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1.
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
2.
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
3.
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
4.
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
5.
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
6.
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
7.
Artigo em Alemão | MEDLINE | ID: mdl-31529187

RESUMO

BACKGROUND: The German Health Interview and Examination Survey for Children and Adolescents (KiGGS) is an important data source for assessing the occurrence of underweight, overweight and obesity in children and adolescents in Germany. However, to assess trends over time, it must be considered that methodological changes in the calculation of prevalences have been necessary and that the reference system has been revised. OBJECTIVE: Are the effects of the methodological changes in weighting factors and reference systems so important that they significantly influence the available prevalence estimates and statements on trends over time? MATERIALS AND METHODS: The data are based on valid measurements of body height and weight from the KiGGS baseline survey (2003-2006, 7531 boys and 7215 girls) and from KiGGS Wave 2 (2014-2017, 1762 boys and 1799 girls). The participants were aged between 3 and 17 years. Prevalences (%, 95% CI) of underweight, overweight and obesity for the KiGGS baseline survey were calculated depending on the reference system and different weighting factors used. RESULTS: The statements on the temporal trend in the prevalence of underweight, overweight, and obesity remain valid even when methodological changes are taken into account. Only among 16- and especially 17-year-old girls, can a noticeable difference due to the altered reference system be noted. DISCUSSION: With regard to the trend examined here, the methodological changes can be neglected, as long as no small subgroups are analysed. However, this conclusion cannot be generalised; the effects of methodological changes must be re-examined for each study question.


Assuntos
Obesidade Pediátrica/epidemiologia , Magreza/epidemiologia , Adolescente , Índice de Massa Corporal , Criança , Pré-Escolar , Estudos Transversais , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Sobrepeso/epidemiologia , Prevalência
8.
Artigo em Alemão | MEDLINE | ID: mdl-31529189

RESUMO

BACKGROUND: The current results of the "German Health Interview and Examination Survey for Children and Adolescents" (KiGGS Wave 2, 2014-2017) indicate that the prevalence of overweight and obesity among children and adolescents in Germany has hardly changed during this period. OBJECTIVES: What are the current prevalences for the other categories of the BMI distribution (severe underweight, underweight, and extreme obesity) and what changes have occurred between the KiGGS baseline survey (2003-2006) and KiGGS Wave 2 with regard to the BMI categories and the distribution of BMI values? MATERIALS AND METHODS: KiGGS Wave 2 analyses are based on data from 1762 boys and 1799 girls aged 3 to 17 years with valid measurements of height and weight. The KiGGS baseline survey provides information on 7531 boys and 7215 girls for trend evaluations. RESULTS: For underweight prevalence as well as for the prevalence of extreme obesity no change over time can be observed. The BMI percentiles also show only minor differences between the two survey periods with a marginal shift of the upper BMI percentiles downwards before puberty and a slight increase after puberty. There is no clear shift in the BMI distribution towards lower BMI values. DISCUSSION: There are now many activities at the national, regional, and local level that focus on prevention and intervention to reduce overweight and obesity. The marginal shifts in the upper BMI percentiles in the upper BMI percentiles before puberty observed here suggest that some success may have been achieved in obesity prevention among children in Germany.


Assuntos
Índice de Massa Corporal , Obesidade/epidemiologia , Magreza/epidemiologia , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Feminino , Alemanha/epidemiologia , Inquéritos Epidemiológicos , Humanos , Masculino , Prevalência
9.
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
10.
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
11.
Hautarzt ; 70(10): 766-772, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31407026

RESUMO

BACKGROUND: There is a lack of epidemiological data describing patterns of hand eczema with reference to the general German population. OBJECTIVE: Epidemiological data were extracted from all internationally published clinical studies which investigated hand eczema in Germany. MATERIAL AND METHODS: A search was carried out for all clinical studies performed in Germany in the previous 10 years involving hand eczema patients. Inclusion criteria were that at least one author was listed with a German affiliation, that the study included original data and was published in an international journal with peer review. RESULTS: This review included 39 studies, which were performed based on 29 original data sets. The median proportion of women was 53.7% and the median age 45.1 years. The 1­year prevalence of hand eczema varied depending on the sample and type of data collection from 0.24% to 9.2%. The lifetime prevalence was estimated to be 2.6-16.0% and the point prevalence in dermatological practice was 6.7 %. In studies assessing the impact of hand eczema in specific occupations, women were underrepresented, large studies were carried out for metal workers but only a few small studies for nursing personnel. CONCLUSION: There is a lack of knowledge concerning the epidemiology of hand eczema in the general German population. While international studies found the first occurrence of hand eczema to be between the ages of 26 and 28 years, the mean age of patients seen in private dermatological practice in Germany was 20 years higher. These findings suggest that patients do not consult a dermatologist when hand eczema first appears, which can lead to a more severe course of the disease.


