Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 105.825
Filtrar
1.
Schmerz ; 33(5): 471-474, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31571060

RESUMO

The treatment of any causal, procedure-specific and/or concomitant acute pain is an essential quality feature in any surgical subspecialty. An interdisciplinary and interprofessional pain therapy aims for an immediate improvement of the patients' quality of life, a reduction of the risk of postoperative morbidity and mortality in the medium term, prevention of any pain chronification in the long run as well as a reduction of hospitalization and sick leave. The "Agreement of the Professional Association of German Anesthesiologists and the Professional Association of German Surgeons for the Organization of Postoperative Pain Therapy" exists since 1992. In view of the continuously developing scientific evidence, updated guideline recommendations and interprofessionally designed treatment pathways, these agreements have been adapted to the current requirements and structural conditions of the German healthcare system. Thus, both aforementioned professional associations promote an up to date version of an "Agreement for the Organization of Pain Therapy for Surgical Patients", a precise recommendation and a manual for the acting partners in order to realize the abovementioned goals.


Assuntos
Anestesiologistas , Manejo da Dor , Dor Pós-Operatória , Cirurgiões , Alemanha , Humanos , Manejo da Dor/normas , Dor Pós-Operatória/tratamento farmacológico , Qualidade de Vida , Sociedades
2.
Bone Joint J ; 101-B(10): 1263-1271, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31564142

RESUMO

AIMS: The aim of this study was to investigate whether clinical and radiological outcomes after intramedullary nailing of displaced fractures of the fifth metacarpal neck using a single thick Kirschner wire (K-wire) are noninferior to those of technically more demanding fixation with two thinner dual wires. PATIENTS AND METHODS: This was a multicentre, parallel group, randomized controlled noninferiority trial conducted at 12 tertiary trauma centres in Germany. A total of 290 patients with acute displaced fractures of the fifth metacarpal neck were randomized to either intramedullary single-wire (n = 146) or dual-wire fixation (n = 144). The primary outcome was the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire six months after surgery, with a third of the minimal clinically important difference (MCID) used as the noninferiority threshold. Secondary outcomes were pain, health-related quality of life (EuroQol five-dimensional questionnaire (EQ-5D)), radiological measures, functional deficits, and complications. RESULTS: Overall, 151/290 of patients (52%) completed the six months of follow-up, leaving 83 patients in the single-wire group and 68 patients in the dual-wire group. In the modified intention-to-treat analysis set, mean DASH scores six months after surgery were 3.8 (sd 7.0) and 4.4 (sd 9.4), respectively. With multiple imputation (n = 288), mean DASH scores were estimated at 6.3 (sd 8.7) and 7.0 (sd 10.0). Upper (1 - 2α)) confidence limits consistently remained below the noninferiority margin of 3.0 points in the DASH instrument. While there was a statistically nonsignificant trend towards a higher rate of shortening and rotational malalignment in the single wire group, no statistically significant differences were observed across groups in any secondary outcome measure. CONCLUSION: A single thick K-wire is sufficient for intramedullary fixation of acute displaced subcapital fractures of the fifth metacarpal neck. The less technically demanding single-wire technique produces noninferior clinical and radiological outcomes compared with the dual-wire approach. Cite this article: Bone Joint J 2019;101-B:1263-1271.


Assuntos
Fios Ortopédicos , Fratura-Luxação/cirurgia , Fixação Interna de Fraturas/instrumentação , Fixação Intramedular de Fraturas/instrumentação , Fraturas Ósseas/cirurgia , Ossos Metacarpais/lesões , Adulto , Feminino , Traumatismos dos Dedos/diagnóstico por imagem , Traumatismos dos Dedos/cirurgia , Fixação Interna de Fraturas/métodos , Fixação Intramedular de Fraturas/métodos , Consolidação da Fratura/fisiologia , Alemanha , Força da Mão/fisiologia , Humanos , Escala de Gravidade do Ferimento , Masculino , Ossos Metacarpais/cirurgia , Pessoa de Meia-Idade , Razão de Chances , Prognóstico , Amplitude de Movimento Articular/fisiologia , Medição de Risco
3.
Z Psychosom Med Psychother ; 65(3): 288-303, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31476999

