[Predictors for low birth weight--an epidemiological case-control study with women in childbed in the federal state Saarland, Germany]. / Prädiktoren für niedriges Geburtsgewicht - Eine epidemiologische Fall-Kontroll-Studie an saarländischen Wöchnerinnen.

BACKGROUND AND AIMS: Low birth weight is associated with elevated health-care costs and adverse conditions for the newborn's start to life. A variety of health problems and an impaired potential for the infant's development are known long-term effects. Only few studies have examined the role of psychosocial and socioeconomic determinants for the incidence of low birth weight, especially in Germany. The aim of our study was to test the impact of maternal socioeconomic and psychosocial characteristics as well as health behaviour on the infant's birth weight. METHODS: In an exploratory case-control study we tested whether the before mentioned potential determinants of low birth weight were observed more often among cases (birth weight <2,500 g) than among controls. Standardised interviews were conducted with maternal cases and controls. RESULTS: The results show that mothers in the control group more often were married or cohabiting (100% vs. 77%; p<0.05) and that they had a higher occupational status (83% non-manual vs. 54%; p<0.05). Level of education was not significantly related to birth weight. Mothers in the case group more often reported exhaustion (p<0.05) and marital problems [M=1.8 (1.1) vs. M=1.3 (0.5); p<0.05). They were characterised by a higher burden of work-strain in terms of weather conditions, heat or infiltration [M=1.7 (1.0) vs. M=1.1 (0.4); p<0.05). The available living space was slightly smaller in the case group [M=96.5 m(2) (31.5 m(2)) vs. M=118.5 m(2) (46.8 m(2)); p<0.1). DISCUSSION AND CONCLUSIONS: Our results confirm international studies showing differences regarding the social context of women who give birth to a child with normal or low birth weight. Apart from vertical status characteristics, marital conditions and resulting psychosocial stressors seem to have an impact.

Coherent-pulse 2D crystallography using a free-electron laser x-ray source.

Coherent diffractive imaging for the reconstruction of a two-dimensional (2D) finite crystal structure with a single pulse train of free-electron laser radiation at 7.97 nm wavelength is demonstrated. This measurement shows an advance on traditional coherent imaging techniques by applying it to a periodic structure. It is also significant that this approach paves the way for the imaging of the class of specimens which readily form 2D, but not three-dimensional crystals. We show that the structure is reconstructed to the detected resolution, given an adequate signal-to-noise ratio.

Qualitative evaluation of titanium implant integration into bone by diffraction enhanced imaging.

Diffraction enhanced imaging (DEI) uses refraction of x-rays at edges, which allows pronounced visualization of material borders and rejects scattering which often obscures edges and blurs images. Here, the first evidence is presented that, using DEI, a destruction-free evaluation of the quality of integration of metal implants into bone is possible. Experiments were performed in rabbits and sheep with model implants to investigate the option for DEI as a tool in implant research. The results obtained from DEI were compared to conventional histology obtained from the specimens. DE images allow the identification of the quality of ingrowth of bone into the hydroxyapatite layer of the implant. Incomplete integration of the implant with a remaining gap of less than 0.3 mm caused the presence of a highly refractive edge at the implant/bone border. In contrast, implants with bone fully grown onto the surface did not display a refractive signal. Therefore, the refractive signal could be utilized to diagnose implant healing and/or loosening.

Comparison of intravenous coronary angiography using synchrotron radiation with selective coronary angiography.

Intravenous coronary angiography with synchrotron radiation is a novel and minimally invasive technique for coronary imaging. At the Hamburger Synchrotronstrahlungslabor HASYLAB at DESY, a dedicated angiography system has been developed, which has been shown to provide detailed images of coronary artery segments. For each scan, two monochromatic X-ray images below and above the K-edge of iodine were recorded simultaneously. The two images were subtracted logarithmically to produce a maximal contrast enhancement of the iodine. To date, the procedure has been carried out on 379 outpatients. No complications occurred during or after the angiographic procedure, and hospitalization was not required in any subject. The acceptance by patient is extremely high. Five outside reviewers, blinded as to the clinical data or prior angiographic interpretation, reviewed the images for the presence or absence of 70% or more occlusion of a vessel. They reached a sensitivity of 79% and a specificity of 99%. The study has demonstrated that the synchrotron method has satisfactory sensitivity and very high specificity for severe stenoses. The new method has several advantages over magnetic resonance imaging (MRI), electron beam computed tomography (EBCT), and multi-slice computed tomography (MSCT). Neither vascular calcification (CT) nor the presence of metal stents (MRI) impairs the evaluation of perfusion of segments of the coronary arteries. Furthermore, the spatial resolution is three or four times higher using synchrotron angiography, and problems due to respiratory motion are eliminated.