Assuntos
Eczema/epidemiologia , Dermatoses da Mão/epidemiologia , Vigilância da População , Adulto , Feminino , Alemanha/epidemiologia , Humanos , Incidência , Prevalência
12.
Fortschr Neurol Psychiatr ; 87(8): 445-461, 2019 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-31430812

RESUMO

At least 300,000 people with idiopathic Parkinson's disease are living in Germany. Due to the demographic change the number of affected patients is expected to increase continuously. This article presents the evidence-based diagnostics and therapy of idiopathic Parkinson's disease. It provides an overview especially on new findings and developments in recent years.


Assuntos
Doença de Parkinson/diagnóstico , Doença de Parkinson/terapia , Alemanha/epidemiologia , Humanos , Doença de Parkinson/classificação , Doença de Parkinson/fisiopatologia
13.
Artigo em Alemão | MEDLINE | ID: mdl-31420716

RESUMO

BACKGROUND: Tattooing has become very popular in recent years. In this context, socio-demographic information and health orientation is important. OBJECTIVES: The objective of this study was to evaluate the development of the prevalence of tattoos over the last thirteen years and the social and economic background of people with tattoos. Three national representative surveys were compared for this purpose; men and women residing in Germany were included. Additionally, the purpose of the study was to assess socio-demographic information and the health orientation of respondents with tattoos. MATERIALS AND METHODS: Three national, representative surveys were conducted on German participants (2016: n = 2510, 2009: n = 2512, 2003: n = 2043). The number of tattoos and socio-demographic information were investigated. The Health Regulatory Focus Scale (HRFS) assessing the individual's health orientation was used in 2016. RESULTS: Currently, one out of five Germans (≥14 years) has at least one tattoo. In Germany, tattoos are most prevalent among younger adults of both sexes aged 25 to 34 years. People with all levels of education have tattoos, although there were weak correlations with a lower education level and unemployment. Only men with several tattoos showed a significantly lower health orientation than non-tattooed ones. CONCLUSION: The fact that nearly one fifth of the German population has tattoos suggests that this permanent body art is becoming more and more accepted in German society. As a result, a need for better health risk information on the topic for both tattooists and the people getting tattoos appears evident because of the high prevalence of tattoos in younger generations as well as the lower health orientation in men with several tattoos.


Assuntos
Tatuagem/estatística & dados numéricos , Adulto , Distribuição por Idade , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Prevalência , Distribuição por Sexo , Fatores Socioeconômicos , Tatuagem/efeitos adversos , Tatuagem/psicologia
14.
Artigo em Alemão | MEDLINE | ID: mdl-31432202

RESUMO

BACKGROUND: Since 2011, German hospitals have been requested to record and evaluate antibiotic use in their institution. In this publication, the use of antibiotics in hospitals belonging to the administrative district Frankfurt/Main between 2012 and 2017 is presented and discussed with regards to the targets set in 2014. These targets are to improve the perioperative prophylaxis, reduce the use of cefuroxime, and increase the penicillin/cephalosporin ratio. METHODS: Since 2012, hospitals in Frankfurt/Main have been transmitting the defined daily doses (DDD) of all antibiotics used, the absolute number of patients, and their days of treatment. Since 2013, the data have also distinguished between intensive care and other units. The Frankfurt health authority calculated the total number of antibiotics and the DDD/100 patient days for all hospitals combined as well as for every hospital compared to each other. RESULTS: From 2012 to 2017, the number of absolute annual patient days increased from 1,592,161 to 1,615,180. Antibiotic use decreased from 1,073,975 DDD to 953,349 DDD, leading to a decrease from 67.5 DDD per 100 patient days to 59.0 DDD per 100 patient days. Cefuroxime was the most frequently used antibiotic in all hospitals. The use of cefuroxime showed a significant decrease between 2012 and 2017 (from 250,398 in 2012 to 165,160 DDD in 2017, a decrease of 34%). The use of ceftriaxone was reduced by 27%, ciprofloxacin by 9%, and levofloxacin by 16%. DISCUSSION: The targets set in 2014 were reached in the entirety of Frankfurt hospitals. However, there were significant differences between the hospitals taking part. The results were given as feedback to the hospitals in order to support their efforts in further improving antibiotic stewardship.