RESUMO

Is the influence of religiousness on fearful, depressive and somatic symptoms and psychic traumatization overestimated? A representative cross-sectional study Objectives: The aim of this study is to prove if religious faith, spirituality and religious praxis are joined with lower depression, anxiety and physical pain-level and if subjects with traumatic experiences report more spirituality. Methods: In this consecutive study, 2508 adults of a representative sample in Germany were interviewed about religious faith and spirituality in relation to depression, anxiety, physical disorders as well as traumatic experiences. Results: Unlike our hypotheses people who are charged with mental (PHQ-4; Löwe et al. 2010) or physical disorders (GBB_8; Kliem et al. 2017) report more spirituality and more private religious/spiritual praxis than people without mental or physical problems. As expected people with traumatic experiences in their childhood (CTS; Grabe et al. 2012) describe significantly more spirituality than people without these experiences. Conclusions: Other than expected people with more mental or physical disorders report more spirituality and more private religious/spiritual praxis. It is to discuss if spirituality is less a protective factor for mental or physical disorders than disorders activate to look for spirituality and private religious/spiritual praxis.


Assuntos
Ansiedade/psicologia , Depressão/psicologia , Medo/psicologia , Sintomas Inexplicáveis , Trauma Psicológico/psicologia , Religião e Psicologia , Espiritualidade , Adulto , Ansiedade/epidemiologia , Criança , Estudos Transversais , Depressão/epidemiologia , Alemanha/epidemiologia , Humanos , Entrevistas como Assunto , Trauma Psicológico/epidemiologia
4.
Z Psychosom Med Psychother ; 65(3): 272-287, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31477000

RESUMO

Development of an evaluation system for online self-help groups by using the example of German-speaking cancer forums Objectives: This paper pursues the question how the quality of forums can be evaluated. Therefor a grading system was designed and 23 German-speaking cancer forums were evaluated by content and formal criteria Methods: Using a keyword-based internet search, 23 forums were identified. Data was gathered about: number of themes, posts and members, structure, key subjects and type of financing. Furthermore, an evaluation system was developed, with which the forums where assessed. Results: The forums were divided in forums with (n = 10) and without (n = 9) focus on a type of cancer. Four are health portals with forum-function. The quality of online cancer forums is heterogeneous, the evaluation resulted an average quality index of 2.7 for the total cancer forums Conclusion: A good information editing, moderation, data protection and transparency are important quality criteria. The evaluation of forums may help the patients, to autonomously value the quality of the presented information.


Assuntos
Internet , Linguagem , Neoplasias , Avaliação de Programas e Projetos de Saúde/métodos , Grupos de Autoajuda/normas , Mídias Sociais/normas , Alemanha , Humanos
5.
Prax Kinderpsychol Kinderpsychiatr ; 68(6): 488-502, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31480942

RESUMO

Quality of Life and Behavioral Problems of Unaccompanied Minor Refugees in Child Care Facilities Unaccompanied minor refugees (UMR) who arrive in Germany are generally placed in institutional child care facilities. UMR are a very burdened group, however other children and adolescents in institutional care are burdened as well, and their quality of life is often reduced. The aim of the current study was thus to compare quality of life and behavioral problems of UMR in child care facilities with those of other resident adolescents. For a total of 50 UMR, data regarding behavioral problems was available, for 41 UMR ratings on quality of life, both from external assessments. Two parallel comparison samples of other adolescents in the same institutional care facilities were drawn with adolescents with and without a migration background. Results show that in general, UMR show fewer behavioral problems than the other two groups, especially in externalizing behavior. For internalizing behavior, no differences were evident. For quality of life, no differences could be found between the three groups of inhabitants in institutional care. This indicates that the same factors determining quality of life are present in all three groups, but that the underlying mental problems are different in UMR than in other adolescents. Thus, staff in institutional care should possibly work differently with these group of adolescents than with other inhabitants and should be educated respectively.


Assuntos
Cuidado da Criança , Menores de Idade/psicologia , Comportamento Problema , Qualidade de Vida , Refugiados/psicologia , Adolescente , Criança , Cuidado da Criança/organização & administração , Alemanha , Instalações de Saúde , Humanos
6.
Fortschr Neurol Psychiatr ; 87(9): 499-502, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31519025

