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1.
Georgian Med News ; (346): 113-118, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38501632

RESUMEN

The purpose of the article is to find out the scope of the criminal law protection of the circulation of medicinal products according to the legislation of the Federal Republic of Germany, the Republic of Austria, and the Swiss Confederation. The materials of the research were the legislation of the Federal Republic of Germany, the Republic of Austria, and the Swiss Confederation. Dialectical, axiological, comparative, and legal methods were applied during the research. Having studied the experience of the scope of criminal law protection of the circulation of medicinal products made it possible to conclude about the importance of having a certain legislative reference point that can help improve the criminal legislation of these and other countries and build a new model of the system of norms that ensure the criminal law protection of circulation of medicinal products. It has been concluded that in the criminal legislation of the Federal Republic of Germany, the Republic of Austria, and the Swiss Confederation there is an "aspiration" of the legislator to ensure the most complete scope of criminal law protection of circulation of medicinal products by creating their own specific systems. It has been proposed to single out separate groups of signs of criminal protection of pharmaceutical activity, since the scope of such protection is not the same in such countries (but has a lot in common). This may be a certain legislative guideline of the systematization of norms that ensure the circulation of medicinal products from the point of view of their criminal law protection.


Asunto(s)
Derecho Penal , Criminales , Humanos , Austria , Alemania Occidental , Alemania
2.
Longit Life Course Stud ; 14(4): 492-513, 2023 10 02.
Artículo en Inglés | MEDLINE | ID: mdl-37874201

RESUMEN

This paper examines and compares the impact of non-employment - more precisely female and male unemployment and female labour-market inactivity - on cohabiting and married couples' separation risk in eastern and western Germany. Although Germany has experienced substantial changes in the spheres of family and labour market in recent decades, differences between the former East and West Germany persist even over 30 years after reunification. Applying conditional logistic fixed-effect models to German Socio-Economic Panel (SOEP) data, I find the following: in western Germany, where - despite a trend towards more egalitarian gender norms - traditional gender norms still prevail, male unemployment increases couples' separation risk, whereas female labour-market inactivity reduces it. Examining change across two birth cohorts - women born in or before 1971 and women born after 1971 - I find for western Germany that the effects of male and female unemployment on couple separation appear to be converging, and the relationship-stabilising effect of female labour-market inactivity seems to be diminishing. This is in line with the trend towards egalitarian gender norms in that region. In eastern Germany, both female and male unemployment have a relationship-destabilising effect in the older birth cohort, which might reflect the more egalitarian gender norms there. However, the relationship-destabilising effect of male and female unemployment is diminishing, and can no longer be found in the younger birth cohort. Unexpectedly, for eastern German women born after 1971, labour-market inactivity is relationship-stabilising, which was not the case in the older cohort.


Asunto(s)
Matrimonio , Humanos , Masculino , Femenino , Alemania/epidemiología , Alemania Occidental
3.
BMC Public Health ; 23(1): 1601, 2023 08 23.
Artículo en Inglés | MEDLINE | ID: mdl-37608365

RESUMEN

BACKGROUND: Epidemiological research on the prevalence of traumatic events and PTSD has shown that there are significant differences between countries, due to their different history and socialization processes. In the case of Germany, this is particularly relevant. Germany was divided into two states from 1949 to 1990. This study examines the prevalence of traumatic events and PTSD in the formerly divided East and West Germany. METHODS: For the prevalence of traumatic events, we used data from four representative surveys (years 2005, 2007, 2008, and 2016) with a total of N = 9,200 respondents. For the analyses of PTSD prevalence, we used data from three representative surveys (years 2005, 2007, 2008) with a total of N = 6676 respondents. We compared different birth cohorts, persons living in the former West vs. East Germany, and the application of different diagnostic criteria using a chi-square test. RESULTS: The overall one-month prevalence rate for PTSD was 3.4% (3.0% for men and 3.8% for women). We found significant differences in the occurrence of traumatic events between genders, different age cohorts as well as between people who live in East and West Germany. Significant differences in the prevalence of PTSD can only be observed for different age cohorts. Most of the age effects are due to traumatic events related to World War II (WWII). Prevalence rates for PTSD were higher when the diagnostic criterions of the DSM-V were applied compared to the criterions of the DSM-IV. CONCLUSIONS: Our data suggests that socio-political factors may need to be considered when accounting for differences in occurrence rates of traumatic events, but not for prevalence rates of PTSD, between East and West Germany. People who have experienced WW II have a higher risk of suffering from PTSD. Future epidemiological trauma research should take historical and regional peculiarities of countries into account.


