Genetic diversity in German draught horse breeds compared with a group of primitive, riding and wild horses by means of microsatellite DNA markers.

PubMed

Aberle, K S; Hamann, H; Drögemüller, C; Distl, O

2004-08-01

We compared the genetic diversity and distance among six German draught horse breeds to wild (Przewalski's Horse), primitive (Icelandic Horse, Sorraia Horse, Exmoor Pony) or riding horse breeds (Hanoverian Warmblood, Arabian) by means of genotypic information from 30 microsatellite loci. The draught horse breeds included the South German Coldblood, Rhenish German Draught Horse, Mecklenburg Coldblood, Saxon Thuringa Coldblood, Black Forest Horse and Schleswig Draught Horse. Despite large differences in population sizes, the average observed heterozygosity (H(o)) differed little among the heavy horse breeds (0.64-0.71), but was considerably lower than in the Hanoverian Warmblood or Icelandic Horse population. The mean number of alleles (N(A)) decreased more markedly with declining population sizes of German draught horse breeds (5.2-6.3) but did not reach the values of Hanoverian Warmblood (N(A) = 6.7). The coefficient of differentiation among the heavy horse breeds showed 11.6% of the diversity between the heavy horse breeds, as opposed to 21.2% between the other horse populations. The differentiation test revealed highly significant genetic differences among all draught horse breeds except the Mecklenburg and Saxon Thuringa Coldbloods. The Schleswig Draught Horse was the most distinct draught horse breed. In conclusion, the study demonstrated a clear distinction among the German draught horse breeds and even among breeds with a very short history of divergence like Rhenish German Draught Horse and its East German subpopulations Mecklenburg and Saxon Thuringa Coldblood.

Individual-based assessment of population structure and admixture in Austrian, Croatian and German draught horses.

PubMed

Druml, T; Curik, I; Baumung, R; Aberle, K; Distl, O; Sölkner, J

2007-02-01

All over Europe, the number of draught horses has decreased drastically during the last 50 years. As a prerequisite for efficient management decisions, we analysed the conservation status in Austrian (Noriker Carinthia - NC, Noriker Salzburg - NS), Croatian (Croatian Coldblood - C, Posavina horse - P) and German (Altmaerkisch Coldblood - A, Black Forest horse - BF, Mecklenburg Coldblood - M, Rhenish German Draught horse - R, Saxon Thuringa Coldblood - ST, Schleswig Draught horse - Sch, South German Coldblood - SG) draught horses (434) using multilocus genotypic information from 30 (effectively 27) microsatellite loci. Populations located in areas with less intensive agricultural production (C, NC, NS, P and SG) had greater diversity within the population and estimated effective population size than A, BF, Sch, M, R and ST populations. The PCA plots revealed that populations form five separate groups. The 'Noriker' group (NC, NS and SG) and the 'Rhenish' group (A, M, R and ST) were the most distinctive (pairwise F(ST) values ranged from 0.078 to 0.094). The 'Croatian' group (C and P) was in the centre, while the BF and Sch populations formed two out-groups. A posterior Bayesian analysis detected further differentiation, mainly caused by political and geographical factors. Thus, it was possible to separate the South German Coldblood from the Austrian Noriker population where no subpopulation structure was detected. The admixture analysis revealed imprecise classification between C and P populations. A small but notable separation of R from A, M and ST populations was detected, while Sch and BF populations remained as out-groups. The information obtained should aid in making efficient conservation decisions.

Adiposity indices in German children and adolescents with genetically confirmed Prader-Willi syndrome (PWS).

PubMed

Hauffa, B P; Schlippe, G; Gillessen-Kaesbach, G

2001-05-01

Morbid obesity develops as a result of hyperphagia and compulsive eating behavior in patients with Prader-Willi syndrome (PWS), if caloric intake is not rigorously controlled. PWS-specific centile curves for adiposity indices constructed in the past were based on clinically diagnosed patients. With the advent of molecular genetic methods, allowing for an unequivocal diagnosis, new PWS curves based exclusively on molecularly diagnosed patients are becoming available, eliminating a potential diagnostic bias. To compare fat distribution in molecularly confirmed German PWS patients to that of clinically diagnosed American PWS patients and a healthy reference population. Cross-sectional anthropometric study. One hundred German patients (49 F) with molecularly confirmed PWS (age: <30 y). Triceps (subscapular) skinfold thickness, waist and hip circumference. Skinfold thickness was massively elevated in the majority of the molecularly confirmed German PWS patients compared to a healthy reference population. Whereas triceps skinfold thickness was in good agreement with American PWS patients, subscapular skinfold thickness in German girls rose earlier than in American PWS girls, indicating possible differences between caloric intake or the proportion of patients entering puberty spontaneously. Waist circumference and waist-hip ratio (n=89) were elevated in a relative small proportion of patients only and did not reflect lower abdominal fat. This may be due to the peculiar shape of many patients with a typical fat accumulation around the buttocks. In addition to body mass index, use of skinfold thickness is recommended for follow-up of dietary interventions in PWS.

Attitudes of the German General Population toward Early Diagnosis of Dementia – Results of a Representative Telephone Survey

PubMed Central

Luck, Tobias; Luppa, Melanie; Sieber, Jennifer; Schomerus, Georg; Werner, Perla; König, Hans-Helmut; Riedel-Heller, Steffi G.

2012-01-01

Background Early detection of dementia has clearly improved. Even though none of the currently available treatments for the most common form of dementia, Alzheimer’s dementia, promises a cure, early diagnosis provides several benefits for patients, caregivers, and health care systems. This study aimed to describe attitudes toward early diagnosis of dementia in the German general population. Methods A representative telephone survey of the German population aged 18+ years (n = 1,002) was conducted in 2011. Results The majority of respondents (69%) would be willing to be examined for early diagnosis of dementia. Almost two thirds reported that they would prefer their general practitioner (GP) as the first source of professional help. More than half of the respondents (55%) stated their belief that dementia could be prevented. Respondents mostly indicated psychosocial prevention options. Conclusions Our findings suggest that the general population in Germany is very open to early diagnosis of dementia; however, this seems connected with large expectations on the effectiveness of prevention options. Dementia awareness campaigns may be employed to carefully inform the public about the prevention options currently available and their efficacy. To exploit GPs’ potential as a gatekeeper for early detection of dementia, their ability to identify patients with antecedent and mild stages of the disease must be improved. PMID:23209827

Detecting and treating occlusal caries lesions: a cost-effectiveness analysis.

PubMed

Schwendicke, F; Stolpe, M; Meyer-Lueckel, H; Paris, S

2015-02-01

The health gains and costs resulting from using different caries detection strategies might not only depend on the accuracy of the used method but also the treatment emanating from its use in different populations. We compared combinations of visual-tactile, radiographic, or laser-fluorescence-based detection methods with 1 of 3 treatments (non-, micro-, and invasive treatment) initiated at different cutoffs (treating all or only dentinal lesions) in populations with low or high caries prevalence. A Markov model was constructed to follow an occlusal surface in a permanent molar in an initially 12-y-old male German patient over his lifetime. Prevalence data and transition probabilities were extracted from the literature, while validity parameters of different methods were synthesized or obtained from systematic reviews. Microsimulations were performed to analyze the model, assuming a German health care setting and a mixed public-private payer perspective. Radiographic and fluorescence-based methods led to more overtreatments, especially in populations with low prevalence. For the latter, combining visual-tactile or radiographic detection with microinvasive treatment retained teeth longest (mean 66 y) at lowest costs (329 and 332 Euro, respectively), while combining radiographic or fluorescence-based detections with invasive treatment was the least cost-effective (<60 y, >700 Euro). In populations with high prevalence, combining radiographic detection with microinvasive treatment was most cost-effective (63 y, 528 Euro), while sensitive detection methods combined with invasive treatments were again the least cost-effective (<59 y, >690 Euro). The suitability of detection methods differed significantly between populations, and the cost-effectiveness was greatly influenced by the treatment initiated after lesion detection. The accuracy of a detection method relative to a "gold standard" did not automatically convey into better health or reduced costs. Detection methods should be evaluated not only against their criterion validity but also the long-term effects resulting from their use in different populations. © International & American Associations for Dental Research 2014.

Food consumption of adults in Germany: results of the German National Nutrition Survey II based on diet history interviews.

PubMed

Heuer, Thorsten; Krems, Carolin; Moon, Kilson; Brombach, Christine; Hoffmann, Ingrid

2015-05-28

The second German National Nutrition Survey (NVS II) aimed to evaluate food consumption and other aspects of nutritional behaviour of a representative sample of the German population, using a modular design with three different dietary assessment methods. To assess usual food consumption, 15,371 German speaking subjects 14-80 years of age completed a diet history interview between November 2005 and November 2006. With reference to the guidelines of the German Nutrition Society (DGE), NVS II observed that the German population did not eat enough foods of plant origin, especially vegetables and consumed too much of meat and meat products. While generally similar food consumption is observed in other European countries, consumption of bread, fruit juices/nectars and beer is higher in Germany. On average, men consumed two times more meat and soft drinks as well as six times more beer than women did, whereas the consumption of vegetables, fruit as well as herbal/fruit tea was higher in women. Older participants showed a lower consumption of meat, fruit juice/nectars, soft drinks and spirits as well as a higher consumption of fish, vegetables, fruit, and herbal/fruit tea than adolescents and younger adults did. There are also differences in food consumption with regard to socio-economic status (SES). Persons with higher SES consumed more vegetables, fruit, fish, water, coffee/tea and wine, while persons with lower SES consumed more meat and meat products, soft drinks and beer. In general, the food consumption of women, the elderly and the higher SES group tends to be closer to the official dietary guidelines in Germany.

Estimated breeding values for canine hip dysplasia radiographic traits in a cohort of Australian German Shepherd dogs.

PubMed

Wilson, Bethany J; Nicholas, Frank W; James, John W; Wade, Claire M; Thomson, Peter C

2013-01-01

Canine hip dysplasia (CHD) is a serious and common musculoskeletal disease of pedigree dogs and therefore represents both an important welfare concern and an imperative breeding priority. The typical heritability estimates for radiographic CHD traits suggest that the accuracy of breeding dog selection could be substantially improved by the use of estimated breeding values (EBVs) in place of selection based on phenotypes of individuals. The British Veterinary Association/Kennel Club scoring method is a complex measure composed of nine bilateral ordinal traits, intended to evaluate both early and late dysplastic changes. However, the ordinal nature of the traits may represent a technical challenge for calculation of EBVs using linear methods. The purpose of the current study was to calculate EBVs of British Veterinary Association/Kennel Club traits in the Australian population of German Shepherd Dogs, using linear (both as individual traits and a summed phenotype), binary and ordinal methods to determine the optimal method for EBV calculation. Ordinal EBVs correlated well with linear EBVs (r = 0.90-0.99) and somewhat well with EBVs for the sum of the individual traits (r = 0.58-0.92). Correlation of ordinal and binary EBVs varied widely (r = 0.24-0.99) depending on the trait and cut-point considered. The ordinal EBVs have increased accuracy (0.48-0.69) of selection compared with accuracies from individual phenotype-based selection (0.40-0.52). Despite the high correlations between linear and ordinal EBVs, the underlying relationship between EBVs calculated by the two methods was not always linear, leading us to suggest that ordinal models should be used wherever possible. As the population of German Shepherd Dogs which was studied was purportedly under selection for the traits studied, we examined the EBVs for evidence of a genetic trend in these traits and found substantial genetic improvement over time. This study suggests the use of ordinal EBVs could increase the rate of genetic improvement in this population.

Estimating vaccination coverage in the absence of immunisation registers--the German experience.

PubMed

Siedler, A; Rieck, T; Reuss, A; Walter, D; Poggensee, G; Poethko-Muller, C; Reiter, S

2012-04-26

Immunisation registers are regarded as an appropriate solution to measure vaccination coverage on a population level. In Germany, a decentralised healthcare system and data protection regulations constrain such an approach. Moreover, shared responsibilities in the process of immunisation and multiple providers form the framework for public health interventions on vaccination issues. On the national level, those interventions consist mainly of conceptualising immunisation strategies, establishing vaccination programmes, and issuing recommendations. This paper provides an overview on sources and methods for collecting appropriate coverage data at national level and their public health relevance in Germany. Methods of data collection and available information on immunisations are described for three approaches: school entrance health examination, population surveys and insurance refund claim data. School entrance health examinations allow regional comparisons and estimation of trends for a specific cohort of children and for all recommended childhood vaccinations. Surveys deliver population based data on completeness and timeliness of selected vaccinations in populations defined by age or socio-demographic parameters and on knowledge and attitudes towards vaccination. Insurance refund claim data inform continuously on immunisation status (e.g. of children aged two years) or on vaccination incidence promptly after new or modified recommendations. In a complex healthcare system, the German National Public Health Institute (Robert Koch Institute, RKI) successfully compiles coverage data from different sources, which complement and validate one another. With the German approach of combining different data sources in the absence of immunisation registers, it is possible to gain solid and reliable data on the acceptance of vaccination programmes and target groups for immunisation. This approach might be of value for other countries with decentralised healthcare systems.

Structural validation of the Self-Compassion Scale with a German general population sample

PubMed Central

Kwakkenbos, Linda; Moran, Chelsea; Thombs, Brett; Albani, Cornelia; Bourkas, Sophia; Zenger, Markus; Brahler, Elmar; Körner, Annett

2018-01-01

Background Published validation studies have reported different factor structures for the Self-Compassion Scale (SCS). The objective of this study was to assess the factor structure of the SCS in a large general population sample representative of the German population. Methods A German population sample completed the SCS and other self-report measures. Confirmatory factor analysis (CFA) in MPlus was used to test six models previously found in factor analytic studies (unifactorial model, two-factor model, three-factor model, six-factor model, a hierarchical (second order) model with six first-order factors and two second-order factors, and a model with arbitrarily assigned items to six factors). In addition, three bifactor models were also tested: bifactor model #1 with two group factors (SCS positive items, called SCS positive) and SCS negative items, called SCS negative) and one general factor (overall SCS); bifactor model #2, which is a two-tier model with six group factors, three (SCS positive subscales) corresponding to one general dimension (SCS positive) and three (SCS negative subscales) corresponding to the second general dimension (SCS negative); bifactor model #3 with six group factors (six SCS subscales) and one general factor (overall SCS). Results The two-factor model, the six-factor model, and the hierarchical model showed less than ideal, but acceptable fit. The model fit indices for these models were comparable, with no apparent advantage of the six-factor model over the two-factor model. The one-factor model, the three-factor model, and bifactor model #3 showed poor fit. The other two bifactor models showed strong support for two factors: SCS positive and SCS negative. Conclusion The main results of this study are that, among the German general population, six SCS factors and two SCS factors fit the data reasonably well. While six factors can be modelled, the three negative factors and the three positive factors, respectively, did not reflect reliable or meaningful variance beyond the two summative positive and negative item factors. As such, we recommend the use of two subscale scores to capture a positive factor and a negative factor when administering the German SCS to general population samples and we strongly advise against the use of a total score across all SCS items. PMID:29408888

Self-reported asthma and allergies in top athletes compared to the general population - results of the German part of the GA2LEN-Olympic study 2008

PubMed Central

2010-01-01

Background Prevalence of asthma and allergies in top athletes is high. However, most previous studies did not include a general population comparison group. We aimed to compare the prevalence of asthma, allergies and medical treatment in different groups of German top athletes to the general population. Methods Prior to the 2008 Summer Olympic Games, 291 German candidates for participation (65%) completed a questionnaire on respiratory and allergic symptoms. Results were compared to those of a general population study in Germany (n = 2425, response 68%). Furthermore, associations between types of sports and the self-reported outcomes were calculated. All models were adjusted for age, sex, level of education and smoking. Results Athletes reported significantly more doctors' diagnosed asthma (17% vs. 7%), more current use of asthma medication (10% vs. 4%) and allergic rhinitis (25% vs. 17%) compared to the general population. After adjustment, top athletes only had an increased Odds Ratio for doctor's diagnosed asthma (OR: 1.6; 95% CI 1.1-2.5). Compared to the general population, athletes in endurance sports had an increased OR for doctor's diagnosed asthma (2.4; 1.5-3.8) and current use of asthma medication (1.8; 1.0-3.4). In this group, current wheeze was increased when use of asthma medication was taken into account (1.8; 1.1-2.8). For other groups of athletes, no significantly increased ORs were observed. Conclusions Compared to the general population, an increased risk of asthma diagnosis and treatment was shown for athletes involved in endurance sports. This might be due to a better medical surveillance and treatment of these athletes. PMID:21118543

The German version of the Material Values Scale

PubMed Central

Müller, Astrid; Smits, Dirk J. M.; Claes, Laurence; Gefeller, Olaf; Hinz, Andreas; de Zwaan, Martina

2013-01-01

Aim: The Material Values Scale is an instrument to assess beliefs about the importance to own material things. This instrument originally consists of the three subscales: ‘centrality’, ‘success’, and ‘happiness’. The present study investigated the psychometric properties of the German version of the MVS (G-MVS). Method: A population-based sample of 2,295 adult Germans completed the questionnaire in order to investigate the factorial structure. To test construct validity, additional samples were gathered among patients with compulsive buying (N=52) and medical students (N=347) who also answered the Compulsive Buying Scale (CBS) and the Patient Health Questionnaire depression scale (PHQ-8). Results: In the German population-based sample we could not confirm the 3-factor model but rather suggest a 2-factor solution with a first collapsed factor ‘centrality/success’, and the second factor ’happiness’. Patients with compulsive buying showed the highest scores on the G-MVS. While G-MVS scores among compulsive buyers and medical students were significantly related to compulsive buying scores, the correlation between the G-MVS and the depression measure appeared substantially lower. We did not find any gender differences regarding materialism, neither in the population-based sample nor in the students’ or compulsive buyers’ samples. However, age was negatively related to G-MVS scores. Conclusion: Confirmatory factor analyses suggest a 2-factor model of the G-MVS. Overall, the results indicate the use of the G-MVS as a brief, psychometrically sound, and potentially valid measure for the assessment of material values. PMID:23802017

Comparison of hospitalization among German coastal and deep sea fishermen.

PubMed

Oldenburg, M; Harth, V; Manuwald, U

2015-08-01

This study aims to compare the hospitalization of German fishermen employed on German-flagged fishing vessels with that of the general German population in consideration of differences between coastal and deep sea fishery. By means of a database from the health insurance company for seafarers, diagnoses of German fishermen treated in German hospitals were determined from January 1997 to December 2007. Compared with the general German population, the fishermen's risk for specific diseases leading to hospitalization was calculated as standardized hospitalization ratio (SHR). Compared with the German reference population, German fishermen showed a considerably high SHR for malignant neoplasms at all sites (SHR 1.46; 95% CI 1.37-1.56), for respiratory cancer, and for non-Hodgkin lymphoma (NHL). Furthermore, they had more often been hospitalized due to diabetes mellitus, diseases of the respiratory and digestive systems as well as due to injury and poisoning. The risk for respiratory cancer and NHL among coastal fishermen exceeded that of deep sea fishermen, whereas the latter displayed a considerably higher SHR for diabetes mellitus, diseases of the respiratory system and metabolic and nutritional disorders. In contrast, the SHR for hypertensive and ischemic heart diseases was decreased among deep sea fishermen. Less qualified deep sea fishermen displayed a considerably higher SHR for malignant neoplasms at all sites than more highly qualified ones. Fishery is still an occupation which poses a high risk for malignant neoplasms and injuries. This is likely due to lifestyle and work-related factors. Further studies are needed to evaluate the different working and living conditions of coastal and deep sea fishermen.

Pitfalls of the Geographic Population Structure (GPS) Approach Applied to Human Genetic History: A Case Study of Ashkenazi Jews

PubMed Central

Flegontov, Pavel; Kassian, Alexei; Thomas, Mark G.; Fedchenko, Valentina; Changmai, Piya; Starostin, George

2016-01-01

In a recent interdisciplinary study, Das et al. have attempted to trace the homeland of Ashkenazi Jews and of their historical language, Yiddish (Das et al. 2016. Localizing Ashkenazic Jews to Primeval Villages in the Ancient Iranian Lands of Ashkenaz. Genome Biol Evol. 8:1132–1149). Das et al. applied the geographic population structure (GPS) method to autosomal genotyping data and inferred geographic coordinates of populations supposedly ancestral to Ashkenazi Jews, placing them in Eastern Turkey. They argued that this unexpected genetic result goes against the widely accepted notion of Ashkenazi origin in the Levant, and speculated that Yiddish was originally a Slavic language strongly influenced by Iranian and Turkic languages, and later remodeled completely under Germanic influence. In our view, there are major conceptual problems with both the genetic and linguistic parts of the work. We argue that GPS is a provenancing tool suited to inferring the geographic region where a modern and recently unadmixed genome is most likely to arise, but is hardly suitable for admixed populations and for tracing ancestry up to 1,000 years before present, as its authors have previously claimed. Moreover, all methods of historical linguistics concur that Yiddish is a Germanic language, with no reliable evidence for Slavic, Iranian, or Turkic substrata. PMID:27389685

Migration pattern and mortality of ethnic German migrants from the former Soviet Union: a cohort study in Germany

PubMed Central

Kaucher, Simone; Deckert, Andreas; Becher, Heiko; Winkler, Volker

2017-01-01

Objective We aimed to investigate all-cause and cause-specific mortality among ethnic German migrants from the former Soviet Union by different immigration periods to describe associations with migration pattern and mortality. Design We used pooled data from three retrospective cohort studies in Germany. Participants Ethnic German migrants from the former Soviet Union (called resettlers), who immigrated to Germany since 1990 to the federal states North Rhine-Westphalia and Saarland and to the region of Augsburg (n=59 390). Outcome All-cause and cause-specific mortality among resettlers in comparison to the general German population, separated by immigration period. Methods Immigration periods were defined following legislative changes in German immigration policy (1990–1992, 1993–1995, 1996+). Resettlers’ characteristics were described accordingly. To investigate mortality differences by immigration period, we calculated age-standardised mortality rates (ASRs) and standardised mortality ratios (SMRs) of resettlers in comparison to the general German population. Additionally, we modelled sex-specific ASRs with Poisson regression, using age, year and immigration period as independent variables. Results The composition of resettlers differed by immigration period. Since 1993, the percentage of resettlers from the Russian Federation and non-German spouses increased. Higher all-cause mortality was found among resettlers who immigrated in 1996 and after (ASR 628.1, 95% CI 595.3 to 660.8), compared with resettlers who immigrated before 1993 (ASR 561.8, 95% CI 537.2 to 586.4). SMR analysis showed higher all-cause mortality among resettler men from the last immigration period compared with German men (SMR 1.11, 95% CI 1.04 to 1.19), whereas resettlers who immigrated earlier showed lower all-cause mortality. Results from Poisson regression, adjusted for age and year, corroborated those findings. Conclusions Mortality differences by immigration period suggest different risk-factor patterns and possibly deteriorated integration opportunities. Health policy should guard the consequences of immigration law alterations with respect to changing compositions of migrant groups and their health status. PMID:29259065

Stochastic Forecasting of Labor Supply and Population: An Integrated Model.

PubMed

Fuchs, Johann; Söhnlein, Doris; Weber, Brigitte; Weber, Enzo

2018-01-01

This paper presents a stochastic model to forecast the German population and labor supply until 2060. Within a cohort-component approach, our population forecast applies principal components analysis to birth, mortality, emigration, and immigration rates, which allows for the reduction of dimensionality and accounts for correlation of the rates. Labor force participation rates are estimated by means of an econometric time series approach. All time series are forecast by stochastic simulation using the bootstrap method. As our model also distinguishes between German and foreign nationals, different developments in fertility, migration, and labor participation could be predicted. The results show that even rising birth rates and high levels of immigration cannot break the basic demographic trend in the long run. An important finding from an endogenous modeling of emigration rates is that high net migration in the long run will be difficult to achieve. Our stochastic perspective suggests therefore a high probability of substantially decreasing the labor supply in Germany.

Polymorphic haplotypes and recombination rates at the LDL receptor gene locus in subjects with and without familial hypercholesterolemia who are from different populations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Miserez, A.R.; Chiodetti, N.; Keller, U.

1993-04-01

RFLPs at the low-density lipoprotein (LDL) receptor locus for TaqI, StuI, HincII, AvaII, ApaLI (5[prime] and 3[prime]), PvuII, and NcoI were studied in Swiss and German families with familial hypercholesterolemia (FH). A total of 1,104 LDL receptor alleles were analyzed using Southern blotting and new PCR-based techniques for detection of the TaqI, StuI, HincII, AvaII, NcoI RFLPs. Two hundred fifty-six independent haplotypes from 368 individuals of 61 unrelated Swiss families, as well as 114 independent haplotypes from 184 subjects of 25 unrelated German families, were constructed. In 76 families, clinical diagnosis of FH was confirmed by cosegregation analysis. Of themore » 43 unique haplotypes consisting of seven RFLPs detected in the Swiss and Germans, only 9 were common in both population samples. Analysis of linkage disequilibrium revealed nonrandom associations between several of the investigated RFLPs. ApaLI (5[prime]), NcoI, PvuII, TaqI, and AvaII or HincII were particularly informative. Relative frequencies, heterozygosity indexes, and PICs of the RFLPs from the Swiss and Germans were compared with values calculated from reported haplotype data for Italians, Icelanders, North American Caucasians, South African Caucasians, and Japanese. Pairwise comparisons of population samples by common RFLPs demonstrated unexpected differences even between geographically adjacent populations (e.g., the Swiss and Germans). Furthermore, genetic distances from the Germans to the other Caucasians were larger than to the Japanese. An unexpected lack of correlation between linkage disequilibria and physical distances was detected for the German and Japanese data, possibly because of nonuniform recombination with excessively high rates between exon 13 and intron 15. Hence, the present study revealed a striking variety of polymorphic haplotypes and heterogeneity of RFLP frequencies and recombination rates among the seven population samples. 60 refs., 2 figs., 8 tabs.« less

Public Support for Weight-Related Antidiscrimination Laws and Policies

PubMed Central

Hilbert, Anja; Hübner, Claudia; Schmutzer, Gabriele; Danielsdottir, Sigrun; Brähler, Elmar; Puhl, Rebecca

2017-01-01

Objective Weight-related discrimination is prevalent and associated with health impairments for those who are targeted, which underscores the need of antidiscrimination legislation. This study is the first to examine public support of weight-related antidiscrimination laws or policies in Germany, compared to the US and Iceland. Methods In a representative German population sample (N = 2,513), public support for general and employment-specific weight-related antidiscrimination policies, weight-based victimization, and weight bias internalization were measured through established self-report questionnaires. Results Half of the German population sample agreed with antidiscrimination policies. General antidiscrimination laws received lower support than employment-specific laws. Support for policies considering obesity a physical disability was greatest in Germany, whereas support for employment-specific antidiscrimination laws was lower in Germany than in the US and Iceland. Total support for weight-related antidiscrimination policies was significantly predicted by lower age, female gender, obese weight status, residence in West Germany, church membership, and readiness to vote in elections. Conclusion German support for weight-related antidiscrimination policies is moderate. Increasing awareness about weight-related discrimination and laws prohibiting this behavior may help to promote policy acceptance. PMID:28384631

Prostate cancer in Germany among migrants from the Former Soviet Union

PubMed Central

Winkler, Volker; Holleczek, Bernd; Stegmaier, Christa; Becher, Heiko

2012-01-01

Background In Germany, prostate cancer is the leading cause of cancer and the third leading cause of death from cancer in males. We investigate prostate cancer in Gernmany among migrants from the Former Soviet Union (FSU) and compare them to indigenous German population with regard to prostate cancer incidence, mortality and longitudinal effects. Methods Data were obtained from two migrant cohorts residing in the federal states of North Rhine Westphalia (n=34,393) and Saarland (n=18,619). Vital status was ascertained through local population registries. Causes of death were obtained from the federal statistical office or from local health authorities. Cancer incidence of the Saarland cohort was derived from the Saarland Cancer Registry using record linkage. Results From 1990 to 2005 we observed 3360 deaths of which 28 were due to prostate cancer. In the Saarland cohort 35 men were diagnosed with prostate cancer during the respective period. Migrants had lower prostate cancer incidence (SIR 0.74 (95% CI: 0.52–1.03)) and mortality (SMR 0.57 (95% CI: 0.38–0.83)) compared to the German population. Multivariate analysis showed a strong age effect on incidence meaning young migrants (below age 60) were diagnosed significantly more often with prostate cancer compared to Germans of the same age. However, mortality did not show any effects. Discussion Lower prostate cancer mortality and incidence among migrants may reflect an ongoing situation in the FSU. Additionally, longitudinal analysis did not reveal convergence of migrant prostate cancer to German rates as expected from lifestyle driven cancer sites. Therefore, our results support the hypothesis of a genetic effect on prostate cancer risk. PMID:22229025

[The representation of population density in school atlases: a critical examination of population maps].

PubMed

Schroder, P

1997-01-01

The author critiques the way population density is represented in school atlases, focusing on those used in German-speaking countries. After a discussion of the methodological problems underlying such representations, he selects examples from several German atlases to illustrate the transmission of contradictory, misleading, or out-of-date information. He also suggests ways to improve this situation, including better teaching of underlying cartographical issues and the use of a dot system to illustrate population density.

Screening disordered eating in a representative sample of the German population: Usefulness and psychometric properties of the German SCOFF questionnaire.

PubMed

Richter, Felicitas; Strauss, Bernhard; Braehler, Elmar; Adametz, Luise; Berger, Uwe

2017-04-01

The prevention of eating disorders and the identification of high-risk individuals are essential for the public health sector. There is need for sensitive and specific screening instruments of disordered eating that can be applied in universal samples as an initial step into disease prevention. The SCOFF is a screening instrument for disordered eating, frequently used in international and cross-cultural contexts to detect individuals at risk. The objective of this research is to evaluate whether the SCOFF can be used as a screening tool for disordered eating in universal samples. This is the first study which examined the psychometric properties of the German version of the SCOFF in a general population sample. A representative sample (N=2527) of the German population, aged 14-95years, was recruited. Psychometric properties were determined including reliability, concurrent and construct validity, and factor structure. The prevalence of disordered eating was assessed. The prevalence of disordered eating in the general population was 10%. Using the established cutoff point of ≥2, values for diagnostic accuracy were 26% (sensitivity), 97% (specificity), 80% (positive predictive value), and 74% (negative predictive value). Factorial analyses revealed an excellent model fit of a unidimensional model. Due to its low sensitivity and a high percentage of false negatives, there are limitations in using the German version of the SCOFF in general population samples with wide age ranges. Copyright © 2016 Elsevier Ltd. All rights reserved.

Pitfalls of the Geographic Population Structure (GPS) Approach Applied to Human Genetic History: A Case Study of Ashkenazi Jews.

PubMed

Flegontov, Pavel; Kassian, Alexei; Thomas, Mark G; Fedchenko, Valentina; Changmai, Piya; Starostin, George

2016-08-16

In a recent interdisciplinary study, Das et al. have attempted to trace the homeland of Ashkenazi Jews and of their historical language, Yiddish (Das et al. 2016 Localizing Ashkenazic Jews to Primeval Villages in the Ancient Iranian Lands of Ashkenaz. Genome Biol Evol. 8:1132-1149). Das et al. applied the geographic population structure (GPS) method to autosomal genotyping data and inferred geographic coordinates of populations supposedly ancestral to Ashkenazi Jews, placing them in Eastern Turkey. They argued that this unexpected genetic result goes against the widely accepted notion of Ashkenazi origin in the Levant, and speculated that Yiddish was originally a Slavic language strongly influenced by Iranian and Turkic languages, and later remodeled completely under Germanic influence. In our view, there are major conceptual problems with both the genetic and linguistic parts of the work. We argue that GPS is a provenancing tool suited to inferring the geographic region where a modern and recently unadmixed genome is most likely to arise, but is hardly suitable for admixed populations and for tracing ancestry up to 1,000 years before present, as its authors have previously claimed. Moreover, all methods of historical linguistics concur that Yiddish is a Germanic language, with no reliable evidence for Slavic, Iranian, or Turkic substrata. © The Author 2016. Published by Oxford University Press on behalf of the Society for Molecular Biology and Evolution.

Setting up an Online Panel Representative of the General Population: The German Internet Panel

ERIC Educational Resources Information Center

Blom, Annelies G.; Gathmann, Christina; Krieger, Ulrich

2015-01-01

This article looks into the processes and outcomes of setting up and maintaining a probability-based longitudinal online survey, which is recruited face-to-face and representative of both the online and the offline population aged 16-75 in Germany. This German Internet Panel studies political and economic attitudes and reform preferences through…

[Pruritus in Germany-a Google search engine analysis].

PubMed

Zink, A; Rüth, M; Schuster, B; Darsow, U; Biedermann, T; Ständer, S

2018-06-06

Because affected persons often do not visit a doctor, the prevalence of chronic and acute pruritus in the general population is difficult to determine. The aim of this study is to estimate the frequency and the most common locations of pruritus in German internet users, who-with 62.4 million persons-represent a large majority of the German population, by analysing the Google search volume. Relevant keywords for the subject "pruritus" were identified and analysed using the Google AdWords Keyword Planner. The assessment period was January 2015 to December 2016. In total the Google AdWords Keyword Planner identified 701 keywords for the topic "Juckreiz" (German lay word for pruritus), resulting in 7,531,890 pruritus-related Google searches during the assessment period. Most common search terms were the German lay term for atopic eczema ("Neurodermitis", 23.7%), the German lay term for psoriasis ("Schuppenflechte", 17.8%) and "psoriasis" (13%). The German lay term for pruritus ("Juckreiz") was only the sixth most searched term (3%). Most searches (72%) focused on influencing factors for pruritus, especially on skin diseases and skin conditions. The most commonly searched location was pruritus on the whole body, followed by anal pruritus. Analysis of the temporal course showed a higher monthly search volume during winter. With its unconventional methodology, a Google search engine analysis, this study allows a rough estimation of the medical need of pruritus in the German general population, which seems to be higher than expected. Especially pruritus in the anal area was identified as an unmet medical need.

Validation of the German Diabetes Risk Score among the general adult population: findings from the German Health Interview and Examination Surveys

PubMed Central

Paprott, Rebecca; Mühlenbruch, Kristin; Mensink, Gert B M; Thiele, Silke; Schulze, Matthias B; Scheidt-Nave, Christa; Heidemann, Christin

2016-01-01

Objective To evaluate the German Diabetes Risk Score (GDRS) among the general adult German population for prediction of incident type 2 diabetes and detection of prevalent undiagnosed diabetes. Methods The longitudinal sample for prediction of incident diagnosed type 2 diabetes included 3625 persons who participated both in the examination survey in 1997–1999 and the examination survey in 2008–2011. Incident diagnosed type 2 diabetes was defined as first-time physician diagnosis or antidiabetic medication during 5 years of follow-up excluding potential incident type 1 and gestational diabetes. The cross-sectional sample for detection of prevalent undiagnosed diabetes included 6048 participants without diagnosed diabetes of the examination survey in 2008–2011. Prevalent undiagnosed diabetes was defined as glycated haemoglobin ≥6.5% (48 mmol/mol). We assessed discrimination as area under the receiver operating characteristic curve (ROC-AUC (95% CI)) and calibration through calibration plots. Results In longitudinal analyses, 82 subjects with incident diagnosed type 2 diabetes were identified after 5 years of follow-up. For prediction of incident diagnosed diabetes, the GDRS yielded an ROC-AUC of 0.87 (0.83 to 0.90). Calibration plots indicated excellent prediction for low diabetes risk and overestimation for intermediate and high diabetes risk. When considering the entire follow-up period of 11.9 years (ROC-AUC: 0.84 (0.82 to 0.86)) and including incident undiagnosed diabetes (ROC-AUC: 0.81 (0.78 to 0.84)), discrimination decreased somewhat. A previously simplified paper version of the GDRS yielded a similar predictive ability (ROC-AUC: 0.86 (0.82 to 0.89)). In cross-sectional analyses, 128 subjects with undiagnosed diabetes were identified. For detection of prevalent undiagnosed diabetes, the ROC-AUC was 0.84 (0.81 to 0.86). Again, the simplified version yielded a similar result (ROC-AUC: 0.83 (0.80 to 0.86)). Conclusions The GDRS might be applied for public health monitoring of diabetes risk in the German adult population. Future research needs to evaluate whether the GDRS is useful to improve diabetes risk awareness and prevention among the general population. PMID:27933187

The Levels of German Teacher Trainers Working in Turkey Regarding Reigeluth's Organizational Strategies

ERIC Educational Resources Information Center

Batdi, Veli; Elaldi, Senel

2016-01-01

The purpose of this study is to evaluate the views of German teacher trainers working in Turkey about their level regarding Reigeluth's organizational strategies and to analyze their views in terms of gender, geographic region, seniority, and graduated high school variables. While the population of the study consisted of German teacher trainers…

Attitudes towards the Euro: An Empirical Study Based on the German Socio-Economic Panel (SOEP)

ERIC Educational Resources Information Center

Isengard, Bettina; Schneider, Thorsten

2007-01-01

This paper investigates changing attitudes towards the euro over time in Germany using longitudinal micro-data from the German Socio Economic Panel Study. We observe that a large part of the German population was worried about the new currency both before and after its introduction. Social psychological theories provide insight into these…

A population-based survey on tanning bed use in Germany

PubMed Central

Börner, Franziska U; Schütz, Holger; Wiedemann, Peter

2009-01-01

Background The suntanning industry has grown up over the last decade in Europe, mainly because tanned skin is considered socially desirable and attractive. Because of the potential negative impact of artificial tanning on public health, this study was to investigate tanning bed use behaviour, UV related risk perception and beliefs about tanning in the German population. Methods In 2007, a representative telephone survey was carried out among 1501 German residents aged 14 years and older. Results More than one fourth (28%) of the German population have used tanning beds at least once before in their lifetime. High-frequency tanning behaviour, i.e. using tanning beds more than 10 times per year, were recorded for 11%. Men and women aged 18 to 44 years and young women under the age of 18 used tanning beds more frequently (>10 times per year). Tanning bed use was positively related to appearance and lifestyle related beliefs as well as to the perception that tanned skin is healthy. Conclusion This analysis indicates that tanning bed use is common in Germany. The positive relationships of appearance and health related beliefs with tanning bed use are of great concern. The results indicate underlying misconceptions about the positive effect of artificial UV radiation compared to natural UV radiation particular for high-frequency tanners. The data shows the importance as well as the limitations for risk communication in its current effort to inform effectively about the dangers of artificial UV radiation. PMID:19619281

German health interview and examination survey for adults (DEGS) - design, objectives and implementation of the first data collection wave

PubMed Central

2012-01-01

Background The German Health Interview and Examination Survey for Adults (DEGS) is part of the recently established national health monitoring conducted by the Robert Koch Institute. DEGS combines a nationally representative periodic health survey and a longitudinal study based on follow-up of survey participants. Funding is provided by the German Ministry of Health and supplemented for specific research topics from other sources. Methods/design The first DEGS wave of data collection (DEGS1) extended from November 2008 to December 2011. Overall, 8152 men and women participated. Of these, 3959 persons already participated in the German National Health Interview and Examination Survey 1998 (GNHIES98) at which time they were 18–79 years of age. Another 4193 persons 18–79 years of age were recruited for DEGS1 in 2008–2011 based on two-stage stratified random sampling from local population registries. Health data and context variables were collected using standardized computer assisted personal interviews, self-administered questionnaires, and standardized measurements and tests. In order to keep survey results representative for the population aged 18–79 years, results will be weighted by survey-specific weighting factors considering sampling and drop-out probabilities as well as deviations between the design-weighted net sample and German population statistics 2010. Discussion DEGS aims to establish a nationally representative data base on health of adults in Germany. This health data platform will be used for continuous health reporting and health care research. The results will help to support health policy planning and evaluation. Repeated cross-sectional surveys will permit analyses of time trends in morbidity, functional capacity levels, disability, and health risks and resources. Follow-up of study participants will provide the opportunity to study trajectories of health and disability. A special focus lies on chronic diseases including asthma, allergies, cardiovascular conditions, diabetes mellitus, and musculoskeletal diseases. Other core topics include vaccine-preventable diseases and immunization status, nutritional deficiencies, health in older age, and the association between health-related behavior and mental health. PMID:22938722

Health-related quality of life of prostate cancer patients compared to the general German population: age-specific results.

PubMed

Zenger, Markus; Hinz, Andreas; Stolzenburg, Jens-Uwe; Rabenalt, Robert; Schwalenberg, Thilo; Schwarz, Reinhold

2009-01-01

The objective of this study was to examine the age-specific health-related quality of life (HRQOL) of prostate cancer patients (PCPs). 387 PCPs were asked to self-assess their HRQOL with the EORTC QLQ-C30 questionnaire. Patients' data were compared with those of the general German population. The reported global health/QOL scores of the study group and the general German population are nearly equal. However, most of the subdomains of HRQOL are negatively affected in PCPs, especially in younger patients (

Analysis of relationships between German heavy horse breeds based on pedigree information.

PubMed

Aberle, Kerstin; Wrede, Jörn; Distl, Ottmar

2004-01-01

We analysed the relationship coefficients (R) between the four German heavy horse breeds South German Coldblood, Rhenish German Draught Horse, Schleswig Draught Horse and Black Forest Draught Horse. The relationship coefficient makes it possible to ascertain crossbreeding between the breeds over time, or autonomous developments of the breeds, respectively. The investigation revealed that the relationship coefficients between the German draught horse breeds were very low. The mean relationship coefficients between the four German heavy horse breeds were largest between the South German Coldblood and Schleswig Draught Horse (0.103%), whereas mean relationship coefficients were lowest between the Rhenish German and Black Forest Draught Horse (0.001%). The Rhenish German Draught Horse showed largest relationship coefficients with the Schleswig Draught Horse (0.09%), while the Black Forest Draught Horse was mostly related to the South German Coldblood (0.06%). The results reveal the presence of very few common progenitors of the breeds. The gene flow between the breeds is primarily due to crossbreeding of stallions and, especially, in the Rhenish German Draught Horse population breeding with a few mares from other German draught horse breeds.

Egg donation, surrogate mothering, and cloning: attitudes of men and women in Germany based on a representative survey.

PubMed

Stöbel-Richter, Yve; Goldschmidt, Susanne; Brähler, Elmar; Weidner, Kerstin; Beutel, Manfred

2009-07-01

To determine opinions and attitudes of the German general population toward the treatment methods of reproductive medicine: egg donation, surrogate mothering, and reproductive cloning. Representative survey. German general population: face-to-face interviews at home with 2,110 persons, aged 18-50 years. Patients were not included. No interventions took place. Approval and disapproval of treatment methods of reproductive medicine and preimplantation genetic diagnosis were assessed by questionnaires regarding medical, age, reasons, or general. Overall, the diverse treatment methods of reproductive medicine found comparable rates of approval and disapproval. Legalization of egg donation was approved by a slight majority (50.8%), particularly for medical reasons (35.9%). Surrogate mothering found lower overall rates of approval (43.7%), 28.5% supported an admission for medical reasons. Reproductive cloning was rejected by the vast majority (82.9%). Attitudes to reproductive medicine were affected by age and the individual reproductive experiences. New techniques in reproductive medicine and their development provide hope and health promises for affected couples but also entail long-term risks and ethical issues. Balancing the individual's right to a reproductive autonomy and choice and ethical standards will constitute a future challenge for society. Results demonstrate considerable uncertainty and information deficits in the community.

The risk of coronary heart disease of seafarers on vessels sailing under a German flag.

PubMed

Oldenburg, Marcus; Jensen, Hans-Joachim; Latza, Ute; Baur, Xaver

2010-01-01

This study aimed to predict the risk of coronary heart disease (CHD) among seafarers on German-flagged vessels and to assess the association of shipboard job duration at sea with the risk of CHD. During the legally required medical fitness test for nautical service, 161 seafarers in Hamburg participated in a cross-sectional study which included an interview, blood sampling, and blood pressure measurements (response 84.9%). The predicted 10-year risk of an acute coronary event of the examined German seafarers aged 35 to 64 years (n = 46) was assessed in comparison with a sample of male German employees of the same age working ashore (PROCAM study). The number of independent CHD risk factors (according to the PROCAM study) was compared in the groups with 'shorter' and 'longer' median shipboard job duration at sea (15.0 years). The examined German seafarers had a similar age-standardized predicted 10-year CHD risk as the German reference population. Nearly all independent CHD risk factors were significantly more frequent in seamen with job duration at sea of ≥ 15 years than in those with 〈 15 years. After adjusting for age, the number of CHD risk factors was associated with job duration (OR 1.08 [95% CI 1.02-1.14] per year). Seafarers on German-flagged ships have to attend a medical fitness test for nautical service every 2 years. Thus, it can be assumed that seafarers present a healthier population than employees ashore. In this study, however, CHD risk of seafarers was similar to that of the reference population. This may indicate that working onboard implies a high coronary risk. Furthermore, the study results suggest a tendency of increased risk of CHD among seafarers with longer job duration at sea.

[Self-Stigma of Depression Scale SSDS - Evaluation of the German Version].

PubMed

Makowski, Anna Christin; Mnich, Eva E; von dem Knesebeck, Olaf

2017-05-12

Objectives A better understanding of self-stigma facilitates the development and evaluation of anti-stigma measures. In this study, the Self-Stigma of Depression Scale (SSDS) is applied for the first time in Germany. The focus lies on feasibility and psychometric characteristics of the scale. Methods Data stem from a representative population survey in Germany (N = 2,013). The 16 items of the original SSDS are used to assess anticipated self-stigma in case of depression. Main component analysis is applied to analyze the factor structure. Results The original version of the SDSS could not be replicated in the German sample. Instead of four, three factors emerged in the German version. They are similar to three subscales of the original SSDS: "social inadequacy", "help-seeking inhibition" and "self-blame". The internal reliability of the total scale as well as of the first two subscales is acceptable. Conclusion SSDS is a multidimensional construct and can serve as an important instrument in research regarding self-stigma of depression in Germany. A further development of the German scale is recommended in order to gain greater insight into the nature of (anticipated) depression self-stigma. © Georg Thieme Verlag KG Stuttgart · New York.

Occurrence and Spread of the Invasive Asian Bush Mosquito Aedes japonicus japonicus (Diptera: Culicidae) in West and North Germany since Detection in 2012 and 2013, Respectively.

PubMed

Kampen, Helge; Kuhlisch, Cornelius; Fröhlich, Andreas; Scheuch, Dorothee E; Walther, Doreen

2016-01-01

The invasive Asian bush mosquito Aedes japonicus japonicus was first recognised as established in Germany in 2008. In addition to the first known and quickly expanding population in the southwestern part of the country, three separate populations were discovered in West, North and southeastern Germany in 2012, 2013 and 2015, respectively, by means of the 'Mueckenatlas', a German instrument of passive mosquito surveillance. Since the first findings of mosquito specimens in West and North Germany, these regions were checked annually for continuing colonisation and spread of the species. Both affected areas were covered by a virtual 10x10km2 grid pattern in the cells of which cemeteries were screened for immature stages of the mosquito. The cells were considered populated as soon as larvae or pupae were detected, whereas they were classified as negative when no mosquito stages were found in the cemeteries of at least three different towns or villages. Presence was also recorded when Ae. j. japonicus adults were submitted to the 'Mueckenatlas' from the respective cell or when there was evidence of local occurrence in localities other than cemeteries. Based on this approach, a significant expansion of the populated area was documented in West Germany since the first detection of Ae. j. japonicus in 2012 (increase in positive grid cells by more than 400%), while the North German population appears not to be expanding so far (reduction of positive grid cells by ca. 30% since 2013). As Ae. j. japonicus finds suitable climatic and ecological conditions in Germany, the differential expansion of the two populations might be attributed to the West German population being older and thus more firmly established than the closely related but younger North German population that might still be in its founder phase. However, geographic spread of all German populations in the future is anticipated. Continuous surveillance is recommended, as Ae. j. japonicus is a competent vector of several pathogens in the laboratory.

A great lack of knowledge regarding umbilical cord blood banking among pregnant women in Berlin, Germany.

PubMed

Palten, Patricia E; Dudenhausen, Joachim W

2010-11-01

we evaluated what German-speaking women in Berlin know about umbilical cord blood banking (UCBB) and whether a correlation exists between women's knowledge about UCBB and level of education. we used the anonymous questionnaire given to German-speaking women in Berlin, Germany. a total of 300 questionnaires could be evaluated. Although three quarters of our population heard of UCBB, most had no further knowledge about the method. Only about one-third of the interviewed women were informed about whether certain diseases had been treated with umbilical cord blood (UCB) by the time the survey was being conducted, whereas 50-65% did not know how to answer these questions. women in Berlin were poorly educated about the usefulness, the costs and the methods of cryopreservation. To some extent there is a correlation between women's level of education and their knowledge regarding UCB.

Long-Term Health-Related Quality of Life in German Patients with Juvenile Idiopathic Arthritis in Comparison to German General Population.

PubMed

Barth, Swaantje; Haas, Johannes-Peter; Schlichtiger, Jenny; Molz, Johannes; Bisdorff, Betty; Michels, Hartmut; Hügle, Boris; Radon, Katja

2016-01-01

Aims of the study were to investigate health-related quality of life (HRQOL) in adult patients with former diagnosis of Juvenile Idiopathic Arthritis (JIA), to compare their HRQOL with the general population and to identify factors related to a poor outcome. In 2012, a cross-sectional survey was performed by mailing a questionnaire to a large cohort of former and current patients of the German Centre for Rheumatology in Children and Adolescents. Only adult patients (≥18 years) with a diagnosis compatible with JIA were included (n = 2592; response 66%). The questionnaire included information about HRQOL (EQ5D), disease-related questions and socio-demographics. Prevalence and 95% confidence intervals (CI) of problems with mobility, self-care, usual activities, pain and anxiety/depression were standardized to the German general population. Factors associated with low HRQOL in JIA patients were identified using logistic regression models. Sixty-two percent of the study population was female; age range was 18-73 years. In all dimensions, JIA patients reported statistically significantly more problems than the general population with largest differences in the pain dimension (JIA patients 56%; 95%CI 55-58%; general population 28%; 26-29%) and the anxiety/depression dimension (28%; 27-29% vs. 4%; 4-5%). Lower HRQOL in JIA patients was associated with female sex, older age, lower level of education, still being under rheumatic treatment and disability. HRQOL in adult JIA patients is considerably lower than in the general population. As this cohort includes historic patients the new therapeutic schemes available today are expected to improve HRQOL in future.

The Fifth German Oral Health Study (Fünfte Deutsche Mundgesundheitsstudie, DMS V) - rationale, design, and methods.

PubMed

Jordan, Rainer A; Bodechtel, Constanze; Hertrampf, Katrin; Hoffmann, Thomas; Kocher, Thomas; Nitschke, Ina; Schiffner, Ulrich; Stark, Helmut; Zimmer, Stefan; Micheelis, Wolfgang

2014-12-29

Oral diseases rank among the most prevalent non-communicable diseases in modern societies. In Germany, oral epidemiological data show that both dental caries and periodontal diseases are highly prevalent, though significant improvements in oral health has been taking in the population within the last decades, particularly in children. It is, therefore, the aim of the Fifth German Oral Health Study (DMS V) to actualize the data on current oral health status and to gather information on oral health behavior and risk factors. In addition to current oral health monitoring, the study will also permit conclusions about trends in the development of oral health in Germany between 1989 and 2014. DMS V is a cross-sectional, multi-center, nationwide representative, socio-epidemiological study to investigate the oral health status und behavior of the German resident population in four age cohorts. Study participants are children (12-year-olds), adults (35- to 44-year-olds), young olds (65- to 74-year-olds), and old olds (75- to 100-year-olds) who are drawn from local residents' registration offices. Social-science investigation parameters concern subjective perceptions and attitudes regarding oral health and nutrition, sense of coherence, and socio-demographic data. Clinical oral parameters are tooth loss, caries and periodontitis, prosthodontic status, further developmental and acquired dental hard tissue and mucosal lesions. To ensure reproducibility, the dental investigators are trained and calibrated by experts and multiple reliability checks are performed throughout the field phase. Statistical analyses are calculated according to a detailed statistical analysis plan. The DMS studies first performed in 1989, 1992 and repeated in 1997 and 2005 are the only cross-sectional oral health studies conducted in Germany on a population-based national representative level. Updated prevalence and trend analyses of key oral diseases are, therefore, of major epidemiological and health services research interest. German Health Services Research Data Bank VfD_DMSV_13_002152.

Language-related differential item functioning between English and German PROMIS Depression items is negligible.

PubMed

Fischer, H Felix; Wahl, Inka; Nolte, Sandra; Liegl, Gregor; Brähler, Elmar; Löwe, Bernd; Rose, Matthias

2017-12-01

To investigate differential item functioning (DIF) of PROMIS Depression items between US and German samples we compared data from the US PROMIS calibration sample (n = 780), a German general population survey (n = 2,500) and a German clinical sample (n = 621). DIF was assessed in an ordinal logistic regression framework, with 0.02 as criterion for R 2 -change and 0.096 for Raju's non-compensatory DIF. Item parameters were initially fixed to the PROMIS Depression metric; we used plausible values to account for uncertainty in depression estimates. Only four items showed DIF. Accounting for DIF led to negligible effects for the full item bank as well as a post hoc simulated computer-adaptive test (< 0.1 point on the PROMIS metric [mean = 50, standard deviation =10]), while the effect on the short forms was small (< 1 point). The mean depression severity (43.6) in the German general population sample was considerably lower compared to the US reference value of 50. Overall, we found little evidence for language DIF between US and German samples, which could be addressed by either replacing the DIF items by items not showing DIF or by scoring the short form in German samples with the corrected item parameters reported. Copyright © 2016 John Wiley & Sons, Ltd.

Reconstruction of two colonisation pathways of Mantis religiosa (Mantodea) in Germany using four mitochondrial markers.

PubMed

Linn, Catherine Anne; Griebeler, Eva Maria

2015-02-01

Past and recent climatic changes induced shifts in species ranges. Mantis religiosa has also expanded its range across Germany within the past decades. To determine the ancestry of German M. religiosa we sequenced four mitochondrial genes (COI, COII, Cyt b, ND4) of European M. religiosa populations. We found an east, central and west European lineage of M. religiosa. These distinct lineages are consistent with genetic isolation by distance during glacial periods, and the re-colonization of northern parts of Europe by species from different refugia. Within Germany, we found haplotypes clustering to the central and west European lineage suggesting that M. religiosa immigrated from two directions into Germany. Mismatch distributions, and negative Tajima's D and Fu's Fs values indicate a current range expansion of the central and west European lineage. We hypothesise that ongoing global warming which increases the availability of thermally favourable areas in Germany for M. religiosa adds to its current range expansion. In conclusion, M. religiosa colonized Germany via two directions: west German populations descended from French populations and east German populations from Czech populations.

Lead exposure from food: the German LExUKon project.

PubMed

Schneider, Klaus; Schwarz, Markus A; Lindtner, Oliver; Blume, Katrin; Heinemeyer, Gerhard

2014-01-01

Lead is a highly toxic contaminant with food being the major source of exposure for the general public. The second German food consumption survey (Nationale Verzehrsstudie II - NVS II) with about 20 000 participants (15 371 for dietary history interviews used for this study) allowed for an updated exposure assessment for the German population. Based on these comprehensive data, information on consumption of 545 individual food items by the German population was generated. Lead concentrations in food were compiled from the German food monitoring programme, European countries' authority programmes and the published literature, covering the years from 2000 to 2009, and were multiplied with consumption data to obtain estimates of lead intake from food. Average lead concentrations per main food group were highest for meat (including offal), followed by fish (including seafood), vegetables and cereals. Due to high consumption, beverages contributed most to the intake of the general public, followed by main groups vegetables, fruits & nuts and cereals. Lead intake from food was estimated to be 0.53 and 0.72 µg kg(-1) bw and day for average and high-end consumers, respectively. This is close to (average consumers) respectively above (high-end consumers) a reference value derived from a recent health risk evaluation performed by EFSA, using the benchmark approach. Uncertainties in these estimates pertain to the influence of values below the limit of quantification and some foods not considered due to lacking occurrence data. In conclusion, the estimated lead intake of the German population from food is still close to health-based reference values. Further efforts to reduce lead intake are required.

Alexithymia in the German general population.

PubMed

Franz, Matthias; Popp, Kerstin; Schaefer, Ralf; Sitte, Wolfgang; Schneider, Christine; Hardt, Jochen; Decker, Oliver; Braehler, Elmar

2008-01-01

The Toronto-Alexithymia-Scale (TAS-20) is used worldwide as a valid measurement of alexithymia. Until now, population-based standardization and cut-off values of the German TAS-20 version have not been available. This study provides these by means of a representative German sample and by investigating the factorial structure of the TAS-20. Data were generated from a representative random sample of the German general population (1,859 subjects aged between 20 and 69). The TAS-20 sum score was normally distributed. The mean value was 49.5 (SD=9.3) in men and 48.2 (SD=9.2) in women. Divorce, single and low social status were associated with enhanced sum scores. Ten percent of the population exceeded the TAS-20 sum score threshold of >or=61. The 66th percentile reached 53 for men and 52 for women. Factor analysis identified three factors that match the scales of the English original version. An additional fourth factor ("importance of emotional introspection") was extracted. Total explanation of variance by these four factors was 52.27%. The sum score of the German TAS-20 version is suited for the standardized measure of alexithymia. For selecting alexithymic individuals in experimental studies, the cut-off >or=61 is possibly too restrictive. Therefore, we propose the 66th percentile for the identification of high alexithymics. The TAS-20 sum score is associated with important socio-demographic variables. The factorial structure is reliable; the fourth factor ("importance of emotional introspection") provides differentiation of content and allows for enhanced explanation of variance.

Working conditions and Work-Family Conflict in German hospital physicians: psychosocial and organisational predictors and consequences.

PubMed

Fuss, Isabelle; Nübling, Matthias; Hasselhorn, Hans-Martin; Schwappach, David; Rieger, Monika A

2008-10-07

Germany currently experiences a situation of major physician attrition. The incompatibility between work and family has been discussed as one of the major reasons for the increasing departure of German physicians for non-clinical occupations or abroad. This study investigates predictors for one particular direction of Work-Family Conflict--namely work interfering with family conflict (WIF)--which are located within the psychosocial work environment or work organisation of hospital physicians. Furthermore, effects of WIF on the individual physicians' physical and mental health were examined. Analyses were performed with an emphasis on gender differences. Comparisons with the general German population were made. Data were collected by questionnaires as part of a study on Psychosocial work hazards and strains of German hospital physicians during April-July 2005. Two hundred and ninety-six hospital physicians (response rate 38.9%) participated in the survey. The Copenhagen Psychosocial Questionnaire (COPSOQ), work interfering with family conflict scale (WIF), and hospital-specific single items on work organisation were used to assess WIF, its predictors, and consequences. German hospital physicians reported elevated levels of WIF (mean = 74) compared to the general German population (mean = 45, p < .01). No significant gender difference was found. Predictors for the WIF were lower age, high quantitative demands at work, elevated number of days at work despite own illness, and consequences of short-notice changes in the duty roster. Good sense of community at work was a protective factor. Compared to the general German population, we observed a significant higher level of quantitative work demands among hospital physicians (mean = 73 vs. mean = 57, p < .01). High values of WIF were significantly correlated to higher rates of personal burnout, behavioural and cognitive stress symptoms, and the intention to leave the job. In contrast, low levels of WIF predicted higher job satisfaction, better self-judged general health status, better work ability, and higher satisfaction with life in general. Compared to the German general population, physicians showed significantly higher levels of individual stress and quality of life as well as lower levels for well-being. This has to be judged as an alerting finding regarding the state of physicians' health. In our study, work interfering with family conflict (WIF) as part of Work-Family Conflict (WFC) was highly prevalent among German hospital physicians. Factors of work organisation as well as factors of interpersonal relations at work were identified as significant predictors for WIF. Some of these predictors are accessible to alteration by improving work organisation in hospitals.

Analysis of forensically used autosomal short tandem repeat markers in Polish and neighboring populations.

PubMed

Soltyszewski, Ireneusz; Plocienniczak, Andrzej; Fabricius, Hans Ake; Kornienko, Igor; Vodolazhsky, Dmitrij; Parson, Walther; Hradil, Roman; Schmitter, Hermann; Ivanov, Pavel; Kuzniar, Piotr; Malyarchuk, Boris A; Grzybowski, Tomasz; Woźniak, Marcin; Henke, Jurgen; Henke, Lotte; Olkhovets, Sergiv; Voitenko, Vladimir; Lagus, Vita; Ficek, Andrej; Minárik, Gabriel; de Knijff, Peter; Rebała, Krzysztof; Wysocka, Joanna; Kapińska, Ewa; Cybulska, Lidia; Mikulich, Alexei I; Tsybovsky, Iosif S; Szczerkowska, Zofia; Krajewski, Paweł; Ploski, Rafał

2008-06-01

The purpose of this study was to evaluate the homogeneity of Polish populations with respect to STRs chosen as core markers of the Polish Forensic National DNA Intelligence Database, and to provide reference allele frequencies and to explore the genetic interrelationship between Poland and neighboring countries. The allele frequency distribution of 10 STRs included in the SGMplus kit was analyzed among 2176 unrelated individuals from 6 regional Polish populations and among 4321 individuals from Germany (three samples), Austria, The Netherlands, Sweden, Czech Republic, Slovakia, Belarus, Ukraine and the Russian Federation (six samples). The statistical approach consisted of AMOVA, calculation of pairwise Rst values and analysis by multidimensional scaling. We found homogeneity of present day Poland and consistent differences between Polish and German populations which contrasted with relative similarities between Russian and German populations. These discrepancies between genetic and geographic distances were confirmed by analysis of an independent data set on Y chromosome STRs. Migrations of Goths, Viking influences, German settlements in the region of Volga river and/or forced population resettlements and other events related to World War II are the historic events which might have caused these finding.

Zoonoses research in the German National Cohort : feasibility of parallel sampling of pets and owners.

PubMed

Hille, Katja; Möbius, Nadine; Akmatov, Manas K; Verspohl, Jutta; Rabold, Denise; Hartmann, Maria; Günther, Kathrin; Obi, Nadia; Kreienbrock, Lothar

2014-11-01

Cats and dogs live in more than 20 % of German households and the contact between these pets and their owners can be very close. Therefore, a transmission of zoonotic pathogens may occur. To investigate whether zoonotic research questions can be examined in the context of population-based studies like the German National Cohort (GNC), two studies on different study populations were conducted as part of the feasibility tests of the GNC. The aim of the first study was to quantify the actual exposure of participants of the GNC to cats and dogs. In the second study summarised here the feasibility of the sampling of cats and dogs by their owners was tested. To quantify the exposure of participants of the GNC to cats and dogs 744 study participants of the Pretests of the GNC were asked whether they had contact with animals. Currently 10 % have a dog and 14 % have a cat in their household. These figures confirm that a large proportion of the German population has contact with pets and that there is a need for further zoonoses research. To establish the collection of biological samples from cats and dogs in the context of large-scale population-based studies feasible methods are needed. Therefore, a study was conducted to test whether pet owners can take samples from their cats and dogs and whether the quality of these samples is comparable to samples taken by a qualified veterinarian. A total of 82 dog and 18 cat owners were recruited in two veterinary practices in Hannover and the Clinic for Small Animals at the University of Veterinary Medicine in Hannover. Sampling instructions and sample material for nasal and buccal swabs, faecal samples and, in the case of cat owners, a brush for fur samples, were given to the pet owners. The pet owners were asked to take the samples from their pets at home and to send the samples by surface mail. Swab samples were cultured and bacterial growth was quantified independent of bacterial species. The growth of Gram-positive and Gram-negative bacteria from samples taken by the veterinarian and the pet owners were compared. For Gram-positive bacteria the agreement of laboratory results was 71 % for nasal swabs and 78 % for oral swabs while for Gram-negative bacteria the agreement of laboratory results was 55 % for nasal swabs and 87 % for oral swabs. In conclusion it has been shown that participants of the GNC are exposed to cats and dogs and that the sampling of cats and dogs by their owners is a feasible method which can be a useful tool for zoonoses research in population-based studies.

The German version of the Camberwell Assessment of Need for the Elderly (CANE): evaluation of content validity and adaptation to the German-speaking context.

PubMed

Stein, Janine; Luppa, Melanie; König, Hans-Helmut; Riedel-Heller, Steffi G

2015-11-01

The Camberwell Assessment of Need for the Elderly (CANE) was developed for the assessment of physical-, psychological-, and environment-related needs in the elderly. The aim of this study was to revise and adapt the German version of the CANE with regard to the content validity of the instrument. Following a multistage approach, face-to-face interviews using the CANE, an expert survey and a multidisciplinary consensus conference were conducted in order to evaluate the frequency and relevance of met and unmet needs in the German elderly population, and to modify the content of the CANE for the German-speaking countries. In Germany, unmet physical needs including physical health, medication, eyesight/hearing/communication, mobility/falls, self-care, and continence were found to have top priority closely followed by social needs (company, intimate relationships, daytime activities, information, and abuse/neglect). Psychological needs were the lowest ranked care category. Experts' proposals for the improvement of the German version of the CANE were collected. All findings were discussed and integrated in the multidisciplinary consensus conference with the result of a revised and adapted CANE that is applicable in the German-speaking context. The provision of an adapted and improved German version of the CANE may substantially contribute to a comprehensive and valid assessment of needs in the elderly population. The results of this study represent an important basis for comprehensive needs assessment in the elderly in the theoretical and practical field of healthcare and health services research.

Health-Related Quality of Life of the General German Population in 2015: Results from the EQ-5D-5L.

PubMed

Huber, Manuel B; Felix, Julia; Vogelmann, Martin; Leidl, Reiner

2017-04-16

The EQ-5D-5L is a widely used generic instrument to measure health-related quality of life. This study evaluates health perception in a representative sample of the general German population from 2015. To compare results over time, a component analysis technique was used that separates changes in the description and valuation of health states. The whole sample and also subgroups, stratified by sociodemographic parameters as well as disease affliction, were analyzed. In total, 2040 questionnaires (48.4% male, mean age 47.3 year) were included. The dimension with the lowest number of reported problems was self-care (93.0% without problems), and the dimension with the highest proportion of impairment was pain/discomfort (71.2% without problems). Some 64.3% of the study population were identified as problem-free. The visual analog scale (VAS) mean for all participants was 85.1. Low education was connected with significantly lower VAS scores, but the effect was small. Depression, heart disease, and diabetes had a strong significant negative effect on reported VAS means. Results were slightly better than those in a similar 2012 survey; the most important driver was the increase in the share of the study population that reported to be problem-free. In international comparisons, health perception of the general German population is relatively high and, compared with previous German studies, fairly stable over recent years. Elderly and sick people continue to report significant reductions in perceived health states.

Gaussian Graphical Models Identify Networks of Dietary Intake in a German Adult Population.

PubMed

Iqbal, Khalid; Buijsse, Brian; Wirth, Janine; Schulze, Matthias B; Floegel, Anna; Boeing, Heiner

2016-03-01

Data-reduction methods such as principal component analysis are often used to derive dietary patterns. However, such methods do not assess how foods are consumed in relation to each other. Gaussian graphical models (GGMs) are a set of novel methods that can address this issue. We sought to apply GGMs to derive sex-specific dietary intake networks representing consumption patterns in a German adult population. Dietary intake data from 10,780 men and 16,340 women of the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort were cross-sectionally analyzed to construct dietary intake networks. Food intake for each participant was estimated using a 148-item food-frequency questionnaire that captured the intake of 49 food groups. GGMs were applied to log-transformed intakes (grams per day) of 49 food groups to construct sex-specific food networks. Semiparametric Gaussian copula graphical models (SGCGMs) were used to confirm GGM results. In men, GGMs identified 1 major dietary network that consisted of intakes of red meat, processed meat, cooked vegetables, sauces, potatoes, cabbage, poultry, legumes, mushrooms, soup, and whole-grain and refined breads. For women, a similar network was identified with the addition of fried potatoes. Other identified networks consisted of dairy products and sweet food groups. SGCGMs yielded results comparable to those of GGMs. GGMs are a powerful exploratory method that can be used to construct dietary networks representing dietary intake patterns that reveal how foods are consumed in relation to each other. GGMs indicated an apparent major role of red meat intake in a consumption pattern in the studied population. In the future, identified networks might be transformed into pattern scores for investigating their associations with health outcomes. © 2016 American Society for Nutrition.

Heterogeneity among violence-exposed women: applying person-oriented research methods.

PubMed

Nurius, Paula S; Macy, Rebecca J

2008-03-01

Variability of experience and outcomes among violence-exposed people pose considerable challenges toward developing effective prevention and treatment protocols. To address these needs, the authors present an approach to research and a class of methodologies referred to as person oriented. Person-oriented tools support assessment of meaningful patterns among people that distinguish one group from another, subgroups for whom different interventions are indicated. The authors review the conceptual base of person-oriented methods, outline their distinction from more familiar variable-oriented methods, present descriptions of selected methods as well as empirical applications of person-oriented methods germane to violence exposure, and conclude with discussion of implications for future research and translation between research and practice. The authors focus on violence against women as a population, drawing on stress and coping theory as a theoretical framework. However, person-oriented methods hold utility for investigating diversity among violence-exposed people's experiences and needs across populations and theoretical foundations.

The Use of Double Translocation Heterozygotes To Control Populations of the German Cockroach and the Use of Genetic Mechanisms and Behavioral Characteristics To Control Natural Populations of the German Cockroach.

DTIC Science & Technology

1986-05-30

insecticide resistance, pheromones 3 A 817 R4A(1 (,CctinL’e on reverse if nece’ssary and idenity by block number) !’,--arch supported by this Contract .as...reproductive state. The results left 1 !7e doubt that females play a leading role in regulating population behavior. Subsequent research on pheromones showed...aggregation pheromone and a less well known dispersal pheromone revealed differences in response with age/sex class Ta the aggregation experiments

A comparison of rural high school students in Germany with rural Tennessee high school students' mathematics and science achievement

NASA Astrophysics Data System (ADS)

Harding, R. Fredrick

This descriptive study compared the science and mathematics aptitudes and achievement test scores for the final school year students in rural White County and Van Buren County, Tennessee with rural county students in Germany. In accordance with the previous research literature (Stevenson, 2002), German students outperformed U.S. students on The International Trends in Math and Science test (TIMSS). As reform in the U.S. education system has been underway, this study intended to compare German county student final school year performance with White County and Van Buren County (Grade 12) performance in science and mathematics. The entire populations of 176 White and Van Buren Counties senior high final school year students were compared with 120 school final year students from two rural German county high schools. The student responses to identical test and questionnaire items were compared using the t-test statistical analysis. In conclusion after t-test analyses, there was no significant difference (p>.05 level) in student attitudes on the 27 problem achievement and the 35 TIMSS questionnaire items between the sampled population of 120 German students compared with the population of 176 White and Van Buren students. Also, there was no statistically significant difference (p>.05 level) between the German, White, and Van Buren County rural science and math achievement in the TIMSS problem section of the final year test. Based on the research, recommendations to improve U.S. student scores to number one in the world include making changes in teaching methodology in mathematics and science; incorporating pamphlet lessons rather than heavily reliance on textbooks; focusing on problem solving; establishing an online clearinghouse for effective lessons; creating national standards in mathematics and science; matching students' course choices to job aspirations; tracking misbehaving students rather than mainstreaming them into the regular classroom; and designing individual educational plans for every student. Further study and future investigations are recommended from this study to compare White County and Van Buren County Students with other rural county schools in Tennessee, as well as other states. In addition, the Tennessee students' state mandated science and mathematics could be correlated to the TIMMS to identify trends and relationships. Future comparisons of White County and Van Buren County with higher scoring rural Asian students could be done in search of more effective methods of teaching science and mathematics.

German Value Set for the EQ-5D-5L.

PubMed

Ludwig, Kristina; Graf von der Schulenburg, J-Matthias; Greiner, Wolfgang

2018-06-01

The objective of this study was to develop a value set for EQ-5D-5L based on the societal preferences of the German population. As the first country to do so, the study design used the improved EQ-5D-5L valuation protocol 2.0 developed by the EuroQol Group, including a feedback module as internal validation and a quality control process that was missing in the first wave of EQ-5D-5L valuation studies. A representative sample of the general German population (n = 1158) was interviewed using a composite time trade-off and a discrete choice experiment under close quality control. Econometric modeling was used to estimate values for all 3125 possible health states described by EQ-5D-5L. The value set was based on a hybrid model including all available information from the composite time trade-off and discrete choice experiment valuations without any exclusions due to data issues. The final German value set was constructed from a combination of a conditional logit model for the discrete choice experiment data and a censored at -1 Tobit model for the composite time trade-off data, correcting for heteroskedasticity. The value set had logically consistent parameter estimates (p < 0.001 for all coefficients). The predicted EQ-5D-5L index values ranged from -0.661 to 1. This study provided values for the health states of the German version of EQ-5D-5L representing the preferences of the German population. The study successfully employed for the first time worldwide the improved protocol 2.0. The value set enables the use of the EQ-5D-5L instrument in economic evaluations and in clinical studies.

Hierarchical Genetic Analysis of German Cockroach (Blattella germanica) Populations from within Buildings to across Continents

PubMed Central

Vargo, Edward L.; Crissman, Jonathan R.; Booth, Warren; Santangelo, Richard G.; Mukha, Dmitry V.; Schal, Coby

2014-01-01

Understanding the population structure of species that disperse primarily by human transport is essential to predicting and controlling human-mediated spread of invasive species. The German cockroach (Blattella germanica) is a widespread urban invader that can actively disperse within buildings but is spread solely by human-mediated dispersal over longer distances; however, its population structure is poorly understood. Using microsatellite markers we investigated population structure at several spatial scales, from populations within single apartment buildings to populations from several cities across the U.S. and Eurasia. Both traditional measures of genetic differentiation and Bayesian clustering methods revealed increasing levels of genetic differentiation at greater geographic scales. Our results are consistent with active dispersal of cockroaches largely limited to movement within a building. Their low levels of genetic differentiation, yet limited active spread between buildings, suggests a greater likelihood of human-mediated dispersal at more local scales (within a city) than at larger spatial scales (within and between continents). About half the populations from across the U.S. clustered together with other U.S. populations, and isolation by distance was evident across the U.S. Levels of genetic differentiation among Eurasian cities were greater than those in the U.S. and greater than those between the U.S. and Eurasia, but no clear pattern of structure at the continent level was detected. MtDNA sequence variation was low and failed to reveal any geographical structure. The weak genetic structure detected here is likely due to a combination of historical admixture among populations and periodic population bottlenecks and founder events, but more extensive studies are needed to determine whether signatures of global movement may be present in this species. PMID:25020136

Working conditions and effort-reward imbalance of German physicians in Sweden respective Germany: a comparative study.

PubMed

Ohlander, Johan; Weigl, Matthias; Petru, Raluca; Angerer, Peter; Radon, Katja

2015-05-01

Work stress among physicians is a growing concern in various countries and has led to migration. We compared the working conditions and the work stress between a migrated population of German physicians in Sweden and a population of physicians based in Germany. Additionally, specific risk factors for work stress were examined country wise. Using a cross-sectional design, 85 German physicians employed in Sweden were surveyed on working conditions and effort-reward imbalance and compared with corresponding data on 561 physicians working in Germany. Multiple linear regression analyses were applied on both populations separately to model the associations between working conditions and effort-reward ratio (ERR), adjusted for a priori confounders. German physicians in Sweden had a significantly lower ERR than physicians in Germany: mean (M) = 0.47, standard deviation (SD) = 0.24 vs. M = 0.80, SD = 0.35. Physicians in Sweden worked on average 8 h less per week and reported higher work support and responsibility. Multivariate analyses showed in both populations a negative association between work support and the ERR (β = -0.148, 95% CI -0.215 to (-0.081) for physicians in Sweden and β = -0.174, 95% CI -0.240 to (-0.106) for physicians in Germany). Further significant associations with the ERR were found among physicians in Sweden for daily breaks (β = -0.002, 95% CI -0.004 to (-0.001)) and among physicians in Germany for working hours per week (β = 0.006, 95% CI 0.002-0.009). Our findings show substantial differences in work stress and working conditions in favor of migrated German physicians in Sweden. To confirm our results and to explain demonstrated differences in physicians' work stress, longitudinal studies are recommended.

Cross-cultural measurement invariance of the General Health Questionnaire-12 in a German and a Colombian population sample.

PubMed

Romppel, Matthias; Hinz, Andreas; Finck, Carolyn; Young, Jeremy; Brähler, Elmar; Glaesmer, Heide

2017-12-01

While the General Health Questionnaire, 12-item version (GHQ-12) has been widely used in cross-cultural comparisons, rigorous tests of the measurement equivalence of different language versions are still lacking. Thus, our study aims at investigating configural, metric and scalar invariance across the German and the Spanish version of the GHQ-12 in two population samples. The GHQ-12 was applied in two large-scale population-based samples in Germany (N = 1,977) and Colombia (N = 1,500). To investigate measurement equivalence, confirmatory factor analyses were conducted in both samples. In the German sample mean GHQ-12 total scores were higher than in the Colombian sample. A one-factor model including response bias on the negatively worded items showed superior fit in the German and the Colombian sample; thus both versions of the GHQ-12 showed configural invariance. Factor loadings and intercepts were not equal across both samples; thus GHQ-12 showed no metric and scalar invariance. As both versions of the GHQ-12 did not show measurement equivalence, it is not recommendable to compare both measures and to conclude that mental distress is higher in the German sample, although we do not know if the differences are attributable to measurement problems or represent a real difference in mental distress. The study underlines the importance of measurement equivalence in cross-cultural comparisons. Copyright © 2017 John Wiley & Sons, Ltd.

Genetic structure in contemporary south Tyrolean isolated populations revealed by analysis of Y-chromosome, mtDNA, and Alu polymorphisms.