RESUMO

Strains of methicillin-resistant Staphylococcus aureus (MRSA) are of major economic and health-related importance to early neurological and neurosurgical rehabilitation. It is crucial to identify MRSA-carriers as soon as possible upon admission in order to prevent transmissions and to initiate contact precautions and decolonization. The present study focuses on validity of a polymerase chain reaction (PCR) test to identify MRSA genetic material from nasopharyngeal samples (BD MAX MRSA XT, BD Diagnostics, Heidelberg, Germany) of early neurological and neurosurgical rehabilitation patients. PCR-results were compared to gold standard (culture). In 2013, 66 patients were tested using PCR and incubation within one week after admission. Sensitivity of PCR was 84.6 %, specificity 86.6 %. Positive predictive value (PPV) was only 61.1 %, while negative predictive value was as high as 95.8 %. In 39 cases, PCR and subsequent culture were done within one day, leading to a sensitivity of 100 % and a specificity of 90.3 %. In this subgroup, PPV was 72.7 %, NPV 100 %. The results from the study suggest that incubation should quickly follow a positive PCR finding (within 24 hours) in order to verify MRSA colonization. High NPV (95.8 resp. 100 %) indicate that PCR negative patients very likely are not colonized with MRSA. A positive PCR test is less reliable (due to false positive results) and should be followed by incubation in due course in order to avoid unnecessary contact precautions.


Assuntos
Programas de Rastreamento/normas , Staphylococcus aureus Resistente à Meticilina/genética , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Reabilitação Neurológica , Reação em Cadeia da Polimerase/normas , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/microbiologia , Alemanha , Humanos , Sensibilidade e Especificidade
7.
Fortschr Neurol Psychiatr ; 87(9): 504-510, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31519026

RESUMO

BACKGROUND: Neuropsychological dementia diagnosis of migrants are limited regarding the testing of cognitive abilities as well as the recording of everyday activities (Activities of Daily Living, ADL) such as linguistic, educational, lifestyle and cultural-religious factors have not been taken into account in psychometric instruments. AIM OF THE STUDY: We aimed to develop a culturally sensitive ADL scale, which is suitable for both German people and Turkish migrants that takes into consideration gender, cultural-religious and lifestyle aspects. A further aim was to determine the quality criteria for the newly proposed ADL scale. METHODS: After the initial phase, including qualitative interviews (N = 15) with cognitively unimpaired German participants and Turkish migrants, a first version of the ADL instrument was developed. This version was then completed by cognitively unimpaired Germans (n = 197) and Turkish participants (n = 53) and the shortened ADL scale was generated based on an item analysis. It consisted of the three subscales 'cognition', 'Basic Activities of Daily Living (BADL)' and 'Instrumental Activities of Daily Living (IADL)'. For Turkish participants, questions about Islamic prayers were added. Montreal Cognitive Assessment (MoCA) and Geriatric Depression Scale (GDS) were applied to rule out cognitive impairment and depression. The 'Bayer-ADL' was used to measure the validity of the scale. RESULTS: The everyday life of Germans and Turkish migrants differs in aspects of religious practice and in terms of sociocultural activities, which are taken into account in the CC-ADL. The reliability of the new ADL scale in terms of internal consistency (Cronbach's alpha) were regarding 'cognition' α = .43 for Germans and α = .80 for Turkish migrants; 'BADL' α = .55 for Germans and α = -.04 for Turkish migrants; 'IADL' α = .91 for Germans and α = .83 for Turkish migrants and α = .73 for Turkish migrants under the 'prayer items'. The correlation of the ADL total score with the Bayer ADL for Germans was ρ = .347 (p < .00) and for the Turkish sample ρ = .520 (p < .01). CONCLUSION: The development of a final version of the CC-ADL scale requires further data from healthy participants and patients (Mild Cognitive Impairment and dementia).


Assuntos
Atividades Cotidianas , Competência Cultural , Demência/diagnóstico , Demência/psicologia , Emigrantes e Imigrantes/psicologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Feminino , Alemanha , Humanos , Estilo de Vida/etnologia , Masculino , Testes Neuropsicológicos , Religião e Psicologia , Reprodutibilidade dos Testes , Turquia/etnologia
8.
Z Gastroenterol ; 57(9): 1051-1058, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31525797

RESUMO

BACKGROUND AND AIM: Colorectal cancer (CRC) screening can effectively reduce cancer-associated mortality. In Germany, individuals over the age of 50 or 55 have access to CRC screening services. However, utilization rates are persistently low, particular in the male population. This observational study investigates the effect of standard versus gender-specific invitation letters on utilization of CRC screening services. METHODS: We analyzed utilization rates of individuals who were insured by a large health insurance fund in Bavaria, Germany. Persons who became eligible for CRC screening received a standard (2013-2014) or a gender-specific invitation letter (2015-2016). We compared utilization rates within 6 months after receipt of the invitation letter using billing codes of the health insurance fund. RESULTS: Invitation letters were sent to 49 535 individuals, of which 48.8 % were gender-specific. The overall utilization rate did not differ between recipients of the standard versus gender-specific invitation letter (11.6 % vs 11.1 %; RR: 0.97 [0.92-1.02], p = 0.19). However, uptake of screening colonoscopy was significantly higher among recipients of gender-specific invitations (2.9 % vs 3.5 %; RR: 1.21 [1.04-1.39], p = 0.01), whereas utilization of fecal occult blood tests declined (10.4 % vs 9.7 %; RR: 0.93 [0.88-0.99], p = 0.016). CONCLUSIONS: Gender-specific design of invitation letters can modify the patients' preference for specific CRC screening services and increase the acceptance of screening colonoscopy.