[Burned-out or depressive? An empirical study regarding the construct validity of burnout in contrast to depression]. / Ausgebrannt oder depressiv? Eine empirische Studie zur Konstruktvalidität von Burnout in Abgrenzung zur Depression.

Our study tested the discriminant validity of burnout in contrast to depression using the Maslach Burnout Inventory (MBI, Maslach u. Jackson 1986) and the Allgemeine Depressionsskala (ADS, Hautzinger u. Bailer 1993). Furthermore the relationships between burnout and depression to social support, occupational and health variables were examined. Pre-school teachers (n = 101), physician-assistants (n = 81) and their intimates were asked to complete a self-administered questionnaire. Spearman-correlations and factor analysis were conducted with SPSS. The results indicate validity for the burnout construct.

Eating habits, health status, and concern about health: a study among 1641 employees in the German metal industry.

BACKGROUND: Nutrition has been found to be associated with sociodemographic characteristics and concern about health. There is limited knowledge, however, of associations between blue-collar worker's diet, morbidity, and health care utilization. METHODS: We conducted a survey on eating habits, physical symptoms, health care utilization, health status, and concern about health in two German metal companies. A self-administered questionnaire was mailed to employees of whom 1641 participated in the study (response rate 54. 7%). RESULTS: Most employees were characterized by a combination of healthy and unhealthy eating elements. Using linear regression analyses adjusted for age, gender, and occupational status, healthy eating was negatively associated with stomach aches and headaches, but not with cardiovascular disease. Restricted activity days and days in hospital were associated with healthy eating, but self-assessed health status and physician consultations were not. Using stepwise multiple regression analysis, age, gender, and concern about health were strongly and morbidity was weakly related to diet. Occupational status, marital status, and number of children were not associated with nutrition. CONCLUSIONS: Health promotion programs should motivate younger and male employees to participate in and aim toward increasing concern about health.

[Attitudes and health status as determinants of participation in individually oriented health promotion]. / Einstellungen und Gesundheitsstatus als Bestimmungsfaktoren einer Beteiligung an Massnahmen verhaltensorientierter Gesundheitsförderung.

In a cross-sectional health survey among employees of a large German metal company with 974 study participants, attitudes and aspects of the individual health status were identified which predispose employees to take part in individual health promotion activities. Apart from higher participation rates in women and white collar employees, participants reported on average a less favourable subjective health status, more complaints and diseases, better health related behaviours, and a more intensive utilization of curative and preventive medical services than nonparticipants. Among men, participation in all types of courses increased from the youngest to the oldest group, among women only until the middle-aged groups with a consequent decline thereafter. In men, the image of a person living health-consciously showed the strongest positive association with participation, and not the degree of internal control and responsibility with respect to the maintenance of health or the acquisition and overcoming of disease. The low participation of blue collar workers compared to white collar employees could be attributed to group specific differences in individual health consciousness only to a very small extent. Blue collar participants reported a positive image of a person living health-consciously that was more similar to that of white collar participants than to that of nonparticipants of their own occupational group. Advertisement for health promoting activities should place more emphasis on increasing the image of personal health promotion than on internal control and responsibility for health.

[Back pain in industry: prevalence, correlation with work conditions and requests for reassignment by employees]. / Rückenschmerzen im Betrieb: Verbreitung, Zusammenhänge mit Arbeitsbedingungen und Anderungswünsche der Beschäftigten.

