[Memorandum on sustainable reinforcement of prevention and health promotion: challenges at the federal, state and local level]. / Memorandum--Prävention und Gesundheitsförderung nachhaltig stärken: Herausforderungen auf Bundes-, Landes- und kommunaler Ebene.

Research-based evidence and practice-based experience are core requirements for the effective implementation of preventive interventions. The knowledge gained in the Prevention Research Funding Initiative of the German Federal Ministry of Education and Research (2004-2013) was therefore amalgamated, reflected and consolidated in the Cooperation for Sustainable Prevention Research (KNP) meta-project. In annual strategy meetings, researchers and practitioners from the field and other experts developed 3 memoranda providing recommendations for the further development of research and practice in the field of prevention and health promotion. Memorandum III is primarily aimed at decision-makers in politics and administration at the federal, state and local level, in civil society and in the workplace. Its recommendations show that structuring efforts are urgently needed to achieve sustainable policy, particularly in the fields of health, education, employment and social affairs. Memorandum III brings together the knowledge extracted and problems identified in research projects. More so than its 2 predecessors, Memorandum III abstracts knowledge from the individual projects and attempts to derive guidance for action and decision-making, as shown by the 7 recommendations that appear to useful for consensus-building in practice and research. Value judgments are inevitable. Prevention and health promotion are an investment in the future: of social health, social capital and social peace. Improvement of the framework conditions is needed to achieve the harmonized awareness and the sustained effectiveness of these structure-building efforts in different policy areas, spheres of life, fields of action, and groups of actors. This includes the implementation of an overall national strategy as well as the expansion of sources of funding, extension of the legal framework, overarching coordination, and the establishment of a National Center of Excellence to develop and safeguard prevention and health promotion. The memorandum is intended to stimulate a discourse resulting in structure-building and stabilizing measures designed to ensure the sustainability of prevention and health promotion.

[Lifestyle modification programs protecting cardiovascular health in Germany and Sweden. A qualitative interview study]. / Lebensstiländerungen zur Förderung der kardiovaskulären Gesundheit in Deutschland und Schweden. Eine qualitative Interviewstudie.

A large amount of evidence, including neurohumoral, inflammatory, and metabolic physiological adaptations, emphasize the importance of the individual lifestyle as a public health concern. The related burden of chronic diseases in the European Union, which could be minimized by appropriate lifestyles, requires consistent transfer of evidence-based prevention guidelines. Due to the epidemiologic importance of cardiovascular diseases and innovative health-promoting strategies in Sweden, a comparative analysis between German and Swedish practices preventing cardiovascular events in high-risk populations is presented in this paper. This qualitative analysis demonstrates that lifestyle-related risk and protective factors based on smoking, physical activity, nutrition, and psychosocial determinants are of growing importance in cardiac death prevention. Especially in Sweden, behavioral prevention is joined by condition prevention. In Germany, intersectoral rehabilitation concepts improve patient adherence to behavioral recommendations but interdisciplinary communication between different health experts needs to be improved. The health-promoting hospital composes a health professional's interface, which is based on the understanding that behavioral risk factors are not only highly interrelated, but also require sophisticated healthcare delivery to optimize health management effectiveness.

[Type II diabetes (NIDDM): overview of the preclinical and clinical status exemplified by the patient sample of a general hospital in a rural district]. / Diabetes Typ II (NIDDM): Ubersicht über die präklinische und klinische Situation am Beispiel des Krankengutes eines Krankenhauses der Regelversorgung im ländlichen Bereich.

From unselected patients of a general hospital 198 patients with diabetes mellitus type II (NIDDM) were registrated between May and December 1990 by means of a standardized questionnaire and with the help of standardized clinical diagnostics epidemiological as well as anamnestic and clinical data were collected. In the great majority of the cases, the only therapeutical approach consisted in medical treatment, most commonly lacking dietary advices. The patients knowledge concerning diabetes and dietary treatment strongly correlated with the participation in specific education courses in the past. There was a high incidence of relevant concomitant diseases and pathological appearances succeeded to the diabetes mellitus. In view of the actually pronounced risk factors and concomitant diseases the importance of a "metabolic syndrome" becomes evident alluding to consequences in diagnosis and treatment. With regard to public health aspects and financial implications extensive education and training programs, especially in the field of ambulant care, seem to be necessary. Rising prevalence- and incidence rates of the diabetic disease claim, besides preventive means, for initiative in this subject.