Assuntos
Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/métodos , Programas de Rastreamento/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Participação do Paciente/estatística & dados numéricos , Colonoscopia , Neoplasias Colorretais/prevenção & controle , Feminino , Alemanha , Humanos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Sangue Oculto
9.
Z Gastroenterol ; 57(9): 1059-1066, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31525798

RESUMO

BACKGROUND: In Germany, colorectal cancer (CRC) screening includes a fecal blood test or colonoscopy, but not a sigmoidoscopy, which has been shown to reduce CRC incidences and mortality. Our aim was to compile physicians' experiences with sigmoidoscopy and their assessments of this procedure being an additional, possible screening method for early CRC detection. METHODS: At the end of 2015, gastroenterologists and internists in Lower Saxony and North Rhine-Westphalia who regularly perform screening colonoscopies in outpatient care were contacted per mail. Standardized telephone interviews consisting of 17 questions and lasting 10-15 minutes were conducted. RESULTS: Nearly two-thirds (56/87) of the respondents reject sigmoidoscopy as an acceptable early detection method. Compared to colonoscopy, key features of the sigmoidoscopy include more favorable patient-related aspects, while procedural aspects, except sedation, clearly rate in favor of the colonoscopy. In the instance that colonoscopy is rejected, 75 % of the physicians consider a sigmoidoscopy to be a possible alternative. CONCLUSIONS: The survey provides important practical insights into outpatient sigmoidoscopy. A majority of the physicians does not support evidence-based sigmoidoscopy for CRC screening. However, individuals who reject a colonoscopy are, in line with the current guideline, identified as a target group for a screening sigmoidoscopy. The benefit from an additionally offered sigmoidoscopy in CRC screening should be further analyzed with special consideration given to the preferences of insurees within the German healthcare system.


Assuntos
Atitude do Pessoal de Saúde , Neoplasias Colorretais/diagnóstico , Programas de Rastreamento/métodos , Médicos/psicologia , Padrões de Prática Médica/estatística & dados numéricos , Sigmoidoscopia , Colonoscopia , Detecção Precoce de Câncer , Alemanha , Humanos , Sangue Oculto
10.
Pneumologie ; 73(9): 516-522, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31533173

RESUMO

BACKGROUND: Big cities in Europe have the highest incidence rates of TB in otherwise low incidence settings. Understanding of the spatio-temporal patterns of TB incidence can support efforts for TB prevention and control in line with the End-TB Strategy of the WHO in such settings for low incidence settings. METHODS: Data from the municipal TB register of Cologne collected between 2006 and 2015 under the infection prevention legislation were retrieved, addresses geographically identified and all notified incident TB cases retrospectively analysed for their spatial and temporal distribution in this large German city using a geographic information system. RESULTS: During the analysed period 1,038 incident cases were reported, equivalent to an incidence rate of 10.03 cases per 100,000 inhabitants. Contagious pulmonary TB contributed 57 % of all cases. Distribution patterns changed over time with decreases in 37 and increases in 22 of the 77 urban sub-districts, three of which showing constant high rates of TB incidence. CONCLUSION: The study presents a complementary method to monitor the distribution and development of incident TB cases at a disaggregated level of urban sub-districts. Identification of areas with comparatively high incidence can support identification of clusters respectively their prevention and allow better planning for targeted local TB services.


