[Assessment of health risks due to heat and fine particles in Germany: an epidemiological study approach]. / Erfassung von hitze- und feinstaubbedingten Gesundheitsrisiken in Deutschland: Ein epidemiologischer Studienansatz.

BACKGROUND: Exposure to heat and particulate matter is a cause of increased mortality. Climate change and increasing climate variability exacerbate these problems. Experts require assessments with which health risks and the success of preventative measures can be estimated. We implemented an ecological study approach to assess these risks at both small and large scales of reference levels (Federal Republic of Germany and territorial authority). METHODS: We utilised a case-crossover design to investigate the relationship between exposure and mortality. This study design uses a logistic regression model. Analogously to a matched case-control study, the odds ratio maps the effect strength. The study period included the years 2002-2006. RESULTS: The analysis demonstrated health risks from exposure to heat for the German population (OR 1.1529, 95% CI 1.1517-1.1541; adjusted OR 1.0658). Significant evidence of a health risk was also documented for exposure to particulate matter (PM10; OR 1.2987, 95% CI 1.2951-1.3024; adjusted OR 1.0128). The risk does not significantly differ for women versus men; the variable age was also not significant at the level of the country-wide analysis, but for a few subordinate units of space. This study approach can be adapted for assessments at varying levels of reference and periods of time as well as for different populations. DISCUSSION: The methodological approach is useful for a reproducible study design. Nevertheless, other influencing factors such as ozone or PM2.5 should be incorporated in subsequent analyses to clarify whether these factors skew the results. Further analysis would also be useful to investigate if and to what extent socio-structural and socio-economic factors affect the associated risk.

[Forensic nursing in Germany? Nurses' perceptions of domestic violence]. / "Forensic Nursing" in Deutschland? Wahrnehmungen von Pflegekräften zu häuslicher Gewalt.

More than one of three women has been a victim of domestic violence at least once. Victims would like to have a well-informed contact person within the healthcare system who knows about support programs. In many countries that is the responsibility of the healthcare system and is called Forensic Nursing. Therefore, it is interesting to know how nurses in Germany perceive domestic violence and under what circumstances they could imagine taking on tasks in the fields of documentation and nursing. The data for this qualitative study was collected via four focus groups consisting of 38 nurses--3 men and 35 women--with work experience in a hospital. Nurses seem to have difficulties in recognising domestic violence. Whether the subject of domestic violence is addressed explicitly depends on the relationship built up between the patient and the nurses. Nurses do not necessarily take further steps. They could imagine providing help by listening actively, providing information about support programs and providing consulting services. Only occasionally nurses agree to document the case to be used as forensic evidence. Another open issue is appropriate remuneration. It is necessary to integrate that subject systematically into basic and advanced training on different levels of qualification.