Using data from a cross-sectional survey of 974 employees of a metal company in Germany, we analysed the frequency of chronic back pain, ist associations with working conditions, and the requests for workplace modifications, expressed by persons afflicted with chronic back pain. With a prevalence of 32% chronic back pain was the most common health problem. Physical work exposures, such as lifting and carrying as well as working in an awkward position, were strongly (multivariable odds ratios > or = 2.8) associated with chronic back pain, whereas environmental factors were moderately (multivariable odds ratios = 1.6) associated. Most psychosocial stressors, such as time pressure, and conflicts with co-workers and superiors, were moderately associated with chronic back pain as well (age-adjusted odds ratios between 1.4 and 1.8). Stress symptoms, such as irritation and strain, are rated as mediators by possibly linking psychosocial stressors to chronic back pain. If the individual subject is compelled to perform monotonous or repetitive work, he feels underrated, and this has proved to be a risk factor in its own right. Prolonged exposure to physical stressors (> 7 years) was associated with a strongly elevated risk for chronic back pain (age-adjusted odds ratios > or = 4.0 compared to the nonexposed). Blue collar workers afflicted with chronic back pain requested a reduction of their physical work load significantly more often than their non-afflicted colleagues. In contrast, female white collar employees with chronic back pain layed most emphasis on more physical exercise at work. Worksite health promotion programmes should consider these differences in order to meet the specific needs and preferences of different occupational groups.

[Eating habits of employees in the metal industry: determinants and patterns]. / Ernährungsgewohnheiten bei Beschäftigten in der Metallindustrie: Determinanten und Muster.

We conducted a survey on chances and barriers of occupational health promotion and health behaviour including diet in two South German metal companies. Only a small percentage of the 1641 participants consumed healthy food each day, but many avoided eating unhealthy food. Most employees are characterized by a combination of healthy and unhealthy elements. The group of "healthy eaters" consists of more women than men, more older than younger people and more non-manual than manual workers. The level of education and number of children have not been associated with eating habits. Healthy eaters consumed less alcohol and tobacco and were more engaged in sports and in health promotion programmes than unhealthy eaters.

[Need adjustment of utilization of occupational health promotion for reducing back pain? Results of an employee survey of the metal industry]. / Bedarfsgerechtigkeit der Inanspruchnahme betrieblicher Gesundheitsförderung zur Reduktion von Rückenschmerzen? Ergebnisse einer Mitarbeiterbefragung in der Metallindustrie.

We analysed data of a cross-sectional survey of 974 employees in the German metal industry to determine the degree to which worksite health promotion matches the needs of employees. 27% of study participants have already taken part in individually oriented health promotion, and another 48% want to participate most readily in activities aiming at preventing and reducing musculo-skeletal complaints. Recent participation (within a fourteen-month period) in these classes was low among male blue collar workers (7%) compared to male and female white collar employees (18 and 26%). Among blue collar workers the percentage of subjects who suffered from chronic back pain and did not recently participate in the relevant classes of the company health insurance plan (unserved prevalence) was 30%, compared to 17 and 26% in male and female white collar employees. Participants were less exposed to work-related predictors of chronic back pain than non-participants. Participants were, however, more often afflicted with chronic back pain than non-participants. In addition, the intention to participate was strongly associated with this type of complaint. Shift work was the most important single explanation for the low participation rates of blue collar workers. Suggestions are advanced to neutralise the adverse effects of shift work on participation, to strengthen the primary preventive functions of individual worksite health promotion, and to integrate it with structural measures of health and safety at work.

Intravenous coronary angiography with dichromography using synchrotron radiation.

Dichromography represents a digital subtraction angiography mode based on energy substraction which allows imaging of fast moving subjects like the heart. For logarithmic subtraction 2 images with X-rays just below and above the iodine K-edge (33.17 keV) are simultaneously obtained in a line scan mode. Monochromatic X-rays of sufficient intensity to visualize coronary arteries of 1 mm diameter with extremely low iodine concentrations (1 mg/cm2) after venous injection is only provided by synchrotron radiation. The system NIKOS (non-invasive coronary arteriography with synchrotron radiation) at the Deutsches Elektronen Synchrotron (DESY) consists of 6 components: a wiggler, a monochromator, a safety system, a scanning device, a detector and a computer system. After experimental studies in dogs patients are imaged since 1990. Initial results demonstrate feasibility and safety of synchrotron radiation coronary angiography. Large scale studies are designed to further evaluate sensitivity and specificity. When compact synchrotron radiation sources become available, this technique could be used for follow-up studies and for evaluation of certain high coronary risk populations.