Asunto(s)
Trastornos por Estrés Postraumático , Femenino , Humanos , Masculino , Trastornos por Estrés Postraumático/epidemiología , Prevalencia , Alemania Occidental/epidemiología , Alemania/epidemiología , Ansiedad
4.
Psychiatr Prax ; 50(6): 308-315, 2023 Sep.
Artículo en Alemán | MEDLINE | ID: mdl-37146641

RESUMEN

OBJECTIVE: The socioecological model emphasize the relevance of political, cultural and economic socialization effects for the prevalence of childhood maltreatment, which are analyzed by comparing child maltreatment between East and West German subjects who came of age before the fall of the Berlin Wall. METHODS: Using an online survey, a representative general population sample with respect to age, gender distribution and income was assessed regarding child maltreatment and current psychological distress using standardized self-report instruments. RESULTS: Of 507 study participants, 22,5% reported being born and socialized in East Germany. They reported significantly less emotional abuse than the 77,5% who grew up in the FRG. The East and West German subjects did not differ in any other form of abuse. CONCLUSION: Our findings underline the importance of socialization and enculturation effects on memory, which should be considered when interpreting the results.


Asunto(s)
Maltrato a los Niños , Humanos , Niño , Autoinforme , Alemania/epidemiología , Maltrato a los Niños/psicología , Alemania Occidental/epidemiología , Encuestas y Cuestionarios , Alemania Oriental
5.
J Public Health (Oxf) ; 45(3): e426-e436, 2023 08 28.
Artículo en Inglés | MEDLINE | ID: mdl-36866396

RESUMEN

AIM: The present study investigated regional differences in response behaviour for the Patient Health Quetionnaire-9. We tested for measurement invariance and differential item and test functioning between formerly divided East- and West-Germany: the former German Democratic Republic and Federal Republic of Germany. Diverging socialization experiences in socialist versus capitalist and collectivist versus individualist systems may affect culturally sensitive assessments of mental health. SUBJECT AND METHODS: To test this empirically, we used factor analytic and item-response-theoretic frameworks, differentiating between East- and West-Germans by birthplace and current residence based on several representative samples of the German general population (n = 3 802). RESULTS: Across all survey, we discovered slightly higher depression sum scores for East- versus West-Germans. The majority of items did not display differential item functioning-with a crucial exception in the assessment of self-harm tendencies. The scale scores were largely invariant exhibiting only small amounts of differential test functioning. Nonetheless, they made up on average about a quarter of the observed group differences in terms of effect magnitude. CONCLUSION: We explore possible causes and discuss explanations for the item-level differences. Overall, analyses of East- and West-German depressive symptom developments in the wake of reunification are feasible and statistically grounded.


Asunto(s)
Depresión , Salud Mental , Humanos , Alemania Occidental/epidemiología , Alemania Oriental/epidemiología , Depresión/diagnóstico , Depresión/epidemiología , Encuestas y Cuestionarios , Alemania/epidemiología
6.
Demography ; 60(1): 303-325, 2023 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-36656287

RESUMEN

The mortality gap between former East and West Germany decreased rapidly in the decade following the reunification of the country in 1990. However, because no previous study has estimated life expectancy (e0) over time for all German districts, the extent of mortality convergence across districts and its determinants are largely unknown. We used a novel relational Bayesian model to estimate district e0 in Germany during 1997-2016, examined mortality convergence using a novel convergence groups approach, and explored the role of selected district characteristics in the process. Differences in e0 between German districts decreased for both sexes during 1997-2016, mainly driven by rapid mortality improvements in eastern German districts. However, considerable heterogeneity in district-level e0 trajectories within federal states was evident. For example, district clusters in northwestern Germany showed increasing e0 disadvantage, which led to a north-south divergence in mortality. A multinomial regression analysis showed a robust association between the e0 trajectory and the district-level tax base and long-term unemployment but not with hospital density. Thus, an equitable "leveling up" of health seems possible with policies investing in places and the people who inhabit them.


