[Effectiveness of interventions to strengthen cognitive resources in nursing home residents : A systematic review and network meta-analysis]. / Wirksamkeit von Interventionen zur Stärkung kognitiver Ressourcen bei Bewohnenden in Pflegeheimen : Eine systematische Übersichtsarbeit und Netzwerkmetaanalyse.

BACKGROUND: Strengthening cognitive resources of residents in nursing homes is an important goal of preventive activities. The aim of this systematic review was to answer the question which intervention is most effective for nursing home residents to strengthen their cognitive resources. METHOD: A systematic literature search was carried out in the Cochrane Library and the MEDLINE (PubMed), Embase, CINAHL, PsycINFO and PEDro databases. Reference lists of publications classified as relevant were checked and trial registries were searched. The literature selection, data extraction and assessment of the study quality were carried out by two reviewers independently. A frequentist network meta-analysis was conducted using a random effects model. RESULTS: A total of 29 studies with 1816 participants were included. Both physical activity (standardized mean difference [SMD] = 0.70, 95%-confidence interval [CI] 0.35-1.06, p < 0.001) and cognitive activity (SMD = 0.61, 95%-CI 0.22-1.01, p < 0.01) were statistically significantly superior in strengthening cognitive resources compared to usual care. Physical and cognitive activities did not differ statistically significantly from each other. In addition, neither physical activity nor cognitive activity showed statistically significantly better cognitive resources in nursing home residents compared to social activities. CONCLUSION: The findings imply that physical activity as well as cognitive activity could be effective to strengthen cognitive resources of nursing home residents. Considering the low-quality of available evidence, performance of high-quality studies is essential in order to verify the robustness of the statistical results.

[Psychosocial interventions in inpatient care : Systematic review of the effectiveness of universal and selective prevention on mental health]. / Psychosoziale Interventionen in der stationären Pflege : Systematische Übersicht des Effekts universeller und selektiver Prävention auf die psychische Gesundheit.

BACKGROUND: There are no sufficient findings from synthesized evidence for the effectiveness of psychosocial interventions to improve mental health in inpatient care. METHODS: A systematic literature search in the databases of MEDLINE, The Cochrane Library, EMBASE, CINAHL, and PsycINFO was carried out, as well as a manual search in Google Scholar and reference lists. Studies which focused on physical or individual activities or therapy or other groups and settings were excluded. The heterogeneity of the studies did not allow meta-analysis. RESULTS: Seven primary studies were included, whose interventions were assigned to the intervention types activation of memories, leisure activities, and social participation. Overall, the quality of studies was rather low. Compared to usual care or the alternative interventions of memory therapy or leisure activities, the positive effects on depressive symptoms, as well as externally assessed and self-reported quality of life or life satisfaction, were not significant. The absence of these measures lead to deterioration of depressive symptoms among residents with dementia. In contrast to memory activation, common leisure activities led to an improvement in wellbeing. One intervention for social participation increased wellbeing and reduced the occurrence of depressive symptoms. CONCLUSION: There is a considerable need for conceptual-theoretical work and research on the effectiveness of psychosocial interventions, particularly for raising participation among persons in inpatient care facilities.

[Cognitive interventions in nursing homes : Systematic review of the preventive effectiveness on cognitive performance in persons in need of care]. / Kognitive Interventionen in Pflegeheimen : Systematische Übersicht der präventiven Wirksamkeit auf die kognitive Leistungsfähigkeit von Pflegebedürftigen.

BACKGROUND: The strengthening of cognitive resources is considered to be a preventive field of action within inpatient care. The aim is to evaluate the effectiveness of such interventions on cognitive performance in nursing home residents. METHODS: A systematic literature search was carried out in the databases MEDLINE, the Cochrane Library, EMBASE, CINAHL and PsycINFO, as well as searches in trial registries and a screening of reference lists. The combined results were based on meta-analyses in random-effects models. RESULTS: By including 10 primary studies, participating in cognitive activities showed a statistically significant greater cognitive performance compared to controls (standardized mean difference SMD = 0.46, 95% confidence interval CI 0.06-0.87, p = 0.0252). Subgroup analyses suggest a superiority of individually oriented cognitive activities with longer training periods and that especially nursing home residents with a better initial level of cognitive performance might benefit from cognitive interventions. However, due to the high risk of bias in the included studies and the presence of substantial heterogeneity, the results must be interpreted with caution. CONCLUSION: The findings imply that cognitive activities implemented in nursing homes might be effective. Considering the low-quality evidence, performance of high-quality studies is essential in order to verify our results.