PubMed

Pichler, Irene; Mueller, Jakob C; Stefanov, Stefan A; De Grandi, Alessandro; Volpato, Claudia Beu; Pinggera, Gerd K; Mayr, Agnes; Ogriseg, Martin; Ploner, Franz; Meitinger, Thomas; Pramstaller, Peter P

2006-08-01

Most of the inhabitants of South Tyrol in the eastern Italian Alps can be considered isolated populations because of their physical separation by mountain barriers and their sociocultural heritage. We analyzed the genetic structure of South Tyrolean populations using three types of genetic markers: Y-chromosome, mitochondrial DNA (mtDNA), and autosomal Alu markers. Using random samples taken from the populations of Val Venosta, Val Pusteria, Val Isarco, Val Badia, and Val Gardena, we calculated genetic diversity within and among the populations. Microsatellite diversity and unique event polymorphism diversity (on the Y chromosome) were substantially lower in the Ladin-speaking population of Val Badia compared to the neighboring German-speaking populations. In contrast, the genetic diversity of mtDNA haplotypes was lowest for the upper Val Venosta and Val Pusteria. These data suggest a low effective population size, or little admixture, for the gene pool of the Ladin-speaking population from Val Badia. Interestingly, this is more pronounced for Ladin males than for Ladin females. For the pattern of genetic Alu variation, both Ladin samples (Val Gardena and Val Badia) are among the samples with the lowest diversity. An admixture analysis of one German-speaking valley (Val Venosta) indicates a relatively high genetic contribution of Ladin origin. The reduced genetic diversity and a high genetic differentiation in the Rhaetoroman- and German-speaking South Tyrolean populations may constitute an important basis for future medical genetic research and gene mapping studies in South Tyrol.

Eating pathology in medical students in Eastern Germany: comparison with general population and a sample at the time of the German reunification.

PubMed

Weigel, Angelika; Hofmeister, Dirk; Pröbster, Kristin; Brähler, Elmar; Gumz, Antje

2016-09-01

Medical students have been found to be vulnerable to mental health problems due to the high pressures of medical school. Countries developing into industrial nations tend to adopt Western beauty ideals which might increase eating disorder risk. This cross-sectional study compared eating (Eating Disorder Inventory 2 EDI-2) and general psychopathology (General Health Questionnaire-28) in medical students from the newly formed German states with a historical sample of East German medical students examined at the time of the German reunification. Current medical students were also compared to population-based samples assessed before the German Reunification as well as recently to consider time trends in EDI scores. The current sample comprised 316 medical students (232 female) from the newly formed German states (mean age = 21.7 years, SD = 2.6). Significantly higher levels of drive for thinness as well as body dissatisfaction and higher levels of general psychopathology were displayed in female medical students 20 years after the German reunification. In male medical students, no significant changes of eating pathology were observable. However, male medical students expressed significantly more anxiety and insomnia and a higher GHQ-28 total score than their counterparts examined in 1989. Twenty years after the Reunification, an acculturation to Western beauty ideals seems to be more pronounced in female than in male medical students. Still, as a group, medical students from the newly formed German states did not appear to display a particular risk to develop eating disorders. However, due to the low response rate, results of this study should be interpreted cautiously.

Validation and reliability of the VF-14 questionnaire in a German population.

PubMed

Chiang, Peggy Pei-Chia; Fenwick, Eva; Marella, Manjula; Finger, Robert; Lamoureux, Ecosse

2011-11-21

To evaluate the validity, reliability, and measurement characteristics of the Visual Function 14 (VF-14) in a German sample using Rasch analysis. This was a clinic-based, cross-sectional study with 184 patients with low vision recruited from an outpatient clinic at a German eye hospital. Participants underwent a clinical examination and completed the German VF-14 scale. The validity of the VF-14 scale was assessed using Rasch analysis. The main outcome measure was the overall functional score provided by the VF-14. After collapsing two response categories for items 13 and 14, the VF-14 scale satisfied fundamental criteria to achieve fit to the Rasch model, namely, ordered thresholds, the ability to distinguish between different strata of participant ability, absence of misfitting items, no evidence of unidimensionality, and no significant differential item functioning for key sociodemographic covariates. The VF-14 is able to discriminate between participants with different levels of vision impairment and across different cultural groups. The VF-14 is a valid, reliable, and unidimensional questionnaire for use in a German population. These findings contribute to the growing evidence base for second generation patient reported outcome measures in ophthalmology, and support the use of the German VF-14 in tertiary eye clinics in Germany to capture the impact of visual impairment on visual function from the patient's perspective and to inform low vision rehabilitation and interventions.

Workplace stress, lifestyle and social factors as correlates of back pain: a representative study of the German working population.

PubMed

Schneider, Sven; Schmitt, Holger; Zoller, Silke; Schiltenwolf, Marcus

2005-05-01

To investigate the prevalence of back pain in the German working population and the relationship between back pain and workplace stresses, lifestyle and social factors. The first National Health Survey of the Federal Republic of Germany was carried out between October 1997 and March 1999. It comprised a representative epidemiological cross-sectional study of the working population, with a total sample of 3,488 persons between the ages of 18 and 69 years. The participants took part in a medical examination and answered a self-rating questionnaire. The relationship between subjective back pain and workplace stresses and social and lifestyle factors was investigated with bivariate tests and multiple logistical regression analyses. The 7-day prevalence for back pain in the German working population was found to be 34%, and the 1-year prevalence was 60%. The odds ratios were significantly higher in women, persons of lower socioeconomic status, married and depressed persons and non-athletes. Carrying heavy loads or maintaining a single working posture were the most significant work-related correlates of back pain, for members of both the female and male working population, while environmental stress and psychological stress correlated significantly with back pain in men only. This study reports the first representative epidemiological prevalence data for back pain, and its correlates and potential risk factors, for the German working population. To reduce the negative impact of back pain the most promising behavioural and conditional prevention measures in the workplace would be to reduce carrying stress and to vary working posture. In addition, a more active, athletic lifestyle, plus the avoidance of being overweight, should provide an additional protective or preventive effect.

Official statistics and claims data records indicate non-response and recall bias within survey-based estimates of health care utilization in the older population

PubMed Central

2013-01-01

Background The validity of survey-based health care utilization estimates in the older population has been poorly researched. Owing to data protection legislation and a great number of different health care insurance providers, the assessment of recall and non-response bias is challenging to impossible in many countries. The objective of our study was to compare estimates from a population-based study in older German adults with external secondary data. Methods We used data from the German KORA-Age study, which included 4,127 people aged 65–94 years. Self-report questions covered the utilization of long-term care services, inpatient services, outpatient services, and pharmaceuticals. We calculated age- and sex-standardized mean utilization rates in each domain and compared them with the corresponding estimates derived from official statistics and independent statutory health insurance data. Results The KORA-Age study underestimated the use of long-term care services (−52%), in-hospital days (−21%) and physician visits (−70%). In contrast, the assessment of drug consumption by postal self-report questionnaires yielded similar estimates to the analysis of insurance claims data (−9%). Conclusion Survey estimates based on self-report tend to underestimate true health care utilization in the older population. Direct validation studies are needed to disentangle the impact of recall and non-response bias. PMID:23286781

Inter-rater reliability of the German version of the Nurses' Global Assessment of Suicide Risk scale.

PubMed

Kozel, Bernd; Grieser, Manuela; Abderhalden, Christoph; Cutcliffe, John R

2016-10-01

In comparison to the general population, the suicide rates of psychiatric inpatient populations in Germany and Switzerland are very high. An important preventive contribution to the lowering of the suicide rates in mental health care is to ensure that the risk of suicide of psychiatric inpatients is assessed as accurately as possible. While risk-assessment instruments can serve an important function in determining such risk, very few have been translated to German. Therefore, in the present study, we reported on the German version of Nurses' Global Assessment of Suicide Risk (NGASR) scale. After translating the original instrument into German and pretesting the German version, we tested the inter-rater reliability of the instrument. Twelve video case studies were evaluated by 13 raters with the NGASR scale in a 'laboratory' trial. In each case, the observer's agreement was calculated for the single items, the overall scale, the risk levels, and the sum scores. The statistical data analysis was conducted with kappa and AC1 statistics for dichotomous (items, scale) scales. A high-to-very high observers' agreement (AC1: 0.62-1.00, kappa: 0.00-1.00) was determined for 16 items of the German version of the NGASR scale. We conclude that the German version of the NGASR scale is a reliable instrument for evaluating risk factors for suicide. A reliable application in the clinical practise appears to be enhanced by training in the use of the instrument and the right implementation instructions. © 2016 Australian College of Mental Health Nurses Inc.

German EstSmoke: estimating adult smoking-related costs and consequences of smoking cessation for Germany.

PubMed

Sonntag, Diana; Gilbody, Simon; Winkler, Volker; Ali, Shehzad

2018-01-01

We compared predicted life-time health-care costs for current, never and ex-smokers in Germany under the current set of tobacco control polices. We compared these economic consequences of the current situation with an alternative in which Germany were to implement more comprehensive tobacco control policies consistent with the World Health Organization (WHO) Framework Convention for Tobacco Control (FCTC) guidelines. German EstSmoke, an adapted version of the UK EstSmoke simulation model, applies the Markov modelling approach. Transition probabilities for (re-)currence of smoking-related diseases were calculated from large German disease-specific registries and the German Health Update (GEDA 2010). Estimations of both health-care costs and effect sizes of smoking cessation policies were taken from recent German studies and discounted at 3.5%/year. Germany. German population of prevalent current, never and ex-smokers in 2009. Life-time cost and outcomes in current, never and ex-smokers. If tobacco control policies are not strengthened, the German smoking population will incur €41.56 billion life-time excess costs compared with never smokers. Implementing tobacco control policies consistent with WHO FCTC guidelines would reduce the difference of life-time costs between current smokers and ex-smokers by at least €1.7 billion. Modelling suggests that the life-time healthcare costs of people in Germany who smoke are substantially greater than those of people who have never smoked. However, more comprehensive tobacco control policies could reduce health-care expenditures for current smokers by at least 4%. © 2017 Society for the Study of Addiction.

Olfaction and Environment: Tsimane’ of Bolivian Rainforest Have Lower Threshold of Odor Detection Than Industrialized German People

PubMed Central

Sorokowska, Agnieszka; Sorokowski, Piotr; Hummel, Thomas; Huanca, Tomas

2013-01-01

Olfactory sensitivity varies between individuals. However, data regarding cross-cultural and inter-group differences are scarce. We compared the thresholds of odor detection of the traditional society of Tsimane’ (native Amazonians of the Bolivian rainforest; n = 151) and people living in Dresden (Germany; n = 286) using “Sniffin’ Sticks” threshold subtest. Tsimane’ detected n-butanol at significantly lower concentrations than the German subjects. The distribution of thresholds of the Tsimane’ was very specific, with 25% of Tsimane’ obtaining better results in the olfactory test than any member of the German group. These data suggest that differences in olfactory sensitivity seem to be especially salient between industrialized and non-industrialized populations inhabiting different environmental conditions. We hypothesize that the possible sources of such differences are: (i) the impact of pollution which impairs the olfactory abilities of people from industrialized countries; (ii) better training of olfaction because of the higher importance of smell in traditional populations; (iii) environmental pressures shaping olfactory abilities in these populations. PMID:23922693

Olfaction and environment: Tsimane' of Bolivian rainforest have lower threshold of odor detection than industrialized German people.

PubMed

Sorokowska, Agnieszka; Sorokowski, Piotr; Hummel, Thomas; Huanca, Tomas

2013-01-01

Olfactory sensitivity varies between individuals. However, data regarding cross-cultural and inter-group differences are scarce. We compared the thresholds of odor detection of the traditional society of Tsimane' (native Amazonians of the Bolivian rainforest; n = 151) and people living in Dresden (Germany; n = 286) using "Sniffin' Sticks" threshold subtest. Tsimane' detected n-butanol at significantly lower concentrations than the German subjects. The distribution of thresholds of the Tsimane' was very specific, with 25% of Tsimane' obtaining better results in the olfactory test than any member of the German group. These data suggest that differences in olfactory sensitivity seem to be especially salient between industrialized and non-industrialized populations inhabiting different environmental conditions. We hypothesize that the possible sources of such differences are: (i) the impact of pollution which impairs the olfactory abilities of people from industrialized countries; (ii) better training of olfaction because of the higher importance of smell in traditional populations; (iii) environmental pressures shaping olfactory abilities in these populations.

Operationalizing multimorbidity and autonomy for health services research in aging populations - the OMAHA study

PubMed Central

2011-01-01

Background As part of a Berlin-based research consortium on health in old age, the OMAHA (Operationalizing Multimorbidity and Autonomy for Health Services Research in Aging Populations) study aims to develop a conceptual framework and a set of standardized instruments and indicators for continuous monitoring of multimorbidity and associated health care needs in the population 65 years and older. Methods/Design OMAHA is a longitudinal epidemiological study including a comprehensive assessment at baseline and at 12-month follow-up as well as brief intermediate telephone interviews at 6 and 18 months. In order to evaluate different sampling procedures and modes of data collection, the study is conducted in two different population-based samples of men and women aged 65 years and older. A geographically defined sample was recruited from an age and sex stratified random sample from the register of residents in Berlin-Mitte (Berlin OMAHA study cohort, n = 299) for assessment by face-to-face interview and examination. A larger nationwide sample (German OMAHA study cohort, n = 730) was recruited for assessment by telephone interview among participants in previous German Telephone Health Surveys. In both cohorts, we successfully applied a multi-dimensional set of instruments to assess multimorbidity, functional disability in daily life, autonomy, quality of life (QoL), health care services utilization, personal and social resources as well as socio-demographic and biographical context variables. Response rates considerably varied between the Berlin and German OMAHA study cohorts (22.8% vs. 59.7%), whereas completeness of follow-up at month 12 was comparably high in both cohorts (82.9% vs. 81.2%). Discussion The OMAHA study offers a wide spectrum of data concerning health, functioning, social involvement, psychological well-being, and cognitive capacity in community-dwelling older people in Germany. Results from the study will add to methodological and content-specific discourses on human resources for maintaining quality of life and autonomy throughout old age, even in the face of multiple health complaints. PMID:21352521

Psychometric properties and measurement invariance of the Beck hopelessness scale (BHS): results from a German representative population sample.

PubMed

Kliem, Sören; Lohmann, Anna; Mößle, Thomas; Brähler, Elmar

2018-04-25

The Beck Hopelessness Scale (BHS) has been the most frequently used instrument for the measurement of hopelessness in the past 40 years. Only recently has it officially been translated into German. The psychometric properties and factor structure of the BHS have been cause for intensive debate in the past. Based on a representative sample of the German population (N = 2450) item analysis including item sensitivity, item-total correlation and item difficulty was performed. Confirmatory factor analyses (CFA) for several factor solutions from the literature were performed. Multiple group factor analysis was performed to assess measurement invariance. Construct validity was assessed via the replication of well-established correlations with concurrently assessed measures. Most items exhibited adequate properties. Items #4, #8 and #13 exhibited poor item characteristics- each of these items had previously received negative evaluations in international studies. A one-dimensional factor solution, favorable for the calculation and interpretation of a sum score, was regarded as adequate. A bi-factor model with one content factor and two method factors (defined by positive/negative item coding) resulted in an excellent model fit. Cronbach's alpha in the current sample was .87. Hopelessness, as measured by the BHS, significantly correlated in the expected direction with suicidal ideation (r = .36), depression (r = .53) and life satisfaction (r = -.53). Strict measurement invariance could be established regarding gender and depression status. Due to limited research regarding the interpretation of fit indices with dichotomous data, interpretation of CFA results needs to remain tentative. The BHS is a valid measure of hopelessness in various subgroups of the general population. Future research could aim at replicating these findings using item response theory and cross-cultural samples. A one-dimensional bi-factor model seems appropriate even in a non-clinical population.

Cancer patterns among children of Turkish descent in Germany: A study at the German Childhood Cancer Registry

PubMed Central

Spallek, Jacob; Spix, Claudia; Zeeb, Hajo; Kaatsch, Peter; Razum, Oliver

2008-01-01

Background Cancer risks of migrants might differ from risks of the indigenous population due to differences in socioeconomic status, life style, or genetic factors. The aim of this study was to investigate cancer patterns among children of Turkish descent in Germany. Methods We identified cases with Turkish names (as a proxy of Turkish descent) among the 37,259 cases of childhood cancer registered in the German Childhood Cancer Registry (GCCR) during 1980–2005. As it is not possible to obtain reference population data for children of Turkish descent, the distribution of cancer diagnoses was compared between cases of Turkish descent and all remaining (mainly German) cases in the registry, using proportional cancer incidence ratios (PCIRs). Results The overall distribution of cancer diagnoses was similar in the two groups. The PCIRs in three diagnosis groups were increased for cases of Turkish descent: acute non-lymphocytic leukaemia (PCIR 1.23; CI (95%) 1.02–1.47), Hodgkin's disease (1.34; 1.13–1.59) and Non-Hodgkin/Burkitt lymphoma (1.19; 1.02–1.39). Age, sex, and period of diagnosis showed no influence on the distribution of diagnoses. Conclusion No major differences were found in cancer patterns among cases of Turkish descent compared to all other cases in the GCCR. Slightly higher proportions of systemic malignant diseases indicate that analytical studies involving migrants may help investigating the causes of such cancers. PMID:18462495

Heritability and phenotypic variation of canine hip dysplasia radiographic traits in a cohort of Australian German shepherd dogs.

PubMed

Wilson, Bethany J; Nicholas, Frank W; James, John W; Wade, Claire M; Tammen, Imke; Raadsma, Herman W; Castle, Kao; Thomson, Peter C

2012-01-01

Canine Hip Dysplasia (CHD) is a common, painful and debilitating orthopaedic disorder of dogs with a partly genetic, multifactorial aetiology. Worldwide, potential breeding dogs are evaluated for CHD using radiographically based screening schemes such as the nine ordinally-scored British Veterinary Association Hip Traits (BVAHTs). The effectiveness of selective breeding based on screening results requires that a significant proportion of the phenotypic variation is caused by the presence of favourable alleles segregating in the population. This proportion, heritability, was measured in a cohort of 13,124 Australian German Shepherd Dogs born between 1976 and 2005, displaying phenotypic variation for BVAHTs, using ordinal, linear and binary mixed models fitted by a Restricted Maximum Likelihood method. Heritability estimates for the nine BVAHTs ranged from 0.14-0.24 (ordinal models), 0.14-0.25 (linear models) and 0.12-0.40 (binary models). Heritability for the summed BVAHT phenotype was 0.30 ± 0.02. The presence of heritable variation demonstrates that selection based on BVAHTs has the potential to improve BVAHT scores in the population. Assuming a genetic correlation between BVAHT scores and CHD-related pain and dysfunction, the welfare of Australian German Shepherds can be improved by continuing to consider BVAHT scores in the selection of breeding dogs, but that as heritability values are only moderate in magnitude the accuracy, and effectiveness, of selection could be improved by the use of Estimated Breeding Values in preference to solely phenotype based selection of breeding animals.

Polymorphisms of methylenetetrahydrofolate reductase (MTHFR) and susceptibility to pediatric acute lymphoblastic leukemia in a German study population

PubMed Central

Schnakenberg, Eckart; Mehles, Andrea; Cario, Gunnar; Rehe, Klaus; Seidemann, Kathrin; Schlegelberger, Brigitte; Elsner, Holger A; Welte, Karl H; Schrappe, Martin; Stanulla, Martin

2005-01-01

Background Methylenetetrahydrofolate reductase (MTHFR) has a major impact on the regulation of the folic acid pathway due to conversion of 5,10-methylenetetrahydrofolate (methylene-THF) to 5-methyl-THF. Two common polymorphisms (677C>T and 1298A>C) in the gene coding for MTHFR have been shown to reduce MTHFR enzyme activity and were associated with the susceptibility to different disorders, including vascular disease, neural tube defects and lymphoid malignancies. Studies on the role of these polymorphisms in the susceptibility to acute lymphoblastic leukemia (ALL) led to discrepant results. Methods We retrospectively evaluated the association of the MTHFR 677C>T and 1298A>C polymorphisms with pediatric ALL by genotyping a study sample of 443 ALL patients consecutively enrolled onto the German multicenter trial ALL-BFM 2000 and 379 healthy controls. We calculated odds ratios of MTHFR genotypes based on the MTHFR 677C>T and 1298A>C polymorphisms to examine if one or both of these polymorphisms are associated with pediatric ALL. Results No significant associations between specific MTHFR variants or combinations of variants and risk of ALL were observed neither in the total patient group nor in analyses stratified by gender, age at diagnosis, DNA index, immunophenotype, or TEL/AML1 rearrangement. Conclusion Our findings suggest that the MTHFR 677C>T and 1298A>C gene variants do not have a major influence on the susceptibility to pediatric ALL in the German population. PMID:15921520

Prevalence and comorbidity of diabetes mellitus among non-institutionalized older adults in Germany - results of the national telephone health interview survey ‘German Health Update (GEDA)’ 2009

PubMed Central

2013-01-01

Background Despite the major public health impact of diabetes, recent population-based data regarding its prevalence and comorbidity are sparse. Methods The prevalence and comorbidity of diabetes mellitus were analyzed in a nationally representative sample (N = 9133) of the non-institutionalized German adult population aged 50 years and older. Information on physician-diagnosed diabetes and 20 other chronic health conditions was collected as part of the national telephone health interview survey ‘German Health Update (GEDA)’ 2009. Overall, 51.2% of contacted persons participated. Among persons with diabetes, diabetes severity was defined according to the type and number of diabetes-concordant conditions: no diabetes-concordant condition (grade 1); hypertension and/or hyperlipidemia only (grade 2); one comorbidity likely to represent diabetes-related micro- or macrovascular end-organ damage (grade 3); several such comorbidities (grade 4). Determinants of diabetes severity were analyzed by multivariable ordinal regression. Results The 12-month prevalence of diabetes was 13.6% with no significant difference between men and women. Persons with diabetes had a significantly higher prevalence and average number of diabetes-concordant as well as diabetes-discordant comorbidities than persons without diabetes. Among persons with diabetes, 10.2%, 46.8%, 35.6% and 7.4% were classified as having severity grade 1–4, respectively. Determinants of diabetes severity included age (cumulative odds ratio 1.05, 95% confidence interval 1.03-1.07, per year) and number of discordant comorbidities (1.40, 1.25-1.55). With respect to specific discordant comorbidities, diabetes severity was correlated to depression (2.15, 1.29-3.56), respiratory disease (2.75, 1.72-4.41), musculoskeletal disease (1.53, 1.06-2.21), and severe hearing impairment (3.00, 1.21-7.41). Conclusions Diabetes is highly prevalent in the non-institutionalized German adult population 50 years and older. Diabetes comorbidities including diabetes-concordant and diabetes-discordant conditions need to be considered in epidemiological studies, in order to monitor disease burden and quality of diabetes care. Definitional standards of diabetes severity need to be refined and consented. PMID:23433228

Insecticide resistance and diminished secondary kill performance of bait formulations against German cockroaches (Dictyoptera: Blattellidae)

PubMed Central

Ko, Alexander E.; Bieman, Donald N.; Schal, Coby; Silverman, Jules

2015-01-01

BACKGROUND Bait formulations are considered the most effective method for reducing German cockroach infestations. An important property of some bait formulations is secondary kill, whereby active ingredient is translocated in insect-produced residues throughout the cockroach population, especially affecting relatively sedentary early instar nymphs. RESULTS Blattella germanica was collected from a location where baits containing hydramethylnon, fipronil, or indoxacarb became ineffective, and these AIs were topically applied to adult males. Results revealed the first evidence for hydramethylnon resistance, moderate resistance to fipronil and extremely high resistance to indoxacarb. Insecticide residues excreted by field-collected males that ingested commercial baits effectively killed nymphs of an insecticide-susceptible laboratory strain of B. germanica but failed to kill most nymphs of the field-collected strain. CONCLUSIONS We report three novel findings: 1) The first evidence for hydramethylnon resistance in any insect; 2) extremely high levels of indoxacarb resistance in a field population; and 3) reduced secondary mortality in an insecticide-resistant field-collected strain of B. germanica. We suggest that while secondary mortality is considered to be advantageous in cockroach interventions, the ingestion of sublethal doses of AI by nymphs may select for high insecticide resistance by increasing the frequency of AI resistance alleles within the population. PMID:26689433

Prevalence of Obesity, Binge Eating, and Night Eating in a Cross-Sectional Field Survey of 6-Year-Old Children and Their Parents in a German Urban Population

ERIC Educational Resources Information Center

Lamerz, Andreas; Kuepper-Nybelen, Jutta; Bruning, Nicole; Wehle, Christine; Trost-Brinkhues, Gabriele; Brenner, Hermann; Hebebrand, Johannes; Herpertz-Dahlmann, Beate

2005-01-01

Background: To assess the prevalence of obesity, obesity-related binge eating, non-obesity-related binge eating, and night eating in five- to six-year-old children and to examine the impact of parental eating disturbances. Methods: When 2020 children attended their obligatory health exam prior to school entry in the city of Aachen, Germany, 1979…

Assessing met and unmet needs in the oldest-old and psychometric properties of the German version of the Camberwell assessment of need for the elderly (CANE)--a pilot study.

PubMed

Stein, Janine; Luppa, Melanie; König, Hans-Helmut; Riedel-Heller, Steffi G

2014-02-01

The current demographic and social developments in our society will lead to a significant increase in treatment and healthcare needs in the future, particularly in the elderly population. The Camberwell Assessment of Need for the Elderly (CANE) was developed in the United Kingdom to measure physical-, psychological-, and environment-related treatment as well as healthcare needs of older people in order to identify their unmet needs. So far, the German version of the CANE has not been established in health services research. Major reasons for this are a lack of publications of CANE's German version and the missing validation of the instrument. The aims of the present study were to evaluate the currently available German version of the CANE in a sample of older primary care patients. Descriptive statistics and inference-statistical analyses were calculated. Patients reported unmet needs mostly in CANE's following sections: mobility/falls, physical health, continence, company, and intimate relationships. Agreement level between patients' and relatives' ratings in CANE was moderate to low. Evidence for the construct validity of CANE was found in terms of significant associations between CANE and other instruments or scores. The study results provide an important basis for studies aiming at the assessment of met and unmet needs in the elderly population. Using the German version of the CANE may substantially contribute to an effective and good-quality health and social care as well as an appropriate allocation of healthcare resources in the elderly population.

Genomic epidemiology of the Escherichia coli O104:H4 outbreaks in Europe, 2011.

PubMed

Grad, Yonatan H; Lipsitch, Marc; Feldgarden, Michael; Arachchi, Harindra M; Cerqueira, Gustavo C; Fitzgerald, Michael; Godfrey, Paul; Haas, Brian J; Murphy, Cheryl I; Russ, Carsten; Sykes, Sean; Walker, Bruce J; Wortman, Jennifer R; Young, Sarah; Zeng, Qiandong; Abouelleil, Amr; Bochicchio, James; Chauvin, Sara; Desmet, Timothy; Gujja, Sharvari; McCowan, Caryn; Montmayeur, Anna; Steelman, Scott; Frimodt-Møller, Jakob; Petersen, Andreas M; Struve, Carsten; Krogfelt, Karen A; Bingen, Edouard; Weill, François-Xavier; Lander, Eric S; Nusbaum, Chad; Birren, Bruce W; Hung, Deborah T; Hanage, William P

2012-02-21

The degree to which molecular epidemiology reveals information about the sources and transmission patterns of an outbreak depends on the resolution of the technology used and the samples studied. Isolates of Escherichia coli O104:H4 from the outbreak centered in Germany in May-July 2011, and the much smaller outbreak in southwest France in June 2011, were indistinguishable by standard tests. We report a molecular epidemiological analysis using multiplatform whole-genome sequencing and analysis of multiple isolates from the German and French outbreaks. Isolates from the German outbreak showed remarkably little diversity, with only two single nucleotide polymorphisms (SNPs) found in isolates from four individuals. Surprisingly, we found much greater diversity (19 SNPs) in isolates from seven individuals infected in the French outbreak. The German isolates form a clade within the more diverse French outbreak strains. Moreover, five isolates derived from a single infected individual from the French outbreak had extremely limited diversity. The striking difference in diversity between the German and French outbreak samples is consistent with several hypotheses, including a bottleneck that purged diversity in the German isolates, variation in mutation rates in the two E. coli outbreak populations, or uneven distribution of diversity in the seed populations that led to each outbreak.

Genomic epidemiology of the Escherichia coli O104:H4 outbreaks in Europe, 2011

PubMed Central

Grad, Yonatan H.; Lipsitch, Marc; Feldgarden, Michael; Arachchi, Harindra M.; Cerqueira, Gustavo C.; FitzGerald, Michael; Godfrey, Paul; Haas, Brian J.; Murphy, Cheryl I.; Russ, Carsten; Sykes, Sean; Walker, Bruce J.; Wortman, Jennifer R.; Young, Sarah; Zeng, Qiandong; Abouelleil, Amr; Bochicchio, James; Chauvin, Sara; DeSmet, Timothy; Gujja, Sharvari; McCowan, Caryn; Montmayeur, Anna; Steelman, Scott; Frimodt-Møller, Jakob; Petersen, Andreas M.; Struve, Carsten; Krogfelt, Karen A.; Bingen, Edouard; Weill, François-Xavier; Lander, Eric S.; Nusbaum, Chad; Birren, Bruce W.; Hung, Deborah T.; Hanage, William P.

2012-01-01

The degree to which molecular epidemiology reveals information about the sources and transmission patterns of an outbreak depends on the resolution of the technology used and the samples studied. Isolates of Escherichia coli O104:H4 from the outbreak centered in Germany in May–July 2011, and the much smaller outbreak in southwest France in June 2011, were indistinguishable by standard tests. We report a molecular epidemiological analysis using multiplatform whole-genome sequencing and analysis of multiple isolates from the German and French outbreaks. Isolates from the German outbreak showed remarkably little diversity, with only two single nucleotide polymorphisms (SNPs) found in isolates from four individuals. Surprisingly, we found much greater diversity (19 SNPs) in isolates from seven individuals infected in the French outbreak. The German isolates form a clade within the more diverse French outbreak strains. Moreover, five isolates derived from a single infected individual from the French outbreak had extremely limited diversity. The striking difference in diversity between the German and French outbreak samples is consistent with several hypotheses, including a bottleneck that purged diversity in the German isolates, variation in mutation rates in the two E. coli outbreak populations, or uneven distribution of diversity in the seed populations that led to each outbreak. PMID:22315421

[Systematic Readability Analysis of Medical Texts on Websites of German University Clinics for General and Abdominal Surgery].

PubMed

Esfahani, B Janghorban; Faron, A; Roth, K S; Grimminger, P P; Luers, J C

2016-12-01

Background: Besides the function as one of the main contact points, websites of hospitals serve as medical information portals. As medical information texts should be understood by any patients independent of the literacy skills and educational level, online texts should have an appropriate structure to ease understandability. Materials and Methods: Patient information texts on websites of clinics for general surgery at German university hospitals (n = 36) were systematically analysed. For 9 different surgical topics representative medical information texts were extracted from each website. Using common readability tools and 5 different readability indices the texts were analysed concerning their readability and structure. The analysis was furthermore stratified in relation to geographical regions in Germany. Results: For the definite analysis the texts of 196 internet websites could be used. On average the texts consisted of 25 sentences and 368 words. The reading analysis tools congruously showed that all texts showed a rather low readability demanding a high literacy level from the readers. Conclusion: Patient information texts on German university hospital websites are difficult to understand for most patients. To fulfill the ambition of informing the general population in an adequate way about medical issues, a revision of most medical texts on websites of German surgical hospitals is recommended. Georg Thieme Verlag KG Stuttgart · New York.

[Frailty in Germany: status and perspectives : Results from a workshop of the German Society for Epidemiology].

PubMed

Fuchs, Judith; Scheidt-Nave, Christa; Gaertner, Beate; Dapp, Ulrike; von Renteln-Kruse, Wolfgang; Saum, Kai-Uwe; Thorand, Barbara; Strobl, Ralf; Grill, Eva

2016-12-01

A standardized, valid and comparable operationalization and assessment of frailty in population-based studies is essential in order to describe the prevalence and determinants of frailty in the population. After an introduction to the subject the main goal of a workshop at the 9th annual meeting of the German Society for Epidemiology (DGEpi) was to present approaches and results from four different studies in Germany. The following four population-based studies were used to describe frailty in Germany: the German health interview and examination survey for adults (DEGS1), the epidemiological study on the chances of prevention, early recognition and optimized treatment of chronic diseases in the older population (ESTHER), the cooperative health research in the region Augsburg (KORA Age) study and the longitudinal urban cohort ageing study (LUCAS) in Hamburg. The four studies consistently showed that frailty is widespread in older and oldest-old persons in Germany. It is obvious that frailty represents a relevant concept in Germany even if there is currently no uniform basis for operationalization. Concepts and instruments for the collation of frailty should be included in future population-based studies in order to make a better assessment of older people's health situation and to describe the unused potential for prevention in an aging society.

Germany: The Search for Unity.

ERIC Educational Resources Information Center

Blankenship, Glen, Ed.

The 12 lessons in this collection are designed so that they may be used individually, integrated into the curriculum at appropriate places, or used as a complete unit. The lessons are entitled: (1) Impressions of Germany and Germans; (2) The Location and Population of Germany; (3) Pollution in Germany: A Complex Problems; (4) German Political…

An Investigation of Syntactic Priming among German Speakers at Varying Proficiency Levels

ERIC Educational Resources Information Center

Ruf, Helena T.

2011-01-01

This dissertation investigates syntactic priming in second language (L2) development among three speaker populations: (1) less proficient L2 speakers; (2) advanced L2 speakers; and (3) LI speakers. Using confederate scripting this study examines how German speakers choose certain word orders in locative constructions (e.g., "Auf dem Tisch…

Situation Report--Burma, Chile, German Democratic Republic, Indonesia, Jamaica, Poland, Singapore, St. Christopher/Nevis, Trinidad & Tobago, Venezuela.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Data relating to population and family planning in ten foreign countries are presented in these situation reports. Countries included are Burma, Chile, German Democratic Republic, Indonesia, Jamaica, Poland, Singapore, St. Christopher/Nevis, Trinidad and Tobago, and Venezuela. Information is provided, where appropriate and available, under two…

Situation Report - Denmark, France, German Federal Republic, Luxembourg, Poland, Portugal, Romania, Spain, and Switzerland.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Data relating to population and family planning in nine foreign countries are presented in these situation reports. Countries included are Denmark, France, German Federal Republic, Luxembourg, Poland, Portugal, Romania, Spain, and Switzerland. Information is provided in the following areas where appropriate and if it is available: (1) statistics…

Blindness and low vision in Germany 1993-2009.

PubMed

Wolfram, Christian; Pfeiffer, Norbert

2012-02-01

To describe the development of the prevalence of blindness and low vision in the German population between 1993 and 2009 with respect to major demographic changes and to investigate how the prevalence of blindness would have developed without demographic aging. Investigation of the prevalence for blindness and low vision in the German population on the basis of the official German statistics for severely handicapped people and population statistics between 1993 and 2009. Age-specific prevalence rates and the prevalence based on a standardized population were calculated and the progression is demonstrated. The overall prevalence of blindness and low vision in Germany increased between 1993 and 2009 by 12.3% from 314,404 to 352,943 subjects. The absolute number of blind or visually impaired persons in the eldest group (75 years and above) has grown by 38.2% from 126,023 to 174,127 subjects. At the same time, both age-specific prevalence rates as well as the prevalence that was based on a standardized population decreased, matching more than 30,000 fewer cases of blindness in 2009 as compared to 1993. The increase in absolute prevalence numbers for blindness and low vision implies an increase in the ophthalmic workload. At the same time, the decrease in the age-specific and standardized prevalence indicates possible improvements in the overall eye health status of the population since 1993.

Health care utilization among first and second generation immigrants and native-born Germans: a population-based study in Germany.

PubMed

Glaesmer, Heide; Wittig, Ulla; Braehler, Elmar; Martin, Alexandra; Mewes, Ricarda; Rief, Winfried

2011-10-01

There are contradictory findings on health care utilization (HCU) of immigrants compared to native-born populations. Our study focuses on this topic using a population-based approach and differentiates generational cohorts of immigrants. In a representative population survey in Germany (N = 2,510), immigrant background/generational cohort and HCU in the preceding 12 months were screened by means of self-rating instruments. 11.1% (7.0% first and 4.1% second generation) of the sample are immigrants. No differences have been detect with regard to subjective state of health, satisfaction with life and with health and functional disabilities. First generation immigrants contacted a medical specialist less likely, but they more frequently use general practitioners (GPs) than the native-born Germans and the second generation immigrants. First generation immigrants show remarkable differences in HCU compared to the native-born Germans and the second generation immigrants. Their HCU seems to be focused on primary care, and access to secondary care might be complicated. It seems relevant to especially pay attention to HCU of first generation immigrants and to support equal access to care for this subgroup.

[Criterion Validity of the German Version of the CES-D in the General Population].

PubMed

Jahn, Rebecca; Baumgartner, Josef S; van den Nest, Miriam; Friedrich, Fabian; Alexandrowicz, Rainer W; Wancata, Johannes

2018-04-17

The "Center of Epidemiologic Studies - Depression scale" (CES-D) is a well-known screening tool for depression. Until now the criterion validity of the German version of the CES-D was not investigated in a sample of the adult general population. 508 study participants of the Austrian general population completed the CES-D. ICD-10 diagnoses were established by using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Receiver Operating Characteristics (ROC) analysis was conducted. Possible gender differences were explored. Overall discriminating performance of the CES-D was sufficient (ROC-AUC 0,836). Using the traditional cut-off values of 15/16 and 21/22 respectively the sensitivity was 43.2 % and 32.4 %, respectively. The cut-off value developed on the basis of our sample was 9/10 with a sensitivity of 81.1 % und a specificity of 74.3 %. There were no significant gender differences. This is the first study investigating the criterion validity of the German version of the CES-D in the general population. The optimal cut-off values yielded sufficient sensitivity and specificity, comparable to the values of other screening tools. © Georg Thieme Verlag KG Stuttgart · New York.

Self-rated treatment outcomes in medical rehabilitation among German and non-German nationals residing in Germany: an exploratory cross-sectional study.

PubMed

Brzoska, P; Sauzet, O; Yilmaz-Aslan, Y; Widera, T; Razum, O

2016-03-28

In many European countries, foreign nationals experience, on average, less favorable treatment outcomes in rehabilitative care than the respective majority population. In Germany, this for example is reflected in a lower occupational performance and a higher risk of disability retirement after rehabilitation as analyses of routine data show. However, little is known about the perspective of health care users. The aim of the present study was to compare self-rated treatment outcomes between German and non-German nationals undergoing in-patient medical rehabilitation in Germany. We analyzed data from a cross-sectional representative rehabilitation patient survey of 239,811 patients from 642 clinics in Germany who completed about 3 weeks of in-patient rehabilitative treatment. The self-rating of the treatment outcome was based on a dichotomized Likert scale consisting of three items. A multilevel logistic regression analysis adjusted for various demographic, socio-economic, health and other covariates was conducted to examine differences in the self-rated treatment outcome between German and non-German nationals. Of the 239,811 respondents 0.9% were nationals from Turkey, 0.8% had a nationality from a former Yugoslavian country, 0.9% held a nationality from the South European countries Portugal, Spain, Italy or Greece and 1.9% were nationals from other countries. Non-German nationals reported a less favorable self-rated outcome than Germans. Adjusted odds ratios [OR] for reporting a less favorable treatment outcome were 1.24 (95%-confidence interval [95%-CI]: 1.12-1.37) for nationals from the South European countries Portugal/Spain/Italy/Greece, 1.62 (95%-CI: 1.45-1.80) for Turkish nationals and 1.68 (95%-CI: 1.52-1.85) for nationals from Former Yugoslavia. Knowledge on health outcomes from the patients' point of view is important for the provision of patient-centered health care. Our study showed that non-German nationals report less favorable outcomes of rehabilitative care than Germans. This may be due to cultural and religious needs not sufficiently addressed by health care providers. In order to improve rehabilitative care for non-German nationals, rehabilitative services must become sensitive to the needs of this population group. Diversity management can contribute to this process.

Preliminary Validation of a German Version of the Sexual Complaints Screener for Women in a Female Population Sample.

PubMed

Burri, Andrea; Porst, Hartmut

2018-06-01

To date, neither the original English nor any of the translated versions of the Sexual Complaints Screener for Women (SCS-W) have been tested for their psychometric properties. To evaluate the validity and utility of the German version of the SCS-W by assessing content, convergent, and discriminant validity. A population sample of 309 women (mean age = 26.9 years) completed the online survey and had matching data available on the SCS-W and the Female Sexual Function Index (FSFI). Spearman bivariate correlations between the SCS-W and FSFI domain scores and exploratory factor analysis with principal component analysis were conducted. Convergent validity was excellent for the domain of orgasm, good for satisfaction, dyspareunia, and the total questionnaire score, and acceptable for desire, lubrication, arousal, and vaginismus. Discriminant validity was present for all domains apart from arousal, lubrication, and vaginismus. Varimax rotation suggested an 8-factor model was the most robust. This brief screener seems suitable to provide a brief overview of female patients' sexual problems in a clinical setting. This is the 1st study to assess the psychometric properties of the German version of the SCS-W. However, available information on the psychometric properties of the German SCS-W was limited because the validity of the screener could not be counterchecked against a clinical diagnosis of female sexual dysfunction. Our results provide preliminary evidence of good validity of the German version of the SCS-W. Overall, the SCS-W can offer support for clinicians who are less familiar with sexual medicine and who might not routinely discuss sexual issues with their patients. Burri A, Porst H. Preliminary Validation of a German Version of the Sexual Complaints Screener for Women in a Female Population Sample. Sex Med 2018;6:123-130. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Strengthening health data on a rare and heterogeneous disease: sarcoma incidence and histological subtypes in Germany.

PubMed

Ressing, Meike; Wardelmann, Eva; Hohenberger, Peter; Jakob, Jens; Kasper, Bernd; Emrich, Katharina; Eberle, Andrea; Blettner, Maria; Zeissig, Sylke Ruth

2018-02-12

The population-based incidence of sarcoma and its histological subtypes in Germany is unknown. Up-to-date information on a disease with an incidence comparable to other cancer entities is of high public health relevance. The aim of this study was to determine this incidence and to detect significant changes in incidence trends using data from German epidemiological cancer registries. Pooled data from the German Centre for Cancer Registry Data with a primary diagnosis occurring in 2013 were used. To date, this is the latest data on cancer incidence available for Germany. All German cancer registries with sufficient completeness were included (10 out of 11), covering a population of 70.0 million people, representing 87% of the German population. All malignant sarcomas according to the RARECARE Project and the WHO classification 2002 were considered for analysis and, above all, gastrointestinal stromal tumours (GIST) of uncertain behaviour. Sensitivity analysis was performed excluding certain histologies. The analysis included 3404 cases in men and 3442 cases in women diagnosed in 2013. The age adjusted sarcoma incidence (European standard) was 7.4 (men) and 6.6 (women) per 100,000 inhabitants. About 70% of sarcomas were soft tissue sarcomas, about 22% GIST, and about 9% bone sarcomas. The most common histological subtypes besides GIST were fibrosarcomas (14%) and liposarcomas (12%) in men and complex mixed and stromal neoplasms (22%), non-uterine leiomysarcomas (10%) and fibrosarcomas (9%) in women. Considering the trend for the years of diagnosis 2004 to 2013, there was a significant increase in incidence for GIST while the incidence of soft tissue sarcomas (only men) as well as of bone sarcoma stayed constant over time. As to soft tissue sarcoma in women, the incidence stayed constant up to the year 2009 and significantly decreased afterwards. This study is the first detailed analysis of a German-wide population-based sarcoma incidence showing results comparable to the incidence detected in the RARECARE Project.

Teaching Controversal Topics in Contemporary German Culture through Hip-Hop

ERIC Educational Resources Information Center

Putnam, Michael

2006-01-01

This article discusses the rich cultural resources embedded with German hip-hop music and its potential impact on the foreign language classroom. In particular, this article suggests methods and materials for integrating German hip-hop music in the discussion of recent controversial cultural events and attitudes in German after the "Wende."

Regular and problematic leisure-time Internet use in the community: results from a German population-based survey.

PubMed

Beutel, Manfred E; Brähler, Elmar; Glaesmer, Heide; Kuss, Daria J; Wölfling, Klaus; Müller, Kai W

2011-05-01

In our study, we attempted to identify systematically the use of Internet applications in the German population in order to derive risk factors for problematic use. In a representative survey of the German population, we queried 1,401 women and 1,111 men between the ages of 14 and 94 years by specific questions and standardized questionnaires on depression, anxiety (HADS), and depersonalization (CDS-2). The majority of the German population (55%) used the Internet in their leisure time. Users were younger and had a higher socioeconomic status (education, employment, income). Leisure-time use included e-mail and information search, as well as shopping. Chatting, online communities, games and sex were domains of young, mostly male adults. Overall, 9.3% reported at least one negative consequence of Internet use, especially neglect of recreational activities and problems with family/partner, work or education, and health. Problematic use was associated with longer average daily online times, avoidance of negative emotions, preference for certain applications (gaming, gambling, online sex) and an increased rate of depersonalization. The extent of Internet use per se is not sufficient as an addiction criterion and other negative consequences; rather, specific adverse consequences need to be identified. If the Internet is used excessively to cope with negative affect states and alternative means of coping (e.g., social support, health-promoting behavior) are diminished, a vicious cycle may ensue with increasing stress and reliance on the reinforcing properties of certain online activities that may finally lead to addictive behavior.

[Prevalence of dermatomycoses in professional football players : A study based on data of German Bundesliga fitness check-ups (2013-2015) compared to data of the general population].

PubMed

Buder, V; Augustin, M; Schäfer, I; Welsch, G; Catala-Lehnen, P; Herberger, K

2018-05-01

The prevention, early diagnosis and treatment of onychomycosis is of great importance for professional athletes to avoid physical limitations by complications. So far, there is only little data on the prevalence of dermatomycosis in professional athletes. The aim of the study was to detect the prevalence of dermatomycosis in professional football players compared to the general population. The prospective, non-interventional, controlled study on the prevalence of dermatomycosis in professional football players was carried out on football players of a German Bundesliga team compared with a previously studied, equivalently aged German working population. A questionnaire survey, a dermatological check-up and a microbiological detection of pathogens in cases of suspicion were performed. Data of 84 football players (n = 45 in 2013; n = 39 in 2015) were compared to data of n = 8186 male employees between 17 and 35 years of age. In the group of athletes, there were findings of 60.7% onychomycosis, 36.9% of tinea pedis and 17.8% of pityriasis versicolor. In the group of the age-equivalent general German working population the findings were: onychomycosis 3.3%, tinea pedis 3.2%, pityriasis versicolor 1.4%. Our study shows a clearly higher risk for fungal diseases of the skin especially on the feet of professional football players. The results show a necessity for elucidation within prevention and the establishment of an appropriate therapy of dermatomycosis for professional football players.

Situation Reports--Austria, Belgium, Bolivia, Botswana, Finland, German Federal Republic, Italy, Luxembourg, Mauritania, Netherlands, Norway, Portugal, Puerto Rico, Sweden, Tanzania, Yugoslavia, and Zambia.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Data pertaining to population and family planning in seventeen foreign countries are presented in these situation reports. Countries included are Austria, Belgium, Bolivia, Botswana, Finland, German Federal Republic, Italy, Luxembourg, Mauritania, Netherlands, Norway, Portugal, Puerto Rico, Sweden, Tanzania, Yugoslavia, and Zambia. Information is…

Together, Not Alone: Positive Peer Culture in a German School

ERIC Educational Resources Information Center

Opp, Gunther; Unger, Nicola; Teichmann, Jana

2007-01-01

The many sea-changes in German culture have given rise to a growing population of children and youth at risk. This article describes the creation of a Positive Peer Culture in a special school for students with emotional and behavioural problems. The authors review challenges facing youth in modern Germany, the implementation of the PPC program,…

Key Aspects of a Sustainable Health Insurance System in Germany.

PubMed

Pelster, Matthias; Hagemann, Vera; Laporte Uribe, Franziska

2016-06-01

The main goals of health-care systems are to improve the health of the population they serve, respond to people's legitimate expectations, and offer fair financing. As a result, the health system in Germany is subject to continuous adaption as well as public and political discussions about its design. This paper analyzes the key challenges for the German health-care system and the underlying factors driving these challenges. We aim to identify possible solutions to put the German health-care system in a better position to face these challenges. We utilize a broad array of methods to answer these questions, including a review of the published and grey literature on health-care planning in Germany, semi-structured interviews with stakeholders in the system, and an online questionnaire. We find that the most urgent (and manageable) aspects that merit attention are holistic hospital planning, initiatives to increase (administrative) innovation in the health-care system, incentives to increase prevention, and approaches to increase analytical quality assurance. We found that hospital planning, innovation, quality control, and prevention, are considered to be the topics most in need of attention in the German health system.

Surgery and national identity in late nineteenth-century Vienna

PubMed Central

Buklijas, Tatjana

2008-01-01

For historians of medicine, the professor Theodor Billroth of the University of Vienna was the leading European surgeon of late nineteenth century and the personification of intervention by organ or body part removal. For social and political historians, he was a German nationalist whose book on medical education heralded the rise of anti-Semitism in the Austrian public sphere. This article brings together and critically reassesses these two hitherto separate accounts to show how, in a period of dramatic social and political change, Viennese surgery split into two camps. One, headed by Billroth, was characterized by an alliance with the German educational model, German nationalism leading to racial anti-Semitism and an experimental approach to the construction of surgical procedure, which heavily relied on the methods of pathological physiology. The other, which followed a long Austrian tradition, stood for a clinically-oriented and strictly organized medical education that catered to an ethnically and socially diverse population and, simultaneously, for an anatomically oriented surgery, largely of the locomotor apparatus. This study shows how, in a major centre of medical education and capital of a multiethnic empire, surgical and national identities were forged together. PMID:18053931

Mortality in incident dementia - results from the German Study on Aging, Cognition, and Dementia in Primary Care Patients.

PubMed

Roehr, S; Luck, T; Bickel, H; Brettschneider, C; Ernst, A; Fuchs, A; Heser, K; König, H-H; Jessen, F; Lange, C; Mösch, E; Pentzek, M; Steinmann, S; Weyerer, S; Werle, J; Wiese, B; Scherer, M; Maier, W; Riedel-Heller, S G

2015-10-01

Dementia is known to increase mortality, but the relative loss of life years and contributing factors are not well established. Thus, we aimed to investigate mortality in incident dementia from disease onset. Data were derived from the prospective longitudinal German AgeCoDe study. We used proportional hazards models to assess the impact of sociodemographic and health characteristics on mortality after dementia onset, Kaplan-Meier method for median survival times. Of 3214 subjects at risk, 523 (16.3%) developed incident dementia during a 9-year follow-up period. Median survival time after onset was 3.2 years (95% CI = 2.8-3.7) at a mean age of 85.0 (SD = 4.0) years (≥2.6 life years lost compared with the general German population). Survival was shorter in older age, males other dementias than Alzheimer's, and in the absence of subjective memory complaints (SMC). Our findings emphasize that dementia substantially shortens life expectancy. Future studies should further investigate the potential impact of SMC on mortality in dementia. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Demographic Histories, Isolation and Social Factors as Determinants of the Genetic Structure of Alpine Linguistic Groups

PubMed Central

Coia, Valentina; Capocasa, Marco; Anagnostou, Paolo; Pascali, Vincenzo; Scarnicci, Francesca; Boschi, Ilaria; Battaggia, Cinzia; Crivellaro, Federica; Ferri, Gianmarco; Alù, Milena; Brisighelli, Francesca; Busby, George B. J.; Capelli, Cristian; Maixner, Frank; Cipollini, Giovanna; Viazzo, Pier Paolo; Zink, Albert; Destro Bisol, Giovanni

2013-01-01

Great European mountain ranges have acted as barriers to gene flow for resident populations since prehistory and have offered a place for the settlement of small, and sometimes culturally diverse, communities. Therefore, the human groups that have settled in these areas are worth exploring as an important potential source of diversity in the genetic structure of European populations. In this study, we present new high resolution data concerning Y chromosomal variation in three distinct Alpine ethno-linguistic groups, Italian, Ladin and German. Combining unpublished and literature data on Y chromosome and mitochondrial variation, we were able to detect different genetic patterns. In fact, within and among population diversity values observed vary across linguistic groups, with German and Italian speakers at the two extremes, and seem to reflect their different demographic histories. Using simulations we inferred that the joint effect of continued genetic isolation and reduced founding group size may explain the apportionment of genetic diversity observed in all groups. Extending the analysis to other continental populations, we observed that the genetic differentiation of Ladins and German speakers from Europeans is comparable or even greater to that observed for well known outliers like Sardinian and Basques. Finally, we found that in south Tyroleans, the social practice of Geschlossener Hof, a hereditary norm which might have favored male dispersal, coincides with a significant intra-group diversity for mtDNA but not for Y chromosome, a genetic pattern which is opposite to those expected among patrilocal populations. Together with previous evidence regarding the possible effects of “local ethnicity” on the genetic structure of German speakers that have settled in the eastern Italian Alps, this finding suggests that taking socio-cultural factors into account together with geographical variables and linguistic diversity may help unveil some yet to be understood aspects of the genetic structure of European populations. PMID:24312576

Demographic histories, isolation and social factors as determinants of the genetic structure of Alpine linguistic groups.

PubMed

Coia, Valentina; Capocasa, Marco; Anagnostou, Paolo; Pascali, Vincenzo; Scarnicci, Francesca; Boschi, Ilaria; Battaggia, Cinzia; Crivellaro, Federica; Ferri, Gianmarco; Alù, Milena; Brisighelli, Francesca; Busby, George B J; Capelli, Cristian; Maixner, Frank; Cipollini, Giovanna; Viazzo, Pier Paolo; Zink, Albert; Destro Bisol, Giovanni

2013-01-01

Great European mountain ranges have acted as barriers to gene flow for resident populations since prehistory and have offered a place for the settlement of small, and sometimes culturally diverse, communities. Therefore, the human groups that have settled in these areas are worth exploring as an important potential source of diversity in the genetic structure of European populations. In this study, we present new high resolution data concerning Y chromosomal variation in three distinct Alpine ethno-linguistic groups, Italian, Ladin and German. Combining unpublished and literature data on Y chromosome and mitochondrial variation, we were able to detect different genetic patterns. In fact, within and among population diversity values observed vary across linguistic groups, with German and Italian speakers at the two extremes, and seem to reflect their different demographic histories. Using simulations we inferred that the joint effect of continued genetic isolation and reduced founding group size may explain the apportionment of genetic diversity observed in all groups. Extending the analysis to other continental populations, we observed that the genetic differentiation of Ladins and German speakers from Europeans is comparable or even greater to that observed for well known outliers like Sardinian and Basques. Finally, we found that in south Tyroleans, the social practice of Geschlossener Hof, a hereditary norm which might have favored male dispersal, coincides with a significant intra-group diversity for mtDNA but not for Y chromosome, a genetic pattern which is opposite to those expected among patrilocal populations. Together with previous evidence regarding the possible effects of "local ethnicity" on the genetic structure of German speakers that have settled in the eastern Italian Alps, this finding suggests that taking socio-cultural factors into account together with geographical variables and linguistic diversity may help unveil some yet to be understood aspects of the genetic structure of European populations.

Satisfaction with rehabilitative health care services among German and non-German nationals residing in Germany: a cross-sectional study.

PubMed

Brzoska, Patrick; Sauzet, Odile; Yilmaz-Aslan, Yüce; Widera, Teresia; Razum, Oliver

2017-08-11

Rehabilitation following medical conditions is largely offered as in-patient service in Germany. Foreign-national residents use rehabilitative services less often than Germans and attain less favourable treatment outcomes. These differences are independent of demographic, socioeconomic and health characteristics. Satisfaction with different aspects of rehabilitative care presumably affects the effectiveness of rehabilitative services. We compared the degree of satisfaction with different domains of the rehabilitative care process between Germans and non-German nationals residing in Germany. We used data from a cross-sectional rehabilitation patient survey annually conducted by the German Statutory Pension Insurance Scheme. The sample comprises 274 513 individuals undergoing medical rehabilitation in 642 hospitals during the years 2007-2011. Participants rated their satisfaction with different domains of rehabilitation on multi-item scales. We dichotomised each scale to low/moderate and high satisfaction. For each domain, a multilevel adjusted logistic regression analysis was conducted to examine differences in the levels of satisfaction between German and non-German nationals. Average marginal effects (AMEs) and 99.5% CI were computed as effect estimates. AMEs represent differences in the probability for the occurrence of the outcome. Turkish nationals had a higher probability for being less satisfied with most aspects of their rehabilitation, with AMEs ranging between 0.05 (99.5% CI 0.00 to 0.09) for 'satisfaction with psychological care' and 0.11 (99.5% CI 0.08 to 0.14) for 'satisfaction with treatments during rehabilitation'. Patients from former Yugoslavia and from Portugal/Spain/Italy/Greece were as satisfied as Germans with most aspects of their rehabilitation. Turkish nationals are less satisfied with their rehabilitative care than other population groups. This may be attributable to the diversity of the population in terms of its expectations towards rehabilitation. Rehabilitative care institutions need to provide services that are sensitive to the needs of all clients. Diversity management can contribute to this process. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Ernest Starling's analysis of the energy balance of the German people during the blockade, 1914-19.

PubMed

Van der Kloot, William

2003-05-01

Ernest H. Starling FRS (1866-1927) is remembered as a great physiologist; nevertheless a paper of his that is of substantial historical interest has dropped out of sight. It is a quantitative analysis of the effects of the Allied food blockade during World War I on the energy available to the German population and of the failure by the German government to distribute the available energy fairly. He shows that by 1919 a substantial proportion of the urban Germans were starving. His data are summarized in this article. Starling concluded that empty stomachs were a major reason for the German capitulation. His analysis grew out of his work as the second chairman of the Food [War] Committee of The Royal Society and as one of the two British members of the International Scientific Food Commission, pioneering bodies in using science to help to set public policy.

Regional medicine use in the Rhine basin and its implication on water quality

NASA Astrophysics Data System (ADS)

Hut, R. W.; Houtman, C. J.; van de Giesen, N. C.; de Jong, S. A. P.

2012-04-01

Do Germans use more painkillers than the French? Pharmaceuticals used in our Western society form an important group of contaminants found in the river Rhine. As this river is the drinking water source for millions of Europeans, methods to investigate relations between drug use and their penetration in the watercycle are of great importance. An analysis is presented relating medicine residue in the river Rhine to the number of people living in its watershed. An extensive measuring campaign was carried out, sampling river Rhine at 42 locations from its source to the start of its delta (Dutch-German border). The samples were analyzed for 40 common pharmaceuticals. Using discharge data, digital elevation models and demographic data from Eurostat, the relation between total load of drug residue and population was analyzed. Results show regional differences in drug use as well as implications for (down)stream water quality concerning contamination with pharmaceuticals.

A Study on the Phenomenon of Collocations: Methodology of Teaching English and German Collocations to Russian Students

ERIC Educational Resources Information Center

Varlamova, Elena V.; Naciscione, Anita; Tulusina, Elena A.

2016-01-01

Relevance of the issue stated in the article is determined by the fact that there is a lack of research devoted to the methods of teaching English and German collocations. The aim of our work is to determine methods of teaching English and German collocations to Russian university students studying foreign languages through experimental testing.…

People with dementia in nursing home research: a methodological review of the definition and identification of the study population.

PubMed

Palm, Rebecca; Jünger, Saskia; Reuther, Sven; Schwab, Christian G G; Dichter, Martin N; Holle, Bernhard; Halek, Margareta

2016-04-05

There are various definitions and diagnostic criteria for dementia, leading to discrepancies in case ascertainment in both clinical practice and research. We reviewed the different definitions, approaches and measurements used to operationalize dementia in health care studies in German nursing homes with the aim of discussing the implications of different approaches. We conducted a systematic search of the MEDLINE and CINAHL databases to identify pre-2016 studies conducted in German nursing homes that focused on residents with dementia or cognitive impairment. In- or exclusion of studies were consented by all authors; data extraction was independently carried out by 2 authors (RP, SJ). The studies' sampling methods were compared with respect to their inclusion criteria, assessment tools and methods used to identify the study population. We summarized case ascertainment methods from 64 studies. Study participants were identified based on a diagnosis that was evaluated during the study, or a recorded medical dementia diagnosis, or a recorded medical diagnosis either with additional cognitive screenings or using screening tests exclusively. The descriptions of the diagnostics that were applied to assess a diagnosis of dementia were not fully transparent in most of the studies with respect to either a clear reference definition of dementia or applied diagnostic criteria. If reported, various neuropsychological tests were used, mostly without a clear rationale for their selection. Pragmatic considerations often determine the sampling strategy; they also may explain the variances we detected in the different studies. Variations in sampling methods impede the comparability of study results. There is a need to consent case ascertainment strategies in dementia studies in health service research in nursing homes. These strategies should consider resource constraints and ethical issues that are related to the vulnerable population of nursing home residents. Additionally, reporting about dementia studies in nursing homes need to be improved. If a diagnosis cannot be evaluated based on either ICD or DSM criteria, the study population may not be reported as having dementia. If a diagnosis is evaluated based on ICD or DSM criteria within the study, there is a need for more transparency of the diagnostic process.

[Attitudes towards psychotherapy of young second-generation Turkish immigrants living in Germany].

PubMed

Calliess, Iris Tatjana; Schmid-Ott, Gerhard; Akguel, Gülay; Jaeger, Burkard; Ziegenbein, Marc

2007-10-01

To assess the effect of cultural identification in Turkish immigrants living in Germany on attitudes towards psychotherapy. The approach to psychotherapy of 139 Turkish immigrants and 164 Germans was examined. Overall the Turkish population reported a less positive attitude towards psychotherapy in comparison to the German population. The Turkish immigrants with a less traditional cultural background reported a more positive attitude towards psychotherapy when compared to Turkish immigrants of a more Turkish identified traditional cultural background. Results suggest that culture-specific factors affect attitudes towards psychotherapy in Turkish immigrants, which indicates a need for intercultural psychotherapeutic education.

A Retrospective Perinatal Data Analysis of Immigrant and German Women from Representative Birth Cohorts at the Virchow Hospital, Berlin

PubMed Central

Armbrust, R.; von Rennenberg, R.; David, M.

2016-01-01

Introduction: The aim of this study was to define and characterise differences in the level of obstetric care provided to immigrant and German women. Materials and Methods: An analysis of the Virchow Hospitalʼs birth registers was conducted for the years 1974, 1984 and 1994. The study population of 5445 patients was grouped according to ancestry/family origin on the basis of a name analysis, and subsequently also according to parity (primiparous or multiparous). On name analysis 2741 women were defined as German, 1598 were grouped as women of Turkish origin and 810 as immigrants of other origin. χ2 tests and Fisherʼs exact test were used for significance testing (significance level p < 0.05), and a logistic regression analysis was performed. Results: Rates of caesarean section, episiotomy, higher grade perineal tears and severe postpartum haemorrhage did not differ between the groups. There were however significant differences in the use of uterine stimulants, analgesics in labour and both local and regional anaesthesia, with women of Turkish origin and other immigrants receiving anaesthesia less, but oxytocin more often. Rooming-in was more common among German primipara and multipara from 1984 onwards. Discussion: This retrospective analysis of three historical birth cohorts showed significant differences in perinatal care between German and immigrant women, presumably reflecting deficits in care. It seems remarkable that this trend has not changed over a time span of three decades despite a continuous increase in immigration and acculturation. A “research paradox”, however, remains: Despite these increasing rates, there are no current or older, prospective or systematic studies of obstetric care in immigrants. PMID:27904165

Cancer in populations living in regions with radioecological problems in Bulgaria.

PubMed

Chobanova, N; Genchev, G; Yagova, A; Georgieva, L

2003-01-01

To analyse the incidence and mortality of some malignant diseases among the population living in regions of past uranium extraction in Bulgaria. A retrospective study on cancer incidence and mortality in the population living around two regions with radioecological problems was conducted. According to the expected individual annual effective doses for the population, regions with expected highest radiation risk (average effective dose > 10 mSv per year) were the villages Yana, Eleshnitza and Seslavtzi (group A), and with expected relatively high radiation risk (average effective dose > 5 mSv per year) were the town of Buhovo, and the villages Dolni Bogrov and Gorni Bogrov (group B). The ecologically clean village German was chosen as a control settlement. The incidence and mortality of gastrointestinal tract cancers, bronchus and lung cancer, breast cancer, thyroid cancer, and myeloid leukaemia for the period 1995- 2001 were studied. The incidence of the gastrointestinal tract cancers in the population of German was significantly lower than those for Bulgaria and for group B. The mortality from this disease of groups A, B and Bulgaria were significantly higher than in the control settlement. Standardized mortality of lung cancer in the population of the villages with highest and relatively high radiation risk was significantly higher than in German and Bulgaria. The incidence and mortality changes of diseases studied are a consequence of the impact of many factors. Moreover, they do not characterize the impact of the radiation factor.

Situation Report--Barbados, Finland, German Democratic Republic, Italy, Lesotho, Luxembourg, Malagasy Republic (Madagascar), Malaysia (West), Netherlands, Poland, Portugal, Singapore, Sweden, Syrian Arab Republic, and Yugoslavia.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Data relating to population and family planning in 15 foreign countries are presented in these situation reports. Countries included are Barbados, Finland, German Democratic Republic, Italy, Lesotho, Luxembourg, Malagasy Republic, Malaysia (West), Netherlands, Poland, Portugal, Singapore, Sweden, Syrian Arab Republic, and Yogoslavia. Information…

Long-term effects on adult attachment in German occupation children born after World War II in comparison with a birth-cohort-matched representative sample of the German general population.

PubMed

Kaiser, Marie; Kuwert, Philipp; Braehler, Elmar; Glaesmer, Heide

2018-02-01

Children born of war are a phenomenon of every conflict. At the end of World War II and thereafter, approximately 400,000 children were fathered by foreign soldiers and born to local women in Germany. Quantitative research on psychosocial consequences of growing up as German occupation child (GOC) has been missing so far. This study examines adult attachment and its association with current depression in GOC (N = 146) using self-report instruments: Adult Attachment Scale, Patient Health Questionnaire. Data were compared to a birth-cohort-matched representative sample of the German population (BCMS; N = 786). GOC differ in both attachment dimensions (less comfortable with closeness/intimacy, lowered ability to depend on others) and adult attachment (more dismissive and fearful) compared to BCMS. Insecure adult attachment is associated with current depression. GOC grew up under difficult circumstances (e.g. poverty, adverse events, and stigmatization). Even decades later they display more insecure attachment in current relationships. Findings underline the complex and long-term impact of their developmental conditions on attachment and current mental health.

Analytical and statistical consideration on the use of the ISAG-ICAR-SNP bovine panel for parentage control, using the Illumina BeadChip technology: example on the German Holstein population.

PubMed

Schütz, Ekkehard; Brenig, Bertram

2015-02-05

Parentage control is moving from short tandem repeats- to single nucleotide polymorphism (SNP) systems. For SNP-based parentage control in cattle, the ISAG-ICAR Committee proposes a set of 100/200 SNPs but quality criteria are lacking. Regarding German Holstein-Friesian cattle with only a limited number of evaluated individuals, the exclusion probability is not well-defined. We propose a statistical procedure for excluding single SNPs from parentage control, based on case-by-case evaluation of the GenCall score, to minimize parentage exclusion, based on miscalled genotypes. Exclusion power of the ISAG-ICAR SNPs used for the German Holstein-Friesian population was adjusted based on the results of more than 25,000 individuals. Experimental data were derived from routine genomic selection analyses of the German Holstein-Friesian population using the Illumina BovineSNP50 v2 BeadChip (20,000 individuals) or the EuroG10K variant (7000 individuals). Averages and standard deviations of GenCall scores for the 200 SNPs of the ISAG-ICAR recommended panel were calculated and used to calculate the downward Z-value. Based on minor allelic frequencies in the Holstein-Friesian population, one minus exclusion probability was equal to 1.4×10⁻¹⁰ and 7.2×10⁻²⁶, with one and two parents, respectively. Two monomorphic SNPs from the 100-SNP ISAG-ICAR core-panel did not contribute. Simulation of 10,000 parentage control combinations, using the GenCall score data from both BeadChips, showed that with a Z-value greater than 3.66 only about 2.5% parentages were excluded, based on the ISAG-ICAR recommendations (core-panel: ≥ 90 SNPs for one, ≥ 85 SNPs for two parents). When applied to real data from 1750 single parentage assessments, the optimal threshold was determined to be Z = 5.0, with only 34 censored cases and reduction to four (0.2%) doubtful parentages. About 70 parentage exclusions due to weak genotype calls were avoided, whereas true exclusions (n = 34) were unaffected. Using SNPs for parentage evaluation provides a high exclusion power also for parent identification. SNPs with a low GenCall score show a high tendency towards intra-molecular secondary structures and substantially contribute to false exclusion of parentages. We propose a method that controls this error without excluding too many parent combinations from the evaluation.

Extrinsic skin ageing in German, Chinese and Japanese women manifests differently in all three groups depending on ethnic background, age and anatomical site.

PubMed

Vierkötter, Andrea; Hüls, Anke; Yamamoto, Ai; Stolz, Sabine; Krämer, Ursula; Matsui, Mary S; Morita, Akimichi; Wang, Sijia; Li, Zhiwen; Jin, Li; Krutmann, Jean; Schikowski, Tamara

2016-09-01

It has been suggested that extrinsic skin ageing manifests differently in Caucasians versus East Asians. In particular, from previous studies it was concluded that Caucasians are more prone to develop wrinkles, whereas pigment spot formation is the hallmark of extrinsic skin ageing in East Asians. However, these assumptions are based on a very limited number of studies which did not include different East Asian populations. We here compare the manifestation of extrinsic skin ageing signs in German, Japanese and Chinese women by specifically elucidating the age and anatomical site dependence of any potential ethnic difference. In the present study, we assessed skin ageing in N=902 German, N=165 Japanese and N=1260 Chinese women ranging from 30 to 90 years by means of SCINEXA™. Linear regression analysis was used to test for ethnic differences and their age and site dependence adjusted for educational level, sun exposure, smoking and sun protection behaviours. Pigment spots and wrinkles on the face were present among all three ethnic groups and differences were influenced by age and anatomical sites independently of further influencing factors. Pigment spots on the forehead were most pronounced over the whole age range in Chinese and German women and least developed in Japanese. Pigment spots on cheeks were a typical extrinsic skin an ageing sign in the two East Asian populations in all age groups. However, in older German women they reach the same level as observed in the two East Asian populations. In contrast, pigment spots on arms and hands were significantly more pronounced in German women ≥45years of age. Wrinkles were not exclusively a skin an ageing sign of German women, but were also very pronounced in Chinese women on forehead, between the eyebrows and in the crow's feet area. These results corroborate the previous notion that the occurrence of pigments spots and wrinkles is different between Caucasians and East Asians. In addition, this study shows that this difference depends on age and anatomical site and that it also differs between different ethnic groups from East Asia. Copyright © 2016 Japanese Society for Investigative Dermatology. Published by Elsevier Ireland Ltd. All rights reserved.

Mortality and life expectancy of professional fire fighters in Hamburg, Germany: a cohort study 1950 – 2000

PubMed Central

Wagner, Norbert L; Berger, Jürgen; Flesch-Janys, Dieter; Koch, Peter; Köchel, Anja; Peschke, Michel; Ossenbach, Trude

2006-01-01

Background The healthy worker effect may hide adverse health effects in hazardous jobs, especially those where physical fitness is required. Fire fighters may serve as a good example because they sometimes are severely exposed to hazardous substances while on the other hand their physical fitness and their strong health surveillance by far exceeds that of comparable persons from the general population. Methods To study this effect a historic cohort study was conducted to assess mortality and life expectancy of professional fire fighters of the City of Hamburg, Germany. Fire departments and trade unions questioned the validity of existing studies from outside Germany because of specific differences in the professional career. No mortality study had been conducted so far in Germany and only few in Europe. Information on all active and retired fire fighters was extracted from personnel records. To assure completeness of data the cohort was restricted to all fire fighters being active on January 1, 1950 or later. Follow up of the cohort ended on June 30th 2000. Vital status was assessed by personnel records, pension fund records and the German residence registries. Mortality of fire fighters was compared to mortality of the Hamburg and German male population by means of standardized mortality ratios. Life expectancy was calculated using life table analysis. Multivariate proportional hazard models were used to assess the effect of seniority, time from first employment, and other occupational characteristics on mortality. Results The cohort consists of 4640 fire fighters accumulating 111796 person years. Vital status could be determined for 98.2% of the cohort. By the end of follow up 1052 person were deceased. Standardized Mortality Ratio (SMR) for the total cohort was 0.79 (95% CI, 0.74–0.84) compared to Hamburg reference data and 0.78 (95% CI, 0.74–0.83) compared to National German reference data. Conditional life expectancy of a 30 year old fire fighter was 45.3 years as compared to 42.9 year of a German male in normal population. Job tasks, rank status and early retirement negatively influenced mortality. For fire fighters with comparably short duration of employment the mortality advantage diminished with longer time since first employment. SMR of persons who retired early was 1.25 (95% CI, 1.13–1.60) in reference to the general German population and the SMR of 1.71 (1.18–2.50) in the multivariate regression model. Conclusion A strong healthy worker effect was observed for the cohort, which diminished with longer time since first employment for fire fighters with shorter duration of employment, as expected. The negative effects on mortality of job tasks, rank status and in particular early retirement indicate the presence of undetermined and specific risks related to occupational hazards of fire fighters. PMID:17020604

How Accurate Are German Work-Time Data? A Comparison of Time-Diary Reports and Stylized Estimates

ERIC Educational Resources Information Center

Otterbach, Steffen; Sousa-Poza, Alfonso

2010-01-01

This study compares work time data collected by the German Time Use Survey (GTUS) using the diary method with stylized work time estimates from the GTUS, the German Socio-Economic Panel, and the German Microcensus. Although on average the differences between the time-diary data and the interview data is not large, our results show that significant…

FOXE1 Association with Differentiated Thyroid Cancer and Its Progression

PubMed Central

Penna-Martinez, Marissa; Epp, Friederike; Kahles, Heinrich; Ramos-Lopez, Elizabeth; Hinsch, Nora; Hansmann, Martin-Leo; Selkinski, Ivan; Grünwald, Frank; Holzer, Katharina; Bechstein, Wolf O.; Zeuzem, Stefan; Vorländer, Christian

2014-01-01

Background: Single nucleotide polymorphisms (SNPs) near thyroid transcription factor genes (FOXE1 rs965513/NKX2-1 rs944289) have been shown to be associated with differentiated thyroid cancer (DTC) in Caucasoid populations. We investigated the role of those SNPs in German patients with DTC and also extended our analysis to tumor stages and lymphocytic infiltration of the tumors (ITL). Methods: Patients with DTC (n=243; papillary, PTC; follicular, FTC) and healthy controls (HC; n=270) were analyzed for the rs965513 and rs944289 SNPs. Results: The case-control analysis for rs965513 SNP showed that the genotypes “AA,” “AG,” and minor allele “A” were more frequent in patients with DTC than in HC (pronounced in PTC pgenotype=0.000084, pallele=0.006 than FTC pgenotype=0.29 and pallele=0.06). Furthermore, subgroup analysis of the DTC patients stratified for primary tumor stage (T1–T2, T3–T4), the absence or presence of regional lymph node metastases (N0, N1), for distant metastases (M0, M1), as well as for ITL, showed an association of rs965513 with stages T1–T2, T1–T3, N1, and absence of ITL. The NKX2-1 SNP rs944289, however, was not associated with DTC. Conclusion: Our results confirm that the FOXE1 rs965513 SNP confers an increased risk for DTC in the German population, particularly allele “A” and the genotypes “AA” and “AG” for PTC. This increased risk was also observed in advanced tumor stages and absence of ITL, which may reflect the course of a more aggressive disease. The NKX2-1 rs944289 SNP, however, appears to play a secondary role in the development of DTC in the German population. PMID:24325646

Wind Farm Facilities in Germany Kill Noctule Bats from Near and Far

PubMed Central

Lehnert, Linn S.; Kramer-Schadt, Stephanie; Schönborn, Sophia; Lindecke, Oliver; Niermann, Ivo; Voigt, Christian C.

2014-01-01

Over recent years, it became widely accepted that alternative, renewable energy may come at some risk for wildlife, for example, when wind turbines cause large numbers of bat fatalities. To better assess likely populations effects of wind turbine related wildlife fatalities, we studied the geographical origin of the most common bat species found dead below German wind turbines, the noctule bat (Nyctalus noctula). We measured stable isotope ratios of non-exchangeable hydrogen in fur keratin to separate migrants from local individuals, used a linear mixed-effects model to identify temporal, spatial and biological factors explaining the variance in measured stable isotope ratios and determined the geographical breeding provenance of killed migrants using isoscape origin models. We found that 72% of noctule bat casualties (n = 136) were of local origin, while 28% were long-distance migrants. These findings highlight that bat fatalities at German wind turbines may affect both local and distant populations. Our results indicated a sex and age-specific vulnerability of bats towards lethal accidents at turbines, i.e. a relatively high proportion of killed females were recorded among migratory individuals, whereas more juveniles than adults were recorded among killed bats of local origin. Migratory noctule bats were found to originate from distant populations in the Northeastern parts of Europe. The large catchment areas of German wind turbines and high vulnerability of female and juvenile noctule bats call for immediate action to reduce the negative cross-boundary effects of bat fatalities at wind turbines on local and distant populations. Further, our study highlights the importance of implementing effective mitigation measures and developing species and scale-specific conservation approaches on both national and international levels to protect source populations of bats. The efficacy of local compensatory measures appears doubtful, at least for migrant noctule bats, considering the large geographical catchment areas of German wind turbines for this species. PMID:25118805

Wind farm facilities in Germany kill noctule bats from near and far.