Assuntos
Antibacterianos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Prescrições de Medicamentos/estatística & dados numéricos , Revisão de Uso de Medicamentos/legislação & jurisprudência , Uso de Medicamentos/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Uso de Medicamentos/tendências , Revisão de Uso de Medicamentos/estatística & dados numéricos , Alemanha/epidemiologia , Regulamentação Governamental , Pesquisas sobre Serviços de Saúde , Humanos , Vigilância da População
15.
BMC Public Health ; 19(1): 851, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31262269

RESUMO

BACKGROUND: This study estimates the prevalence and incidence rates of primary open -angle glaucoma (POAG) as well as risk factors based on a dataset from the largest German health insurance company. METHODS: A random sample of 250,000 persons at age 50+ of the Allgemeine Ortskrankenkasse (AOK) from 2010 to 2013 was used. Selected risk factors of POAG incidence were analyzed using multivariate Cox proportional hazard models. RESULTS: The age-standardized prevalence of POAG at age 50+ in 2010 was 2.79% (95%-CI: 2.72-2.85%). The age-standardized total incidence rate was 0.38 (0.36-0.39) per 100 person-years. Sex differences were significant for total prevalence and total incidence rates, with higher prevalence and incidence rates for women compared to men. The Cox model revealed a strong age effect, a significantly 19% higher incidence for women (p ≤ 0.001), injuries of the eye and orbit (175%, p ≤ 0.001), degeneration of iris and ciliary body (155%, p = 0.022), myopia (155%, p ≤ 0.001), retinal vascular occlusions (134%, p ≤ 0.001), hypertension (13%, p ≤ 0.001) and diabetes mellitus (23%, p ≤ 0.001). CONCLUSION: Health claims data are an important data source for estimating POAG occurrence and help overcome the problems of small sample sizes. These results may help to understand the causal pathways of POAG and to develop intervention strategies to increase the awareness of patients and physicians with the aim of reducing POAG incidence.


Assuntos
Glaucoma de Ângulo Aberto/epidemiologia , Idoso , Estudos de Coortes , Bases de Dados Factuais , Feminino , Alemanha/epidemiologia , Humanos , Incidência , Seguro Saúde , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco
16.
BMC Infect Dis ; 19(1): 613, 2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31299924

RESUMO

BACKGROUND: The Respiratory Syncytial Virus (RSV) A genotype ON1, which was first detected in Ontario (Canada) in 2010/11, appeared in Germany in 2011/12. Preliminary observations suggested a higher clinical severity in children infected with this new genotype. We investigated spread and disease severity of RSV-A ON1 in pediatric in- and outpatient settings. METHODS: During 2010/11 to 2016/17, clinical characteristics and respiratory samples from children with acute respiratory tract infections (RTI) were obtained from ongoing surveillance studies in 33 pediatric practices (PP), one pediatric hospital ward (PW) and 23 pediatric intensive care units (PICU) in Germany. RSV was detected in the respiratory samples by PCR; genotypes were identified by sequencing. Within each setting, clinical severity markers were compared between RSV-A ON1 and RSV-A non-ON1 genotypes. RESULTS: A total of 603 children with RSV-RTI were included (132 children in PP, 288 in PW, and 183 in PICU). Of these children, 341 (56.6%) were infected with RSV-A, 235 (39.0%) with RSV-B, and one child (0.2%) with both RSV-A and RSV-B; in 26 (4.3%) children, the subtype could not be identified. In the 341 RSV-A positive samples, genotype ON1 was detected in 247 (72.4%), NA1 in 92 (26.9%), and GA5 in 2 children (0.6%). RSV-A ON1, rarely observed in 2011/12, was the predominant RSV-A genotype in all settings by 2012/13 and remained predominant until 2016/17. Children in PP or PW infected with RSV-A ON1 did not show a more severe clinical course of disease compared with RSV-A non-ON1 infections. In the PICU group, hospital stay was one day longer (median 8 days, inter-quartile range (IQR) 7-12 vs. 7 days, IQR 5-9; p = 0.02) and duration of oxygen treatment two days longer (median 6 days, IQR 4-9 vs. 4 days, IQR 2-6; p = 0.03) for children infected with RSV-A ON1. CONCLUSIONS: In children, RSV-A ON1 largely replaced RSV-A non-ON1 genotypes within two seasons and remained the predominant RSV-A genotype in Germany during subsequent seasons. A higher clinical severity of RSV-A ON1 was observed within the group of children receiving PICU treatment, whereas in other settings clinical severity of RSV-A ON1 and non-ON1 genotypes was largely similar.