[Interventions for promoting physical activity in nursing homes : Systematic review of the effectiveness of universal prevention]. / Interventionen zur Förderung der körperlichen Aktivität in Pflegeheimen : Systematische Übersicht der Wirksamkeit universeller Prävention.

BACKGROUND: Among residents of nursing homes, physical activity might be beneficial in maintaining health-related quality of life because impairment is caused in particular by functional decline. The aim is the evaluation of the effectiveness of universal preventive interventions directed at increasing physical activity on activities of daily living in nursing home residents. MATERIAL AND METHODS: Relevant studies were identified through database searching in MEDLINE, the Cochrane library, EMBASE, CINAHL, PsycINFO and PEDro. Two review authors independently selected articles, assessed the risk of bias and extracted data. Results were combined in random effects meta-analyses. RESULTS: By including 14 primary studies, nursing home residents participating in physical activities showed a statistically significant greater physical functioning compared to controls (standardized mean difference [SMD] = 0.48, 95% confidence interval [95% CI] 0.26-0.71, p < 0.0001). Subgroup analyses suggest that especially nursing home residents with severe physical and cognitive impairment might benefit from participation in physical activities. Results after non-training periods substantiate the necessity of a sustained implementation. Due to the high risk of bias in included studies, the results must be interpreted with caution. CONCLUSION: Physical activity for nursing home residents can be effective. Considering the low-quality evidence, performance of high-quality studies is essential in order to verify the statistical results.

[Non-Respectful Behavior and Violence in Romantic Relationships between Adolescents: Prevalence and Quality of Life among Hesse Pupils]. / Grenzüberschreitendes Verhalten und Gewalt in Liebesbeziehungen unter Jugendlichen: Prävalenz und Lebensqualität unter Hessischen Schülerinnen und Schülern.

BACKGROUND: International studies illustrate the high prevalence of non-respectful or violent behaviour in adolescents' romantic relationships (teen dating violence) and health implications being comparable to intimate partner violence between adults. For Germany, there have been only data on sexual aggressive acting. The study investigated the magnitude of teen dating violence among secondary school pupils between 14 and 18 years in Hesse. METHODS: Adolescents attending general education system and vocational schools in Hesse were standardised and anonymously surveyed with a modified paper-pencil version of the YPRQ and the KIDSCREEN-10. 462 questionnaires were included into the analysis. In a first step, weighted data have been analysed descriptively. RESULTS: 181 female students (78%) and 173 male students (75%) affirmed the question concerning first experiences with dates or relationships. About 65.7% of the girls [95% CI 58.8-72.6] and 60.1% of the boys [95% CI 52.8-67.4] at risk stated that they suffered from at least one form of non-respectful behaviour or violence. 61% of the girls and 57% of the boys reported on emotionally difficult situations, 26% of the girls and 13% of the boys experienced unwanted sexually behaviour as well as physical violence in 11% of the girls and 10% of the boys. Life quality was lower between victimised adolescents (female 45.25; SD 7.2 and males 50.19; SD 8.3) compared to non-victimised females (47.40; SD 7.06) or males (51.04; (SD 7.5). CONCLUSION: The high prevalence rates are comparable with results of existing studies and demonstrate the need for prevention. An underestimation of serious violence is assumed due to methodical reasons. Due to the cross-sectional design, the direction of a cause-and-effect association between victimisation and quality of life remains uncertain.

[Strengthening Public and Global Health in Germany - an Appraisal of the Statement "Public Health in Germany" by the German Scientific Academies from June 16th 2015]. / Public und Global Health in Deutschland stärken - Eine Einordnung der Stellungnahme "Public Health in Deutschland" der wissenschaftlichen Akademien vom 16.6.2015.

In June 2015 the scientific academies "Leopoldina" and "acatech" and the union of the German academies of sciences and humanities published a statement on public and global health in Germany. The statement contains many valuable albeit generic and well-known recommendations. The few specific recommendations focus on centralizing research while weakening the role of universities and on the relative increase of research on public health genomics. These recommendations are not based on empirical or theoretical analyses and risk subverting successful developments of the recent past. To actually strengthen public and global health in Germany the existing institutions need to be backed up while designated funding of public and global health needs to be extended.