PubMed

Lehnert, Linn S; Kramer-Schadt, Stephanie; Schönborn, Sophia; Lindecke, Oliver; Niermann, Ivo; Voigt, Christian C

2014-01-01

Over recent years, it became widely accepted that alternative, renewable energy may come at some risk for wildlife, for example, when wind turbines cause large numbers of bat fatalities. To better assess likely populations effects of wind turbine related wildlife fatalities, we studied the geographical origin of the most common bat species found dead below German wind turbines, the noctule bat (Nyctalus noctula). We measured stable isotope ratios of non-exchangeable hydrogen in fur keratin to separate migrants from local individuals, used a linear mixed-effects model to identify temporal, spatial and biological factors explaining the variance in measured stable isotope ratios and determined the geographical breeding provenance of killed migrants using isoscape origin models. We found that 72% of noctule bat casualties (n = 136) were of local origin, while 28% were long-distance migrants. These findings highlight that bat fatalities at German wind turbines may affect both local and distant populations. Our results indicated a sex and age-specific vulnerability of bats towards lethal accidents at turbines, i.e. a relatively high proportion of killed females were recorded among migratory individuals, whereas more juveniles than adults were recorded among killed bats of local origin. Migratory noctule bats were found to originate from distant populations in the Northeastern parts of Europe. The large catchment areas of German wind turbines and high vulnerability of female and juvenile noctule bats call for immediate action to reduce the negative cross-boundary effects of bat fatalities at wind turbines on local and distant populations. Further, our study highlights the importance of implementing effective mitigation measures and developing species and scale-specific conservation approaches on both national and international levels to protect source populations of bats. The efficacy of local compensatory measures appears doubtful, at least for migrant noctule bats, considering the large geographical catchment areas of German wind turbines for this species.

From One Generation to the Next: Teachers and Teaching in the German Colonies in South Russia 1804-1914

ERIC Educational Resources Information Center

Steinberg, Neta

2009-01-01

Among the ethnic groups that composed the population of the Russian Empire, one unique group was that of the Ethnic Germans ("Volksdeutschen") who had immigrated to Russia since the second half of the eighteenth century. Over the years, there had been a change in the process of the settlers' assimilation as an outcome of their…

Situation Report--Austria, Cameroon, Canada, Czechoslovakia, Denmark, Egypt, France, German Federal Republic, Greece, Hungary, Irish Republic, Jamaica, Malta, Norway, Sabah, Sarawak, Spain, Tahiti (French Polynesia), Tonga, Turkey, and United Kingdom.

ERIC Educational Resources Information Center

International Planned Parenthood Federation, London (England).

Data relating to population and family planning in 21 foreign countries are presented in these situation reports. Countries included are Austria, Cameroon, Canada, Czechoslovakia, Denmark, Egypt, France, German Federal Republic, Greece, Hungary, Irish Republic, Jamaica, Malta, Norway, Sabah, Sarawak, Spain, Tahiti, Tonga, Turkey, and United…

Cross-cultural adaptation and validation of the VISA-A questionnaire for German-speaking Achilles tendinopathy patients

PubMed Central

Lohrer, Heinz; Nauck, Tanja

2009-01-01

Background Achilles tendinopathy is the predominant overuse injury in runners. To further investigate this overload injury in transverse and longitudinal studies a valid, responsive and reliable outcome measure is demanded. Most questionnaires have been developed for English-speaking populations. This is also true for the VISA-A score, so far representing the only valid, reliable, and disease specific questionnaire for Achilles tendinopathy. To internationally compare research results, to perform multinational studies or to exclude bias originating from subpopulations speaking different languages within one country an equivalent instrument is demanded in different languages. The aim of this study was therefore to cross-cultural adapt and validate the VISA-A questionnaire for German-speaking Achilles tendinopathy patients. Methods According to the "guidelines for the process of cross-cultural adaptation of self-report measures" the VISA-A score was cross-culturally adapted into German (VISA-A-G) using six steps: Translation, synthesis, back translation, expert committee review, pretesting (n = 77), and appraisal of the adaptation process by an advisory committee determining the adequacy of the cross-cultural adaptation. The resulting VISA-A-G was then subjected to an analysis of reliability, validity, and internal consistency in 30 Achilles tendinopathy patients and 79 asymptomatic people. Concurrent validity was tested against a generic tendon grading system (Percy and Conochie) and against a classification system for the effect of pain on athletic performance (Curwin and Stanish). Results The "advisory committee" determined the VISA-A-G questionnaire as been translated "acceptable". The VISA-A-G questionnaire showed moderate to excellent test-retest reliability (ICC = 0.60 to 0.97). Concurrent validity showed good coherence when correlated with the grading system of Curwin and Stanish (rho = -0.95) and for the Percy and Conochie grade of severity (rho 0.95). Internal consistency (Cronbach's alpha) for the total VISA-A-G scores of the patients was calculated to be 0.737. Conclusion The VISA-A questionnaire was successfully cross-cultural adapted and validated for use in German speaking populations. The psychometric properties of the VISA-A-G questionnaire are similar to those of the original English version. It therefore can be recommended as a sufficiently robust tool for future measuring clinical severity of Achilles tendinopathy in German speaking patients. PMID:19878572

Migration pattern and mortality of ethnic German migrants from the former Soviet Union: a cohort study in Germany.

PubMed

Kaucher, Simone; Deckert, Andreas; Becher, Heiko; Winkler, Volker

2017-12-19

We aimed to investigate all-cause and cause-specific mortality among ethnic German migrants from the former Soviet Union by different immigration periods to describe associations with migration pattern and mortality. We used pooled data from three retrospective cohort studies in Germany. Ethnic German migrants from the former Soviet Union (called resettlers), who immigrated to Germany since 1990 to the federal states North Rhine-Westphalia and Saarland and to the region of Augsburg (n=59 390). All-cause and cause-specific mortality among resettlers in comparison to the general German population, separated by immigration period. Immigration periods were defined following legislative changes in German immigration policy (1990-1992, 1993-1995, 1996+). Resettlers' characteristics were described accordingly. To investigate mortality differences by immigration period, we calculated age-standardised mortality rates (ASRs) and standardised mortality ratios (SMRs) of resettlers in comparison to the general German population. Additionally, we modelled sex-specific ASRs with Poisson regression, using age, year and immigration period as independent variables. The composition of resettlers differed by immigration period. Since 1993, the percentage of resettlers from the Russian Federation and non-German spouses increased. Higher all-cause mortality was found among resettlers who immigrated in 1996 and after (ASR 628.1, 95% CI 595.3 to 660.8), compared with resettlers who immigrated before 1993 (ASR 561.8, 95% CI 537.2 to 586.4). SMR analysis showed higher all-cause mortality among resettler men from the last immigration period compared with German men (SMR 1.11, 95% CI 1.04 to 1.19), whereas resettlers who immigrated earlier showed lower all-cause mortality. Results from Poisson regression, adjusted for age and year, corroborated those findings. Mortality differences by immigration period suggest different risk-factor patterns and possibly deteriorated integration opportunities. Health policy should guard the consequences of immigration law alterations with respect to changing compositions of migrant groups and their health status. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Spatial and temporal determinants of genetic structure in Gentianella bohemica

PubMed Central

Königer, Julia; Rebernig, Carolin A; Brabec, Jiří; Kiehl, Kathrin; Greimler, Josef

2012-01-01

The biennial plant Gentianella bohemica is a subendemic of the Bohemian Massif, where it occurs in seminatural grasslands. It has become rare in recent decades as a result of profound changes in land use. Using amplified fragment length polymorphisms (AFLP) fingerprint data, we investigated the genetic structure within and among populations of G. bohemica in Bavaria, the Czech Republic, and the Austrian border region. The aim of our study was (1) to analyze the genetic structure among populations and to discuss these findings in the context of present and historical patterns of connectivity and isolation of populations, (2) to analyze genetic structure among consecutive generations (cohorts of two consecutive years), and (3) to investigate relationships between intrapopulational diversity and effective population size (Ne) as well as plant traits. (1) The German populations were strongly isolated from each other (pairwise FST= 0.29–0.60) and from all other populations (FST= 0.24–0.49). We found a pattern of near panmixis among the latter (FST= 0.15–0.35) with geographical distance explaining only 8% of the genetic variance. These results were congruent with a principal coordinate analysis (PCoA) and analysis using STRUCTURE to identify genetically coherent groups. These findings are in line with the strong physical barrier and historical constraints, resulting in separation of the German populations from the others. (2) We found pronounced genetic differences between consecutive cohorts of the German populations (pairwise FST= 0.23 and 0.31), which can be explained by local population history (land use, disturbance). (3) Genetic diversity within populations (Shannon index, HSh) was significantly correlated with Ne (RS= 0.733) and reflected a loss of diversity due to several demographic bottlenecks. Overall, we found that the genetic structure in G. bohemica is strongly influenced by historical periods of high connectivity and isolation as well as by marked demographic fluctuations in declining populations. PMID:22822440

[Different explanatory models for addictive behavior in Turkish and German youths in Germany: significance for prevention and treatment].

PubMed

Penka, S; Krieg, S; Hunner, Ch; Heinz, A

2003-07-01

Due to cultural and social barriers, immigrants seldom frequent centers for information, counseling, and treatment of addictive disorders. We examine cultural differences in the explanatory models of addictive behavior among Turkish and German youths in Germany with statistical devices that map the concepts associated with problems of addiction. Relevant differences were found between the disorder concepts of Turkish and German youth. German but not Turkish youths classified eating disorders among severe addictive disorders and associated them with embarrassment and shame. Concerning substance abuse, German but not Turkish youths clearly differentiated between illegal drug abuse and the abuse of alcohol and nicotine. Nearly half of all Turkish youths rejected central medical concepts such as "physical dependence" or "reduced control of substance intake" as completely inadequate to characterize problems of addictive behavior. Preventive information programs must consider these differences and use concepts that are accepted and clearly associated with addictive behavior by immigrant populations.

Stress, health and satisfaction of Australian and German doctors--a comparative study.

PubMed

Mache, Stefanie; Vitzthum, Karin; Klapp, Burghard F; Groneberg, David A

2012-01-01

Currently no study exists focusing on international differences in perception of stress, working conditions and satisfaction of hospital staff. Therefore the present study aimed to examine and compare the work and privacy situation of Australian and German physicians. The present study was designed as a cross-sectional comparison using questionnaire data. The population consisted of representative samples of 310 German and 256 Australian hospital doctors who received mailed questionnaires. The questionnaires contained items on demography, perception of stress, working conditions, job satisfaction and Life satisfaction. According to the comparison, German physicians perceived higher values of work stress. They work significantly longer hours than Australian doctors. In general, work intensity and demands are highly rated in both countries. In terms of job and life satisfaction, Australian doctors responded more positively than German doctors. This is the first comparative study illustrating a subjective evaluation of physicians' perception of stress, their work and privacy situation in two different countries. Based on these results health policy decisions can be developed.

Health-Related Behaviour Among Children of Childhood Cancer Survivors in Germany.

PubMed

Balcerek, M; Schuster, T; Korte, E; Seidel, J; Schilling, R; Hölling, H; Borgmann-Staudt, A

2017-05-01

Purpose: Childhood cancer survivors fear that previous therapy could not only impair their own but also their children's health. We examined whether health-related behaviour in children of childhood cancer survivors differs from the general population. Methods: Our first nationwide survey wave (2013-2014) surveyed offspring health in 396 German childhood cancer survivors known to have a child of their own. Answers about health behaviour were analysed using descriptive statistics. Data were collected for 418 offspring and 394 could be integrated for matched-pair analyses with data from the German general population (KIGGS, n=17 641). Results: Teeth-cleaning routine, body-mass-index or subjective body image evaluation by parents were no different from children in the general population. Parents who included a cancer survivor smoked less in the presence of their children (p=0.01). During pregnancy, mothers in cancer survivor parent pairs abstained from drinking alcohol more often (p=0.01) and smoked less (p=0.05). While the calculated effect sizes (Phi) were generally low (0.135-0.247), children from cancer survivors played less outdoors than peers did (p=0.01). Boys participated in sports outside a club more often (p=0.05) and watched less TV on weekdays (p=0.01) and girls spent more time on the computer during weekdays than peers did (p=0.01). Conclusions: This study provides the first data for health-related behaviour in cancer survivors' offspring and sheds light on differences to parenting in the general population. Multivariate analyses in a larger study population are needed to relate these differences to fear issues in cancer survivors. © Georg Thieme Verlag KG Stuttgart · New York.

Parents with mental health problems and their children in a German population based sample: Results of the BELLA study

PubMed Central

Otto, Christiane; Barkmann, Claus; Wiegand-Grefe, Silke; Hölling, Heike; Schulte-Markwort, Michael; Ravens-Sieberer, Ulrike; Klasen, Fionna

2017-01-01

Background Mental health problems (MHP) of parents are associated with an increased risk of psychological and developmental difficulties in their children. This study aims at analyzing population-based data of parents with MHP and their children and the effects of associated risk factors in order to further targeted preventive and therapeutic interventions. Methods The BELLA study is the mental health module of the German National Health Interview and Examination Survey among Children and Adolescents. MHP in parents and in their children as well as associated risk factors were examined in a sample of N = 1158 parents with children aged 11 to 17 years. Results Parental MHP were identified in 18.6% of the sample. Risk factors associated with parental MHP were low SES, parental unemployment, stressful life events, parental daily strain, parental chronic disease, and child MHP. A rate of 19.1% of the children of parents with MHP reported MHP themselves, the corresponding rate among children of parents without MHP was 7.7%. In multiple regression analyses the risk for children of parents with MHP to report MHP themselves was almost two times higher than the risk of children of parents without MHP. Other significant associations with child MHP included gender, the parents’ age, and stressful life events. Conclusions Parental MHP constitute a significant risk for the mental health of their children. Targeted screening methods and preventive interventions are needed. PMID:28671981

[The design of a nationwide cohort study in Germany : the pretest studies of the German National Cohort (GNC)].

PubMed

Ahrens, W; Greiser, H; Linseisen, J; Kluttig, A; Schipf, S; Schmidt, B; Günther, K

2014-11-01

The German National Cohort (GNC) is the largest population-based cohort study in Germany. Beginning in 2014, a total of 200,000 women and men aged 20-69 years will be examined in 18 study centers. The aim of the study is to investigate the etiology of chronic diseases in relation to lifestyle, genetic, socioeconomic, and environmental factors and to develop appropriate methods for early diagnosis and prevention of diseases such as cardiovascular and respiratory diseases, cancer, diabetes, neurodegenerative/psychiatric diseases, as well as musculoskeletal and infectious diseases. Pretest studies (phase 1 and 2) were conducted to select methods, instruments, and procedures for the main study, to develop standard operating procedures, and to design and test the examination program according to acceptance, expected duration, and feasibility. The pretest studies included testing of interviews, questionnaires, anthropometric measurements, several medical examinations, and the collection of biosamples. In addition, the logistic, technical, and personnel infrastructure for the main study could be established including the study centers, the central infrastructure for data management, processes to coordinate the study, and data protection and quality management concepts. The examination program for the main phase of the GNC was designed and optimized based on the results of the pretest studies. The GNC is a population-based, highly standardized and excellently phenotyped cohort that will be the basis for new strategies for risk assessment and identification, early diagnosis, and prevention of multifactorial diseases.

Nutritional status in sick children and adolescents is not accurately reflected by BMI-SDS.

PubMed

Fusch, Gerhard; Raja, Preeya; Dung, Nguyen Quang; Karaolis-Danckert, Nadina; Barr, Ronald; Fusch, Christoph

2013-01-01

Nutritional status provides helpful information of disease severity and treatment effectiveness. Body mass index standard deviation scores (BMI-SDS) provide an approximation of body composition and thus are frequently used to classify nutritional status of sick children and adolescents. However, the accuracy of estimating body composition in this population using BMI-SDS has not been assessed. Thus, this study aims to evaluate the accuracy of nutritional status classification in sick infants and adolescents using BMI-SDS, upon comparison to classification using percentage body fat (%BF) reference charts. BMI-SDS was calculated from anthropometric measurements and %BF was measured using dual-energy x-ray absorptiometry (DXA) for 393 sick children and adolescents (5 months-18 years). Subjects were classified by nutritional status (underweight, normal weight, overweight, and obese), using 2 methods: (1) BMI-SDS, based on age- and gender-specific percentiles, and (2) %BF reference charts (standard). Linear regression and a correlation analysis were conducted to compare agreement between both methods of nutritional status classification. %BF reference value comparisons were also made between 3 independent sources based on German, Canadian, and American study populations. Correlation between nutritional status classification by BMI-SDS and %BF agreed moderately (r (2) = 0.75, 0.76 in boys and girls, respectively). The misclassification of nutritional status in sick children and adolescents using BMI-SDS was 27% when using German %BF references. Similar rates observed when using Canadian and American %BF references (24% and 23%, respectively). Using BMI-SDS to determine nutritional status in a sick population is not considered an appropriate clinical tool for identifying individual underweight or overweight children or adolescents. However, BMI-SDS may be appropriate for longitudinal measurements or for screening purposes in large field studies. When accurate nutritional status classification of a sick patient is needed for clinical purposes, nutritional status will be assessed more accurately using methods that accurately measure %BF, such as DXA.

Comparison of Subjective Health Complaints between Chinese and German University Students: A Cross-Sectional Study

PubMed Central

Chu, Janet Junqing; Khan, Mobarak Hossain; Jahn, Heiko J.; Kraemer, Alexander

2015-01-01

High rates of health complaints (HCs) with substantial variation are reported in different university populations, which can be linked to socio-demographic, lifestyle-related factors, and cultural differences. HCs can be categorized into distinct components. This study aimed to identify and compare underlying dimensions of HCs (HC components); to access and compare HC prevalence, and the associations between HC components, socio-demographic, lifestyle-related factors, and perceived stress in German and Chinese university students. Two health surveys were conducted among 5159 university students (1853 Chinese, 3306 German). Factor analysis and logistic regression were applied. The prevalence of HC ranged from 4.6% to 40.2% over the two countries. Germans reported at least three HCs more often (47.2% vs. 35.8%). Chinese students more often reported gastrointestinal complaints. Perceived stress was positively associated with all three HC components in both countries (OR = 1.03–1.50) with stronger associations among Germans. Women more often reported HCs (OR = 1.32–2.43) with stronger associations among the Germans. Having a father with a low educational level was associated with high psychological symptoms among the Chinese (OR = 1.51), but with low gastrointestinal complaints among the Germans (OR = 0.79). The high prevalence of HCs in students requires country-specific interventions. PMID:26690463

Epidemiology in Germany-general development and personal experience.

PubMed

Wichmann, Heinz-Erich

2017-08-01

Did you ever hear about epidemiology in Germany? Starting from an epidemiological desert the discipline has grown remarkably, especially during the last 10-15 years: research institutes have been established, research funding has improved, multiple curriculae in Epidemiology and Public Health are offered. This increase has been quite steep, and now the epidemiological infrastructure is much better. Several medium-sized and even big population cohorts are ongoing, and the number and quality of publications from German epidemiologists has reached a respectable level. My own career in epidemiology started in the field of environmental health. After German reunification I concentrated for many years on environmental problems in East Germany and observed the health benefits after improvement of the situation. Later, I concentrated on population-based cohorts in newborns (GINI/LISA) and adults (KORA, German National Cohort), and on biobanking. This Essay describes the development in Germany after worldwar 2, illustrated by examples of research results and build-up of epidemiological infractructures worth mentioning.

Recalibration of the ACC/AHA Risk Score in Two Population-Based German Cohorts

PubMed Central

de las Heras Gala, Tonia; Geisel, Marie Henrike; Peters, Annette; Thorand, Barbara; Baumert, Jens; Lehmann, Nils; Jöckel, Karl-Heinz; Moebus, Susanne; Erbel, Raimund; Meisinger, Christine

2016-01-01

Background The 2013 ACC/AHA guidelines introduced an algorithm for risk assessment of atherosclerotic cardiovascular disease (ASCVD) within 10 years. In Germany, risk assessment with the ESC SCORE is limited to cardiovascular mortality. Applicability of the novel ACC/AHA risk score to the German population has not yet been assessed. We therefore sought to recalibrate and evaluate the ACC/AHA risk score in two German cohorts and to compare it to the ESC SCORE. Methods We studied 5,238 participants from the KORA surveys S3 (1994–1995) and S4 (1999–2001) and 4,208 subjects from the Heinz Nixdorf Recall (HNR) Study (2000–2003). There were 383 (7.3%) and 271 (6.4%) first non-fatal or fatal ASCVD events within 10 years in KORA and in HNR, respectively. Risk scores were evaluated in terms of calibration and discrimination performance. Results The original ACC/AHA risk score overestimated 10-year ASCVD rates by 37% in KORA and 66% in HNR. After recalibration, miscalibration diminished to 8% underestimation in KORA and 12% overestimation in HNR. Discrimination performance of the ACC/AHA risk score was not affected by the recalibration (KORA: C = 0.78, HNR: C = 0.74). The ESC SCORE overestimated by 5% in KORA and by 85% in HNR. The corresponding C-statistic was 0.82 in KORA and 0.76 in HNR. Conclusions The recalibrated ACC/AHA risk score showed strongly improved calibration compared to the original ACC/AHA risk score. Predicting only cardiovascular mortality, discrimination performance of the commonly used ESC SCORE remained somewhat superior to the ACC/AHA risk score. Nevertheless, the recalibrated ACC/AHA risk score may provide a meaningful tool for estimating 10-year risk of fatal and non-fatal cardiovascular disease in Germany. PMID:27732641

Psychiatric disorders and urbanization in Germany

PubMed Central

Dekker, Jack; Peen, Jaap; Koelen, Jurrijn; Smit, Filip; Schoevers, Robert

2008-01-01

Background Epidemiological studies over the last decade have supplied growing evidence of an association between urbanization and the prevalence of psychiatric disorders. Our aim was to examine the link between levels of urbanization and 12-month prevalence rates of psychiatric disorders in a nationwide German population study, controlling for other known risk factors such as gender, social class, marital status and the interaction variables of these factors with urbanization. Methods The Munich Composite International Diagnostic Interview (M-CIDI) was used to assess the prevalence of mental disorders (DSM-IV) in a representative sample of the German population (N = 4181, age: 18–65). The sample contains five levels of urbanization based on residence location. The epidemiological study was commissioned by the German Ministry of Research, Education and Science (BMBF) and approved by the relevant Institutional Review Board and ethics committee. Written informed consent was obtained for both surveys (core survey and Mental Health Supplement). Subjects did not get any financial compensation for their study participation. Results Higher levels of urbanization were linked to higher 12-month prevalence rates for almost all major psychiatric disorders (with the exception of substance abuse and psychotic disorders). The weighted prevalence percentages were highest in the most urbanized category. Alongside urbanization, female gender, lower social class and being unmarried were generally found to be associated with higher levels of psychopathology. The impact of urbanization on mental health was about equal (for almost all major psychiatric disorders) in young people and elderly people, men and women, and in married and single people. Only people from a low social class in the most urbanized settings had more somatoform disorders, and unmarried people in the most urbanized settings had more anxiety disorders. Conclusion Psychiatric disorders are more prevalent among the inhabitants of more urbanized areas. probably because of environmental stressors. PMID:18201380

Back pain in the German adult population: prevalence, severity, and sociodemographic correlates in a multiregional survey.

PubMed

Schmidt, Carsten Oliver; Raspe, Heiner; Pfingsten, Michael; Hasenbring, Monika; Basler, Heinz Dieter; Eich, Wolfgang; Kohlmann, Thomas

2007-08-15

A population-based cross-sectional multiregion postal survey. To provide a descriptive epidemiology of the prevalence and severity of back pain in German adults and to analyze sociodemographic correlates for disabling back pain within and across regions. Back pain is a leading health problem in Germany. However, comprehensive population-based evidence on the severity of back pain is still fragmentary for this country. Despite earlier findings concerning large prevalence differences across regions, systematic explanations remain to be ascertained. Questionnaire data were collected for 9263 subjects in 5 German cities and regions (population-based random samples, postal questionnaire). Point, 1-year, and lifetime prevalence were assessed using direct questions, and graded back pain was determined using the Graded Chronic Pain Scale. Poststratification was applied to adjust for cross-regional sociodemographic differences. Point-prevalence was 37.1%, 1-year prevalence 76.0%, and lifetime prevalence 85.5%. A substantial minority had severe (Grade II, 8.0%) or disabling back pain (Grade III-IV, 11.2%). Subjects with a low educational level reported substantially more disabling back pain. This variable was an important predictor for large cross-regional differences in the burden of back pain. Back pain is a highly prevalent condition in Germany. Disabling back pain in this country may be regarded as part of a social disadvantage syndrome. Educational level should receive greater attention in future cross-regional comparisons of back pain.

Is Seeing Believing? How Americans and Germans Think about Their Schools. Program on Education Policy and Governance Working Papers Series. PEPG 15-02

ERIC Educational Resources Information Center

Henderson, Michael B.; Lergetporer, Philipp; Peterson, Paul E.; Werner, Katharina; West, Martin R.; Woessmann, Ludger

2015-01-01

What do citizens of the United States and Germany think about their schools and school policies? This paper offers the first broad comparison of public thinking on education in the two countries. We carried out opinion surveys of representative samples of the German and American adult populations in 2014 that included experiments in which we…

Depression, Somatization, and Posttraumatic Stress Disorder in Children Born of Occupation After World War II in Comparison With a General Population.

PubMed

Kaiser, Marie; Kuwert, Philipp; Braehler, Elmar; Glaesmer, Heide

2015-10-01

At the end of World War II and during the first decade after the war, roughly 200,000 children were fathered in intimate contacts between German women and foreign soldiers. The experiences of these German occupation children (GOC) have been so far described in case reports and from historical perspective only. Research on psychosocial consequences of growing up as a GOC has been missing so far. This study examined traumatic experiences, posttraumatic stress disorder, somatization, and depression in GOC (N = 146) using self-report instruments: Posttraumatic Diagnostic Scale and Patient Health Questionnaire. Findings have then been compared with a representative birth cohort-matched sample from the German general population (N = 977). German occupation children showed significantly higher prevalence rates of most traumatic experiences, higher point prevalence rates of full and partial posttraumatic stress disorder, depression, and somatization than the control group. In summary, GOC often grew up under difficult conditions (e.g., poverty, single mothers, and stigmatization). Even decades later, they showed higher rates of different mental disorders and higher comorbidity. These findings underline the complex and long-term impact of their burdened social, financial, and familial conditions. The results underpin the importance of conceptualizing occupation children as a vulnerable group in postconflict settings.

Is it necessary to assume an apartheid-like social structure in Early Anglo-Saxon England?

PubMed

Pattison, John E

2008-11-07

It has recently been argued that there was an apartheid-like social structure operating in Early Anglo-Saxon England. This was proposed in order to explain the relatively high degree of similarity between Germanic-speaking areas of northwest Europe and England. Opinions vary as to whether there was a substantial Germanic invasion or only a relatively small number arrived in Britain during this period. Contrary to the assumption of limited intermarriage made in the apartheid simulation, there is evidence that significant mixing of the British and Germanic peoples occurred, and that the early law codes, such as that of King Ine of Wessex, could have deliberately encouraged such mixing. More importantly, the simulation did not take into account any northwest European immigration that arrived both before and after the Early Anglo-Saxon period. In view of the uncertainty of the places of origin of the various Germanic peoples, and their numbers and dates of arrival, the present study adopts an alternative approach to estimate the percentage of indigenous Britons in the current British population. It was found unnecessary to introduce any special social structure among the diverse Anglo-Saxon people in order to account for the estimates of northwest European intrusion into the British population.

Is it necessary to assume an apartheid-like social structure in Early Anglo-Saxon England?

PubMed Central

Pattison, John E

2008-01-01

It has recently been argued that there was an apartheid-like social structure operating in Early Anglo-Saxon England. This was proposed in order to explain the relatively high degree of similarity between Germanic-speaking areas of northwest Europe and England. Opinions vary as to whether there was a substantial Germanic invasion or only a relatively small number arrived in Britain during this period. Contrary to the assumption of limited intermarriage made in the apartheid simulation, there is evidence that significant mixing of the British and Germanic peoples occurred, and that the early law codes, such as that of King Ine of Wessex, could have deliberately encouraged such mixing. More importantly, the simulation did not take into account any northwest European immigration that arrived both before and after the Early Anglo-Saxon period. In view of the uncertainty of the places of origin of the various Germanic peoples, and their numbers and dates of arrival, the present study adopts an alternative approach to estimate the percentage of indigenous Britons in the current British population. It was found unnecessary to introduce any special social structure among the diverse Anglo-Saxon people in order to account for the estimates of northwest European intrusion into the British population. PMID:18430641

Secular change of sexually dimorphic cranial variables in Euro-Americans and Germans.

PubMed

Manthey, Laura; Jantz, Richard L; Bohnert, Michael; Jellinghaus, Katharina

2017-07-01

Crania are a reliable source for sex estimation in Euro-Americans, Europeans, and most other populations. Besides morphological assessments, the application of Fordisc® has become a useful tool within the last two decades, creating discriminant functions from morphometric data. Unfortunately, until now, white populations are mostly represented by measurements of American individuals. Therefore, classification rates are lower for European skulls than for Euro-Americans. The aim of this study was to show differences in sexual dimorphism between German and Euro-American crania. Furthermore, their secular change from the nineteenth to the twentieth century has been investigated. Analyses have been performed on glabella subtense (GLS), mastoid height (MDH), and bizygomatic breadth (ZYB). Fordisc® 3.1 was used to study sexual dimorphism and secular change, whereas SAS® was used to perform a two-level ANOVA to test for variation in sex dimorphism. Euro-Americans show greater dimorphism than Germans in all three measurements tested. This larger difference is even increasing from the late nineteenth through the late twentieth century in terms of GLS and MDH, while it stays almost the same in the present Europeans. These results explain the unsatisfying classification rates of German and other European crania on Fordisc®. Data collection for European Fordisc® samples is in progress and should improve the current situation.

The Relative Age Effect and Physical Fitness Characteristics in German Male Tennis Players

PubMed Central

Ulbricht, Alexander; Fernandez-Fernandez, Jaime; Mendez-Villanueva, Alberto; Ferrauti, Alexander

2015-01-01

The aims of the study were to test: 1) whether the relative age effect (RAE) was prevalent in young (U12-U18) German male tennis players; 2) the potential influence of age and/or skill level on RAE and 3) whether maturity, anthropometric and fitness measures vary according to birth date distribution in elite youth tennis players. For the present study the following male populations were analysed: Overall German population (n = 3.216.811), all players affiliated to the German Tennis Federation (DTB) (n = 120.851), players with DTB official ranking (n = 7165), regional (n = 381) and national (n = 57) squads (11-17 years old), as well as the top 50 German senior players were analyzed. RAEs were more prevalent at higher competitive levels with more players born in the first quarter of the year compared with the reference population for ranked (29.6%), regional (38.1%) and national (42.1%) players. No systematic differences were found in any of the maturity, anthropometric and fitness characteristics of the regional squad players born across different quarters. RAEs are present in the DTB competitive system and it was more pronounced at higher competitive levels. Compared with early born, late born players who were selected into elite squads did not differ in maturation, anthropometric and fitness characteristics. Key points RAEsexist in the selection of youth tennis players in Germany, a greater percentage of players analyzed was born in the 1st quarter compared to all licensed tennis players in the country, and more pronounced with an increased competition level in youth players. Players born later in the selection year and still selected in elite squads were likely to be similar across a range of physical fitness attributes compared with those born earlier in the year. The selection process should be reevaluated and changed to reduce the impact of RAEs on tennis players. PMID:26336351

[DRG-based cost analysis of inpatient conservative treatment of stage III/IV peripheral arterial occlusive disease].

PubMed

Heidrich, H; Rogatti, W; Altmann, E; Bauersachs, R; Diehm, C; Fahrig, C; Lawall, H; Ranft, J; Schenker, M; Schweizer, H J; Stiegler, H; Wilke, M

2003-11-01

DRG-based cost analysis of inpatient conservative treatment of PAD stage III/IV BACKGROUND: In a prospective study carried out by the German Society of Angiology and the DRG Competence Center, Munich, the question was investigated whether the costs of conservative treatment of patients with PAOD stage III/IV (DRG F65) are adequately represented within the current G-DRG system. METHODS UND PATIENTS: Between September 1 and December 16, 2002, a total of 704 patients with DRG F65 (peripheral vascular diseases) were evaluated at 8 angiologic centers in Germany. Apart from the length of hospital stay, the total costs (cost equivalents) were calculated using a method developed by the DRG Research Group at the University of Münster. Moreover, the study population was compared with a German calculation sample for the DRGs F65A/B, as published by InEK. As it turned out, conservatively treated patients with PAOD stage III or IV (DRGs F65A/B) cause significantly (p < 0.001) higher costs and have significantly (p < 0.001) greater lengths of hospital stay than patients who were also assigned to DRG F65 because of other vascular diseases. At the same time it became clear that angiologic centers treat twice as many patients with critical limb ischemia in comparison with the German average. The reimbursement hitherto estimated by InEK covers not even half the cost actually produced by conservative treatment of PAD stage III/IV. To ensure a performance-related reimbursement, a new basis DRG for patients with PAD stage III/IV has to be created, as has ben proposed by the German Society of Angiology. Otherwise, adequate conservative therapy in accordance with existing guidelines, of patients who cannot be treated surgically or interventionally will not be possible any more in the future.

The cost-effectiveness of screening for hereditary hemochromatosis in Germany: a remodeling study.

PubMed

Rogowski, Wolf H

2009-01-01

Genetic tests for hereditary hemochromatosis (HH) are currently included in the German ambulatory care reimbursement scheme but only for symptomatic individuals and the offspring of HH patients. This study synthesizes the most current evidence to examine whether screening in the broader population is cost-effective and to identify the best choice of initial and follow-up screening tests. A probabilistic decision-analytic model was constructed to calculate cost per life year gained (LYG) for HH screening among male Caucasians aged 30. Three strategies were considered in both the general population and male offspring of HH patients: phenotypic (transferrin saturation, TS), genotypic (C282Y mutation), and sequential (genotype if TS is elevated) screening. The incremental cost-effectiveness of sequential screening among male offspring, sequential population-wide screening, and genotypic screening is 41000, 124000, and 161000 Eero/LYG, respectively. All other strategies were subject to simple or extended dominance. The results are subject to high uncertainty. The most influential parameters in the deterministic one-way sensitivity analysis are discounting of life years gained and the adherence of patients to preventive phlebotomy. The current German policy of only screening at-risk individuals is consistent with health economic decision making based on typically accepted thresholds. However, conducting the DNA test after the first elevated TS result is more cost-effective than waiting for a second TS result as recommended by the German guidelines. Further empirical work regarding adherence to long-term prevention recommendations and explicit and well-justified guidance for the choice of discount rates in German economic evaluation are needed.

Survival of elderly patients with multiple myeloma-Effect of upfront autologous stem cell transplantation.

PubMed

Merz, Maximilian; Jansen, Lina; Castro, Felipe A; Hillengass, Jens; Salwender, Hans; Weisel, Katja; Scheid, Christof; Luttmann, Sabine; Emrich, Katharina; Holleczek, Bernd; Katalinic, Alexander; Nennecke, Alice; Straka, Christian; Langer, Christian; Engelhardt, Monika; Einsele, Hermann; Kröger, Nicolaus; Beelen, Dietrich; Dreger, Peter; Brenner, Hermann; Goldschmidt, Hartmut

2016-07-01

The aim of this study was to determine the value of upfront autologous transplantation (ASCT) in elderly patients (60-79 years) with myeloma. We analysed relative survival (RS) of patients diagnosed in 1998-2011 and treated with ASCT within 12 months after diagnosis in Germany (n = 3591; German Registry of Stem Cell Transplantation) and compare RS with survival of myeloma patients diagnosed in the same years in Germany (n = 13,903; population-based German Cancer Registries). Utilisation of ASCT has increased rapidly between 2000-2002 and 2009-2011 (60-64years: 7.0-43.0%; 65-69 years: 6.6-23.7%; 70-79 years: 0.4-4.0%). Comparison of 5-year RS of patients from the general German myeloma population who have survived the first year after diagnosis with 5-year RS of patients treated with ASCT revealed higher survival for transplanted patients among all age groups (60-64: 59.2% versus 66.1%; 65-69: 57.4% versus 61.7%; 70-79: 51.0% versus 56.6%). RS increased strongly between 2003-2005 and 2009-2011 for the general German myeloma population (+8.5%) and for patients treated with ASCT (+11.8%). Differences in RS between these groups increased over time from +1.9% higher age-standardised survival in transplanted patients in 2003-2005 to 5.2% higher survival in 2009-2011. We conclude that upfront ASCT might be a major contributor to improved survival for elderly myeloma patients in Germany. Copyright © 2016 Elsevier Ltd. All rights reserved.

Body mass index distribution in rheumatoid arthritis: a collaborative analysis from three large German rheumatoid arthritis databases.

PubMed

Albrecht, Katinka; Richter, Adrian; Callhoff, Johanna; Huscher, Dörte; Schett, Georg; Strangfeld, Anja; Zink, Angela

2016-06-23

METARTHROS (Metabolic impact on joint and bone disease) is a nationwide German network to investigate the overlap between inflammatory and metabolic diseases. The objective of this study was to compare the body mass index (BMI) distribution in patients with early and established rheumatoid arthritis (RA) with data from the general population, and to evaluate the association of BMI with patient characteristics and clinical markers. The BMI distribution was examined with data collected at inclusion of patients in the early arthritis cohort CAPEA, the biologics register RABBIT, and the National database of the German Collaborative Arthritis Centers. A data source with a representative sample of the German population (German Ageing Survey) was used as a comparator. BMI categories of <18.5 kg/m(2) (underweight), 18.5 to <25 kg/m(2) (normal weight), 25 to <30 kg/m(2) (overweight), and ≥30 kg/m(2) (obese) were used. Patients were stratified by age and sex, and compared to controls from the German Ageing Survey. Associations between BMI and markers of disease activity were analysed with non-parametric tests and linear models. Data from 1207 (CAPEA), 12,230 (RABBIT), and 3424 (National database) RA patients and 6202 population controls were evaluated. The mean age was 56, 56, 62, and 62 years, respectively, the mean disease duration was 13 weeks, 9.9 years, and 13.5 years, respectively, and the mean disease activity score (DAS28) was 5.1, 5.2, and 3.1, respectively. In all RA cohorts, obesity was more frequent (23.8 %, 23.4 %, 21.4 %, respectively) than in controls (18.2 %). This applied to all age groups <70 years, was independent of disease duration, and was more pronounced in females. In all cohorts, the age at RA onset was associated with BMI, being higher in overweight/obese patients compared to normal-weight patients. Current smoking was negatively associated with BMI. Linear analyses revealed increased erythrocyte sedimentation rate (ESR) values in underweight and obese females, and an increasing disparity between tender joint counts (TJCs) and swollen joint counts (SJCs) in higher BMI categories. Compared to the general population, a higher prevalence of obesity was observed in all RA cohorts. The dominance of obesity in females and the different behaviour of disease activity markers in relation to the BMI in females indicate that additional parameters need to be considered when analysing the impact of obesity on inflammation in RA.

[Migrants from the former Soviet Union born in German families and their relatives as patients in forensic units].

PubMed

Hoffmann, Klaus

2007-10-01

Young migrants from Russia born in German families are seen as a special risk group for drug and alcohol addiction as well as for criminality. In Russia, they were marginalized as Germans, now in Germany, they are marginalized as Russians--and they repeat in Germany the internal structures of distrust against the police and other government agencies. In prisons and in forensic units, this group of young German-Russians are strongly over represented compared with to share in the general population. In prisons, they are a problem group mainly speaking Russian language, forming mafia like clans and dealing drugs--all this prevents the rehabilitation. In sharp contrast, a forensic department succeeds in integrating these people by a consequent therapeutic community approach with highly frequent group psychotherapy, intensive work, sports, autonomy in cleaning the rooms and individual teaching possibilities in German language and other specialties with a teacher working on the ward. Despite published negative experiences, it is well possible to improve the legal and social prognosis of Russian-German migrants by applying a consequent milieu- and psychotherapeutic setting utilizing actively the resources of these patients.

Hypersensitivity of bronchial asthmatics to cockroach in Taiwan. comparative study between American and German cockroaches.

PubMed

Tsai, J J; Kao, M H; Wu, C H

1998-11-01

This study was performed to test the hypersensitivity of asthmatics to American and German cockroaches, which are both common in Taiwan. A total of 236 asthmatic patients received skin prick test using allergen extracts from both American and German cockroaches, and 596 sera from asthmatic patients were analyzed for their specific IgE against German cockroach extract. The results of skin test showed that 39.4 and 36.4% asthmatic patients were hypersensitive to American and German cockroaches. Fifteen among 236 patients were only allergic to American cockroaches and 8 were only allergic to German cockroaches. Using the Pharmacia CAP system, 36% of the sera were found to contain the specific IgE to German cockroach extract. Eighty-nine sera positive for German cockroach extract were then tested for their reactivity to American cockroach extract using the fluoroallergosorbent test (FAST). Sixty among 89 (68%) of their sera contained American cockroach-specific IgE. The correlation coefficient between both parameters was r = 0.45. Immunoblot and immunoblot inhibition studies were performed to analyze the IgE-binding components and the cross-reactivity between American and German cockroaches. The results showed that there are different IgE-binding components between American and German cockroaches. Sera containing specific IgE to both species of cockroach were absorbed with both species of cockroach extracts. The specific IgE to German cockroaches can be absorbed by American cockroach extract in all selected sera and the specific IgE to American cockroaches can only partially be absorbed by German cockroaches. The nonabsorbed allergens in American cockroaches had molecular weights of 33 and 50 kD. In conclusion, one-third of the asthmatic population tested was allergic to cockroaches. Although most cockroach-hypersensitive patients were allergic to both American and German cockroaches, more asthmatic patients were allergic to American cockroaches in Taiwan. The use of non-crossreacting allergen in detecting American cockroach-specific IgE might be important not only for the diagnosis and treatment of cockroach hypersensitivity in asthmatics but also for the differentiation between German and American cockroach hypersensitivity.

[Gambling and internet addiction: review and research agenda].

PubMed

Wölfling, K; Bühler, M; Leménager, T; Mörsen, C; Mann, K

2009-09-01

Behavioral addictions, especially pathological gambling and internet addiction, have become a growing concern in research and health policy. Similarities between behavioral addictions and substance dependency are currently being discussed in the scientific community. Unfortunately the number of scientific studies on pathological gambling and internet addiction is still very low. The estimated prevalence of pathological gambling among the German population is 0.2-0.5%. These numbers are comparable to prevalence rates reported for illegal drug dependency. About 1.5 million people, i.e. 3% of the German population, are believed to be at risk of internet addiction. Therefore, it is important to investigate in more detail the clinical and neuroscientific basis of pathological gambling and internet addiction. In this review we summarize the current status of research regarding pathological gambling and internet addiction and outline possible future research perspectives in the field of neuroimaging and genetics. The aim is to develop a multifactorial and explanatory model which helps to improve the quality of existing therapeutic approaches and prevention strategies. At present, parts of the research are funded by the federal states. The authors of this article, supported by scientific associations, have established a research platform called 'pathological gambling' in which research methods and strategies will be discussed which facilitate the implementation of different studies on pathological gambling.

Impact of Lanice conchilega on seafloor microtopography off the island of Sylt (German Bight, SE North Sea)

NASA Astrophysics Data System (ADS)

Schönke, M.; Feldens, P.; Wilken, D.; Papenmeier, S.; Heinrich, C.; von Deimling, J. Schneider; Held, P.; Krastel, S.

2017-06-01

This study presents a new in situ method to explore the impact of macrofauna on seafloor microtopography and corresponding microroughness based on underwater laser line scanning. The local microtopography was determined with mm-level accuracy at three stations colonised by the tubeworm Lanice conchilega offshore of the island of Sylt in the German Bight (south-eastern North Sea), covering approximately 0.5 m2 each. Ground truthing was done using underwater video data. Two stations were populated by tubeworm colonies of different population densities, and one station had a hydrodynamically rippled seafloor. Tubeworms caused an increased skewness of the microtopography height distribution and an increased root mean square roughness at short spatial wavelengths compared with hydrodynamic bedforms. Spectral analysis of the 2D Fourier transformed microtopography showed that the roughness magnitude increased at spatial wavelengths between 0.020 and 0.003 m independently of the tubeworm density. This effect was not detected by commonly used 1D roughness profiles but required consideration of the complete spectrum. Overall, the results reveal that new indicator variables for benthic organisms may be developed based on microtopographic data. An example demonstrates the use of local slope and skewness to detect tubeworms in the measured digital elevation model.

Willingness to pay for health insurance among the elderly population in Germany.

PubMed

Bock, Jens-Oliver; Heider, Dirk; Matschinger, Herbert; Brenner, Hermann; Saum, Kai-Uwe; Haefeli, Walter E; König, Hans-Helmut

2016-03-01

All elderly Germans are legally obliged to have health insurance. About 90 % of this population are members of social health insurances (SHI) whose premiums are generally income-related and independent of health status. For most of these members, holding social health insurance is mandatory. As a consequence, genuine information about preferences for health insurance is not available. The aim of this study was therefore to determine and analyze the willingness to pay (WTP) for health insurance among elderly Germans. Data from a population-based 8-year follow-up of a large cohort study conducted in the Saarland, Germany was used. Participants aged 57-84 years passed a geriatric assessment and responded to a health economic questionnaire. Individuals' WTP was elicited based on a contingent valuation method with a payment card. Mean monthly WTP per capita for health insurance amounted to €260. This corresponded to about 20% of individual disposable income. Regression analyses showed that WTP increased significantly with higher income, male gender, higher educational level, and privately insured status. In contrast, neither increasing morbidity level nor higher individual health care costs influenced WTP significantly. The relatively large extent of average WTP for health insurance indicates that the elderly would probably accept higher contributions to SHI rather than policy efforts to reduce contributions. The identified determinants of WTP might indicate that elderly generally approve the principle of solidarity of the SHI with contributions depending on income rather than morbidity.

Investigations on the prevalence of the photo-induced sneezing reflex in the German population, a representative cross-sectional study.

PubMed

Kulas, Philipp; Hecker, Dietmar; Schick, Bernhard; Bozzato, Alessandro

2017-03-01

The sneezing reflex is a common phenomenon in human beings and animals. Until now largely uninvestigated sneezing phenomenon is the photic sneeze reflex, also known as the ACHOO (Autosomal Cholinergic Helio-Ophtalmologic Outburst). This light induced sneezing reflex is triggered by a bright light like the sun but also by artificial light. In former publications the prevalence of this phenomenon in the population is specified up to 35 % and can result in a potential endangerment in numerous everyday situations as driving a car or controlling an airplane. In our present study we interviewed 1042 patients in the Department of Otorhinolaryngology of the Saarland University Hospital using standardized questionnaires to analyse epidemiological data as age, gender and known diseases. Additionally, the questionnaire focused on the occurrence of sneezing events, extend of sneezing, potential triggers, and methods of evasion. In our data analysis, we were able to show a high prevalence of the ACHOO in 57 % of our cohort, suffering from regular light induced sneezing events. Excluding subjects reporting only occasional sneezing events our results were comparable to findings in literature. As expected a familial disposition was observed, additionally tobacco smoking correlated with light induced sneezing events. Analyzing a large cohort, we were able to demonstrate that the prevalence of the ACHOO in the german population may be higher than expected. Taken into account the potential hazard caused by this phenomenon, further investigations should identify the pathophysiologic pathway.

Worlds Apart? English in German Youth Cultures and in Educational Settings

ERIC Educational Resources Information Center

Grau, Maike

2009-01-01

This paper focuses on German teenagers and their contact with English in two different contexts: in free-time activities typically involving the mass media, and in institutionalised language learning settings at school. It draws on an empirical study carried out in German secondary schools. Its mixed methods approach combines a questionnaire study…

German Basic Course. Volume II, Lessons 16-25.

ERIC Educational Resources Information Center

Defense Language Inst., Washington, DC.

This is the first volume of the Intermediate Phase (lessons 16-92) of the German Basic Course developed by the Defense Language Institute. The course, normally requiring 19 weeks of training, focuses on developing mastery of structural elements of German through the audiolingual method. Dialogues are based on life situations and progress towards…

The Latest Developments in the Field of University Teaching Methods: A View from the German Democratic Republic.

ERIC Educational Resources Information Center

Klose-Berger, Annelore; Mohle, Horst

1989-01-01

Several aspects of East German research on university teaching methods, with special reference to Karl Marx University, are discussed: the development of teaching methods as part of the educational sciences field; selected recent research results, and the application of research findings to practice in the training and retraining of university…

Characteristics and external validity of the German Health Risk Institute (HRI) Database.

PubMed

Andersohn, Frank; Walker, Jochen

2016-01-01

The aim of this study was to describe characteristics and external validity of the German Health Risk Institute (HRI) Database. The HRI Database is an anonymized healthcare database with longitudinal data from approximately six Mio Germans. In addition to demographic information (gender, age, region of residence), data on persistence of insurants over time, hospitalization rates, mortality rates and drug prescription rates were extracted from the HRI database for 2013. Corresponding national reference data were obtained from official sources. The proportion of men and women was similar in the HRI Database and Germany, but the database population was slightly younger (mean 40.4 vs 43.7 years). The proportion of insurants living in the eastern part of Germany was lower in the HRI Database (10.1% vs 19.7%). There was good accordance to German reference data with respect to hospitalization rates, overall mortality rate and prescription rates for the 20 most often reimbursed drug classes, with the overall burden of morbidity being slightly lower in the HRI database. From insurants insured on 1 January 2009 (N = 6.2 Mio), a total of 70.6% survived and remained continuously insured with the same statutory health insurance until 31 December 2013. This proportion increased to 77.5% if only insurants ≥40 years were considered. There was good overall accordance of the HRI database and the German population in terms of measures of morbidity, mortality and drug usage. Persistence of insurants with the database over time was high, indicating suitability of the data source for longitudinal epidemiological analyses. Copyright © 2015 John Wiley & Sons, Ltd.

Phylogenetic relationships of German heavy draught horse breeds inferred from mitochondrial DNA D-loop variation.

PubMed

Aberle, K S; Hamann, H; Drögemüller, C; Distl, O

2007-04-01

We analysed a 610-bp mitochondrial (mt)DNA D-loop fragment in a sample of German draught horse breeds and compared the polymorphic sites with sequences from Arabian, Hanoverian, Exmoor, Icelandic, Sorraia and Przewalski's Horses as well as with Suffolk, Shire and Belgian horses. In a total of 65 horses, 70 polymorphic sites representing 47 haplotypes were observed. The average percentage of polymorphic sites was 11.5% for the mtDNA fragment analysed. In the nine different draught horse breeds including South German, Mecklenburg, Saxon Thuringa coldblood, Rhenisch German, Schleswig Draught Horse, Black Forest Horse, Shire, Suffolk and Belgian, 61 polymorphic sites and 24 haplotypes were found. The phylogenetic analysis failed to show monophyletic groups for the draught horses. The analysis indicated that the draught horse populations investigated consist of diverse genetic groups with respect to their maternal lineage.

Communication in Health Professions: A European consensus on inter- and multi-professional learning objectives in German.

PubMed

Bachmann, Cadja; Kiessling, Claudia; Härtl, Anja; Haak, Rainer

2016-01-01

Communication is object of increasing attention in the health professions. Teaching communication competencies should already begin in undergraduate education or pre-registration training. The aim of this project was to translate the Health Professions Core Communication Curriculum (HPCCC), an English catalogue of learning objectives, into German to make its content widely accessible in the German-speaking countries. This catalogue lists 61 educational objectives and was agreed on by 121 international communication experts. A European reference framework for inter- and multi-professional curriculum development for communication in the health professions in German-speaking countries should be provided. The German version of the HPCCC was drafted by six academics and went through multiple revisions until consensus was reached. The learning objectives were paired with appropriate teaching and assessment tools drawn from the database of the teaching Committee of the European Association for Communication Health Care (tEACH). The HPCCC learning objectives are now available in German and can be applied for curriculum planning and development in the different German-speaking health professions, the educational objectives can also be used for inter-professional purposes. Examples for teaching methods and assessment tools are given for using and implementing the objectives. The German version of the HPCCC with learning objectives for communication in health professions can contribute significantly to inter- and multi-professional curriculum development in the health care professions in the German-speaking countries. Examples for teaching methods and assessment tools from the materials compiled by tEACH supplement the curricular content and provide suggestions for practical implementation of the learning objectives in teaching and assessment. The relevance of the German HPCCC to the processes of curriculum development for the various health professions and inter-professional approaches should be the subject of further evaluation.

Norms of German adolescents for the Harvard Group Scale of Hypnotic Susceptibility, Form A.

PubMed

Peter, Burkhard; Geiger, Emilia; Prade, Tanja; Vogel, Sarah; Piesbergen, Christoph

2015-01-01

The Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A) has not been explicitly tested on an adolescent population. In this study, the German version of the HGSHS:A was administered to 99 German adolescents aged 15 to 19. In contrast to other studies, the gender distribution was relatively balanced: 57% female and 43% male. Results were comparable to 14 earlier studies with regard to distribution, mean, and standard deviation. Some peculiarities in contrast to the 14 previous studies are pointed out. It is concluded that the HGSHS:A can be used as a valid and reliable instrument to measure hypnotic suggestibility in adolescent samples.

German translation of the Alberta context tool and two measures of research use: methods, challenges and lessons learned

PubMed Central

2013-01-01

Background Understanding the relationship between organizational context and research utilization is key to reducing the research-practice gap in health care. This is particularly true in the residential long term care (LTC) setting where relatively little work has examined the influence of context on research implementation. Reliable, valid measures and tools are a prerequisite for studying organizational context and research utilization. Few such tools exist in German. We thus translated three such tools (the Alberta Context Tool and two measures of research use) into German for use in German residential LTC. We point out challenges and strategies for their solution unique to German residential LTC, and demonstrate how resolving specific challenges in the translation of the health care aide instrument version streamlined the translation process of versions for registered nurses, allied health providers, practice specialists, and managers. Methods Our translation methods were based on best practices and included two independent forward translations, reconciliation of the forward translations, expert panel discussions, two independent back translations, reconciliation of the back translations, back translation review, and cognitive debriefing. Results We categorized the challenges in this translation process into seven categories: (1) differing professional education of Canadian and German care providers, (2) risk that German translations would become grammatically complex, (3) wordings at risk of being misunderstood, (4) phrases/idioms non-existent in German, (5) lack of corresponding German words, (6) limited comprehensibility of corresponding German words, and (7) target persons’ unfamiliarity with activities detailed in survey items. Examples of each challenge are described with strategies that we used to manage the challenge. Conclusion Translating an existing instrument is complex and time-consuming, but a rigorous approach is necessary to obtain instrument equivalence. Essential components were (1) involvement of and co-operation with the instrument developers and (2) expert panel discussions, including both target group and content experts. Equivalent translated instruments help researchers from different cultures to find a common language and undertake comparative research. As acceptable psychometric properties are a prerequisite for that, we are currently carrying out a study with that focus. PMID:24238613

[Physical activity: results of the German Health Interview and Examination Survey for Adults (DEGS1)].

PubMed

Krug, S; Jordan, S; Mensink, G B M; Müters, S; Finger, J; Lampert, T

2013-05-01

Regular physical activity can have a positive effect on health at any age. Today's lifestyles, however, can often be characterised as sedentary. Therefore, the promotion of physical activity and sports has become an integral part of public health measures. The representative data of adults aged 18 to 79 years in Germany obtained from the "German Health Interview and Examination Survey for Adults" (DEGS1) provide an overview of self-estimated current physical activity behaviour. The results show that one third of the adult population claims to pay close attention to reaching a sufficient level of physical activity and one fourth participates in sports for at least 2 h/week on a regular basis. Thus, the percentage of adults regularly engaged in sports has increased compared to the previous "German National Health Interview and Examination Survey 1998". Still, four out of five adults do not achieve at least 2.5 h/week of moderate-intensity physical activity as recommended by the World Health Organisation. Consequently, future individual-level and population-level interventions should focus on target group-specific measures while continuing to promote regular physical activity in all segments of the population. An English full-text version of this article is available at SpringerLink as supplemental.

[Family Health Teams in Ontario: Ideas for Germany from a Canadian Primary Care Model].

PubMed

Ulrich, Lisa-R; Pham, Thuy-Nga Tia; Gerlach, Ferdinand M; Erler, Antje

2017-07-11

The German healthcare system is struggling with fragmentation of care in the face of an increasing shortage of general practitioners and allied health professionals, and the time-demanding healthcare needs of an aging, multimorbid patient population. Innovative interprofessional, intersectoral models of care are required to ensure adequate access to primary care across a variety of rural and urban settings into the foreseeable future. A team approach to care of the complex multimorbid patient population appears particularly suitable in attracting and retaining the next generation of healthcare professionals, including general practitioners. In 2014, the German Advisory Council on the Assessment of Developments in the Health Care System highlighted the importance of regional, integrated care with community-based primary care centres at its core, providing comprehensive, population-based, patient-centred primary care with adequate access to general practitioners for a given geographical area. Such centres exist already in Ontario, Canada; within Family Health Teams (FHT), family physicians work hand-in-hand with pharmacists, nurses, nurse practitioners, social workers, and other allied health professionals. In this article, the Canadian model of FHT will be introduced and we will discuss which components could be adapted to suit the German primary care system. © Georg Thieme Verlag KG Stuttgart · New York.

Training of Older Workers in the Federal Republic of Germany. Training Discussion Paper No. 24.

ERIC Educational Resources Information Center

Sutter, Hannelore

Following tremendous growth in the population of West Germany until the early 1970s, the population stabilized with a slower birth rate but higher foreign immigration. The population is becoming increasingly older. About 28 percent of the German population is aged 55 or older; by the year 2030, this figure will be about 44 percent. In 1985, the…

Essential Cultural Information and Suggestions for Teaching It in German Business Courses.

ERIC Educational Resources Information Center

Gerulaitis, Renate

A course in German for business on the college level must engage in cross-cultural training as well as teach specialized vocabulary and conversational German for international business dealings. Materials and methods for such a course are described. Some generally untapped sources for material on corporate culture that are suited for use in the…

The Expertise in Working with Pedagogically Neglected Adolescents on the Example of German Universities

ERIC Educational Resources Information Center

Pylypyk, Katherine N.

2016-01-01

The article deals with the attitudes of German scientists towards the levels and identification methods of pedagogical neglect. The experience of German scientists in self-development and skills' development of academic staff to conduct relationship with pedagogically neglected adolescents was studied for the first time. The aim of the study is to…

Obesity, Blood Pressure and Health-Related Behaviour among German Children and Adolescents

ERIC Educational Resources Information Center

Graf, Christine; Jouck, Stefanie; Koch, Benjamin; Platschek, Anna-Maria; Arnold, Christiane; Bohm, Michael; Dordel, Sigrid; Tokarski, Walter

2008-01-01

Study aim: To examine the prevalence of obesity and its correlation with blood pressure, waist circumference and other health related risk factors (smoking, alcohol consumption, physical inactivity and TV/PC-screen time) in German youths. Material and methods: A cohort of 831 boys and 808 girls, fifth- to tenth-graders from 3 German high schools…

Towards Automatically Aligning German Compounds with English Word Groups in an Example-Based Translation System.

ERIC Educational Resources Information Center

Jones, Daniel; Alexa, Melina

As part of the development of a completely sub-symbolic machine translation system, a method for automatically identifying German compounds was developed. Given a parallel bilingual corpus, German compounds are identified along with their English word groupings by statistical processing alone. The underlying principles and the design process are…

The interbelic Germans from the Banat Highland. Coal, steel, mines and forges

NASA Astrophysics Data System (ADS)

Rudolf, C.; Micliuc, D. M.; Nedeloni, M. D.; Birtarescu, E.; Varga, A.

2018-01-01

The difficulties of the reconstruction era, following World War I had been increased by the cessation of some activities in the industrial centres of the Banat Highland. For instance, the copper mines were closed in 1921, the Romanian state forbidding the extraction of this ore. Only in Ocna de Fier a special dispensation had been given. The copper mines from Moldova Nouă, Sasca Montană, Ciclova, Dognecea had also been shut down. This fact caused the acid reaction of some writers. We recall that one of the main ways for improving the material condition, embraced by the ethnic Germans, was working abroad. Many German workers of the Banat Highland had emigrated, taking up an offer of well-paid work during the crisis years: 1929-1933. The miners of the Banat Highland, especially those of German origin, travelled to the areas rich in iron ore and coal of France, namely Alsace and Loraine. Considering that German was spoken there by a significant percentage of the population, the integration into the new working environment did not represent a problem.

Validating the German Version of the Quality of Relationship Inventory: Confirming the Three-Factor Structure and Report of Psychometric Properties

PubMed Central

Reiner, Iris; Beutel, Manfred; Skaletz, Christian; Brähler, Elmar; Stöbel-Richter, Yve

2012-01-01

Research on psychosocial influences such as relationship characteristics has received increased attention in the clinical as well as social-psychological field. Several studies demonstrated that the quality of relationships, in particular with respect to the perceived support within intimate relationships, profoundly affects individuals' mental and physical health. There is, however, a limited choice of valid and internationally known assessments of relationship quality in Germany. We report the validation of the German version of the Quality of Relationships Inventory (QRI). First, we evaluated its factor structure in a representative German sample of 1.494 participants by means of confirmatory factor analysis. Our findings support the previously proposed three-factor structure. Second, importance and satisfaction with different relationship domains (family/children and relationship/sexuality) were linked with the QRI scales, demonstrating high construct validity. Finally, we report sex and age differences regarding the perceived relationship support, conflict and depth in our German sample. In conclusion, the QRI is a reliable and valid measurement to assess social support in romantic relationships in the German population. PMID:22662151

Teaching German with TPRS.

ERIC Educational Resources Information Center

Davidheiser, James

2002-01-01

Outlines the research leading to Total Physical Response (TRP) and later Total Physical Response Storytelling (TPRS) methods. Discusses the day-to-day use in the German classroom of TPRS by an experienced practitioner and explains the reasons for its success. Presents student evaluations of the method and the material available for its use. (AS)

Translation and validation of the vertigo symptom scale into German: A cultural adaption to a wider German-speaking population

PubMed Central

2012-01-01

Background Dizziness and comorbid anxiety may cause severe disability of patients with vestibulopathy, but can be addressed effectively with rehabilitation. For an individually adapted treatment, a structured assessment is needed. The Vertigo Symptom Scale (VSS) with two subscales assessing vertigo symptoms (VSS-VER) and associated symptoms (VSS-AA) might be used for this purpose. As there was no validated VSS available in German, the aim of the study was the translation and cross-cultural adaptation in German (VSS-G) and the investigation of its reliability, internal and external validity. Methods The VSS was translated into German according to recognized guidelines. Psychometric properties were tested on 52 healthy controls and 202 participants with vestibulopathy. Internal validity and reliability were investigated with factor analysis, Cronbach’s α and ICC estimations. Discriminant validity was analysed with the Mann–Whitney-U-Test between patients and controls and the ROC-Curve. Convergent validity was estimated with the correlation with the Hospital Anxiety Subscale (HADS-A), Dizziness Handicap Inventory (DHI) and frequency of dizziness. Results Internal validity: factor analysis confirmed the structure of two subscales. Reliability: VSS-G: α = 0.904 and ICC (CI) =0.926 (0.826, 0.965). Discriminant validity: VSS-VER differentiate patients and controls ROC (CI) =0.99 (0.98, 1.00). Convergent validity: VSS-G correlates with DHI (r = 0.554) and frequency (T = 0.317). HADS-A correlates with VSS-AA (r = 0.452) but not with VSS-VER (r = 0.186). Conclusions The VSS-G showed satisfactory psychometric properties to assess the severity of vertigo or vertigo-related symptoms. The VSS-VER can differentiate between healthy subjects and patients with vestibular disorders. The VSS-AA showed some screening properties with high sensitivity for patients with abnormal anxiety. PMID:22747644

Toxicity of Cypermethrin and Chlorpyrifos Against German Cockroach [ Blattella germanica (Blattaria: Blattellidae)] Strains from Hamadan, Iran.

PubMed

Nazari, Mansour; Motlagh, Behrouz Alipourian; Nasirian, Hassan

German cockroach has relatively short life cycle and reproduce rapidly. It is the most common medically and public health pest. As a result, it is essential to combat this pest. Cypermethrin and chlorpyrifos are used by private companies in Hamadan to control Blattella germanica. It seems necessary to determine its susceptibility levels to these insecticides. The aim of this study was to determine the susceptibility levels of B. germanica strains to cypermethrin and chlorpyrifos in Hamadan. In this study, the German cockroach strains were collected from two hospitals (Fatemiyeh and Atiyeh) in Hamadan and transfered to the insectarium. The cockroach strains were reared under the same laboratory condition. Then their sensitivity levels were considered to 1, 2, 4, 8 and 16 mg m -2 for cypermethrin and 0.82, 1.65, 3.31, 6.63, 9.945 and 13.26 mg m -2 for chlorpyrifos using surface contact method. Results based on insecticide treated doses, B. germanica strains showed different percent mortality to the insecticides ranged from 13.3-100. The LD 50 and LD 90 and regression lines of the treated insecticides against German cockroach strains indicate that Fatemiyeh Hospital strain is more susceptible to the treated insecticides than Atiyeh Hospital strain. The LD 50 and LD 90 of chlorpyrifos are also lower than cypermethrin, indicated that chlorpyrifos is more effective than cypermethrin against German cockroach. As the slopes of the regression lines are observed mild in this study indicate that the population of the cockroach strains is very heterogeneous. It can be a symbol of insecticides resistance to cypermethrin and chlorpyrifos. As chlorpyrifos and cypermethrin insecticides are also used for residual spraying by private companies and the doses which provide more than 90% mortality are below the WHO recommended insecticide doses. Therefore, chlorpyrifos and cypermethrin insecticides can be used for B. germanica control in Hamadan within regular monitoring and preventive measures of resistance.

Pasture names with Romance and Slavic roots facilitate dissection of Y chromosome variation in an exclusively German-speaking alpine region.

PubMed

Niederstätter, Harald; Rampl, Gerhard; Erhart, Daniel; Pitterl, Florian; Oberacher, Herbert; Neuhuber, Franz; Hausner, Isolde; Gassner, Christoph; Schennach, Harald; Berger, Burkhard; Parson, Walther

2012-01-01

The small alpine district of East Tyrol (Austria) has an exceptional demographic history. It was contemporaneously inhabited by members of the Romance, the Slavic and the Germanic language groups for centuries. Since the Late Middle Ages, however, the population of the principally agrarian-oriented area is solely Germanic speaking. Historic facts about East Tyrol's colonization are rare, but spatial density-distribution analysis based on the etymology of place-names has facilitated accurate spatial mapping of the various language groups' former settlement regions. To test for present-day Y chromosome population substructure, molecular genetic data were compared to the information attained by the linguistic analysis of pasture names. The linguistic data were used for subdividing East Tyrol into two regions of former Romance (A) and Slavic (B) settlement. Samples from 270 East Tyrolean men were genotyped for 17 Y-chromosomal microsatellites (Y-STRs) and 27 single nucleotide polymorphisms (Y-SNPs). Analysis of the probands' surnames revealed no evidence for spatial genetic structuring. Also, spatial autocorrelation analysis did not indicate significant correlation between genetic (Y-STR haplotypes) and geographic distance. Haplogroup R-M17 chromosomes, however, were absent in region A, but constituted one of the most frequent haplogroups in region B. The R-M343 (R1b) clade showed a marked and complementary frequency distribution pattern in these two regions. To further test East Tyrol's modern Y-chromosomal landscape for geographic patterning attributable to the early history of settlement in this alpine area, principal coordinates analysis was performed. The Y-STR haplotypes from region A clearly clustered with those of Romance reference populations and the samples from region B matched best with Germanic speaking reference populations. The combined use of onomastic and molecular genetic data revealed and mapped the marked structuring of the distribution of Y chromosomes in an alpine region that has been culturally homogeneous for centuries.

Pasture Names with Romance and Slavic Roots Facilitate Dissection of Y Chromosome Variation in an Exclusively German-Speaking Alpine Region

PubMed Central

Niederstätter, Harald; Rampl, Gerhard; Erhart, Daniel; Pitterl, Florian; Oberacher, Herbert; Neuhuber, Franz; Hausner, Isolde; Gassner, Christoph; Schennach, Harald; Berger, Burkhard; Parson, Walther

2012-01-01

The small alpine district of East Tyrol (Austria) has an exceptional demographic history. It was contemporaneously inhabited by members of the Romance, the Slavic and the Germanic language groups for centuries. Since the Late Middle Ages, however, the population of the principally agrarian-oriented area is solely Germanic speaking. Historic facts about East Tyrol's colonization are rare, but spatial density-distribution analysis based on the etymology of place-names has facilitated accurate spatial mapping of the various language groups' former settlement regions. To test for present-day Y chromosome population substructure, molecular genetic data were compared to the information attained by the linguistic analysis of pasture names. The linguistic data were used for subdividing East Tyrol into two regions of former Romance (A) and Slavic (B) settlement. Samples from 270 East Tyrolean men were genotyped for 17 Y-chromosomal microsatellites (Y-STRs) and 27 single nucleotide polymorphisms (Y-SNPs). Analysis of the probands' surnames revealed no evidence for spatial genetic structuring. Also, spatial autocorrelation analysis did not indicate significant correlation between genetic (Y-STR haplotypes) and geographic distance. Haplogroup R-M17 chromosomes, however, were absent in region A, but constituted one of the most frequent haplogroups in region B. The R-M343 (R1b) clade showed a marked and complementary frequency distribution pattern in these two regions. To further test East Tyrol's modern Y-chromosomal landscape for geographic patterning attributable to the early history of settlement in this alpine area, principal coordinates analysis was performed. The Y-STR haplotypes from region A clearly clustered with those of Romance reference populations and the samples from region B matched best with Germanic speaking reference populations. The combined use of onomastic and molecular genetic data revealed and mapped the marked structuring of the distribution of Y chromosomes in an alpine region that has been culturally homogeneous for centuries. PMID:22848647

Cross-cultural opening in German outpatient mental healthcare service: an exploratory study of structural and procedural aspects.

PubMed

Mösko, Mike-Oliver; Gil-Martinez, Fernanda; Schulz, Holger

2013-01-01

Mental healthcare services need to be sensitive towards the cultural needs of patients. Cross-cultural opening is an organizational process to fulfil these needs. This study aims to provide representative structural and procedural data regarding the use of German outpatient mental healthcare services by allochthonous patients, the diversity of psychotherapists in outpatient mental healthcare service, the cross-cultural encounters of therapists and the cross-cultural sensitivity of psychotherapists working in this healthcare area. Of all public outpatient psychotherapists in Hamburg, 81% (n = 485) participated in this survey. Regarding the distribution of the population in this metropolis, allochthonous therapists were underrepresented. Unlike the overall distribution of foreign inhabitants, the largest groups of immigrant therapists came from England, German-speaking countries and other countries within the European Union. The proportion of allochthonous patients in outpatient mental healthcare service was almost half of the proportion of the allochthonous in the general population. Psychotherapists with a migration background regarded themselves as having a higher level of cross-cultural sensitivity than their native colleagues, especially those who have had fewer cross-cultural encounters. Overall, psychotherapists named different challenges in providing cross-cultural treatment. For the German outpatient mental healthcare service to be more accessible to immigrants and their descendants, a greater number of bilingual psychotherapists must gain access to the mental healthcare service, and more advanced cross-cultural sensitivity training and supervision should be provided. German outpatient psychotherapists are culturally and linguistically diverse. Nevertheless, psychotherapists with a migration background are underrepresented in outpatient mental healthcare services. Patients with a migration background are also underrepresented in the German outpatient mental healthcare system. Because mental healthcare services must be sensitive and respectful towards patients' cultural and linguistic needs, the mental healthcare outpatient service must be more accessible to therapists who speak languages other than German and English. Psychotherapeutic treatment of patients with a migration background can be tremendously challenging because of other cultures' differing value systems. Prospective, advanced training in cross-cultural sensitivity and cross-cultural supervision should be provided. Copyright © 2012 John Wiley & Sons, Ltd.

Validation of the German Diabetes Risk Score within a population-based representative cohort.

PubMed

Hartwig, S; Kuss, O; Tiller, D; Greiser, K H; Schulze, M B; Dierkes, J; Werdan, K; Haerting, J; Kluttig, A

2013-09-01

To validate the German Diabetes Risk Score within the population-based cohort of the Cardiovascular Disease - Living and Ageing in Halle (CARLA) study. The sample included 582 women and 719 men, aged 45-83 years, who did not have diabetes at baseline. The individual risk of every participant was calculated using the German Diabetes Risk Score, which was modified for 4 years of follow-up. Predicted probabilities and observed outcomes were compared using Hosmer-Lemeshow goodness-of-fit tests and receiver-operator characteristic analyses. Changes in prediction power were investigated by expanding the German Diabetes Risk Score to include metabolic variables and by subgroup analyses. We found 58 cases of incident diabetes. The median 4-year probability of developing diabetes based on the German Diabetes Risk Score was 6.5%. The observed and predicted probabilities of developing diabetes were similar, although estimation was imprecise owing to the small number of cases, and the Hosmer-Lemeshow test returned a poor correlation (chi-squared = 55.3; P = 5.8*10⁻¹²). The area under the receiver-operator characteristic curve (AUC) was 0.70 (95% CI 0.64-0.77), and after excluding participants ≥66 years old, the AUC increased to 0.77 (95% CI 0.70-0.84). Consideration of glycaemic diagnostic variables, in addition to self-reported diabetes, reduced the AUC to 0.65 (95% CI 0.58-0.71). A new model that included the German Diabetes Risk Score and blood glucose concentration (AUC 0.81; 95% CI 0.76-0.86) or HbA(1c) concentration (AUC 0.84; 95% CI 0.80-0.91) was found to peform better. Application of the German Diabetes Risk Score in the CARLA cohort did not reproduce the findings in the European Prospective Investigation into Cancer and Nutrition (EPIC) Potsdam study, which may be explained by cohort differences and model overfit in the latter; however, a high score does provide an indication of increased risk of diabetes. © 2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.

The psychometric properties of the German version of the WHOQOL-OLD in the German population aged 60 and older.

PubMed

Conrad, Ines; Matschinger, Herbert; Riedel-Heller, Steffi; von Gottberg, Carolin; Kilian, Reinhold

2014-09-05

The WHOQOL-OLD is an instrument for the assessment of subjective quality of life in elderly people. It is based on the WHO definition of quality of life and is available in more than 20 languages. However, in most countries, the psychometric properties of the WHOQOL-OLD have been assessed only on the basis of small local samples and not in representative studies. In this study, the psychometric properties of the WHOQOL-OLD are evaluated based on a representative sample of Germany's elderly population. Face-to-face interviews with 1133 respondents from the German population aged 60 years and older were conducted. Quality of life was assessed by means of the WHOQOL-BREF, the WHOQOL-OLD and the SF12. Moreover, the GDS, the DemTect and the IADL were applied for the assessment of depressive symptoms, cognitive capacities and capacity for carrying out daily activities. Psychometric properties of the WHOQOL-OLD were evaluated by means of classical and probabilistic test theory, confirmatory factor analysis and multivariate regression model. Cronbach's alpha was found to be above 0.85 for four and above .75 for two of the six facets of the WHOQOL-OLD. IRT analyses indicated that all items of the WHOQOL-OLD contribute considerably to the measurement of the associated facets. While the six-facet structure of the WHOQOL-OLD was well supported by the results of the confirmatory factor analysis, a common latent factor for the WHOQOL-OLD total scale could not be identified. Correlations with other quality of life measures and multivariate regression models with GDS, IADL and the DemTect indicate a good criterion validity of all six WHOQOL-OLD facets. Study results confirm that the good psychometric properties of the WHOQOL-OLD that have been found in international studies could be replicated in a representative study of the German population. These results suggest that the WHOQOL-OLD is an instrument that is well suited to identify the needs and the wishes of an aging population.

Economic consequences of the demography of MRSA patients and the impact of broad-spectrum antimicrobials.

PubMed

Kaier, K; Moog, S

2012-07-01

Studies have determined the societal impact of methicillin-resistant Staphylococcus aureus (MRSA) by modelling its impact on labour supply and productivity. In addition, most of the studies on the topic conclude that the problem of resistance should be counteracted on the macro level by reducing overall antibacterial consumption. Two major questions have been raised in the present work. Firstly, is MRSA impairing labour supply and productivity? Secondly, is it the overall use of antibacterials that may be seen as crucial to the spread of MRSA infections? The age distribution of MRSA patients is compared with the age distribution of the entire patient population at a German teaching hospital. In addition, the age distribution of MRSA patients was applied to the age distribution of the German population in the year 2050 in order to identify the effects of the double-ageing process on the spread of MRSA. Furthermore, recent epidemiological studies were reviewed on the impact of overall antibacterial consumption on MRSA infection rates. Based on available data, we show that patients infected or colonized with MRSA are, for the most part, beyond retirement age and thus not responsible for changes in labour supply or productivity. Application of age distribution of MRSA patients to the age distribution of the German population in the year 2050 gives a 24% increase in the number of MRSA cases to a total of 182 778 due to an ageing population. In addition, we show that a 32% reduction in the cost of MRSA to the German healthcare system could be reached if use of fluoroquinolones and third-generation cephalosporins was reduced by just 10% and, correspondingly, use of antiseptics for hand disinfection was increased by 10%. MRSA is a phenomenon that, to a larger degree, affects the elderly population rather than the labour force. When it comes to policy options to counteract MRSA on the macro level, most economic research on the topic is biased in assuming that the overall use of antibacterials is responsible for the spread of MRSA infections.

Incidence of the Recently Described Sulfonamide Resistance Gene sul3 among German Salmonella enterica Strains Isolated from Livestock and Food

PubMed Central

Guerra, Beatriz; Junker, Ernst; Helmuth, Reiner

2004-01-01

The sul3 gene recently described in Escherichia coli was found in 22 of 512 (4.3%) German Salmonella isolates from different regions and sources and of different serotypes, antimicrobial resistance phenotypes, and genomic groups. This is the first report on the prevalence of sul3 among Salmonella strains, and the findings support the strong potential of this determinant to spread within bacterial populations. PMID:15215132

[Measuring health-related quality of life with the SF-8. Normal sample of the German population].