Assuntos
Infecções por Vírus Respiratório Sincicial/patologia , Vírus Sincicial Respiratório Humano/genética , Infecções Respiratórias/patologia , Pré-Escolar , Feminino , Genótipo , Alemanha/epidemiologia , Hospitais Pediátricos , Humanos , Lactente , Unidades de Terapia Intensiva Pediátrica , Tempo de Internação , Masculino , Filogenia , RNA Viral/metabolismo , Infecções por Vírus Respiratório Sincicial/epidemiologia , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sincicial Respiratório Humano/isolamento & purificação , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/virologia , Estações do Ano , Índice de Gravidade de Doença
17.
BMC Public Health ; 19(1): 957, 2019 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-31315596

RESUMO

BACKGROUND: Over-indebtedness is currently rising in high-income countries. Millions of citizens are confronted with the persistent situation when household income and assets are insufficient to cover payment obligations and living expenses. Previous research shows that over-indebtedness increases the risk of various adverse health effects. However, its association with sleep problems has not yet been examined. The objective of this study was to investigate the association between over-indebtedness and sleep problems and sleep medication use. METHODS: A cross-sectional study on over-indebtedness (OID survey) was conducted in 70 debt advisory centres in Germany in 2017 that included 699 over-indebted respondents. The survey data were combined with the nationally representative German Health Interview and Examination Survey for Adults (DEGS1; n = 7987). We limited analyses to participants with complete data on all sleep variables (OID: n = 538, DEGS1: n = 7447). Descriptive analyses and logistic regression analyses were used to examine the association between over-indebtedness and difficulty initiating and maintaining sleep, and sleep medication use. RESULTS: A higher prevalence of sleep problems and sleep medication use was observed among over-indebted individuals compared to the general population. After adjustment for socio-economic and health factors (age, sex, education, marital status, employment status, subjective health status and mental illness), over-indebtedness significantly increased the risk of difficulties with sleep onset (adjusted odds ratio (aOR) 1.79, 95%-confidence interval (CI) 1.45-2.21), sleep maintenance (aOR 1.45, 95%-CI 1.17-1.80) and sleep medication use (aOR 3.94, 95%-CI 2.96-5.24). CONCLUSIONS: Evidence suggests a strong association between over-indebtedness and poor sleep and sleep medication use independent of conventional socioeconomic measures. Considering over-indebtedness in both research and health care practice will help to advance the understanding of sleep disparities, and facilitate interventions for those at risk. TRIAL REGISTRATION: German Clinical Trials Register: DRKS00013100 (OID survey, ArSemü); Date of registration: 23.10.2017; Date of enrolment of the first participant: 18.07.2017, retrospectively registered.


Assuntos
Administração Financeira , Medicamentos Indutores do Sono/uso terapêutico , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
18.
BMC Public Health ; 19(1): 908, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31286909

RESUMO

BACKGROUND: Asylum-seeking children and adolescents (ASCs) who have resettled in Western countries show elevated rates of psychological distress, including Posttraumatic Stress Symptoms (PTSS), depression, and anxiety. Most longitudinal data suggest a relatively stable course of symptoms during the first years in exile. However, no longitudinal examination of the mental health of ASCs, who resettled in Europe in the wake of the 2015-17 European migrant crisis, has been conducted so far. METHODS: A prospective cohort study looked at 98 ASCs who resettled in southern Germany throughout 2015-17. They mainly came from Afghanistan, Syria, Eritrea, and Iraq. Baseline assessments were undertaken 22 months, on average, after resettlement, and follow-up assessments 1 year thereafter. Seventy-two ASCs could be secured for the follow-up. The measures included self-report questionnaires screening for PTSS, depression, anxiety, externalizing behavior, and post-migration factors that were administered in an interview-like setting. Results were analyzed using hierarchical multiple regression analysis. RESULTS: Participating ASCs reported on average eight potentially traumatic experiences and high levels of psychological distress at baseline that had significantly declined at follow-up. At follow-up, rates of clinically significant symptoms ranged from 9.7% (externalizing behavior) to 37.5% (PTSS). There was considerable individual variation in symptom change resulting in multiple mental health trajectories. ASCs whose asylum applications had been rejected presented significantly more symptoms than ASCs whose asylum applications had been accepted between assessments. Baseline psychopathology and asylum status predicted follow-up symptom severity. CONCLUSIONS: In contrast to earlier studies, the symptom severity in this sample of ASCs in Germany ameliorated between assessments. Decisions on the asylum applications of ASCs are thought to contribute to the course of symptoms. Since levels of psychological distress were still high, dissemination and implementation of appropriate treatments for ASCs is crucial.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Estresse Psicológico/epidemiologia , Adolescente , Afeganistão/etnologia , Ansiedade/psicologia , Criança , Depressão/psicologia , Eritreia/etnologia , Feminino , Seguimentos , Alemanha/epidemiologia , Humanos , Iraque/etnologia , Estudos Longitudinais , Masculino , Análise Multivariada , Estudos Prospectivos , Análise de Regressão , Autorrelato , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/psicologia , Síria/etnologia , Fatores de Tempo
19.
BMC Public Health ; 19(1): 1009, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31357973