[Competence centre for victims of violence as part of the public health services--a consecutive case series of the "Schutzambulanz Fulda"]. / Kompetenzzentrum für Gewaltopfer im ÖGD--Analyse des Fallaufkommens der Schutzambulanz Fulda.

Health-care services often fail to address violence sufficiently and to provide adequate forensic medical examination and documentation, especially in cases of intimate partner violence and violence against people in need of care. The "Schutzambulanz Fulda", hosted by the public health department of Fulda county, aims to close this gap in the east Hessian region. We have evaluated the first year of service. Between November 26(th) 2010 and November 26(th) 2011 a total of 154 persons called for support. Data concerning personal characteristics of the victims and the suspected perpetrators, the time and place of the incidents, and their impacts were analysed. 76.6% of th subjects were female, 23.4% male and 18.8% were less than 18 years old. In 60 cases a documentation of the injuries suitable for use in court was made. The majority of clients were women who reported having been assaulted by their partner or ex-partner. Community violence was less frequently stated. Contact to people in need of care suffering from violence was very rare. Currently, the "Schutzambulanz" as part of a public health department meets the goals to some degree. A comparative evaluation could help to identify the benefits and disadvantages of various trusteeships within the health-care system.

[Health protection during heat waves: European recommendations and experience in Hesse]. / Gesundheitsschutz bei Hitzewellen: Europäische Empfehlungen und hessische Erfahrungen.

BACKGROUND: In the course of climate change periods of extreme heat will probably happen more frequently. The aim of heat health action plans is to prevent the health consequences of heat. OBJECTIVES: The purpose of the present work is to develop a proposal for a heat health action plan for Hesse, Germany. MATERIALS AND METHODS: In 34 interviews with experts the existing heat health warning system was evaluated. Heat health action plans of 8 European countries were analysed. On this basis a concept for a heat health action plan for Hesse was developed. RESULTS: In Hesse only nursing homes take preventative measures reliably, other health care sectors act along varying individual criteria. Heat health action plans include a heat health warning system and measures. They arrange competences and risk communication. Local authorities are responsible for implementation. Some plans include a surveillance system of mortality or morbidity. In a heat health action plan for Hesse measures should be specified and adapted to specific needs on the local level. Physicians in outpatient clinics are in a key position having contact with the vulnerable group of the elderly. CONCLUSION: A heat health action plan offers opportunities for effective prevention if responsibilities are defined and evaluated, and monitoring of mortality and morbidity is integrated. In the structures of the German health care system efforts to prevent heat-related illness cannot succeed without reliable participation of the outpatient medical system.

[Violence during pregnancy: prevalence studies in OECD countries]. / Gewalterfahrungen in der Schwangerschaft: Prävalenzstudien in OECD-Ländern.

Violence during pregnancy can be associated with health consequences for both the pregnant woman und the unborn child. The available data on prevalence are insufficient in Germany, an underestimation of the problem is probable. Therefore data from other OECD countries are considered. Searching in the databases EMBASE (incl. Medline), CINAHL, PsycINFO and SSCI in English or German language, primary and secondary studies from OECD countries published from 2004 to 2011 were identified. Studies without a valid instrument were excluded. 20 studies using 6 different, partially modified instruments were identified. In OECD countries the prevalence data vary, depending on the instrument applied and the design of the studies. The majority of the studies underestimate the prevalence of violence during pregnancy. Study results from OECD countries are in the analysed range of the reviews. The data collected in Germany are at the bottom of the spectrum. This suggests an underestimation of the problem in Germany. Further research is needed using more valid instruments and better study designs.

[Health consequence of stalking victimization]. / Gesundheitliche Folgen von Stalking.

Life time prevalence of stalking is about 12-20%, while females are more often affected than male. Stalking is a statutory offense. However, it is not an assault of victims' law. For the purpose of health consequences for stalking victims, research in following database were conducted: EMBASE, CINAHL, MEDLINE, PsycINFO and Social Science Index. English and German published studies of the years 2002-2010 were included. 17 primary studies and 2 meta-analyses were identified. Direct physiological consequences are relatively rare; however stalking victims report a poorer physiological health status. Almost every second stalking victim shows impairments on his/her psychical well-being. Impairments of social well-being are common, too. As a result, there is still a lot of research, especially in long-term studies, required. Socio-legal reassessment of stalking will probably benefit only a few of the affected people.