PubMed

Ellert, U; Lampert, T; Ravens-Sieberer, U

2005-12-01

The SF-8, a relatively new instrument for measuring health-related quality of life, was used in the German National Telephone Health Survey 2003. The SF-8 provides results which are comparable to those of the SF-36, the instrument most commonly used internationally. The German National Telephone Health Survey provides nationally representative data for the residential population in Germany aged 18 and older. In addition to the measurement of health-related quality of life, comprehensive information on chronic illnesses and complaints, health care needs, utilisation of health care, risk factors, risk behaviour and social status is also collected, making differentiated analyses possible. According to the data collected, men rate their quality of life in all dimensions higher than women. With increasing age, quality of life for both men and women decreases in the physical dimensions, while increasing in the mental health dimensions. Apart from chronic disease and pain having a negative impact on health-related quality of life, social differences are also observable, in that worse health-related quality of life is reported by respondents with lower socioeconomic status.

[Factor structure of the German version of the BIS/BAS Scales in a population-based sample].

PubMed

Müller, A; Smits, D; Claes, L; de Zwaan, M

2013-02-01

The Behavioural Inhibition System/Behavioural Activation System Scale (BIS/BAS-Scales) developed by Carver and White 1 is a self-rating instrument to assess the dispositional sensitivity to punishment and reward. The present work aims to examine the factor structure of the German version of the BIS/BAS-Scales. In a large German population-based sample (n = 1881) the model fit of several factor models was tested by using confirmatory factor analyses. The best model fit was found for the 5-factor model with two BIS (anxiety, fear) and three BAS (drive, reward responsiveness, fun seeking) scales, whereas the BIS-fear, the BAS-reward responsiveness, and the BAS-fun seeking subscales showed low internal consistency. The BIS/BAS scales were negatively correlated with age, and women reported higher BIS subscale scores than men. Confirmatory factor analyses suggest a 5-factor model. However, due to the low internal reliability of some of the subscales the use of this model is questionable. © Georg Thieme Verlag KG Stuttgart · New York.

Using Geography and a Story-Based Approach in the Beginning German Classroom

ERIC Educational Resources Information Center

Hager, Michael

2004-01-01

This article provides ideas for teaching culture using of a story-based approach. An overview of the story-based approach followed by a discussion about the application of this method to the teaching of culture in the beginning German classroom is presented. The primary cultural focus is on the teaching of geography for German speaking countries.

Teaching Literature in a Proficiency Oriented Classroom. Pedagogically Prepared Units by Teachers of German, 1991, NEH German Institute, Westminster College, Berlin, Germany.

ERIC Educational Resources Information Center

Moeller, Aleidine J., Ed.

A number of papers by secondary school German language teachers resulting from an institute on incorporation of literature into classroom instruction jointly sponsored by the National Endowment for the Humanities and the Goethe Institute of Germany are collected here. They represent classroom methods and materials developed by institute…

John Dewey's Teaching Methods in the Discussion on German-Language Kindergartens--A Case of Non-Perception?

ERIC Educational Resources Information Center

Sorensen Criblez, Barbara

2000-01-01

During the first half of the 20th century, Emmy Walser of Switzerland helped to incorporate John Dewey's "free working method" into German-language kindergartens. The kindergartens were previously organized around a rigid interpretation of Friedrich Froebel's educational principles, characterized by constant guiding of the child's…

Colonia Tovar: the history of a semi-isolated Venezuelan population of German ancestry described by HLA class I genes.

PubMed

Gendzekhadze, K; Montagnani, S; Ogando, V; Balbas, O; Mendez-Castellano, H; Layrisse, Z

2003-11-01

The history of Colonia Tovar is very complex, being the home of descendants of only a small fraction of immigrants arriving to the South American continent from a specific region of Germany, with a restricted number of founders, small population size and consanguineous mating, experiencing isolation for 100 years, with later migrations, a low rate of population growth and a high mean number of children per couple. How complex is its genetic structure? Do the highly polymorphic HLA genes reflect its history and confirm the story of this population described by other genes? Several studies have been made in this population, but we describe for the first time the HLA Class I variability in the population of Colonia Tovar using PCR-SSOP. Random genetic drift, founder effect and gene flow could explain the HLA allele and haplotype frequencies observed in this population but alleles at the class I loci were insufficient to identify the German origin of the community established through history. This agrees with findings obtained testing other genetic systems (ACP, AK, ESD, G6PD, GLO, PGM, PGD, ALB, CP, HP, TF), but the HLA-typing results indicate that the original gene pool has been diluted due to gene flow from the surrounding Mestizo population.

Prevalence of BK virus subtype I in Germany.

PubMed

Krumbholz, Andi; Zell, Roland; Egerer, Renate; Sauerbrei, Andreas; Helming, Andrea; Gruhn, Bernd; Wutzler, Peter

2006-12-01

The primary infection with human polyomavirus BK (BKV) occurs in early childhood and leads to viral latency within the urogenital tract. Up to 90% of the adult population are seropositive. In immunosuppressed patients, the BKV may be reactivated resulting in typical disease patterns like hemorrhagic cystitis and tubulointerstitial nephritis. Based on serological and molecular methods, BKV isolates were classified into four subtypes previously. Sixty specimens obtained from German renal and bone marrow transplant recipients were analyzed to gain data on the prevalence of BKV subtypes in Germany. With 90.9%, BKV subtype I was found to be predominant in both patient groups. 6.1% of BKV strains were classified as subtype IV. This pattern of phylogenetic distribution is similar to that demonstrated previously in England, Tanzania, the United States and Japan. Remarkably, there was one German BKV virus with a sequence which clusters together with strain SB in subtype II. The BKV subtype I was found to consist of at least three subgroups designated as Ia, Ib, and Ic. While the majority of the German sequences represent subgroup Ic, most of the Japanese sequences are clearly distinct. These findings support the hypothesis of distinct geographical prevalence of BKV subgroups. For the genotyping region, a relationship of BKV subgroups to disease patterns like hemorrhagic cystitis or tubulointerstitial nephritis could not be demonstrated. (c) 2006 Wiley-Liss, Inc.

Is the Internet a useful and relevant source for health and health care information retrieval for German cardiothoracic patients? First results from a prospective survey among 255 Patients at a German cardiothoracic surgical clinic

PubMed Central

Stoevesandt, Dietrich; Diez, Claudius

2006-01-01

Background It is not clear how prevalent Internet use among cardiopathic patients in Germany is and what impact it has on the health care utilisation. We measured the extent of Internet use among cardiopathic patients and examined the effects that Internet use has on users' knowledge about their cardiac disease, health care matters and their use of the health care system. Methods We conducted a prospective survey among 255 cardiopathic patients at a German university hospital. Results Forty seven respondents (18 %) used the internet and 8,8 % (n = 23) went online more than 20 hours per month. The most frequent reason for not using the internet was disinterest (52,3 %). Fourteen patients (5,4 %) searched for specific disease-related information and valued the retrieved information on an analogous scale (1 = not relevant, 5 = very relevant) on median with 4,0. Internet use is age and education dependent. Only 36 (14,1 %) respondents found the internet useful, whereas the vast majority would not use it. Electronic scheduling for ambulatory visits or postoperative telemedical monitoring were rather disapproved. Conclusion We conclude that Internet use is infrequent among our study population and the search for relevant health and disease related information is not well established. PMID:17054799

Examination of iodine status in the German population: an example for methodological pitfalls of the current approach of iodine status assessment.

PubMed

Johner, S A; Thamm, M; Schmitz, R; Remer, T

2016-04-01

Preliminary iodine concentration (UIC) measurements in spot urines of the representative German adult study DEGS indicated a severe worsening of iodine status compared to previous results in German children (KiGGS study). Therefore, we aimed to evaluate adult iodine status in detail and to investigate the impact of hydration status on UIC. UIC and creatinine concentrations were measured in 6978 spot urines from the German nationwide DEGS study (2008-2011). Twenty-four-hour iodine excretions (24-h UIE) were estimated by relating iodine/creatinine ratios to age- and sex-specific 24-h creatinine reference values. Urine osmolality was measured in two subsamples of spot urines (n = 100 each) to determine the impact of hydration status on UIC. In DEGS, median UIC was 69 µg/L in men and 54 µg/L in women, lying clearly below the WHO cutoff for iodine sufficiency (100 µg/L). Estimated median 24-h UIE was 113 µg/day, accompanied by 32 % of DEGS adults, lying below the estimated average requirement (EAR) for iodine. Comparative analysis with the KiGGS data (>14,000 spot urines of children; median UIC 117 µg/L) revealed a comparable percentage

Asthma management practices in adults--findings from the German Health Update (GEDA) 2010 and the German National Health Interview and Examination Survey (DEGS1) 2008-2011.

PubMed

Steppuhn, Henriette; Langen, Ute; Mueters, Stephan; Dahm, Stefan; Knopf, Hildtraud; Keil, Thomas; Scheidt-Nave, Christa

2016-01-01

In Germany, population-wide data on adherence to national asthma management guidelines are lacking, and performance measures (PM) for quality assurance in asthma care are systematically monitored for patients with German national asthma disease management program (DMP) enrollment only. We used national health survey data to assess variation in asthma care PM with respect to patient characteristics and care context, including DMP enrollment. Among adults 18-79 years with self-reported physician-diagnosed asthma in the past 12 months identified from a recent German National Health Interview Survey (GEDA 2010: N = 1096) and the German National Health interview and Examination Survey 2008-2011 (DEGS1: N = 333), variation in asthma care PM was analyzed using logistic regression analysis. Overall, 38.4% (95% confidence interval: 32.5-44.6%) of adults with asthma were on current inhaled corticosteroid therapy. Regarding non-drug asthma management, low coverage was observed for inhaler technique monitoring (35.2%; 31.2-39.3%) and for provision of an asthma management plan (27.3%; 24.2-30.7%), particularly among those with low education. Specific PM were more complete among persons with than without asthma DMP enrollment (adjusted odds ratios ranging up to 10.19; 5.23-19.86), even if asthma patients were regularly followed in a different care context. Guideline adherence appears to be suboptimal, particularly with respect to PM related to patient counseling. Barriers to the translation of recommendations into practice need to be identified and continuous monitoring of asthma care PM at the population level needs to be established.

Life satisfaction and health-related quality of life in immigrants and native-born Germans: the role of immigration-related factors.

PubMed

Nesterko, Yuriy; Braehler, Elmar; Grande, Gesine; Glaesmer, Heide

2013-06-01

There is a lack of population-based studies on health-related quality of life (HRQoL) and satisfaction with life (SWL) of immigrants compared to the native populations. Findings of previous research are inconclusive. Our study compares HRQoL and SWL in immigrants and native-born Germans, investigating immigration-related factors as suspected determinants of HRQoL and SWL in immigrants. In the German Socio-economic panel from 2006, HRQoL (measured with the SF-12v2) and SWL as well as immigration-related factors were assessed in 21,079 subjects (including 2,971 immigrants). Analyses of variance were applied as statistical tests in our study. Native-born Germans report a higher amount of SWL and of HRQoL on the physical health component compared to the immigrants. With effect sizes ranging from E² = 0.001 to 0.111, these findings are of minimal practical relevance. In immigrants, the physical health component of HRQoL is significantly associated with younger age at migration and with country of origin. As the effect sizes are extremely low, these findings have limited practical relevance. There are small differences in SWL and HRQoL of immigrants and native-born Germans. Some immigration-related factors are related to HRQoL, but not to SWL. As immigrants are a quite heterogeneous group, it seems useful to focus on immigration-related factors, not simply comparing immigrants and the native-born. Our findings suggest that research on the association of immigration-related factors with quality of life in immigrants seems a promising approach to better identify subgroups of immigrants with lower levels of quality of life.

Migrant Background and Weight Gain in Early Infancy: Results from the German Study Sample of the IDEFICS Study

PubMed Central

Reeske, Anna; Spallek, Jacob; Bammann, Karin; Eiben, Gabriele; De Henauw, Stefaan; Kourides, Yiannis; Nagy, Peter; Ahrens, Wolfgang

2013-01-01

Objective To examine variations in infant weight gain between children of parents with and without migrant background and to investigate how these differences are explained by pre- and perinatal factors. Methods We used data on birth weight and weight at six months from well-child check-up books that were collected from a population-based German sample of children in the IDEFICS study (n = 1,287). We calculated unadjusted and adjusted means for weight z-scores at birth and six months later. We applied linear regression for change in weight z-score and we calculated odds ratios and 95% confidence intervals (95% CI) for rapid weight gain by logistic regression, adjusted for biological, social and behavioural factors. Results Weight z-scores for migrants and Germans differed slightly at birth, but were markedly increased for Turkish and Eastern European infants at age six months. Turkish infants showed the highest change in weight z-score during the first 6 months (ß = 0.35; 95% CI 0.14–0.56) and an increased probability of rapid weight gain compared with German infants. Examination of the joint effect of migrant and socioeconomic status (SES) showed the greatest change in weight z-scores in Turkish infants from middle SES families (ß = 0.77; 95% CI 0.40–1.14) and infants of parents from Eastern European countries with high SES (ß = 0.72; 95% CI 0.13–1.32). Conclusions Our results support the hypothesis that migrant background is an independent risk factor for infant weight gain and suggest that the onset of health inequalities in overweight starts in early infancy. PMID:23593270

Job satisfaction among hospital doctors in Norway and Germany. A comparative study on national samples.

PubMed

Rosta, Judith; Nylenna, Magne; Aasland, Olaf G

2009-07-01

To compare German and Norwegian hospital doctors on 10 different aspects of job satisfaction and general life satisfaction. The study population consisted of a representative sample of 1,448 German and 484 Norwegian hospital doctors aged 33-65 years (n = 1,932), selected from nationwide postal surveys in 2006. The questionnaires contained items on subjective life satisfaction and the validated 10-item Job Satisfaction Scale. Each item was scored on a seven-point Likert scale from 1 (very dissatisfied) to 7 (very satisfied). A mean sum score was calculated, ranging from 1 to 7. Regression analyses and generalized-linear-model-estimated means controlled for age and gender with 95% confidence intervals were used for comparison. Norwegian hospital doctors had significantly higher life satisfaction (mean 5.31 vs. 5.15) and job satisfaction (mean 5.09 vs. 4.55) than their German colleagues. Item by item, doctors in Norway were significantly more content with seven aspects of their work: "Freedom to choose your own methods of working'' (mean 5.00 vs. 4.72), "opportunities to use your skills'' (mean 5.49 vs. 5.01), "physical working conditions'' (mean 4.62 vs. 4.08), "recognition you get for good achievements'' (mean 4.83 vs. 4.26), "overall job situation'' (mean 5.57 vs. 4.64), "work hours'' (mean 4.39 vs. 3.39), "ate of pay'' (mean 4.70 vs. 3.70). General life satisfaction and age, but not gender, were positively associated with job satisfaction in both countries. Norwegian hospital doctors enjoy a higher level of life and job satisfaction than German hospital doctors. The most likely reasons for this are more acceptable work hours, salary and control over clinical work in Norway.

Inequalities in out-of-pocket payments for health care services among elderly Germans – results of a population-based cross-sectional study

PubMed Central

2014-01-01

Introduction In order to limit rising publicly-financed health expenditure, out-of-pocket payments for health care services (OOPP) have been raised in many industrialized countries. However, higher health-related OOPP may burden social subgroups unequally. In Germany, inequalities in OOPP have rarely been analyzed. The aim of this study was to examine OOPP of the German elderly population in the different sectors of the health care system. Socio-economic and morbidity-related determinants of inequalities in OOPP were analyzed. Methods This cross-sectional analysis used data of N = 3,124 subjects aged 57 to 84 years from a population-based prospective cohort study (ESTHER study) collected in the Saarland, Germany, from 2008 to 2010. Subjects passed a geriatric assessment, including a questionnaire for health care utilization and OOPP covering a period of three months in the following sectors: inpatient care, outpatient physician and non-physician services, medical supplies, pharmaceuticals, dental prostheses and nursing care. Determinants of OOPP were analyzed by a two-part model. The financial burden of OOPP for certain social subgroups (measured by the OOPP-income-ratio) was investigated by a generalized linear model for the binomial family. Results Mean OOPP during three months amounted to €119, with 34% for medical supplies, 22% for dental prostheses, 21% for pharmaceuticals, 17% for outpatient physician and non-physician services, 5% for inpatient care and 1% for nursing care. The two-part model showed a significant positive association between income (square root equivalence scale) and total OOPP. Increasing morbidity was associated with significantly higher total OOPP, and in particular with higher OOPP for pharmaceuticals. Total OOPP amounted to about 3% of disposable income. The generalized linear model for the binomial family showed a significantly lower financial burden for the wealthiest quintile as compared to the poorest one. Conclusions This is the first study providing evidence of inequalities in OOPP in the German elderly population. Socio-economic and morbidity-related inequalities in OOPP and the resulting financial burden could be identified. The results of this study may contribute to the discussion about the mechanisms causing the observed inequalities and can thus help decision makers to consider them when adapting future regulations on OOPP. PMID:24397544

Continuing German in Grade Five: MLA Teacher's Guide. A Course of Study Including Methods, Materials, and Aids for Teaching German to Fifth-Grade Pupils.

ERIC Educational Resources Information Center

Memming, Agnes K.; And Others

This teacher's guide, for use in a fifth-grade German course, contains 12 units of instructional materials which concentrate on the development of basic audiolingual skills. Each of the units consists of conversational skits, dialogue adaptation, directed dialogue review, and classroom drills. Units include: (1) Das Aufstehen und das Fruhstuck,…

Appropriate evidence sources for populating decision analytic models within health technology assessment (HTA): a systematic review of HTA manuals and health economic guidelines.

PubMed

Zechmeister-Koss, Ingrid; Schnell-Inderst, Petra; Zauner, Günther

2014-04-01

An increasing number of evidence sources are relevant for populating decision analytic models. What is needed is detailed methodological advice on which type of data is to be used for what type of model parameter. We aim to identify standards in health technology assessment manuals and economic (modeling) guidelines on appropriate evidence sources and on the role different types of data play within a model. Documents were identified via a call among members of the International Network of Agencies for Health Technology Assessment and by hand search. We included documents from Europe, the United States, Canada, Australia, and New Zealand as well as transnational guidelines written in English or German. We systematically summarized in a narrative manner information on appropriate evidence sources for model parameters, their advantages and limitations, data identification methods, and data quality issues. A large variety of evidence sources for populating models are mentioned in the 28 documents included. They comprise research- and non-research-based sources. Valid and less appropriate sources are identified for informing different types of model parameters, such as clinical effect size, natural history of disease, resource use, unit costs, and health state utility values. Guidelines do not provide structured and detailed advice on this issue. The article does not include information from guidelines in languages other than English or German, and the information is not tailored to specific modeling techniques. The usability of guidelines and manuals for modeling could be improved by addressing the issue of evidence sources in a more structured and comprehensive format.

[Prevalence and Comorbidity of Self-Reported Diagnosis of Burnout Syndrome in the General Population - Results of the German Health Interview and Examination Survey for Adults (DEGS1)].

PubMed

Maske, Ulrike E; Riedel-Heller, Steffi G; Seiffert, Ingeburg; Jacobi, Frank; Hapke, Ulfert

2016-01-01

Objective: To determine the prevalence and comorbid mental disorders of self-reported diagnosis of burnout syndrome in the general population of Germany. Methods: In the German Health Interview and Examination Survey (DEGS1) self-reported diagnosis of a burnout syndrome made by a physician or psychotherapist was assessed in a standardized interview (N = 7987). For N = 4483 mental disorders were determined with the Composite International Diagnostic Interview (CIDI). Weighted lifetime and 12-month prevalences were calculated. Results: Lifetime prevalence of diagnosed burnout syndrome was 4.2 % (women 5.2 %, men 3.3 %), 12-month prevalence was 1.5 % (women 1.9 %, men 1.1 %). Highest prevalences were found in 40 - 59 year olds, in people with middle and high socio-economic status and in women with low and men with high social support. Among the 12-month cases, 70.9 % had at least one DSM-IV disorder. Associations were found for the diagnosis of burnout syndrome with somatoform, affective and anxiety disorders. Conclusion: The diagnosis of burnout syndrome is less frequently given and reported than expected. People with a burnout diagnosis often have a manifest mental disorder. © Georg Thieme Verlag KG Stuttgart · New York.

Parents with mental health problems and their children in a German population based sample: Results of the BELLA study.

PubMed

Plass-Christl, Angela; Haller, Anne-Catherine; Otto, Christiane; Barkmann, Claus; Wiegand-Grefe, Silke; Hölling, Heike; Schulte-Markwort, Michael; Ravens-Sieberer, Ulrike; Klasen, Fionna

2017-01-01

Mental health problems (MHP) of parents are associated with an increased risk of psychological and developmental difficulties in their children. This study aims at analyzing population-based data of parents with MHP and their children and the effects of associated risk factors in order to further targeted preventive and therapeutic interventions. The BELLA study is the mental health module of the German National Health Interview and Examination Survey among Children and Adolescents. MHP in parents and in their children as well as associated risk factors were examined in a sample of N = 1158 parents with children aged 11 to 17 years. Parental MHP were identified in 18.6% of the sample. Risk factors associated with parental MHP were low SES, parental unemployment, stressful life events, parental daily strain, parental chronic disease, and child MHP. A rate of 19.1% of the children of parents with MHP reported MHP themselves, the corresponding rate among children of parents without MHP was 7.7%. In multiple regression analyses the risk for children of parents with MHP to report MHP themselves was almost two times higher than the risk of children of parents without MHP. Other significant associations with child MHP included gender, the parents' age, and stressful life events. Parental MHP constitute a significant risk for the mental health of their children. Targeted screening methods and preventive interventions are needed.

[German medicine of the age of romanticism (1797-1848) as research problem].

PubMed

Płonka-Syroka, B

1997-01-01

In the period between 1797 and 1848, German medicine was considerably influenced by philosophy. It absorbed ideas deriving from neo-Platonism and vitalism, as well as the modern philosophy of nature (Naturphilosophie), especially the ideas of Schelling. The article presents the main tendencies in the German medicine of that period: the distinct character of German medical thought as compared to the rest of Europe, the deductive character of medical theories, the grounding of medical thought in non-materialist philosophy and its close ties with the Protestant religion. The author's aim is investigate how German medicine of the period evolved away from European standards set by the model of medicine as an empirical science, based on the inductive method of research. The article presents the state of German medicine of the first half of the nineteenth century against the background of socio-cultural factors and relates German medical theory of the period to the social awareness of that time.

Incidence of migraine and tension-type headache in three different populations at risk within the German DMKG headache study.

PubMed

Khil, Laura; Pfaffenrath, Volker; Straube, Andreas; Evers, Stefan; Berger, Klaus

2012-03-01

Unlike the prevalence, the incidence of headache disorders has attracted only little attention in epidemiological research. Different definitions of the 'population at risk' among the few published migraine and tension-type headache incidence studies limit their comparability and warrant further research. Therefore, we analysed data from the German Migraine and Headache Society (DMKG). Incidences were assessed in the general population in Germany via standardized headache questions using the International Classification of Headache Disorders, 2nd Edition (ICHD-2). The population was drawn from a 5-year age-group- stratified and gender-stratified random sample from the population register. Of the 1312 baseline participants examined between 2003 and 2004, 1122 (85.5%) participated in the follow-up in 2006 and were the basis for three different populations at risk. We found that the three populations differed in size, age, gender and incidence estimate. The total sample incidence of migraine ranged between 0% and 3.3% and of tension-type headache between 5.3% and 9.2% depending on the definition of 'at risk'. We concluded that one significant problem in headache incidence estimation is the definition of 'at risk', limiting comparability. Thus, this study supports the need for a common definition for prospective headache incidence estimations.

Penetrated system' or normal' state An exploration of INF arms control policy, East-West economic relations, and inter-German policy in the Federal Republic of Germany, 1979-1987

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fisher, C.S.

1991-01-01

The thesis explores policy-making processes in the Federal Republic from 1979-1987 in three areas: INF arms control policy, East-West economic relations, and inter-German policy. Each case study assesses the degree of complexity and domestic accountability in policy-making processes and evaluates the relative influence of domestic and external factors on policy choices. It argues that the trends in West German foreign policy toward greater assertiveness reflected the evolution of the FRG as a state, society, and polity. The maturation' of the Federal Republic has introduced greater complexity into foreign policy-making processes, and more frequent societal intervention into what heretofore were elitemore » deliberations. Domestic actors have begun to demand greater accountability, while West German leaders, in turn, have become more assertive and confident in defending German national interests. As the FRG has gained respect and self-respect, it has begun to assume the international role that might be expected of a state of its size, population, geo-political importance, and level of political and economic development. The FRG has become a normal' state.« less

Affective, anxiety, and substance-related disorders in patients undergoing herniated disc surgery.

PubMed

Zieger, Margrit; Luppa, Melanie; Matschinger, Herbert; Meisel, Hans J; Günther, Lutz; Meixensberger, Jürgen; Toussaint, René; Angermeyer, Matthias C; König, Hans-Helmut; Riedel-Heller, Steffi G

2011-11-01

At present only a small number of studies have investigated psychiatric comorbidity in disc surgery patients. Objectives of this study are (1) to examine the prevalence rate of comorbid affective, anxiety, and substance-related disorders in nucleotomy patients in comparison to the German general population and (2) to investigate associations between psychiatric comorbidity and socio-demographic and illness-related characteristics. The study refers to 349 consecutive disc surgery patients (response rate 87%) between the age of 18 and 55 years. The final study sample consists of 239 lumbar and 66 cervical nucleotomy patients. Face-to-face interviews were conducted approximately 3.45 days (SD 3.170) after disc surgery, during hospital stay. Psychiatric comorbidity was assessed by means of the Composite International Diagnostic Interview (CIDI-DIA-X). The corresponding data of the German general population were derived from the German National Health Interview and Examination Survey (GHS). 12-Month prevalence rates of any affective, anxiety or substance-related disorders range between 33.7% in cervical and 23.5% in lumbar disc surgery patients. Four-week prevalence rates of any affective, anxiety or substance disorder vary between 13.2% in cervical and 14.0% in lumbar nucleotomy patients. Disc surgery patients suffer more often from affective disorders and illicit substance abuse than the general population. Significant associations were found between psychiatric comorbidity and gender, as well as pain intensity. Disc surgery patients show a higher risk to suffer from mental disorders than the general population. The assessment of psychiatric distress and the assistance by mental health professionals should be considered during hospital and rehabilitation treatment.

[Anthropology and "crisis in medicine": The pathologist M. Kuczynski-Godard (1890-1967) and the indigenous peoples of Central Asia and Peru].

PubMed

Knipper, Michael

2009-01-01

This article examines the work of the German-Peruvian physician Max Kuczynski/Máxime Kuczynski-Godard (Berlin 1890-Lima 1967) in rural areas of Central Asia (1924-26) and Peru (1938-48). The main focus of the text is on the scientific approach behind the specific interest of this pathologist in disease and health issues among native populations. Kuczynski's theoretical considerations are analyzed in the context of the wide controversies within the German medical community around a "crisis in medicine" when he was professor at Berlin University during the interwar years. Accordingly, his determination to leave the laboratory and to shift research and healthcare practice closer to rural populations proves to be the expression of profound epistemological and ethical considerations.

Screening for social phobia in medical in- and outpatients with the German version of the Social Phobia Inventory (SPIN).

PubMed

Sosic, Z; Gieler, U; Stangier, U

2008-06-01

To evaluate the German version of the Social Phobia Inventory (SPIN) as a screening device and to report corresponding cut-off scores for different populations. In Study 1, 2043 subjects from a representative sample completed the SPIN. Cut-off values were established on the basis of means and standard deviations. In Study 2, different aspects of validity were examined in a clinical sample comprising 164 subjects, including social phobic individuals, individuals with other anxiety disorders and depression, and non-clinical control subjects. Internal consistency was evaluated. Convergent and divergent validity were explored using several established measures. Finally, the sensitivity and specificity of the German SPIN with regard to social anxiety classification were investigated by means of receiver operating characteristics (ROC) analyses. In Study 1, mean scores and standard deviations were used to determine cut-off scores for the German SPIN. In Study 2, excellent internal consistency and good convergent and divergent validity were obtained. ROC analyses revealed that the German SPIN performed well in discriminating between social phobic individuals on the one hand and psychiatric and non-psychiatric controls on the other. A cut-off score of 25 represented the best balance between sensitivity and specificity. Comparable to the original version, the German SPIN demonstrates solid psychometric properties and shows promise as an economic, reliable, and valid screening device.

La lexicometrie allemande: 1898-1970 (German Lexicometry from 1898 to 1970).

ERIC Educational Resources Information Center

Njock, Pierre Emmanuel

The role of lexicometry is to furnish statistical data on all measurable aspects of vocabulary. This study presents an inventory of works on the choice of elements of the German language and outlines the methods of compiling vocabulary with specific reference to the method of choosing words useful for the teaching of a language. It also attempts…

Deutsch Durch Audio-Visuelle Methode: An Audio-Lingual-Oral Approach to the Teaching of German.

ERIC Educational Resources Information Center

Dickinson Public Schools, ND. Instructional Media Center.

This teaching guide, designed to accompany Chilton's "Deutsch Durch Audio-Visuelle Methode" for German 1 and 2 in a three-year secondary school program, focuses major attention on the operational plan of the program and a student orientation unit. A section on teaching a unit discusses four phases: (1) presentation, (2) explanation, (3)…

Insecticide resistance and nutrition interactively shape life-history parameters in German cockroaches

NASA Astrophysics Data System (ADS)

Jensen, Kim; Ko, Alexander E.; Schal, Coby; Silverman, Jules

2016-06-01

Fitness-related costs of evolving insecticide resistance have been reported in a number of insect species, but the interplay between evolutionary adaptation to insecticide pressure and variable environmental conditions has received little attention. We provisioned nymphs from three German cockroach (Blattella germanica L.) populations, which differed in insecticide resistance, with either nutritionally rich or poor (diluted) diet throughout their development. One population was an insecticide-susceptible laboratory strain; the other two populations originated from a field-collected indoxacarb-resistant population, which upon collection was maintained either with or without further selection with indoxacarb. We then measured development time, survival to the adult stage, adult body size, and results of a challenge with indoxacarb. Our results show that indoxacarb resistance and poor nutritional condition increased development time and lowered adult body size, with reinforcing interactions. We also found lower survival to the adult stage in the indoxacarb-selected population, which was exacerbated by poor nutrition. In addition, nutrition imparted a highly significant effect on indoxacarb susceptibility. This study exemplifies how poor nutritional condition can aggravate the life-history costs of resistance and elevate the detrimental effects of insecticide exposure, demonstrating how environmental conditions and resistance may interactively impact individual fitness and insecticide efficacy.

Enabling the participation of marginalized populations: case studies from a health service organization in Ontario, Canada.

PubMed

Montesanti, Stephanie R; Abelson, Julia; Lavis, John N; Dunn, James R

2017-08-01

We examined efforts to engage marginalized populations in Ontario Community Health Centers (CHCs), which are primary health care organizations serving 74 high-risk communities. Qualitative case studies of community participation in four Ontario CHCs were carried out through key informant interviews with CHC staff to identify: (i) the approaches, strategies and methods used in participation initiatives aimed specifically at engaging marginalized populations in the planning of and decision making for health services; and (ii) the challenges and enablers for engaging these populations. The marginalized populations involved in the community participation initiatives studied included Low-German Speaking Mennonites in a rural town, newcomer immigrants and refugees in an urban downtown city, immigrant and francophone seniors in an inner city and refugee women in an inner city. Our analysis revealed that enabling the participation of marginalized populations requires CHCs to attend to the barriers experienced by marginalized populations that constrain their participation. Key informants outlined the features of a 'community development approach' that they rely on to address the barriers to marginalized peoples' involvement by strengthening their skills, abilities and leadership in capacity-building activities. The community development approach also shaped the participation methods that were used in the engagement process of CHCs. However, key informants also described the challenges of applying this approach, influenced by the cultural values of some groups, which shaped their willingness and motivation to participate. This study provides further insight into the approach, strategies and methods used in the engagement process to enable the participation of marginalized populations, which may be transferable to other health services settings. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Clinical evaluation study of the German network of disorders of sex development (DSD)/intersexuality: study design, description of the study population, and data quality

PubMed Central

Lux, Anke; Kropf, Siegfried; Kleinemeier, Eva; Jürgensen, Martina; Thyen, Ute

2009-01-01

Background The German Network of Disorders of Sex Development (DSD)/Intersexuality carried out a large scale clinical evaluation study on quality of life, gender identity, treatment satisfaction, coping, and problems associated with diagnoses and therapies in individuals with disorders of sex development (DSD). DSD are a heterogeneous group of various genetic disorders of sex determination or sex differentiation, all of which are rare conditions. In about half of all cases the molecular genetic diagnosis is unknown and diagnosis rests on clinical features. Methods and design The multi-centre clinical evaluation study includes short-term follow-up in some and cross-sectional assessments in all age and diagnostic groups fitting the criteria of DSD. Recruitment was from January 2005 until December 2007 in whole Germany and, additionally, in 2007 in Austria and German-speaking Switzerland. The study consists of a psychosocial inquiry for children, adolescents and their parents, and adults with standardized instruments and the collection of DSD-specific medical data by the attending physician. The main goal was the description of clinical outcomes and the health-care situation of individuals with DSD using a broad generic definition of DSD including all conditions with a mismatch of chromosomal, gonadal and phenotypical sex. 439 children and adolescents, their parents and adults with DSD participated. Discussion The clinical evaluation study represents the most comprehensive study in this clinical field. The paper discusses the study protocol, the data management and data quality as well as the classification used, and it describes the study population. Given the lack of large datasets in rare conditions such as DSD and often biased results from small scale clinical case series, the study aims to generate concrete hypotheses for evidence-based guidelines, which should be tested in further studies. PMID:19383134

TAS2R38 and Its Influence on Smoking Behavior and Glucose Homeostasis in the German Sorbs

PubMed Central

Keller, Maria; Liu, Xuanshi; Wohland, Tobias; Rohde, Kerstin; Gast, Marie-Therese; Stumvoll, Michael; Kovacs, Peter; Tönjes, Anke; Böttcher, Yvonne

2013-01-01

Background Genetic variants within the bitter taste receptor gene TAS2R38 are associated with sensitivity to bitter taste and are related to eating behavior in the Amish population. Sensitivity to bitter taste is further related to anthropometric traits in an genetically isolated Italian population. We tested whether the TAS2R38 variants (rs713598; rs1726866 and rs10246939) may be related to eating behavior, anthropometric parameters, metabolic traits and consumer goods intake in the German Sorbs. Materials and Methods The three SNPs were genotyped in a total cohort of 1007 individuals (male/female: 405/602). The German version of the three-factor eating questionnaire was completed by 548 individuals. Genetic association analyses for smoking behavior, alcohol and coffee intake, eating behavior factors (restraint, disinhibition and hunger) and other metabolic traits were analyzed. Further, by combining the three SNPs we applied comparative haplotype analyses categorizing PAV (proline-alanine-valine) carriers (tasters) vs. homozygous AVI (alanin-valine-isoleucine) carriers (non-tasters). Results Significant associations of genetic variants within TAS2R38 were identified with percentage of body fat, which were driven by associations in women. In men, we observed significant associations with 30 min plasma glucose, and area under the curve for plasma glucose (0–120 min) (all adjusted P≤0.05). Further, we found that carriers of at least one PAV allele show significantly lower cigarette smoking per day (P = 0.002) as well as, albeit non-significant, lower alcohol intake. We did not confirm previously reported associations between genetic variants of TAS2R38 and eating behavior. Conclusion Our data suggest that genetic variation in TAS2R38 is related to individual body composition measures and may further influence consumer goods intake in the Sorbs possibly via individual sensitivity to bitter taste. PMID:24312479

Health-related quality of life and sense of coherence among Polish immigrants in Germany and indigenous Poles.

PubMed

Morawa, Eva; Erim, Yesim

2015-06-01

Immigrants are faced with several impediments in the host country that may affect their quality of life (QoL), but little is known about the impact of these stressors as well as about the protective role of sense of coherence (SoC) in the context of Polish immigration to Germany. Health Related QoL (Short Form Health Survey SF-36) and SoC (Sense of Coherence Scale SOC-29) were assessed in a total sample consisting of 511 participants aged between 18 and 84 years (260 Polish immigrants in Germany and 251 indigenous Poles). Polish immigrants reported a significantly lower mental and physical health-related QoL than the German norm population, but they were comparable to native Poles. This result remained the same when the model was adjusted for age but physical health status was better for immigrants compared with indigenous Poles. Both groups scored significantly lower for SoC than Germans, but did not differ from each other. The main differences concerning the examined variables were with respect to the German norm population and are putatively shaped by culture. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

The prevalence of compulsive hoarding and its association with compulsive buying in a German population-based sample.

PubMed

Mueller, Astrid; Mitchell, James E; Crosby, Ross D; Glaesmer, Heide; de Zwaan, Martina

2009-08-01

The aims of the study were to estimate the prevalence rate of compulsive hoarding, and to determine the association between compulsive hoarding and compulsive buying in a nationally representative sample of the German population (N = 2307). Compulsive hoarding was assessed with the German version of the Saving Inventory-Revised (SI-R; Frost, R.O., Steketee, G., & Grisham, J. (2004). Measurement of compulsive hoarding: saving inventory-revised. Behaviour Research and Therapy, 42, 1163-1182.). The point prevalence of compulsive hoarding was estimated to be 4.6%. Individuals with compulsive hoarding did not differ significantly from those without compulsive hoarding regarding age, gender, and other sociodemographic characteristics. Significant correlations were found between the compulsive hoarding and the compulsive buying measures. Participants with compulsive hoarding reported a higher propensity to compulsive buying than respondents without hoarding. About two thirds of participants classified as having compulsive hoarding were also defined as suffering from compulsive buying. In summary, these results suggest that compulsive hoarding may be relatively prevalent in Germany and they confirm the close association between compulsive hoarding and compulsive buying through the investigation of a large scale representative sample.

Germany's long-term-care insurance: putting a social insurance model into practice.

PubMed

Geraedts, M; Heller, G V; Harrington, C A

2000-01-01

A growing population of elderly has intensified the demand for long-term care (LTC) services. In response to the mounting need, Germany put into effect a LTC Insurance Act in 1995 that introduced mandatory public or private LTC insurance for the entire population of 82 million. The program was based on the organizational principles that define the German social insurance system. Those individuals in the public system and their employers each pay contributions equal to 0.85 percent of each employee's gross wages or salary. Ten percent of the population with the highest incomes have chosen the option of purchasing private long term care insurance. Provisions were made for uniform eligibility criteria, benefits based on level of care needs, cost containment, and quality assurance. Over the first four years of its operation, the system has proved financially sound and has expanded access to organized LTC services. The German system thus may serve as an example for other countries that are planning to initiate social LTC insurance systems in other nations.

Prevalence of syringomyelia in clinically unaffected Cavalier King Charles Spaniels in Germany (2006-2016).

PubMed

Schulze, Sabine; Refai, Miriam; Deutschland, Martin; Failing, Klaus; Schmidt, Martin

2018-06-01

The aim of the study was to investigate the prevalence of syringomyelia in clinically unaffected Cavalier King Charles Spaniels (CKCS) in Germany. From 2006 to 2016 a total of 339 asymptomatic CKCSs from all over Germany were included. Age ranged from 3 months to 11 years (mean 3.72 years ± 2.17 years). T1- and T2-weighted magnetic resonance images of the head and cervical spine were obtained. Overall, 163 out of 339 (48.1 %) CKCSs showed evidence of syringomyelia. The results (odds ratio of 1.27 per year; p < 0.0001) corroborate the findings of other studies, in which the risk of developing syringomyelia increases with age. In conclusion, around half of the dogs within the German CKCS population are affected by syringomyelia. The prevalence of syringomyelia of the German CKCS population is similar to that of the British CKCS population, which is subjected to breeding strategies on the basis of magnetic resonance imaging investigations. Schattauer GmbH.

Risk factors for nasal malignancies in German men: the South-German Nasal cancer study.

PubMed

Greiser, Eberhard M; Greiser, Karin Halina; Ahrens, Wolfgang; Hagen, Rudolf; Lazszig, Roland; Maier, Heinz; Schick, Bernhard; Zenner, Hans Peter

2012-11-06

There are few studies of the effects of nasal snuff and environmental factors on the risk of nasal cancer. This study aimed to investigate the impact of using nasal snuff and of other risk factors on the risk of nasal cancer in German men. A population-based case-control study was conducted in the German Federal States of Bavaria and Baden-Württemberg. Tumor registries and ear, nose and throat departments provided access to patients born in 1926 or later. Telephone interviews were conducted with 427 cases (mean age 62.1 years) and 2.401 population-based controls (mean age 60.8 years). Ever-use of nasal snuff was associated with an odds ratio (OR) for nasal cancer of 1.45 (95% confidence interval [CI] 0.88-2.38) in the total study population, whereas OR in smokers was 2.01 (95% CI 1.00-4.02) and in never smokers was 1.10 (95% CI 0.43-2.80). The OR in ever-smokers vs. never-smokers was 1.60 (95% CI 1.24-2.07), with an OR of 1.06 (95% CI 1.05-1.07) per pack-year smoked, and the risk was significantly decreased after quitting smoking. Exposure to hardwood dust for at least 1 year resulted in an OR of 2.33 (95% CI 1.40-3.91) in the total population, which was further increased in never-smokers (OR 4.89, 95% CI 1.92-12.49) in analyses stratified by smoking status. The OR for nasal cancer after exposure to organic solvents for at least 1 year was 1.53 (1.17-2.01). Ever-use of nasal sprays/nasal lavage for at least 1 month rendered an OR of 1.59 (1.04-2.44). The OR after use of insecticides in homes was 1.48 (95% CI 1.04-2.11). Smoking and exposure to hardwood dust were confirmed as risk factors for nasal carcinoma. There is evidence that exposure to organic solvents, and in-house use of insecticides could represent novel risk factors. Exposure to asbestos and use of nasal snuff were risk factors in smokers only.

Anti-nuclear autoantibodies in the general German population: prevalence and lack of association with selected cardiovascular and metabolic disorders-findings of a multicenter population-based study.

PubMed

Akmatov, Manas K; Röber, Nadja; Ahrens, Wolfgang; Flesch-Janys, Dieter; Fricke, Julia; Greiser, Halina; Günther, Kathrin; Kaaks, Rudolf; Kemmling, Yvonne; Krone, Bastian; Linseisen, Jakob; Meisinger, Christa; Moebus, Susanne; Obi, Nadia; Guzman, Carlos A; Conrad, Karsten; Pessler, Frank

2017-06-06

We determined the prevalence of anti-nuclear autoantibodies (ANAs) in the German adult population and examined the association between ANAs and cardiovascular and metabolic disorders. We used data and blood samples from the pretest phases of the German National Cohort, obtained from six of the 18 study centers (n = 1199). All centers applied standardized instruments including face-to-face interviews, anthropometric measurements and collection of blood samples. Self-reported histories of diabetes mellitus, heart attack and elevated blood cholesterol and/or lipids were recorded. Height, weight and blood pressure were measured. ANAs were detected using a semi-automated system (AKLIDES®; Medipan GmbH, Dahlewitz, Germany). A positive ANA was defined as a titer ≥ 1:80. ANA were classified as weakly (1:80 or 1:160), moderately (1:320 or 1:640) or strongly (≥1:1280) positive. Specific autoantibodies against nuclear antigens were detected with second-step assays according to the ANA staining pattern. Associations between the assessed disorders and ANA positivity and pattern were examined using sex and age-adjusted mixed-effects logistic regression models. Thirty-three percent (95% confidence interval; 31-36%) of the 1196 participants (measurements could not be obtained from three samples) were ANA positive (titer ≥ 1:80). The proportions of weakly, moderately and strongly positive ANA were 29%, 3.3% and 1.3%, respectively. ANA positivity was more common among women than men across all titers (χ 2 , p = 0.03). ANA positivity, even when stratified according to height of titer or immunofluorescent pattern, was not associated with diabetes, elevated blood cholesterol and/or lipids, obesity or hypertension. Second-step autoantibody assays were positive in 41 of the 83 samples (49%) tested, with anti-DFS70 (n = 13) and anti-dsDNA (n = 7) being most frequent. These subgroups were too small to test for associations with the disorders assessed. The prevalence of ANA positivity in the German general population was similar to values reported from other countries. Contrary to other studies, there was no association with selected self-reported and objectively measured cardiovascular and metabolic variables.

The Effect of Population Distribution on L1 and L2 Acquisition: Evidence from the Multilingual Region of South Tyrol

ERIC Educational Resources Information Center

De Angelis, Gessica

2012-01-01

The present article examines the effect of population distribution on L1 (Italian) and L2 (German) acquisition in the multilingual context of South Tyrol, Italy. Population distribution is regarded as a central variable to assess the impact of two factors included in willingness to communicate (WTC) theory: (1) Fear of assimilation to the L2…

Investigating population continuity with ancient DNA under a spatially explicit simulation framework.

PubMed

Silva, Nuno Miguel; Rio, Jeremy; Currat, Mathias

2017-12-15

Recent advances in sequencing technologies have allowed for the retrieval of ancient DNA data (aDNA) from skeletal remains, providing direct genetic snapshots from diverse periods of human prehistory. Comparing samples taken in the same region but at different times, hereafter called "serial samples", may indicate whether there is continuity in the peopling history of that area or whether an immigration of a genetically different population has occurred between the two sampling times. However, the exploration of genetic relationships between serial samples generally ignores their geographical locations and the spatiotemporal dynamics of populations. Here, we present a new coalescent-based, spatially explicit modelling approach to investigate population continuity using aDNA, which includes two fundamental elements neglected in previous methods: population structure and migration. The approach also considers the extensive temporal and geographical variance that is commonly found in aDNA population samples. We first showed that our spatially explicit approach is more conservative than the previous (panmictic) approach and should be preferred to test for population continuity, especially when small and isolated populations are considered. We then applied our method to two mitochondrial datasets from Germany and France, both including modern and ancient lineages dating from the early Neolithic. The results clearly reject population continuity for the maternal line over the last 7500 years for the German dataset but not for the French dataset, suggesting regional heterogeneity in post-Neolithic migratory processes. Here, we demonstrate the benefits of using a spatially explicit method when investigating population continuity with aDNA. It constitutes an improvement over panmictic methods by considering the spatiotemporal dynamics of genetic lineages and the precise location of ancient samples. The method can be used to investigate population continuity between any pair of serial samples (ancient-ancient or ancient-modern) and to investigate more complex evolutionary scenarios. Although we based our study on mitochondrial DNA sequences, diploid molecular markers of different types (DNA, SNP, STR) can also be simulated with our approach. It thus constitutes a promising tool for the analysis of the numerous aDNA datasets being produced, including genome wide data, in humans but also in many other species.

Pharmaceutical Spending and German Reunification: Parity Comes Quickly to Berlin

PubMed Central

Katz, Eric M.

1994-01-01

As the Berlin Wall fell and the population of the Federal Republic of Germany (FRG, West Germany) swelled by 25 percent with the addition of the former German Democratic Republic (GDR, East Germany), the health care system struggled to keep pace. This article examines drug outlays by the statutory sickness funds during the first 2 years of unified operations. It shows that providing equivalent coverage quickly led to equal rates of pharmaceutical consumption nationwide, while in Berlin the former East outdistanced the West by a considerable margin. PMID:10137795

The Acquisition of Mathematics Pedagogical Content Knowledge in University Mathematics Education Courses: Results of a Mixed Methods Study on the Effectiveness of Teacher Education in Germany

ERIC Educational Resources Information Center

Buchholtz, Nils Frederik

2017-01-01

This paper reports on a longitudinal mixed methods evaluation study on the acquisition and development of mathematical pedagogical content knowledge (MPCK) of future teachers at several German universities. The study is a German supplementary study to the international comparative TEDS-M 2008 study. Besides the pedagogical content knowledge that…

How can teachers assess reading skills of generation z learners in German language class?

NASA Astrophysics Data System (ADS)

Dirga, R. N.; Wijayati, P. H.

2018-01-01

Generation Z is a digital native generation who has unique characteristics on the daily basis includes reading. In order to assess their reading skills correctly, teachers need to take these characteristics into consideration. This paper aims to describe the process in developing an instrument to assess reading skills of Generation Z learners in German language class. This study used developmental method. The developed instrument has not only good quality but also consists of texts that are suitable for German learners of Generation Z. This instrument can be used as an example in assessing German learners’ reading skills in the 21st century.

Travelling home for treatment and EU patients' rights to care abroad: results of a survey among German students at Maastricht University.

PubMed

Glinos, Irene A; Doering, Nora; Maarse, Hans

2012-04-01

Empirical evidence on patient mobility in Europe is lacking despite widespread legal, policy and media attention which the phenomenon attracts. This paper presents quantitative data on the health care seeking behaviour of German students at Maastricht University in the Netherlands. A cross-sectional survey design was applied with a mixed-methods approach including open and closed questions. Questionnaire items were based on a theoretical model of patient mobility and input from focus group discussions with German students living in Maastricht. 235 valid surveys were completed, representing ca. 8% of the target population. Data collection took place in Oct-Dec 2010. Of respondents who received medical care over the last two years, 97% returned to Germany; of these, 76% travelled to their home city for medical treatment. 72% received care only in Germany, i.e. not even once in Maastricht. Distance partly influenced whether students travelled to Germany, returned home or stayed in Maastricht, and the type of care accessed. Key motivations were familiarity with home providers/system, and reimbursement issues. In the context of the new EU Directive on patients' rights, the findings call into question whether Europeans use entitlements to cross-border care and what the real potential of patient mobility is. The results demonstrate the existence and magnitude of return movements as a sub-group of patient mobility. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Predicting risk of substantial weight gain in German adults—a multi-center cohort approach

PubMed Central

Bachlechner, Ursula; Boeing, Heiner; Haftenberger, Marjolein; Schienkiewitz, Anja; Scheidt-Nave, Christa; Vogt, Susanne; Thorand, Barbara; Peters, Annette; Schipf, Sabine; Ittermann, Till; Völzke, Henry; Nöthlings, Ute; Neamat-Allah, Jasmine; Greiser, Karin-Halina; Kaaks, Rudolf

2017-01-01

Abstract Background A risk-targeted prevention strategy may efficiently utilize limited resources available for prevention of overweight and obesity. Likewise, more efficient intervention trials could be designed if selection of subjects was based on risk. The aim of the study was to develop a risk score predicting substantial weight gain among German adults. Methods We developed the risk score using information on 15 socio-demographic, dietary and lifestyle factors from 32 204 participants of five population-based German cohort studies. Substantial weight gain was defined as gaining ≥10% of weight between baseline and follow-up (>6 years apart). The cases were censored according to the theoretical point in time when the threshold of 10% baseline-based weight gain was crossed assuming linearity of weight gain. Beta coefficients derived from proportional hazards regression were used as weights to compute the risk score as a linear combination of the predictors. Cross-validation was used to evaluate the score’s discriminatory accuracy. Results The cross-validated c index (95% CI) was 0.71 (0.67–0.75). A cutoff value of ≥475 score points yielded a sensitivity of 71% and a specificity of 63%. The corresponding positive and negative predictive values were 10.4% and 97.6%, respectively. Conclusions The proposed risk score may support healthcare providers in decision making and referral and facilitate an efficient selection of subjects into intervention trials. PMID:28013243

Pharmacokinetic Evaluation of Empagliflozin in Healthy Egyptian Volunteers Using LC-MS/MS and Comparison with Other Ethnic Populations.

PubMed

Ayoub, Bassam M; Mowaka, Shereen; Elzanfaly, Eman S; Ashoush, Nermeen; Elmazar, Mohamed M; Mousa, Shaker A

2017-05-31

The present study considered the pharmacokinetic evaluation of empagliflozin after administration to Egyptian volunteers, and the results were compared with other ethnic populations. The FDA recognizes that standard methods of defining racial subgroups are necessary to compare results across pharmacokinetic studies and to assess potential subgroup differences. The design of the study was as an open labeled, randomized, one treatment, one period, single dose pharmacokinetic study. The main pharmacokinetic parameters estimated were C max , T max , t 1/2 , elimination rate constant, AUC 0-t and AUC 0-inf . The insignificant difference in pharmacokinetic parameters between Egyptians and white German subjects suggests that no dose adjustment should be considered with administration of 25 mg empagliflozin to Egyptian population. A new LC-MS/MS method was developed and validated, allowing sensitive estimation of empagliflozin (25-600 ng mL -1 ) in human plasma using dapagliflozin as an internal standard (IS). The method was applied successfully on the underlying pharmacokinetic study with enhanced sample preparation that involved liquid-liquid extraction. Multiple Reaction Monitoring (MRM) of the transition pairs of m/z 449.01 to 371.21 for empagliflozin and m/z 407.00 to 328.81 for dapagliflozin (IS) was employed utilizing negative mode Electro Spray Ionization (ESI). The validated LC-MS/MS method is suitable for further toxicodynamic and bioequivalence studies.

Patterns of Childhood Abuse and Neglect in a Representative German Population Sample

PubMed Central

Schilling, Christoph; Weidner, Kerstin; Brähler, Elmar; Glaesmer, Heide; Häuser, Winfried; Pöhlmann, Karin

2016-01-01

Background Different types of childhood maltreatment, like emotional abuse, emotional neglect, physical abuse, physical neglect and sexual abuse are interrelated because of their co-occurrence. Different patterns of childhood abuse and neglect are associated with the degree of severity of mental disorders in adulthood. The purpose of this study was (a) to identify different patterns of childhood maltreatment in a representative German community sample, (b) to replicate the patterns of childhood neglect and abuse recently found in a clinical German sample, (c) to examine whether participants reporting exposure to specific patterns of child maltreatment would report different levels of psychological distress, and (d) to compare the results of the typological approach and the results of a cumulative risk model based on our data set. Methods In a cross-sectional survey conducted in 2010, a representative random sample of 2504 German participants aged between 14 and 92 years completed the Childhood Trauma Questionnaire (CTQ). General anxiety and depression were assessed by standardized questionnaires (GAD-2, PHQ-2). Cluster analysis was conducted with the CTQ-subscales to identify different patterns of childhood maltreatment. Results Three different patterns of childhood abuse and neglect could be identified by cluster analysis. Cluster one showed low values on all CTQ-scales. Cluster two showed high values in emotional and physical neglect. Only cluster three showed high values in physical and sexual abuse. The three patterns of childhood maltreatment showed different degrees of depression (PHQ-2) and anxiety (GAD-2). Cluster one showed lowest levels of psychological distress, cluster three showed highest levels of mental distress. Conclusion The results show that different types of childhood maltreatment are interrelated and can be grouped into specific patterns of childhood abuse and neglect, which are associated with differing severity of psychological distress in adulthood. The results correspond to those recently found in a German clinical sample and support a typological approach in the research of maltreatment. While cumulative risk models focus on the number of maltreatment types, the typological approach takes the number as well as the severity of the maltreatment types into account. Thus, specific patterns of maltreatment can be examined with regard to specific long-term psychological consequences. PMID:27442446

Cross-cultural adaptation of the delphi definitions of low back pain prevalence (German DOLBaPP).

PubMed

Leonhardt, Marja; Liebers, Falk; Dionne, Clermont E; Latza, Ute

2014-11-25

Assessed dimensions of low back pain (LBP) vary in prevalence studies. This may explain the heterogeneity in frequency estimates. To standardize definitions of LBP, an English consensus with 28 experts from 12 countries developed the "Delphi Definitions of Low Back Pain Prevalence" (DOLBaPP). The optimal definition and the shorter minimal definition with the related questionnaires for online, paper, and face-to-face use and telephone surveys are suitable for population-based studies. The definitions have to be adapted to different languages and cultures to provide comparable frequency estimates. The objective was to culturally adapt and pre-test the English definitions and corresponding Delphi DOLBaPP questionnaire forms into German. The German DOLBaPP adaptation was conducted using the systematic approach suggested by Beaton et al. A pre-test of the Delphi DOLBaPP optimal paper questionnaire including an additional evaluation form was conducted in a sample of 121 employees (mainly office workers). In order to evaluate the comprehensibility, usability, applicability, and completeness of the adapted questionnaire, response to the questionnaire and 6 closed evaluation questions were analyzed descriptively. Qualitative methods were used for the 3 open questions of the evaluation form. The cultural adaptation of the DOLBaPP for a German-speaking audience required little linguistic adaptation. Conceptual equivalence was difficult for the expression "low back pain". The expert committee considered the face validity of the pre-final version of the related Delphi DOLBaPP questionnaires as good. In the pre-test, most participants (95%) needed less than 5 minutes to fill in the optimal Delphi DOLBaPP questionnaire. They were generally positive regarding length, wording, diagram, and composition. All subjects with LBP (n=61 out of 121 - 50.4%) answered the questions on functional limitation, sciatic pain, frequency and duration of symptoms as well as pain severity. The results indicate that the cross-cultural German adaptation of the DOLBaPP Definitions and the corresponding questionnaires was successful. The definitions can be used in epidemiological studies to measure the prevalence of LBP. Some critical issues were raised regarding the general features of the Delphi DOLBaPP questionnaires. Future research is needed to evaluate these instruments.

[The German program for disease management guidelines. Background, methods, and development process].

PubMed

Ollenschläger, Günter; Kopp, Ina; Lelgemann, Monika; Sänger, Sylvia; Heymans, Lothar; Thole, Henning; Trapp, Henrike; Lorenz, Wilfried; Selbmann, Hans-Konrad; Encke, Albrecht

2006-10-15

The Program for National Disease Management Guidelines (German DM-CPG Program) was established in 2002 by the German Medical Association (umbrella organization of the German Chambers of Physicians) and joined by the Association of the Scientific Medical Societies (AWMF; umbrella organization of more than 150 professional societies) and by the National Association of Statutory Health Insurance Physicians (NASHIP) in 2003. The program provides a conceptual basis for disease management, focusing on high-priority health-care topics and aiming at the implementation of best practice recommendations for prevention, acute care, rehabilitation and chronic care. It is organized by the German Agency for Quality in Medicine, a founding member of the Guidelines International Network (G-I-N). The main objective of the German DM-CPG Program is to establish consensus of the medical professions on evidence-based key recommendations covering all sectors of health-care provision and facilitating the coordination of care for the individual patient through time and across interfaces. Within the last year, DM-CPGs have been published for asthma, chronic obstructive pulmonary disease, type 2 diabetes, and coronary heart disease. In addition, experts from national patient self-help groups have been developing patient guidance based upon the recommendations for health-care providers. The article describes background, methods, and tools of the DM-CPG Program, and is the first of a publication series dealing with innovative recommendations and aspects of the program.

Microsatellite loci analysis for the genetic variability and the parentage test of five dog breeds in South Korea.

PubMed

Kang, Byeong-Teck; Kim, Kyung-Seok; Min, Mi-Sook; Chae, Young-Jin; Kang, Jung-Won; Yoon, Junghee; Choi, Jihye; Seong, Je-Kyung; Park, Han-Chan; An, Junghwa; Lee, Mun-Han; Park, Hee-Myung; Lee, Hang

2009-06-01

To investigate the population structure of five dog breeds in South Korea and to validate polymorphic microsatellite markers for the parentage test, microsatellite loci analyses were conducted for two Korean native dog breeds, Poongsan and Jindo, and three imported dog breeds, German Shepherd, Beagle and Greyhound. Overall genetic diversity was high across all dog breeds (expected heterozygosity range: 0.71 to 0.85), although breeds differed in deviations from Hardy-Weinberg equilibrium (HWE). Significant reduction of heterozygosity in the Poongsan and Greyhound breeds was caused by non-random mating and population substructure within these breeds (the Wahlund effects). The close relationship and high degree of genetic diversity for two Korean native dog breeds were substantial. The mean polymorphism information content value was highest in Jindos (0.82) and Poongsans (0.81), followed by Beagles (0.74), Greyhounds (0.72), and German Shepherds (0.66). Accumulated exclusion power values, as an indication of marker validity for parentage tests, were varied but very high across breeds, 0.9999 for Jindos, Poongsans, and Beagles, 0.9997 for Greyhounds, and 0.9995 for German Shepherds. Taken together, the microsatellite loci investigated in this study can serve as suitable markers for the parentage test and as individual identification to establish a reliable pedigree verification system of dog breeds in South Korea. This study also stresses that the population subdivision within breeds can become an important cause of deviation from HWE in dog breeds.

A population-based survey on tanning bed use in Germany.

PubMed

Börner, Franziska U; Schütz, Holger; Wiedemann, Peter

2009-07-20

The suntanning industry has grown up over the last decade in Europe, mainly because tanned skin is considered socially desirable and attractive. Because of the potential negative impact of artificial tanning on public health, this study was to investigate tanning bed use behaviour, UV related risk perception and beliefs about tanning in the German population. In 2007, a representative telephone survey was carried out among 1501 German residents aged 14 years and older. More than one fourth (28%) of the German population have used tanning beds at least once before in their lifetime. High-frequency tanning behaviour, i.e. using tanning beds more than 10 times per year, were recorded for 11%. Men and women aged 18 to 44 years and young women under the age of 18 used tanning beds more frequently (>10 times per year). Tanning bed use was positively related to appearance and lifestyle related beliefs as well as to the perception that tanned skin is healthy. This analysis indicates that tanning bed use is common in Germany. The positive relationships of appearance and health related beliefs with tanning bed use are of great concern. The results indicate underlying misconceptions about the positive effect of artificial UV radiation compared to natural UV radiation particular for high-frequency tanners. The data shows the importance as well as the limitations for risk communication in its current effort to inform effectively about the dangers of artificial UV radiation.

[Epidemiology of hepatitis A, B, and C among adults in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)].

PubMed

Poethko-Müller, C; Zimmermann, R; Hamouda, O; Faber, M; Stark, K; Ross, R S; Thamm, M

2013-05-01

Ten years after seroepidemiological data were obtained in the German National Health Interview and Examination Survey 1998 (GNHIES98), German Health Interview and Examination Survey (DEGS1) data contribute to a population-based, representative surveillance of hepatitis A and B immunity and of the serological markers for hepatitis C in Germany. The prevalence of antibodies against the hepatitis A virus is 48.6 %. In comparison to the situation 10 years ago, seroprevalence is significantly higher among 18- to 39-year-old adults and is significantly lower in those aged 50-79 years. The association between age and seroprevalence has changed, indicating a decrease in naturally acquired hepatitis A immunity. Individual and population immunity has to be achieved through vaccination. Prevalence of hepatitis B antibodies indicates that 5.1 % of adults have been exposed to the virus, significantly fewer than 10 years ago (7.9 %). Prevalence of hepatitis B surface antibodies indicates that 22.9 % of adults have been vaccinated against hepatitis B. Vaccination coverage has increased in all age groups and is highest in the younger age groups. These positive trends can be attributed to the general recommendation since 1995 to vaccinate against hepatitis B. For hepatitis C, the prevalence of antibodies in the general population is 0.3 %. Germany thus remains a low-HCV-endemic country. An English full-text version of this article is available at SpringerLink as supplemental.

Toxicity of entomopathogenic fungi, Beauveria bassiana and Lecanicillium muscarium against a field-collected strain of the German cockroach Blattella germanica (L.) (Dictyoptera: Blattellidae).

PubMed

Davari, B; Limoee, M; Khodavaisy, S; Zamini, G; Izadi, S

2015-09-01

The German cockroach, Blattella germanica (L.) has been recognized as a serious health problem throughout the world. Control failures due to insecticide resistance and chemical contamination of environment have led some researchers focus on the other alternative strategy controls. Microbial insecticides such as those containing entomo pathogenic fungi could be of high significance. Lecanicillium muscarium and Beauveria bassiana grow naturally in soils throughout the world and act as a parasite on various arthropod species, causing white muscardine disease. Thus, these two species could be considered as entomopathogenic fungi. The current study conducted to evaluate the toxicity of Beauveria bassiana and Lecanicillium muscarium against German cockroach, Blattella germanica. Conidial formulations of L. muscarium (PTCC 5184) and B. bassiana (PTCC5197) were prepared in aqueous suspensions with Tween 20. Bioassays were performed using two methods including submersion of cockroaches in conidial suspension and baiting. Data were analyzed by Probit program and LC50 and LC90 were estimated. The obtained results indicated that both fungi species were toxic against German cockroach however; Beauveria bassiana was significantly 4.8 fold more toxic than L. muscarium against German cockroach using submersion method.

Down Syndrome: Gestational Age-Related Neonatal Anthropometrics for Germany.

PubMed

Hoffmann, Paul F; Jung, Anna-Maria; Stierkorb, Eva; Monz, Dominik; Gortner, Ludwig; Rohrer, Tilman R

2016-01-01

Neonates with Down syndrome (DS) weigh less, are smaller and have increased first-year mortality, especially if born small for gestational age (GA). DS-specific GA-related neonatal anthropometrics for Germany are lacking. To construct reference tables and centile curves for birth weight (g), crown-heel length (cm) and head circumference (cm) by sex and GA for German DS neonates. Retrospective anthropometric data from live-born singleton DS neonates born in Germany from January 1966 to June 2010 were collected using standardized questionnaires and patient records. Reference tables were created based on means and standard deviations. The 3rd, 10th, 25th, 50th, 75th, 90th and 97th centile curves were constructed and smoothed using running medians and Cole's LMS method. Anthropometric measurements were obtained for 1,304 DS neonates [males/females: 713/591 (54.7%/45.3%)]. Reference tables and centile charts were constructed from 3,542 (males/females: 1,932/1,610) observations for GA 32-41 weeks. Compared with general-population newborns, prematurity was increased (21.1 vs. 6.3%) at GA 32-36 weeks. Term-born (GA 40 weeks) male and female DS neonates were 352.5 and 223.5 g lighter and 1.5 and 1.4 cm smaller than general-population neonates, and head circumference was also 1.4 and 1.5 cm smaller, respectively. This is the first study to report GA-related, sex-specific reference tables and centile charts of birth weight, length and head circumference for DS neonates born in Germany. Compared with the general German population, DS newborns are more frequently born prematurely, weigh less, are smaller and have a smaller head circumference at birth. © 2016 S. Karger AG, Basel.

FTO Is Associated with Aortic Valve Stenosis in a Gender Specific Manner of Heterozygote Advantage: A Population-Based Case-Control Study

PubMed Central

Thron, Cindy; Akhyari, Payam; Godehardt, Erhard; Lichtenberg, Artur; Rüther, Ulrich; Seehaus, Stefanie

2015-01-01

Background Single nucleotide polymorphisms (SNPs) within the Fat mass and obesity associated (FTO) gene have been linked with increased body weight. However, the data on an association of FTO with cardiovascular diseases remains conflicting. Therefore, we ascertained whether FTO is associated with aortic valve stenosis (AVS), one of the most frequent cardiovascular diseases in the Western world. Methods and Findings In this population-based case-control study the FTO SNP rs9939609 was analyzed in 300 German patients with AVS and 429 German controls of the KORA survey S4, representing a random population. Blood samples were collected prior to aortic valve replacement in AVS cases and FTO rs9939609 was genotyped via ARMS-PCR. Genotype frequencies differed significantly between AVS cases and KORA controls (p = 0.004). Separate gender-analyses uncovered an association of FTO with AVS exclusively in males; homozygote carriers for the risk-allele (A) had a higher risk to develop AVS (p = 0.017, odds ratio (OR) 1.727; 95% confidence interval (CI) 1.087–2.747, recessive model), whereas heterozygote carriers for the risk-allele showed a lower risk (p = 0.002, OR 0.565, 95% CI 0.384–0.828, overdominant model). After adjustment for multiple co-variables, the odds ratios of heterozygotes remained significant for an association with AVS (p = 0.008, OR 0.565, 95% CI 0.369–0.861). Conclusions This study revealed an association of FTO rs9939609 with AVS. Furthermore, this association was restricted to men, with heterozygotes having a significantly lower chance to develop AVS. Lastly, the association between FTO and AVS was independent of BMI and other variables such as diabetes mellitus. PMID:26431034

German 1990: Intensive and Diverse.

ERIC Educational Resources Information Center

Kempf, Franz R.

1990-01-01

Suggests the following methods for improving university-level German language education curricula: reduce skill-development time through immersion programs, adopt Zertifikat Deutsch als Fremdsprache as the proficiency standard for advanced students, and include literature from a variety of liberal arts disciplines in the reading materials for…

[The Prevalence of Current Depressive Symptoms in an Urban Adult Population].

PubMed

Luck, Tobias; Then, Francisca S; Engel, Christoph; Loeffler, Markus; Thiery, Joachim; Villringer, Arno; Riedel-Heller, Steffi G

2017-04-01

Objective We sought to provide prevalence rates of depressive symptoms in the adult population of the city of Leipzig, Germany (18 - 79 years; N = 8,861). Methods Data were derived from the Leipzig population-based study of adults (LIFE-ADULT-Study). The German version of the Center for Epidemiological Studies Depression Scale (CES-D) was used to assess depressive symptoms using a cut-off score ≥ 23 points. Results The prevalence of current depressive symptoms was 6.4 % (95 %-KI = 5.4 - 7.4). Significantly higher prevalence rates were found in females than in males, in individuals in middle age (40 - 59 years) than in younger and older adults as well as in those individuals with lower socioeconomic status (SES). Conclusion The study findings did not indicate a generally increased risk of depressive symptoms in urban-living adults. © Georg Thieme Verlag KG Stuttgart · New York.

From Wolves to Dogs, and Back: Genetic Composition of the Czechoslovakian Wolfdog.

PubMed

Smetanová, Milena; Černá Bolfíková, Barbora; Randi, Ettore; Caniglia, Romolo; Fabbri, Elena; Galaverni, Marco; Kutal, Miroslav; Hulva, Pavel

2015-01-01

The Czechoslovakian Wolfdog is a unique dog breed that originated from hybridization between German Shepherds and wild Carpathian wolves in the 1950s as a military experiment. This breed was used for guarding the Czechoslovakian borders during the cold war and is currently kept by civilian breeders all round the world. The aim of our study was to characterize, for the first time, the genetic composition of this breed in relation to its known source populations. We sequenced the hypervariable part of the mtDNA control region and genotyped the Amelogenin gene, four sex-linked microsatellites and 39 autosomal microsatellites in 79 Czechoslovakian Wolfdogs, 20 German Shepherds and 28 Carpathian wolves. We performed a range of population genetic analyses based on both empirical and simulated data. Only two mtDNA and two Y-linked haplotypes were found in Czechoslovakian Wolfdogs. Both mtDNA haplotypes were of domestic origin, while only one of the Y-haplotypes was shared with German Shepherds and the other was unique to Czechoslovakian Wolfdogs. The observed inbreeding coefficient was low despite the small effective population size of the breed, possibly due to heterozygote advantages determined by introgression of wolf alleles. Moreover, Czechoslovakian Wolfdog genotypes were distinct from both parental populations, indicating the role of founder effect, drift and/or genetic hitchhiking. The results revealed the peculiar genetic composition of the Czechoslovakian Wolfdog, showing a limited introgression of wolf alleles within a higher proportion of the dog genome, consistent with the reiterated backcrossing used in the pedigree. Artificial selection aiming to keep wolf-like phenotypes but dog-like behavior resulted in a distinctive genetic composition of Czechoslovakian Wolfdogs, which provides a unique example to study the interactions between dog and wolf genomes.

Changes in body weight and obesity status in German adults: results of seven population-based prospective studies.

PubMed

Haftenberger, M; Mensink, G B M; Herzog, B; Kluttig, A; Greiser, K H; Merz, B; Nöthlings, U; Schlesinger, S; Vogt, S; Thorand, B; Peters, A; Ittermann, T; Völzke, H; Schipf, S; Neamat-Allah, J; Kühn, T; Kaaks, R; Boeing, H; Bachlechner, U; Scheidt-Nave, C; Schienkiewitz, A

2016-03-01

The objective of this study was to quantify body weight changes in German adult populations during the past decades. Longitudinal analysis of seven cohort studies covering different age ranges between 18 and 83 years. Baseline examinations were between 1994 and 2007 and follow-up durations between 4.0 and 11.9 years. For each study, mean change in body weight per year and 10-year change in body mass index (BMI) classification were analyzed. For the middle age group of 45-64 years, meta-analysis was conducted to obtain an overall estimate for Germany. Among men weight gain was highest in the youngest participants and decreased with advancing age. Among women weight gain was on a stable high level among those younger than 45 years and decreased at older age. Within 10 years, 30-40% of middle-aged participants with normal baseline weight became pre-obese or obese and 20-25% of those with pre-obesity at baseline became obese, whereas >80% of persons who were obese at baseline remained obese over time. The estimated average weight change in adults aged 45-64 years was 0.25 (95% confidence interval (CI): 0.18-0.33) kg/year among men and 0.24 (0.17-0.30) kg/year among women. We could observe a moderate weight gain over the past years in German middle-aged populations of 0.25 kg/year. Obesity prevention needs to be targeted to specific subgroups in the population, especially to younger adults, who seem to be most vulnerable for gaining weight. Obesity intervention needs to be improved, as the majority of obese adults remained obese over time.

Cultural differences in symptom representation for depression and somatization measured by the PHQ between Vietnamese and German psychiatric outpatients.

PubMed

Dreher, Annegret; Hahn, Eric; Diefenbacher, Albert; Nguyen, Main Huong; Böge, Kerem; Burian, Hannah; Dettling, Michael; Burian, Ronald; Ta, Thi Minh Tam

2017-11-01

Despite an extensive body of research on somatic symptom presentation among people of East- and Southeast-Asian descent, results are still inconclusive. Examining and comparing symptom presentation in clinically and ethnically well-characterized populations may constitute a step towards understanding symptom presentation between patients with a different cultural background. This study aims to compare Vietnamese and German patients regarding cultural dynamics of symptom presentation upon first admission to a psychiatric outpatient service. 110 Vietnamese and 109 German patients seeking psychiatric treatment at two outpatient clinics completed the Patient Health Questionnaire (PHQ). The somatic symptom subscale (PHQ-15), the depression subscale (PHQ-9) and PHQ-subscales examining anxiety and psychosocial stress levels were analyzed and compared for both groups using multivariate analysis of covariance. Regression analysis was utilized to examine the influences of sociodemographic and migration specific factors. Vietnamese and German patients showed comparable Cronbach's alpha for all subscales. Vietnamese patients endorsed significantly higher levels of somatic symptoms overall and on certain items (as pain-related items, dizziness, and fainting spells) despite similar levels of depression severity in comparison with German patients. Vietnamese patients with poor German language skills showed a significantly higher focus on somatic symptoms. Raising awareness for cultural dynamics of symptom presentation in patients with depression is indispensable. Cross-cultural symptom assessment using the PHQ seems feasible and expands our understanding of depressive and psychosomatic symptoms when assessed by clinicians. Copyright © 2017. Published by Elsevier Inc.

[How are religiosity, psychological distress and integration interrelated? A comparative study of the religiosity in Turkish/Kurdish migrants in comparison to Germans].

PubMed

Tagay, Sefik; Düllmann, Sonja; Brähler, Elmar; Stecker, Anja; Senf, Wolfgang

2009-09-01

The current study aimed to assess the association between religious involvement, psychological distress and various aspects of integration in a population of Turkish/Kurdish migrants in primary care. We compared the group of Turkish/Kurdish migrants (n = 179, age m = 39.4 years, 65.0 % female) with German dermatological patients (n = 184, age m = 43.1 years, 60.9 % female) with regard to their religiosity. On average the migrants lived in Germany for 24.98 years (SD = 8.90). Compared to the German patients, they showed higher religious involvement and participation. The migrants were highly significant more religious (p < 0.001) than the German patients. Contrary to expectation, no significant correlations between measures of religiosity and psychological distress were found for the Turkish migrant group. Further, inverse relationships between measures of religiosity and measures of integration resulted. Migrants who were more acculturated showed less religiosity. The religious affiliation of the examined group was islamic. It remains open if the inverse association between religiosity and integration would be the same also for other religions.

[The link between self-construal and mental distress in Turkish migrants and German women with depression].

PubMed

Balkir, Nazli; Arens, Elisabeth A; Wolff, Carolin; Barnow, Sven

2013-04-01

The current study aims to analyze cultural differences in the patterns of self-construals (interdependent vs. independent) and their relation to mental distress in a sample of depressed Turkish migrants and German women. A total number of 56 in-patients with a diagnosis of major depression were compared in terms of self-construals and their relations to different aspects of mental distress. Turkish patients exhibited a stronger interdependent self-construal compared to Germans, whereas no group differences were observed with respect to independence. While for Turkish patients a higher level of interdependence was associated with lower levels of mental distress, the reverse was true for German patients. However, there were no significant ethnic differences in the associations between independence and mental distress. The current study provides evidence that the relation between self-construal and mental distress is moderated by patient's cultural background. The findings have implications for integrating self-construals into psychotherapy practice with culturally diverse populations, in order to adjust therapy goals and intervention techniques. © Georg Thieme Verlag KG Stuttgart · New York.

Low migrant mortality in Germany for men aged 65 and older: fact or artifact?

PubMed Central

Scholz, Rembrandt; Shkolnikov, Vladimir M.

2008-01-01

Migrant mortality in Europe was found to be lower than mortality of host populations. In Germany, residents with migrant background constitute nearly one tenth of the population aged 65+ with about 40% of them being foreigners. The German Pension Scheme follows vital status of pensioners very accurately. Mortality re-estimation reveals two-fold underestimation of mortality of foreigners due to biased death numerator and population denominator. PMID:18418717

Incidence of malignant mesothelioma in Germany 2009-2013.

PubMed

Lehnert, Martin; Kraywinkel, Klaus; Heinze, Evelyn; Wiethege, Thorsten; Johnen, Georg; Fiebig, Julia; Brüning, Thomas; Taeger, Dirk

2017-02-01

The malignant mesothelioma is a rare malignancy and mainly caused by occupational exposure to asbestos. German cancer registries are providing a national database to investigate temporal and regional patterns of mesothelioma incidence. These may be of interest for healthcare planning and for surveillance programs aiming at the formerly exposed workforce. We analyzed population-based incidence data of malignant mesothelioma by site, type, sex, age, as well as district and state of patient's residence. Age-standardized incidence rates (AIRs40+) were calculated according to the European standard population truncated to the age of 40 years and older. We present rates at national, state, and district level and trends of incidence of northern states of Germany. In total, 7,547 malignant mesotheliomas were reported to German cancer registries diagnosed between 2009 and 2013-90% located to the pleura. On average, 1,198 men and 312 women were affected each year. We estimated AIR40+ of 4.77 in 100,000 German men and 0.98 in 100,000 German women. Regional clusters were predominantly located to the seaports of West Germany. The highest regional AIR40+ was 20 per 100,000 men. Corresponding rates in northeast Germany were between 2 and 4 per 100,000 men. Regional clusters of high incidence indicate districts with former shipyards and steel industry, but predominantly in the western part of Germany. The West-to-East difference corresponds to patterns of mortality. Twenty years after banning asbestos in Germany, Bremen and Hamburg are presenting the highest mesothelioma incidence but show steadily decreasing trends.