Assuntos
Análise Espaço-Temporal , Tuberculose Pulmonar/epidemiologia , Tuberculose/epidemiologia , População Urbana/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Criança , Pré-Escolar , Feminino , Geografia , Alemanha/epidemiologia , Humanos , Incidência , Lactente , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Estudos Retrospectivos , Distribuição por Sexo , Fatores Socioeconômicos , Tuberculose/diagnóstico , Tuberculose Pulmonar/diagnóstico
11.
Schmerz ; 33(5): 443-448, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31478141

RESUMO

BACKGROUND: Since March 2017 the law amending narcotics and other legal regulations has made it possible for doctors to prescribe cannabis and cannabis-derived medicines. The introduction of § 31 para 6 of the Social Code Book V (SGB V) allows that patients can be treated with cannabis-derived medicines at the expense of the statutory health insurance if they have a severe illness. COURT DECISIONS: The law requires the approval of a prescription of cannabis for medical purposes by the health insurance before the granting of benefits. Due to denied permission, numerous cases are pending before the social tribunals. The article presents which legal issues are decided and why there is still no case law from the Federal Social Court on the essential questions. OUTLOOK: The possibility of prescribing cannabis as medicine at the expense of the health insurance is an important advance in social law. The § 31 para 6 SGB V should be evaluated as soon as possible. The provisions of SGB V for the reimbursement of off-label treatment should be harmonized with § 31 para 6 SGB V.


Assuntos
Cannabis , Seguro Saúde , Médicos , Prescrições , Assistência à Saúde/legislação & jurisprudência , Alemanha , Humanos , Seguro Saúde/economia , Seguro Saúde/legislação & jurisprudência , Médicos/legislação & jurisprudência , Prescrições/estatística & dados numéricos
12.
Schmerz ; 33(5): 466-470, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31478143

RESUMO

Since the adoption of the law of March 6, 2017, any German physician can prescribe medical cannabis flowers and cannabis-based magistral and finished medicinal products. No specific indications for prescriptions are provided in the law. The statutory health insurance companies bear the costs once an application for cost coverage has been approved by the Medical Service of the Health Funds. The German associations of psychiatry (child, adolescents, and adults), neurology, palliative care, addictology, and pain medicine are watching these developments in the media, politics, and medical world with concern due to: the option to prescribe cannabis flowers despite the lack of sound evidence and against the recommendations of the German Medical Association; the lack of distinction between medical cannabis flowers and cannabis-based magistral and finished medical products; the indiscriminately positive reports on the efficacy of cannabis-based medicines for chronic pain and mental disorders; the attempts by the cannabis industry to influence physicians; the increase in potential indications by leaders of medical opinion paid by manufacturers of cannabis-based medicines. The medical associations make the following appeal to journalists: To report on the medical benefits and risks of cannabis-based medicines in a balanced manner. To physicians: to prescribe cannabis-based medicines with caution; to prefer magistral and finished medicinal products over cannabis flowers. To politicians: to consider data according to the standards of evidence-based medicine when making decisions and provide financial support for medical research into cannabis-based medicines.


Assuntos
Cannabis , Dor Crônica , Seguro Saúde , Jornalismo , Maconha Medicinal , Política , Padrões de Prática Médica , Dor Crônica/tratamento farmacológico , Alemanha , Humanos , Seguro Saúde/ética , Seguro Saúde/normas , Maconha Medicinal/uso terapêutico , Médicos/ética , Médicos/normas , Padrões de Prática Médica/ética , Padrões de Prática Médica/normas
13.
Schmerz ; 33(5): 437-442, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31531729

RESUMO

BACKGROUND: On March 10th 2017, the law amending narcotic and other regulations was expanded, thereby allowing physicians, irrespective of their specialization, to prescribe cannabis-derived medicines as magistral formulas or proprietary medicinal products at the expense of the German statutory health insurance (GKV). First prescription requires approval from the respective health insurance, which in turn commissions the Medical Advisory Board of the Statutory Health Insurance Funds (MDK) to prepare a medico-legal report. OBJECTIVES: Since § 31 Para. 6 of the German Social Code, Book V (SGB V) came into effect, a multitude of imponderables have been reported regarding reimbursement. Based on the experience of the MDK Nord, problems within the fields of patients, physicians and cannabis-derived medicines are illustrated. MATERIAL AND METHODS: Considering current literature, a retrospective review was conducted including approximately 2200 applications for reimbursement received in 2018 from patients residing in Hamburg and Schleswig-Holstein. RESULTS: A relevant problem within the field of patients resulted from the lack of a specific definition of the term "severe (chronic) disease". Although this term is mentioned several times in SGB V, it is not put into concrete terms. Circumstances like multimorbidity are not taken into account. Another problem consisted in an irreproducible anticipation of treatment with cannabis-derived medicines. Within the field of physicians, a major problem was caused by missing, fragmentary or inconsistent information regarding disease and/or therapy. Hence, initially, almost one-third of all applications could not be appraised. Amongst various cannabis-derived medicines, dried flowers were found to be the most problematic regarding doses and effective levels. Notably, a marked increase in numbers of applications for reimbursement of therapy with pure cannabidiol was noted. DISCUSSION: Numerous problems reported elsewhere and relating to prescription of cannabis-derived medicines were also observed by the MDK Nord. Many prescriptions reflected an uncertainty regarding therapeutic use of cannabis-derived medicines. Thus, one should consider restricting the prescription of cannabis-derived medicines to selected specialists. It should be noted that, in individual cases, e.g., patients suffering from neuropathic pain, treatment with cannabis-derived medicines seems to be a reasonable therapeutic option taking into account the risks and benefits.


