and lifestyle factors could also modify asthma risk.     

Soziale Ungleichheit und chronische Rückenschmerzen bei Erwachsenen in Deutschland

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Rückenschmerzen sind ein häufiger Grund für Arbeitsunfähigkeit und die Inanspruchnahme von...     

Rechtfertigung und Begründung für die Fortsetzung des Archivs für Gewerbepathologie

Ohne ZusammenfassungProf. Dr. med., Dr. med. h. c., Dr. phil. h. c., Dr. jur. h. c., Dr. sc. tech. h. c.     

Zur Ausgabe 2004 der Falldefinitionen für die Surveillance meldepflichtiger Infektionskrankheiten in Deutschland

With the beginning of the year 2004, new case definitions of the Robert Koch Institute (RKI) replace those introduced in 2001. The new edition provides definitions for 53 categories of cases that are to be reported by local health departments through state health authorities to the RKI according to the German infectious disease control act. The new case definitions take into account recent developments in laboratory methods and indications for improvement identified through systematic evaluation. The case definitions consist of three types of evidence-clinical picture, laboratory detection, and epidemiological confirmation-all of which list disease- or pathogen-specific test criteria. Combining the three evidence types results in five case definition categories: clinically diagnosed illness, clinically and epidemiologically confirmed illness, clinically and laboratory-confirmed illness, laboratory-detected infection not fulfilling clinical criteria, and laboratory-detected infection with unknown clinical picture.     

Nutzungskonzepte für Proben und Daten aus humanen Biobanken für die Forschung

It is accepted worldwide that biospecimen and data sharing (BDS) play an essential role for the future of medical research to improve diagnostics and prognostics, e.g. by validated biomarkers. BDS is also pivotal to the development of new therapeutic treatments and for the improvement of population health. Human biobanks can generate an added value to this need by providing biospecimens and/or associated data to researchers. An inspection of several examples of epidemiological as well as clinical/disease-oriented biobanks in Germany shows that best practice procedures (BPP) that are internationally agreed on are being installed for biospecimen and/or data access. In general, fair access is aimed at requiring a written application by the requesting scientist, which is then peer-reviewed for scientific and ethical validity by the Biobank. Applied BPP take into account (i) patient education/agreement according to the informed consent model, (ii) privacy protection, (iii) intellectual property rights, the (iv) notification obligation of health-related findings (including incidental findings), the (v) use of material (MTA) and data transfer agreements (DTA) for mutual legal security, the avoidance of conflicts of interests, as well as for cost recovery/fee for service as a basis for sustainability of the biobank. BPP are rooted in the self-regulation efforts of life sciences and are supported by parent ethics committees in Germany. Central biobank registries displaying aggregated information on biospecimens stored and the research foci constitute an important tool to make biobanks that are scattered across the country visible to each other, and, can thus promote access to hitherto unknown biospecimen and data resources.     

Public-Health-Ethik – Zeit für systematische Diskussionen in Deutschland

Ohne Zusammenfassung     

Ambulant betreute Wohngemeinschaften für pflegebedürftige Menschen in Deutschland

A main factor for the development of shared-housing arrangements (SHA) was the wish of more self-determination in old age. Since January 2013 SHA is government-funded through the “Pflege-Neuausrichtungs-Gesetz” (PNG). Yet, an overview of the situation of SHA in Germany is not available. Therefore, a systematic literature search (databases CareLit, CINAHL, GeroLit, PubMed) was conducted in order to identify publications regarding resident- and care-specific characteristics, resident-related health outcomes and setting-specific quality management systems. The currently available knowledge in these fields is not exhaustive and further research is needed. The results indicate that care in SHA is not more efficient regarding residents’ quality of life than in institutional care settings. Valid studies regarding the quality of care provision in SHA and conceptual basics concerning quality assessment are widely lacking. Thus, the goal of expanding SHA within the framework of the PNG has to be accompanied by in-depth health services research.     

Das neue Genehmigungsverfahren für klinische Arzneimittelprüfungen in der Europäischen Union – Herausforderungen für die pharmazeutische Industrie in Deutschland

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Der 27.05.2014 war ein bedeutendes Datum für klinische Prüfungen in der Europäischen Union (EU). Seit diesem Tag...