RESUMO

BACKGROUND: The effort-reward imbalance (ERI) model is well-established in explaining work-related stress and health differences. A lack of reciprocity between efforts and rewards at the workplace is central to the theory. The third component (over-commitment) was defined to be a moderator of high-cost/low gain-working conditions increasing the risk of ill-health. Although the theory has been widely supported empirically, all underlying hypotheses have not been sufficiently tested. This article examines whether the strength of the effect of the effort-reward imbalance ratio on health indicators is bigger than the effects of efforts and rewards individually. Another research gap on the interaction with over-commitment is addressed and health measures are compared. METHODS: This study applied the effort-reward imbalance model on health satisfaction and the SF-12v2™ indicators physical health composite score (PCS) and mental health composite score (MCS) within a representative sample of German employees. After confirmatory factor analyses of the items of the components effort, reward and over-commitment were applied, multiple linear regression models and interaction effects were calculated for more than 7000 respondents within the German Socio-Economic Panel (GSOEP) study. RESULTS: Against the model's hypothesis, effort and especially reward had a stronger effect on health satisfaction and mental health individually than the effort-reward imbalance ratio. Over-commitment exerted a negative influence on health indicators and its interaction with the effort-reward imbalance ratio intensified this effect significantly for mental health. Overall, the best model fit was reached for mental health, which is in line with the model's stress theory foundation. CONCLUSIONS: Although the ERI model has been applied for more than 20 years, theoretical and methodological demands can no longer be neglected. This article contributes to the revision of the effort-reward imbalance (ERI) model and demonstrates possible starting points for prevention programs focusing on rewards.


Assuntos
Atitude Frente a Saúde , Estresse Ocupacional/epidemiologia , Carga de Trabalho/psicologia , Adulto , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Psicológicos , Recompensa
20.
Gynecol Oncol ; 154(3): 475-479, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31345606

RESUMO

BACKGROUND: The relationship between nodal micrometastases and clinical outcome of endometrial cancer is unclear. PATIENTS AND METHODS: We performed a multicenter, retrospective registry-based study of 2392 patients with endometrial cancer with and without nodal micrometastases. The primary outcome measure was disease-free survival. RESULTS: After exclusions, the final study involved 428 patients: 302 (70.6%) with node-negative endometrial cancer, who did not receive adjuvant treatment, 95 (22.2%) with nodal micrometastases who received adjuvant treatment, and 31 (7.2%) with nodal micrometastases who did not receive adjuvant treatment. The median follow-up was 84.8 months. Without adjuvant therapy the disease-free survival in the cohort of patients with micrometastases was significantly reduced as compared with disease-free survival in the node-negative cohort (p = 0.0001). With adjuvant therapy the median disease-free survival of patients with nodal micrometastases was similar with those of node-negative patients (p = 0.648). The adjusted hazard ratio for disease events among patients with micrometastases and no adjuvant therapy, as compared with node-negative patients, was 2.23 (95% confidence interval [CI] 1.26-3.95). In the cohort with micrometastases the relative risk of events was significantly decreased by adjuvant therapy (HR 0.29, 95%CI 0.13-0.65) even after adjustment for age at diagnosis, myometrial invasion, histological grade and type, and performance status. CONCLUSIONS: Nodal micrometastases are associated with decreased disease-free survival of patients with endometrial cancer. Adjuvant therapy was associated with improved disease-free survival of patients with micrometastases.


Assuntos
Hiperplasia Endometrial/mortalidade , Hiperplasia Endometrial/patologia , Linfonodos/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Quimioterapia Adjuvante , Estudos de Coortes , Intervalo Livre de Doença , Hiperplasia Endometrial/terapia , Feminino , Alemanha/epidemiologia , Humanos , Metástase Linfática , Pessoa de Meia-Idade , Micrometástase de Neoplasia , Radioterapia Adjuvante , Sistema de Registros , Estudos Retrospectivos
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