Assuntos
Cannabis , Dor Crônica , Administração Financeira , Reembolso de Seguro de Saúde , Dor Crônica/tratamento farmacológico , Administração Financeira/normas , Administração Financeira/estatística & dados numéricos , Alemanha , Humanos , Seguro Saúde/economia , Seguro Saúde/estatística & dados numéricos , Reembolso de Seguro de Saúde/estatística & dados numéricos , Maconha Medicinal/economia , Maconha Medicinal/uso terapêutico , Estudos Retrospectivos
14.
Artigo em Alemão | MEDLINE | ID: mdl-31529180

RESUMO

Eating disorders are of high clinical and societal relevance. They are among the most common chronic mental illnesses in adulthood, but show a high incidence rate and peak of disease onset even in adolescence. Eating disorders are associated with far-reaching costs, such as acute or chronic comorbidities and educational or professional attainment.Thus, from a public mental health perspective, it is essential to explore symptoms and risk factors of eating disorders and to monitor prevalence rates across time to evaluate the relevance and effectiveness of prevention measures.In the present study, the recent prevalence of eating disorder symptoms among 11- to 17-year-old children and adolescents living in Germany is reported based on the Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2, 2014-2017, N = 6599, 51.7% boys) and compared to the prevalence rates 10 years ago (KiGGS Baseline, 2003-2006, N = 6633, 51.5% boys). Moreover, we investigate a selection of risk factors for eating disorder symptoms.In KiGGS Wave 2, 19.8% of the children and adolescents showed eating disorder symptoms, a drop of 2.8 percentage points in the prevalence rate as compared to the KiGGS Baseline. The drop in the prevalence rate pertains to 11- to 13-year-old boys while the risk for 14- to 17-year-old adolescents and particularly among girls remained comparably high. Children and adolescents with emotional problems, low family cohesion, low self-efficacy, or who perceive themselves as too thick or thin, show an increased risk for eating disorder symptoms.Previous approaches and possible supplements for the prevention of eating disorders are discussed.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Adolescente , Adulto , Criança , Estudos Transversais , Feminino , Alemanha/epidemiologia , Inquéritos Epidemiológicos , Humanos , Masculino , Fatores de Risco
15.
Artigo em Alemão | MEDLINE | ID: mdl-31529181

RESUMO

Trends of frequent chronic diseases and health problems, e.g. allergic diseases, have already been published based on the KiGGS Wave 2 study as part of the health monitoring of children and adolescents in Germany. The present work complements these findings with results on less frequent noncommunicable diseases and the trend of communicable, vaccine-preventable diseases.Information from parents about diagnoses and diseases of their 0­ to 17-year-old children from the representative cross-sectional survey KiGGS Wave 2 (2014-2017) are compared with those from the KiGGS baseline survey (2003-2006) and KiGGS Wave 1 (2009-2012).The current KiGGS results show almost unchanged prevalences for the noncommunicable diseases epilepsy, migraine, and heart disease. However, the data from KiGGS Wave 2 are supportive of an increased prevalence of diabetes mellitus, which nevertheless continues to be relatively rare and predominantly type 1 diabetes in children and adolescents.The decline in measles, chicken pox, and whooping cough diseases related to changes in vaccination recommendations shows that preventive measures can effectively benefit children and adolescents.However, the data on vaccine-preventable diseases indicate regionally varying immunity gaps in certain age groups, so the prevention potential of the vaccination recommendations of the Standing Vaccination Commission (STIKO) at the Robert Koch Institute does not seem to have been sufficiently exploited.