Asunto(s)
Esperanza de Vida , Desempleo , Masculino , Femenino , Humanos , Teorema de Bayes , Alemania/epidemiología , Alemania Occidental , Mortalidad
7.
J Cancer Res Clin Oncol ; 149(7): 3335-3347, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-35932301

RESUMEN

PURPOSE: Cancer and its therapy causes severe symptoms, most of which are amendable to nutrition and physical activity (PA). Counselling on nutrition and PA empowers patients to take part more actively in their treatment. Many cancer patients are yet in need of information on these topics. In this study, we investigate the perception of family physicians (FP) on nutrition and PA in cancer patient care and assess barriers and steps to improve their involvement in counselling on these topics. METHODS: Based on qualitative content analysis of 5 semi-structured interviews with FP, a questionnaire was developed and completed by 61 German FP. RESULTS: Most of the FP acknowledged the importance of nutrition and PA during (91.4%) and after (100%) cancer therapy. While many participants were involved in cancer patient care, 65.6% of FP viewed themselves as primary reference person to address these topics. However, a third (32.8%) of FP were unfamiliar with information thereof. Some were unsatisfied regarding timely updates on their patient's treatment course via discharge letters (25.0%) or phone calls (36.2%). FP would like to dedicate more consultation time addressing nutrition and PA than they currently do (p < 0.001). CONCLUSION: Communication btween healthcare practitioners about mutual cancer patient's treatment must be improved, e.g. utilising electronic communication to quicken correspondence. Acquisition of information on nutrition and PA in cancer patient care needs to be facilitated for FP, approachable by compiling reliable information and their sources. Involvement of FP in structured treatment programs could benefit cancer patient care. TRIAL REGISTRATION NUMBER: (May 7, 2021): 2021-2149-Bef.


Asunto(s)
Consejo , Ejercicio Físico , Neoplasias , Necesidades Nutricionales , Médicos de Familia , Alemania Occidental , Neoplasias/terapia , Encuestas y Cuestionarios , Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano
8.
Psychiatr Prax ; 50(5): 264-269, 2023 Jul.
Artículo en Alemán | MEDLINE | ID: mdl-36126936

RESUMEN

Gerd Huber (1921-2012) was an influential West German psychiatrist and neurologist of the postwar period. Especially his studies with imaging techniques on the question of brain atrophy, the long-term course and the basic symptoms of schizophrenic disorders made a significant contribution to the research of schizophrenia and were discussed internationally. The Huber Archive, which was handed over to Bezirkskrankenhaus Günzburg, is currently being catalogued for research purposes. The archive contains Huber's private and professional papers, his writings, and a small partial archive of Kurt Schneider. These archival records not only reflect the development of Gerd Huber's academic career, but also are significant for research on the history of psychiatry in postwar West Germany, the development of concepts in the fields of schizophrenia research and biological psychiatry, the history of universities and everyday life, and other topics.


Asunto(s)
Psiquiatría , Esquizofrenia , Humanos , Historia del Siglo XX , Alemania , Esquizofrenia/diagnóstico , Alemania Occidental , Atrofia
9.
Front Public Health ; 10: 1000651, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36523589