[Situation and perspectives of public health in Germany--research and teaching. Position paper of the German Public Health Association]. / Situation und Perspektiven von Public Health in Deutschland--Forschung und Lehre. Positionspapier der Deutschen Gesellschaft für Public Health e. V.

This position paper of the German Public Health Association describes current situation and perspectives of public health in Germany with emphasis on research and teaching. It outlines those measures necessary for strengthening of public health research in Germany.

[Community-based prevention of climate-associated health risks]. / Prävention klimabedingter Gesundheitsrisiken in der Kommune.

BACKGROUND: Climate changes and their impact on public health services are presenting officials with new challenges. The Klimzug Nordhessen project provides a framework for the development of suitable adaptation strategies to deal with climate changes. PROJECT: The demographic and climatic circumstances in the region in and surrounding Kassel require a focus on the prevention of heat-caused morbidity and mortality among adults 75 or more years old. The Klimzug Nordhessen project assesses the feasibility of heat monitoring for city and county regions and collects data about the temperature-related comfort of older people. The main focus of the project is the development of prevention strategies for older people who live at home in climatic and demographic high-risk regions. CONCLUSIONS: In the face of inadequate data, the current cooperation between science and practice seems to be an appropriate base for the development of verifiable empirical methods and instruments as well as evidence-based prevention strategies at the communal level.

[Screening for intimate partner violence against women. International discussion, considerations for Germany]. / Screening nach Gewalt gegen Frauen durch den Partner. Internationale Diskussion, Uberlegungen für Deutschland.

Domestic violence and partner violence against women is a serious problem in many countries, including Germany. This type of violence has far-reaching social, economic, and health consequences for victims. The health sector can play a decisive role within intervention and prevention, if healthcare providers discover at an early stage that violence is the cause for injuries and disorders. Screenings can identify victims of domestic and partner violence. In several other countries, recommendations or agreements about screening for domestic and partner violence in the health sector are already in place. In Germany, however, the discussion about this kind of screening is just beginning. This article introduces the debate by referring to a Health Technology Assessment from the UK and giving an overview. The present findings also justify screening for partner violence against women in Germany. However, further research on the screening instruments used with women as well as other victims, such as men or elderly, is recommended.

[Identifying residential areas with heat-related health risks. Sociodemographic and climate data mapping as a planning tool for targeted prevention strategies]. / Wohngebiete mit hitzeabhängigen Gesundheitsrisiken ermitteln. Soziodemografische und klimatische Kartierung als Planungsinstrument gezielter Prävention.

Prognosticated heat waves in the context of climate change require appropriate strategies to prevent harmful health effects in the population. In a model project within the public health department of the Kassel region, elderly living in areas at risk of over-heating will be identified and advised. The localization of high-risk residential areas was part of the planning process. Through mapping of demographic and microclimate data and the characteristics of the material of the residential buildings, high-risk areas that require preventive measures as a top priority were identified. The prevention of heat-related mortality and morbidity by communal health authorities requires close cooperation with other administrative bodies, especially with town planning departments. Mapping demographic and microclimate data and the characteristics of the material of the residential buildings can facilitate the planning of preventive measures.

[Promoting health instead of health education]. / Gesundheit fördern statt erziehen.

The idea of health education--meaning experts telling laymen how to setup a healthy behaviour by applying educational tricks--is an illusion. Humans don't act as they should by following the ideas of public health scientists, not even after an intensive educational training. They aren't trivial machines. Their way of acting ist not predeterminable. A change of strategy from health promotion to changing the attitude to health promotion to random circumstances of living has been of limited success. Changing these circumstances (top down) improves only a part of health influencing factors. It is impossible to exclude that by changing these factors others are made worse. But by ethic standards we are titled to check decisions relating to living conditions in respect of their health relevance. Therefore, health promotion meaning the promotion of more self-determination of one's own health is inevitable if a sustainable success is wanted. The request for a short-time measure of success is understandable from an economic point of view but it is not adequate. In the long run this would lead to trivilaesation++ of matters that are not trivial.