Assuntos
Saúde do Adolescente/estatística & dados numéricos , Doença Crônica/epidemiologia , Viroses/epidemiologia , Adolescente , Varicela/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Epilepsia/epidemiologia , Alemanha/epidemiologia , Inquéritos Epidemiológicos , Cardiopatias/epidemiologia , Humanos , Lactente , Recém-Nascido , Sarampo/epidemiologia , Transtornos de Enxaqueca/epidemiologia , Convulsões Febris/epidemiologia , Coqueluche/epidemiologia
16.
Artigo em Alemão | MEDLINE | ID: mdl-31529182

RESUMO

In KiGGS Wave 2, data from 3­ to 17-year-olds were collected from a total of 3462 persons using a standardized interview on the current use of AM/NEM in the last seven days. For trends analysis, data from 14,679 study participants in the same age group from the KiGGS baseline study were used.In KiGGS Wave 2, 36.4% (95% CI 34.1-38.8) of the 3­ to 17-year-olds had used at least one AM/NEM in the last seven days. The prevalence was highest at 46.5% in 14- to 17-year-olds and significantly different between girls and boys (56.4% vs. 37.3%). Only among girls were there significant differences by migrant background with a higher prevalence of use among girls without a migrant background.Most frequently, the preparations used were for treatment of the respiratory tract (girls: 14.2%, boys: 14.9%), followed by "Varia" (girls: 8.7%, boys: 9.3%) and preparations for the treatment of the musculoskeletal system (girls: 8.9%, boys: 5.8%). There was a significant decrease in the overall prevalence of medicine use compared to the KiGGS baseline study (46.4% vs. 36.4%). This decrease was mainly due to lower prevalences of use in the ATC main groups "N Nervous System" (7.5% vs. 5.4%), "J Systemic Anti-infectives" (2.5% vs. 1.4%) and "H Systemic Hormones, excl. Sexual Hormones and Insulins" (2.0% vs. 1.1%).The results describe key points in the use of AM/NEM, including self-medication for children and adolescents in Germany. They illustrate the use behaviour and represent a valuable supplement to prescription data.


Assuntos
Suplementos Nutricionais/estatística & dados numéricos , Automedicação/estatística & dados numéricos , Adolescente , Saúde do Adolescente , Criança , Saúde da Criança , Estudos Transversais , Feminino , Alemanha/epidemiologia , Inquéritos Epidemiológicos , Humanos , Masculino , Prevalência
17.
Artigo em Alemão | MEDLINE | ID: mdl-31529183

RESUMO

BACKGROUND: Pain not only causes suffering in children and adolescents, but also leads to school absenteeism, medication intake, medical treatment, and an increased risk of recurrent pain in adulthood. OBJECTIVES: Based on data from the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2, 2014-2017), the 3­month prevalence of recurrent headache, abdominal and back pain in girls and boys is reported, and is compared with the prevalence from the KiGGS baseline survey (2003-2006). The consequences of recurrent headache were also explored. MATERIALS AND METHODS: Data from >11,000 participants (KiGGS Wave 2) and from >12,000 (KiGGS baseline) participants aged between 3 and 17 years were analyzed. For 3­ to 10-year-olds, parents/guardians answered the questions, while 11- to 17-year-olds provided information themselves. RESULTS: In 3­ to 10-year-olds, recurrent abdominal pain was most prevalent, affecting one third of girls and one quarter of boys. Headache was the most frequent type of pain in 11- to 17-year-olds, affecting almost every second girl and about every third boy. The 3­month prevalence of recurrent headache, abdominal and back pain has increased in girls and boys, especially in the age groups 7 to 10 years and 11 to 13 years. Among recurrent headache sufferers, adolescents take medication almost twice as often as children. CONCLUSIONS: Headache, abdominal, and back pain are still and with increasing prevalence very common symptoms in children and adolescents in Germany. Their prevention requires a holistic view of children's health in the psychosocial living environment, and healthcare context.


Assuntos
Dor/epidemiologia , Dor Abdominal/epidemiologia , Adolescente , Adulto , Dor nas Costas/epidemiologia , Criança , Saúde da Criança , Pré-Escolar , Estudos Transversais , Feminino , Alemanha/epidemiologia , Cefaleia/epidemiologia , Inquéritos Epidemiológicos , Humanos , Masculino , Prevalência
18.
Artigo em Alemão | MEDLINE | ID: mdl-31529184