RESUMEN

Objective: The reunification of Germany after the separation between 1949 and 1990 has offered a unique chance of studying the impact of socialization, political transformation, and migration on mental health. The purpose of this article was to compare mental distress, resources, and life satisfaction (1) between residents of East and West Germany and migrants who have fled from East to West Germany before reunification and (2) between three generations. Methods: We assessed anxiety, depression, resilience, self-esteem, and life satisfaction, comparing groups based on their residency and migration, as well as three different birth cohorts. Using a representative survey of 2006, analyses of variance show the differences between these groups. Based on a representative survey (N = 4,530), the effects of gender (53.6% women), residency/migration (74.4% grown up in the West, 20.4% in the East, 5.3% migrants from the East to the West) from three generations (32% born until 1945, 39% until 1967, and 29% to 1989), and positive and negative mental health indicators were analyzed. Results: Women reported higher distress and lower resilience. Residents of the Western states reported the lowest burden of distress (depressive and anxiety symptoms) and the highest overall life satisfaction, exceeding residents from the Eastern states and migrants from the Eastern to the Western states. Migrants from the Eastern to the Western states, however, reported the lowest resilience and self-esteem. They reported lower satisfaction with income, living conditions (compared to the Western residents), and the lowest levels of satisfaction with family (compared to East and West). Conclusion: Overall, our data point to inequalities between the Eastern and Western states regarding mental health 16 years after reunification favoring the residents of the Western states by lower distress and life satisfaction. Our data attest to the stresses and adjustments associated with migration from the Eastern to the Western states before reunification. A lower level of mental health and life satisfaction in the oldest generation may be related to the sequelae of World War II and also to aging.


Asunto(s)
Ansiedad , Salud Mental , Humanos , Femenino , Masculino , Alemania/epidemiología , Ansiedad/epidemiología , Satisfacción Personal , Alemania Occidental
10.
Psychother Psychosom Med Psychol ; 72(12): 524-532, 2022 Dec.
Artículo en Alemán | MEDLINE | ID: mdl-36323333

RESUMEN

RESEARCH: Question How did the general and area specific life satisfaction evolve between East and West Germany between 1991 and 2020? METHODS: Based on three representative surveys in the years 1991, 2006 and 2020 life satisfaction between East and West Germany was examined using mean comparison with tests of significance. The influence of relevant sociodemographic variables was calculated using Univariate Variance Analyses. RESULTS: 1991 large differences in the general life satisfaction as well as with satisfaction in the areas of living, spare time, health, finances and occupational did occur, with people in East Germany reporting to be less satisfied. These differences align during the observation time. DISCUSSION: The discrepancy in the general and area specific life satisfaction between East and West Germans did align during the last 30 years. A reason might be the improved economical living conditions in East Germany.


Asunto(s)
Encuestas y Cuestionarios , Humanos , Alemania Oriental , Alemania Occidental/epidemiología , Alemania/epidemiología
11.
Psychother Psychosom Med Psychol ; 72(12): 533-541, 2022 Dec.
Artículo en Alemán | MEDLINE | ID: mdl-36195102

RESUMEN

QUESTIONS: More than 15 years after the German reunification, were there differences in the personal resources among adolescents born around 1989 between East and West? How did the differences of this generation develop? METHODS: Data from the study on the health of children, adolescents and young adults in Germany (KiGGS study) from the years 2003-2006 and 2014-2017 are used to determine the prevalence of low personal resources in 14-17-year-old adolescents in Eastern and Western Germany. Cross-sectional data at both time periods are compared between East and West, and longitudinal data are used to follow the cohort over the course of age RESULTS: Around 15 years after the German reunification, 14- to 17-year-olds from East Germany more frequently show fewer personal resources and have lower self-efficacy expectations than adolescents of the same age in West Germany. 10 years later, these differences are barely visible and have partially reversed. The east-west differences found cannot be explained by the different socio-economic situations of the families in East and West. DISCUSSION: The results show that in the 2000s, adolescents born around 1989 from families living in Eastern Germany, showed a higher risk of having fewer personal resources than adolescents from families living in Western Germany. 25 years after the German reunification this is no longer recognizable. While the differences between East and West decrease over time, the importance of the socio-economic situation of the family for the personal resources of adolescents as a whole increases, to the detriment of those with a lower socioeconomic status. The results indicate the need for targeted interventions to strengthen psychosocial resources especially for children and adolescents in phases of transformation and biographical breaks.


Asunto(s)
Estudios Transversales , Niño , Adolescente , Adulto Joven , Humanos , Alemania/epidemiología , Alemania Oriental/epidemiología , Alemania Occidental/epidemiología , Prevalencia
12.
Artículo en Inglés | MEDLINE | ID: mdl-36141803

RESUMEN

Chronic exhaustion is a consequence of detrimental working conditions and demands, as well as inadequate coping techniques, potentially resulting in burnout. Previous research has studied occupational environment and individual factors as predictors of exhaustion. Although these differ between former East and West German states, the regional distinction regarding exhaustion has been neglected. To fill this gap, we used the Copenhagen Burnout Inventory in a representative German sample from 2014 to assess the burnout symptom exhaustion. Estimating ordinary least squares regressions, important burnout predictors were compared between the former East and West German states. Regional differences concerning occupational environments were related to the associations between individual factors, situational aspects of technostress and exhaustion. Associations between individual factors (e.g., female sex, lower working hours, age, partnership status, and household income) and exhaustion were stronger in East Germany, whereas technostress (strain of internet use, number of e-mails during leisure time, and social pressure to be constantly available) was more strongly associated with exhaustion in West Germany. Despite lower financial gratification and a higher social pressure to be constantly available in the East, West Germans were more afflicted by exhaustion. Individual factors and technostress should thus be considered when focusing on job-related mental health issues.


Asunto(s)
Agotamiento Profesional , Agotamiento Profesional/epidemiología , Agotamiento Profesional/psicología , Femenino , Alemania/epidemiología , Alemania Oriental/epidemiología , Alemania Occidental/epidemiología , Humanos , Encuestas y Cuestionarios
14.
NTM ; 30(1): 63-88, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-35166855

RESUMEN

Patient history has enriched medical history since about the 1980s. But there are still research gaps in certain periods and themes, especially in topics related to the medical history of West Germany. This paper deals with the efforts of patients, lay persons, and medical advisors (diabetologists) to enable diabetics to secure employment as civil servants (Verbeamtung). Attention will be payed to the fact that this success relied on the activities of mediators, who translated and conveyed the patients' interests to society at large. This victory was concordant with similar initiatives in other fields of the diabetic life, including sexuality and lifestyle management. Therefore, efforts to achieve civil servant employment for diabetic patients were constitutive of a broader initiative that changed the image of the disease and promoted the integration of diabetic patients into West German society.


Asunto(s)
Diabetes Mellitus , Estereotipo , Empleo , Alemania , Alemania Occidental , Historia del Siglo XX , Humanos
15.
Psychiatr Prax ; 49(6): 296-303, 2022 Sep.
Artículo en Alemán | MEDLINE | ID: mdl-34905781

RESUMEN

OBJECTIVE: Investigating the effects of internal migration on somatoform complaints (GBB-8) as well as psychological distress (PHQ-4; captures symptoms of anxiety and depression). METHODS: A representative sample from 2019 is used and divided into four groups (West, East, East-West, West-East). A variance analysis was conducted. RESULTS: The West group reports significantly more distress and somatoform symptoms than the East group. The group East-West report significantly more distress and somatoform complaints. CONCLUSION: The influence of internal migration, especially from East to West Germany, should be considered in future studies.


Asunto(s)
Distrés Psicológico , Alemania , Alemania Oriental , Alemania Occidental , Humanos
16.
Anaesthesiologie ; 71(7): 502-509, 2022 07.
Artículo en Alemán | MEDLINE | ID: mdl-34889966

RESUMEN

BACKGROUND: In contrast to prehospital care there is a lack of specifications for the organization and equipment of medical emergency teams for in-hospital emergency care. OBJECTIVE: Evaluation of the organization, team composition, training, equipment and tasks of medical emergency teams in the Federal Republic of Germany. MATERIAL AND METHODS: Evaluation of a web-based survey of all hospitals participating in the German Resuscitation Register between February and March2020. The participants were asked about team composition; emergency equipment; type, content and scope of special training or further training as well as other additional tasks in the everyday clinical routine when participating in the medical emergency team. Hospitals with ≤ or >600 beds were compared. RESULTS: A total of 21 (>600 beds: 10, 48%; ≤600 beds: 11, 52%) hospitals participated in the survey. Team composition requirements were present at 76% (n = 16; ≤600 beds: 8, 72% vs. >600 beds: 8, 80%), training requirements for medical emergency teams at 38% (n = 16; ≤600 beds: 4, 36% vs. >600 beds: 4, 40%) of hospitals, with a focus on cardiac life support (n = 6, 28%; ≤600 beds: 3, 27% vs. >600 beds: 3, 30%) and airway management (n = 4, 19%; ≤600 beds: 3, 27% vs. >600 beds: 1, 10%). A 12-lead electrocardiogram (n = 7, 33%; ≤600 beds: 1, 9% vs. >600 beds: 6, 60%; p = 0.02), video laryngoscope (n = 7, 33%; ≤600 beds: 2, 18% vs. >600 beds: 5, 50%), ventilator without (n = 7, 33%; ≤600 beds: 2, 18% vs. >600 beds: 5, 50%) or with the possibility of non-invasive ventilation was part of the standard equipment in n = 4, 19% (≤600 beds: 1, 9% vs. >600 beds: 3, 30%). A total of 85% (n = 18; ≤600 beds: 10, 100% vs. >600 beds 8, 72%), had additional tasks in the daily clinical routine. While clinics with >600 beds staffed medical emergency teams 100% of the time from the intensive care units, in clinics ≤600 beds medical emergency teams were deployed significantly more often in the emergency department (n = 5, 45%) and in the normal wards (n = 5, 45%, p = 0.03). CONCLUSION: Training and equipment of medical emergency teams in the Federal Republic of Germany is heterogeneous. They should at least meet the standards commonly used in prehospital emergency medicine and include the availability of a portable 12-lead electrocardiogram, a ventilator with the possibility of noninvasive ventilation and a video laryngoscope. Regardless of the size of the hospital, continuous availability of all members of the medical emergency teams should be ensured.


Asunto(s)
Servicios Médicos de Urgencia , Resucitación , Alemania Occidental , Hospitales , Humanos , Sistema de Registros
17.
Gesundheitswesen ; 83(S 02): S77-S86, 2021 Nov.
Artículo en Alemán | MEDLINE | ID: mdl-34695865

RESUMEN

ZIEL DER STUDIE: Routinedaten von Krankenkassen sind als Datenquelle mittlerweile gut etabliert. Hinsichtlich der Verallgemeinerbarkeit der Ergebnisse bei Analysen mit Daten einer Krankenkasse treten Fragen der Repräsentativität der Versichertenpopulation auf, insbesondere da nicht alle Studien auf soziodemografische Merkmale adjustieren. Diese Arbeit untersucht mittels deskriptiver Analyse, ob und inwieweit sich die Sozialstruktur der Versichertenpopulation der AOK Niedersachsen von der Sozialstruktur der Allgemeinbevölkerung und der sozialversicherungspflichtig Beschäftigten in Niedersachsen (NDS) und in der Bundesrepublik (BRD) unterscheiden. METHODIK: Die Datengrundlage bilden pseudonymisierte Daten der AOK NDS, die Beschäftigtenstatistik der Bundesagentur für Arbeit und der Bevölkerungsstand in NDS und der BRD. Die Versichertenpopulation wird an zwei Stichtagen 31.12.2012 und 31.12.2017 hinsichtlich der Geschlechter-und Altersstruktur mit der Bevölkerung in NDS und der BRD verglichen. Anschließend werden die Daten der sozialversicherungspflichtig Beschäftigten in der AOK NDS und aus der Beschäftigtenstatistik der Bundesagentur für Arbeit gegenübergestellt, um Ausbildungsabschlüsse, Komplexität der ausgeübten Tätigkeit und elf Berufsbereiche zu vergleichen. ERGEBNISSE: Die Geschlechterstruktur unterscheidet sich nicht zwischen den drei Vergleichspopulationen. Verglichen mit der Bevölkerung in NDS und der BRD ist der Anteil der unter 30-Jährigen in der AOK NDS überdurchschnittlich, der Anteil der Personen zwischen 50 und 76 Jahren etwas unterdurchschnittlich. Sozialversicherungspflichtig Beschäftigte mit Hochschulabschluss und in Tätigkeiten mit höherer Komplexität sind in der AOK NDS unterrepräsentiert. Die Verteilung der sozialversicherungspflichtig Beschäftigten auf elf Berufsbereiche unterscheidet sich ebenfalls. SCHLUSSFOLGERUNG: Die Studie zeigt, dass soziodemographische und sozio-ökonomische Merkmale in Studien mit Krankenkassendaten wann immer möglich berücksichtigt werden sollten. In Zukunft wird das Informationssystem Versorgungsdaten krankenkassenübergreifende Analysen mit Sekundärdaten ermöglichen. Fragestellungen der gesundheitlichen Ungleichheit können damit jedoch aufgrund des Fehlens von sozio-ökonomischen Merkmalen nicht beantwortet werden. Auch die Identifikation von vulnerablen Gruppen, die gezielt geeigneten Maßnahmen zugeführt werden könnten, ist ohne Berücksichtigung von sozio-ökonomischen Merkmalen erschwert. AIM OF THE WORK: Routine data from statutory health insurance funds are now a well-established source of data for scientific research. With regard to the generalizability of findings based on data from one health insurance fund, questions arise regarding the representativeness of the insured population, especially since not all studies adjust for socio-demographic characteristics. Our study examines whether and to what extent socio-demographic and occupational characteristics of the population insured with the AOK Lower Saxony differ from the total and working population of Lower Saxony and the Federal Republic of Germany. METHODS: The analyses are based on pseudonymised data from the AOK, the employment statistics of the Federal Employment Agency (FEA) and population statistics. The insured population was compared with the population of Lower Saxony and Germany at two cut-off dates (31.12.2012 and 31.12.2017) with respect to the distributions of age and gender. Subsequently, data of employed insured persons were compared with FEA-data in order to compare educational level, complexity of the work and occupational areas. RESULTS: The gender structure did not differ between the three populations. The proportion of insured women and men below 30 years of age was above the corresponding figures of Lower Saxony and Germany. Employed individuals holding a university degree or jobs with higher complexity were under-represented in the AOK. The distribution across eleven occupational areas in the AOK also differed from the reference populations. CONCLUSIONS: The study shows that socio-demographic and socio-economic characteristics should be considered whenever possible in studies using statutory health insurance data. In future, the new database "Information System Health Care Data" will enable analyses across all statutory health insurance providers. However, research questions of health inequalities cannot be answered with this approach due to the lack of socio-economic characteristics in these data. Identifying vulnerable groups that could be targeted for appropriate interventions is also difficult without taking socio-economic characteristics into account.


Asunto(s)
Seguro de Salud , Femenino , Alemania , Alemania Occidental , Humanos , Seguro de Salud/economía , Masculino , Factores Socioeconómicos
18.
Z Kinder Jugendpsychiatr Psychother ; 49(4): 284-294, 2021 Jul.
Artículo en Alemán | MEDLINE | ID: mdl-34240622

RESUMEN

ADHS - Disorder concepts and the beginnings of pharmacotherapy in the Federal Republic of Germany and the German Democratic Republic Abstract. After sporadic references before 1900, the concept of attention deficit/hyperactivity disorder became established in the 20th century. The hyperactive and inattentive child then became the focus of neuropediatrics in the wake of the encephalitis lethargica epidemic by clinical presentations of postencephalitic residual conditions. From these patients, physicians distilled a subgroup with an blank neurological history but impressive clinical symptoms. Child psychiatry, which emerged in the middle of the last century, studied these minimally brain-damaged patients, searching for both causes and therapies. The disorder concepts of Reinhart Lempp and Gerhard Göllnitz are significant contributions from the Federal Republic of Germany and the GDR, respectively, which provide revealing insights into the establishment of pharmacotherapy with stimulants in the 1970s.


Asunto(s)
Trastornos Mentales , Niño , Alemania , Alemania Oriental , Alemania Occidental , Historia del Siglo XX , Humanos
19.
Front Public Health ; 9: 691680, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34268291

RESUMEN

A substantial body of research has shown worse health conditions for East- vs. West-Germany in the wake of reunification. In the present study, we investigate how these differences between the two formerly divided regions developed and what maintains them. Specifically, we consider the associations between health status, income satisfaction, and health-related locus of control. In a quasi-experimental and longitudinal study design, we are particularly interested in the differences between individuals who stayed in East-Germany and those who were born in the East but migrated to West-Germany. To this end, we examined data from seven waves of the Saxony Longitudinal Study (2003-2009). Specifically, we tested a cross-lagged panel model with random effects, which evinced very good model fit. Most parameters and processes were equivalent between individuals who stayed in East-Germany vs. moved to West-Germany. Crucially, there was the expected pattern of positive correlations between health, income, and locus of control. In addition, we found substantially lower values for all three of these variables for the individuals who stayed in East-Germany (vs. moved to West-Germany). A possible explanation is the increase in socio-economic status that the internal migrants experienced. These findings present an important contribution of research in order to foster a better understanding on the social dynamics in Germany related to internal/domestic migrants and implications in the context of health outcomes (e.g., significantly more unemployment in East vs. West-Germany), especially since almost 20-25% of East-German citizens migrated to West-Germany. Until now, there are no similar studies to the Saxony longitudinal project, since the data collection started in 1987 and almost every year an identical panel has been surveyed; which can be particularly useful for health authorities. The study mainly focuses on social science research and deals with the phenomenon of reunification, approaching several subjects such as mental and physical health, quality of life and the evaluation of the political system. Yet even though many people have experienced such a migration process, there has been little research on the subjects we approach. With our research we deepen the understanding of the health consequences of internal migration.


Asunto(s)
Calidad de Vida , Alemania/epidemiología , Alemania Oriental , Alemania Occidental , Humanos , Estudios Longitudinales
20.
Cancer Epidemiol ; 73: 101968, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-34174725

RESUMEN

BACKGROUND: The aetiology of childhood leukaemia is largely unknown. Analyses of geographical differences may enhance aetiologic insights. The reunification of Germany in 1990 provides a unique opportunity to evaluate incidence patterns and time trends in two merging countries with substantial lifestyle, social and socioeconomic differences. With this study we provide an extensive assessment of 28-year incidence patterns and temporal trends after the German reunification. METHODS: We identified all children diagnosed with a lymphoid leukaemia (LL) or acute myeloid leukaemia (AML) before the age of 15 years between 1991 and 2018 using the German Childhood Cancer Registry (N = 14,922), and evaluated the incidence pattern and temporal trends in former East Germany compared to West Germany by subtype, age at diagnosis and sex. RESULTS: Incidence rates of LL were substantially lower (around 20 %) in Eastern Germany compared to Western Germany at the time of reunification. This was followed by a remarkable increase in Eastern Germany across both sexes and age groups until around 2000, when incidence rates reached the same levels as those in Western German federal states. Thereafter, incidence rates remained rather stable with some indications of a slightly decreasing tendency in both Eastern and Western Germany (estimated annual percentage changes (EAPC) 2005-2018: East Germany = -0.8 %; West Germany = -0.4 %), driven by the 0- to 4-year olds. Overall, AML incidence rates were stable over time in Western Germany, while EAPC for Eastern Germany indicated an increasing tendency (EAPC 1991-2018 = 1.3 %) driven by the older children, mostly during the early 2000s and in most recent years. CONCLUSION: The underlying mechanisms driving the childhood leukaemia rates remain inconclusive. Linkage studies including individual and clinical data would be valuable in evaluating the impact of a population's social, socioeconomic and lifestyle changes on the risk of childhood leukaemia and disease aetiology overall.


Asunto(s)
Leucemia Linfoide , Leucemia Mieloide Aguda , Adolescente , Niño , Preescolar , Femenino , Alemania Oriental/epidemiología , Alemania Occidental/epidemiología , Humanos , Incidencia , Lactante , Recién Nacido , Leucemia Linfoide/epidemiología , Leucemia Mieloide Aguda/epidemiología , Masculino , Sistema de Registros
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