[Depressive symptoms in older prisoners : Results of two studies]. / Depressive Symptome bei älteren Inhaftierten : Ergebnisse zweier Studien.

BACKGROUND: The proportion of prisoners aged 60 years and above is steadily rising both nationally and internationally. With advancing age the risk of developing physical and mental illnesses also increases. International studies have demonstrated a higher prevalence of mental disorders among older prisoners compared to the general population; however, there are few data on this, at least for Germany. OBJECTIVE: Collation of empirical data on the presence of depressive symptoms among older prisoners. MATERIAL AND METHODS: There were two independent cross-sectional studies conducted in North Rhine-Westphalia (NRW) and Rhineland-Palatinate (RLP), which included prisoners aged 50 years and above. In NRW a purely quantitative survey of depressive symptoms was carried out using the German version of the patient health questionnaire (PHQ-D) and in RLP the quantitative measurements using the general depression scale short form (ADS-K) were supplemented by qualitative interviews. RESULTS: In total, data from 315 inmates were available for a joint analysis (222 from RLP, 93 from NRW). Among the prisoners in RLP 63.4% exhibited mild to clinically significant depressive symptoms, while in NRW this was the case for 46.2%. The treatment with antidepressants was carried out only in a small proportion in both federal states. DISCUSSION: Both surveys showed a clearly elevated prevalence of depressive symptoms compared to the non-prison population. The results also suggest a need for optimization in terms of treatment. Particularly concerning potential interactions with somatic illnesses, efforts should be made to improve the diagnostics and treatment of depressive symptoms.

[First Insights into Scope of Practice and Salary of Physician Assistants, A New Healthcare Profession, in Germany]. / Eine neue Berufsgruppe kommt in der Praxis an: Erste Erkenntnisse über Einsatzgebiete, Tätigkeiten und Gehalt von Physician Assistants/Arztassistenten in Deutschland.

BACKGROUND: In 2010, the first government-approved physician assistant (PA) program was introduced at the Baden-Wuerttemberg Cooperative State University Karlsruhe (DHBW). There are not sufficient data regarding the scope of practice and salary of our graduates. Therefore, the aim of the present study was to obtain information regarding these. METHODS: The survey included all graduates (2 classes, n=27). A specific questionnaire was developed, including 37 questions e. g. on the current employment status, scope of practice, salary and job satisfaction regarding the PA program and career. A descriptive analysis of the data was carried out using SPSS. RESULTS: 25 graduates participated in the survey (96.1%); the average age of participants was 32.2 years (25-53 years). 88% (n=22) were employed as a PA, most of them worked in internal medicine (n=11) or surgery (n=9). Responsibilities that are often or very often assigned to the PAs are preparing final documents, taking over a coordinating role in the therapeutic team, as well as participation in taking patient medical history and conducting physical examinations. In two-thirds of respondents, the gross monthly base salary (full-time position) was about 3000 euros. 77.3% (n=17) of graduates were generally satisfied or very satisfied with their current situation. CONCLUSIONS: It appears that graduates of the DHBW are well integrated into the staff structure of hospitals, as far as the scope of practice and average salary are concerned. Further studies on the integration of this new profession in Germany and on their extended scope of practice in comparison to established healthcare professions will be conducted.

[Physician assistants in surgery : A young profession through graduates' eyes]. / Physician Assistants in der Chirurgie : Ein junges Berufsbild aus Absolventensicht.

BACKGROUND: In Germany, physician assistant (PA) is a comparatively young profession. The concept paper by the German Medical Association (BÄK) and the Federation of Statutory Health Insurance Physicians (KBV) from 2017 defines the new occupational profile in detail. In contrast, there is hardly any information on the day to day working life of a PA in Germany OBJECTIVE: The aim of this study was to map the employment reality of the PA graduates of the study program of the Baden-Wuerttemberg Cooperative State University Karlsruhe. MATERIAL AND METHODS: Graduates of the PA study program were interviewed using the web-based evaluation system EvaSys V7.1 (Electric Paper Evaluationssysteme GmbH, Lüneburg, Deutschland) in the spring of 2018. The information was evaluated descriptively. RESULTS: The response rate was 70% (48 out of 69 graduates), 44 graduates were employed as a PA and 27 worked in a surgical department. The core tasks of the surgically active PA, which were often performed to varying frequency included assisting surgery and the performance of simple wound closures. In addition, activities in the areas of documentation, communication and information sharing were emphasized. The average salary of a surgical PA was 3718 €. This amount was rated by 44.4% as appropriate or very appropriate. The current occupational situation for 81.5% of the study participants was much better or better than expected before the start of their PA studies. Overall satisfaction was very high: 85.1% of the graduates were satisfied to very satisfied. CONCLUSION: The graduates' level of job satisfaction is remarkable. Many of the activities mentioned in the concept paper of the BÄK and KBV were carried out frequently or very frequently by the PA. Nonetheless, the PA profession has significant development potential, especially in the realm of surgical PAs.

High impact of migration on the prevalence of chronic hepatitis B in the Netherlands.

OBJECTIVES: A representative serosurveillance study (1995) resulted in an estimate of 0.2% for the HBsAg prevalence in the Netherlands. Some risk groups, especially migrants, were not well represented in the study, which probably led to an underestimation of the true HBsAg prevalence. The aim of this study was to calculate an adjusted HBsAg prevalence estimate for the total Dutch population including these risk groups. METHODS: According to their country of origin first-generation migrants (FGM) were classified into groups with low, intermediate and high prevalence using data from the WHO and Statistics Netherlands. The number of chronic HBsAg carriers in different age and population groups was estimated based on studies about age-specific prevalence in different countries. The number of carriers in the indigenous population was estimated using the serosurveillance study. A combination of these estimates led to an estimate of the total prevalence rate in the Netherlands. RESULTS: Nearly 10% of the Dutch population are FGM. Of these, about 18% were born in low-endemic, 71% in middle-endemic and 11% in high-endemic countries. The overall prevalence of HBsAg in FGM is estimated to be at 3.77%. Combining these results with the results of the serosurveillance study the HBsAg prevalence in the Dutch population is estimated to be between 0.32 and 0.51%, and when including injecting drug users and mentally handicapped persons the prevalence rates are 0.36 and 0.55%, respectively. CONCLUSION: Our results show the high importance of targeting migrants and their close contacts adequately in screening programmes, vaccination and treatment for chronic hepatitis B.