RESUMO

BACKGROUND: Health-related quality of life (HRQoL) is increasingly established as an indicator for the subjective health of children and adolescents. The aim of this study was to describe the current HRQoL among children and adolescents in Germany aged between 11 and 17 years taking into account common chronic diseases (bronchial asthma, atopic dermatitis, obesity, ADHD) and mental health problems. METHODS: The analysis is based on information obtained from 6,599 children and adolescents (51.9% girls; 48.1% boys) from KiGGS Wave 2 (2014-2017). HRQoL was measured with the multidimensional KIDSCREEN-27. The chronic diseases and mental health problems under investigation were assessed by several indicators. RESULTS: Differences in HRQoL could be found as a function of age and gender. The HRQoL among girls was lower at an older age across all dimensions. These age-related differences are less pronounced among boys. The HRQoL of children and adolescents with chronic diseases and mental health problems was lower compared to their healthy peer groups. The comparison of the investigated chronic diseases and mental health problems revealed significant differences. Particularly, HRQoL was lower for children and adolescents with obesity and mental health problems. DISCUSSION: The distinction of several dimensions of HRQoL allows a comprehensive understanding of age- and gender-related effects and provides a detailed assessment of the impact of chronic diseases and mental health problems. The present findings underline the importance of HRQoL as an indicator for the subjective health of children and adolescents.


Assuntos
Doença Crônica/epidemiologia , Saúde Mental/estatística & dados numéricos , Qualidade de Vida , Adolescente , Saúde do Adolescente , Idoso , Criança , Saúde da Criança , Estudos Transversais , Feminino , Alemanha/epidemiologia , Inquéritos Epidemiológicos , Humanos , Masculino , Inquéritos e Questionários
19.
Artigo em Alemão | MEDLINE | ID: mdl-31529185

RESUMO

BACKGROUND: Unintentional injuries are one of the most common health problems in childhood and adolescence. Information on the distribution and variation of accident prevalence is an important basis for accident prevention. The second follow-up survey of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2, 2014-17) enables the continuation of non-fatal accident monitoring at the federal level that began with the KiGGS baseline study (2003-06). METHODS: KiGGS Wave 2 is a nationwide cross-sectional survey conducted by the Robert Koch Institute (RKI) with participation of 15,023 children and adolescents aged 0 to 17 (response rate: 40.1%). Parents were interviewed about unintentional injuries of their children. Information on accidents is available from 2429 children and adolescents (1-17 years). Twelve-month prevalences with 95% CI were calculated and comparisons were made between KiGGS Wave 2 and the previous KiGGS surveys. RESULTS: Within the last 12 months, 16.5% of 1­ to 17-year-old children and adolescents were medically treated for an accidental injury, with boys (18.6%) requiring treatment significantly more frequently than girls (14.3%). Of the total, 4.8% had three or more accidents. Every eighth injured child (12.4%) stayed in hospital for at least one night. Children and adolescents under 18 years were most likely to have accidents at home, in educational and care facilities, on playgrounds and in sports facilities. CONCLUSION: Injury risks in childhood and adolescence vary primarily according to age and gender, but also, for example, according to personal and environmental factors. Knowledge of such contextual conditions is of great importance for the development of prevention measures. Since the beginning of the KiGGS study, there have been hardly any changes and no decrease in unintentional injuries in childhood and adolescence.


Assuntos
Indicadores Básicos de Saúde , Nível de Saúde , Ferimentos e Lesões/epidemiologia , Adolescente , Saúde do Adolescente , Criança , Saúde da Criança , Pré-Escolar , Estudos Transversais , Feminino , Seguimentos , Alemanha/epidemiologia , Inquéritos Epidemiológicos , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Prevalência , Qualidade de Vida , Fatores de Risco , Distribuição por Sexo
20.
Artigo em Alemão | MEDLINE | ID: mdl-31529186

RESUMO

INTRODUCTION: Differences in the health status and health behavior of children and adolescents are analyzed, taking the income situation of the family into account. METHOD: The data is based on the second wave of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2, 2014-2017). Health outcomes are the subjective health, chronic health limitations, mental disorders, ADHD, consumption of fresh fruit, consumption of sugary soft drinks, physical activity, sports activity during leisure time, overweight, and obesity. The income situation is recorded using the equivalized household income. RESULTS: Poor children and adolescents are more likely to have health problems than their peers from the middle- and, especially, the high-income group; their health behavior is less favorable. The biggest relative income-related differences are found in subjective health. With statistical control for parental education and occupational status, income-related differences in health status remain consistent while being significantly reduced for health behavior. DISCUSSION: The results confirm that low family income has a significant impact on the health of children and adolescents. Partly, this also applies to their health behavior, whereby the observed differences between the income groups can be attributed mainly to parental education and occupational status. This shows once again that children and adolescents growing up in poverty should be a key target group for prevention and health promotion.


Assuntos
Comportamentos Relacionados com a Saúde , Nível de Saúde , Pobreza , Adolescente , Criança , Estudos Transversais , Alemanha , Inquéritos Epidemiológicos , Humanos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA