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.     

Der Einfluß des Grubenstaubes auf die Entwicklung der chronischen asthmoidalen Bronchitis

Ohne ZusammenfassungMit 3 Textabbildungen     

Einfluss der Ernährung und des Essverhaltens auf die Entwicklung der Adipositas bei Kindern und Jugendlichen

Diet is of major interest in research on the etiology of obesity. Research in this field comprises investigation of the role of individual nutrients and foods, nutrient composition, as well as dietary patterns and habits. Longitudinal data on the association between dietary factors and the development of obesity in childhood and adolescence are sparse; therefore, conclusions on the impact of energy density, consumption of carbohydrates and proteins, snack foods and fast food, meal patterns and speed of eating cannot be drawn. More data exist with respect to the role of energy intake and consumption of fat and sugar-sweetened beverages; however, findings are inconsistent. This could be due to methodological shortcomings that mark dietary assessment in children and adolescents. However, as a direct modulator of energy balance, diet still needs to be part of a comprehensive strategy to combat overweight and obesity in children and adolescents.     

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.     

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.     

Welchen Einfluss hat das Geschlecht auf die Mundgesundheit?

Most oral diseases show gender-specific differences in prevalence. This is true for common diseases such as caries and periodontitis, which are considered the main causes of tooth loss, affecting women more often than men. Furthermore, other diseases, e.g. temporomandibular joint dysfunction, malignant oral tumours, and several diseases of the oral mucosa show differing incidences between men and women. This is confirmed by empirical evidence from studies in Germany and other European countries, the USA, and emerging nations in Amercia and Southeast Asia. The present article aims to summarize gender-specific knowledge on oral health and present perspectives for future research. The main focus is on tooth loss and edentulism, a key measure of oral health, and their main causes, i.e. caries and periodontitis.     

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.

     

Auswirkungen des Menschenhandels auf die Gesundheit von betroffenen Frauen und m?gliche Handlungsoptionen

Human trafficking is the modern form of slavery. Annually, thousands of women, children and men of all ages are affected. Trafficking in persons has a severe impact on the health of those affected. In particular, young women are very vulnerable and easily accessible for perpetrators. They are forced into prostitution in their own country or abroad. The soundest knowledge is available in the field of exploitation of women with the purpose of prostitution which is why this article will focus on this phenomenon. The causes are reflected in a complex system of push and pull factors. The health implications are enormous. Not only do the women suffer from sexually and non-sexually transmitted infections but also from the physical abuse caused by the perpetrators. The injuries and trauma often lead to post-traumatic stress disorder (PTSD). Doctors are often the only ones who have contact with those concerned which is the reason why they are responsible for identifying and treating the victims as well as helping them to escape their miserable situation. In the area of trafficking in women and minors for sexual exploitation much research is needed. Furthermore, an extensive education campaign is necessary to sensitize medical health care professionals to this situation. Thus, doctors can handle and use the given diagnostic questions and symptom complexes to identify victims and although medical health care professionals are capable of using and handling diagnostic measures to identify the victims, they are not able to prevent human trafficking. However, they can contribute by identifying victims and supply them with medical services and provide educational work.     

Der einfluß der bleivergiftung auf die bildung von fetalem hämoglobin

Zusammenfassung Dargestellt sind Untersuchungen des Hb F-Spiegels im Blut bei gewerblicher Bleivergiftung und bei tierexperimenteller akuter Bleivergiftung. Die Krankheitsfälle wurden auf Grund klinischer und hämatologischer Diagnostik ausgewählt. Das Tiermaterial wurde durch i.v. Bleiacetatgaben vergiftet. Die Bestimmung des Hb F-Spiegels erfolgte mit Hilfe von SINGERS Methode in der Modifizierung von ben johnson.Die Untersuchungsergebnisse zeigten statistisch signifikante Erhöhung des Hb F-Spiegels bei Bleivergifteten. Noch deutlicher trat sie im Tierversuch zum Vorschein, was als eine zusätzliche Ursache verstarkter Hämolyse bei der Bleivergiftung angesehen werden könnte.     

Der Einfluss von Geschlecht und sozialer Lage auf Ernährung und Übergewicht im Kindesalter

Overweight and adiposity in children and adolescents are increasing problems in Germany, and more and more primary and secondary prevention programs are being developed. When planning and designing prevention strategies, one should be aware of the target groups and settings. Analysis of epidemiological data for sex/gender, social class, and ethnicity indicates where there is increased need for intervention. Clearly elevated prevalence rates for overweight and adiposity can be found in socially underprivileged children, whereas findings for sex differences are inconsistent because of different systems of reference. This paper gives an overview of epidemiological data in Germany and discusses starting points for prevention. The argumentation focuses on the idea of cooperation between health,education, and social services to reach socially underprivileged children without stigmatizing them and their families.     

Der Einfluß von Schwefelkohlenstoff auf proteolytische Enzyme

Zusammenfassung 1. Die proteolytischen Enzyme Pepsin, Trypsin und Chymotrypsin verbinden sich mit dem Schwefelkohlenstoff. Die durch diese Reaktion entstandenen Verbindungen spalten Albumin nicht und werden nur teilweise durch sauere Hydrolyse zersetzt.2. Albumin, das mit Schwefelkohlenstoff reagiert hat, wird durch die erwähnten Enzyme in bedeutend geringerem Maße gespalten als normales Albumin.3. Die Spaltung normalen Albumins durch normale Enzyme ist in Gegenwart von freiem Schwefelkohlenstoff oder in Gegenwart des Calciumsalzes der Dithiocarbaminopropionsäure verringert, falls es sich um Trypsin und Chymotrypsin handelt. Auf die Spaltung durch Pepsin hat die Gegenwart dieser Stoffe keinen Einfluß.4. Man kann annehmen, daß im Organismus durch den Einfluß von Schwefelkohlenstoff und seinen Metaboliten, den Dithiocarbaminocarboxylsäuren, Albumin und möglicherweise auch andere Proteine unvollkommener und weniger gespalten werden als unter normalen Umständen. Deren Verwertung ist daher unvollständig.Mit 1 Textabbildung     

Der Einfluß von Strahlen auf das Nervensystem

Ohne ZusammenfassungMit 5 TextabbildungenVorgetragen am 18. 4. 57 in der gemeinsamen Sitzung der internistischen und neurologischen Sektion der Gesellschaft J. E. Purkyn in Prag.     

Der Einfluss von Ausbildung und beruflicher Position auf Ver?nderungen im Zigarettenrauchen und Alkoholkonsum: Ergebnisse der MONICA Augsburg Kohortenstudie

Zusammenfassung In der vorliegenden Studie wurde der Einfluß von Ausbildung und beruflicher Position auf Veränderungen im Zigarettenrauchen und Alkoholkonsum untersucht. Die Studienpopulation bestand aus 3753 Männern und Frauen (Alter 25–64) einer Zufallsstichprobe der Augsburger Bevölkerung, die im Rahmen der MONICA-Studie (MONItoring trends and determinants in CArdiovascular disease) im Jahre 1984–85 ein erstes Mal und 1987–88 ein weiteres Mal untersucht wurden. Im Jahre 1984–85 zeigte sich, daß der altersstandardisierte prozentuale Anteil Zigarettenraucher bei Männern und Frauen der höchsten Ausbildungsschicht am niedrigsten war, und daß dieser Anteil, insbesondere bei Männern, im Verlauf von drei Jahren noch einmal relativ stark abnahm. So waren 1987–88 nur noch 21% der am besten ausgebildeten Männer Zigarettenraucher gegenüber 38% der unteren Ausbildungsschicht. Weniger gut ausgebildete Männer tranken auch mehr Alkohol als besser ausgebildete, während dieser Zusammenhang bei Frauen umgekehrt verlief. Unabhängig von Ausbildung und Alter hatten im Querschnitt und im Verlauf männliche Beamte und Landwirte den niedrigsten Anteil Zigarettenraucher, Arbeiter und leitende Angestellte den höchsten. Im Falle der Frauen fanden sich die meisten Raucherinnen bei den einfachen Angestellten und die wenigsten bei den Beamtinnen. Generell war festzustellen, daß die Art des Berufes einen Einfluß auf das Verhalten hat, der teilweise unabhängig ist von der Höhe der Position. Außerdem zeigte sich, daß trotz abnehmenden Risikoverhaltens in allen hier untersuchten Gruppen, diese Tendenz bei denjenigen am stärksten war, die schon zu Beginn der Studie relativ gesund lebten.

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Educational and occupational correlates of changes in cigarette smoking and alcohol consumption: Findings of the MONICA Augsburg cohort study

Summary This study examined the influence of educational achievement and occupational position on changes in risk behavior. Study population were 3753 men and women aged 25–64 years who were sampled by the first MONICA Augsburg Survey (Monitoring trends and determinants in cardiovascular disease). The subjects were sampled in 1984–85, were followed up for three years, and were reexamined in 1987–88. The baseline findings showed for both men and women a statistically significant inverse association between current cigarette smoking and educational level. During the follow-up period the differences between highest and lowest educational levels increased significantly among men. In 1987–88 only 21% of the best educated men were smokers compared to 38% of those with the lowest educational level. Men with low educational levels also drank more alcohol than better educated men, whereas among women those with lowest educational level drank less alcohol than the better educated. Statistically independent of education and age it was found that male civil servants and farmers had the lowest proportion of smokers in cross-sectional as well as longitudinal analyses. Among women, smoking was and remained most prevalent in simple white-collar occupations. In general, the findings indicate that the type of occupation and the actual working conditions have effects on life-style related risk factors which are in part independent of a social gradient. The results also suggest that the tendency to change unhealthy behavior is less pronounced in high risk groups.

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Influence de la formation et de la position professionnelle sur les changements de la consommation de tabac et d'alcool

Résumé Cette étude est consacrée à l'analyse de l'influence de la formation scolaire et professionnelle et de la position atteinte par rapport au métier sur la consommation de tabac et, en particulier, sur le changement des habitudes. La cohorte de l'étude est constituée de 3753 hommes et femmes (âge 25–64 ans), tirés au hasard parmi les habitants d'Augsburg. Cette même population a déjà participé en 1984–85 et en 1987–88 à e'étude MONICA (Monitoring trends and determinants in cardiovascular disease). En 1984–85, il a été observé que le taux de consommateurs de cigarettes, stratifié selon l'âge, était le plus bas chez les hommes ou femmes ayant le niveau professionnel le plus élevé. Le nombre de ces consommateurs, surtout les hommes, diminuait fortement au cours des trois ans qui suivaient. En effet, en 1987–88, il n'y avait plus que 21% de consommateurs de cigarettes chez les hommes professionnellement mieux formés tandis que chez ceux sans formation le taux était de (38%). Les hommes ayant un bas niveau de formation professionnelle consommaient davantage d'alcool que les autres. En revanche, cette relation était exactement inverse chez les femmes. Les fonctionnaires masculins et les agriculteurs présentaient, indépendamment de leur formation scolaire ou de leur âge, le taux de tabagisme le plus bas, alors que ce dernier était le plus élevé chez les ouvriers et les cadres moyens. Le taux le plus bas se trouvait chez les femmes fonctionnaires, le plus haut chez les petites salariées. En général, le métier était un des facteurs principaux de l'influence sur la consommation de tabac et cette influence était tout à fait indépendante de la position au travail. En outre, la tendance à une diminution du tabagisme était la plus prononcée chez les personnes qui, au début de l'étude, avaient déjà présenté un mode de vie plutôt sain et pauvre en facteurs de risque comportementaux, bien que le tabagisme ait diminué dans tous les groupes étudiés.

     

Einfluss von Prüfungen auf emotionales Befinden und Ernährung?

Background

The effect of stress on student’s diet has been frequently examined. However, there is no information on the effect of emotional stress on the nutrition of bachelor students during a high-stress period (examination week).

Methods

A total of 28 bachelor students completed a questionnaire to assess academic demands, positive and negative affect and a standardized 24 h dietary recall during times of low academic stress at the beginning of the semester (baseline, t₁), and high academic stress after an examination at the end of the semester (t₂).

Results

During the high-stress period academic demands and negative affect (NA) increased significantly. The positive affect (PA) decreased significantly, mainly due to the decrease of the PA dimension joy. The nutrition intake differentiated slightly between t₁ and t₂. In nutrition there was an increased intake of protein. Furthermore the meal frequency and the consumption of nuts increased significantly. The consumption of alcoholic beverages was also significantly lower during the high-stress period.

Conclusion

Bachelor students are both subjectively and objectively stressed by increased academic demands during a high-stress period at the end of the semester. In contrast to the affect, the student’s nutrition hardly changed in the high-stress period compared to the low-stress period. This suggests nutrition is a robust behaviour during short stress periods. Further research is needed to examine eating habits during longer periods of stress to estimate its robustness.

     

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.     

Der Einfluß von Aerosolinhalationen auf die durch gemischten Kohlen- und Quarzstaub verursachte Staublunge bei Ratten

Ohne ZusammenfassungMit 9 Textabbildungen     

Einfluss körperlicher Aktivität auf die menschliche Gesundheit

Zusammenfassung Der zunehmende Mangel an körperlichen Aktivitäten – häufig in Verbindung mit einer Fehlernährung – führt zu einer dramatischen Zunahme sog. Zivilisationserkrankungen in den Industrienationen. Hierzuzählen nebenden Herz-Kreislauf-Erkrankungen insbesondere Erkrankungen des Zucker- und Fettstoffwechsels sowie des muskulo-skelettalen Systems. Körperliche Inaktivität gilt hier für als gesicherter Risikofaktor. Immer häufiger sind bereits Kinder und Jugendliche betroffen. Bei der Entwicklung effektiver präventiver Strategien kommt somit der Steigerung der körperlichen/sportlichen Aktivitäten sowohl im Alltag als auch im Rahmen eines systematischen gesundheitsorientierten Trainings eine zentrale Bedeutung zu. So belegt eine Fülle wissenschaftlicher Untersuchungen, dass regelmäßig durchgeführte sportliche/körperliche Aktivitäten ein enormes Potenzial im Hinblick auf die physische und psychische Gesunderhaltung des Menschen in allen Lebensphasen besitzen. Die zugrunde liegenden biologischen Mechanismen sind komplex und betreffen nahezu sämtliche Organsysteme. Der gesundheitliche Nutzen ist allerdings entscheidend davon abhängig, in welcher Form, Dauer und Intensität diese durchgeführt werden. Empfohlen werden ausdauer orientierte Bewegungs formen, wie z. B. Gehen, Laufen, Fahrradfahren etc., im moderaten In tensitätsbereich, betrieben an mindestens 2 Tagen pro Woche mit einer Dauer von je weils 30– 60 min. Ergänzend sollte ein maßvolles Krafttraining unter Einbeziehung aller relevanten Muskelgruppen hinzukommen. Ein frühzeitiger Beginn regelmäßiger körperlicher Aktivitäten bei kontinuierlicher, lebenslanger Fortführung ist besonders effektiv und daher aus gesundheitlicher Sicht empfehlenswert.     

Die Bedeutung von Biobanken für die klinische Entwicklung

Access to samples in biobanks and collection of samples for evaluation of biomarkers in clinical trials are an essential basis for the identification and development of biomarkers. From the perspective of a research-based pharmaceutical company identification of biomarkers and the accompanying diagnostics are an essential prerequisite for the further evolution of personalised healthcare—and the key to more effective and efficient healthcare. Research-based pharmaceutical companies can basically use four types of biobanks: biobanks of university hospitals, commercial providers, collaborative groups and company-owned biobanks. Areas of application, arising from the use of biobanks in the context of clinical development, are collection of prevalence data, evaluation of biomarker stability in different disease stages, technical validation of assays, an optimized course of clinical studies by focusing on defined, biomarker-stratified groups of patients and pharmacogenetic research. Challenges are, in particular, the availability of clinically annotated samples and tissue matching blood samples, in addition to sample quality, number and amount. An acceptable legal and regulatory framework, as well as the positive perception of biomarker data by politicians and the public, are important prerequisites for translational research for identification of biomarkers in clinical studies. Also, the early establishment of research alliances between academia and the pharmaceutical industry are required to transfer research results in new strategies for prevention, diagnosis and treatment of patients.