Seafarer deaths at sea: a German mortality study.

PubMed

Oldenburg, M; Herzog, J; Harth, V

2016-03-01

Seafarers face numerous hazards during their work at sea. To demonstrate the frequency and causes of mortality in German seafarers. The deaths of all German seafarers from 1998 to 2008 were counted and evaluated using the German central civil register in Berlin. The study cohort comprised a total of 159588 seafarer-years. During the 11 year period, 68 male seafarers died on board. The average age was 48.5 years (SD 12.7 years) and comprised 35 deck officers, 16 engine officers and 17 general crew members (i.e. non-officers from the deck and engine room crew and galley staff). Cause of death was documented in 45 cases (66%): 26 were due to unnatural causes (occupational accidents, suicides) and 19 due to natural causes (particularly, ischaemic heart disease). The crude annual mortality rate for German seamen was 65 per 100000 seafarer-years. For cardiac causes, this rate was significantly higher among deck and engine officers (24 and 38) than among crew ranks (7 per 100000 seafarer-years) (P < 0.05). Deck and engine offi-cers also showed a higher mortality rate for accidents (28 and 22) than crew ranks (15) (P < 0.05). The age-stratified fatal accident rate of German seafarers aboard was 10 times higher than the mortality of the German general population on shore. Seafaring constitutes an occupation with a high risk for serious accidents. Due to the unexpectedly high mortality rate among officers associated with work-related accidents, this occupational group should receive more effective education on safety behaviour on board. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Climate Change: A "Green" Approach to Teaching Contemporary Germany

ERIC Educational Resources Information Center

Melin, Charlotte

2013-01-01

This article describes a newly designed upper division German language course, "Contemporary Germany: Food, Energy Politics," and two sampling methods of assessment for measuring parallel gains in German skills and sustainable development (SD) thinking. Second Language Acquisition (SLA) informed course design, key assignments, and…

Applying the effort-reward imbalance model to household and family work: a population-based study of German mothers

PubMed Central

2012-01-01

Background This paper reports on results of a newly developed questionnaire for the assessment of effort-reward imbalance (ERI) in unpaid household and family work. Methods: Using a cross-sectional population-based survey of German mothers (n = 3129) the dimensional structure of the theoretical ERI model was validated by means of Confirmatory Factor Analysis (CFA). Analyses of Variance were computed to examine relationships between ERI and social factors and health outcomes. Results CFA revealed good psychometric properties indicating that the subscale 'effort' is based on one latent factor and the subscale 'reward' is composed of four dimensions: 'intrinsic value of family and household work', 'societal esteem', 'recognition from the partner', and 'affection from the child(ren)'. About 19.3% of mothers perceived lack of reciprocity and 23.8% showed high rates of overcommitment in terms of inability to withdraw from household and family obligations. Socially disadvantaged mothers were at higher risk of ERI, in particular with respect to the perception of low societal esteem. Gender inequality in the division of household and family work and work-family conflict accounted most for ERI in household and family work. Analogous to ERI in paid work we could demonstrate that ERI affects self-rated health, somatic complaints, mental health and, to some extent, hypertension. Conclusions The newly developed questionnaire demonstrates satisfied validity and promising results for extending the ERI model to household and family work. PMID:22221851

The Diffusion of Evidence-Based Practice: Reviewing the Evidence-Based Practice Networks in the United States and German-Speaking Countries.

PubMed

Ghanem, Christian; Lawson, Thomas R; Pankofer, Sabine; Maragkos, Markos; Kollar, Ingo

2017-01-01

Evidence-based practice (EBP) has had a major influence on U.S. social work while it has rarely been adapted in German-speaking countries. This study investigates how knowledge about EBP is diffused within and across geographical contexts. Network analysis methods reveals different diffusion patterns and provide reasons for these differences. For example, the U.S. discourse is self-contained and based on a more homogeneous knowledge base, while the German discourse is more heterogeneous and focuses on a notion of reflexive professionalism. The different conceptual influences within the U.S. and German discourses are discussed in light of future directions of disciplinary social work.

Mental health differences between German gay and bisexual men and population-based controls.

PubMed

Sattler, Frank A; Franke, Gabriele H; Christiansen, Hanna

2017-07-21

International studies have revealed that gay and bisexual men present more mental health problems than the general male population. Furthermore, there is evidence that minority stress predicts mental health problems in gay and bisexual men. The aim of the present study is to provide initial data on mental health differences in Germany and to analyze the effect of minority stress. Mental health data on n = 1903 German gay and bisexual men and n = 958 men from a population-based sample were assessed using a shortened version of the SCL-90-S. The mental health of the two samples was compared. Furthermore, a linear regression was conducted for the gay and bisexual sample: mental health was used as the criterion and minority stressors as predictors. As compared to our population sample, gay and bisexual men demonstrated more mental health problems with a moderate effect size. In the regression, minority stress predicted mental health problems in the gay and bisexual sample. We observed pronounced mental health differences between gay and bisexual men versus the population sample. These differences could be at least partly due to the minority stress gay and bisexual men face. Research should focus on how to reduce and cope with minority stress.

Insecticide resistance and nutrition interactively shape life-history parameters in German cockroaches

PubMed Central

Jensen, Kim; Ko, Alexander E.; Schal, Coby; Silverman, Jules

2016-01-01

Fitness-related costs of evolving insecticide resistance have been reported in a number of insect species, but the interplay between evolutionary adaptation to insecticide pressure and variable environmental conditions has received little attention. We provisioned nymphs from three German cockroach (Blattella germanica L.) populations, which differed in insecticide resistance, with either nutritionally rich or poor (diluted) diet throughout their development. One population was an insecticide-susceptible laboratory strain; the other two populations originated from a field-collected indoxacarb-resistant population, which upon collection was maintained either with or without further selection with indoxacarb. We then measured development time, survival to the adult stage, adult body size, and results of a challenge with indoxacarb. Our results show that indoxacarb resistance and poor nutritional condition increased development time and lowered adult body size, with reinforcing interactions. We also found lower survival to the adult stage in the indoxacarb-selected population, which was exacerbated by poor nutrition. In addition, nutrition imparted a highly significant effect on indoxacarb susceptibility. This study exemplifies how poor nutritional condition can aggravate the life-history costs of resistance and elevate the detrimental effects of insecticide exposure, demonstrating how environmental conditions and resistance may interactively impact individual fitness and insecticide efficacy. PMID:27345220

[A new German Scale for Assessing Parental Stress after Preterm Birth (PSS:NICU_German/2-scales)].

PubMed

Urlesberger, P; Schienle, A; Pichler, G; Baik, N; Schwaberger, B; Urlesberger, B; Pichler-Stachl, E

2017-04-01

Background Preterm birth is known to be a stressful and anxious situation for parents, which might have long-term impact on the psychological health of mothers and even on the development of their preterm infants. Objective The Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU) was developed to assess parental stress after preterm birth through three subscales [1]. The aim of the present study was to examine the psychometric properties and the dimensionality of the German version of the PSS:NICU to develop a reliable German version of the PSS:NICU. Methods For the development (exploratory factor analysis) 100 parents of preterm infants answered the questionnaire. Results The Sights and Sounds subscale was removed from the German version of the PSS:NICU due to low number of items. NICU_German/2-scales was developed consisting of 2 subscales: Infant Behavior and Appearance (7 Items, Cronbach's α=0,82) and Parental Role Alteration (6 Items, Cronbach's α=0,87). Conclusions The PSS:NICU_German/2-scales is a reliable and economic scale for the assessment of parental stress after preterm birth. © Georg Thieme Verlag KG Stuttgart · New York.

OBSERVATIONS ON DIAGNOSTIC ACTIVITIES AND PRACTICES IN TUBERCULOSIS DISPENSARIES AND RADIATION PROTECTION (in Hungarian)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hopf, K.

1961-09-01

A comparison of the number of registered tuberculous patients in the German Democratic Republic and Hungary showed that in 1956 Hungary recorded a rate of 1.33% patients with active tuberculosis, whereas Germany showed 1.22%. The difference in these percentages indicates that different standards were applied in classifying patients as inactive, chronic-active, or infectuous tuberculotics. This study showed that some patients were carried Mn the records as tuberculotics who have long been cured and should have been classified ss inactive. The practice of annual chest x-ray examination for the entire population for the purpose of detecting new cases of tuberculosis ismore » discussed (and accepted practice in the German Democratic Republic). The possible hazards to humans from such radiation exposure are considered. It is concluded that chest x rays carried out by properly trained personnel do not constitute and particular hazard to the patient provided proper screens are used and fluoroscopic exposure is not longer thand 30 sec. Testimony of expert roentgenologists is cited which maintains that the doses received in a series of routine chest x rays are no more than the average natural radiation dose received by and individual. This method, therefore, should not be discarded as an effective method for the detection of new, active cases of tuberculosis. (BBB)« less

Analysis of Six Reviews on the Quality of Instruments for the Evaluation of Interprofessional Education in German-Speaking Countries.

PubMed

Ehlers, Jan P; Kaap-Fröhlich, Sylvia; Mahler, Cornelia; Scherer, Theresa; Huber, Marion

2017-01-01

Background: More and more institutions worldwide and in German-speaking countries are developing and establishing interprofessional seminars in undergraduate education of health professions. In order to evaluate the different didactic approaches and different outcomes regarding the anticipated interprofessional competencies, it is necessary to apply appropriate instruments. Cross-cultural instruments are particularly helpful for international comparability. The Interprofessional Education working group of the German Medical Association (GMA) aims at identifying existing instruments for the evaluation of interprofessional education in order to make recommendations for German-speaking countries. Methods: Systematic literature research was performed on the websites of international interprofessional organisations (CAIPE, EIPEN, AIPEN), as well as in the PubMed and Cinahl databases. Reviews focusing on quantitative instruments to evaluate competencies according to the modified Kirkpatrick competency levels were searched for. Psychometrics, language/country and setting, in which the instrument was applied, were recorded. Results: Six reviews out of 73 literature research hits were included. A large number of instruments were identified; however, their psychometrics and the applied setting were very heterogeneous. The instruments can mainly be assigned to Kirkpatrick levels 1, 2a & 2b. Most instruments have been developed in English but their psychometrics were not always reported rigorously. Only very few instruments are available in German. Conclusion: It is difficult to find appropriate instruments in German. Internationally, there are different approaches and objectives in the measurement and evaluation of interprofessional competencies. The question arises whether it makes sense to translate existing instruments or to go through the lengthy process of developing new ones. The evaluation of interprofessional seminars with quantitative instruments remains mainly on Kirkpatrick levels 1 and 2. Levels 3 and 4 can probably only be assessed with qualitative or mixed methods. German language instruments are necessary.

Analysis of Six Reviews on the Quality of Instruments for the Evaluation of Interprofessional Education in German-Speaking Countries

PubMed Central

Ehlers, Jan P.; Kaap-Fröhlich, Sylvia; Mahler, Cornelia; Scherer, Theresa; Huber, Marion

2017-01-01

Background: More and more institutions worldwide and in German-speaking countries are developing and establishing interprofessional seminars in undergraduate education of health professions. In order to evaluate the different didactic approaches and different outcomes regarding the anticipated interprofessional competencies, it is necessary to apply appropriate instruments. Cross-cultural instruments are particularly helpful for international comparability. The Interprofessional Education working group of the German Medical Association (GMA) aims at identifying existing instruments for the evaluation of interprofessional education in order to make recommendations for German-speaking countries. Methods: Systematic literature research was performed on the websites of international interprofessional organisations (CAIPE, EIPEN, AIPEN), as well as in the PubMed and Cinahl databases. Reviews focusing on quantitative instruments to evaluate competencies according to the modified Kirkpatrick competency levels were searched for. Psychometrics, language/country and setting, in which the instrument was applied, were recorded. Results: Six reviews out of 73 literature research hits were included. A large number of instruments were identified; however, their psychometrics and the applied setting were very heterogeneous. The instruments can mainly be assigned to Kirkpatrick levels 1, 2a & 2b. Most instruments have been developed in English but their psychometrics were not always reported rigorously. Only very few instruments are available in German. Conclusion: It is difficult to find appropriate instruments in German. Internationally, there are different approaches and objectives in the measurement and evaluation of interprofessional competencies. The question arises whether it makes sense to translate existing instruments or to go through the lengthy process of developing new ones. The evaluation of interprofessional seminars with quantitative instruments remains mainly on Kirkpatrick levels 1 and 2. Levels 3 and 4 can probably only be assessed with qualitative or mixed methods. German language instruments are necessary. PMID:28890927

Hypochondriasis and health anxiety in the German population.

PubMed

Bleichhardt, G; Hiller, W

2007-11-01

Epidemiologic studies on hypochondriasis are very rare and have not been included in large North American community surveys until now. In order to gain information on the prevalence as well as the socio-demographic characteristics of hypochondriasis, the following community study was carried out. Analyses are based on an assessment of 1575 subjects selected by socio-demographic representation criteria for the German community. All subjects completed the Illness Attitude Scales (IAS) and responded to several additional questions on sociodemographics and diagnostic criteria pertaining to Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) hypochondriasis. The IAS is internationally one of the best-established self-rating questionnaires for the assessment of hypochondriasis and health anxiety. Results reveal a 0.4% point prevalence rate of DSM-IV hypochondriasis. In contrast to that, 6% of the German population suffers from severe health anxiety. There are small positive effects for female gender, higher age and lower school education on health anxiety. Subjects with high health anxiety report a much lower health-related quality of life and a higher risk for a type of psychotherapeutic or psychiatric treatment. These results support the development of less restrictive criteria for hypochondriasis and place emphasis on the clinical and socio-economic relevance of health anxiety.

Epidemiology of trichinellosis in Germany, 1996-2006.

PubMed

Jansen, Andreas; Schöneberg, Irene; Stark, Klaus; Nöckler, Karsten

2008-04-01

The epidemiology of trichinellosis in Germany was investigated by analyzing national surveillance data from 1996-2006. During this period, 95 laboratory-confirmed infections and 12 outbreaks were reported. The highest mean annual incidence was found in immigrants from southeast European countries (0.3 cases/100,000 vs. 0.01 cases/100,000 in the German population) with an incidence rate ratio of 26.0 (95% confidence interval 11.6-51.8). The predominant clinical symptom was muscle pain in 79 patients (83%). Mean diagnostic delay was 49 days. Among patients with reported source of infection (85%; n = 81), the consumption of pork (mostly originating from endemic countries) represented the most frequent exposure (93%; n = 75). In addition, trichinellosis cases were associated with both indigenous (n = 1) and imported (n = 5) wild boar meat. Although domestic pigs in Germany are practically free from Trichinella spp., the parasite was found in German wild animals such as wild boars, foxes, and racoon dogs. We conclude that trichinellosis still remains a public health issue in Germany, especially among individuals with a migrational background. Immigrants from endemic countries need to be educated about the risks of consuming raw or inadequately cooked pork and wild boar products from their homeland. In addition, German healthcare providers need to be aware of trichinellosis, especially in areas with a large immigrant population.

[Improved opportunities for the identification of people with a migrant background for mortality research using the example of Bremen].

PubMed

Makarova, N; Reiss, K; Zeeb, H; Razum, O; Spallek, J

2013-06-01

19.6% of Germany's population has a "migrant" background. Comprehensive epidemiological research on health and health development of this large, heterogeneous and increasingly important population group in Germany is still deficient. There is a lack of results on mortality and morbidity, particularly concerning chronic diseases and disease processes. The aim of this paper is to combine and to compare already applied methods with new methodological approaches for determining the vital status and the mortality of immigrants from Turkey and the former Soviet Union. For this purpose we used data from the state of Bremen (666 709 residents, last update 2010). We examined 2 methodological aspects: (i) possibilities for identifying immigrant background in the data of residents' registration office with different methods (onomastic, toponomastic, etc.) and (ii) opportunities for record linkage of the obtained data with the Bremen mortality index. Immigrants from Turkey and the former Soviet Union were successfully identified in databases of the residents' registration office by a combination of different methods. The combination of different methodological approaches proved to be considerably better than using one method only. Through the application of a name-based algorithm we found that Turkish immigrants comprise 6.9% of the total population living in Bremen. By combining the variables "citizenship" and "country of birth" the total population proportion of immigrants from the former Soviet Union was found to be 5%. We also identified the deceased immigrant population in Bremen. The information obtained from residents' registration office could be successfully linked by death register number with the data of the Bremen mortality index. This information can be used in further detailed mortality analyses. The results of this analysis show the existing opportunities to consider the heterogeneity of the German population in mortality research, especially by means of combination of different methods to identify the immigrant background. © Georg Thieme Verlag KG Stuttgart · New York.

A dangerous method? The German discourse on hypnotic suggestion therapy around 1900

PubMed Central

Maehle, Andreas-Holger

2017-01-01

In the late nineteenth century, German-speaking physicians and psychiatrists intensely debated the benefits and risks of treatment by hypnotic suggestion. While practitioners of the method sought to provide convincing evidence for its therapeutic efficacy in many medical conditions, especially nervous disorders, critics pointed to dangerous side effects, including the triggering of hysterical attacks or deterioration of nervous symptoms. Other critics claimed that patients merely simulated hypnotic phenomena in order to appease their therapist. A widespread concern was the potential for abuses of hypnosis, either by giving criminal suggestions or in the form of sexual assaults on hypnotized patients. Official inquiries by the Prussian Minister for Religious, Educational and Medical Affairs in 1902 and 1906 indicated that relatively few doctors practised hypnotherapy, whereas the method was increasingly used by lay healers. Although the Ministry found no evidence for serious harm caused by hypnotic treatments, whether performed by doctors or by lay healers, many German doctors seem to have regarded hypnotic suggestion therapy as a problematic method and abstained from using it.

[Surgical research in Germany--an international comparison].

PubMed

Fendrich, V; Rothmund, M

2010-04-01

Surgical research in Germany occupies a lower position in international ranking than expected. According to the size of the population, the economic impact, the gross domestic product and the research funding capacity, the impact of German surgical research should be much higher. Reasons are a more intensive commitment to patient care, structural differences and a changing lifestyle in younger doctors in comparison to many leading countries. If the situation is to be improved all factors have to be evaluated and, if possible, changed. Overall, German surgeons are underrepresented as readers and authors in the scientific market, which is mostly in the English language.

Anxiety and depression in cardiac patients: age differences and comparisons with the general population.

PubMed

Hinz, Andreas; Kittel, Jörg; Karoff, Marthin; Daig, Isolde

2011-01-01

Anxiety and depression are often found in cardiac patients, but also in the general population. Therefore, evaluation of these symptoms in patients requires a comparison with norm values. The purpose of this study was to explore differences between cardiac patients and the general population in age dependency of anxiety and depression, and to discuss possible reasons for these differences. A sample of German cardiac patients (n = 2,696) and a sample of the German general population (n = 2,037) were tested using the Hospital Anxiety and Depression Scale (HADS). While we confirmed a linear age trend of anxiety and depression in the general population, we observed an inverted U-shaped age dependency in the patient sample. Young patients are especially affected by anxiety and depression. Five items of the HADS that mainly contributed to the age differences were identified. Formal characteristics of these 5 items could not explain the age differences. Concerning the meaning of the items, however, most of the items refer to worrying about the future. The relatively low rates of anxiety and depression in older patients (compared with the general population) indicate that adaptation processes took place, which should be taken into account in studies concerning the psychological status of patients. Young patients need special attention when dealing with mental distress. Copyright © 2011 S. Karger AG, Basel.

Prevalence of sarcopenia in Germany and the corresponding effect of osteoarthritis in females 70 years and older living in the community: results of the FORMoSA study

PubMed Central

Kemmler, Wolfgang; Teschler, Marc; Goisser, Sabine; Bebenek, Michael; von Stengel, Simon; Bollheimer, Leo Cornelius; Sieber, Cornel C; Freiberger, Ellen

2015-01-01

Background Although sarcopenia represents a challenging burden for health care systems around the world, its prevalence in the elderly population varies widely. The primary aim of the study was to determine the prevalence of sarcopenia in community-dwelling (CD) German women aged 70 years and older; the secondary aim was to assess the effect of osteoarthritis (OA) on sarcopenia prevalence in this cohort. Methods A total of 689 Caucasian females 18–35 years old and 1,325 CD females 70 years+ living in Northern Bavaria, Germany, were assessed during the initial phase of the FORMoSA research project. Anthropometry, total and regional muscle mass, were assessed by segmental multifrequency Bioelectrical Impedance Analysis. Further 10 m walking speed and handgrip strength were evaluated to apply the European Working Group on Sarcopenia in Older People definition of sarcopenia. Covariates were determined by questionnaires and interviews. Results Applying the algorithm of the European Working Group on Sarcopenia in Older People of two standard deviations below the mean value for appendicular skeletal muscle mass of a reference cohort of the young cohort (5.66 kg/m2), low gait speed (≤0.8 m/s), and low grip strength (<20 kg), the prevalence of sarcopenia in CD German females 70 years and older was 4.5% (70–79 years: 2.8% vs ≥80 years: 9.9%; P<0.001). Participants with OA at the hip and lower limbs (n=252) exhibited significantly higher rates of sarcopenia (OA: 9.1 vs non-OA: 3.5%). Of importance, anthropometric, demographic, health, and lifestyle parameters (except exercise participation) of our cohorts corresponded with Bavarian or German data for CD women 70 years+. Conclusion The prevalence of sarcopenia in CD German females 70 years+ is relatively low. However, participants with OA at the hip or lower limbs were at increased risk for sarcopenia. PMID:26491272

Fine-grained information extraction from German transthoracic echocardiography reports.

PubMed

Toepfer, Martin; Corovic, Hamo; Fette, Georg; Klügl, Peter; Störk, Stefan; Puppe, Frank

2015-11-12

Information extraction techniques that get structured representations out of unstructured data make a large amount of clinically relevant information about patients accessible for semantic applications. These methods typically rely on standardized terminologies that guide this process. Many languages and clinical domains, however, lack appropriate resources and tools, as well as evaluations of their applications, especially if detailed conceptualizations of the domain are required. For instance, German transthoracic echocardiography reports have not been targeted sufficiently before, despite of their importance for clinical trials. This work therefore aimed at development and evaluation of an information extraction component with a fine-grained terminology that enables to recognize almost all relevant information stated in German transthoracic echocardiography reports at the University Hospital of Würzburg. A domain expert validated and iteratively refined an automatically inferred base terminology. The terminology was used by an ontology-driven information extraction system that outputs attribute value pairs. The final component has been mapped to the central elements of a standardized terminology, and it has been evaluated according to documents with different layouts. The final system achieved state-of-the-art precision (micro average.996) and recall (micro average.961) on 100 test documents that represent more than 90 % of all reports. In particular, principal aspects as defined in a standardized external terminology were recognized with f 1=.989 (micro average) and f 1=.963 (macro average). As a result of keyword matching and restraint concept extraction, the system obtained high precision also on unstructured or exceptionally short documents, and documents with uncommon layout. The developed terminology and the proposed information extraction system allow to extract fine-grained information from German semi-structured transthoracic echocardiography reports with very high precision and high recall on the majority of documents at the University Hospital of Würzburg. Extracted results populate a clinical data warehouse which supports clinical research.

Debating Sex: Education Films and Sexual Morality for the Young in Post-War Germany, 1945-1955.

PubMed

Winkler, Anita

2015-01-01

After 1945 rapidly climbing figures of venereal disease infections menaced the health of the war-ridden German population. Physicians sought to gain control over this epidemic and initiated large-scale sex education campaigns to inform people about identification, causes and treatment of VD and advised them on appropriate moral sexual behaviour as a prophylactic measure. Film played a crucial role in these campaigns. As mass medium it was believed film could reach out to large parts of society and quickly disseminate sexual knowledge and moral codes of conduct amongst the population. This essay discusses the transition of the initial central role of sex education films in the fight against venereal disease in the immediate post-war years towards a more critical stance as to the effects of cinematographic education of the young in an East and West German context.

["What is a bipolar disorder?" Results of a representative survey of the German population].

PubMed

Angermeyer, Matthias C; Matschinger, Herbert

2005-09-01

To explore to what extent the lay public knows that the term bipolar disorder denotes a mental disorder. In January 2005, a telephone survey was conducted among a random sample of the German population (n = 1006). Out of four options given, respondents were asked to select the one they considered to be the correct explanation of what is meant by bipolar disorder. Most of the respondents (61%) believed that bipolar disorder is just another term for the melting of the polar ice caps, only 4.6 % associated it with mental illness. The question arises as to whether it makes sense to use a diagnosis which the lay public associates with everything but a mental illness. Since it is impossible to erase the term bipolar disorder from the psychiatric terminology, it seems necessary to increasingly propagate this term among the lay public.

Social norm enforcement in ethnically diverse communities

PubMed Central

Zhang, Nan

2018-01-01

Recent waves of immigration to Western nations have fueled a debate over the consequences of ethnic diversity for social cohesion. One prominent argument in this debate holds that diversity is detrimental to trust and cooperation because individuals in heterogeneous communities face difficulties in enforcing social norms across ethnic lines. We examine this proposition in a field experiment involving real-life interactions among residents of multiethnic German neighborhoods. We find significant ethnic asymmetries in the pattern of norm enforcement: Members of the majority “native” German population are more active in sanctioning norm violations, while ethnic minorities are more likely to find themselves the target of sanctions. We interpret these results in light of prevailing status inequalities between ethnic minorities and the native majority. We further calculate that, as a result of ethnic discrimination, social control is likely to rise in communities with moderate minority population shares. PMID:29483253

Debating Sex: Education Films and Sexual Morality for the Young in post-War Germany, 1945-55

PubMed Central

Winkler, Anita

2015-01-01

Summary After 1945 rapidly climbing figures of venereal disease infections menaced the health of the war-ridden German population. Physicians sought to gain control over this epidemic and initiated large-scale sex education campaigns to inform people about identification, causes and treatment of VD and advised them on appropriate moral sexual behaviour as a prophylactic measure. Film played a crucial role in these campaigns. As mass medium it was believed film could reach out to large parts of society and quickly disseminate sexual knowledge and moral codes of conduct amongst the population. This essay discusses the transition of the initial central role of sex education films in the fight against venereal disease in the immediate post-war years towards a more critical stance as to the effects of cinematographic education of the young in an East and West German context. PMID:26403056

[Total hip replacement in the G-DRG-system].

PubMed

Kaufmann, M M; Franz, D; Lassahn, C; Siebert, C H

2007-01-01

Due to the continuing increase in life expectancy, the ageing process of the German population in general and the high demands placed on activity levels and quality of life today, the demand for primary and secondary joint replacement surgery continues to increase. To distribute the economic and medical resources properly, while still making technical and surgical innovations available to a broad public, hospitals must be able to adequately finance these procedures with the help of the proper diagnosis related groups. The development of the German DRG-system over the past years, as well as the new calculation for the year 2006 are to be reviewed and analysed in this article with this in mind. An improvement in the degree of differentiation between the individual procedures can be documented. Whether or not these changes will ensure the long-term financial survival of the German health care system will remain to be seen.

Childhood leukemia and cancers near German nuclear reactors: significance, context, and ramifications of recent studies.

PubMed

Nussbaum, Rudi H

2009-01-01

A government-sponsored study of childhood cancer in the proximity of German nuclear power plants (German acronym KiKK) found that children < 5 years living < 5 km from plant exhaust stacks had twice the risk for contracting leukemia as those residing > 5 km. The researchers concluded that since "this result was not to be expected under current radiation-epidemiological knowledge" and confounders could not be identified, the observed association of leukemia incidence with residential proximity to nuclear plants "remains unexplained." This unjustified conclusion illustrates the dissonance between evidence and assumptions. There exist serious flaws and gaps in the knowledge on which accepted models for population exposure and radiation risk are based. Studies with results contradictory to those of KiKK lack statistical power to invalidate its findings. The KiKK study's ramifications add to the urgency for a public policy debate regarding the health impact of nuclear power generation.

[A ''humanitarian duty and a matter of honour for German Jewry": "feeble-minded" Jewish children and the Institution in Beelitz].

PubMed

Prestel, Claudia

2014-01-01

In 1908, in collaboration with the Bnei Briss, the German Association of Israelite Communities founded an institution for intellectually disabled Jewish children in Beelitz with the aim of educating 7-14-year-olds, using therapeutic pedagogy. The institution was part of the philanthropic efforts undertaken by German Jewry in that period. It was set up in the wake of the German Kaiser's call to found more philanthropic institutions, and its establishment is indicative of the efforts at integration being made by German Jewry. In their fund-raising material, the German Association of Israelite Communities stressed the "loyalty and patriotism" of German Jewry and described the establishment of the institution as "a humanitarian duty" and "a matter of honour for German Jewry". It was, therefore, demands from the non-Jewish world that led to the foundation of a Jewish institution; however, its establishment was also symbolic of the struggle against anti-Semitism and indicative both of German Jewry's dissimilation and their efforts at integration. The article investigates the struggle of Jewish parents to have their children admitted to the institution, the philosophy and teaching methods of the director Sally Bein (1881-1942) and his wife Friederike Rebeka Bein (1883-1942), the background of the students, the causes of intellectual disability, as well as the disagreements that occurred between parents, teachers and the director. The article also discusses the successes and failures of therapeutic pedagogy.

German Ambulatory Care Physicians' Perspectives on Continuing Medical Education--A National Survey

ERIC Educational Resources Information Center

Kempkens, Daniela; Dieterle, Wilfried E.; Butzlaff, Martin; Wilson, Andrew; Bocken, Jan; Rieger, Monika A.; Wilm, Stefan; Vollmar, Horst C.

2009-01-01

Introduction: This survey aimed to investigate German ambulatory physicians' opinions about mandatory continuing medical education (CME) and CME resources shortly before the introduction of mandatory CME in 2004. Methods: A structured national telephone survey of general practitioners and specialists was conducted. Main outcome measures were…

Identity Development in German Adolescents with and without Visual Impairments

ERIC Educational Resources Information Center

Pinquart, Martin; Pfeiffer, Jens P.

2013-01-01

Introduction: The study reported here assessed the exploration of identity and commitment to an identity in German adolescents with and without visual impairments. Methods: In total, 178 adolescents with visual impairments (blindness or low vision) and 526 sighted adolescents completed the Ego Identity Process Questionnaire. Results: The levels of…

Where Are We Today? A Survey of Current German Teaching Methods in American Colleges and Universities.

ERIC Educational Resources Information Center

Helt, Richard C.; Woloshin, David J.

1982-01-01

Reports on survey of beginning German at colleges and universities in the U.S. Results show grammatical knowledge is most important objective followed by speaking, listening, and reading comprehension, cultural awareness, then writing. Results indicate growth within the profession. (BK)

Learning by Teaching: Developing Transferable Skills

ERIC Educational Resources Information Center

Stollhans, Sascha

2016-01-01

"Learning by teaching" (German: "Lernen durch Lehren," commonly abbreviated as "LdL") is a teaching and learning approach which was developed by the French language teacher Jean-Pol Martin in German schools in the 1980s (Martin, 1985). The method sees students in the role of the teacher, and enhances their learning…

Everyday Pedagogical Practices in Mathematical Play Situations in German "Kindergarten"

ERIC Educational Resources Information Center

Brandt, Birgit

2013-01-01

This study describes situations in German daycare facilities (Kindergarten) in which the development of mathematical thinking in children is specifically encouraged through examination of common play objects. Using micro-sociological methods of analysis, the mathematical potential of such interactions between teacher and child is elaborated within…

The Educational Governance of German School Social Science: The Example of Globalization

ERIC Educational Resources Information Center

Szukala, Andrea

2016-01-01

Purpose: This article challenges the outsiders' views on European school social science adopting genuine cosmopolitan views, when globalisation is treated in social science classrooms. Method: The article is based on the theoretical framework of educational governance analysis and on qualitative corpus analysis of representative German Laenders'…

[Qualitative research in health services research - discussion paper, Part 2: Qualitative research in health services research in Germany - an overview].

PubMed

Karbach, U; Stamer, M; Holmberg, C; Güthlin, C; Patzelt, C; Meyer, T

2012-08-01

This is the second part of a 3-part discussion paper by the working group on "Qualitative Methods" in the German network of health services research (DNVF) that shall contribute to the development of a memorandum concerning qualitative health services research. It aims to depict the different types of qualitative research that are conducted in health services research in Germany. In addition, the authors present a specific set of qualitative data collection and analysis tools to demonstrate the potential of qualitative research for health services research. QUALITATIVE RESEARCH IN HEALTH SERVICES RESEARCH - AN OVERVIEW: To give an overview of the types of qualitative research conducted in German health services research, the abstracts of the 8th German Conference on Health Services Research were filtered to identify qualitative or mixed-methods studies. These were then analysed by looking at the context which was studied, who was studied, the aims of the studies, and what type of methods were used. Those methods that were mentioned most often for data collection and analysis are described in detail. QUALITATIVE RESEARCH AT THE CONFERENCE FOR HEALTH SERVICES RESEARCH 2009: Approximately a fifth of all abstracts (n=74) had a qualitative (n=47) or a mixed-methods approach combining quantitative and qualitative methods (n=27). Research aims included needs assessment (41%), survey development (36%), evaluation (22%), and theorizing (1%). Data collection mostly consisted of one-on-one interviews (n=45) and group discussions (n=29). Qualitative content analysis was named in 35 abstracts, 30 abstracts did not reference their method of analysis. In addition to a quantitative summary of the abstract findings, the diversity of fields addressed by qualitative methods is highlighted. Although drawing conclusions on the use of qualitative methods in German health services research from the analysis of conference abstracts is not possible, the overview we present demonstrates the diversity of methods used for data collection and analysis and showed that a few select methods are extensively used. One of the tasks a memorandum of qualitative health services research should accomplish is to highlight underutilized research methods, which may help to develop the potential of qualitative methodology in German health services research. © Georg Thieme Verlag KG Stuttgart · New York.

German translation, cultural adaptation, and validation of the Health Literacy Questionnaire (HLQ).

PubMed

Nolte, Sandra; Osborne, Richard H; Dwinger, Sarah; Elsworth, Gerald R; Conrad, Melanie L; Rose, Matthias; Härter, Martin; Dirmaier, Jörg; Zill, Jördis M

2017-01-01

The Health Literacy Questionnaire (HLQ), developed in Australia in 2012 using a 'validity-driven' approach, has been rapidly adopted and is being applied in many countries and languages. It is a multidimensional measure comprising nine distinct domains that may be used for surveys, needs assessment, evaluation and outcomes assessment as well as for informing service improvement and the development of interventions. The aim of this paper is to describe the German translation of the HLQ and to present the results of the validation of the culturally adapted version. The HLQ comprises 44 items, which were translated and culturally adapted to the German context. This study uses data collected from a sample of 1,058 persons with chronic conditions. Statistical analyses include descriptive and confirmatory factor analyses. In one-factor congeneric models, all scales demonstrated good fit after few model adjustments. In a single, highly restrictive nine-factor model (no cross-loadings, no correlated errors) replication of the original English-language version was achieved with fit indices and psychometric properties similar to the original HLQ. Reliability for all scales was excellent, with a Cronbach's Alpha of at least 0.77. High to very high correlations between some HLQ factors were observed, suggesting that higher order factors may be present. Our rigorous development and validation protocol, as well as strict adaptation processes, have generated a remarkable reproduction of the HLQ in German. The results of this validation provide evidence that the HLQ is robust and can be recommended for use in German-speaking populations. German Clinical Trial Registration (DRKS): DRKS00000584. Registered 23 March 2011.

[Immunogenetic characteristics of the population of the Transcarpathian region of the UkrSSR ABO system erythrocyte antigen findings].

PubMed

Levaniuk, V F

1977-01-01

The phenotypes with their respective alleles frequencies of the ABO system were studied in 33 230 individuals of 9 ethnic groups of the Transcarpathian Region population. Statistically significant differences in allele frequencies were found in Gypsies, Germans and Slovaks as compared to those in the main Ukrainian population. There are significant differences between Hungarians and Gypsies of the Transcarpathian Region and analogous populations beyond the region. Absence of a reliable difference between gene pools of the Slav groups of the population and of Hungarians may point to the local origin of the later.

Costs and outcomes of the German disease management programme (DMP) for chronic obstructive pulmonary disease (COPD)-A large population-based cohort study.

PubMed

Achelrod, Dmitrij; Welte, Tobias; Schreyögg, Jonas; Stargardt, Tom

2016-09-01

To curb costs and improve health outcomes in chronic obstructive pulmonary disease (COPD), a nationwide disease management programme (DMP) was introduced in Germany in 2005. Yet, its effectiveness has not been comprehensively evaluated. To examine the effects of the German COPD DMP over three years on costs and health resource utilisation from the payer perspective, process quality, morbidity and mortality. A retrospective, population-based cohort study design is applied, using administrative data. After eliminating differences in observable characteristics between the DMP and the control group with entropy balancing, difference-in-difference estimators were computed to account for time-invariant unobservable heterogeneity. 215,104 individuals were included into the analysis of whom 25,269 were enrolled in the DMP. DMP patients had a reduced mortality hazard ratio (0.89, 95%CI: 0.84-0.94) but incurred excess costs of €553 per year. DMP enrolees reveal higher healthcare utilisation with larger shares of individuals being hospitalised (3.14%), consulting an outpatient clinic due to exacerbations (11.13%) and pharmaceutical prescriptions (2.78). However, average length of hospitalisation due to COPD fell by 0.49 days, adherence to medication guidelines as well as indicators for morbidity improved. The German COPD DMP achieved significant improvements in mortality, morbidity and process quality, but at higher costs. Given the low ICER per life year gained, DMP COPD may constitute a cost-effective option to promote COPD population health. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The association of traumatic experiences and posttraumatic stress disorder with physical morbidity in old age: a German population-based study.

PubMed

Glaesmer, Heide; Brähler, Elmar; Gündel, Harald; Riedel-Heller, Steffi G

2011-06-01

To examine the relationship of traumatic experiences and posttraumatic stress disorder (PTSD) among a representative population sample of 1456 German elderly (60-85 years). Several studies have suggested that PTSD and traumatic experiences are related to adverse health outcomes. However, many past studies were based on special samples such as combat veterans or survivors of natural disasters. Using self-report data and regression analyses, we investigated the association of traumatic experiences and PTSD with several medical conditions. Traumatized subjects had a significantly increased risk for all the medical conditions under study compared with those participants without a traumatic exposure, ranging from odds ratio of 1.37 (95% confidence interval [CI] = 1.07-1.75) for hypertension up to 5.12 (95% CI = 2.25-11.6) for cancer. There are significant associations of current PTSD with cardiovascular diseases (angina pectoris/coronary artery disease, congestive heart failure, and peripheral vascular disease) and cardiovascular risk factors (hypertension and elevated cholesterol level; odds ratio of 1.94 [95% CI = 1.14-3.31]) for peripheral vascular disease up to 3.76 [95% CI = 2.11-6.70] for elevated cholesterol level), as well as with asthma, cancer, back pain, hard of hearing, osteoporosis, stomach problems, and thyroid disorders. These findings suggest an association between traumatic stress and PTSD with impaired physical health in a general population sample in the German elderly. It underscores the importance of traumatic experiences and PTSD not only for mental health but also for physical health as a long-term consequence.

[Health literacy of adults in Germany: Findings from the German Health Update (GEDA) study].

PubMed

Jordan, Susanne; Hoebel, Jens

2015-09-01

In today's information society, health literacy (HL) is considered important for health maintenance and disease management. In this context, dealing with health information is fundamental and requires different cognitive and social skills. The aim of this study was to investigate the distribution of HL levels in the adult population of Germany, and to identify associations with health behaviours and health status. The analyses were based on data from the German Health Update (GEDA) study, a cross-sectional survey of the German-speaking adult population of Germany, which was conducted from October 2013 to June 2014. Health literacy was assessed with the short form of the European Health Literacy Questionnaire (HLS EU-Q16), along with questions about socio-demographics, health behaviours, and health status. The HLS-EU-Q16 index could be calculated for 4845 respondents. According to the criteria of the HLS-EU-Q16, more than half of the adults had "adequate" HL (55.8 %). Every third person (31.9 %) had "problematic" and almost every eighth person (12.3 %) had "inadequate" HL. We found significant differences in HL by educational level, but no differences in HL by sex and age group. Certain health behaviours were positively associated with health literacy. A low HL level was associated with poorer physical and mental health. The results point to a need for action to improve HL in the adult population. The strengthening of health literacy should not solely aim at the promotion of individual skills, but also give high priority to the development of health-literate settings.

Assessment methods for rehabilitation.

PubMed

Biefang, S; Potthoff, P

1995-09-01

Diagnostics and evaluation in medical rehabilitation should be based on methods that are as objective as possible. In this context quantitative methods are an important precondition. We conducted for the German Pensions Insurance Institutions (which are in charge of the medical and vocational rehabilitation of workers and employees) a survey on assessment methods for rehabilitation which included an evaluation of American literature, with the aim to indicate procedures that can be considered for adaptation in Germany and to define further research requirements. The survey identified: (1) standardized procedures and instrumented tests for the assessment of musculoskeletal, cardiopulmonary and neurophysiological function; (2) personality, intelligence, achievement, neuropsychological and alcoholism screening tests for the assessment of mental or cognitive function; (3) rating scales and self-administered questionnaires for the assessment of Activities of Daily Living and Instrumental Activities of Daily Living (ADL/IADL Scales); (4) generic profiles and indexes as well as disease-specific measures for the assessment of health-related quality of life and health status; and (5) rating scales for vocational assessment. German equivalents or German versions exist only for a part of the procedures identified. Translation and testing of Anglo-Saxon procedures should have priority over the development of new German methods. The following procedures will be taken into account: (a) instrumented tests for physical function, (b) IADL Scales, (c) generic indexes of health-related quality of life, (d) specific quality of life and health status measures for disorders of the circulatory system, metabolic system, digestive organs, respiratory tract and for cancer, and (e) vocational rating scales.

HydroCrowd: a citizen science snapshot to assess the spatial control of nitrogen solutes in surface waters

PubMed Central

Breuer, Lutz; Hiery, Noreen; Kraft, Philipp; Bach, Martin; Aubert, Alice H.; Frede, Hans-Georg

2015-01-01

We organized a crowdsourcing experiment in the form of a snapshot sampling campaign to assess the spatial distribution of nitrogen solutes, namely, nitrate, ammonium and dissolved organic nitrogen (DON), in German surface waters. In particular, we investigated (i) whether crowdsourcing is a reasonable sampling method in hydrology and (ii) what the effects of population density, soil humus content and arable land were on actual nitrogen solute concentrations and surface water quality. The statistical analyses revealed a significant correlation between nitrate and arable land (0.46), as well as soil humus content (0.37) but a weak correlation with population density (0.12). DON correlations were weak but significant with humus content (0.14) and arable land (0.13). The mean contribution of DON to total dissolved nitrogen was 22%. Samples were classified as water quality class II or above, following the European Water Framework Directive for nitrate and ammonium (53% and 82%, respectively). Crowdsourcing turned out to be a useful method to assess the spatial distribution of stream solutes, as considerable amounts of samples were collected with comparatively little effort. PMID:26561200

Dermatologists combat leprosy in Yemen.

PubMed

al-Qubati, Y; al-Kubati, A S

1997-12-01

Leprosy has been prevalent in Yemen for many years. The ostracization and stigmatization of leprosy patients are well documented in the yemeni literature. No control activities were carried out until 1980. To document the development of leprosy control activities in the Republic of Yemen during the period from 1982 to 1996. The dermatologists in Yemen used various methods, including the media, to fight the stigma of leprosy and thus to mobilize the community for the reintegration of leprosy patients. They sought support from international non-governmental organizations (NGOs) to start mobile teams all over the country. The support of the German Leprosy Relief Association (GLRA) and the World Health Organization (WHO) enabled the National Leprosy Control Program (NLCP) to reach people in remote areas. The prevalence of leprosy has declined from 1.9 per 10,000 population in 1989 to 0.5 per 10,000 population in 1996. The stigma associated with leprosy also extends to other skin diseases. To combat this stigma, various methods, such as health education, training of medical personnel, and mass treatment for skin diseases, have been used.

Ethnic Origin and Educational Attainment: November 1969. Population Characteristics, Current Population Reports.

ERIC Educational Resources Information Center

Johnson, Charles E., Jr.

A study of educational attainment of adults (25 years old and over) in the United States (by ethnic origin) shows a wide range among the ethnic groups. The following is a breakdown of the main national lineage of the 106.3 million respondents: German, 12.8 million; English, 12.0 million; Irish, 8.6 million; Italian, 4.7 million; Polish, 2.8…

Juvenile obesity and its association with utilisation and costs of pharmaceuticals - results from the KiGGS study

PubMed Central

2011-01-01

Background According to a national reference, 15% of German children and adolescents are overweight (including obese) and 6.3% are obese. An earlier study analysed the impact of childhood overweight and obesity on different components of direct medical costs (physician, hospital and therapists). To complement the existing literature for Germany, this study aims to explore the association of body mass index (BMI) with utilisation of pharmaceuticals and related costs in German children and adolescents. Methods Based on data from 14, 836 respondents aged 3-17 years in the German Interview and Examination Survey for Children and Adolescents (KiGGS), drug intake and associated costs were estimated using a bottom-up approach. To investigate the association of BMI with utilisation and costs, univariate analyses and multivariate generalised mixed models were conducted. Results There was no significant difference between BMI groups regarding the probability of drug utilisation. However, the number of pharmaceuticals used was significantly higher (14%) for obese children than for normal weight children. Furthermore, there was a trend for more physician-prescribed medication in obese children and adolescents. Among children with pharmaceutical intake, estimated costs were 24% higher for obese children compared with the normal weight group. Conclusions This is the first study to estimate excess drug costs for obesity based on a representative cross-sectional sample of the child and adolescent population in Germany. The results suggest that obese children should be classified as a priority group for prevention. This study complements the existing literature and provides important information concerning the relevance of childhood obesity as a health problem. PMID:22176689

China's Oral Care System in Transition: Lessons to be Learned from Germany

PubMed Central

Saekel, Ruediger

2010-01-01

Aim The objective of this discussion paper is to investigate whether the experience gained through the German paradigm shift in dental care can be of benefit in China's deliberations on the introduction of universal dental care for its people. Methodology A comparison of representative oral health outcome data from China and Germany, two countries at different stages in their development, is presented here in order to analyse whether the findings meet expected outcome and confirm the presumption that more developed countries perform better. Results The epidemiological comparison reveals surprising findings concerning the severity of dental diseases and, in particular, missing teeth per person in adults and rates of total edentulousness in seniors. In all of these areas German adults and seniors show significantly inferior outcomes compared with the Chinese population. The main reason for these striking discrepancies, as it turned out, is the decisive role played by the treatment philosophies and strategies of German dentists. Conclusion and recommendations If dentists take a less interventionist approach, checking as well as treating dental diseases with preventive and strictly tooth-preserving methods, dental treatment results in oral health. Under these conditions it can be assumed that modern dentistry is generally good for the teeth. These findings are important for developing countries that are seeking to integrate dental care into their health care system. On the basis of long-term experience from highly industrialized Western countries and especially from Germany we will attempt to put forward proposals for creating an effective and efficient dental care system in China. PMID:21125794

What Do Germans Want to Know About Skin Cancer? A Nationwide Google Search Analysis From 2013 to 2017.

PubMed

Seidl, Stefanie; Schuster, Barbara; Rüth, Melvin; Biedermann, Tilo; Zink, Alexander

2018-05-02

Experts worldwide agree that skin cancer is a global health issue, but only a few studies have reported on world populations' interest in skin cancer. Internet search data can reflect the interest of a population in different topics and thereby identify what the population wants to know. Our aim was to assess the interest of the German population in nonmelanoma skin cancer and melanoma. Google AdWords Keyword Planner was used to identify search terms related to nonmelanoma skin cancer and melanoma in Germany from November 2013 to October 2017. The identified search terms were assessed descriptively using SPSS version 24.0. In addition, the search terms were qualitatively categorized. A total of 646 skin cancer-related search terms were identified with 19,849,230 Google searches in the period under review. The search terms with the highest search volume were "skin cancer" (n=2,388,500, 12.03%), "white skin cancer" (n=2,056,900, 10.36%), "basalioma" (n=907,000, 4.57%), and "melanoma" (n=717,800, 3.62%). The most searched localizations of nonmelanoma skin cancer were "nose" (n=93,370, 38.99%) and "face" (n=53,270, 22.24%), and the most searched of melanoma were "nails" (n=46,270, 70.61%) and "eye" (n=10,480, 15.99%). The skin cancer‒related category with the highest search volume was "forms of skin cancer" (n=10,162,540, 23.28%) followed by "skin alterations" (n=4,962,020, 11.36%). Our study provides insight into terms and fields of interest related to skin cancer relevant to the German population. Furthermore, temporal trends and courses are shown. This information could aid in the development and implementation of effective and sustainable awareness campaigns by developing information sources targeted to the population's broad interest or by implementing new Internet campaigns. ©Stefanie Seidl, Barbara Schuster, Melvin Rüth, Tilo Biedermann, Alexander Zink. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.05.2018.

Comparison of skeletal muscle mass to fat-free mass ratios among different ethnic groups.

PubMed

Abe, T; Bemben, M G; Kondo, M; Kawakami, Y; Fukunaga, T

2012-01-01

Asians seem to have less skeletal muscle mass (SMM) than other ethnic groups, but it is not clear whether relative SMM, i.e., SMM / height square or SMM to fat-free mass (FFM) ratio, differs among different ethnic groups at the same level of body mass index (BMI). To compare the SMM to fat-free mass (FFM) ratio as well as anthropometric variables and body composition among 3 ethnic groups. Three hundred thirty-nine Japanese, 343 Brazilian, and 183 German men and women were recruited for this cross-sectional study. Muscle thickness (MTH) and subcutaneous fat thickness (FTH) were measured by ultrasound at nine sites on the anterior and posterior aspects of the body. FTH was used to estimate the body density, from which fat mass and fat-free mass (FFM) was calculated by using Brozek equation. Total SMM was estimated from ultrasound-derived prediction equations. Percentage body fat was similar among the ethnic groups in men, while Brazilians were higher than Japanese in women. In German men and women, absolute SMM and FFM were higher than in their Japanese and Brazilians counterparts. SMM index and SMM:FFM ratios were similar among the ethnic groups in women, excluding SMM:FFM ratio in Brazilian. In men, however, these relative values (SMM index and SMM:FFM ratio) were still higher in Germans. After adjusting for age and BMI, the SMM index and SMM:FFM ratios were lower in Brazilian men and women compared with the other two ethnic groups, while the SMM index and SMM:FFM ratios were similar in Japanese and German men and women, excluding SMM:FFM ratio in women. Our results suggest that relative SMM is not lower in Asian populations compared with European populations after adjusted by age and BMI.

[Participation of migrants in health surveys conducted by telephone: potential and limits].

PubMed

Schenk, L; Neuhauser, H

2005-10-01

Migrants living in Germany are a both large and vulnerable population subgroup. They are not easily induced to participate in health surveys, Hence, achieving high participation rates of migrants in health surveys and avoiding selection bias is a difficult task. In this study, we report on the participation of migrants in the German National Health Telephone Survey 2003 (GSTel03), the first comprehensive national health survey conducted by telephone in Germany. Three migrant groups were identified: individuals with non-German citizenship (foreigners), naturalized migrants, and ethnic German immigrants (Spätaussiedler). The aim of this study is to evaluate the degree to which the GSTel03 subsample of foreigners is representative for foreigners living in Germany. We compare the prevalence of sociodemographic characteristics and selected health indicators of foreigners in the GNTel03 subsample with prevalences from national statistics and from a large national household survey ("Mikrozensus 2003"). The proportion of participants with non-German nationality in the overall GSTel03 sample was significantly lower than the proportion of foreigners in the residential population in Germany (3.7 % vs. 8.9 %). While there was no evidence of selection bias with regard to age and sex distribution, we found significant differences with regard to other factors, including nationality, length of stay in Germany, unemployment rate and education. The comparison of health indicators showed only moderate differences between GSTel03 sample and "Mikrozensus" results. However, these differences did not consistently point to a better or worse health status in the GSTel03 sample of foreigners and should therefore not be generalised in respect of other health indicators. Our study emphasises the importance of a continuous effort to improve migrant participation in health studies and of a thorough analysis of selection bias when interpreting results.

Considering genetic characteristics in German Holstein breeding programs.

PubMed

Segelke, D; Täubert, H; Reinhardt, F; Thaller, G

2016-01-01

Recently, several research groups have demonstrated that several haplotypes may cause embryonic loss in the homozygous state. Up to now, carriers of genetic disorders were often excluded from mating, resulting in a decrease of genetic gain and a reduced number of sires available for the breeding program. Ongoing research is very likely to identify additional genetic defects causing embryonic loss and calf mortality by genotyping a large proportion of the female cattle population and sequencing key ancestors. Hence, a clear demand is present to develop a method combining selection against recessive defects (e.g., Holstein haplotypes HH1-HH5) with selection for economically beneficial traits (e.g., polled) for mating decisions. Our proposed method is a genetic index that accounts for the allele frequencies in the population and the economic value of the genetic characteristic without excluding carriers from breeding schemes. Fertility phenotypes from routine genetic evaluations were used to determine the economic value per embryo lost. Previous research has shown that embryo loss caused by HH1 and HH2 occurs later than the loss for HH3, HH4, and HH5. Therefore, an economic value of € 97 was used against HH1 and HH2 and € 70 against HH3, HH4, and HH5. For polled, € 7 per polled calf was considered. Minor allele frequencies of the defects ranged between 0.8 and 3.3%. The polled allele has a frequency of 4.1% in the German Holstein population. A genomic breeding program was simulated to study the effect of changing the selection criteria from assortative mating based on breeding values to selecting the females using the genetic index. Selection for a genetic index on the female path is a useful method to control the allele frequencies by reducing undesirable alleles and simultaneously increasing economical beneficial characteristics maintaining most of the genetic gain in production and functional traits. Additionally, we applied the genetic index to real data and found a decrease of the genetic trend for the birth years 1990 to 2006. Since 2010 the genetic index has increased due to a strong increase in the polled frequency. However, further investigation is needed to better understand the biology to determine the correct time of embryo loss and the economic value of fertility disorders. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Genetic variation at the ApoB 3[prime] HVR, D2S44, and D7S21 loci in the Ewondo ethnic group of Cameroon

DOE Office of Scientific and Technical Information (OSTI.GOV)

Destro-Bisol, G.; d'Aloja, E.; Dobosz, M.

1994-07-01

A sample of the Ewondo population (a Bantu-speaking group of Southern Cameroon) was analyzed for the polymorphism at three tandem repeated DNA loci (ApoB 3[prime] HVR, D2S44, and D7S21). The authors observed a greater number of ApoB 3[prime] HVR alleles (17) and a significantly higher estimated heterozygosity (.879[+-].011) than in previously surveyed populations, with the exception of U.S. Blacks. The higher genetic variability of Ewondo and U.S. Blacks was also shown by the ApoB 3[prime] HVR allele-frequency spectra. A method for measuring population distances, based on cumulative fragment-size distribution, is described. Interpopulation comparisons for ApoB 3[prime] HVR were carried outmore » by this method and were compared with those obtained by a genetic distance measurement. The two sets of results showed a consistent pattern of population differentiation: the Ewondos and the U.S. Blacks clustered together and were apart from both a Caucasian cluster (Swedes, U.S. Whites, Italians, and Germans) and other well-defined populations (Sikhs of India and Pehuence Indians of Chile). Profile distances were then computed from D2S44 and D7S21 binned data. This analysis indicated a genetic affinity between Ewondos, U.S. Blacks, and Afro-Caribbean Blacks and outlined the genetic diversity between Ewondos, Caucasians, and Asian Indians. 56 refs., 5 figs., 1 tab.« less

Validation of life-charts documented with the personal life-chart app - a self-monitoring tool for bipolar disorder.

PubMed

Schärer, Lars O; Krienke, Ute J; Graf, Sandra-Mareike; Meltzer, Katharina; Langosch, Jens M

2015-03-14

Long-term monitoring in bipolar affective disorders constitutes an important therapeutic and preventive method. The present study examines the validity of the Personal Life-Chart App (PLC App), in both German and in English. This App is based on the National Institute of Mental Health's Life-Chart Method, the de facto standard for long-term monitoring in the treatment of bipolar disorders. Methods have largely been replicated from 2 previous Life-Chart studies. The participants documented Life-Charts with the PLC App on a daily basis. Clinicians assessed manic and depressive symptoms in clinical interviews using the Inventory of Depressive Symptomatology, clinician-rated (IDS-C) and the Young Mania Rating Scale (YMRS) on a monthly basis on average. Spearman correlations of the total scores of IDS-C and YMRS were calculated with both the Life-Chart functional impairment rating and mood rating documented with the PLC App. 44 subjects used the PLC App in German and 10 subjects used the PLC App in English. 118 clinical interviews from the German sub-sample and 97 from the English sub-sample were analysed separately. The results in both sub-samples are similar to previous Life-Chart validation studies. Again statistically significant high correlations were found between the Life-Chart function rating assigned through the PLC App and well-established observer-rated methods. Again correlations were weaker for the Life-Chart mood rating than for the Life-Chart function impairment. No relevant correlation was found between the Life-chart mood rating and YMRS in the German sub-sample. This study gives further evidence for the validity of the Life-Chart method as a valid tool for the recognition of both manic and depressive episodes. Documenting Life-Charts with the PLC App (English and German) does not seem to impair the validity of patient ratings.

[German translation and validation of the Stress Appraisal Measure (SAM)].

PubMed

Delahaye, M; Stieglitz, R D; Graf, M; Keppler, C; Maes, J; Pflueger, M

2015-05-01

In the present study, the German-language version of the Stress Appraisal Measure (SAM) by Peacock and Wong was validated in a student population. SAM is a relatively short questionnaire (28 items) that evaluates a current, stress-triggering event. The theoretical background is provided by the stress model of Lazarus and Folkman. 85 students (age: 23; 59 female, 26 male) were exposed to two stress scenarios in order to test whether they were suited to provoke stress. A factor analysis was performed and the internal consistency of the seven SAM scales was determined. In addition, the convergent validity of SAM with State and Trait Anxiety Inventory (STAI), Coping Inventory for Stressful Situations (CISS) and specific emotion scales was investigated via Pearson's product-moment correlation. The two stress scenarios were suited to evoke stress. The factor structure and the internal consistency of the individual scales, as well as the convergent validity of SAM were replicated with minor limitations in the present German version. Some items (especially from the fifth factor) were only replicated partially. SAM can also be employed in the German language version. © Georg Thieme Verlag KG Stuttgart · New York.

The health status of Russian-speaking immigrants in Germany.

PubMed

Tselmin, S; Korenblum, W; Reimann, M; Bornstein, S R; Schwarz, P E H

2007-12-01

Germany developed today into a country of immigration, which creates an additional burden for the social security system and results in a new challenge for the healthcare. In the last 17 years more than two million "Russia Germans" have been repatriated and about two hundred thousand Jewish refugees have resettled in Germany from the former Soviet Union. Nevertheless relevant data concerning migration-related public health care are very scare. Search of PubMed and Journals extracts combined with the own researches, analysing the health status indices of the Russian-speaking immigrants in Germany. Both repatriates of German origin and Jewish refugees demonstrated higher prevalence of impaired lipid metabolism in comparison with native population. 42 % of the 503,040 HBsAg (hepatitis B s-Antigen) carriers in Germany were migrants. The Jewish refugees demonstrated the highest rates of depression and anxiety and the highest levels of awakening cortisol. On the other side German resettlers showed lower cardiovascular as well as all-cause death rates compared to the native Germans. The development of adequate health care programmes to address migratory aspects as well as the establishment of quality standards will realistically enhance the capability of responding rapidly to migrant health aspects and help to tackle inequalities in health.

German Public Support for Tobacco Control Policy Measures: Results from the German Study on Tobacco Use (DEBRA), a Representative National Survey

PubMed Central

Shahab, Lion; Kastaun, Sabrina

2018-01-01

Smoking prevalence in Germany remains high at approximately 28%. We assessed public support for tobacco legislation and associations between level of support and smoking and socio-demographic characteristics. Data from 2087 people were collected as part of the German Study on Tobacco Use (“DEBRA”): a nationally representative, face-to-face household survey. Public support was measured on total ban of sale, raising the minimum age for sales, taxation of tobacco industry sales, research into e-cigarettes, and ban of smoking in cars when children are present. Associations were assessed with multivariate logistic regression. Over 50% of the German population support taxing industry profits (57.3%) and assessing e-cigarettes as an aid to quit smoking (55.5%). Over 40% support raising the legal age of sale (43.1%), and 22.9% support a total ban on tobacco sales. A smoking ban in cars when children are present was most popular (71.5%), even among current smokers (67.0%). There is public support for stricter tobacco control measures in Germany. A smoking ban in cars when children are present could be a feasible policy to implement. PMID:29642461

The changing psychology of culture in German-speaking countries: A Google Ngram study.

PubMed

Younes, Nadja; Reips, Ulf-Dietrich

2017-05-05

This article provides evidence for the long-term affiliation between ecological and cultural changes in German-speaking countries, based on the assumptions derived from social change and human development theory. Based on this theory, the increase in urbanisation, as a measure of ecological change, is associated with significant cultural changes of psychology. Whereas urbanisation is linked to greater individualistic values and materialistic attitudes, rural environments are strongly associated with collectivistic values like allegiance, prevalence of religion, and feelings of belonging and benevolence. Due to an increase in the German urbanisation rate over time, our study investigates whether Germany and the German-speaking countries around show the presumed changes in psychology. By using Google Books Ngram Viewer, we find that word frequencies, signifying individualistic (collectivistic) values, are positively (negatively) related to the urbanisation rate of Germany. Our results indicate that predictions about implications of an urbanising population for the psychology of culture hold true, supporting international universality of the social change and human development theory. Furthermore, we provide evidence for a predicted reversal for the time during and after World War II, reflecting Nazi propaganda and influence. © 2017 International Union of Psychological Science.

Teaching German with TPRS (Total Physical Response Storytelling)

ERIC Educational Resources Information Center

Davidheiser, James

2002-01-01

Total Physical Response Storytelling (TPRS) has enjoyed a tremendous increase of interest in recent years because so many teachers in high schools and colleges are finding that it reinvigorates their German programs. Some even claim that it has saved them. TPRS actually consists of two complementary pedagogical methods: (1) Total Physical Response…

Occupational Socialization of Sport Pedagogy Faculty: Two German Case Studies

ERIC Educational Resources Information Center

Merrem, Anne M.; Curtner-Smith, Matthew D.

2018-01-01

Purpose: The purpose of this study was to describe the influence of occupational socialization on the perspectives and practices of two female German sport pedagogy faculty members, Heidi and Lisa, regarding physical education (PE) and PE teacher education (PETE). Method: The main data sources were six formal interviews. Supplementary data were…

Measuring Second Language Acquisition. Studies in Language Education, No. 6.

ERIC Educational Resources Information Center

Cooper, Thomas C.

This research project was designed to analyze by quantitative methods a corpus of writing produced by four groups of American college students enrolled in German courses and by one group of professional German writers. Analysis was undertaken in order to determine whether or not significant quantitative differences in the use of selected syntactic…

Computed tomographic method for measurement of inclination angles and motion of the sacroiliac joints in German Shepherd Dogs and Greyhounds.

PubMed

Saunders, Fritha C; Cave, Nick J; Hartman, Karl M; Gee, Erica K; Worth, Andrew J; Bridges, Janis P; Hartman, Angela C

2013-09-01

To develop an in vivo CT method to measure inclination angles and motion of the sacroiliac joints in dogs of performance breeds. 10 German Shepherd Dogs and 12 Greyhounds without signs of lumbosacral region pain or neurologic problems. CT of the ilium and sacrum was performed in flexed, neutral, and extended hind limb positions. Lines were drawn on volume-rendered images acquired in the flexed and extended positions to measure motion of the ilia relative to the sacra. Inclination angles of the synovial and ligamentous components of the sacroiliac joints were measured on transverse-plane CT images acquired at cranial and caudal locations. Coefficients of variance of measurements were calculated to determine intraobserver variability. Coefficients of variance of measurements ranged from 0.17% to 2.45%. A significantly higher amount of sacroiliac joint rotational motion was detected for German Shepherd Dogs versus Greyhounds. The cranial synovial joint component had a significantly more sagittal orientation in German Shepherd Dogs versus Greyhounds. No significant differences were detected between breeds for x- or y-axis translational motion or caudal synovial or ligamentous joint component inclination angles. The small amounts of sacroiliac joint motion detected in this study may buffer high-frequency vibrations during movement of dogs. Differences detected between breeds may be associated with the predisposition of German Shepherd Dogs to develop lumbosacral region signs of pain, although the biological importance of this finding was not determined. Future studies are warranted to compare sacroiliac joint variables between German Shepherd Dogs with and without lumbosacral region signs of pain.

Analyzing Genetic Diversity for Virulence and Resistance Phenotypes in Populations of Stem Rust (Puccinia graminis f. sp. secalis) and Winter Rye (Secale cereale).

PubMed

Miedaner, Thomas; Schmitt, Ann-Kristin; Klocke, Bettina; Schmiedchen, Brigitta; Wilde, Peer; Spieß, Hartmut; Szabo, Lilla; Koch, Silvia; Flath, Kerstin

2016-11-01

Stem rust (Puccinia graminis f. sp. secalis) leads to considerable yield losses in rye-growing areas with continental climate, from Eastern Germany to Siberia. For implementing resistance breeding, it is of utmost importance to (i) analyze the diversity of stem rust populations in terms of pathotypes (= virulence combinations) and (ii) identify resistance sources in winter rye populations. We analyzed 323 single-uredinial isolates mainly collected from German rye-growing areas across 3 years for their avirulence/virulence on 15 rye inbred differentials. Out of these, 226 pathotypes were detected and only 56 pathotypes occurred more than once. This high diversity was confirmed by a Simpson index of 1.0, a high Shannon index (5.27), and an evenness index of 0.97. In parallel, we investigated stem rust resistance among and within 121 heterogeneous rye populations originating mainly from Russia, Poland, Austria, and the United States across 3 to 15 environments (location-year combinations). While German rye populations had an average stem rust severity of 49.7%, 23 nonadapted populations were significantly (P < 0.01) more resistant with a stem rust severity ranging from 3 to 40%. Out of these, two modern Russian breeding populations and two old Austrian landraces were the best harboring 32 to 70% fully resistant plants across 8 to 10 environments. These populations with the lowest disease severity in adult-plant stage in the field also displayed resistance in leaf segment tests. In conclusion, stem rust populations are highly diverse and the majority of resistances in rye populations seems to be race specific.

FOEHN: The critical experiment for the Franco-German High Flux Reactor

DOE Office of Scientific and Technical Information (OSTI.GOV)

Scharmer, K.; Eckert, H. G.

1991-01-01

A critical experiment for the Franco-German High Flux Reactor was carried out in the French reactor EOLE (CEN Cadarache). The purpose of the experiment was to check the calculation methods in a realistic geometry and to measure effects that can only be calculated imprecisely (e.g. beam hole effects). The structure of the experiment and the measurement and calculation methods are described. A detailed comparison between theoretical and experimental results was performed. 30 refs., 105 figs.

Approaching population thresholds in presence of uncertainty: Assessing displacement of seabirds from offshore wind farms

DOE Office of Scientific and Technical Information (OSTI.GOV)

Busch, Malte, E-mail: der.malte.busch@gmail.com; Garthe, Stefan

Assessment of the displacement impacts of offshore wind farms on seabirds is impeded by a lack of evidence regarding species-specific reactions to developed sites and the potential ecological consequences faced by displaced individuals. In this study, we present a method that makes best use of the currently limited understanding of displacement impacts. The combination of a matrix table displaying the full range of potential displacement and mortality levels together with seasonal potential biological removal (PBR) assessments provides a tool that increases confidence in the conclusions of impact assessments. If unrealistic displacement levels and/or mortality rates are required to equal ormore » approach seasonal PBRs, this gives an indication of the likeliness of adverse impacts on the assessed population. This approach is demonstrated by assessing the displacement impacts of an offshore wind farm cluster in the German North Sea on the local common guillemot (Uria aalge) population. - Highlights: • A novel approach for assessing displacement impacts of offshore wind farms on seabirds is presented making best use of limited data • A displacement matrix approach is linked with PBR analysis to increased confidence in assessment conclusions drawn • A case example demonstrates the applicability of the methods described in practice.« less

PubMed Central

Schlembach, Dietmar; Helmer, Hanns; Henrich, Wolfgang; von Heymann, Christian; Kainer, Franz; Korte, Wolfgang; Kühnert, Maritta; Lier, Heiko; Maul, Holger; Rath, Werner; Steppat, Susanne; Surbek, Daniel; Wacker, Jürgen

2018-01-01

Purpose This is an official interdisciplinary guideline, published and coordinated by the German Society of Gynaecology and Obstetrics (DGGG), the Austrian Society of Gynaecology and Obstetrics (OEGGG) and the Swiss Society of Gynaecology and Obstetrics (SGGG). The guideline was developed for use in German-speaking countries and is backed by the German Society of Anaesthesiology and Intensive Medicine (DGAI), the Society of Thrombosis and Haemostasis Research (GTH) and the German Association of Midwives. The aim is to provide a consensus-based overview of the diagnosis and management of peripartum bleeding obtained from an evaluation of the relevant literature. Methods This S2k guideline was developed from the structured consensus of representative members of the various professional associations and professions commissioned by the Guideline Commission of the DGGG. Recommendations The guideline encompasses recommendations on definitions, risk stratification, prevention and management. PMID:29720744

Regional medicine use in the Rhine basin and its implication on water quality

NASA Astrophysics Data System (ADS)

Hut, R.; Van De Giesen, N.; de Jong, S.

2011-12-01

Do Germans use more painkillers than the French? An analysis is presented relating medicine residue in the river Rhine to the amount of people living in its watershed. An extensive measuring campaign was carried out, sampling river Rhine at 42 locations from its source to the start of its delta (Dutch-German border). The samples were analyzed for 40 common pharmaceuticals. Using discharge data, digital elevation models and demographic data from Eurostat, the relation between total load of drug residue and population is analyzed. Results show regional differences in drug use as well as implications for (downstream) use of river water for drinking purposes.

Education and employment in patients with juvenile idiopathic arthritis - a standardized comparison to the German general population.

PubMed

Schlichtiger, Jenny; Haas, Johannes-Peter; Barth, Swaantje; Bisdorff, Betty; Hager, Lisa; Michels, Hartmut; Hügle, Boris; Radon, Katja

2017-05-22

Although several studies show that JIA-patients have significantly lower employment rates than the general population, the research on educational and occupational attainments in patients with juvenile idiopathic arthritis (JIA) remain conflicting most likely due to small sample sizes. Therefore, aim of this study is to compare the educational achievements and employment status of 3698 JIA-patients with the German general population (GGP). "SEPIA" was a large cross-sectional study on the current status of a historic cohort of JIA-patients treated in a single center between 1952 and 2010. For the analyses of education and employment a sub-cohort was extracted, including only adult cases with a confirmed diagnosis of JIA (N = 2696). Participants were asked to fill out a standardized written questionnaire on education and employment. Outcome measures (education/unemployment) were directly standardized to the GGP using data obtained from the National Educational Panel Study 2013 (N = 11,728) and the German Unemployment Statistics 2012 of the Federal Statistical Office (N = 42,791,000). After age- and sex-standardization, 3% (95% Confidence Interval 1.9 to 4.1%) more of the JIA-patients (26%) than of the GGP (23%) had only reached primary education. In contrast, parents of JIA-patients had similar levels of education as parents in the GGP. With a standardized difference of 0.2% (95% CI: 0.16 to 0.19%), the unemployment rate in JIA-patients was slightly, but not significantly higher than in the GGP. Stratifying for disease duration and the current treatment status, differences were confirmed for persons diagnosed before 2001, whilst for patients diagnosed after 2000, differences were found only in JIA-patients with ongoing disease. Medium and high educational achievements did not differ statistically significant between JIA patients and the GPP. Educational achievements in German JIA-patients are significantly lower than in the GGP. Furthermore we were able to identify a slightly higher level of unemployment, especially in those with still under treatment and longer disease duration. Better treatment options as well as further development of social support programs might help to overcome this lifelong secondary effect of JIA.

Accounting for tastes: a German perspective on the inclusion of patient preferences in healthcare.

PubMed

Vogt, Florian; Schwappach, David L B; Bridges, John F P

2006-01-01

Internationally, there has been a movement in medicine to better involve patients in decision making, whether it be at the individual or aggregate level. However, the German health sector has been slow to understand and accommodate the preferences of patients. This paper discusses the reasons why and attempts to highlight some of the consequences of not involving patients in healthcare decision making within the German context. We argue that a fundamental paradigm shift at all levels of the German health system, including better doctor/patient communication, is necessary for more choices to be available to patients and to better reflect patient preferences in centralised healthcare decision making. The newly created German health technology assessment agency (IQWiG; Institute for Quality and Economic Efficiency in the Health Care Sector) has indicated that they are interested in focusing on patient preferences, but there is a need for them to clarify what methods they deem suitable for doing so.

The dietary trends and social relations in the migration period.

PubMed

Václav, Smrcka; Antónia, Marcsik; Markéta, Svenssonová

2009-01-01

Central Europe is situated just in the place, where two main eastern and western migration waves overlaped in the Migration period (4th to 6th centuries). The progress of the eastern migration wave, its beginning, course and disappearance is characterised by deformations of skulls. The deformations are indirect expression of the migrations of the Huns and the Sarmatian-Alanian tribes. Diet and social stratification at the Sarmatian burial ground Madaras was reconstructed based on the analyses of contents of trace elements Sr, Zn, Pb in 44 skeletons. At Madaras the principal foodstuffs in the diet were of vegetal origin. Based on statistical testing by means of Scheff's test a significant difference (p = 0.0003) in strontium content in the bones of rich women (garnitures 200, 300, 400) was found being the average 506 microg Sr/g of bone) compared with men with iron knife and the individuals without grave goods (garnitures 100, 800) where the average was 268 microg Sr/g of bone. Western migration wave with German tribes in the 6th century characterised by artificial grinding of front teeth was found in the largest Langorbardic burial-ground in Moravia at Luzice. Compact bone of the femora from two Moravian Prelangobardic sites (Vyskov and Strachotin, N-20 skeletons) of German population dated from Migration period was analysed by content of lead as a cultural factor and Zn and Sr from a health point of view. The Pb exposure was much lower than that from the Roman period (5.7-23 microg Pb/g of bone in the German tribes on the north of Danube) being on an average below 3 microg Pb/g of bone tissue. Content of zinc in migrating German population in the region of the middle Danube (Strachotin, at an average of 188 microg Zn/g of bone; Vyskov, at an average of 111 microg Zn/g of bone) are lower than those from the original settlements (230-500 microg Zn/g of bone). The strontium content in bones was directly proportional to the level of social rank. From 20 analysed skeletons from Strachotin and Vyskov signifies the statistic difference between the social groups of warriors in which concentration of strontium (340 microSr/g bone) was higher compared with woman with jewels (204 microSr) and graves without grave goods (228 micro Sr). The societies in the Germans and the Sarmatians were less differentiated than in the La Tène period. Especially the garnitures 400, 500 and 600 feature little differentiation. The garniture 500 is even missing in the Prelangobardic population at Strachotin.

Persistence of a sugar-rejecting cockroach genotype under various dietary regimes

NASA Astrophysics Data System (ADS)

Jensen, Kim; Wada-Katsumata, Ayako; Schal, Coby; Silverman, Jules

2017-04-01

Glucose-aversion is a heritable trait that evolved in a number of German cockroach (Blattella germanica L.) populations in response to strong selection with glucose-containing insecticide baits. However, in the absence of glucose-containing bait, glucose-averse (GA) cockroaches have lower performance than wild-type (WT) cockroaches in several fitness-determining traits. We allocated 48 caged populations initiated with homozygous GA and WT adults to four dietary treatments consisting of either pure rodent chow, rodent chow mixed to yield a content of either 20% glucose or 20% fructose, or a treatment consisting of choice between the 20% glucose- and the 20% fructose-containing food. After 6 months we found significantly higher frequency of WT individuals in populations restricted to the 20% glucose food, and after 12 months all dietary treatments contained significantly more WT individuals than expected. In accompanying experiments, we found lower survival and longer development time of GA nymphs restricted to glucose-containing food. We furthermore found evidence for assortative mating of females with males from their own genotype, with significant differences within WT cockroaches. Our study shows experimental evidence that within heterogeneous populations, WT German cockroaches will over time prevail in abundance over GA individuals, even when glucose is not a dietary component.

Long-term population patterns of rodents and associated damage in German forestry.

PubMed

Imholt, Christian; Reil, Daniela; Plašil, Pavel; Rödiger, Kerstin; Jacob, Jens

2017-02-01

Several rodent species can damage forest trees, especially at young tree age in afforestation. Population outbreaks of field voles (Microtus agrestis L.) and bank voles (Myodes glareolus Schreber) in particular can cause losses. Analyses of long-term time series indicate good synchrony of population abundance in rodent species associated with damage in forestry. This synchrony could be related to the effect of beech (Fagus spec.) mast in the previous year on population growth rates of both species. In shorter time series from Eastern Germany, damage in forestry was mostly associated with autumn abundances of rodents. Environmental factors such as beech mast and snow cover did not explain additional variation in rodent damage to trees. Beech mast is a good indicator of long-term rodent abundance in Northern German afforestation areas. However, rodent damage to forestry in Central Germany did not seem to depend on environmental parameters other than rodent abundance at large scale. As a result, there is still uncertainty about the link between environmental predictors and rodent damage to forestry, and further experimental work is required to identify suitable environmental drivers and their interplay with other potential factors such as the local predator community. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

Burden of Mortality Attributable to Diagnosed Diabetes: A Nationwide Analysis Based on Claims Data From 65 Million People in Germany.

PubMed

Jacobs, Esther; Hoyer, Annika; Brinks, Ralph; Kuss, Oliver; Rathmann, Wolfgang

2017-12-01

In Germany, as in many other countries, nationwide data on mortality attributable to diagnosed diabetes are not available. This study estimated the absolute number of excess deaths associated with diabetes (all types) and type 2 diabetes in Germany. A prevalence approach that included nationwide routine data from 64.9 million people insured in the German statutory health insurance system in 2010 was used for the calculation. Because nationwide data on diabetes mortality are lacking in Germany, the mortality rate ratio from the Danish National Diabetes Register was used. The absolute number of excess deaths associated with diabetes was calculated as the number of deaths due to diabetes minus the number of deaths due to diabetes with a mortality that was as high as in the population without diabetes. Furthermore, the mortality population-attributable fraction was calculated. A total of 174,627 excess deaths were due to diabetes in 2010, including 137,950 due to type 2 diabetes. Overall, 21% of all deaths in Germany were attributable to diabetes and 16% were attributable to type 2 diabetes. Most of the excess deaths (34% each) occurred in the 70- to 89-year-old age-group. In this first nationwide calculation of excess deaths related to diabetes in Germany, the results suggest that the official German estimates that rely on information from death certificates are grossly underestimated. Countries without national cohorts or diabetes registries could easily use this method to estimate the number of excess deaths due to diabetes. © 2017 by the American Diabetes Association.

Risk of Japanese carriers of hyperphosphorylated paratarg-7, the first autosomal-dominantly inherited risk factor for hematological neoplasms, to develop monoclonal gammopathy of undetermined significance and multiple myeloma.

PubMed

Grass, Sandra; Iida, Shinsuke; Wikowicz, Aleksandra; Preuss, Klaus-Dieter; Inagaki, Atsushi; Shimizu, Kazuyuki; Ziepert, Marita; Ueda, Ryuzo; Pfreundschuh, Michael

2011-03-01

Hyperphosphorylated paratarg-7 (pP-7) is a frequent target of paraproteins in German patients with monoclonal gammopathy of undetermined significance (MGUS)/multiple myeloma (MM). The frequency of MGUS/MM is lower in Japan than in Europe. As pP-7, the first molecularly defined autosomal-dominant risk factor for any hematological neoplasm, is inherited in a dominant fashion, we determined the incidence of the pP-7 carrier state in a Japanese population, and compared the frequency of pP-7-specific paraproteins and the pP-7 carrier state in Japanese and German patients with MGUS/MM. Peripheral blood from 111 Japanese patients with MGUS/MM and 278 healthy blood donors was analyzed for the pP-7 carrier state by isoelectric focusing and for pP-7-specific antibodies by ELISA. The Japanese group was compared with 252 German MGUS/MM patients and 200 healthy controls. Five of 111 (4.5%) Japanese and 35/252 (13.9%) German IgA/IgG MGUS/MM patients had a pP-7-specific paraprotein (P=0.009). The prevalence of healthy pP-7 carriers in the Japanese study group was 1/278 (0.36%), whereas it was 4/200 in the German group (P=0.166). The relative risk for pP-7 carriers developing MGUS/MM had an odds ratio of 13.1 in the Japanese and 7.9 in the German group. In conclusion, the fraction of pP-7 carriers with a pP-7-specific paraprotein is lower among Japanese than in German patients with MGUS/MM, but pP-7 carriers in both ethnic groups have a high risk of developing MGUS/MM. © 2011 Japanese Cancer Association.

[Musical Inactivity - A Risk Factor? A Short Questionnaire to Assess Musical Activity (MusA)].

PubMed

Fernholz, Isabel; Menzel, Juliane; Jabusch, Hans-Christian; Gembris, Heiner; Fischer, Felix; Kendel, Friederike; Kreutz, Gunter; Schmidt, Alexander; Willich, Stefan N; Weikert, Cornelia

2018-02-27

There is only a limited number of studies on associations between musical activity and health issues. It seems that musical activity has physiological and psychological benefits, as well as effects on the mental capacity, but this has been studied only in a few clinical and epidemiological studies. One reason might be that no appropriate survey instrument assessing musical activity is available. Here we provide an overview of survey instruments that assess musicality and musical activity. One focus is the presentation of a newly developed German questionnaire (MusA), which assesses musical activity (active music making and music reception) and was specifically developed for the "German National Cohort", a German health study. Through literature research, questionnaires were identified that assess musicality and / or musical activity. A new German questionnaire was developed from a panel of experts and tested in a small study (n=121, women and men age 18-70 years). In the literature research, 3 questionnaires were identified which focus on musicality and musical activity with different aspects (Gold-MSI, MUSE, MEQ). All 3 instruments may be characterized as large psychometric scales, which especially assess aspects of musicality in the English language. The Gold-MSI is additionally available in German. None of the existing questionnaires covers musical activities in detail. A new short German questionnaire consisting of 9 questions with a maximum filling time of 3-5 min has been developed. There are few questionnaires available for assessing musicality and musical activity with different aspects. The newly developed MusA in the German language focuses on the assessment of musical activity and is intended to be used in larger, population-based as well as clinical studies, to examine music activities and listening to music as independent factors in connection with prevention and therapy of chronic diseases. © Georg Thieme Verlag KG Stuttgart · New York.

Moyamoya vasculopathy - Patient demographics and characteristics in the Finnish population.

PubMed

Saarela, Marika; Mustanoja, Satu; Pekkola, Johanna; Tyni, Tiina; Hernesniemi, Juha; Kivipelto, Leena; Tatlisumak, Turgut

2017-01-01

Background and purpose Moyamoya vasculopathy, a rare steno-occlusive progressive cerebrovascular disorder, has not been thoroughly studied in Caucasian populations. We established a registry of Finnish patients treated at the Helsinki University Hospital, to collect and report demographic and clinical data. Methods We collected data both retrospectively and prospectively from all the patients with a moyamoya vasculopathy referred to our hospital between January 1987 and December 2014. All patients underwent a neurological outpatient clinic visit. Results We diagnosed 61 patients (50 females, 10 children) with moyamoya vasculopathy. The mean age at the disease-onset was 31.5 ± 17.9 years. The two most common presenting symptoms were ischemic stroke (n = 31) and hemorrhage (n = 8). Forty-four percent underwent revascularization surgery, and 70% were prescribed antithrombotic treatment. Conclusions The results support in part the Western phenotype of the disease considering the later presentation and larger female predominance compared to the Asian moyamoya vasculopathy reports. However, the proportion of ischemic strokes and hemorrhagic strokes is closer to Japanese population than German population. The absence of familial cases points to a different genetic profile in the Finnish patients.

German version of the intuitive eating scale: Psychometric evaluation and application to an eating disordered population.

PubMed

van Dyck, Zoé; Herbert, Beate M; Happ, Christian; Kleveman, Gillian V; Vögele, Claus

2016-10-01

Intuitive eating has been described to represent an adaptive eating behaviour that is characterised by eating in response to physiological hunger and satiety cues, rather than situational and emotional stimuli. The Intuitive Eating Scale-2 (IES-2) has been developed to measure such attitudes and behaviours on four subscales: unconditional permission to eat (UPE), eating for physical rather than emotional reasons (EPR), reliance on internal hunger and satiety cues (RHSC), and body-food choice congruence (B-FCC). The present study aimed at validating the psychometric properties of the German translation of the IES-2 in a large German-speaking sample. A second objective was to assess levels of intuitive eating in participants with an eating disorder diagnosis (anorexia nervosa, bulimia nervosa, or binge eating disorder). The proposed factor structure of the IES-2 could be confirmed for the German translation of the questionnaire. The total score and most subscale scores were negatively related to eating disorder symptomatology, problems in appetite and emotional awareness, body dissatisfaction, and self-objectification. Women with eating disorders had significantly lower values on all IES-2 subscale scores and the total score than women without an eating disorder diagnosis. Women with a binge eating disorder (BED) diagnosis had higher scores on the UPE subscale compared to participants with anorexia nervosa (AN) or bulimia nervosa (BN), and those diagnosed with AN had higher scores on the EPR subscale than individuals with BN or BED. We conclude that the German IES-2 constitutes a useful self-report instrument for the assessment of intuitive eating in German-speaking samples. Further studies are warranted to evaluate psychometric properties of the IES-2 in different samples, and to investigate its application in a clinical setting. Copyright © 2016 Elsevier Ltd. All rights reserved.

Selected Results of a Cross-Sectional/Longitudinal Research on Sex-Role Development in German Children.

ERIC Educational Resources Information Center

Trautner, Hanns Martin

Following an outline of the theoretical approach and method of a study of components of sex role development among German children, results which concern ontogenetic changes in sex role stereotypes preferences are presented. In addition, interrelations of different components of sex role development and cognitive variables are analyzed. The…

Internet Use with Learning Aim: Views of German Language Pre-Service Teachers

ERIC Educational Resources Information Center

Yucel, Mukadder Seyhan

2011-01-01

The aim of this study is to indicate the views of teacher candidates of German Language Department at Education Faculty, Trakya University about the use of internet with the aim of learning. This study was designed as phenomenology which is one of the qualitative research methods. The study data were obtained via semi-constructed interview…

Past Tense Production in Children with and without Specific Language Impairment across Germanic Languages: A Meta-Analysis

ERIC Educational Resources Information Center

Krok, Windi C.; Leonard, Laurence B.

2015-01-01

Purpose: This study examined the extent to which children with specific language impairment (SLI) across Germanic languages differ from their typically developing (TD) peers in the use of past tense morphology. Method: A systematic literature search identified empirical studies examining regular and/or irregular past tense production by English…

Why Do First-Year Students of German Lose Motivation during their First Year at University?

ERIC Educational Resources Information Center

Busse, Vera

2013-01-01

This article explores motivational changes of first-year students enrolled on German degree courses at two major UK universities. It reports on the qualitative data obtained by a longitudinal mixed-methods study, and focuses on the interplay between students' motivation and the higher education learning environment. In particular, the article aims…

Facet joint geometry and intervertebral disk degeneration in the L5-S1 region of the vertebral column in German Shepherd dogs.

PubMed

Seiler, Gabriela S; Häni, Hansjürg; Busato, André R; Lang, Johann

2002-01-01

To evaluate the possible association between facet joint geometry and intervertebral disk degeneration in German Shepherd Dogs. 25 German Shepherd Dogs and 11 control dogs of similar body weight and condition. Facet joint angles in the caudal portion of the lumbar region of the vertebral column (L5-S1) were measured by use of computed tomography, and the intervertebral discs were evaluated microscopically. The relationship between facet joint geometry and disk degeneration was evaluated by use of statistical methods. German Shepherd Dogs had significantly more facet joint tropism than control dogs, but an association with disk degeneration was not found. However, German Shepherd Dogs had a different facet joint conformation, with more sagittally oriented facet joints at L5-L6 and L6-L7 and a larger angle difference between the lumbar and lumbosacral facet joints, compared with control dogs. A large difference between facet joint angles at L6-L7 and L7-S1 in German Shepherd Dogs may be associated with the frequent occurrence of lumbosacral disk degeneration in this breed.

Burden of cardiovascular risk factors and cardiovascular disease in childhood cancer survivors: data from the German CVSS-study.

PubMed

Faber, J; Wingerter, A; Neu, M A; Henninger, N; Eckerle, S; Münzel, T; Lackner, K J; Beutel, M E; Blettner, M; Rathmann, W; Peters, A; Meisinger, C; Linkohr, B; Neuhauser, H; Kaatsch, P; Spix, C; Schneider, A; Merzenich, H; Panova-Noeva, M; Prochaska, J H; Wild, P S

2018-05-01

The cardiac and vascular late sequelae in long-term survivors of childhood cancer (CVSS)-study aimed to quantify the prevalence of cardiovascular risk factors (CVRF) and cardiovascular disease (CVD) in German childhood cancer survivors (CCS). In the CVSS-study (NCT02181049), 1002 CCS (age range 23-48 years) diagnosed with neoplasia prior to 15 years of age between 1980 and 1990 prospectively underwent a systematic, standardized clinical and laboratory cardiovascular screening, identical to the population-based Gutenberg Health Study (GHS) cohort. For 951 individuals, prevalences of CVRF and CVD were primarily compared to the GHS sample and to two further German population-based cohorts. Using log-binomial regression models, an increased risk for occurrence of arterial hypertension [relative risk (RR) 1.38, 95% confidence interval (95% CI 1.21-1.57)] and dyslipidaemia [RR 1.26 (95% CI 1.12-1.42)] was found. This indicates a premature occurrence compared to the general population of approximately 6 and 8 years, respectively [rate advancement period estimator, RAPhypertension 5.75 (95% CI 3.5-8.0) and RAPdyslipidaemia 8.16 (95% CI 4.4-11.9)]. Overall, no differences were observed for obesity and diabetes. Overt CVD was present in 4.5% (95% CI 3.0-6.6%) of CCS [RR 1.89 (95% CI 1.34-2.66), RAPCVD 7.9 (95% CI 4.1-11.7)], of which the most frequent entities were congestive heart failure and venous thromboembolism. Prevalences of CVRF and CVD increased with age without reaching a plateau over time. This large CCS screening examination revealed consistently in comparison to three population samples a considerably increased risk for premature CVD. The findings in these young adult CCS indicate a high burden of cardiovascular morbidity and mortality in the long term. NCT02181049.

[Vaccination among students in grades 6-10, 2011 - a comparison of German states: need for action for a targeted nationwide immunisation strategy].

PubMed

Ellsäßer, G; Trost-Brinkhues, G

2013-11-01

In Germany, surveillance of the population's immunisation is only mandatory for school beginners, not for adolescents. Therefore, no current data are available from the public health service related to the immunisation of adolescents. Also lacking are nationwide monitoring data regarding HPV vaccination among girls aged 12-18 years and the meningococcal C vaccination, both recently introduced by the German Standing Committee on Vaccination (STIKO) in 2009 and 2006, respectively. The present research and analysis therefore aims to determine which German states perform a monitoring of the vaccination status of adolescents, how immunisation rates differ across German states and what need for action, in terms of a nationwide immunisation strategy, can be derived. A systematic survey of vaccination coverage among students in grades 6-10 (age group 12-16 years) for the school year 2010/11 was undertaken. The defined documentation standard is based on the standard vaccinations for children and adolescents according to STIKO, requiring complete primary immunization (PI) and the number of booster vaccinations. In the analysis, 8 of 16 states were included, due to lack of data for the remaining states. In total, the public health service -examined 157,599 school children in 8 German states and checked 103,250 vaccination certificates (on average 68.1%, range 54.9-85.2%). The implementation of the booster vaccination among students in grades 6-10 proved to be insufficient. The 2-dose measles vaccination, required by the WHO for 95% of the population, was only nearly achieved by 2 of 8 German states -(Saxony-Anhalt, Brandenburg). The effects of insufficient immunisation coverage are shown by, for example, a higher measles incidence rate in children under 15 years and a persisting peak of pertussis incidence in 10- to 15-year-olds. The meningococcal C vaccination, introduced in 2006, was insufficiently taken up by students and very differently implemented among the 8 -German states (Saxony 73.9% vs. Bavaria 29.1%). HPV vaccination in girls has not yet been established (Brandenburg maximum 39.8%). Findings of this study show that the primary health care system is insufficient in reaching adolescents. Systematic checks of vaccination certificates in schools need to be extended, in cooperation with the public health service in order to identify gaps in vaccination. Through counselling and referrals to general practitioners or paediatricians there is the chance to catch up on missing vaccinations. It is necessary to promote catch-up programmes for newly indroduced vaccinations as well as for missed and booster vaccinations and to implement them in the health care system. © Georg Thieme Verlag KG Stuttgart · New York.

[Nationwide evaluation of German university teaching methods in neurology].

PubMed

Biesalski, A-S; Zupanic, M; Isenmann, S

2015-06-01

Germany is confronted with a lack of medical doctors and an increasing need for neurologists in particular. In order to recruit future doctors in neurology it is essential to attract young students when still at university. This article presents the first German national survey of medical students' acceptance of teaching methods in neurology. The participants evaluated teaching methods and examination formats and were asked about their preferences. The survey was based on a questionnaire distributed to 22 German medical schools and 1245 participating students. Interactive teaching methods, especially courses in practical examinations, clinical internships and bedside teaching were highly rated among the students. In contrast, multiple choice tests, as one of the most widespread examination methods, were poorly rated compared to practical and oral examinations. For most of the students it was not decisive, in which semester teaching of neurology took place, while the majority asked for additional and more intensive neurological education. The data give an overview of teaching of neurology in Germany and students' assessment of various approaches. The results should be utilized towards reorientation of future curricula that should aim at innovative and even more practically oriented teaching.

The Effect of Union Status at First Childbirth on Union Stability: Evidence from Eastern and Western Germany.

PubMed

Schnor, Christine

2014-01-01

It is often assumed that cohabitation is much less stable than marriage. If cohabitation becomes more common among parents, children may be increasingly exposed to separation. However, little is known about how the proportion of cohabiting parents relates to their separation behavior. Higher shares of childbearing within cohabitation might reduce the proportion of negatively selected couples among cohabiting parents, which could in turn improve their union stability. This study focuses on parents who were cohabiting when they had their first child. It compares their union stability within a context in which they represent the majority or the minority. The German case is well-suited to this research goal because non-marital childbearing is common in eastern Germany (60 %) but not in western Germany (27 %). The data came from the German Family Panel (pairfam), and include 1,844 married and cohabiting mothers born in 1971-1973 and 1981-1983. The empirical results suggest that the union stability of cohabiting mothers is positively related to their prevalence: survival curves showed that eastern German cohabiting mothers had a greater degree of union stability than their western German counterparts. This difference increased in the event-history model, which accounted for the particular composition of eastern German society, including the relatively low level of religious affiliation among the population. Controlling for unobserved heterogeneity did not change this result. In sum, these findings indicate that context plays an important role in the union stability of cohabiting parents.

Psychometric evaluation of the German version of the Intuitive Eating Scale-2 in a community sample.

PubMed

Ruzanska, Ulrike Alexandra; Warschburger, Petra

2017-10-01

Intuitive eating is based on a strong physical connection with the body, aligned to internal cues of hunger and satiety, and a low preoccupation with food. The aim of this study was to provide a German version of the Intuitive Eating Scale-2 (IES-2) and to examine its psychometric properties with data collected from 532 participants aged 18-91 years. The IES-2 was translated into German following the World Health Organization guidelines (2016). Cronbach's alpha as a measure of internal consistency was 0.89 for the IES-2 total score, as well as 0.73 - 0.92 for the IES-2 subscale scores. For group differences, the results were as hypothesized: men had higher IES-2 scores than women, and participants with under- and average weight showed higher IES-2 scores than participants with overweight and obesity. Participants without a dieting history had higher IES-2 scores than former or current dieters. In line with our hypotheses regarding construct validity, the IES-2 score had negative associations with emotional eating, restraint eating, external eating, binge eating and eating disorder symptomatology, as well as positive associations with self-efficacy and mental health-related quality of life. Second-order confirmatory factor analysis replicated the four-factor solution, with intuitive eating as a higher-order factor. These findings demonstrate that the German version of the IES-2 is a useful tool to assess intuitive eating in the general German population. Copyright © 2017 Elsevier Ltd. All rights reserved.

The challenge of comprehensively mapping children's health in a nation-wide health survey: design of the German KiGGS-Study.

PubMed

Kurth, Bärbel-Maria; Kamtsiuris, Panagiotis; Hölling, Heike; Schlaud, Martin; Dölle, Rüdiger; Ellert, Ute; Kahl, Heidrun; Knopf, Hiltraud; Lange, Michael; Mensink, Gert Bm; Neuhauser, Hannelore; Rosario, Angelika Schaffrath; Scheidt-Nave, Christa; Schenk, Liane; Schlack, Robert; Stolzenberg, Heribert; Thamm, Michael; Thierfelder, Wulf; Wolf, Ute

2008-06-04

From May 2003 to May 2006, the Robert Koch Institute conducted the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Aim of this first nationwide interview and examination survey was to collect comprehensive data on the health status of children and adolescents aged 0 to 17 years. Participants were enrolled in two steps: first, 167 study locations (sample points) were chosen; second, subjects were randomly selected from the official registers of local residents. The survey involved questionnaires filled in by parents and parallel questionnaires for children aged 11 years and older, physical examinations and tests, and a computer assisted personal interview performed by study physicians. A wide range of blood and urine testing was carried out at central laboratories. A total of 17 641 children and adolescents were surveyed - 8985 boys and 8656 girls. The proportion of sample neutral drop-outs was 5.3%. The response rate was 66.6%. The response rate showed little variation between age groups and sexes, but marked variation between resident aliens and Germans, between inhabitants of cities with a population of 100 000 or more and sample points with fewer inhabitants, as well as between the old West German states and the former East German states. By analysing the short non-responder questionnaires it was proven that the collected data give comprehensive and nationally representative evidence on the health status of children and adolescents aged 0 to 17 years.

The Construct Validity of the German Academic Self-regulation Questionnaire (SRQ-A) within Primary and Secondary School Children.

PubMed

Kröner, Julia; Goussios, Christina; Schaitz, Caroline; Streb, Judith; Sosic-Vasic, Zrinka

2017-01-01

The assessment of students' motivation can be a powerful tool in enhancing and understanding students' learning. One valid and often applied self-report measure is the Academic Self-Regulation Questionnaire (SRQ-A) which is grounded in the self-determination theory. However, to date, there is still no German equivalent to the English version of this questionnaire. Therefore, the aim of the present study was to adapt and validate the SRQ-A on a representative German student sample, consisting of 672 children (327 girls), ages 8-14 from one primary and two secondary German schools. First, the translation-back-translation method was used to ensure the linguistic equivalence of the German questionnaire. Second, item analysis of the generated scores of the German SRQ-A were conducted. Third, the multidimensional factorial structure of the original measure was tested with confirmatory factor analysis (CFA) using maximum likelihood estimation. Last, additional construct validity of the German SRQ-A was tested using correlational analyses with convergent and divergent measures. After conducting CFA, four items were excluded from the original questionnaire, due to loadings lower than 0.40, resulting in 28 items. The German SRQ-A showed good internal consistency for all subscales, with Chronbach's α ranging between 0.75 and 0.88. The simplex-structure of the original measurement could also be confirmed, however, the four-factorial model could not be replicated. The measurement showed good convergent and discriminant validity with other related questionnaires. In summary, the German SRQ-A is a reliable and valid self-report instrument for the assessment of self-determined motivational styles within the school context.

The Construct Validity of the German Academic Self-regulation Questionnaire (SRQ-A) within Primary and Secondary School Children

PubMed Central

Kröner, Julia; Goussios, Christina; Schaitz, Caroline; Streb, Judith; Sosic-Vasic, Zrinka

2017-01-01

The assessment of students' motivation can be a powerful tool in enhancing and understanding students' learning. One valid and often applied self-report measure is the Academic Self-Regulation Questionnaire (SRQ-A) which is grounded in the self-determination theory. However, to date, there is still no German equivalent to the English version of this questionnaire. Therefore, the aim of the present study was to adapt and validate the SRQ-A on a representative German student sample, consisting of 672 children (327 girls), ages 8–14 from one primary and two secondary German schools. First, the translation-back-translation method was used to ensure the linguistic equivalence of the German questionnaire. Second, item analysis of the generated scores of the German SRQ-A were conducted. Third, the multidimensional factorial structure of the original measure was tested with confirmatory factor analysis (CFA) using maximum likelihood estimation. Last, additional construct validity of the German SRQ-A was tested using correlational analyses with convergent and divergent measures. After conducting CFA, four items were excluded from the original questionnaire, due to loadings lower than 0.40, resulting in 28 items. The German SRQ-A showed good internal consistency for all subscales, with Chronbach's α ranging between 0.75 and 0.88. The simplex-structure of the original measurement could also be confirmed, however, the four-factorial model could not be replicated. The measurement showed good convergent and discriminant validity with other related questionnaires. In summary, the German SRQ-A is a reliable and valid self-report instrument for the assessment of self-determined motivational styles within the school context. PMID:28690567

[Attitudes towards professional euthanasia in the range between grement in the society and personal preferences--results of a representative examination of the German general population].

PubMed

Schröder, Christina; Schmutzer, Gabriele; Klaiberg, Antje; Brähler, Elmar

2003-08-01

Several surveys of the German population concerning the attitude towards euthanasia in patients with terminal illness yielded contradictory results, ranging from high acquisition to high refusal rates. After a critical discussion of the methodological concepts of these investigations, we present the results of a representative study of 1957 German persons (age range: 14 - 96 years) which was performed by the institute USUMA in February 2001. Four different types of euthanasia were included in the study: active, passive, and indirect euthanasia as well as physician's assisted suicide. The affirmative response categories were "declared will and unbearable pain", "declared will", "referred will", and "in the responsibility of the physician". Additionally, we asked to state the personal preference in the case of an own incurable illness. The resulting frequency distributions stress the autonomy of the patients (declared will) and the legal forms of professional euthanasia (passive and indirect euthanasia), independent from the degree of pain. The rank order of the hypothetic personal preferences was: passive euthanasia (26.1 %), active euthanasia (21.1 %), indirect euthanasia (13.1 %) and assisted suicide (6.2 %). For each category the hypothetic personal will to utilize euthanasia personally is markedly lower than the consent to legalize euthanasia in the society. This points to a diminished readiness of the population to seek for euthanasia. Persons aged 60 years and above deny all types of euthanasia significantly more often than younger persons. Persons with subjectively bad health status prefer the category "in the responsibility of the physician" more often than healthy subjects. The representative study proves that there is no polarized public opinion concerning euthanasia, rather there is a picture of high complexity.

Association of neighbourhood unemployment rate with incident Type 2 diabetes mellitus in five German regions.

PubMed

Müller, G; Wellmann, J; Hartwig, S; Greiser, K H; Moebus, S; Jöckel, K-H; Schipf, S; Völzke, H; Maier, W; Meisinger, C; Tamayo, T; Rathmann, W; Berger, K

2015-08-01

To analyse the association of neighbourhood unemployment with incident self-reported physician-diagnosed Type 2 diabetes in a population aged 45-74 years from five German regions. Study participants were linked via their addresses at baseline to particular neighbourhoods. Individual-level data from five population-based studies were pooled and combined with contextual data on neighbourhood unemployment. Type 2 diabetes was assessed according to a self-reported physician diagnosis of diabetes. We estimated proportional hazard models (Weibull distribution) in order to obtain hazard ratios and 95% CIs of Type 2 diabetes mellitus, taking into account interval-censoring and clustering. We included 7250 participants residing in 228 inner city neighbourhoods in five German regions in our analysis. The incidence rate was 12.6 per 1000 person-years (95% CI 11.4-13.8). The risk of Type 2 diabetes mellitus was higher in men [hazard ratio 1.79 (95% CI 1.47-2.18)] than in women and higher in people with a low education level [hazard ratio 1.55 (95% CI 1.18-2.02)] than in those with a high education level. Independently of individual-level characteristics, we found a higher risk of Type 2 diabetes mellitus in neighbourhoods with high levels of unemployment [quintile 5; hazard ratio 1.72 (95% CI 1.23-2.42)] than in neighbourhoods with low unemployment (quintile 1). Low education level and high neighbourhood unemployment were independently associated with an elevated risk of Type 2 diabetes mellitus. Studies examining the impact of the residential environment on Type 2 diabetes mellitus will provide knowledge that is essential for the identification of high-risk populations. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

Comparison of health-seeking characteristics of German and Belgian university students.

PubMed

Koop, R; Kartounian, H; Devroey, D

2017-01-01

Introduction. The aim of this study was to determine whether the use of primary health care differs between students enrolled in Belgian and German government-funded universities. The secondary aim of the study was to determine the factors that might explain such a difference. Methods. Participants were recruited through all Belgian and German government-funded universities. Because not all the universities agreed to participate, recruiting was also done through social media groups of the universities. An anonymous online survey was used for data collection. Results. In total, 2238 completed surveys were evaluated, of which 544 from students in Belgium and 1694 from students in Germany. In Belgium, more students had a family physician (87%) as compared to the students in Germany (73%) (p < 0.001). During the two months prior to the study, 37% of the Belgian students and 35% of the German students attended a family physician (p = 0.37). More German students attended a specialist (40%) as compared to the Belgian students (24%) (p<0.001). The German students also attended the emergency department more frequently (6%) as compared to their Belgian counterparts (3%) (p = 0.004). Conclusion. Belgian university students were more likely to attend a primary care physician than the German students. The health care seemed to be better organized for Belgian students and they were more satisfied with the delivered care.

[Physiotherapy Education in Germany: Ready for Direct Access?

PubMed

Konrad, R; Konrad, A; Geraedts, M

2017-07-01

Objective: The aim of this study is to investigate whether the curricula for physiotherapy education in Germany conform to standards recommended in the World Confederation for Physical Therapy (WCPT) guideline for physical therapist professional entry-level education, published by the WCPT. This Guideline specifies education standards for physical therapists that are able to act as independent practitioners, without referral from another health care professional. Methods: To assess the German curricula of physical therapist education, a list of assessment dimensions was derived from the WCPT-Guideline by means of content analysis. The content validity of this list was estimated by nine experts using Lawshe's method. The German Training and Examination Regulations for Physiotherapists (PhysTh-AprV) and all available regional curricula were studied. All documents were evaluated by 2 independent coders who rated the conformity of the documents with the assessment dimensions. Results: Based on the Lawshe procedure, the whole test content validity index of the 61 out of 67 examined assessment dimensions was 0,84. Cohen's kappa coefficient for intercoder reliability was 0,71-0,97. The German curricula showed high correlation with the WCPT Guideline on many theoretical basic subjects. Fulfillment of some of the requirements showed heterogeneous results. Autonomous practitioners largely lacked special competencies. Conclusions: None of the German educational standards meets the expectations of the WCPT Guideline in terms of direct access. Considering the deficits of the German educational standards and the release date of some of them, a continuous development of the German education does not appear to be adequate. This issue needs to be addressed in the current debate on health policy. © Georg Thieme Verlag KG Stuttgart · New York.

Prevalence of Chronic Disabling Noncancer Pain and Associated Demographic and Medical Variables: A Cross-Sectional Survey in the General German Population.

PubMed

Häuser, Winfried; Schmutzer, Gabriele; Hilbert, Anja; Brähler, Elmar; Henningsen, Peter

2015-10-01

In population surveys, up to 30% of participants reported chronic pain. Reports of chronic pain do not necessarily imply disability associated with pain. We assessed the prevalence of chronic disabling noncancer pain and associated demographic and medical variables in a sample of the general German population. A cross-sectional survey was conducted with 4360 people aged 14 years and above, who were representative of the German population. Measures were obtained for demographic variables, presence of chronic pain (based on the definition of the International Association for the Study of Pain), chronic pain stages (based on a chronic pain grade questionnaire), and disease load (based on the self-reported comorbidity questionnaire). Responses were received from 2508 people. The prevalence of chronic pain was 28.3% (95% [confidence interval] CI, 26.5%-30.1%). In all, 7.3% (95% CI, 5.9%-8.7%) of participants met the criteria of chronic disabling noncancer pain. Chronic disabling noncancer pain was associated with age above 65 years (odds ratios [OR]=4.81 [95% CI, 1.57-14.79]), low family income (OR=2.54 [95% CI, 1.36-4.74]), obesity (OR=3.58 [95% CI, 2.21-5.79]), heart disease (OR=2.23 [95% CI, 3.69-11.40]), stomach disease (OR=4.24 [95% CI, 2.12-8.49]), and rheumatic disease (OR=3.67 [95% CI, 2.16-6.23]) when compared with no chronic pain. Chronic disabling noncancer pain was associated with low family income (OR=2.29 [95% CI, 1.23-4.27]), obesity (OR=2.14 [95% CI, 1.30-3.52]), and depression (OR=3.26 [95% CI, 1.90-5.66]) when compared with chronic nondisabling noncancer pain. Prevalence rates of chronic disabling pain in the general population rather than prevalence rates of chronic pain might provide evidence in support of pain specialist care. The association of chronic disabling noncancer pain with mental disorders highlights the need for psychosocial services in chronic pain management.

Mapping Populations: An Objective Measurement of Revolutionary Dynamics

DTIC Science & Technology

2013-06-01

the figurehead for the NSDAP because of his apparent ubiquity with the working class and the machinations of the bourgeoisie society members...dynamics between the proletariat and the bourgeoisie of German society in the 1920’s exemplified the need for a figurehead. Furthermore, the

[A short version of the Narcissistic Personality Inventory (NPI-15): dimensionality and psychometric properties in a representative sample of the German population].

PubMed

Spangenberg, Lena; Romppel, Matthias; Bormann, Bianca; Hofmeister, Dirk; Brähler, Elmar; Strauß, Bernhard

2013-08-01

The Narcissistic Personality Inventory (NPI) is a commonly used measure of narcissism. This study administered a 15 item short version of the NPI (NPI-15). Central aims of the present study were to examine its dimensionality, and to provide data on its psychometric properties. NPI-15 and Hospital Anxiety and Depression Scale (HADS-D) were assessed in a representative sample of the German population (N=2,512). According to Scree-plot and model fit, a solution with 2 or 3 factors seemed feasible. Because of factor loadings and item-level associations to depression/anxiety we decided to favour a 2-factor-solution. 2 subscales reflecting different facets of narcissism were compiled (leadership ability/personality [LA/LP], grandiosity [G]). The psychometric properties of these scales were good (LA/LP) respectively unsatisfactory (G). The validity of the NPI-15 needs to be further studied. © Georg Thieme Verlag KG Stuttgart · New York.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Avonto, Cristina

German chamomile is one of the most popular herbal ingredients used in cosmetics and personal care products. Allergic skin reactions following topical application of German chamomile have been occasionally reported, although it is not fully understood which of the chemical constituents is responsible for this adverse effect. In the present work, three candidate sensitizers were isolated from German chamomile based on activity-guided fractionation of chamomile extracts tested using the in vitro KeratinoSens™ assay. The compounds were identified as the polyacetylene tonghaosu (1), and both trans- and cis-glucomethoxycinnamic acids (2 and 3). These three compounds were classified as non- to weaklymore » reactive using in chemico methods; however, aged tonghaosu was found to be more reactive when compared to freshly isolated tonghaosu. The polyacetylene (1) constituent was determined to be chemically unstable, generating a small electrophilic spirolactone, 1,6-dioxaspiro[4.4]non-3-en-2-one (4), upon aging. This small lactone (4) was strongly reactive in both in chemico HTS- and NMR-DCYA methods and further confirmed as a potential skin sensitizer by Local Lymph Node Assay (LLNA). - Highlights: • Fractions of German chamomile tested positive in the KeratinoSens™ assay. • Three compounds containing structural alerts were isolated and tested with in chemico methods. • The polyacetylene tonghaosu was found to be unstable and categorized as potential pre-hapten. • A degradation product of tonghaosu tested as positive dermal sensitizer in animal studies.« less

JPRS Report Science and Technology: Europe.

DTIC Science & Technology

1991-08-19

Fireproof Glass Foam Developed [Paris SCIENCES & AVENIR, Apr 91] 1 German University Develops Anticorrosion Coating [Bonn WISSENSCHAFT WIRTSCHAFT...Alain Chevy from the Solid-State Physics Laboratory at the University of Paris-VI. To demonstrate the efficiency of their method , the two researchers...are still highly confidential for the time being. German University Develops Anticorrosion Coating 91MI0339Bonn WISSENSCHAFT WIRTSCHAFT POLITIK in

Who Wants to Become a Child Psychiatrist? Lessons for Future Recruitment Strategies from a Student Survey at Seven German Medical Schools

ERIC Educational Resources Information Center

Lempp, Thomas; Neuhoff, Nina; Renner, Tobias; Vloet, Timo D.; Fischer, Helmut; Stegemann, Thomas; Zepf, Florian D.; Robner, Veit; Kolch, Michael; Haessler, Frank; Mattejat, Fritz; Lehr, Dirk; Bachmann, Christian

2012-01-01

Objective: The objective of this survey was to investigate undergraduate German medical students' attitudes toward child and adolescent psychiatry (CAP) and to describe the characteristics of students considering CAP as a possible career choice. Methods: The authors conducted a cross-sectional, multicenter survey of medical students (at the time…

How L2-Learners' Brains React to Code-Switches: An ERP Study with Russian Learners of German

ERIC Educational Resources Information Center

Ruigendijk, Esther; Hentschel, Gerd; Zeller, Jan Patrick

2016-01-01

This Event Related Potentials (ERP) study investigates auditory processing of sentences with so-called code-switches in Russian learners of German. It has often been argued that switching between two languages results in extra processing cost, although it is not completely clear yet what exactly causes these costs. ERP presents a good method to…

Digitization as a Method of Preservation? Final Report of a Working Group of the Deutsche Forschungsgemeinschaft (German Research Association).

ERIC Educational Resources Information Center

Weber, Hartmut; Dorr, Marianne

The German Research Association (DFG) is actively involved in preservation of research materials; it takes the view that in preservation, the enormous potential of digitization for access should be combined with the stability of microfilm for long-term storage. A working group was convened to investigate the technical state of digitization of…

Identification of a compound isolated from German chamomile (Matricaria chamomilla) with dermal sensitization potential.

PubMed

Avonto, Cristina; Rua, Diego; Lasonkar, Pradeep B; Chittiboyina, Amar G; Khan, Ikhlas A

2017-03-01

German chamomile is one of the most popular herbal ingredients used in cosmetics and personal care products. Allergic skin reactions following topical application of German chamomile have been occasionally reported, although it is not fully understood which of the chemical constituents is responsible for this adverse effect. In the present work, three candidate sensitizers were isolated from German chamomile based on activity-guided fractionation of chamomile extracts tested using the in vitro KeratinoSens™ assay. The compounds were identified as the polyacetylene tonghaosu (1), and both trans- and cis-glucomethoxycinnamic acids (2 and 3). These three compounds were classified as non- to weakly reactive using in chemico methods; however, aged tonghaosu was found to be more reactive when compared to freshly isolated tonghaosu. The polyacetylene (1) constituent was determined to be chemically unstable, generating a small electrophilic spirolactone, 1,6-dioxaspiro[4.4]non-3-en-2-one (4), upon aging. This small lactone (4) was strongly reactive in both in chemico HTS- and NMR-DCYA methods and further confirmed as a potential skin sensitizer by Local Lymph Node Assay (LLNA). Copyright © 2017 Elsevier Inc. All rights reserved.

Sol-hydrothermal synthesis and optical properties of Eu3+, Tb(3+)-codoped one-dimensional strontium germanate full color nano-phosphors.

PubMed

Lin, Liangwu; Sun, Xinyuan; Jiang, Yao; He, Yuehui

2013-12-21

Novel near-UV and blue excited Eu(3+), Tb(3+)-codoped one dimensional strontium germanate full-color nano-phosphors have been successfully synthesized by a simple sol-hydrothermal method. The morphologies, internal structures, chemical constitution and optical properties of the resulting samples were characterized using FE-SEM, TEM, HRTEM, EDS, XRD, FTIR, XPS, PL and PLE spectroscopy and luminescence decay curves. The results suggested that the obtained Eu(3+), Tb(3+)-codoped strontium germanate nanowires are single crystal nanowires with a diameter ranging from 10 to 80 nm, average diameter of around 30 nm and the length ranging from tens to hundreds micrometers. The results of PL and PLE spectra indicated that the Eu(3+), Tb(3+)-codoped single crystal strontium germanate nanowires showed an intensive blue, blue-green, green, orange and red or green, orange and red light emission under excitation at 350-380 nm and 485 nm, respectively, which may attributed to the coexistent Eu(3+), Eu(2+) and Tb(3+) ions, and the defects located in the strontium germanate nanowires. A possible mechanism of energy transfer among the host, Eu(3+) and Tb(3+) ions was proposed. White-emission can be realized in a single-phase strontium germanate nanowire host by codoping with Tb(3+) and Eu(3+) ions. The Eu(3+), Tb(3+)-codoped one-dimensional strontium germanate full-color nano-phosphors have superior stability under electron bombardment. Because of their strong PL intensity, good CIE chromaticity and stability, the novel 1D strontium germanate full-color nano-phosphors have potential applications in W-LEDs.

Work Hours and Self rated Health of Hospital Doctors in Norway and Germany. A comparative study on national samples

PubMed Central

2011-01-01

Background The relationship between extended work hours and health is well documented among hospital doctors, but the effect of national differences in work hours on health is unexplored. The study examines the relationship between work hours and self rated health in two national samples of hospital doctors. Methods The study population consisted of representative samples of 1,260 German and 562 Norwegian hospital doctors aged 25-65 years (N = 1,822) who received postal questionnaires in 2006 (Germany) and 2008 (Norway). The questionnaires contained items on demography, work hours (number of hours per workday and on-call per month) and self rated subjective health on a five point scale - dichotomized into "good" (above average) and "average or below". Results Compared to Norway, a significantly higher proportion of German doctors exceeded a 9 hour work day (58.8% vs. 26.7%) and 60 hours on-call per month (63.4% vs. 18.3%). Every third (32.2%) hospital doctor in Germany worked more than this, while this pattern was rare in Norway (2.9%). In a logistic regression model, working in Norway (OR 4.17; 95% CI 3.02-5.73), age 25-44 years (OR 1.66; 95% CI 1.29-2.14) and not exceeding 9 hour work day and 60 hours on-call per month (OR 1.35; 95% CI 1.03-1.77) were all independent significant predictors of good self reported health. Conclusion A lower percentage of German hospital doctors reported self rated health as "good", which is partly explained by the differences in work time pattern. Initiatives to increase doctors' control over their work time are recommended. PMID:21338494

Migrants' educational success through innovation: The case of the Hamburg bilingual schools

NASA Astrophysics Data System (ADS)

Duarte, Joana

2011-12-01

Although Germany has experienced net in-migration for the past five decades, this fact has only recently been officially acknowledged. Furthermore, Germany is marked by a general monolingual self-concept very much attached to the idea of a nation-state with one homogeneous language. However, in large urban areas of Germany about 35 per cent of the population has a migration background, as has almost every second child enrolling in primary school. Hence the country is marked by this dichotomy between a monolingual policy discourse and a multilingual society, manifested in everyday life and, as a consequence, in educational institutions. The fact is that this political attitude towards Germany's own migration history and migrants has led to an educational gap between students with a migration background and their monolingual peers. In 2000, a project was started in Hamburg, aiming to overcome this educational gap and involving the creation of bilingual schools for some of the largest migrant languages. Bilingual classes were thus set up for the following language combinations: German-Portuguese, German-Italian, German-Spanish and German-Turkish, and were evaluated by the University of Hamburg. This paper reports on the model used and the specific school outcomes of the students attending these classes.

[Systematic analysis of the readability of patient information on websites of German nonuniversity ENT hospitals].

PubMed

Meyer, M F; Bacher, R; Roth, K S; Beutner, D; Luers, J C

2014-03-01

Besides their function as one of the main contact points, websites of hospitals serve as medical information portals. All patients should be able to understand medical information texts; regardless of their literacy skills and educational level. Online texts should thus have an appropriate structure to ease their comprehension. Patient information texts on every German nonuniversity ENT hospital website (n = 125) were systematically analysed. For ten different ENT topics a representative medical information text was extracted from each website. Using objective text parameters and five established readability indices, the texts were analysed in terms of their readability and structure. Furthermore, we stratified the analysis in relation to the hospital organisation system and geographical region in Germany. Texts from 142 internet sites could be used for the definite analysis. On average, texts consisted of 15 sentences and 237 words. Readability indices congruously showed that the analysed texts could generally only be understood by a well-educated or even academic reader. The majority of patient information texts on German hospital websites are difficult to understand for most patients. In order to fulfil their goal of adequately informing the general population about disease, therapeutic options and the particular focal points of the clinic, a revision of most medical texts on the websites of German ENT hospitals is recommended.

How Is Emotional Awareness Related to Emotion Regulation Strategies and Self-Reported Negative Affect in the General Population?

PubMed Central

Subic-Wrana, Claudia; Beutel, Manfred E.; Brähler, Elmar; Stöbel-Richter, Yve; Knebel, Achim; Lane, Richard D.; Wiltink, Jörg

2014-01-01

Objective The Levels of Emotional Awareness Scale (LEAS) as a performance task discriminates between implicit or subconscious and explicit or conscious levels of emotional awareness. An impaired awareness of one's feeling states may influence emotion regulation strategies and self-reports of negative emotions. To determine this influence, we applied the LEAS and self-report measures for emotion regulation strategies and negative affect in a representative sample of the German general population. Sample and Methods A short version of the LEAS, the Hospital Anxiety and Depression Scale (HADS) and the Emotion Regulation Questionnaire (ERQ), assessing reappraisal and suppression as emotion regulation strategies, were presented to N = 2524 participants of a representative German community study. The questionnaire data were analyzed with regard to the level of emotional awareness. Results LEAS scores were independent from depression, but related to self-reported anxiety. Although of small or medium effect size, different correlational patters between emotion regulation strategies and negative affectivity were related to implict and explict levels of emotional awareness. In participants with implicit emotional awareness, suppression was related to higher anxiety and depression, whereas in participants with explicit emotional awareness, in addition to a positive relationship of suppression and depression, we found a negative relationship of reappraisal to depression. These findings were independent of age. In women high use of suppression and little use of reappraisal were more strongly related to negative affect than in men. Discussion Our first findings suggest that conscious awareness of emotions may be a precondition for the use of reappraisal as an adaptive emotion regulation strategy. They encourage further research in the relation between subconsious and conscious emotional awareness and the prefarance of adaptive or maladaptive emotion regulation strategies The correlational trends found in a representative sample of the general population may become more pronounced in clinical samples. PMID:24637792

Stature signals status: The association of stature, status and perceived dominance - a thought experiment.

PubMed

Hermanussen, Michael; Scheffler, Christiane

2016-11-01

Background: There is a common perception that tall stature results in social dominance. Evidence in meerkats suggests that social dominance itself may be a strong stimulus for growth. Relative size serves as the signal for individuals to induce strategic growth adjustments . Aim: We construct a thought experiment to explore the potential consequences of the question: is stature a social signal also in humans? We hypothesize that (1) upward trends in height in the lower social strata are perceived as social challenges yielding similar though attenuated upward trends in the dominant strata, and that (2) democratization, but also periods of political turmoil that facilitate upward mobility of the lower strata, are accompanied by upward trends in height. Material and methods: We reanalyzed large sets of height data of European conscripts born between 1856-1860 and 1976-1980; and annual data of German military conscripts, born between 1965 and 1985, with information on height and school education. Results: Taller stature is associated with higher socioeconomic status. Historic populations show larger height differences between social strata that tend to diminish in the more recent populations. German height data suggest that both democratization, and periods of political turmoil facilitating upward mobility of the lower social strata are accompanied by a general upward height spiral that captures the whole population. Discussion: We consider stature as a signal. Nutrition, health, general living conditions and care giving are essential prerequisites for growth, yet not to maximize stature, but to allow for its function as a lifelong social signal. Considering stature as a social signal provides an elegant explanation of the rapid height adjustments observed in migrants, of the hitherto unexplained clustering of body height in modern and historic cohorts of military conscripts, and of the parallelism between changes in political conditions, and secular trends in adult human height since the 19 th century.

Social media targeting of health messages. A promising approach for research and practice.

PubMed

Betsch, Cornelia

2014-01-01

In their contribution, Remschmidt and colleagues (1) put forward an innovative approach for recruiting female, German study participants from diverse social and ethnical backgrounds to assess their knowledge, attitudes, and behaviors regarding HPV vaccination. The approach involves placing advertisements on the social media platform Facebook that specify tags for not only the sought after socio-demographic characteristics (age, gender) but also self-relevant aspects of the target group. These tags determine which Facebook users will see the ad. By sequentially adjusting the tags, the researchers were able to recruit different sub-populations, resulting in a final sample similar to a representative German sample for a particular age group.

Comparison of calculation methods for estimating annual carbon stock change in German forests under forest management in the German greenhouse gas inventory.

PubMed

Röhling, Steffi; Dunger, Karsten; Kändler, Gerald; Klatt, Susann; Riedel, Thomas; Stümer, Wolfgang; Brötz, Johannes

2016-12-01

The German greenhouse gas inventory in the land use change sector strongly depends on national forest inventory data. As these data were collected periodically 1987, 2002, 2008 and 2012, the time series on emissions show several "jumps" due to biomass stock change, especially between 2001 and 2002 and between 2007 and 2008 while within the periods the emissions seem to be constant due to the application of periodical average emission factors. This does not reflect inter-annual variability in the time series, which would be assumed as the drivers for the carbon stock changes fluctuate between the years. Therefore additional data, which is available on annual basis, should be introduced into the calculations of the emissions inventories in order to get more plausible time series. This article explores the possibility of introducing an annual rather than periodical approach to calculating emission factors with the given data and thus smoothing the trajectory of time series for emissions from forest biomass. Two approaches are introduced to estimate annual changes derived from periodic data: the so-called logging factor method and the growth factor method. The logging factor method incorporates annual logging data to project annual values from periodic values. This is less complex to implement than the growth factor method, which additionally adds growth data into the calculations. Calculation of the input variables is based on sound statistical methodologies and periodically collected data that cannot be altered. Thus a discontinuous trajectory of the emissions over time remains, even after the adjustments. It is intended to adopt this approach in the German greenhouse gas reporting in order to meet the request for annually adjusted values.

Analysis of biochemical genetic data on Jewish populations: II. Results and interpretations of heterogeneity indices and distance measures with respect to standards.

PubMed

Karlin, S; Kenett, R; Bonné-Tamir, B

1979-05-01

A nonparametric statistical methodology is used for the analysis of biochemical frequency data observed on a series of nine Jewish and six non-Jewish populations. Two categories of statistics are used: heterogeneity indices and various distance measures with respect to a standard. The latter are more discriminating in exploiting historical, geographical and culturally relevant information. A number of partial orderings and distance relationships among the populations are determined. Our concern in this study is to analyze similarities and differences among the Jewish populations, in terms of the gene frequency distributions for a number of genetic markers. Typical questions discussed are as follows: These Jewish populations differ in certain morphological and anthropometric traits. Are there corresponding differences in biochemical genetic constitution? How can we assess the extent of heterogeneity between and within groupings? Which class of markers (blood typings or protein loci) discriminates better among the separate populations? The results are quite surprising. For example, we found the Ashkenazi, Sephardi and Iraqi Jewish populations to be consistently close in genetic constitution and distant from all the other populations, namely the Yemenite and Cochin Jews, the Arabs, and the non-Jewish German and Russian populations. We found the Polish Jewish community the most heterogeneous among all Jewish populations. The blood loci discriminate better than the protein loci. A number of possible interpretations and hypotheses for these and other results are offered. The method devised for this analysis should prove useful in studying similarities and differences for other groups of populations for which substantial biochemical polymorphic data are available.

Do medical students like communication? Validation of the German CSAS (Communication Skills Attitude Scale)

PubMed Central

Busch, Anne-Kathrin; Rockenbauch, Katrin; Schmutzer, Gabriele; Brähler, Elmar

2015-01-01

Objectives: Attitudes towards communication skills of medical undergraduates can be gathered using the Communication Skills Attitude Scale (CSAS). We aimed to develop a German version of the CSAS (CSAS-G) in order to explore attitudes towards communication skills in a German cohort. Additionally the potential influence of demographic factors was examined. Methods: We realized the CSAS-G and conducted a survey with 529 participants from 3 different years of study. We then carried out an explorative as well as confirmatory factor analysis and compared the attitudinal scores. Multiple regression analysis was performed. Results: The confirmatory analysis confirmed the two-subscale system revealed by the explorative factor analysis. Students indicate low levels of negative attitudes and moderate levels of positive attitudes. Attitudinal scores differ significantly in relation to gender. Conclusion: The CSAS-G can be used in German cohorts to evaluate attitudes towards communication skills. Medical students in our study show basically a positive approach. Further investigation is necessary to explore and understand attitudes towards communication skills of German medical students. PMID:25699103

Regionalisation of statistical model outputs creating gridded data sets for Germany

NASA Astrophysics Data System (ADS)

Höpp, Simona Andrea; Rauthe, Monika; Deutschländer, Thomas

2016-04-01

The goal of the German research program ReKliEs-De (regional climate projection ensembles for Germany, http://.reklies.hlug.de) is to distribute robust information about the range and the extremes of future climate for Germany and its neighbouring river catchment areas. This joint research project is supported by the German Federal Ministry of Education and Research (BMBF) and was initiated by the German Federal States. The Project results are meant to support the development of adaptation strategies to mitigate the impacts of future climate change. The aim of our part of the project is to adapt and transfer the regionalisation methods of the gridded hydrological data set (HYRAS) from daily station data to the station based statistical regional climate model output of WETTREG (regionalisation method based on weather patterns). The WETTREG model output covers the period of 1951 to 2100 with a daily temporal resolution. For this, we generate a gridded data set of the WETTREG output for precipitation, air temperature and relative humidity with a spatial resolution of 12.5 km x 12.5 km, which is common for regional climate models. Thus, this regionalisation allows comparing statistical to dynamical climate model outputs. The HYRAS data set was developed by the German Meteorological Service within the German research program KLIWAS (www.kliwas.de) and consists of daily gridded data for Germany and its neighbouring river catchment areas. It has a spatial resolution of 5 km x 5 km for the entire domain for the hydro-meteorological elements precipitation, air temperature and relative humidity and covers the period of 1951 to 2006. After conservative remapping the HYRAS data set is also convenient for the validation of climate models. The presentation will consist of two parts to present the actual state of the adaptation of the HYRAS regionalisation methods to the statistical regional climate model WETTREG: First, an overview of the HYRAS data set and the regionalisation methods for precipitation (REGNIE method based on a combination of multiple linear regression with 5 predictors and inverse distance weighting), air temperature and relative humidity (optimal interpolation) will be given. Finally, results of the regionalisation of WETTREG model output will be shown.

Owner-collected swabs of pets: a method fit for the purpose of zoonoses research.

PubMed

Möbius, N; Hille, K; Verspohl, J; Wefstaedt, P; Kreienbrock, L

2013-09-01

As part of the preparation of a large cohort study in the entire German population, this study examined the feasibility of cat and dog owners collecting nasal and oral swabs of their animals at home as a method of assessing exposure to zoonoses. In veterinary clinics in Hannover, Germany, 100 pet owners were recruited. Nasal and oral swabs of pets were taken by a veterinarian at the clinic and owners took swabs at home. Swabs were analysed regarding bacterial growth and compared (owner vs. vet) using Cohen's kappa and McNemar's test. The return rate of kits was 92%, and 77% of owners thought it unnecessary to have veterinarian assistance to swab the mouth. McNemar's test results: oral swabs 78% agreement with Gram-positive bacterial growth, 87% agreement with Gram-negative bacterial growth; with similar results for nasal swabs. Although sample quality differed, this method allowed the receipt of swabs from pets in order to obtain information about colonization with zoonotic pathogens.

Do immigration and acculturation have an impact on hyperemesis gravidarum? Results of a study in Berlin/Germany.

PubMed

David, Matthias; Borde, Theda; Siedentopf, Friederike

2012-06-01

How large is the number of immigrant women being treated for hyperemesis gravidarum (HG) among the in-patients in a University hospital in Germany? Does migration have an impact on the psychosocial state of HG patients? Does acculturation have an impact on psychosocial distress in HG patients? The following methods were used: retrospective evaluation of all in-patients with HG from 1/1997 to 11/2009, inquiry of a consecutively surveyed group (from 2007 to 2009) of HG in-patients with a questionnaire set: socio-demographic data, questionnaire on psychic distress (SCL-90-R) questionnaire on migration/acculturation, and comparison of German patients and patients with immigration backgrounds as well as among immigrant groups. During the 13-year study period, there were 4.5 times more immigrants treated for HG than native German patients. Compared to the age standardized resident population, the number of women with immigration backgrounds is over-proportionally high. The HG patients scored high in the SCL-90-R scale "somatization" without showing a higher level of psychic distress than the native patients. Experience of migration is an etiological cofactor for HG. The grade of acculturation does not have a significant influence on the psychic well-being of HG patients.

The Gender Lens: Development of a learning aid to introduce gender medicine.

PubMed

Weyers, Simone; Vervoorts, Anja; Dragano, Nico; Engels, Miriam

2017-01-01

Background and aim: Gender medicine takes into account biological and social differences between men and women in terms of prevalence and course of disease, diagnosis and therapy. Medical students should be made aware of this in the early stages of medical education. However, there is hardly any teaching material currently available. This article presents the adaption and first use of the German "Gender Lens," a tool to introduce gender medicine to medical students. Method: The original Canadian "Gender Lens Tool" was translated into German, tested by (n=5) teachers and adapted based on current scientific concepts. The instrument was applied and evaluated using qualitative methods in a student focus group (n=4). It was then piloted in a cohort of fourth-semester students (n=247) in a seminar addressing gender medicine. These experiences were evaluated using quantitative methods. Results: The German translation of the Gender Lens offers students a framework with which to analyze sex and gender differences in terms of the "prevalence, diagnosis, course, therapy and prevention" of a specific disease. Furthermore, it enables a refined search for causes such as "biological disposition, attitudes and behaviors, family and social networks, occupational and material circumstances and experiences with the health care system." Recommendations were received from the student groups regarding teaching methods. Male and female fourth-semester students agreed that the Gender Lens is useful as an introduction to gender medicine. Discussion: Initial experiences with the Gender Lens adapted for the German curriculum suggest that such a learning aid can contribute to raising awareness of gender medicine in medical students.

Back pain in elite sports: A cross-sectional study on 1114 athletes

PubMed Central

Platen, Petra

2017-01-01

Objectives To establish the prevalence of back pain in German elite athletes; examine the influence of age, sex, sports discipline and training volume; and compare elite athletes with a physically active control group. Methods A standardized and validated online back pain questionnaire was sent by the German Olympic Sports Confederation to approximately 4,000 German national and international elite athletes, and a control group of 253 physically active but non-elite sports students. Results We received responses from 1,114 elite athletes (46.5% male and 53.1% female, mean age 20.9 years ± 4.8 years, mean height 176.5 ± 11.5 cm, mean weight 71.0 ± 10.3 kg) and 166 physically active sports students (74.7% male and 24.1 female, mean age 21.2 ± 2.0 years, mean height 180.0 ± 8.0 cm, mean weight 74.0 ± 14.5 kg). In elite athletes, the lifetime prevalence of back pain was 88.5%, the 12-month prevalence was 81.1%, the 3-month prevalence was 68.3% and the point prevalence was 49.0%, compared with 80.7%, 69.9%, 59.0% and 42.8%, respectively in the control group. The lifetime, 12-month and 3-month prevalences in elite athletes were significantly higher than in the control group. Regarding the individual sports disciplines, the prevalence of back pain was significantly higher in elite rowers, dancers, fencers, gymnasts, track and field athletes, figure skaters and marksmen, and those who play underwater rugby, water polo, basketball, hockey and ice hockey compared with the control group. The prevalence of back pain was significantly lower in elite triathletes. Conclusions Back pain is a common complaint in German elite athletes. Low back pain seems to be a problem in both elite athletes and physically active controls. A high training volume in elite athletes and a low training volume in physically active individuals might increase prevalence rates. Our findings indicate the necessity for specific prevention programs, especially in high-risk sports. Further research should investigate the optimal dose-effect relationship of sporting activity for the general population to prevent back pain. PMID:28662110

Specificity of a whole blood IGRA in German nursing students

PubMed Central

2011-01-01

Background Interferon-gamma release assays (IGRA) are used for tuberculosis (TB) screening in healthcare workers (HCWs). However, data on specificity of IGRA in serial testing of HCWs is sparse. Therefore the specificity and the negative predictive value of the IGRA - QuantiFERON-TB Gold In-Tube (QFT) - in German nursing students was investigated. Methods 194 nursing students at the start of their professional career were tested with the QFT. 14 nursing students were excluded from the specificity analysis, due to exposure to mycobacterium tuberculosis. Two of these subjects were QFT- positive. None of them developed disease during the year of follow-up. A study group of 180 students, all with very low risk of prior TB infection, remained in the specificity analysis. Subjects were monitored for at least two years with respect to the development of active TB disease. IGRA was performed at the start of the training and after one year. Results The mean age of the study group (n = 180) was 23 years (range 18-53) with 70.9% female and 99.4% German born. The specificity of QFT was 98.9% (178/180; 95% CI 0.96-0.99); lowering the cut-off from 0.35 IU/ml to 0.1 IU/ml would have decreased specificity only slightly to 97.8% (176/180; 95% CI 0.94-0.99). Of the 154 nursing students available for re-testing, one student who initially scored positive reverted to negative, and one student initially negative converted to positive. None of the monitored group with initially negative QFT results developed TB disease, indicating a high negative predictive value of the IGRA in this population. Conclusions Following our data, QFT can serve as an effective tool in pre-employment TB screenings for HCWs. As its negative results were stable over time, specificity of the QFT in serial testing of HCWs is high. As the risk of acquiring TB infection in the German healthcare system appears to be low, our data supports the recommendation of performing TB screening only in those HCWs with known contact to TB patients or infectious materials. PMID:21929799

Late Relapse of Classical Hodgkin Lymphoma: An Analysis of the German Hodgkin Study Group HD7 to HD12 Trials.

PubMed

Bröckelmann, Paul J; Goergen, Helen; Kohnhorst, Charlotte; von Tresckow, Bastian; Moccia, Alden; Markova, Jana; Meissner, Julia; Kerkhoff, Andrea; Ludwig, Wolf-Dieter; Fuchs, Michael; Borchmann, Peter; Engert, Andreas

2017-05-01

Purpose Clinical characteristics, therapeutic approaches, and prognosis of late relapse (LR) in patients with classic Hodgkin lymphoma (cHL) are poorly understood. We performed a comprehensive analysis of LR of Hodgkin lymphoma (LR-HL). Methods To estimate the incidence of LR-HL, we retrospectively analyzed 6,840 patients with cHL included in the German Hodgkin Study Group trials HD7 to HD12. Patients who experienced a relapse > 5 years into remission were compared with patients in continued remission for > 5 years and with those who experienced a relapse ≤ 5 years after first diagnosis. Results With a median observation time of 10.3 years, 141 incidences of LR-HL were observed. Cumulative incidences at 10, 15, and 20 years rose linearly and were 2.5%, 4.3%, and 6.9%, respectively. The standardized incidence ratio for HL with respect to age- and sex-matched German reference data was 84.5 (95% CI, 71.2 to 99.7). LR-HL was more frequently observed in patients with early-stage favorable than unfavorable or advanced stage at first diagnosis (15-year cumulative incidence, 5.3% v 3.9% and 3.9%, respectively; P = .01). Overall survival from first diagnosis was worse after LR compared with nonrelapse survivors (10-year estimate, 95.8% v 86.1%; hazard ratio, 2.5; 95% CI, 1.7 to 3.5; P < .001). In patients with LR-HL, survival was better compared with 466 patients with earlier relapse (hazard ratio, 0.6; 95% CI, 0.4 to 0.9, P = .01). Forty-four percent and 49% of patients with LR-HL and earlier relapse, respectively, received stem cell transplantations. Conclusion Apart from treatment-associated adverse effects, survivors after initially successful therapy for cHL are at an 85-fold risk for recurrence of disease compared with the general German population. After risk-adapted treatment strategies, especially in early-stage favorable HL, regular clinical follow-up is recommended for timely detection of LR-HL. With adequate treatment, prognosis of LR-HL is better compared with early relapses.

Concurrent Multiple Outbreaks of Varicella, Rubeola, German Measles in Unvaccinated Children of Co-Educational Mount Carmel Senior Secondary School, Thakurdwara Palampur of Northern Himachal, India

PubMed Central

Gupta, Surender Nikhil; Gupta, Naveen; Gupta, Shivani

2015-01-01

Background: In April, 2009, in a co-education school, we investigated suspected triple outbreak; varicella first and then with chance detection of rubeola and rubella. The aim was to confirm diagnosis and recommend remedial measures to prevent further outbreaks. Materials and Methods: We defined a case of varicella with maculopapulovesicular rash without other apparent cause in students or staff of the school and residents of neighboring villages of Khalet and Roady since 23rd March to 14th October, 2009. We line listed case patients and collected information on age, sex, residence, date of onset, symptoms, signs, traveling, treatment history, and vaccination status. The outbreak was described by time, place, and person characteristics. Diagnosis was confirmed epidemiologically and serologically; first to chickenpox, measles, and german measles viruses. Results: We identified 505 case patients from mixed outbreaks of varicella, measles, and german measles (30/505 clinically, 467/505 epidemiologically linked and 8/505 laboratory confirmed case patients from a study population of 3280. We investigated the suspected outbreak with case definition of varicella but measles 20/3280 (0.60%) and rubella 34/3280 (1.03%) cases were also observed. The overall attack rate (AR) was 15% while in school; it was 22% but highest (56%) in Nursery up to 4th standard with index case in first standard. Sex-specific AR was (23%) more in boys. Triple concurrent infection caused 05% complications but no death was reported. Severity of the symptoms was more in 5th standard onwards with 49–249 lesions and severer in poor villages Roady and Khalet (P < 0.05). Only 4% were immunized against varicella/german measles privately. Seventeen percent of the cases went for traditional treatment vs modern medicine (P < 0.001). 5/10 samples for IgM antibodies for chickenpox and 2/10 samples were positive for rubella. Conclusions: Triple infection of varicella, measles, and rubella was confirmed epidemiologically and serologically. We recommended local authorities for MMRV in the school and near villages with aggressive IEC activities in affected areas. PMID:25811001

Rethinking Side Effects of Accountability in Education: Insights from a Multiple Methods Study in Four German School Systems

ERIC Educational Resources Information Center

Thiel, Corrie; Bellmann, Johannes

2017-01-01

Based on a research project comprising data from an interview study and a survey with teachers and school principals in four German federal states ("Bundesländer"), this paper questions the claim that the side effects of accountability in education are bound to high-stakes contexts, and also provides evidence of side effects occurring in…

The Story in the Mind: The Effect of 3D Gameplay on the Structuring of Written L2 Narratives

ERIC Educational Resources Information Center

Neville, David O.

2015-01-01

The article reports on a mixed-methods study evaluating the use of a three-dimensional digital game-based language learning (3D-DGBLL) environment to teach German two-way prepositions and specialized vocabulary within a simulated real-world context of German recycling and waste management systems. The study assumed that goal-directed player…

Introducing the chronic disease self-management program in Switzerland and other German-speaking countries: findings of a cross-border adaptation using a multiple-methods approach.

PubMed

Haslbeck, Jörg; Zanoni, Sylvie; Hartung, Uwe; Klein, Margot; Gabriel, Edith; Eicher, Manuela; Schulz, Peter J

2015-12-28

Stanford's Chronic Disease Self-Management Program (CDSMP) stands out as having a large evidence-base and being broadly disseminated across various countries. To date, neither evidence nor practice exists of its systematic adaptation into a German-speaking context. The objective of this paper is to describe the systematic German adaptation and implementation process of the CDSMP (2010-2014), report the language-specific adaptation of Franco-Canadian CDSMP for the French-speaking part of Switzerland and report findings from the initial evaluation process. Multiple research methods were integrated to explore the perspective of workshop attendees, combining a longitudinal quantitative survey with self-report questionnaires, qualitative focus groups, and interviews. The evaluation process was conducted in for both the German and French adapted versions to gain insights into participants' experiences in the program and to evaluate its impact. Perceived self-efficacy was measured using the German version of the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6G). Two hundred seventy eight people attending 35 workshops in Switzerland and Austria participated in the study. The study participants were receptive to the program content, peer-led approach and found principal methods useful, yet the structured approach did not address all their needs or expectations. Both short and long-term impact on self-efficacy were observed following the workshop participation (albeit with a minor decrease at 6-months). Participants reported positive impacts on aspects of coping and self-care, but limited effects on healthcare service utilization. Our findings suggest that the process for cross-border adaptation was effective, and that the CDSMP can successfully be implemented in diverse healthcare and community settings. The adapted CDSMP can be considered an asset for supporting self-management in both German-and French-speaking central European countries. It could have meaningful, wide-ranging implications for chronic illness care and primary prevention and potentially tertiary prevention of chronic disease. Further investigations are needed to tailor the program for better access to vulnerable and disadvantaged groups who might benefit the most, in terms of facilitating their health literacy in chronic illness.

Clustering of Helicobacter pylori infection in couples: differences between high- and low-prevalence population groups.

PubMed

Brenner, Hermann; Weyermann, Maria; Rothenbacher, Dietrich

2006-07-01

Several mostly small-scale studies reported clustering of Helicobacter pylori infections as a possible indicator of conjugal transmission, but results have been inconsistent. We assessed clustering of H pylori infections in a large community-based study from Germany that included both high-prevalence and low-prevalence population subgroups. Current H pylori infection was determined among 670 couples by means of carbon-13-urea breath test ((13)C-UBT) breath test and a monoclonal antigen immunoassay for H pylori in stool. Prevalences of infection among women were 34.9% (51 of 146 women) if the partner was infected and 14.5% (76 of 524 women) if the partner was not infected. Stratification by nationality showed a strong association of infection for partners with other than German nationality (adjusted odds ratio [OR], 6.05; 95% confidence interval [CI], 1.31-17.96), for whom prevalence of infection was greater than 50%, whereas no association was seen for German partners born in Germany (OR, 1.10; 95% CI, 0.47-2.61), for whom infection prevalence was approximately 10% (p for interaction = 0.048). Conjugal transmission of infection caused by H pylori is unlikely to be of relevance in low-prevalence population groups. Our results are consistent with the hypothesis of a potential role of conjugal transmission of H pylori infection in high-prevalence population groups.

[Study of efficiancy of teleconsultation: the Telepathology Consultation Service of the Professional Assoziation of German Pathologists for the screening program of breast carcinoma].

PubMed

Schrader, T; Hufnagl, P; Schlake, W; Dietel, M

2005-01-01

In the autumn a German screening program was started for detecting breast cancer in the population of women fifty and above. For the first time in this program, quality assurance rules were established: All statements of the radiologists and pathologists have to be confirmed by a second opinion. This improvement in quality is combined with a delay in time and additional expence. A new Telepathology Consultation Service was developed based on the experiences of the Telepathology Consultation Center of the UICC to speed up the second opinion process. The complete web-based service is operated under MS Windows 2003 Server, as web server the Internet Information Server, and the SQL-Server (both Microsoft) as the database. The websites, forms and control mechanism have been coded in by ASP scripts and JavaScript. A study to evaluate the effectiveness of telepathological consultation in comparison to conventional consultation has been carried out. Pathologists of the Professional Association of German Pathologists took part as well as requesting pathologists and as consultants for other participants. The quality of telepathological diagnosis was comparable to the conventional diagnosis. Telepathology allows a faster respond of 1 to 2 day (conventional postal delay). The time to prepare a telepathology request is about twice as conventional. This ratio may be inverted by an interface between the Pathology Information System and the Telepathology Server and the use of virtual microscopy. The Telepathology Consultation Service of the Professional Association of German Pathologists is a fast and effective German-language, internet-based service for obtaining a second opinion.

Is Germany a model for managers?

PubMed

Wever, K S; Allen, C S

1992-01-01

Most American managers have a hard time making sense of Germany. The country has a fraction of the resources and less than one-third the population of the United States. Labor costs are substantially higher, paid vacations are at least three times as long, and strong unions are deeply involved at all levels of business, from the local plant to the corporate boardroom. Yet German companies manage to produce internationally competitive products in key manufacturing sectors, making Germany the greatest competitive threat to the United States after Japan. The seemingly paradoxical nature of the German economy typically evokes one of two diametrically opposed responses. The first is to celebrate the German economy as a "model" worth emulating--indeed, as the answer to declining U.S. competitiveness. The alternative, more skeptical response is to question Germany's staying power in a new, more competitive global economy. According to Kirsten Wever and Christopher Allen, the problem with both points of view is that they miss the forest for the trees. Observers are so preoccupied with praising--or blaming--individual components of the German economy that they fail to see the dynamic logic that ties these components together into a coherent system. In their review of recent research on the German business system, Wever and Allen argue that managers can learn an important lesson from Germany. In the global economy, competition isn't just between companies but between entire socioeconomic systems. Germany's ability to design a cohesive economic and social system that adapts continuously to changing requirements goes a long way toward explaining that country's competitive success.

Effects of cost sharing on seeking outpatient care: a propensity-matched study in Germany and Switzerland.

PubMed

Huber, Carola A; Rüesch, Peter; Mielck, Andreas; Böcken, Jan; Rosemann, Thomas; Meyer, Peter C

2012-08-01

Several studies have assessed the effect of cost sharing on health service utilization (HSU), mostly in the USA. Results are heterogeneous, showing different effects. Whereas previous studies compared insurants within one health care system but different modes of insurance, we aimed at comparing two different health care systems in Europe: Germany and Switzerland. Furthermore, we assessed the impact of cost sharing depending on socio-demographic factors as well as health status. Two representative samples of 5197 Swiss insurants with and 5197 German insurants without cost sharing were used to assess the independent association between cost sharing and the use of outpatient care. To minimize confounding, we performed cross-sectional analyses between propensity score matched Swiss and German insurants. We investigated subgroups according to health and socio-economic status to assess a potential social gradient in HSU. We found a significant association between health insurance scheme and the use of outpatient services. German insurants without cost sharing (visit rate: 4.8 per year) consulted a general practitioner or specialist more frequently than Swiss insurants with cost sharing (visit rate: 3.0 per year; P < 0.01). Subgroup analyses showed that vulnerable populations were differently affected by cost sharing. In the group of respondents with poor health and low socio-economic status, the cost-sharing effect was strongest. Cost-sharing models reduce HSU. The challenge is to create cost-sharing models which do not preclude vulnerable populations from seeking essential health care. © 2011 Blackwell Publishing Ltd.

Three-dimensional modeling of glucose-6-phosphate dehydrogenase-deficient variants from German ancestry.

PubMed

Kiani, Farooq; Schwarzl, Sonja; Fischer, Stefan; Efferth, Thomas

2007-07-18

Loss of function of dimeric glucose-6-phosphate dehydrogenase (G6PD) represents the most common inborn error of metabolism throughout the world affecting an estimated 400 million people. In Germany, this enzymopathy is very rare. On the basis of G6PD crystal structures, we have analyzed six G6PD variants of German ancestry by three-dimensional modeling. All mutations present in the German population are either close to one of the three G6P or NADP(+) units or to the interface of the two monomers. Two of the three mutated amino acids of G6PD Vancouver are closer to the binding site of NADP(+). The G6PD Aachen mutation is also closer to the second NADP(+) unit. The G6PD Wayne mutation is closer to the G6P binding region. These mutations may affect the binding of G6P and NADP(+) units. Three mutations, i.e. G6PD Munich, G6PD Riverside and G6PD Gastonia, lie closer to the interface of the two monomers. These may also affect the interface of two monomers. None of these G6PD variants share mutations with the common G6PD variants known from the Mediterranean, Near East, or Africa indicating that they have developed independently. The G6PD variants have been compared with mutants from other populations and the implications for survival of G6PD variants from natural selection have been discussed.

[The Quality of the Family Physician-Patient Relationship. Patient-Related Predictors in a Sample Representative for the German Population].

PubMed

Dinkel, Andreas; Schneider, Antonius; Schmutzer, Gabriele; Brähler, Elmar; Henningsen, Peter; Häuser, Winfried

2016-03-01

Patient-centeredness and a strong working alliance are core elements of family medicine. Surveys in Germany showed that most people are satisfied with the quality of the family physician-patient relationship. However, factors that are responsible for the quality of the family physician-patient relationship remain unclear. This study aimed at identifying patient-related predictors of the quality of this relationship. Participants of a cross-sectional survey representative for the general German population were assessed using standardized questionnaires. The perceived quality of the family physician-patient relationship was measured with the German version of the Patient-Doctor Relationship Questionnaire (PDRQ-9). Associations of demographic and clinical variables (comorbidity, somatic symptom burden, psychological distress) with the quality of the family physician-patient relationship were assessed by applying hierarchical linear regression. 2278 participants (91,9%) reported having a family physician. The mean total score of the PDRQ-9 was high (M=4,12, SD=0,70). The final regression model showed that higher age, being female, and most notably less somatic and less depressive symptoms predicted a higher quality of the family physician-patient relationship. Comorbidity lost significance when somatic symptom burden was added to the regression model. The final model explained 11% of the variance, indicating a small effect. Experiencing somatic and depressive symptoms emerged as most relevant patient-related predictors of the quality of the family physician-patient relationship. © Georg Thieme Verlag KG Stuttgart · New York.

Polymorphisms of methylenetetrahydrofolate reductase (MTHFR) and susceptibility to pediatric acute lymphoblastic leukemia in a German study population.

PubMed

Schnakenberg, Eckart; Mehles, Andrea; Cario, Gunnar; Rehe, Klaus; Seidemann, Kathrin; Schlegelberger, Brigitte; Elsner, Holger A; Welte, Karl H; Schrappe, Martin; Stanulla, Martin

2005-05-27

Methylenetetrahydrofolate reductase (MTHFR) has a major impact on the regulation of the folic acid pathway due to conversion of 5,10-methylenetetrahydrofolate (methylene-THF) to 5-methyl-THF. Two common polymorphisms (677C>T and 1298A>C) in the gene coding for MTHFR have been shown to reduce MTHFR enzyme activity and were associated with the susceptibility to different disorders, including vascular disease, neural tube defects and lymphoid malignancies. Studies on the role of these polymorphisms in the susceptibility to acute lymphoblastic leukemia (ALL) led to discrepant results. We retrospectively evaluated the association of the MTHFR 677C>T and 1298A>C polymorphisms with pediatric ALL by genotyping a study sample of 443 ALL patients consecutively enrolled onto the German multicenter trial ALL-BFM 2000 and 379 healthy controls. We calculated odds ratios of MTHFR genotypes based on the MTHFR 677C>T and 1298A>C polymorphisms to examine if one or both of these polymorphisms are associated with pediatric ALL. No significant associations between specific MTHFR variants or combinations of variants and risk of ALL were observed neither in the total patient group nor in analyses stratified by gender, age at diagnosis, DNA index, immunophenotype, or TEL/AML1 rearrangement. Our findings suggest that the MTHFR 677C>T and 1298A>C gene variants do not have a major influence on the susceptibility to pediatric ALL in the German population.

Evaluating the Impact of an Accountable Care Organization on Population Health: The Quasi-Experimental Design of the German Gesundes Kinzigtal.

PubMed

Pimperl, Alexander; Schulte, Timo; Mühlbacher, Axel; Rosenmöller, Magdalena; Busse, Reinhard; Groene, Oliver; Rodriguez, Hector P; Hildebrandt, Helmut

2017-06-01

A central goal of accountable care organizations (ACOs) is to improve the health of their accountable population. No evidence currently links ACO development to improved population health. A major challenge to establishing the evidence base for the impact of ACOs on population health is the absence of a theoretically grounded, robust, operationally feasible, and meaningful research design. The authors present an evaluation study design, provide an empirical example, and discuss considerations for generating the evidence base for ACO implementation. A quasi-experimental study design using propensity score matching in combination with small-scale exact matching is implemented. Outcome indicators based on claims data were constructed and analyzed. Population health is measured by using a range of mortality indicators: mortality ratio, age at time of death, years of potential life lost/gained, and survival time. The application is assessed using longitudinal data from Gesundes Kinzigtal, one of the leading population-based ACOs in Germany. The proposed matching approach resulted in a balanced control of observable differences between the intervention (ACO) and control groups. The mortality indicators used indicate positive results. For example, 635.6 fewer years of potential life lost (2005.8 vs. 2641.4; t-test: sig. P < 0.05*) in the ACO intervention group (n = 5411) attributable to the ACO, also after controlling for a potential (indirect) immortal time bias by excluding the first half year after enrollment from the outcome measurement. This empirical example of the impact of a German ACO on population health can be extended to the evaluation of ACOs and other integrated delivery models of care.

Population. Readings for Senior Secondary Social Studies. Updated 1989.

ERIC Educational Resources Information Center

Victoria International Development Education Association (British Columbia).

This document contains the information kit developed for the annual Model Summit Conferences for schools in the Victoria, British Columbia (Canada) and surrounding school districts. Materials germane to the conference topic were compiled and assembled for participants. The materials are of current interest, concise, simple and provide a balanced…

Attitudes towards the Elderly among German Adolescents

ERIC Educational Resources Information Center

Randler, Christoph; Vollmer, Christian; Wilhelm, David; Flessner, Melanie; Hummel, Eberhard

2014-01-01

Many societies are encountering significant changes in their population structure as the number of older people is increasing while children and adolescents become fewer. This study examines pupils' attitudes towards elderly people in Germany. A total of 935 pupils (458 boys, 477 girls) participated in this study. Grade distribution was as…

Constructing a Normative National Identity: The "Leitkultur" Debate in Germany, 2000/2001

ERIC Educational Resources Information Center

Manz, Stefan

2004-01-01

In recent years, public discourse about German national identity has increasingly focussed on the large foreign population within Germany's borders. Whilst right-wing politicians such as Edmund Stoiber foster fears of identity loss ("Uberfremdung"), more liberal observers, and indeed the ruling red-green coalition, acknowledge that…

[Citation rates of medical German-language journals in English-language papers - do they correlate with the Impact Factor, and who cites?].

PubMed

Winkmann, G; Schlutius, S; Schweim, H G

2002-01-25

Several publications are warning that the German language is no longer needed for transmission of scientific data. One of the causes may be the Impact Factor (IF), which appears to be derived predominantly from Anglo-American journals. The aim of this study was to check actual international attention paid to German-language journals, i. e. their citation frequencies in English-language papers. Are these citing rates in English-language articles correlated to the IF, and from where do citing articles originate? Of 25 arbitrarily selected >85 % German-language medical journals, IF as well as language distributions of citing articles were determined by searching publication years 1995 - 2000 in Science Citation Index (SCI). MEDLINE and EMBASE were used as supplementary retrieval systems. (i) The sample journals displayed an average IF = 0.357. A 99 % correlation (Pearson factor r = 0.987; n = 25) was observed between our > constructed< IF 2000 and IF published in Journal Citation Report 2000. This proves Stegmann's IF determination method to be valid. On the average, 53 % German-language and 45 % English-language articles between 1995 - 2000 cited the 1995 - 1999' contributions of the studied journals. No correlation was observed between IF vs. rates of citing articles in English (r <0.1). 64 % of citing English-language articles showed corporate sources in Germany/ Austria/ Switzerland, and 13.5 % authors' institutions in USA. (i) An IF >/=1 is, obviously, very hard to attain by German-language journals. ISI's differentiation between Citing vs. Cited-only Journals (the latter often serving as MEDLINE/ EMBASE sources) during derivation of IF appears unjustified. (ii) English now serves as the predominant communication language in sciences in German-speaking countries, but has not supplanted the German language. Our study reveals remarkable international attention rates remaining.

Prevalence and Correlates of Self-Harm in the German General Population

PubMed Central

Müller, Astrid; Claes, Laurence; Smits, Dirk; Brähler, Elmar; de Zwaan, Martina

2016-01-01

The study aimed at evaluating the psychometric properties of the German version of the Self- Harm Inventory (SHI) and examining the lifetime prevalence and correlates of self-harm in a representative German population sample (N = 2,507; age mean = 48.79, SD = 18.11; range 14 to 94 years; 55.5% women) using the SHI. All participants answered the German SHI, the short form of the Barratt Impulsiveness Scale (BIS-15), the ultra-brief Patient Health Questionnaire for Depression and Anxiety (PHQ-4), and provided sociodemographic information. The one-factorial structure of the SHI was replicated using a confirmatory factor analysis. Internal consistency coefficients were sufficient and in line with previous studies. Almost half of the sample (49%) acknowledged at least one self-harming behavior over the life-span, most frequently indirect forms of self-harm. The rate of participants who engaged in at least one SHI behavior was higher among men than women (51.6% vs. 46.9%, respectively, χ2 = 5.38, p = 0.020). Higher SHI scores were related to younger age, male gender, living alone, more symptoms of anxiety and depression (PHQ-4), higher impulsivity scores (BIS-15), and suffering from obesity grade 2. Women engaged more often in discreet forms of self-harm than men, e.g., preventing wounds from healing, exercising an injury, starving, and abusing laxatives. In terms of other indirect self-harming behaviors, men admitted more often driving recklessly, being promiscuous and losing a job on purpose, while women reported more frequently engaging in emotionally abusive relationships. With respect to direct self-harm, women were more likely to endorse suicide attempts and cutting, while men admitted more often head-banging. The findings suggest that self-harm constitutes a common problem. Future longitudinal studies are required to examine the natural course, sociodemographic and psychopathological risk factors, as well as possible time-trends of self-harming behaviors in more depth. PMID:27362348

Prevalence and Correlates of Self-Harm in the German General Population.

PubMed

Müller, Astrid; Claes, Laurence; Smits, Dirk; Brähler, Elmar; de Zwaan, Martina

2016-01-01

The study aimed at evaluating the psychometric properties of the German version of the Self- Harm Inventory (SHI) and examining the lifetime prevalence and correlates of self-harm in a representative German population sample (N = 2,507; age mean = 48.79, SD = 18.11; range 14 to 94 years; 55.5% women) using the SHI. All participants answered the German SHI, the short form of the Barratt Impulsiveness Scale (BIS-15), the ultra-brief Patient Health Questionnaire for Depression and Anxiety (PHQ-4), and provided sociodemographic information. The one-factorial structure of the SHI was replicated using a confirmatory factor analysis. Internal consistency coefficients were sufficient and in line with previous studies. Almost half of the sample (49%) acknowledged at least one self-harming behavior over the life-span, most frequently indirect forms of self-harm. The rate of participants who engaged in at least one SHI behavior was higher among men than women (51.6% vs. 46.9%, respectively, χ2 = 5.38, p = 0.020). Higher SHI scores were related to younger age, male gender, living alone, more symptoms of anxiety and depression (PHQ-4), higher impulsivity scores (BIS-15), and suffering from obesity grade 2. Women engaged more often in discreet forms of self-harm than men, e.g., preventing wounds from healing, exercising an injury, starving, and abusing laxatives. In terms of other indirect self-harming behaviors, men admitted more often driving recklessly, being promiscuous and losing a job on purpose, while women reported more frequently engaging in emotionally abusive relationships. With respect to direct self-harm, women were more likely to endorse suicide attempts and cutting, while men admitted more often head-banging. The findings suggest that self-harm constitutes a common problem. Future longitudinal studies are required to examine the natural course, sociodemographic and psychopathological risk factors, as well as possible time-trends of self-harming behaviors in more depth.

Poverty, health, and nutrition in Germany.

PubMed

Helmert, U; Mielck, A; Shea, S

1997-01-01

To investigate the relation between poverty and several variables describing health and nutrition behavior in East Germany and West Germany. Data are from the third National Health Survey in West Germany and the first Health Survey for the new federal states of Germany (1991/92). Both health surveys included a self-administered questionnaire ascertaining sociodemographic variables, smoking history, nutritional behavior (using a food-frequency list), physical activity, and a medical examination comprising measurements of height, weight, blood pressure, and blood sampling for serum cholesterol determination. Participants included 4958 subjects in the West Survey and 2186 subjects in the East Survey aged 25-69 years, with a respective net response rate of 69.0% and 70.2%. Poverty was defined as a household equivalence income of 62.5% or less of the median income of the general population. The lowest income group (poverty or near poverty) comprised 11.6% of East German versus 15.9% of West German males and 14.8% of East German versus 19.3% of West German females. For most but not all health and nutrition parameters, less favorable results were obtained for subjects with an equivalence income below or near poverty. The most striking poverty-related differences regarding cardiovascular disease risk factors were found for lack of regular exercise for both genders and obesity in females. No poverty-related differences were found for the prevalence of hypercholesterolemia, despite a much higher prevalence of obesity in persons with an income below the poverty line. Current nutritional behavior and changes in nutritional behavior during the last three years was strongly related to income status, with a more unhealthy status for low-income population groups in both East and West Germany. In Germany, poverty has strong effects on individual health status and nutritional behavior. Because of rising unemployment rates and reductions in social security payments for low-income groups, it is likely that the negative consequences of poverty on health are increasing.

Determination of nasal and oropharyngeal microbiomes in a multicenter population-based study - findings from Pretest 1 of the German National Cohort.

PubMed

Akmatov, Manas K; Koch, Nadine; Vital, Marius; Ahrens, Wolfgang; Flesch-Janys, Dieter; Fricke, Julia; Gatzemeier, Anja; Greiser, Halina; Günther, Kathrin; Illig, Thomas; Kaaks, Rudolf; Krone, Bastian; Kühn, Andrea; Linseisen, Jakob; Meisinger, Christine; Michels, Karin; Moebus, Susanne; Nieters, Alexandra; Obi, Nadia; Schultze, Anja; Six-Merker, Julia; Pieper, Dietmar H; Pessler, Frank

2017-05-12

We examined acceptability, preference and feasibility of collecting nasal and oropharyngeal swabs, followed by microbiome analysis, in a population-based study with 524 participants. Anterior nasal and oropharyngeal swabs were collected by certified personnel. In addition, participants self-collected nasal swabs at home four weeks later. Four swab types were compared regarding (1) participants' satisfaction and acceptance and (2) detection of microbial community structures based on deep sequencing of the 16 S rRNA gene V1-V2 variable regions. All swabbing methods were highly accepted. Microbial community structure analysis revealed 846 phylotypes, 46 of which were unique to oropharynx and 164 unique to nares. The calcium alginate tipped swab was found unsuitable for microbiome determinations. Among the remaining three swab types, there were no differences in oropharyngeal microbiomes detected and only marginal differences in nasal microbiomes. Microbial community structures did not differ between staff-collected and self-collected nasal swabs. These results suggest (1) that nasal and oropharyngeal swabbing are highly feasible methods for human population-based studies that include the characterization of microbial community structures in these important ecological niches, and (2) that self-collection of nasal swabs at home can be used to reduce cost and resources needed, particularly when serial measurements are to be taken.

Negligible import of enteric pathogens by newly-arrived asylum seekers and no impact on incidence of notified Salmonella and Shigella infections and outbreaks in Rhineland-Palatinate, Germany, January 2015 to May 2016.

PubMed

Ehlkes, Lutz; George, Maja; Knautz, Donald; Burckhardt, Florian; Jahn, Klaus; Vogt, Manfred; Zanger, Philipp

2018-05-01

IntroductionThe 2015 refugee crisis raised concerns about an import of infectious diseases affecting the German population. Aims: To evaluate public and individual health benefits of stool screening, and explore whether importation of enteric pathogens by newly-arrived asylum seekers impacts on the host population. Methods : We used data from mandatory stool screening to determine the overall, age, sex, and country-specific prevalence of enteric bacteria and helminths. We used surveillance data to assess whether the number of incoming asylum seekers influenced notifications of salmonellosis and shigellosis in Rhineland-Palatinate. Results : Salmonella were found in 0.2% (95% confidence interval (CI) 0.2-0.3%) of 23,410 samples collected from January 2015 to May 2016. Prevalence was highest in children under 5 years (0.8%; 95% CI: 0.5-1.3%). No Shigella or invasive Salmonella spp. were detected. In a subset of 14,511 samples, the prevalence of helminth infestation was 2.4% (95% CI: 2.1-2.6%), with highest proportions detected in adolescents (4.6%; 95% CI 3.8-5.4%) and among Eritreans (9.3%; 95% CI: 7.0-12.0%); in the latter particularly Schistosoma mansoni and Taenia spp. The increase in asylum applications did not increase notifications of salmonellosis and shigellosis. No transmission from asylum seekers to German residents was notified. Conclusion : Public health risk associated with imported enteric pathogens is very low overall. Addressing individual and public health risks, we recommend replacing stool screening of all newly-arrived asylum seekers by a targeted approach, with target groups and approaches being adapted if necessary. Target groups supported by our data are children, adolescents, and Eritreans.

Preterm Prelabor Rupture of Membranes and Outcome of Very-Low-Birth-Weight Infants in the German Neonatal Network

PubMed Central

Hanke, Kathrin; Hartz, Annika; Manz, Maike; Bendiks, Meike; Heitmann, Friedhelm; Orlikowsky, Thorsten; Müller, Andreas; Olbertz, Dirk; Kühn, Thomas; Siegel, Jens; von der Wense, Axel; Wieg, Christian; Kribs, Angela; Stein, Anja; Pagel, Julia; Herting, Egbert; Göpel, Wolfgang; Härtel, Christoph

2015-01-01

Objective It was the aim of our study to evaluate the independent effect of preterm prelabor rupture of membranes (PPROM) as a cause of preterm delivery on mortality during primary hospital stay and significant morbidities in very-low-birth-weight (VLBW) infants < 32 weeks of gestation. Design Observational, epidemiological study design. Setting Population-based cohort, German Neonatal Network (GNN). Population 6102 VLBW infants were enrolled in GNN from 2009-2012, n=4120 fulfilled criteria for primary analysis (< 32 gestational weeks, no pre-eclampsia, HELLP (highly elevated liver enzymes and low platelets syndrome) or placental abruption as cause of preterm birth). Methods Multivariable logistic regression analyses included PPROM as potential risk factors for adverse outcomes and well established items such as gestational age in weeks, birth weight, antenatal steroids, center, inborn delivery, multiple birth, gender and being small-for-gestational-age. Results PPROM as cause of preterm delivery had no independent effect on the risk of early-onset sepsis, clinical sepsis and blood-culture proven sepsis, while gestational age proved to be the most important contributor to sepsis risk. The diagnosis of PPROM was associated with an increased risk for bronchopulmonary dysplasia (BPD; OR: 1.25, 95% CI: 1.02-1.55, p=0.03) but not with other major outcomes. Conclusions The diagnosis of PPROM per se is not associated with adverse outcome in VLBW infants < 32 weeks apart from a moderately increased risk for BPD. Randomized controlled trials with primary neonatal outcomes are needed to determine which subgroup of VLBW infants benefit from expectant or intentional management of PPROM. PMID:25856083

[Public reporting of the Californian "pay for performance" conducted by the Integrated Healthcare Association (IHA)].

PubMed

Emmert, M; Schöffski, O

2007-01-01

In Germany, there is little transparency when it comes to quality of care of national health care providers. The population has hardly any opportunity to identify well-performing health-care providers. Therefore, the emerging quality improvement initiative "Pay for Performance (P4P)" developed in California, USA is examined with regard to an implementation into the German health care sector. This program wants to achieve higher levels of health care by setting both goal-oriented financial and non-financial incentives. Therefore, performance-based payment is combined with Public Reporting of the measured quality of care. As people can be influenced by the information provided, Public Reporting is supposed to have a positive effect on the quality of treatment. Published data to the American population will be highlighted as well as indications and examinations included in the P4P program. Also, it will be shown how the performance of health care providers is determined. Since published performance results can be considered not only for a specific indication but also as a whole, patients have the opportunity to choose a well-performing health-care provider, according to their specific requirements. Thus, Public Reporting might be regarded as an effective method in order to improve the quality of care provided by health-care providers. Public Reporting in P4P is already conducted in a differentiated but also in a broad context. In the development of this key success element, many stakeholders have been involved, including health-care providers. So, the presented way of Public Reporting can be regarded as a business case to learn from with regard to more transparency in the German health-care sector.

Relationship between neighbourhood socioeconomic position and neighbourhood public green space availability: An environmental inequality analysis in a large German city applying generalized linear models.

PubMed

Schüle, Steffen Andreas; Gabriel, Katharina M A; Bolte, Gabriele

2017-06-01

The environmental justice framework states that besides environmental burdens also resources may be social unequally distributed both on the individual and on the neighbourhood level. This ecological study investigated whether neighbourhood socioeconomic position (SEP) was associated with neighbourhood public green space availability in a large German city with more than 1 million inhabitants. Two different measures were defined for green space availability. Firstly, percentage of green space within neighbourhoods was calculated with the additional consideration of various buffers around the boundaries. Secondly, percentage of green space was calculated based on various radii around the neighbourhood centroid. An index of neighbourhood SEP was calculated with principal component analysis. Log-gamma regression from the group of generalized linear models was applied in order to consider the non-normal distribution of the response variable. All models were adjusted for population density. Low neighbourhood SEP was associated with decreasing neighbourhood green space availability including 200m up to 1000m buffers around the neighbourhood boundaries. Low neighbourhood SEP was also associated with decreasing green space availability based on catchment areas measured from neighbourhood centroids with different radii (1000m up to 3000 m). With an increasing radius the strength of the associations decreased. Social unequally distributed green space may amplify environmental health inequalities in an urban context. Thus, the identification of vulnerable neighbourhoods and population groups plays an important role for epidemiological research and healthy city planning. As a methodical aspect, log-gamma regression offers an adequate parametric modelling strategy for positively distributed environmental variables. Copyright © 2017 Elsevier GmbH. All rights reserved.

Do perceived job insecurity and annoyance due to air and noise pollution predict incident self-rated poor health? A prospective analysis of independent and joint associations using a German national representative cohort study

PubMed Central

Riedel, Natalie; Loerbroks, Adrian; Bolte, Gabriele; Li, Jian

2017-01-01

Background Current economic and social change has contributed to increasing job insecurity and traffic-related pollution in residential areas. Both job insecurity and exposure to noise and air pollution are known determinants of population health and can concur in peoples' lives. This may hold true particularly for socially disadvantaged subpopulations. Nevertheless, the potential independent and joint links of those exposures to health have been rarely examined so far. We aimed to contribute to the scarce body of evidence. Methods Information on perceived job insecurity and exposures to noise and air pollution as expressed by annoyance as well as on self-rated health were gathered from 2 waves of the population-based German Socio-Economic Panel (2009 and 2011, N=6544). We performed multivariable Poisson regression to examine the independent and joint risk of poor health in 2011 by perceived job insecurity and annoyance due to noise and air pollution in 2009. Results After the 2-year follow-up in 2011, 571 (8.7%) participants rated their health as poor. The risk of reporting incident poor health was increased by roughly 40% in employees reporting high versus low perceived job insecurity and annoyance due to noise and air pollution, respectively. This risk increased when both exposures were present at higher levels (risk ratio=1.95 (1.49 to 2.55)). Conclusions Work-related and environmental exposures may accumulate and have a joint health impact. Elaboration on the link between occupational and residential exposures is warranted in the light of their concurrence and their implications for health inequities. PMID:28115332

Diffraction and Transmission Synchrotron Imaging at the German Light Source ANKA--Potential Industrial Applications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rack, Alexander; Weitkamp, Timm; European Synchrotron Radiation Facility, BP 220, F-38043 Grenoble Cedex

2009-03-10

Diffraction and transmission synchrotron imaging methods have proven to be highly suitable for investigations in materials research and non-destructive evaluation. The high flux and spatial coherence of X-rays from modern synchrotron light sources allows one to work using high resolution and different contrast modalities. This article gives a short overview of different transmission and diffraction imaging methods with high potential for industrial applications, now available for commercial access via the German light source ANKA (Forschungszentrum Karlsruhe) and its new department ANKA Commercial Service (ANKA COS, http://www.anka-cos.de)

Tinnitus functional index: validation of the German version for Switzerland.

PubMed

Peter, Nicole; Kleinjung, Tobias; Jeker, Raphael; Meyer, Martin; Klaghofer, Richard; Weidt, Steffi

2017-05-05

Different standardized questionnaires are used to assess tinnitus severity, making comparisons across studies difficult. These questionnaires are also used to measure treatment-related changes in tinnitus although they were not designed for this purpose. To solve these problems, a new questionnaire - the Tinnitus Functional Index (TFI) - has been established. The TFI is highly responsive to treatment-related change and promises to be the new gold standard in tinnitus evaluation. The aim of the current study was to validate a German version of the TFI for a German-speaking population in Switzerland. At the ENT department of the University Hospital Zurich, 264 subjects completed an online survey including the German version for Switzerland of TFI, Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and sociodemographic variables. Internal consistency of the TFI was calculated with Cronbach's alpha coefficient. Pearson correlation coefficients were used for the test-retest reliability of the TFI and to investigate convergent and discriminant validity between the THI and the BDI and BAI, respectively. Factor analysis was assessed using a principal component analysis with oblique rotation. The different factors extracted were then compared with the original questionnaire. The German version of the TFI for Switzerland showed an excellent internal consistency (Cronbach's alpha of 0.97) and an excellent test-retest reliability of 0.91. The convergent validity with THI was high (r = 0.86). The discriminant validity with BAI and BDI showed moderate results (BAI: r = 0.60 and BDI: r = 0.65). In the factor analysis only five factors with one main factor could be extracted instead of eight factors as described in the original version. Nevertheless, relations to the original eight subscales could be demonstrated. The German version of the TFI for Switzerland is a suitable instrument for measuring the impact of tinnitus. The reliability and validity of this version are comparable with the original version of the TFI. Although this study showed only five factors in the factor analysis, relations to the original eight subscales were identified. Therefore, the German version of the TFI for Switzerland can deliver relevant information regarding the different tinnitus domains. Clinical trial registration number on clinicaltrial.gov: NCT01837368 .

Quantitative Methods for Long-Range Environmental Forecasting. Long-Wave European Projections. Volume 2. Technical Volume

DTIC Science & Technology

1974-03-01

approaches to specific problems within the foreign affairs community ( e . g. , within DoD). The lag resulted from a variety of factors, in...ICATIOH / Prepared by: Herman M. Weil Airon Greenberg Larry German Douglas Hartwick Michael R. Leavitt Sponsored by: Defense Advanced...I Dr. G. Robert Franco, Project Director Dr. Herman M. Weil Mr. Aaron Greenberg Mr. Larry German Mr. Douglas Hartwick Dr. Michael

MindMatters--A Programme for the Promotion of Mental Health in Primary and Secondary Schools: Results of an Evaluation of the German Language Adaptation

ERIC Educational Resources Information Center

Franze, M.; Paulus, P.

2009-01-01

Purpose: The purpose of this article is to present a German adaptation of the Australian programme MindMatters for school mental health promotion in secondary schools. Design/methodology/approach: As well as other methods, the external evaluation consisted of a questionnaire-based pre-post-design (at one year interval of measurement; n=633…

Comparison of stool collection on site versus at home in a population-based study : feasibility and participants' preference in Pretest 2 of the German National Cohort.

PubMed

Schultze, A; Akmatov, M K; Andrzejak, M; Karras, N; Kemmling, Y; Maulhardt, A; Wieghold, S; Ahrens, W; Günther, K; Schlenz, H; Krause, G; Pessler, F

2014-11-01

For certain laboratory investigations it is necessary to obtain native stool samples and process them within a narrow time window at the point of contact or a nearby laboratory. However, it is not known whether it is feasible to obtain stool samples from asymptomatic individuals during an appointment in a study center (SC). We therefore compared participants' preference, feasibility and acceptance of stool sample collection during the appointment at the study center (on-site sampling) to collection at home after the appointment. The study was conducted at two sites in Northern Germany (Bremen, n = 156; Hannover, n = 147) during the Pretest 2 phase of the German National Cohort (GNC), drawing upon a randomly selected population supplemented by a small convenience sample. In the study center, the participants were given the choice to provide a stool sample during the appointment or to collect a sample later at home and return it by mail. In all, 303 of the 351 participants (86 %) of Pretest 2 at these sites participated in this feasibility study. Only 7.9 % (24/303) of the participants chose on-site collection, whereas 92 % (279/303) chose at-home collection. There were significant differences between the two study sites in that 14 % (21/147) of participants in Hannover and 2 % (3/156) of participants in Bremen chose on-site collection. Compliance was high in both groups, as 100 % (24/24) and 98 % (272/279) of participants in the on-site and at-home groups, respectively, provided complete samples. Both methods were highly accepted, as 92 % of the participants in each group (22/24 and 227/248) stated that stool collection at the respective site was acceptable. When given a choice, most participants in this population-based study preferred home collection of stool samples to collection in the study center. Thus, native stool samples for immediate processing in the study center may potentially be obtained only from a subpopulation of participants, which may lead to selection bias. Home collection, on the other hand, proved to be a highly feasible method for studies that do not require freshly collected native stool.

Cross-cultural adaptation and validation of the VISA-A questionnaire for German-speaking achilles tendinopathy patients.

PubMed

Lohrer, Heinz; Nauck, Tanja

2009-10-30

Achilles tendinopathy is the predominant overuse injury in runners. To further investigate this overload injury in transverse and longitudinal studies a valid, responsive and reliable outcome measure is demanded. Most questionnaires have been developed for English-speaking populations. This is also true for the VISA-A score, so far representing the only valid, reliable, and disease specific questionnaire for Achilles tendinopathy. To internationally compare research results, to perform multinational studies or to exclude bias originating from subpopulations speaking different languages within one country an equivalent instrument is demanded in different languages. The aim of this study was therefore to cross-cultural adapt and validate the VISA-A questionnaire for German-speaking Achilles tendinopathy patients. According to the "guidelines for the process of cross-cultural adaptation of self-report measures" the VISA-A score was cross-culturally adapted into German (VISA-A-G) using six steps: Translation, synthesis, back translation, expert committee review, pretesting (n = 77), and appraisal of the adaptation process by an advisory committee determining the adequacy of the cross-cultural adaptation. The resulting VISA-A-G was then subjected to an analysis of reliability, validity, and internal consistency in 30 Achilles tendinopathy patients and 79 asymptomatic people. Concurrent validity was tested against a generic tendon grading system (Percy and Conochie) and against a classification system for the effect of pain on athletic performance (Curwin and Stanish). The "advisory committee" determined the VISA-A-G questionnaire as been translated "acceptable". The VISA-A-G questionnaire showed moderate to excellent test-retest reliability (ICC = 0.60 to 0.97). Concurrent validity showed good coherence when correlated with the grading system of Curwin and Stanish (rho = -0.95) and for the Percy and Conochie grade of severity (rho 0.95). Internal consistency (Cronbach's alpha) for the total VISA-A-G scores of the patients was calculated to be 0.737. The VISA-A questionnaire was successfully cross-cultural adapted and validated for use in German speaking populations. The psychometric properties of the VISA-A-G questionnaire are similar to those of the original English version. It therefore can be recommended as a sufficiently robust tool for future measuring clinical severity of Achilles tendinopathy in German speaking patients.

Larvae of uncommon caridean decapods in the German Bight: Species composition, distribution and abundance

NASA Astrophysics Data System (ADS)

Wehrtmann, I. S.; Greve, W.

1995-03-01

Typically, the most abundant group of shrimp larvae in the German Bight is formed by representatives of the family Crangonidae. Larvae of the remaining species have been largely ignored, and only scarce information concerning their ecology is available. Thus, the purpose of the present study was to determine the species composition, distribution and abundance of noncrangonid shrimp larvae in the German Bight in July 1990, after the mildest winter of the century. The material is based upon plankton samples collected at 77 stations, covering the entire German Bight. Eight species were identified, as well as larvae of Palaemonidae and Processa-juveniles. Processa nouveli holthuisi (53.0%) and P. modica (31.3%) were predominant in the collection. The distribution of the two species was clearly separated: the main concentration of P. nouveli holthuisi (peak concentration of 1.94 larvae per m3) was confined to the northwest corner of the German Bight, while a majority of P. modica larvae (peak concentration of 0.54 larvae per m3) occurred at the southwesterly stations. The spatial distribution of Caridion steveni and Eualus occultus around Helgoland indicates the presence of an adult population at the only rocky island in the study area. Other taxa, such as larvae of Palaemonidae and juvenile Pandalina brevirostris were collected exclusively in estuarine habitats. Based upon both the results of the present study and comparable data, we conclude that developmental stages of ten non-crangonid species, as well as representatives of Palaemonidae, can be expected to occur in the plankton of the German Bight. The extremely mild temperatures of the preceding winter may have been, in part, responsible for the relatively high densities of some taxa encountered during our plankton survey. We assume that warm winter temperatures favour the immigration, reproduction and survival of cold-sensitive species.

Validation of the German version of two scales (RIS, RCS-HCP) for measuring regret associated with providing healthcare.

PubMed

Richner, Silvia C; Cullati, Stéphane; Cheval, Boris; Schmidt, Ralph E; Chopard, Pierre; Meier, Christoph A; Courvoisier, Delphine S

2017-03-24

The regret intensity scale (RIS) and the regret coping scale for healthcare professionals (RCS-HCP) working in hospitals assess the experience of care-related regrets and how healthcare professional deal with these negative events. The aim of this study was to validate a German version of the RIS and the RCS-HCP. The RIS and RCS-HCP in German were first translated into German (forward- and backward translations) and then pretested with 16 German-speaking healthcare professionals. Finally, two surveys (test and 1-month retest) administered the scales to a large sample of healthcare professionals from two different hospitals. Of the 2142 eligible healthcare professionals, 494 (23.1%) individuals (108 physicians) completed the cross-sectional web based survey and 244 completed the retest questionnaire. Participants (n = 165, 33.4% of the total sample) who reported not having experienced a regret in the last 5 years, had significantly more days of sick leave during the last 6 months. These participants were excluded from the subsequent analyses. The structure of the scales was similar to the French version with a single dimension for the regret intensity scale (Cronbach's alpha: 0.88) and three types of coping strategies for the regret coping scale (alphas: 0.69 for problem-focused strategies, 0.67 for adaptive strategies and 0.86 for the maladaptive strategies). Construct validity was good and reproduced the findings of the French study, namely that higher regret intensity was associated with situations that entailed more consequences for the patients. Furthermore, higher regret intensity and more frequent use of maladaptive strategies were associated with more sleep difficulties and less work satisfaction. The German RIS and RCS-HCP scales were found valid for measuring regret intensity and regret coping in a population of healthcare professionals working in a hospital. Reporting no regret, which corresponds to the coping strategy of suppression, seems to be a maladaptive strategy because it was associated with more frequent sick day leaves.

How do hospitalised patients with Turkish migration background estimate their language skills and their comprehension of medical information – a prospective cross-sectional study and comparison to native patients in Germany to assess the language barrier and the need for translation

PubMed Central

2013-01-01

Background Today more than two million people with Turkish migration background live in Germany making them the largest ethnic minority in the country. Data concerning language skills and the perception of medical information in hospitalised patients with Turkish migration background (T) are scarce. Our study is the first to gather quantitative information on this important subject. Methods T and hospitalised German patients without migration background (G) of our university hospital were prospectively included into a cross-sectional study and completed a questionnaire - each group in the appropriate language (T: Turkish, G: German). Results 121 T and 121 G were included. Groups significantly differed in age (T: 44.9 ± 17.8, G: 56.9 ± 16.7y) and proportion of males (T: 37.2, G: 54.5%) but not regarding the proportion of college graduates (T: 19.3, G: 15.7%). The majority of T was born in Turkey (71%) and is of Turkish nationality (66%). 74% of T speak mainly Turkish at home; however, 73% speak German at work. 74.4% of T self-rated their German linguistic proficiency as “average” or better while 25.6% reported it as “very bad” or “bad”. 10.7% of T need translation in order to pursue everyday activities. T were significantly less satisfied with the physician’s information on disease and estimated to understand significantly less of what the physician told them: 46.3% of T estimated their reception of the physician’s information to be “average” or worse. 43.3% of T had the impression that it would have helped them “much” or “very much” to be aided by an interpreter at the hospital. The information transmitted while giving informed consent to invasive medical procedure was judged to be “mostly” or “completely” sufficient by the majority of T (76%) and G (89.8%). In this setting 37 of 96 T (38.5%) reported being helped by an interpreter – in most cases (64.9%) a family member. Conclusion Although the majority of patients with Turkish migration background have spent most of their lives in Germany (28.94 ± 10.41y) a large part of this population has limited German language skills and difficulties obtaining medical information when hospitalised. PMID:23710582

Estimations of daily energy and nutrient availability based on nationally representative household budget survey data. The Data Food Networking (DAFNE) project.

PubMed

Naska, A; Oikonomou, E; Trichopoulou, A; Wagner, K; Gedrich, K

2007-12-01

To describe a cost-efficient method for estimating energy and nutrient availability using household budget survey (HBS) data. Four different approaches were tested and the results were compared with published nutrient intake data. The selected method was exemplarily applied in German and Greek data. Germany, 1998; Greece, 1998/99. Nationally representative HBSs. Comparisons showed that HBS-based estimates were generally close to intake data when results were presented as contributions to daily energy intake. Daily energy and protein availabilities were similar in Germany and Greece. Differences were observed in the availability of carbohydrates (German households reported a 5 percentage points higher contribution to daily energy availability) and lipids (Greek households recorded higher values for total fat, but lower values for saturated fat). Meat, added lipids and potatoes were important energy suppliers in Germany, whereas in Greece the first three energy suppliers were added lipids, cereals and meat. In both countries, meat, cereals, milk and cheese were important protein sources and cereals, potatoes, fruits and nuts contributed more than 60% of the daily carbohydrate availability. Added lipids were the major source of fat in the daily diet of both countries, but their contribution amounted to less than one-third in Germany and two-thirds in Greece. National HBS data can be used for monitoring and comparing nutrient availability among representative population samples of different countries. The ground is set for the development of a harmonised food composition table to be applied to HBS food data at international level.

The punishment of gene doping - The relation between WADA prohibited lists, German Medicinal Products Act, German Doping Agents Amounts Ordinance, and Basic Law of the Federal Republic of Germany.

PubMed

Parzeller, Markus

2011-10-01

The genetic constitution of athletes influences efficiency. Knowledge of genetic influences provides an opportunity for medical diagnostic and therapeutic attempts. Beside risks and therapeutic aspects, however, the possibilities of abuse for gene doping purposes in sports also exist. Genetic screening or gene therapy may have an advantage for athletes who use these methods. In juridical comments, it is pointed out that gene doping so far plays no role in sports, but that the legislator must consider a development in this area. Preventing abuse requires legal regulations. These regulations can include sanctions. This paper deals with the gene doping prohibition of the World Anti-Doping Agency (WADA) as confirmed and accepted by the monitoring group according to Articles 10 and 11 of the European Anti-Doping Convention by the Council of Europe, the prohibition of (gene) doping in sports of the German Medicinal Products Act (Arzneimittelgesetz - AMG) and the German Doping Agents Amounts Ordinance (Dopingmittel-Mengen-Verordnung-DmMV) of the German Federal Ministry of Health (BMG). The comprehensibility of the doping ban on the norm addressee was tested with a questionnaire. In connection with legal regulations of the German constitution, gene doping is discussed and problems which may arise by a state doping prohibition are pointed out. Copyright © 2011 John Wiley & Sons, Ltd.

Incidence of pneumonia in nursing home residents in Germany: results of a claims data analysis.

PubMed

Fassmer, A M; Spreckelsen, O; Hoffmann, F

2018-04-26

Pneumonia is one of the most common infectious diseases with a high mortality, especially in the elderly population. To date, there have been only a few population-based studies dealing with the incidence of pneumonia in nursing homes (NHs). We conducted a cohort study using data from a large German statutory health insurance fund. Between 2010 and 2014, 127 227 NH residents 65 years and older were analysed. For the calculation of incidences per 100 person-years (PY) and 95% confidence intervals (CIs), we assessed the first diagnosis of pneumonia during the time in NH. We compared the rates between sexes, age groups, care levels, and comorbidities and we performed a multivariate Cox regression analysis. The mean age in the cohort was 84.0 years (74.6% female). A total of 19 183 incident cases led to an overall 5-year-incidence of 11.8 per 100 PY (95% CI 11.7-12.0). The incidence in men was substantially higher than in women. Rates were highest in the first month after NH placement. Our study revealed that the incidence of pneumonia is high in German NH residents and especially in males. Due to demographic changes, pneumonia will likely be increasingly relevant in the health care of the elderly and institutionalised population.

Changes in the perception of mental illness stigma in Germany over the last two decades.

PubMed

Angermeyer, Matthias C; Matschinger, Herbert; Carta, Mauro G; Schomerus, Georg

2014-08-01

To examine the evolution of the perception of the stigma attached to mental illness in Germany since 1990 up to the present. Population surveys were conducted in the old German States (former Federal Republic of Germany) in 1990, 2001, and 2011. The perception of stigma attached to people with mental illness was assessed with the help of Link's perceived discrimination and devaluation scale. In the 2011 survey, less mental illness stigma was perceived by respondents than in the previous surveys. In the eyes of the German public, the devaluation and rejection of people with mental illness has substantially decreased since 1990. The perception of a decline of the stigmatization is in contrast to the development of the German public's attitudes towards persons with mental disorders, which remained unchanged or even worsened. Perceived and personal attitudes towards persons with mental illness have developed differently, and it remains to be seen whether perceptions of less public stigma will ultimately be followed by improved personal attitudes. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Estimated prevalence of compulsive buying in Germany and its association with sociodemographic characteristics and depressive symptoms.

PubMed

Mueller, Astrid; Mitchell, James E; Crosby, Ross D; Gefeller, Olaf; Faber, Ronald J; Martin, Alexandra; Bleich, Stefan; Glaesmer, Heide; Exner, Cornelia; de Zwaan, Martina

2010-12-30

The aim of this study was to estimate the prevalence of compulsive buying and its association with sociodemographic characteristics and depressive symptoms in a nationally representative sample of the German population using the validated German version of the Compulsive Buying Scale (CBS; Faber and O'Guinn, 1992) in order to have a direct comparison with U.S. findings. The point prevalence of compulsive buying in the weighted representative sample (N=2,350) was estimated to be 6.9%. This was somewhat higher than the percentage in the American sample assessed in 2004 (5.8%). No significant difference was found between women and men (6.9% and 6.8%, respectively). Age was inversely related to the prevalence of compulsive buying. Individuals with compulsive buying reported more depressive symptoms assessed via the German version of the Brief Patient Health Questionnaire Mood Scale (PHQ-9). Further research on this topic is needed to establish a clearer delineation of when excessive buying is clinically significant and should be treated and how it could be prevented. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

Health literacy in old age: results of a German cross-sectional study.

PubMed

Vogt, Dominique; Schaeffer, Doris; Messer, Melanie; Berens, Eva-Maria; Hurrelmann, Klaus

2017-03-22

Health literacy is especially important for older people to maintain or enhance remaining health resources and self-management skills. The aim of the study was to determine the level of health literacy and the association between health literacy, demographic and socio-economic factors in German older adults aged 65 years and above stratified by age group. Health literacy was assessed via computer-assisted personal interviews using HLS-EU-Q47 on a representative sample of the German-speaking population. Descriptive statistics, bivariate analyses and logistic regression modelling stratified by age group were conducted to assess health literacy of 475 respondents aged 65 years and above. Overall, 66.3% of all respondents aged 65 years and above had limited health literacy. Limited health literacy was especially prevalent among respondents above 76 years of age (80.6%). Limited health literacy was associated with financial deprivation (OR: 3.05; 95% CI: 1.99-4.67) and limited functional health literacy (OR: 2.16; 95% CI: 1.29-3.61). Financial deprivation was strongest predictor for limited health literacy in the total sample and stratified by age group. Limited health literacy is a frequent phenomenon in German adults aged 65 years and above. Research on health literacy in old age and the role in health disparities is urgently needed. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Discovering time-trends of the German populations exposure to contaminants by analysis of human samples of the German Environmental Specimen Bank (ESB).

PubMed

Göen, Thomas; Lermen, Dominik; Hildebrand, Jörg; Bartel-Steinbach, Martina; Weber, Till; Kolossa-Gehring, Marike

2018-06-12

The German Environmental Specimen Bank (ESB) is a monitoring instrument of the German Federal Ministry for the Environment, Nature Conservationand Nuclear Safety. The permanent biobank facility is run since 1981 containing environmental and human samples from Germany. All samples are collected according to standard operating procedures (SOP). An annually standardized collection of human samples at four different regional sites of the country has been established since 1997. Routine sampling is done once a year, recruiting healthy non occupationally exposed students aged 20-29 years, in an equal gender distribution. The number of participants recruited is approximately 120 students per site and year. Directly after the annual sampling process, the human samples are analyzed for selected environmental chemicals. The time-trends of lead in blood, mercury and pentachlorophenol in 24 h-urine and polychlorinated biphenyls in plasma demonstrated a decrease of exposure during the last two decades by about 40 - 90 percent. In parallel retrospective studies using cryo-archived samples revealed increasing time trends of emerging chemicals used as substitutes for regulated toxicants. The data demonstrates the great relevance of the ESB for the health related environmental monitoring and shows the importance of human biomonitoring as a tool in information based policy making. Copyright © 2018 Elsevier B.V. All rights reserved.

[Not Available.

PubMed

Berg, Wieland

2016-01-01

The German Academy of Sciences Leopoldina submitted at the outbreak of the First World War no public opinion - regardless of personal settings of the board and unlike many of its members. Public-meetings, however, were introduced only in 1924, making it the Leopoldina were no opportunities to academy speeches, in contrast to other scientific academies. But in their official bulletin with which they appeared in public, obituaries were published during the entire war period to researchers regardless of the nation, including in French and English scholars. It was only at the suggestion of a member from the July 1915 German war dead were honoured with a symbolic Iron Cross, as was common in German newspapers from the beginning of the war. An exclusion of members from the 'hostile' abroad was never considered. During the war, however, no foreigners were co-opted, but again only immediately after the war. The academy board then pleaded strongly for an international reconciliation of sciences. At the public propaganda war in the "battle of the minds" were also renowned Leopoldina members involved, as reflected in total war and its consequences in the Leopoldina members similar to the entire German population. The analysis of the signatories of various manifestos brings to light that the "Declaration of University Professors of Germany" only just over half of the scholars instead of "almost the whole teaching body" was signed, as previously generalized.

Eat healthy? Attitudes of the German population towards industrially produced cardioprotective food.

PubMed

Jung, F U C E; Luck-Sikorski, C; Krüger, M; Wiacek, C; Braun, P G; Engeli, S; Riedel-Heller, S G

2018-05-01

Cardiovascular disease (CVD) is likely to increase in incidence. Foods with cardioprotective functions, e.g. specific functional food, could reduce CVD risk factors and hence CVD incidence. Little is known about industrially modified foods with cardioprotective functions. In a large German sample (n = 1007), attitudes of consumers in Germany towards industrially produced cardioprotective food were assessed using Cluster analyses. Consumers were contacted via telephone and interviewed using questionnaires. Overall, about 25% knew about industrially produced food with cardioprotective function. Our analysis revealed a small but determined group of consumers who think very skeptical about cardioprotective products, but we also identified a favorable group. These two groups only differed in age, with the skeptical group being ten years older. The rising number of industrially modified products with potential cardioprotective benefit is met by skepticism and a lack of knowledge by German costumers. If large scale studies show health benefits of these products, these will need to be better communicated to German customers in order to address possible doubts or concerns and to encourage healthy eating habits in consumer eating behavior. Copyright © 2018 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

How many years of life did the fall of the Berlin Wall add? A projection of East German life expectancy.

PubMed

Vogt, Tobias C

2013-01-01

In the two decades since reunification, East Germans have experienced a large increase in life expectancy and a convergence with the West German mortality level. This gain in life expectancy appears even more impressive if we assume a different scenario in which the Berlin Wall did not fall, and the old East Germany still existed. This analysis takes into account that East German mortality would not have remained static without reunification. Thus, it shows how many years of life expectancy were actually added by the fall of the Berlin Wall. The analysis shows the improvements for single age groups by projecting life expectancy based on mortality levels during the 1970s and 1980s using the Lee-Carter method. I use national-level data for both sexes for East Germany before reunification. I find that, without reunification, current life expectancy at birth among East Germans would be 4.0 years lower for females and 5.7 years lower for males. I also show that older East Germans were the main demographic beneficiaries of reunification. Female and male mortality improvements in the age groups above 60 contributed up to 80% to the actual gains in life expectancy. Had the Berlin Wall not fallen, East German mortality would not have remained static but improved at a far slower rate. Thus, this counterfactual approach shows for the first time how many years of life were actually gained by reunification and how much of these gains were attributable to mortality improvements among the elderly. Copyright © 2013 S. Karger AG, Basel.

Is German Medical Education Research on the rise? An analysis of publications from the years 2004 to 2013.

PubMed

Ackel-Eisnach, Kristina; Raes, Patricia; Hönikl, Lisa; Bauer, Daniel; Wagener, Stefan; Möltner, Andreas; Jünger, Jana; Fischer, Martin R

2015-01-01

The point of departure for the present work is the observation that, in comparison with Anglo-American countries or the Netherlands, Germany was responsible for only a marginal number of international publications in the field of medical education research before 2004. Recent years, however, have seen an increase in the importance of medical education research in Germany. The objective of this article is to evaluate the extent to which this trend can be substantiated by increased German publishing activity since the year 2004 in international, English-language journals in the subject area of "medical education research". In the framework of a literature and content analysis, German-author articles from the years 2004 to 2013 in six international, English-language medical education research journals were evaluated. In order to obtain an overview of German research activity in this area, all project and original works with German first and last authors were identified and subjected to a more in-depth content analysis. In total, 10,055 articles were examined. The evaluation shows that between the years 2004 and 2013 179 articles (of which 145 are project or original works) by German authors were published in the journals examined. Fluctuations over the course of time were evidenced. The project and original works are primarily cross-sectional studies (27.8%) and randomised control studies (25.6%) on the subject of "teaching and learning methods" (43.6%). In comparison with the years 2004-2008, a significant rise can be seen in the number of publications by German education researchers in international journals since the year 2009.

German Translation and Validation of the Cognitive Style Questionnaire Short Form (CSQ-SF-D)

PubMed Central

Huys, Quentin J. M.; Renz, Daniel; Petzschner, Frederike; Berwian, Isabel; Stoppel, Christian; Haker, Helene

2016-01-01

Background The Cognitive Style Questionnaire is a valuable tool for the assessment of hopeless cognitive styles in depression research, with predictive power in longitudinal studies. However, it is very burdensome to administer. Even the short form is still long, and neither this nor the original version exist in validated German translations. Methods The questionnaire was translated from English to German, back-translated and commented on by clinicians. The reliability, factor structure and external validity of an online form of the questionnaire were examined on 214 participants. External validity was measured on a subset of 90 subjects. Results The resulting CSQ-SF-D had good to excellent reliability, both across items and subscales, and similar external validity to the original English version. The internality subscale appeared less robust than other subscales. A detailed analysis of individual item performance suggests that stable results could be achieved with a very short form (CSQ-VSF-D) including only 27 of the 72 items. Conclusions The CSQ-SF-D is a validated and freely distributed translation of the CSQ-SF into German. This should make efficient assessment of cognitive style in German samples more accessible to researchers. PMID:26934499

European research and commercialisation activities in the field of tissue engineering and liver support in world wide competition.

PubMed

Marx, U; Bushnaq, H; Yalcin, E

1998-02-01

Tissue engineering is seen as an interesting field of technology which could improve medical therapy and could also be considered as a commercial opportunity for the European biotechnological industry. Research in the state of the art of science using the MedLine and the Science Citation Index databases, in the patent situation and of the industry dealing with tissue engineering was done. A special method, based on the Science Citation Index Journal Citation Report 1993, for evaluating scientific work was defined. The main countries working in the field of tissue engineering were evaluated in regard to their scientific performance and their patents. The R&D of German industry was investigated as an exemplary European country. Out of all activities, different tissues were rated with respect to the attention received from research and industry and with regard to the frequency in which patents were applied for. USA, Germany and Japan rank first in most tissues, especially liver. After comparing German patents with the German scientific and industrial work, it seems that the potential in German patents and research is underestimated by German industry and inefficiently exploited.

The German East-West Mortality Difference: Two Crossovers Driven by Smoking.

PubMed

Vogt, Tobias; van Raalte, Alyson; Grigoriev, Pavel; Myrskylä, Mikko

2017-06-01

Before the fall of the Berlin Wall, mortality was considerably higher in the former East Germany than in West Germany. The gap narrowed rapidly after German reunification. The convergence was particularly strong for women, to the point that Eastern women aged 50-69 now have lower mortality despite lower incomes and worse overall living conditions. Prior research has shown that lower smoking rates among East German female cohorts born in the 1940s and 1950s were a major contributor to this crossover. However, after 1990, smoking behavior changed dramatically, with higher smoking intensity observed among women in the eastern part of Germany. We forecast the impact of this changing smoking behavior on East-West mortality differences and find that the higher smoking rates among younger East German cohorts will reverse their contemporary mortality advantage. Mortality forecasting methods that do not account for smoking would, perhaps misleadingly, forecast a growing mortality advantage for East German women. Experience from other countries shows that smoking can be effectively reduced by strict anti-smoking policies. Instead, East Germany is becoming an example warning of the consequences of weakening anti-smoking policies and changing behavioral norms.

[German Validation of the "King's Brief Interstitial Lung Disease (K-Bild) Health Status Questionnaire"].

PubMed

Kreuter, M; Birring, S S; Wijsenbeek, M; Wapenaar, M; Oltmanns, U; Costabel, U; Bonella, F

2016-11-01

Background: Health status and quality of life are impaired in patients with interstitial lung disease (ILD). To assess these parameters in ILD patients no valid and reliable questionnaire exists in German language so far. The K-BILD questionnaire is a brief and valid tool to evaluate health status in ILD patients, with no validated German version. Method: The linguistic validation of K-BILD was carried out in a multistage process in collaboration with the developer of the questionnaire and bilingual, professional translators. Review by the developers and back translations as well as clinical assessment by ILD patients ensured that the translated questionnaire reflected the intention of the original K-BILD. Results: A German version of K-BILD with 15 questions concerning the health status was composed. The questions cover the three domains breathlessness and activities, psychological aspects and chest symptoms. Problems in understanding or difficulties in replying to the questions were not stated by the ILD patients. Conclusion: The German version of the K-BILD questionnaire allows the clinical and scientific use to measure reliable health quality in ILD patients. © Georg Thieme Verlag KG Stuttgart · New York.

White Paper: Radiological Curriculum for Undergraduate Medical Education in Germany.

PubMed

Ertl-Wagner, B; Barkhausen, J; Mahnken, A H; Mentzel, H J; Uder, M; Weidemann, J; Stumpp, P

2016-11-01

Purpose: Radiology represents a highly relevant part of undergraduate medical education from preclinical studies to subinternship training. It is therefore important to establish a content base for teaching radiology in German Medical Faculties. Materials and Methods: The German Society of Radiology (DRG) developed a model curriculum for radiological teaching at German medical universities, which is presented in this article. There is also a European model curriculum for undergraduate teaching (U-level curriculum of the European Society of Radiology). In a modular concept, the students shall learn important radiological core principles in the realms of knowledge, skills and competences as well as core scientific competences in the imaging sciences. Results: The curriculum is divided into two modules. Module 1 includes principles of radiation biology, radiation protection and imaging technology, imaging anatomy as well as the risks and side effects of radiological methods, procedures and contrast media. This module is modality-oriented. Module 2 comprises radiological diagnostic decision-making and imaging-based interventional techniques for various disease entities. This module is organ system-oriented. Conclusion: The curriculum is meant as a living document to be amended and revised at regular intervals. The curriculum can be used as a basis for individual curricular development at German Medical Faculties. It can be integrated into traditional or reformed medical teaching curricula. Key Points: • Radiology is an integral and important part of medical education.• The German Society of Radiology (DRG) developed a model curriculum for teaching radiology at German Medical Faculties to help students develop the ability to make medical decisions based on scientific knowledge and act accordingly.• This curriculum can be used for individual curricular development at medical departments. It is divided into two modules with several chapters. Citation Format: • Ertl-Wagner B, Barkhausen J, Mahnken AH et al. White Paper: Radiological Curriculum for Undergraduate Medical Education in Germany. Fortschr Röntgenstr 2016; 188: 1017 - 1023. © Georg Thieme Verlag KG Stuttgart · New York.

Have “new” methods in medical education reached German-speaking Central Europe: a survey

PubMed Central

2014-01-01

Background Simulation-based-training (SBT) in the education of health professionals is discussed as an effective alternative for knowledge and skills enhancement as well as for the establishment of a secure learning environment, for learners and patients. In the Anglo-American region, SBT and simulation and training centers (STC) are numbered as standard for medical training. In German-speaking Central Europe, priority is still given to the establishment of SBT and STC. The purpose of this study was (i) to survey the status quo relating to the existence and facilities of simulation and training centers at medical universities in German-speaking Central Europe and (ii) the evaluation of training methods, especially in the area of emergency medicine skills. Methods All public and private medical universities or medical faculties in Germany (36), Austria (4) and German-speaking Switzerland (3) were interviewed. In the survey, information regarding the existence and facilities of STCs and information with regards to the use of SBT in the area of emergency medicine was requested. The questions were partly posed in a closed-ended-, in an open-ended- and in a multiple choice format (with the possibility of selecting more than one answer). Results Of a total of 43 contacted medical universities/medical faculties, 40 ultimately participated in the survey. As decisive for the establishment of a STC the potential to improve the clinical-practical training and the demand by students were listed. Obligatory training in a STC during the first and sixth academic year was confirmed only by 12 institutions, before the first invasive procedure on patients by 17 institutions. 13 institutions confirmed the use of the STC for the further training of physicians and care-staff. Training for the acute care and emergency medicine skills in the field of pediatrics, for the most part, occurs decentralized. Conclusions New methods in medical training have reached German-speaking Central Europe, but the simulation and training centers vary in size, equipment or regarding their integration into the obligatory curriculum as much as the number and variety of the offering to be trained voluntarily or on an obligatory basis. PMID:25129398

Making Space for Adult Education in Independent Namibia

ERIC Educational Resources Information Center

Ellis, Justin

2004-01-01

Namibia is a vast and arid African country neighbouring South Africa, Botswana, Zimbabwe, Zambia, Angola and the Atlantic Ocean, with a population of only two million. Namibia achieved its independence in 1990 after a protracted and brutal struggle, latterly against South African occupation, but rooted in the resistance to German colonisation that…

Civil Defence Pedagogies and Narratives of Democracy: Disaster Education in Germany

ERIC Educational Resources Information Center

Chadderton, Charlotte

2015-01-01

"Disaster education" is a fledgling area of study in lifelong education. Many countries educate their populations for disasters, to mitigate potential damage and loss of life, as well as contribute to national security. In this paper, which draws on interview data from the German Federal Office for Civil Defence and Disaster Assistance…

HIGH SCHOOL ENROLLMENTS IN LATIN, 1964-65.

ERIC Educational Resources Information Center

GOLDBERG, SAMUEL A.

A MODERN LANGUAGE ASSOCIATION (MLA) STATISTICAL SURVEY SHOWS THE NUMBER OF STUDENTS STUDYING FRENCH, SPANISH, GERMAN, OR LATIN IN THE SECONDARY SCHOOLS DURING EACH SCHOOL YEAR FROM 1958-59 TO 1964-65, THE PERCENTAGE STUDYING EACH LANGUAGE IN RELATION TO THE TOTAL HIGH SCHOOL POPULATION, AND THE PERCENTAGE STUDYING LATIN IN RELATION TO THE TOTAL…

Income Comparisons among Neighbours and Satisfaction in East and West Germany

ERIC Educational Resources Information Center

Knies, Gundi

2012-01-01

A series of studies have suggested that changes in others' income may be perceived differently in post-transition and capitalist societies. This paper draws on the German Socio-economic Panel Study (SOEP) matched with micro-marketing indicators of population characteristics in very tightly drawn neighbourhoods to investigate whether reactions to…

Vowel Harmony: A Variable Rule in Brazilian Portuguese.

ERIC Educational Resources Information Center

Bisol, Leda

1989-01-01

Examines vowel harmony in the "Gaucho dialect" of the Brazilian state of Rio Grande do Sul. Informants from four areas of the state were studied: the capital city (Porto Alegre), the border region with Uruguay, and two areas of the interior populated by descendants of nineteenth-century immigrants from Europe, mainly Germans and…

Credentials versus Performance: Review of the Teacher Performance Pay Research

ERIC Educational Resources Information Center

Podgursky, Michael; Springer, Matthew G.

2007-01-01

In this article we examine the economic case for merit or performance-based pay for K-12 teachers. We review several areas of germane research. The direct evaluation literature on these incentive plans is slender; highly diverse in terms of methodology, targeted populations, and programs evaluated; and primarily focused on short-run motivational…

Foundations of an Age-Differentiated Adaptation of the Human-Computer Interface

ERIC Educational Resources Information Center

Schneider, N.; Schreiber, S.; Wilkes, J.; Grandt, M.; Schlick, C. M.

2008-01-01

An important issue of the demographic change in the German population is the maintenance and promotion of the employability of aging workforces. However, there are hardly any suitable concepts or usable tools available to realize this goal. Possible approaches should push the individual strengths of the aging workers to the foreground and…

[Instrument for the assessment of middle-aged and older adults' physical activity: design, eliability and application of the German-PAQ-50+].

PubMed

Huy, Christina; Schneider, Sven

2008-06-01

Existing physical activity questionnaires have focused either on young and middle-aged adults or on the elderly. They have mainly assessed only a portion of possible physical activities or contained nation-specific sports. As there is no gold standard for a questionnaire-based assessment of physical activity in the over-50 population, recommendations for such a questionnaire relating to German-speaking countries were developed. This work included a systematic literature research, a survey of experts, and the design of a questionnaire based on validated measuring instruments. Finally, to test its reliability and application in the field, the complete questionnaire, including a retest, was applied by telephone interview (n = 57). The test-retest-correlation was r = 0.60 for the total time of physical activity and r = 0.52 for total energy expenditure. The researchers determined that the instrument is comprehensive in its coverage of all relevant domains of physical activity for the over-50 population; it is economically feasible and showed good acceptance.

Analysis of biochemical genetic data on Jewish populations: II. Results and interpretations of heterogeneity indices and distance measures with respect to standards.

PubMed Central

Karlin, S; Kenett, R; Bonné-Tamir, B

1979-01-01

A nonparametric statistical methodology is used for the analysis of biochemical frequency data observed on a series of nine Jewish and six non-Jewish populations. Two categories of statistics are used: heterogeneity indices and various distance measures with respect to a standard. The latter are more discriminating in exploiting historical, geographical and culturally relevant information. A number of partial orderings and distance relationships among the populations are determined. Our concern in this study is to analyze similarities and differences among the Jewish populations, in terms of the gene frequency distributions for a number of genetic markers. Typical questions discussed are as follows: These Jewish populations differ in certain morphological and anthropometric traits. Are there corresponding differences in biochemical genetic constitution? How can we assess the extent of heterogeneity between and within groupings? Which class of markers (blood typings or protein loci) discriminates better among the separate populations? The results are quite surprising. For example, we found the Ashkenazi, Sephardi and Iraqi Jewish populations to be consistently close in genetic constitution and distant from all the other populations, namely the Yemenite and Cochin Jews, the Arabs, and the non-Jewish German and Russian populations. We found the Polish Jewish community the most heterogeneous among all Jewish populations. The blood loci discriminate better than the protein loci. A number of possible interpretations and hypotheses for these and other results are offered. The method devised for this analysis should prove useful in studying similarities and differences for other groups of populations for which substantial biochemical polymorphic data are available. PMID:380330

[Demography and donation frequencies of blood and plasma donor populations in Germany].

PubMed

Ritter, Sabine; Willand, L; Reinhard, B; Offergeld, R; Hamouda, O

2008-08-01

According to Article 22 of the Transfusion Act, the Robert Koch Institute collects and evaluates nationwide data on the prevalence and incidence of transfusion-relevant infections among blood and plasma donors in Germany. Due to revision of the Transfusion Act in 2005 not only the number of donations but also the number of donors has become available for analysis. Here we give a detailed account on the demographic profile and donation frequencies of German whole blood, plasma and platelet donors in 2006. Overall, 4 % of the German population eligible to donate were active as repeat whole blood donors in 2006; 0.3 % repeatedly donated plasma or platelets. Irrespective of the type of donation, the percentage of donors among the general population was highest among the youngest age group (18 to 24 years). While the age distribution of whole blood repeat donors roughly resembled that of the general population, with the greatest number among those aged 35 to 44, younger age groups were overrepresented among repeat plasma donors. Donation frequency varied depending on donor age and sex, with an average of 1.9 per year for whole blood donations, 11.9 for plasmapheresis and 4.0 for plateletpheresis. With the exception of the latter, men donated more frequently than women. For both sexes, donation frequency increased with age. Detailed knowledge of the demographic profile and changes in the composition of donor populations are essential for planning adequate blood supply. The data presented may serve as reference for assessing the consequences of measures that affect the number of donors and/or donations (for example changing deferral criteria) in Germany.

Contribution of Established Stroke Risk Factors to the Burden of Stroke in Young Adults.

PubMed

Aigner, Annette; Grittner, Ulrike; Rolfs, Arndt; Norrving, Bo; Siegerink, Bob; Busch, Markus A

2017-07-01

As stroke in young adults is assumed to have different etiologies and risk factors than in older populations, the aim of this study was to examine the contribution of established potentially modifiable cardiovascular risk factors to the burden of stroke in young adults. A German nationwide case-control study based on patients enrolled in the SIFAP1 study (Stroke In Young Fabry Patients) 2007 to 2010 and controls from the population-based GEDA study (German Health Update) 2009 to 2010 was performed. Cases were 2125 consecutive patients aged 18 to 55 years with acute first-ever stroke from 26 clinical stroke centers; controls (age- and sex-matched, n=8500, without previous stroke) were from a nationwide community sample. Adjusted population-attributable risks of 8 risk factors (hypertension, hyperlipidemia, diabetes mellitus, coronary heart disease, smoking, heavy episodic alcohol consumption, low physical activity, and obesity) and their combinations for all stroke, ischemic stroke, and primary intracerebral hemorrhage were calculated. Low physical activity and hypertension were the most important risk factors, accounting for 59.7% (95% confidence interval, 56.3-63.2) and 27.1% (95% confidence interval, 23.6-30.6) of all strokes, respectively. All 8 risk factors combined explained 78.9% (95% confidence interval, 76.3-81.4) of all strokes. Population-attributable risks of all risk factors were similar for all ischemic stroke subtypes. Population-attributable risks of most risk factors were higher in older age groups and in men. Modifiable risk factors previously established in older populations also account for a large part of stroke in younger adults, with 4 risk factors explaining almost 80% of stroke risk. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00414583. © 2017 American Heart Association, Inc.

Diapause termination of Rhagoletis cerasi pupae is regulated by local adaptation and phenotypic plasticity: escape in time through bet-hedging strategies.

PubMed

Moraiti, C A; Nakas, C T; Papadopoulos, N T

2014-01-01

Persistence and thriving of univoltine, herbivore insect species of the temperate zone rely on obligate diapause response that ensures winter survival and synchronization with host phenology. We used a stenophagous fruit fly (Rhagoletis cerasi) with obligate pupae diapause to determine genetic and environmental effects on diapause intensity of geographically isolated populations with habitat heterogeneity. Pupae from two Greek and one German populations with various gene flow rates were exposed at five constant chilling temperatures (0-12 °C) for different durations and then incubated at a high temperature until all adults have emerged. Pupae diapause intensity differs among Greek and German populations, suggesting an adaptive response to habitat heterogeneity (mostly differences in phenology patterns of local host cultivars). Moderately warm winter temperatures, such as 8 °C, promote diapause termination in all three populations. Insufficient chilling (short duration or warmer temperatures) regulates the expression of prolonged dormancy. Interestingly, extended chilling (longer than required for terminating diapause) 'return' pupae to another (facultative) cycle of dormancy enabling adults to emerge during the next appropriate 'window of time'; a strategy first time reported for univoltine insects. Consequently, diapause duration of R. cerasi is determined both by i) the adaptive response to local climatic conditions (annual dormancy) and ii) the plastic responses to interannual climatic variability resulting in two types of long life cycles within populations, prolonged and facultative dormancy as response to insufficient chilling and extended exposure to chilling, respectively. Long life cycles are expressed as a part of dormancy bet-hedging strategies of R. cerasi populations. © 2013 The Authors. Journal of Evolutionary Biology © 2013 European Society For Evolutionary Biology.

Prevalence of autosomal dominant polycystic kidney disease in the European Union.

PubMed

Willey, Cynthia J; Blais, Jaime D; Hall, Anthony K; Krasa, Holly B; Makin, Andrew J; Czerwiec, Frank S

2017-08-01

Autosomal dominant polycystic kidney disease (ADPKD) is a leading cause of end-stage renal disease, but estimates of its prevalence vary by >10-fold. The objective of this study was to examine the public health impact of ADPKD in the European Union (EU) by estimating minimum prevalence (point prevalence of known cases) and screening prevalence (minimum prevalence plus cases expected after population-based screening). A review of the epidemiology literature from January 1980 to February 2015 identified population-based studies that met criteria for methodological quality. These examined large German and British populations, providing direct estimates of minimum prevalence and screening prevalence. In a second approach, patients from the 2012 European Renal Association‒European Dialysis and Transplant Association (ERA-EDTA) Registry and literature-based inflation factors that adjust for disease severity and screening yield were used to estimate prevalence across 19 EU countries (N = 407 million). Population-based studies yielded minimum prevalences of 2.41 and 3.89/10 000, respectively, and corresponding estimates of screening prevalences of 3.3 and 4.6/10 000. A close correspondence existed between estimates in countries where both direct and registry-derived methods were compared, which supports the validity of the registry-based approach. Using the registry-derived method, the minimum prevalence was 3.29/10 000 (95% confidence interval 3.27-3.30), and if ADPKD screening was implemented in all countries, the expected prevalence was 3.96/10 000 (3.94-3.98). ERA-EDTA-based prevalence estimates and application of a uniform definition of prevalence to population-based studies consistently indicate that the ADPKD point prevalence is <5/10 000, the threshold for rare disease in the EU. © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA.

Encoding conditions affect recognition of vocally expressed emotions across cultures.

PubMed

Jürgens, Rebecca; Drolet, Matthis; Pirow, Ralph; Scheiner, Elisabeth; Fischer, Julia

2013-01-01

Although the expression of emotions in humans is considered to be largely universal, cultural effects contribute to both emotion expression and recognition. To disentangle the interplay between these factors, play-acted and authentic (non-instructed) vocal expressions of emotions were used, on the assumption that cultural effects may contribute differentially to the recognition of staged and spontaneous emotions. Speech tokens depicting four emotions (anger, sadness, joy, fear) were obtained from German radio archives and re-enacted by professional actors, and presented to 120 participants from Germany, Romania, and Indonesia. Participants in all three countries were poor at distinguishing between play-acted and spontaneous emotional utterances (58.73% correct on average with only marginal cultural differences). Nevertheless, authenticity influenced emotion recognition: across cultures, anger was recognized more accurately when play-acted (z = 15.06, p < 0.001) and sadness when authentic (z = 6.63, p < 0.001), replicating previous findings from German populations. German subjects revealed a slight advantage in recognizing emotions, indicating a moderate in-group advantage. There was no difference between Romanian and Indonesian subjects in the overall emotion recognition. Differential cultural effects became particularly apparent in terms of differential biases in emotion attribution. While all participants labeled play-acted expressions as anger more frequently than expected, German participants exhibited a further bias toward choosing anger for spontaneous stimuli. In contrast to the German sample, Romanian and Indonesian participants were biased toward choosing sadness. These results support the view that emotion recognition rests on a complex interaction of human universals and cultural specificities. Whether and in which way the observed biases are linked to cultural differences in self-construal remains an issue for further investigation.

[MusiQol: international questionnaire investigating quality of life in multiple sclerosis: validation results for the German subpopulation in an international comparison].

PubMed

Flachenecker, P; Vogel, U; Simeoni, M C; Auquier, P; Rieckmann, P

2011-10-01

The existing health-related quality of life questionnaires on multiple sclerosis (MS) only partially reflect the patient's point of view on the reduction of activities of daily living. Their development and validation was not performed in different languages. That is what prompted the development of the Multiple Sclerosis International Quality of Life (MusiQoL) Questionnaire as an international multidimensional measurement instrument. This paper presents this new development and the results of the German subgroup versus the total international sample. A total of 1,992 MS patients from 15 countries, including 209 German patients, took part in the study between January 2004 and February 2005. The patients took the MusiQoL survey at baseline and at 21±7 days as well as completing a symptom-related checklist and the SF-36 short form survey. Demographics, history and MS classification data were also generated. Reproducibility, sensitivity, convergent and discriminant validity were analysed. Convergent and discriminant validity and reproducibility were satisfactory for all dimensions of the MusiQoL. The dimensional scores correlated moderately but significantly with the SF-36 scores, but showed a discriminant validity in terms of gender, socioeconomic status and health status that was more pronounced in the overall population than in the German subpopulation. The highest correlations were observed between the MusiQoL dimension of activities of daily living and the Expanded Disability Status Scale (EDSS). The results of this study confirm the validity and reliability of MusiQoL as an instrument for measuring the quality of life of German and international MS patients.

The incidence of hypertension and its risk factors in the German adult population: results from the German National Health Interview and Examination Survey 1998 and the German Health Interview and Examination Survey for Adults 2008-2011.

PubMed

Diederichs, Claudia; Neuhauser, Hannelore

2017-02-01

To analyze incident hypertension and its risk factors based on 11.9 years follow-up of a recent National Examination Survey cohort in Germany. Out of 7124 participants of the German National Health Interview and Examination Survey 1998 (GNHIES98), 640 had died at follow-up 2008-2011 and 3045 were reexamined as part of the German Health Interview and Examination Survey for Adults 2008-2011 (DEGS1). Baseline and follow-up included standardized blood pressure (BP) measurements. Hypertension was defined as BP of at least 140/90 mmHg or intake of antihypertensive medication in participants with known hypertension. Out of 2231 GNHIES98-DEGS1 participants aged 18-79 years without hypertension in 1998, 26.2% developed hypertension within a mean of 11.9 (range 10.0-14.1) years (men 29.0%, women 23.4%). In univariate analysis, hypertension incidence was positively associated with age, BMI, initial BP levels, pulse pressure, and alcohol consumption. Comorbidities such as diabetes and hyperlipidemia increased the chance to develop hypertension. In the multivariate model, initial SBP and DBP levels had the strongest influence on the development of future hypertension (7% increase in men and 5% in women per mmHg SBP). The percentage of aware, treated, and controlled hypertensive patients were 75.8, 62.1, and 50.3% in men and 83.8, 73.3, and 59.0% in women. The high 11.9-year incidence in all age groups points to the lifelong potential for prevention of hypertension.

On the origin and diffusion of BRCA1 c.5266dupC (5382insC) in European populations

PubMed Central

Hamel, Nancy; Feng, Bing-Jian; Foretova, Lenka; Stoppa-Lyonnet, Dominique; Narod, Steven A; Imyanitov, Evgeny; Sinilnikova, Olga; Tihomirova, Laima; Lubinski, Jan; Gronwald, Jacek; Gorski, Bohdan; Hansen, Thomas v O; Nielsen, Finn C; Thomassen, Mads; Yannoukakos, Drakoulis; Konstantopoulou, Irene; Zajac, Vladimir; Ciernikova, Sona; Couch, Fergus J; Greenwood, Celia M T; Goldgar, David E; Foulkes, William D

2011-01-01

The BRCA1 mutation c.5266dupC was originally described as a founder mutation in the Ashkenazi Jewish (AJ) population. However, this mutation is also present at appreciable frequency in several European countries, which raises intriguing questions about the origins of the mutation. We genotyped 245 carrier families from 14 different population groups (Russian, Latvian, Ukrainian, Czech, Slovak, Polish, Danish, Dutch, French, German, Italian, Greek, Brazilian and AJ) for seven microsatellite markers and confirmed that all mutation carriers share a common haplotype from a single founder individual. Using a maximum likelihood method that allows for both recombination and mutational events of marker loci, we estimated that the mutation arose some 1800 years ago in either Scandinavia or what is now northern Russia and subsequently spread to the various populations we genotyped during the following centuries, including the AJ population. Age estimates and the molecular evolution profile of the most common linked haplotype in the carrier populations studied further suggest that c.5266dupC likely entered the AJ gene pool in Poland approximately 400–500 years ago. Our results illustrate that (1) BRCA1 c.5266dupC originated from a single common ancestor and was a common European mutation long before becoming an AJ founder mutation and (2) the mutation is likely present in many additional European countries where genetic screening of BRCA1 may not yet be common practice. PMID:21119707

Genetics of the peloponnesean populations and the theory of extinction of the medieval peloponnesean Greeks

PubMed Central

Stamatoyannopoulos, George; Bose, Aritra; Teodosiadis, Athanasios; Tsetsos, Fotis; Plantinga, Anna; Psatha, Nikoletta; Zogas, Nikos; Yannaki, Evangelia; Zalloua, Pierre; Kidd, Kenneth K; Browning, Brian L; Stamatoyannopoulos, John; Paschou, Peristera; Drineas, Petros

2017-01-01

Peloponnese has been one of the cradles of the Classical European civilization and an important contributor to the ancient European history. It has also been the subject of a controversy about the ancestry of its population. In a theory hotly debated by scholars for over 170 years, the German historian Jacob Philipp Fallmerayer proposed that the medieval Peloponneseans were totally extinguished by Slavic and Avar invaders and replaced by Slavic settlers during the 6th century CE. Here we use 2.5 million single-nucleotide polymorphisms to investigate the genetic structure of Peloponnesean populations in a sample of 241 individuals originating from all districts of the peninsula and to examine predictions of the theory of replacement of the medieval Peloponneseans by Slavs. We find considerable heterogeneity of Peloponnesean populations exemplified by genetically distinct subpopulations and by gene flow gradients within Peloponnese. By principal component analysis (PCA) and ADMIXTURE analysis the Peloponneseans are clearly distinguishable from the populations of the Slavic homeland and are very similar to Sicilians and Italians. Using a novel method of quantitative analysis of ADMIXTURE output we find that the Slavic ancestry of Peloponnesean subpopulations ranges from 0.2 to 14.4%. Subpopulations considered by Fallmerayer to be Slavic tribes or to have Near Eastern origin, have no significant ancestry of either. This study rejects the theory of extinction of medieval Peloponneseans and illustrates how genetics can clarify important aspects of the history of a human population. PMID:28272534

["Practical clinical competence" - a joint programme to improve training in surgery].

PubMed

Ruesseler, M; Schill, A; Stibane, T; Damanakis, A; Schleicher, I; Menzler, S; Braunbeck, A; Walcher, F

2013-12-01

Practical clinical competence is, as a result of the complexity of the required skills and the immediate consequences of their insufficient mastery, fundamentally important for undergraduate medical education. However, in the daily clinical routine, undergraduate training competes with patient care and experimental research, mostly to the disadvantage of the training of clinical skills and competencies. All students have to spend long periods in compulsory surgical training courses during their undergraduate studies. Thus, surgical undergraduate training is predestined to exemplarily develop, analyse and implement a training concept comprising defined learning objectives, elaborated teaching materials, analysed teaching methods, as well as objective and reliable assessment methods. The aim of this project is to improve and strengthen undergraduate training in practical clinical skills and competencies. The project is funded by the German Federal Ministry of Education and Research with almost two million Euro as a joint research project of the medical faculties of the universities of Frankfurt/Main, Gießen and Marburg, in collaboration with the German Society of Surgery, the German Society of Medical Education and the German Medical Students' Association. Nine packages in three pillars are combined in order to improve undergraduate medical training on a methodical, didactic and curricular level in a nation-wide network. Each partner of this network provides a systematic contribution to the project based on individual experience and competence. Based on the learning objectives, which were defined by the working group "Education" of the German Society of Surgery, teaching contents will be analysed with respect to their quality and will be available for both teachers and students as mobile learning tool (first pillar). The existing surgical curricula at the cooperating medical faculties will be analysed and teaching methods as well as assessment methods for clinical skills will be evaluated regarding their methodological quality and evidence. The existing surgical curricula will be revised and adapted on the basis of these results (second pillar). Qualification programmes for physicians will be implemented in order to improve both undergraduate education and the attractiveness of educational research, the required teaching quality will be imparted in a nationwide "train-the-teacher" program for surgical clinical skills (third pillar). Georg Thieme Verlag KG Stuttgart · New York.

Association of occupation with prevalent hypertension in an elderly East German population: an exploratory cross-sectional analysis.

PubMed

Schumann, Barbara; Seidler, Andreas; Kluttig, Alexander; Werdan, Karl; Haerting, Johannes; Greiser, Karin Halina

2011-04-01

Hypertension is one of the most relevant risk factors for cardiovascular disease; however, little is known about differences in hypertension by occupation. The aim of this study was to explore the association between occupational group and prevalent hypertension. Cross-sectional data of the CARLA study were used, a representative sample of an East German population aged 45-83. Job titles of the current or last held occupation of 967 men and 808 women were coded using the German classification of occupation. Hypertension was defined as blood pressure of ≥140 mmHg (systolic), ≥90 mmHg (diastolic) or use of antihypertensives. Sex-stratified, age-adjusted prevalence risk ratios (PR) with 95% confidence intervals (CI) were calculated for 31 occupational groups. Hypertension was prevalent in 79% of the population. In men, highest age-adjusted prevalence ratios were observed in metal-processing workers, carpenters/painters, and electricians with PRs of 1.31 (CI 1.04-1.65), 1.28 (CI 1.00-1.64), and 1.21 (0.95-1.53), respectively, compared to office clerks. In women, highest PRs were found in technicians/forewomen, scrutinisers/storekeepers, and food-processing occupations with PR 1.28 (1.09-1.49), 1.23 (0.99-1.51), and 1.22 (1.01-1.48), respectively. Adjustment for education, smoking, body mass index, and current work hours did not fully explain occupational differences. Excluding currently non-working subjects lead to decreased PRs in men and to increased PR in women. Differences in the prevalences of hypertension by occupational group were only partly explained by conventional risk factors and may require workplace interventions targeted at high-risk occupations. Longitudinal data with large cohorts and work-related exposure assessment are needed to confirm a temporal relationship between occupation and incident hypertension.

German Beck Scale for Suicide Ideation (BSS): psychometric properties from a representative population survey.

PubMed

Kliem, Sören; Lohmann, Anna; Mößle, Thomas; Brähler, Elmar

2017-12-04

Suicidal ideation has been identified as one of the major predictors of attempted or actual suicide. Routinely screening individuals for endorsing suicidal thoughts could save lives and protect many from severe psychological consequences following the suicide of loved ones. The aim of this study was to validate the German version of the Beck Scale for Suicide Ideation (BSS) in a sample representative for the Federal Republic of Germany. All 2450 participants completed the first part of the Scale, the BSS-Screen. A risk group of n = 112 individuals (4.6%) with active or passive suicidal ideation was identified and subsequently completed the entire BSS. Satisfactory internal reliability (α = .97 for the BSS-Screen; α = .94 for the entire BSS) and excellent model fit indices for the one-dimensional factorial structure of the BSS-Screen (CFI = .998; TLI = .995; RMSEA = .045 [95%-CI: .030-.061]) were confirmed. Measurement invariance analyses supported strict invariance across gender, age, and depression status. We found correlations with related self-report measures in expected directions comparable to previous studies, indicating satisfactory construct validity. Our study involved cross sectional data, hence neither predictive validity nor retest-reliability were examined. As only the risk group of n = 112 individuals completed the entire measure, confirmatory factor analyses could not be conducted for the full BSS. The German translation of the BSS is a reliable and valid instrument for assessing suicidal ideation in the general population. Using it as a screening device in general and specialized medical care could substantially advance suicide prevention.

The epidemiology of sickle cell disease in Germany following recent large-scale immigration.

PubMed

Kunz, Joachim B; Cario, Holger; Grosse, Regine; Jarisch, Andrea; Lobitz, Stephan; Kulozik, Andreas E

2017-07-01

The epidemiology of sickle cell disease (SCD) in Germany is currently changing fundamentally with ongoing immigration. Here, we address the challenges resulting from the increased frequency, that is, the morbidity, and mortality of SCD in this population. The number of immigrants with SCD was estimated based on the data of the German central registry of migrants (2007-2015) and published epidemiologic data. Additional data analysis was based on nationwide aggregated data from the diagnosis-related groups' (DRG) statistics of the German Federal Statistical Office. The total number of patients with SCD among migrants was estimated at 2,016 in 2007 and 3,216 in 2015, thus showing a 60% increase, which was particularly remarkable during 2014 and 2015. The countries of origin included those of West sub-Saharan Africa, followed by Syria, and other countries of the Middle East. In parallel, the number of SCD inpatient treatments increased from 780 in 2002 to 1,340 in 2015. Between 2012 and 2014, 42 patients with SCD died in hospital, mostly at an age of less than 5 years (n = 7) or over 30 years (n = 29). More than 3,000 patients with SCD are estimated to live among the immigrant population in Germany. In addition, the number of SCD patients of German nationality is not known. The increasing number of inpatient treatments and the death of young children from SCD indicate the need for a general newborn screening program and an increased awareness of this disease among medical practitioners in a country in which SCD used to be rare. © 2017 Wiley Periodicals, Inc.

Job stress and job satisfaction of physicians in private practice: comparison of German and Norwegian physicians.

PubMed

Voltmer, Edgar; Rosta, Judith; Siegrist, Johannes; Aasland, Olaf G

2012-10-01

This study examined job satisfaction and job stress of German compared to Norwegian physicians in private practice. A representative sample of physicians in private practice of Schleswig-Holstein, Germany (N = 414) and a nationwide sample of Norwegian general practitioners and private practice specialists (N = 340) were surveyed in a cross-sectional design in 2010. The questionnaire comprised the standard instruments "Job Satisfaction Scale (JSS)" and a short form of the "Effort-Reward Imbalance Questionnaire (ERI)". Norwegian physicians scored significantly higher (<0.01) on all items of the job satisfaction scale compared to German physicians (M 5.57, SD 0.74 vs. M 4.78, SD 1.01). The effect size was highest for the items freedom to choose method (d = 1.012), rate of pay (d = 0.941), and overall job satisfaction (d = 0.931). While there was no significant difference in the mean of the overall effort scale between German and Norwegian physicians, Norwegian physicians scored significantly higher (p < 0.01) on the reward scale. A larger proportion of German physicians (27.6%) presented with an effort/reward ratio beyond 1.0, indicating a risky level of work-related stress, compared to only 10.3% of Norwegian physicians. Working hours, effort, reward, and country differences accounted for 37.4% of the explained variance of job satisfaction. Job satisfaction and reward were significantly higher in Norwegian than in German physicians. An almost threefold higher proportion of German physicians exhibited a high level of work-related stress. Findings call for active prevention and health promotion among stressed practicing physicians, with a special focus on improved working conditions.

T-complex measures in bilingual Spanish-English and Turkish-German children and monolingual peers

PubMed Central

Rinker, Tanja; Shafer, Valerie L.; Kiefer, Markus; Vidal, Nancy; Yu, Yan H.

2017-01-01

Background Lateral temporal neural measures (Na and T-complex Ta and Tb) of the auditory evoked potential (AEP) index maturation of auditory/speech processing. These measures are also sensitive to language experience in adults. This paper examined neural responses to a vowel sound at temporal electrodes in four- to five-year-old Spanish-English bilinguals and English monolinguals and in five- to six-year-old Turkish-German bilinguals and German monolinguals. The goal was to determine whether obligatory AEPs at temporal electrode sites were modulated by language experience. Language experience was defined in terms of monolingual versus bilingual status as well as the amount and quality of the bilingual language experience. Method AEPs were recorded at left and right temporal electrode sites to a 250-ms vowel [Ɛ] from 20 monolingual (American)-English and 18 Spanish-English children from New York City, and from 11 Turkish-German and 13 monolingual German children from Ulm, Germany. Language background information and standardized verbal and non-verbal test scores were obtained for the children. Results The results revealed differences in temporal AEPs (Na and Ta of the T-complex) between monolingual and bilingual children. Specifically, bilingual children showed smaller and/or later peak amplitudes than the monolingual groups. Ta-amplitude distinguished monolingual and bilingual children best at right electrode sites for both the German and American groups. Amount of experience and type of experience with the target language (English and German) influenced processing. Conclusions The finding of reduced amplitudes at the Ta latency for bilingual compared to monolingual children indicates that language specific experience, and not simply maturational factors, influences development of the neural processes underlying the Ta AEP, and suggests that lateral temporal cortex has an important role in language-specific speech perception development. PMID:28267801

Is German Medical Education Research on the rise? An analysis of publications from the years 2004 to 2013

PubMed Central

Ackel-Eisnach, Kristina; Raes, Patricia; Hönikl, Lisa; Bauer, Daniel; Wagener, Stefan; Möltner, Andreas; Jünger, Jana; Fischer, Martin R.

2015-01-01

Objectives: The point of departure for the present work is the observation that, in comparison with Anglo-American countries or the Netherlands, Germany was responsible for only a marginal number of international publications in the field of medical education research before 2004. Recent years, however, have seen an increase in the importance of medical education research in Germany. The objective of this article is to evaluate the extent to which this trend can be substantiated by increased German publishing activity since the year 2004 in international, English-language journals in the subject area of “medical education research”. Methods: In the framework of a literature and content analysis, German-author articles from the years 2004 to 2013 in six international, English-language medical education research journals were evaluated. In order to obtain an overview of German research activity in this area, all project and original works with German first and last authors were identified and subjected to a more in-depth content analysis. Results: In total, 10,055 articles were examined. The evaluation shows that between the years 2004 and 2013 179 articles (of which 145 are project or original works) by German authors were published in the journals examined. Fluctuations over the course of time were evidenced. The project and original works are primarily cross-sectional studies (27.8%) and randomised control studies (25.6%) on the subject of “teaching and learning methods” (43.6%). Conclusions: In comparison with the years 2004-2008, a significant rise can be seen in the number of publications by German education researchers in international journals since the year 2009. PMID:26413168

Prevalence of ‘Food Addiction’ as Measured with the Yale Food Addiction Scale 2.0 in a Representative German Sample and Its Association with Sex, Age and Weight Categories

PubMed Central

Hauck, Carolin; Weiß, Annegret; Schulte, Erica Marla; Meule, Adrian; Ellrott, Thomas

2017-01-01

Background/Aims To assess the prevalence and correlates of addictive-like eating behavior in Germany. Methods The German version of the Yale Food Addiction Scale (YFAS) 2.0 was used to investigate, for the first time, the prevalence of ‘food addiction’ in a representative sample aged 18–65 years (N = 1,034). Results The prevalence of ‘food addiction’ measured by the YFAS 2.0 was 7.9%. Individuals meeting criteria for ‘food addiction’ had higher BMI and were younger than individuals not meeting the threshold. Underweight (15.0%) and obese (17.2%) individuals exhibited the highest prevalence rate of ‘food addiction’. Addictive-like eating was not associated with sex, education level, or place of residence. Conclusion YFAS 2.0 ‘food addiction’ was met by nearly 8% of the population. There is a non-linear relationship between addictive-like eating and BMI, with the highest prevalence among underweight and obese persons. These findings suggest that ‘food addiction’ may be a contributor to overeating but may also reflect a distinct phenotype of problematic eating behavior not synonymous with obesity. Further, the elevated prevalence of YFAS 2.0 ‘food addiction’ among underweight individuals may reflect an overlap with eating disorders and warrants attention in future research. PMID:28190017

[Citation rates of medical German-language journals in English-language papers--do they correlate with the impact factor, and who cites? (reprint)].

PubMed

Winkmann, G; Schlutius, S; Schweim, H G

2002-01-01

Several publications are warning that the German language is no longer needed for transmission of scientific data. One of the causes may be the Impact Factor (IF), which appears to be derived predominantly from Anglo-American journals. The aim of this study was to check actual international attention paid to German-language journals, i. e. their citation frequencies in English-language papers. Are these citing rates in English-language articles correlated to the IF, and from where do citing articles originate? Of 25 arbitrarily selected > 85 % German-language medical journals, IF as well as language distributions of citing articles were determined by searching publication years 1995 - 2000 in Science Citation Index (SCI). MEDLINE and EMBASE were used as supplementary retrieval systems. (i) The sample journals displayed an average IF = 0.357. A 99 % correlation (Pearson factor r = 0.987; n = 25) was observed between our "constructed" IF 2000 and IF published in Journal Citation Report 2000. This proves Stegmann's IF determination method to be valid. On the average, 53 % German-language and 45 % English-language articles between 1995 - 2000 cited the 1995 - 1999' contributions of the studied journals. No correlation was observed between IF vs. rates of citing articles in English (r < 0.1). 64 % of citing English-language articles showed corporate sources in Germany/Austria/Switzerland, and 13.5 % authors' institutions in USA. (i) An IF >/= 1 is, obviously, very hard to attain by German-language journals. ISI's differentiation between Citing vs. Cited-only Journals (the latter often serving as MEDLINE/EMBASE sources) during derivation of IF appears unjustified. (ii) English now serves as the predominant communication language in sciences in German-speaking countries, but has not supplanted the German language. Our study reveals remarkable international attention rates remaining.

Das Licht am Ende des Tunnels: Motivationsstrukturen fur den Deutschunterricht Reflexionen uber ein altes und stets neues Problem (The Light at the End of the Tunnel: Structures for Motivating German Teaching. Reflections on an Old and Continually New Problem).

ERIC Educational Resources Information Center

Classen, Albrecht

2001-01-01

Argues that despite the decline in enrollments in German at elementary and secondary schools and colleges and universities, there is reason to hope that interest can be invigorated. Suggests that there are easy instructional methods and materials for developing a new motivation in learning the language. (Author/VWL)

Skin care practice in German nursing homes: a German-wide cross-sectional study.

PubMed

Kottner, Jan; Rahn, Yasmin; Blume-Peytavi, Ulrike; Lahmann, Nils

2013-04-01

Due to anatomical and physiological changes in the course of aging and due to increased vulnerability, there are special skin care needs in elderly and care-dependent persons. Little is known about skin care practice in German long-term care facilities. The aim of the study was to gather epidemiological data about skin care practice in German nursing homes. In spring 2012 a German-wide cross sectional study was conducted in 47 nursing homes. Based on standardized data collection sheets. demographics and variables about methods and frequencies of skin cleansing and application of skin care products for 3 552 nursing home residents were collected and analyzed. The variables age, gender and level of care dependency was representative for the group of all German nursing home residents. More than 90% of investigated nursing home residents required skin care assistance. Washing body parts or the whole body were conducted most frequently (89.1%, 95% CI 88.0- 90.1). Skin care leave-on products were used in 91.7% (95% CI 90.7-92.6), whereas there were large variations between individuals. In total, more than 100 brands were used. Skin care practice in multimorbid care dependent persons shows large variations. How skin care products meet the special requirements of aged skin and whether they enhance the skin barrier function and prevent cuteneous skin damage is unknown. © The Authors • Journal compilation © Blackwell Verlag GmbH, Berlin.

Abridged version of the AWMF guideline for the medical clinical diagnostics of indoor mould exposure: S2K Guideline of the German Society of Hygiene, Environmental Medicine and Preventive Medicine (GHUP) in collaboration with the German Association of Allergists (AeDA), the German Society of Dermatology (DDG), the German Society for Allergology and Clinical Immunology (DGAKI), the German Society for Occupational and Environmental Medicine (DGAUM), the German Society for Hospital Hygiene (DGKH), the German Society for Pneumology and Respiratory Medicine (DGP), the German Mycological Society (DMykG), the Society for Pediatric Allergology and Environmental Medicine (GPA), the German Federal Association of Pediatric Pneumology (BAPP), and the Austrian Society for Medical Mycology (ÖGMM).

PubMed

Wiesmüller, Gerhard A; Heinzow, Birger; Aurbach, Ute; Bergmann, Karl-Christian; Bufe, Albrecht; Buzina, Walter; Cornely, Oliver A; Engelhart, Steffen; Fischer, Guido; Gabrio, Thomas; Heinz, Werner; Herr, Caroline E W; Kleine-Tebbe, Jörg; Klimek, Ludger; Köberle, Martin; Lichtnecker, Herbert; Lob-Corzilius, Thomas; Merget, Rolf; Mülleneisen, Norbert; Nowak, Dennis; Rabe, Uta; Raulf, Monika; Seidl, Hans Peter; Steiß, Jens-Oliver; Szewszyk, Regine; Thomas, Peter; Valtanen, Kerttu; Hurraß, Julia

2017-01-01

This article is an abridged version of the AWMF mould guideline "Medical clinical diagnostics of indoor mould exposure" presented in April 2016 by the German Society of Hygiene, Environmental Medicine and Preventive Medicine ( Gesellschaft für Hygiene, Umweltmedizin und Präventivmedizin, GHUP ), in collaboration with the above-mentioned scientific medical societies, German and Austrian societies, medical associations and experts. Indoor mould growth is a potential health risk, even if a quantitative and/or causal relationship between the occurrence of individual mould species and health problems has yet to be established. Apart from allergic bronchopulmonary aspergillosis (ABPA) and mould-caused mycoses, only sufficient evidence for an association between moisture/mould damage and the following health effects has been established: allergic respiratory disease, asthma (manifestation, progression and exacerbation), allergic rhinitis, hypersensitivity pneumonitis (extrinsic allergic alveolitis), and increased likelihood of respiratory infections/bronchitis. In this context the sensitizing potential of moulds is obviously low compared to other environmental allergens. Recent studies show a comparatively low sensitizing prevalence of 3-10% in the general population across Europe. Limited or suspected evidence for an association exist with respect to mucous membrane irritation and atopic eczema (manifestation, progression and exacerbation). Inadequate or insufficient evidence for an association exist for chronic obstructive pulmonary disease, acute idiopathic pulmonary hemorrhage in children, rheumatism/arthritis, sarcoidosis and cancer. The risk of infection posed by moulds regularly occurring indoors is low for healthy persons; most species are in risk group 1 and a few in risk group 2 ( Aspergillus fumigatus, A. flavus ) of the German Biological Agents Act ( Biostoffverordnung ). Only moulds that are potentially able to form toxins can be triggers of toxic reactions. Whether or not toxin formation occurs in individual cases is determined by environmental and growth conditions, above all the substrate. In the case of indoor moisture/mould damage, everyone can be affected by odour effects and/or mood disorders. However, this is not a health hazard. Predisposing factors for odour effects can include genetic and hormonal influences, imprinting, context and adaptation effects. Predisposing factors for mood disorders may include environmental concerns, anxiety, condition, and attribution, as well as various diseases. Risk groups to be protected particularly with regard to an infection risk are persons on immunosuppression according to the classification of the German Commission for Hospital Hygiene and Infection Prevention ( Kommission für Krankenhaushygiene und Infektionsprävention, KRINKO ) at the Robert Koch- Institute (RKI) and persons with cystic fibrosis (mucoviscidosis); with regard to an allergic risk, persons with cystic fibrosis (mucoviscidosis) and patients with bronchial asthma should be protected. The rational diagnostics include the medical history, physical examination, and conventional allergy diagnostics including provocation tests if necessary; sometimes cellular test systems are indicated. In the case of mould infections the reader is referred to the AWMF guideline "Diagnosis and Therapy of Invasive Aspergillus Infections". With regard to mycotoxins, there are currently no useful and validated test procedures for clinical diagnostics. From a preventive medicine standpoint it is important that indoor mould infestation in relevant dimension cannot be tolerated for precautionary reasons. With regard to evaluating the extent of damage and selecting a remedial procedure, the reader is referred to the revised version of the mould guideline issued by the German Federal Environment Agency ( Umweltbundesamt, UBA ).

Visualization of Genome Diversity in German Shepherd Dogs.

PubMed

Mortlock, Sally-Anne; Booth, Rachel; Mazrier, Hamutal; Khatkar, Mehar S; Williamson, Peter

2015-01-01

A loss of genetic diversity may lead to increased disease risks in subpopulations of dogs. The canine breed structure has contributed to relatively small effective population size in many breeds and can limit the options for selective breeding strategies to maintain diversity. With the completion of the canine genome sequencing project, and the subsequent reduction in the cost of genotyping on a genomic scale, evaluating diversity in dogs has become much more accurate and accessible. This provides a potential tool for advising dog breeders and developing breeding programs within a breed. A challenge in doing this is to present complex relationship data in a form that can be readily utilized. Here, we demonstrate the use of a pipeline, known as NetView, to visualize the network of relationships in a subpopulation of German Shepherd Dogs.

Global warming's five Germanys: A typology of Germans' views on climate change and patterns of media use and information.

PubMed

Metag, Julia; Füchslin, Tobias; Schäfer, Mike S

2017-05-01

People's attitudes toward climate change differ, and these differences may correspond to distinct patterns of media use and information seeking. However, studies extending analyses of attitude types and their specific media diets to countries beyond the United States are lacking. We use a secondary analysis of survey data from Germany to identify attitudes toward climate change among the German public and specify those segments of the population based on their media use and information seeking. Similar to the Global Warming's Six Americas study, we find distinct attitudes (Global Warming's Five Germanys) that differ in climate change-related perceptions as well as in media use and communicative behavior. These findings can help tailor communication campaigns regarding climate change to specific audiences.

Use of herbal medicinal products among children and adolescents in Germany

PubMed Central

2014-01-01

Background Germany is a country with a high use of herbal medicinal products. Population-based data on the use of herbal medicinal products among children are lacking. The aim of this study is to investigate the prevalence, patterns and determinants of herbal medicine use among children and adolescents in Germany. Methods As data base served the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), a representative population based survey conducted 2003–2006 by the Robert Koch Institute. 17,450 boys and girls aged 0–17 years provided information on drug use in the preceding seven days. Herbal medicinal products were defined according to the European and German drug laws. SPSS Complex Sample method was used to estimate prevalence rates and factors associated with herbal medicine use. Results The prevalence rate of herbal medicinal product use amounts to 5.8% (95% confidence interval 5.3-6.3%). Use of herbal medicine declines along with increasing age and shows no difference between boys and girls in younger age groups. Teenage girls are more likely to use herbal medicines than teenage boys. Two thirds of herbal medicines are used for the treatment of coughs and colds; nearly half of herbal medicines are prescribed by medical doctors. Determinants of herbal medicinal product use are younger age, residing in South Germany, having a poor health status, having no immigration background and coming from a higher social class family. Children’s and parents-related health behavior is not found to be associated with herbal medicine use after adjusting for social class. Conclusions Use of herbal medicinal products among children and adolescents between the ages of 0 and 17 years in Germany is widely spread and shows relatively higher rates compared to international data. This study provides a reference on the use of herbal medicinal products for policy-makers, health professionals and parents. Further studies are needed to investigate the effectiveness and safety of specific herbal medicinal products, potential effects of long term use as well as possible interactions of herbal medicinal products with concomitantly used conventional medicines. PMID:24988878

Multilingual Practices of University Students and Changing Forms of Multilingualism in Luxembourg

ERIC Educational Resources Information Center

de Bres, Julia; Franziskus, Anne

2014-01-01

With its own national language, Luxembourgish, and three languages of administration, French, German and Luxembourgish, Luxembourg has long been a very multilingual country. The nature of this multilingualism is now changing, due to the rising proportion of migrants in the country, who now make up 43% of the resident population. The changing…

Cross-Linguistic Expression of Contrastive Accent: Clinical Assessment in Spanish and English

ERIC Educational Resources Information Center

Martinez-Castilla, Pastora; Peppe, Sue

2010-01-01

Well-documented Romance-Germanic differences in the use of accent in speech to convey information-structure and focus cause problems for the assessment of prosodic skills in populations with clinical disorders. The strategies for assessing the ability to use lexical and contrastive accent in English and Spanish are reviewed, and studies in the…

Workload and quality of life of surgeons. Results and implications of a large-scale survey by the German Society of Surgery.

PubMed

Bohrer, Thomas; Koller, Michael; Schlitt, Hans Juergen; Bauer, Hartwig

2011-06-01

Quality of life is of vital importance for patients undergoing surgery. However, little is known about the quality of life of surgeons who are facing a stressful and dramatically changing working environment. For this reason, this large-scale study investigated the quality of life (QL) of surgeons in Germany in the context of occupational, private, and system-related risk factors. The study population consisted of attendees (surgeons, non-surgical physicians, medical students) of the nine major annual conferences of the German Society of Surgery between 2008 and 2009. Participants filled in a single questionnaire including study-specific questions (demographic variables, professional position, and occupational situation) and a standardized quality of life instrument (Profiles of quality of life of the chronically ill, PLC). Surgeons' responses with regard to their professional situation and their quality of life were contrasted with those of the two controls (non-surgical physicians, medical students). Furthermore, PLC scores were compared with German population reference data and with reference data of several patient groups. Individuals (3,652) (2,991 surgeons, 561 non-surgical physicians, 100 medical students) participated in this study. The average age of surgeons and non-surgeons was in the low forties. In terms of professional qualifications, the majority of surgeons were residents (30%) and the majority of non-surgeons consultants in private practice (38%). Sixty-eight percent of the surgeons, only 39% of the non-surgeons worked more than 60 h per week on average (p < 0.001). Surgeons regarded their administrative workload as high (67% vs. controls 57%, p < 0.001). Surgeons reported restrictions on their private and family life due to work overload, more so than non-surgeons (74% vs. 59%, p < 0.001). Of the surgeons, 40% regarded their quality of life as worse than that of the general public (non-surgeons, 22%; p < 0.001). A third (32%) of the surgeons considered their quality of life even lower than that of their patients (non-surgeons, 17%; p < 0.001). Responses to the PLC quality of life questionnaire confirmed these results, showing score values lower than those of the German population reference data and of several patient groups. Multiple regression analyses showed that the strongest and most consistent influence variable for a low quality of life on all eight quality of life scores were restrictions in private life (range of standardized beta weights beta = 0.259 to 0.325), hierarchical and uncooperative working environment (beta = 0.057 to 0.235), lack of opportunities for continuing education (beta = 0.108 to 0.161), and inadequate salary (beta = 0.036 to 0.172). Improving the working conditions for surgeons requires a concerted action of all relevant parties, including hospital administrators, insurance companies, and the German Society of Surgery. The present study clearly identified measures that should be taken.

An adaptive design for updating the threshold value of a continuous biomarker

PubMed Central

Spencer, Amy V.; Harbron, Chris; Mander, Adrian; Wason, James; Peers, Ian

2017-01-01

Potential predictive biomarkers are often measured on a continuous scale, but in practice, a threshold value to divide the patient population into biomarker ‘positive’ and ‘negative’ is desirable. Early phase clinical trials are increasingly using biomarkers for patient selection, but at this stage, it is likely that little will be known about the relationship between the biomarker and the treatment outcome. We describe a single-arm trial design with adaptive enrichment, which can increase power to demonstrate efficacy within a patient subpopulation, the parameters of which are also estimated. Our design enables us to learn about the biomarker and optimally adjust the threshold during the study, using a combination of generalised linear modelling and Bayesian prediction. At the final analysis, a binomial exact test is carried out, allowing the hypothesis that ‘no population subset exists in which the novel treatment has a desirable response rate’ to be tested. Through extensive simulations, we are able to show increased power over fixed threshold methods in many situations without increasing the type-I error rate. We also show that estimates of the threshold, which defines the population subset, are unbiased and often more precise than those from fixed threshold studies. We provide an example of the method applied (retrospectively) to publically available data from a study of the use of tamoxifen after mastectomy by the German Breast Study Group, where progesterone receptor is the biomarker of interest. PMID:27417407

Predictors of BMI Vary along the BMI Range of German Adults – Results of the German National Nutrition Survey II

PubMed Central

Moon, Kilson; Krems, Carolin; Heuer, Thorsten; Roth, Alexander; Hoffmann, Ingrid

2017-01-01

Objective The objective of the study was to identify predictors of BMI in German adults by considering the BMI distribution and to determine whether the association between BMI and its predictors varies along the BMI distribution. Methods The sample included 9,214 adults aged 18–80 years from the German National Nutrition Survey II (NVS II). Quantile regression analyses were conducted to examine the association between BMI and the following predictors: age, sports activities, socio-economic status (SES), healthy eating index-NVS II (HEI-NVS II), dietary knowledge, sleeping duration and energy intake as well as status of smoking, partner relationship and self-reported health. Results Age, SES, self-reported health status, sports activities and energy intake were the strongest predictors of BMI. The important outcome of this study is that the association between BMI and its predictors varies along the BMI distribution. Especially, energy intake, health status and SES were marginally associated with BMI in normal-weight subjects; this relationships became stronger in the range of overweight, and were strongest in the range of obesity. Conclusions Predictors of BMI and the strength of these associations vary across the BMI distribution in German adults. Consequently, to identify predictors of BMI, the entire BMI distribution should be considered. PMID:28219069

[Depression Literacy - German Translation and Testing of the Depression Literacy Scale].

PubMed

Freitag, Simone; Stolzenburg, Susanne; Schomerus, Georg; Schmidt, Silke

2017-12-13

Objective Translation and psychometric testing of a German adaptation of the Australian Depression Literacy Scale. Methods Translation of the Depression Literacy Scale by Griffith et al. (2004) into German and testing for depression literacy in a sample of 229 people with depressive syndrome. Results The investigated sample had a mean age of 49.4 years (18 - 80 years). On average, 51 % of the 22 questions were correctly answered. The scale showed a satisfactory internal consistency with α = .74. The first-time application of the translated D-Lit German scale showed significant differences in subgroup analyzes of sex, age, and education. Hence, women, younger persons and persons with a higher school education reported higher values on the Depression Literacy Scale. Conclusion The translation of the Depression Literacy Scale (D-Lit German) resulted in an easy-to-understand and applicable questionnaire. Items relating to therapeutic and drug-related treatments of depressen were more difficult to answer. The D-Lit scale proved to be a reliable and economic instrument for the investigation of depression literacy. Future studies should include depression literacy in investigations on the demands and help-seeking behaviour of people with depression. © Georg Thieme Verlag KG Stuttgart · New York.

Sex pheromone monitoring as a versatile tool for determining presence and abundance of Cydia pomonella (Lep.: Tortricidae) in German apple orchards.

PubMed

Hummel, H E; Czyrt, T; Schmid, S; Leithold, G; Vilcinskas, A

2012-01-01

Cydia pomonella (Lep.: Tortricidae), the codling moth, is an apple, pear, quince and walnut pest with considerable impact on horticultural production systems in many parts of the world. In commercial apple production, it is responsible for a yearly damage level of 40 billion dollars. In response to the need of tight codling moth control there are several options for intervention by pest managers in commercially operated orchards. Spray and count methods have been used for decades with success, but at considerable external costs for the integrity of ecological cycles. Also, problems with pesticide residues and with resistant strains are an issue of concern. For environmental reasons, toxicological means are discounted here. Instead, flight curves based on sex pheromone trapping and monitoring are preferred means towards determining the optimal timing of interventions by biotechnical and biological control methods. Finally, ecological reasons are discussed for vastly different population levels of C. pomonella developing in closely neighboring field sections which operated under different environmental management.

Symposium 'Methodology in Medical Education Research' organised by the Methodology in Medical Education Research Committee of the German Society of Medical Education May, 25th to 26th 2013 at Charité, Berlin.

PubMed

Schüttpelz-Brauns, Katrin; Kiessling, Claudia; Ahlers, Olaf; Hautz, Wolf E

2015-01-01

In 2013, the Methodology in Medical Education Research Committee ran a symposium on "Research in Medical Education" as part of its ongoing faculty development activities. The symposium aimed to introduce to participants educational research methods with a specific focus on research in medical education. Thirty-five participants were able to choose from workshops covering qualitative methods, quantitative methods and scientific writing throughout the one and a half days. The symposium's evaluation showed participant satisfaction with the format as well as suggestions for future improvement. Consequently, the committee will offer the symposium again in a modified form in proximity to the next annual Congress of the German Society of Medical Education.

Design and methodology of the Geo-social Analysis of Physicians' settlement (GAP-Study) in Germany.

PubMed

Groneberg, David A; Boll, Michael; Bauer, Jan

2016-01-01

Unequally distributed disease burdens within populations are well-known and occur worldwide. They are depending on residents' social status and/or ethnic background. Country-specific health care systems - especially the coverage and distribution of health care providers - are both a potential cause as well as an important solution for health inequalities. Registers are built of all accredited physicians and psychotherapists within the outpatient care system in German metropolises by utilizing the database of the Associations of Statutory Health Insurance Physicians. The physicians' practice neighborhood will be analyzed under socioeconomic and demographic perspectives. Therefore, official city districts' statistics will be assigned to the physicians and psychotherapists according to their practice location. Averages of neighborhood indicators will be calculated for each specialty. Moreover, advanced studies will inspect differences by physicians' gender or practice type. Geo-spatial analyses of the intra-city practices distribution will complete the settlement characteristics of physicians and psychotherapists within the outpatient care system in German metropolises. The project "Geo-social Analysis of Physicians' settlement" (GAP) is designed to elucidate gaps of physician coverage within the outpatient care system, dependent on neighborhood residents' social status or ethnics in German metropolises. The methodology of the GAP-Study enables the standardized investigation of physicians' settlement behavior in German metropolises and their inter-city comparisons. The identification of potential gaps within the physicians' coverage should facilitate the delineation of approaches for solving health care inequality problems.

Sex ratios in the two Germanies: a test of the economic stress hypothesis.

PubMed

Catalano, Ralph A

2003-09-01

Literature describing temporal variation in the secondary sex ratio among humans reports an association between population stressors and declines in the odds of male birth. Explanations of this phenomenon draw on reports that stressed females spontaneously abort male more than female fetuses, and that stressed males exhibit reduced sperm motility. This work has led to the argument that population stress induced by a declining economy reduces the human sex ratio. No direct test of this hypothesis appears in the literature. Here, a test is offered based on a comparison of the sex ratio in East and West Germany for the years 1946 to 1999. The theory suggests that the East German sex ratio should be lower in 1991, when East Germany's economy collapsed, than expected from its own history and from the sex ratio in West Germany. The hypothesis is tested using time-series modelling methods. The data support the hypothesis. The sex ratio in East Germany was at its lowest in 1991. This first direct test supports the hypothesis that economic decline reduces the human sex ratio.

[Incident reporting systems in anesthesiology--methods and benefits using the example of PaSOS].

PubMed

Rall, Marcus; Reddersen, Silke; Zieger, Jörg; Schädle, Bertram; Hirsch, Patricia; Stricker, Eric; Martin, Jörg; Geldner, Götz; Schleppers, Alexander

2008-09-01

Preventing patient harm is one of the main tasks for the field of anesthesiology from early on. With the introduction of the national German incident reporting system PaSOS, which is hosted by the German anesthesia society, anesthesiology is again leading the field of patient safety. Important elements, success factors and background information for the introduction of successful incident reporting systems in an organization are given. Examples by and from PaSOS are given.

[Sexual maturation of children and adolescents in Germany. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)].

PubMed

Kahl, H; Schaffrath Rosario, A; Schlaud, M

2007-01-01

Following the standstill in maturity acceleration in the eighties of the twentieth century, now a further shift in maturity development towards younger ages is the issue of an international and also German discussion. The collection of sexual maturity data in boys and girls as part of the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS) is intended to pro vide population-representative information on sexual maturation and to evaluate associations between maturity status and selected health and social data. Girls were interviewed regarding their first menstrual period (menarche) and boys regarding voice change (status-quo method). Pubic hair was self-assessed by children and adolescents from 10 to 17 years of age, based on drawings of Tanner's defined developmental stages. The median age for menarche, for voice change and pubic hair stages were calculated using a logit model. At an age of 10 years, 42.4 % of girls and 35.7 % of boys report the development of pubic hair. At 17 years of age, the majority of girls and boys have reached the stages PH5 (girls 57.5 %, boys 47.8 %) and PH6 (girls 23.6 %, boys 46.5 %) according to Tanner. The average age for each pubic hair stage is lower in girls (PH2 10.8; PH3 11.7; PH4 12.3; PH5 13.4 years) than in boys (PH2 10.9; PH3 12.6; PH4 13.4; PH5 14.1). The median age at menarche is 12.8 years, the median for voice change (voice low) 15.1 years. Significant differences in age at menarche are found in girls depending on socioeconomic status (12.7/12.9/13.0 years for low/middle/high status) and between girls with and without migration background (12.5/12.9 years). No differences in age at menarche can be seen between East and West Germany or cities and rural areas. The association between maturity status and BMI is more pronounced in girls than in boys. Overall, the onset of maturity development in German children and adolescents is not significantly earlier than in other European studies.

A prevalence-based approach to societal costs occurring in consequence of child abuse and neglect

PubMed Central

2012-01-01

Background Traumatization in childhood can result in lifelong health impairment and may have a negative impact on other areas of life such as education, social contacts and employment as well. Despite the frequent occurrence of traumatization, which is reflected in a 14.5 percent prevalence rate of severe child abuse and neglect, the economic burden of the consequences is hardly known. The objective of this prevalence-based cost-of-illness study is to show how impairment of the individual is reflected in economic trauma follow-up costs borne by society as a whole in Germany and to compare the results with other countries’ costs. Methods From a societal perspective trauma follow-up costs were estimated using a bottom-up approach. The literature-based prevalence rate includes emotional, physical and sexual abuse as well as physical and emotional neglect in Germany. Costs are derived from individual case scenarios of child endangerment presented in a German cost-benefit-analysis. A comparison with trauma follow-up costs in Australia, Canada and the USA is based on purchasing power parity. Results The annual trauma follow-up costs total to a margin of EUR 11.1 billion for the lower bound and to EUR 29.8 billion for the upper bound. This equals EUR 134.84 and EUR 363.58, respectively, per capita for the German population. These results conform to the ones obtained from cost studies conducted in Australia (lower bound) and Canada (upper bound), whereas the result for the United States is much lower. Conclusion Child abuse and neglect result in trauma follow-up costs of economically relevant magnitude for the German society. Although the result is well in line with other countries’ costs, the general lack of data should be fought in order to enable more detailed future studies. Creating a reliable cost data basis in the first place can pave the way for long-term cost savings. PMID:23158382

Public Attitudes towards Prevention of Obesity

PubMed Central

Sikorski, Claudia; Luppa, Melanie; Schomerus, Georg; Werner, Perla; König, Hans-Helmut; Riedel-Heller, Steffi G.

2012-01-01

Objective To investigate obesity prevention support in the German general public and to assess determinants of general prevention support as well as support of specific prevention measures. Methods This study was a cross-sectional analysis of a telephone based representative German study (3,003 subjects (52.8% women, mean age 51.9, s.d. = 18.0, range 18–97 years). Likert scale-based questions on general prevention support and support of specific measures were used. Furthermore willingness to take part in preventive programs and willingness to pay were assessed. Stigmatizing attitudes were assessed with the Fat Phobia Scale (FPS). Causation of obesity was differentiated in three dimensions (internal, e.g. lack of exercise; external, e.g. social surroundings; and genetic factors). Results Obesity prevention was perceived as possible (98.2%), however, almost exclusively lifestyle changes were named. Participants with higher stigmatizing attitudes were less likely to believe obesity prevention is possible. The majority of participants would take part in preventive programs (59.6%) and pay at least partially themselves (86.9%). Factor analysis revealed three dimensions of preventive measures: promoting healthy eating, restrictive and financial, governmental prevention efforts. In regard to these, promoting healthy eating was the most supported measure. Higher age, female gender and external causation were associated with higher support for all three dimensions of preventive measures. Only for governmental regulation, higher age was associated with lower support. Conclusion Obesity prevention support in Germany is high. Structural prevention efforts are supported by the majority of the general public in Germany. The vast majority proclaims willingness to pay themselves for programs of weight gain prevention. This could be an indication of higher perceived self-responsibility in the German system but also for risen “fear of fat” in the population due to media coverage. For Germany, the government and communities ought to be encouraged by these results to start the implementation of structural obesity prevention. PMID:22723996

Implications of demographics on future blood supply: a population-based cross-sectional study.

PubMed

Greinacher, Andreas; Fendrich, Konstanze; Brzenska, Ralf; Kiefel, Volker; Hoffmann, Wolfgang

2011-04-01

Data on blood recipients are sparse and unconnected to data on blood donors. The objective was to analyze the impact of the demographic change on future blood demand and supply in a German federal state. A population-based cross-sectional study was conducted. For all in-hospital transfused red blood cells (RBCs; n = 95,477), in the German federal state Mecklenburg-Pomerania in 2005, characteristics of the patient and the blood donor (118,406 blood donations) were obtained. Population data were used to predict blood demand and supply until 2020. By 2020 the population increase of those aged 65 years or more (+26.4%) in Mecklenburg-Pomerania will be paralleled by a decrease of the potential donor population (18-68 years; -16.1%). Assuming stable rates per age group until 2020, the demand for in-hospital blood transfusions will increase by approximately 25% (24,000 RBC units) while blood donations will decrease by approximately 27% (32,000 RBC units). The resulting, predicted shortfall is 47% of demand for in-hospital patients (56,000 RBC units). Validation using historical data (1997-2007) showed that the model predicted the RBC demand with a deviation of only 1.2%. Demographic changes are particularly pronounced in former East Germany, but by 2030 most European countries will face a similar situation. The decrease of younger age groups requires an increase of blood donation rates and interdisciplinary approaches to reduce the need for transfusion to maintain sufficient blood supply. Demography is a major determinant of future transfusion demand. All efforts should be made by Western societies to systematically obtain data on blood donors and recipients to develop strategies to meet future blood demand. © 2010 American Association of Blood Banks.

Changes of individual perception in psychosocial stressors related to German reunification in 1989/1990 and cardiovascular risk factors and cardiovascular diseases in a population-based study in East Germany

PubMed Central

Kluttig, Alexander; Werdan, Karl; Nuding, Sebastian; Greiser, Karin Halina; Kuss, Oliver; Markus, Marcello Ricardo Paulista; Schmidt, Carsten Oliver; Völzke, Henry; Krabbe, Christine; Haerting, Johannes

2016-01-01

Objectives Aim was to examine the relationship between individually perceived changes in psychosocial stressors associated with German reunification and cardiovascular effects. We hypothesised that higher levels of psychosocial stress related to German reunification were associated with an increase in cardiovascular risk factors and cardiovascular diseases (CVDs). Design Cross-sectional data from 2 cohort studies in East Germany were used: Cardiovascular Disease, Living and Ageing in Halle Study (CARLA), and Study of Health in Pomerania (SHIP). Setting 2 populations in East Germany. Participants CARLA study: 1779 participants, aged 45–83 years at baseline (812 women), SHIP study: 4308 participants, aged 20–79 years at baseline (2193 women). Primary and secondary outcome measures Psychosocial stressors related to reunification were operationalised by the Reunification Stress Index (RSI; scale from 0 to 10). This index was composed of questions that were related to individually perceived changes in psychosocial stressors (occupational, financial and personal) after reunification. To examine the associations between the RSI and each stressor separately with cardiovascular risk factors and CVD, regression models were used. Results RSI was associated with CVD in women (RR=1.15, 95% CI 1.00 to 1.33). Cardiovascular risk factors were associated with RSI for both men and women, with strongest associations between RSI and diabetes in women (RR=1.10, 95% CI 1.01 to 1.20) and depressive disorders in men (RR=1.15, 95% CI 1.07 to 2.77). The change in occupational situation related to reunification was the major contributing psychosocial stressor. We observed a strong association with CVD in women who experienced occupational deterioration after reunification (RR=4.04, 95% CI 1.21 to 13.43). Conclusions Individually perceived deterioration of psychosocial stressors (occupational, financial and personal) related to German reunification was associated with cardiovascular risk factors and CVD. The associations were stronger for women than for men. An explanation for these findings could be that women were more often affected by unemployment after reunification. Morbidity and mortality follow-up of both cohorts could enhance the results. PMID:26729378

[Diabetes-specific health literacy: what do Turkish immigrants with diabetes mellitus 2 know about their disease?].

PubMed

Kofahl, C; von dem Knesebeck, O; Hollmann, J; Mnich, E

2013-12-01

Only few findings are available for the large group of type 2 diabetics whose origin is not German. This article investigates 1) the degree of diabetes-knowledge among diabetics of Turkish origin, and 2) factors that influence this knowledge and the competencies with handling the disease. In cooperation with 15 medical practices 294 diabetics of Turkish origin were interviewed in person by Turkish-speaking interviewers. There is no established concept for this population to measure their health literacy, therefore we adopted some questions from other tests and added our own items. Besides diabetes knowledge tests with closed and open questions the interviewees had to undertake a reading test and a screening test on German language skills. Socio-demographics and the attendance at diabetes trainings were gathered as well, and analysed in principal component analyses and multiple regressions. On average, the respondents had lived in Germany for 32 years, but 40% of them do not speak German. 25% never went to school and 21% cannot read or write (Turkish). Even though 60% took part in a diabetes training course, it appears that knowledge about the disease is scarce: only 15% could sufficiently explain their diabetes disease with their own words. A dimensional analysis helps to differentiate "theoretical" and "behavioural relevant" knowledge about diabetes. Theoretical knowledge is strongly associated with education, German language skills and attending a training course, whereas competencies that are relevant to the behaviour only are associated with participation in diabetes training courses. The educational effects remain on a rather low level and cannot compensate the fact that theoretical knowledge about diabetes depends on education. Hence, the overall (too) low level of knowledge on health and diabetes is only marginally improved. Education, attending a diabetes training course and language skills are the main factors for explaining poor knowledge about diabetes. A tailor-made training course--considering people's educational background--for the large group of people of Turkish origin could lead to improvements. Moreover, the neglected potential of self-help groups should be developed, as only one person of the reviewed population reported to search for support here. © Georg Thieme Verlag KG Stuttgart · New York.

1A.09: DISTINCT GENETIC ARCHITECTURE OF RENAL IMPAIRMENT COMPONENTS IN TYPE 2 DIABETES WITHIN CAUCASIAN POPULATIONS OF CELTO-GERMANIC AND SLAVIC ORIGINS.

PubMed

Harvey, F; Blanchet, F Marois; Phillips, M S; Haloui, M; Chalmers, J P; Woodward, M; Marre, M; Harrap, S B; Tremblay, J; Hamet, P

2015-06-01

The genetic architecture of type 2 diabetes (T2D) has been reported to be different between Asian and Caucasian populations (BBRC 2014;452:213-220). It is also well recognized that renal complications of T2D start earlier and are more severe in Asian subjects. Our objective was to determine whether such heterogeneity exists within the Caucasian population with respect to phenotypic and genomic determinants of renal complications in T2D. We analyzed two major aspects of renal impairment: increase of albuminuria as UACR and decline of estimated glomerular filtration rate as log(eGFR) in Caucasian patients during the 5 year period of the ADVANCE trial (NEJM 2014;371:1392-406). Celto-Germanic and Slavic origins of 3449 genotyped subjects were determined by principal component analysis with Eigenstrat software. The first principal component separated the 3449 individuals along a geographical gradient from East/West Europe: 1133 T2D patients were Slavic and 2316 were Celto-Germanic. Phenotypic analyses and Genome Wide Association Studies (GWAS) were performed in the two groups separately. The prevalence of hypertension was significantly higher (p = 1.7x10-32) in ADVANCE Slavic subjects. The prevalence of albuminuria and UACR levels were significantly higher (p = 10-4 and 9.5x10-5, respectively) at baseline and its progression over the 5-year period was steeper (p = 6.2x10-4) in patients of Slavic origin, contrasting with a more significant decline of eGFR in Celto-Germanic subjects (p = 4.9x10-21). Other T2D outcomes (myocardial infarction and stroke) did not exhibit such a difference between East and West Europe. GWAS analyses of eGFR decline did not reveal any associated SNPs (threshold p-value of < 10-3) in common between the two geo-ethnic groups and only 6% of associated genes were shared. Similarly, GWAS of UACR progression showed that only 0.1% of SNPs were common and 7% of genes were shared between the two groups. This was very different for stroke: 25% of SNPs and more than 50% of genes were common. Genetic analyses have to consider geo-ethnic characteristics even within Caucasians, demonstrated here for cardinal features of renal impairment in T2D. Our data suggest that distinct understanding of genomic architectures is important to ascertain clinical utility.

Quantifying the intelligibility of speech in noise for non-native listeners.

PubMed

van Wijngaarden, Sander J; Steeneken, Herman J M; Houtgast, Tammo

2002-04-01

When listening to languages learned at a later age, speech intelligibility is generally lower than when listening to one's native language. The main purpose of this study is to quantify speech intelligibility in noise for specific populations of non-native listeners, only broadly addressing the underlying perceptual and linguistic processing. An easy method is sought to extend these quantitative findings to other listener populations. Dutch subjects listening to Germans and English speech, ranging from reasonable to excellent proficiency in these languages, were found to require a 1-7 dB better speech-to-noise ratio to obtain 50% sentence intelligibility than native listeners. Also, the psychometric function for sentence recognition in noise was found to be shallower for non-native than for native listeners (worst-case slope around the 50% point of 7.5%/dB, compared to 12.6%/dB for native listeners). Differences between native and non-native speech intelligibility are largely predicted by linguistic entropy estimates as derived from a letter guessing task. Less effective use of context effects (especially semantic redundancy) explains the reduced speech intelligibility for non-native listeners. While measuring speech intelligibility for many different populations of listeners (languages, linguistic experience) may be prohibitively time consuming, obtaining predictions of non-native intelligibility from linguistic entropy may help to extend the results of this study to other listener populations.

Quantifying the intelligibility of speech in noise for non-native listeners

NASA Astrophysics Data System (ADS)

van Wijngaarden, Sander J.; Steeneken, Herman J. M.; Houtgast, Tammo

2002-04-01

When listening to languages learned at a later age, speech intelligibility is generally lower than when listening to one's native language. The main purpose of this study is to quantify speech intelligibility in noise for specific populations of non-native listeners, only broadly addressing the underlying perceptual and linguistic processing. An easy method is sought to extend these quantitative findings to other listener populations. Dutch subjects listening to Germans and English speech, ranging from reasonable to excellent proficiency in these languages, were found to require a 1-7 dB better speech-to-noise ratio to obtain 50% sentence intelligibility than native listeners. Also, the psychometric function for sentence recognition in noise was found to be shallower for non-native than for native listeners (worst-case slope around the 50% point of 7.5%/dB, compared to 12.6%/dB for native listeners). Differences between native and non-native speech intelligibility are largely predicted by linguistic entropy estimates as derived from a letter guessing task. Less effective use of context effects (especially semantic redundancy) explains the reduced speech intelligibility for non-native listeners. While measuring speech intelligibility for many different populations of listeners (languages, linguistic experience) may be prohibitively time consuming, obtaining predictions of non-native intelligibility from linguistic entropy may help to extend the results of this study to other listener populations.

Two truncating USH3A mutations, including one novel, in a German family with Usher syndrome.

PubMed

Ebermann, Inga; Wilke, Robert; Lauhoff, Thomas; Lübben, Dirk; Zrenner, Eberhart; Bolz, Hanno Jörn

2007-08-30

To identify the genetic defect in a German family with Usher syndrome (USH) and linkage to the USH3A locus. DNA samples of five family members (both parents and the three patients) were genotyped with polymorphic microsatellite markers specific for eight USH genes. Three affected family members underwent detailed ocular and audiologic characterization. Symptoms in the patients were compatible with Usher syndrome and show intrafamilial variation, for both hearing loss (ranging from severe to profound with non-linear progression) and vision. Genotyping of microsatellite markers for the different USH loci was in line with a defect in the USH3A gene on chromosome 3q25. Sequence analysis of the USH3A gene revealed two truncating mutations; c.149_152delCAGGinsTGTCCAAT, which has been described previously, and a novel mutation, c.502_503insA, segregating with the phenotype. To date, only 11 USH3A mutations have been described. This is the first description of a German family with USH due to USH3A mutations, including one novel. Our findings indicate that also in the Central European population, USH3A mutations should be considered in cases of USH.

[Nickel levels in female dermatological patients].

PubMed

Schwegler, U; Twardella, D; Fedorov, M; Darsow, U; Schaller, K-H; Habernegg, R; Behrendt, H; Fromme, H

2009-07-01

Nickel levels in urine were determined among 163 female dermatological patients aged 18 to 46 years. Data on life-style factors were collected in parallel via a questionnaire. Urinary nickel excretion was in the normal range of the German female population (0.2-46.1 microg Ni/g creatinine). The 95th percentile (3.9 microg Ni/l urine) exceeded the German reference value (3.0 microg Ni/l urine). In the multivariate regression analyses we found a statistically significant increase of ln-transformed nickel levels with increase in age and in women using dietary supplements. The following variables were not associated with Nickel urine levels: suffering from nickel eczema, smoking, drinking stagnated water, eating foods with high nickel contents and using nickel-containing kitchen utensils as, for example, an electric kettle with an open heater coil. We conclude that personal urinary levels should be assessed with simultaneous consideration of habits and life-style factors. A German national survery would be useful. Those patients who experience the exacerbation of their eczema in cases of oral provocation, for example, by a high nickel diet should be aware of potential sources of nickel, such as supplements.

Searching for non-genetic molecular and imaging PTSD risk and resilience markers: Systematic review of literature and design of the German Armed Forces PTSD biomarker study.

PubMed

Schmidt, Ulrike; Willmund, Gerd-Dieter; Holsboer, Florian; Wotjak, Carsten T; Gallinat, Jürgen; Kowalski, Jens T; Zimmermann, Peter

2015-01-01

Biomarkers allowing the identification of individuals with an above average vulnerability or resilience for posttraumatic stress disorder (PTSD) would especially serve populations at high risk for trauma exposure like firefighters, police officers and combat soldiers. Aiming to identify the most promising putative PTSD vulnerability markers, we conducted the first systematic review on potential imaging and non-genetic molecular markers for PTSD risk and resilience. Following the PRISMA guidelines, we systematically screened the PubMed database for prospective longitudinal clinical studies and twin studies reporting on pre-trauma and post-trauma PTSD risk and resilience biomarkers. Using 25 different combinations of search terms, we retrieved 8151 articles of which we finally included and evaluated 9 imaging and 27 molecular studies. In addition, we briefly illustrate the design of the ongoing prospective German Armed Forces (Bundeswehr) PTSD biomarker study (Bw-BioPTSD) which not only aims to validate these previous findings but also to identify novel and clinically applicable molecular, psychological and imaging risk, resilience and disease markers for deployment-related psychopathology in a cohort of German soldiers who served in Afghanistan. Copyright © 2014 Elsevier Ltd. All rights reserved.

The German Version of the Herth Hope Index (HHI-D): Development and Psychometric Properties.

PubMed

Geiser, Franziska; Zajackowski, Katharina; Conrad, Rupert; Imbierowicz, Katrin; Wegener, Ingo; Herth, Kaye A; Urbach, Anne Sarah

2015-01-01

The importance of hope is evident in clinical oncological care. Hope is associated with psychological and also physical functioning. However, there is still a dearth of empirical research on hope as a multidimensional concept. The Herth Hope Index is a reliable and valid instrument for the measurement of hope and is available in many languages. Until now no authorized German translation has been published and validated. After translation, the questionnaire was completed by 192 patients with different tumor entities in radiation therapy. Reliability, concurrent validity, and factor structure of the questionnaire were determined. Correlations were high with depression and anxiety as well as optimism and pessimism. As expected, correlations with coping styles were moderate. Internal consistency and test-retest reliability were satisfactory. We could not replicate the original 3-factor model. Application of the scree plot criterion in an exploratory factor analysis resulted in a single-factor structure. The Herth Hope Index - German Version (HHI-D) is a short, reliable, and valid instrument for the assessment of hope in patient populations. We recommend using only the HHI-D total score until further research gives more insights into possible factorial solutions and subscales. © 2015 S. Karger GmbH, Freiburg.

Quantification of ETS exposure in hospitality workers who have never smoked

PubMed Central

2010-01-01

Background Environmental Tobacco Smoke (ETS) was classified as human carcinogen (K1) by the German Research Council in 1998. According to epidemiological studies, the relative risk especially for lung cancer might be twice as high in persons who have never smoked but who are in the highest exposure category, for example hospitality workers. In order to implement these results in the German regulations on occupational illnesses, a valid method is needed to retrospectively assess the cumulative ETS exposure in the hospitality environment. Methods A literature-based review was carried out to locate a method that can be used for the German hospitality sector. Studies assessing ETS exposure using biological markers (for example urinary cotinine, DNA adducts) or questionnaires were excluded. Biological markers are not considered relevant as they assess exposure only over the last hours, weeks or months. Self-reported exposure based on questionnaires also does not seem adequate for medico-legal purposes. Therefore, retrospective exposure assessment should be based on mathematical models to approximate past exposure. Results For this purpose a validated model developed by Repace and Lowrey was considered appropriate. It offers the possibility of retrospectively assessing exposure with existing parameters (such as environmental dimensions, average number of smokers, ventilation characteristics and duration of exposure). The relative risk of lung cancer can then be estimated based on the individual cumulative exposure of the worker. Conclusion In conclusion, having adapted it to the German hospitality sector, an existing mathematical model appears to be capable of approximating the cumulative exposure. However, the level of uncertainty of these approximations has to be taken into account, especially for diseases with a long latency period such as lung cancer. PMID:20704719

Overview of the study design, participation and field work of the German Environmental Survey on Children 2003-2006 (GerES IV).

PubMed

Schulz, Christine; Seiwert, Margarete; Babisch, Wolfgang; Becker, Kerstin; Conrad, André; Szewzyk, Regine; Kolossa-Gehring, Marike

2012-07-01

The German Federal Environment Agency carried out its fourth German Environmental Survey (GerES IV), which is the first survey on children only and the environment-related module of the German Health Interview and Examination Survey for Children and Adolescents (German acronym: KiGGS), conducted by the Robert Koch Institute (RKI). The German Environmental Surveys are nationwide population studies conducted to determine the exposure to environmental pollutants, to explore exposure pathways and to identify sub-groups with higher exposure. GerES IV was conducted on randomly selected 1790 children aged 3-14 years from the cross-sectional sample of KiGGS. The participants of GerES IV lived in 150 sampling locations all over Germany. Field work was carried out from May 2003 to May 2006. The response rate in GerES IV was 77.3%. Due to the fact that participation in GerES IV was limited to children that had previously participated in the KiGGS study, the total response rate in GerES IV resulted in 52.6%. Response rates did neither differ significantly between West and East Germany, nor between different community sizes, age groups and gender. The basic study programme included blood samples, morning urine, tap water and house dust as well as comprehensive questionnaire-based interviews. In addition, subgroups were studied with regard to "noise, hearing capacity and stress hormones", "chemical contamination of indoor air" and "biogenic indoor contamination". A key element of the field work in GerES IV was a home visit to carry out interviews, conduct measurements and collect samples. An exception was blood sampling which was carried out within KiGGS. The quality of field work, data collection, evaluation, and chemical, biological and physical analyses was successfully evaluated by internal and external quality assurance. This comprehensive overview aims at giving other research groups the opportunity to compare different study designs or to adapt their own design to get comparable results. Copyright © 2012 Elsevier GmbH. All rights reserved.

[The Importance of Hospital Hygiene: Findings of a German Nationwide Survey].

PubMed

Haking, Dennis

2017-04-01

Aim of the study: The German legislature reacted to the increasing number of nosocomial infections with a set of laws to strengthen hospital hygiene. The aim of the study is to measure the current and future importance of hospital hygiene in Germany. Methods: CEOs and hygiene staff from German hospitals took part in a survey on 13 items regarding the current and future importance of hospital hygiene. Statistical analyses were conducted to identify significances regarding the professional groups. Results: The results of the study show that hospital hygiene is currently of high importance and will be rising in the future. Hospital hygiene has a high economic impact, especially as a competitive factor. The patients' fear to suffer from a nosocomial infection, especially caused by multi-resistant bacteria, is countered with intensive educational work. Conclusion: The results demonstrate that the legislators' efforts are taken note of in German hospitals and the future strategic impact of hospital hygiene in a pay-for-performance reimbursement system has become clear. © Georg Thieme Verlag KG Stuttgart · New York.

The Comparison of Matching Methods Using Different Measures of Balance: Benefits and Risks Exemplified within a Study to Evaluate the Effects of German Disease Management Programs on Long-Term Outcomes of Patients with Type 2 Diabetes.

PubMed

Fullerton, Birgit; Pöhlmann, Boris; Krohn, Robert; Adams, John L; Gerlach, Ferdinand M; Erler, Antje

2016-10-01

To present a case study on how to compare various matching methods applying different measures of balance and to point out some pitfalls involved in relying on such measures. Administrative claims data from a German statutory health insurance fund covering the years 2004-2008. We applied three different covariance balance diagnostics to a choice of 12 different matching methods used to evaluate the effectiveness of the German disease management program for type 2 diabetes (DMPDM2). We further compared the effect estimates resulting from applying these different matching techniques in the evaluation of the DMPDM2. The choice of balance measure leads to different results on the performance of the applied matching methods. Exact matching methods performed well across all measures of balance, but resulted in the exclusion of many observations, leading to a change of the baseline characteristics of the study sample and also the effect estimate of the DMPDM2. All PS-based methods showed similar effect estimates. Applying a higher matching ratio and using a larger variable set generally resulted in better balance. Using a generalized boosted instead of a logistic regression model showed slightly better performance for balance diagnostics taking into account imbalances at higher moments. Best practice should include the application of several matching methods and thorough balance diagnostics. Applying matching techniques can provide a useful preprocessing step to reveal areas of the data that lack common support. The use of different balance diagnostics can be helpful for the interpretation of different effect estimates found with different matching methods. © Health Research and Educational Trust.

Validation of the Brief Confusion Assessment Method for Screening Delirium in Elderly Medical Patients in a German Emergency Department.

PubMed

Baten, Verena; Busch, Hans-Jörg; Busche, Caroline; Schmid, Bonaventura; Heupel-Reuter, Miriam; Perlov, Evgeniy; Brich, Jochen; Klöppel, Stefan

2018-05-08

Delirium is frequent in elderly patients presenting in the emergency department (ED). Despite the severe prognosis, the majority of delirium cases remain undetected by emergency physicians (EPs). At the time of our study there was no valid delirium screening tool available for EDs in German-speaking regions. We aimed to evaluate the brief Confusion Assessment Method (bCAM) for a German ED during the daily work routine. We implemented the bCAM into practice in a German interdisciplinary high-volume ED and evaluated the bCAM's validity in a convenience sample of medical patients aged ≥ 70 years. The bCAM, which assesses four core features of delirium, was performed by EPs during their daily work routine and compared to a criterion standard based on the criteria for delirium as described in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Compared to the criterion standard, delirium was found to be present in 46 (16.0%) of the 288 nonsurgical patients enrolled. The bCAM showed 93.8% specificity (95% confidence interval [CI] = 90.0%-96.5%) and 65.2% sensitivity (95% CI = 49.8%-78.7%). Positive and negative likelihood ratios were 10.5 and 0.37, respectively, while the odds ratio was 28.4. Delirium was missed in 10 of 16 cases, since the bCAM did not indicate altered levels of consciousness and disorganized thinking. The level of agreement with the criterion standard increased for patients with low cognitive performance. This was the first study evaluating the bCAM for a German ED and when performed by EPs during routine work. The bCAM showed good specificity, but only moderate sensitivity. Nevertheless, application of the bCAM most likely improves the delirium detection rate in German EDs. However, it should only be applied by trained physicians to maximize diagnostic accuracy and hence improve the bCAM's sensitivity. Future studies should refine the bCAM. © 2018 by the Society for Academic Emergency Medicine.

Have "new" methods in medical education reached German-speaking Central Europe: a survey.

PubMed

Fandler, Martin; Habersack, Marion; Dimai, Hans P

2014-08-16

Simulation-based-training (SBT) in the education of health professionals is discussed as an effective alternative for knowledge and skills enhancement as well as for the establishment of a secure learning environment, for learners and patients. In the Anglo-American region, SBT and simulation and training centers (STC) are numbered as standard for medical training. In German-speaking Central Europe, priority is still given to the establishment of SBT and STC. The purpose of this study was (i) to survey the status quo relating to the existence and facilities of simulation and training centers at medical universities in German-speaking Central Europe and (ii) the evaluation of training methods, especially in the area of emergency medicine skills. All public and private medical universities or medical faculties in Germany (36), Austria (4) and German-speaking Switzerland (3) were interviewed. In the survey, information regarding the existence and facilities of STCs and information with regards to the use of SBT in the area of emergency medicine was requested. The questions were partly posed in a closed-ended-, in an open-ended- and in a multiple choice format (with the possibility of selecting more than one answer). Of a total of 43 contacted medical universities/medical faculties, 40 ultimately participated in the survey. As decisive for the establishment of a STC the potential to improve the clinical-practical training and the demand by students were listed. Obligatory training in a STC during the first and sixth academic year was confirmed only by 12 institutions, before the first invasive procedure on patients by 17 institutions. 13 institutions confirmed the use of the STC for the further training of physicians and care-staff. Training for the acute care and emergency medicine skills in the field of pediatrics, for the most part, occurs decentralized. New methods in medical training have reached German-speaking Central Europe, but the simulation and training centers vary in size, equipment or regarding their integration into the obligatory curriculum as much as the number and variety of the offering to be trained voluntarily or on an obligatory basis.

Differences in body fat and central adiposity between Swedes and European immigrants: the Malmö Diet and Cancer Study.

PubMed

Lahmann, P H; Lissner, L; Gullberg, B; Berglund, G

2000-12-01

Comparative data on ecological differences in body fatness and fat distribution within Europe are sparse. Migration studies may provide information on the impact of environmental factors on body size in different populations. The objective was to investigate differences in adiposity between European immigrants and native Swedes, specifically to examine gender differences and the effect of time since immigration, and to compare two selected immigrant groups with their native countrymen. A cross-sectional analysis of 27,808 adults aged 45 to 73 years participating in the Malmö Diet and Cancer prospective cohort study in Sweden was performed. Percentage body fat (impedance analysis) and waist-hip ratio (WHR) were compared between Swedish-born and foreign-born participants. Obesity was 40% more prevalent in non-Swedish Europeans compared with Swedes. Controlling for age, height, smoking, physical activity, and occupation, it was found that women born in the former Yugoslavia, southern Europe, Hungary, and Finland had a significantly higher percentage of body fat, and those from Hungary, Poland, and Germany had more centralized adiposity compared with Swedish women. Men born in the former Yugoslavia, Hungary, and Denmark had a significantly higher mean percentage of body fat compared with Swedish-born men, whereas Yugoslavian, Finnish, and German men differed significantly in mean WHR. Length of residence in Sweden was inversely associated with central adiposity in immigrants. A comparison between German and Danish immigrants, their respective native populations, and Swedes indicated an intermediate positioning of German immigrants with regard to body mass index and WHR. Differences in general and central adiposity by country of origin appear to remain after migration. Central adiposity seems to be more influenced than fatness per se by time of residency in Sweden.

Cost-effectiveness analysis of a vaccination program for the prevention of herpes zoster and post-herpetic neuralgia in adults aged 50 and over in Germany.

PubMed

Préaud, Emmanuelle; Uhart, Mathieu; Böhm, Katharina; Aidelsburger, Pamela; Anger, Delphine; Bianic, Florence; Largeron, Nathalie

2015-01-01

Herpes zoster (HZ; shingles) is a common viral disease that affects the nerves and surrounding skin causing a painful dermatomal rash and leading to debilitating complications such as, mainly, post-herpetic neuralgia (PHN). Currently, there is no effective treatment for HZ and PHN. The objective of this study was to assess the cost-effectiveness of a HZ vaccination program in Germany. An existing Markov Model was adapted to the German healthcare setting to compare a vaccination policy to no vaccination on a lifetime time-horizon, considering 2 scenarios: vaccinating people starting at the age of 50 or at the age of 60 years, from the perspective of the statutory health insurance (SHI) and the societal perspective. According to the perspective, vaccinating 20% of the 60+ German population resulted in 162,713 to 186,732 HZ and 31,657 to 35,793 PHN cases avoided. Corresponding incremental cost-effectiveness ratios (ICER) were 39,306 €/QALY from the SHI perspective and 37,417 €/QALY from a societal perspective. Results for the 50+ German population ranged from 336,468 to 394,575 HZ and from 48,637 to 56,087 PHN cases avoided from the societal perspective. Corresponding ICER were 39,782 €/QALY from a SHI perspective and 32,848 €/QALY from a societal perspective. Sensitivity analyses showed that results are mainly impacted by discount rates, utility values and use of alternative epidemiological data.The model indicated that a HZ vaccination policy in Germany leads to significant public health benefits and could be a cost-effective intervention. The results were robust and consistent with local and international existing literature.

Recalibration of the ACC/AHA Risk Score in Two Population-Based German Cohorts.

PubMed

de Las Heras Gala, Tonia; Geisel, Marie Henrike; Peters, Annette; Thorand, Barbara; Baumert, Jens; Lehmann, Nils; Jöckel, Karl-Heinz; Moebus, Susanne; Erbel, Raimund; Meisinger, Christine; Mahabadi, Amir Abbas; Koenig, Wolfgang

2016-01-01

The 2013 ACC/AHA guidelines introduced an algorithm for risk assessment of atherosclerotic cardiovascular disease (ASCVD) within 10 years. In Germany, risk assessment with the ESC SCORE is limited to cardiovascular mortality. Applicability of the novel ACC/AHA risk score to the German population has not yet been assessed. We therefore sought to recalibrate and evaluate the ACC/AHA risk score in two German cohorts and to compare it to the ESC SCORE. We studied 5,238 participants from the KORA surveys S3 (1994-1995) and S4 (1999-2001) and 4,208 subjects from the Heinz Nixdorf Recall (HNR) Study (2000-2003). There were 383 (7.3%) and 271 (6.4%) first non-fatal or fatal ASCVD events within 10 years in KORA and in HNR, respectively. Risk scores were evaluated in terms of calibration and discrimination performance. The original ACC/AHA risk score overestimated 10-year ASCVD rates by 37% in KORA and 66% in HNR. After recalibration, miscalibration diminished to 8% underestimation in KORA and 12% overestimation in HNR. Discrimination performance of the ACC/AHA risk score was not affected by the recalibration (KORA: C = 0.78, HNR: C = 0.74). The ESC SCORE overestimated by 5% in KORA and by 85% in HNR. The corresponding C-statistic was 0.82 in KORA and 0.76 in HNR. The recalibrated ACC/AHA risk score showed strongly improved calibration compared to the original ACC/AHA risk score. Predicting only cardiovascular mortality, discrimination performance of the commonly used ESC SCORE remained somewhat superior to the ACC/AHA risk score. Nevertheless, the recalibrated ACC/AHA risk score may provide a meaningful tool for estimating 10-year risk of fatal and non-fatal cardiovascular disease in Germany.

Incidence of second cancers after radiotherapy and systemic chemotherapy in heritable retinoblastoma survivors: A report from the German reference center.

PubMed

Temming, Petra; Arendt, Marina; Viehmann, Anja; Eisele, Lewin; Le Guin, Claudia H D; Schündeln, Michael M; Biewald, Eva; Astrahantseff, Kathy; Wieland, Regina; Bornfeld, Norbert; Sauerwein, Wolfgang; Eggert, Angelika; Jöckel, Karl-Heinz; Lohmann, Dietmar R

2017-01-01

Survivors of heritable retinoblastoma carry a high risk to develop second cancers. Eye-preserving radiotherapy raises this risk, while the impact of chemotherapy remains less defined. This population-based study characterizes the impact of all treatment modalities on second cancers incidence and type after retinoblastoma treatment in Germany. Data on second cancer incidence in 648 patients with heritable retinoblastoma treated between 1940 and 2008 at the German national reference center for retinoblastoma were analyzed to identify associations with treatment. The cumulative incidence ratio (per 1,000 person years) of second cancers was 8.6 (95% confidence interval 7.0-10.4). Second cancer incidence was influenced by type of retinoblastoma treatment but not by the year of diagnosis or by sex. Radiotherapy and systemic chemotherapy increased the incidence of second cancers (by 3.0- and 1.8-fold, respectively). While radiotherapy was specifically associated with second cancers arising within the periorbital region in the previously irradiated field, chemotherapy was the strongest risk factor for second cancers in other localizations. Soft tissue sarcomas and osteosarcomas were the most prevalent second cancers (standardized incidence ratio 179.35 compared to the German population). Second cancers remain a major concern in heritable retinoblastoma survivors. Consistent with previous reports, radiotherapy increased second cancer incidence and influenced type and localization. However, chemotherapy was the strongest risk factor for second malignancies outside the periorbital region. Our results provide screening priorities during life-long oncological follow-up based on the curative therapy the patient has received and emphasize the need for less-detrimental therapies for children with heritable retinoblastoma. © 2016 Wiley Periodicals, Inc.

Why Do German Students Learn More, When Their Schools Get Less Money?

ERIC Educational Resources Information Center

Peterson, Paul E.

2015-01-01

Education analysts often compare U.S. schools to those in Finland, Korea, Poland, even Shanghai. But surprisingly, few compare the schools here to those in Germany, though the two countries have much in common. Each nation is the largest democracy, with the biggest economy, on its continent. Each has a diverse population, strong unions, a federal…

Object and Action Naming in Russian- and German-Speaking Monolingual and Bilingual Children

ERIC Educational Resources Information Center

Klassert, Annegret; Gagarina, Natalia; Kauschke, Christina

2014-01-01

The present study investigates the influence of word category on naming performance in two populations: bilingual and monolingual children. The question is whether and, if so, to what extent monolingual and bilingual children differ with respect to noun and verb naming and whether a noun bias exists in the lexical abilities of bilingual children.…

Studies in the Major Modern Languages (English, German, French) at University Level in Denmark by 1980/81.

ERIC Educational Resources Information Center

Dollerup, Cay

This is a descriptive outline of the language situation in the Danish education system. The introductory material discusses the reason for foreign language study. A major reason is that Denmark is a small country with a difficult native language for speakers of other languages to learn. Therefore, the Danish population is exposed to foreign…

Pathways to School Achievement in Very Preterm and Full Term Children

ERIC Educational Resources Information Center

Schneider, Wolfgang; Wolke, Dieter; Schlagmuller, Matthias; Meyer, Renate

2004-01-01

Individual differences in academic success were investigated in a geographically defined whole-population sample of very preterm children with a gestational age of less than 32 weeks or a birth weight of less than 1500 gm. The sample consisted of 264 very preterm children (75.6% of German-speaking survivors) and 264 controls matched for gender,…

Do Tuition Fees Affect Enrollment Behavior? Evidence from a "Natural Experiment" in Germany

ERIC Educational Resources Information Center

Hubner, Malte

2012-01-01

This paper uses the introduction of tuition fees in seven of the sixteen German states in 2007 as a natural experiment to identify the effects of tuition prices on enrollment probabilities. Based on information on enrollment decisions of the entire population of high-school graduates between 2002 and 2008, I find a negative effect of tuition fees…

Features of hypochondriasis and illness worry in the general population in Germany.

PubMed

Martin, Alexandra; Jacobi, Frank

2006-01-01

Although hypochondriasis is considered to be of high relevance in the healthcare sector, its prevalence in the general population has been investigated in few studies. The aims of this study were to estimate prevalence rates of hypochondriasis and of subthreshold conditions and to describe their associated features such as quality of life and healthcare utilization in a representative community sample. Analyses of the present study are based on the German Health Interview and Examination Survey-Mental Health Supplement (N = 4181, representative for the German population from 18-65 years). The assessment included interviews for somatic conditions and mental disorders and self-report ratings on health-related quality of life, healthcare utilization, disability days, and physical activity. Only three cases (0.05%) were identified as meeting full criteria of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) hypochondriasis. The prevalence rate of the less restrictively defined form of hypochondriasis, ("subthreshold hypochondriasis") was 0.58% and an additional 2.12% reported having had illness worries for at least 6 months but did not meet further hypochondriasis criteria. The two subthreshold diagnostic groups provided strong evidence of difference from the nonhypochondriac controls: comorbidity with psychiatric and medical disorders and healthcare utilization were higher, and quality of life was markedly reduced. The results provide additional support to not only consider "full" DSM-IV hypochondriasis, which is a very rare disorder in the general population, but also to include less restrictive hypochondriac conditions--associated with a clinically relevant degree of psychological and physical impairment--into clinical and scientific considerations.

Normative data for the Digit Symbol Substitution Test in a population-based sample aged 65-79 years: Results from the German Health Interview and Examination Survey for Adults (DEGS1).

PubMed

Gaertner, Beate; Wagner, Michael; Luck, Tobias; Buttery, Amanda K; Fuchs, Judith; Busch, Markus A

2018-06-17

To provide normative data for the Digit Symbol Substitution Test (DSST) of the Wechsler Adult Intelligence Scale, 3rd edition (WAIS-III) in a population-based sample of community-dwelling older adults in Germany according to age, sex, and level of education. The sample comprised 1385 participants aged 65-79 years from the nationwide representative 'German Health Interview and Examination Survey for Adults' (DEGS1, 2008-2011). Participants with known cognitive impairment or dementia, other medical conditions affecting cognition, or currently using psychotropic drugs were excluded. Educational level was categorized as low, medium, and high according to the Comparative Analyses of Social Mobility in Industrial Nations (CASMIN) scale. Normative values for the DSST according to age, sex, and level of education were estimated by multiple linear regression using population weights. Mean age was 71.1 years, 48.6% were men and low, medium, and high education levels were 62.8, 24.6, and 12.6%, respectively. Younger age, female sex, and higher level of education were significantly associated with higher DSST scores. Regression-based normative data for the DSST is provided according to age, sex, and level of education. In addition, a normative score calculator is provided. These are the first age-, sex-, and education-specific normative data for older individuals for the DSST of the WAIS-III in Germany. These normative data will enable future population-level analyses on impaired cognitive function according to DSST.

Cancer survival in Eastern and Western Germany after the fall of the iron curtain.

PubMed

Jansen, Lina; Gondos, Adam; Eberle, Andrea; Emrich, Katharina; Holleczek, Bernd; Katalinic, Alexander; Brenner, Hermann

2012-09-01

Prior to the German reunification, cancer survival was much lower in East than in West Germany. We compare cancer survival between Eastern and Western Germany in the early twenty-first century, i.e. the second decade after the German reunification. Using data from 11 population-based cancer registries covering a population of 33 million people, 5-year age-standardized relative survival for the time period 2002-2006 was estimated for the 25 most common cancers using model-based period analysis. In 2002-2006, 5-year relative survival was very similar for most cancers, with differences below 3% units for 20 of 25 cancer sites. Larger, statistically significant survival advantages were seen for oral cavity, oesophagus, and gallbladder cancer and skin melanoma in the West and for leukemia in the East. Our study shows that within two decades after the assimilation of political and health care systems, the former major survival gap of cancer patients in Eastern Germany has been essentially overcome. This result is encouraging as it suggests that, even though economic conditions have remained difficult in Eastern Germany, comparable health care provision may nevertheless enable comparable levels of cancer survival within a relatively short period of time.

Prison suicides in Germany from 2000 to 2011.

PubMed

Opitz-Welke, Annette; Bennefeld-Kersten, Katharina; Konrad, Norbert; Welke, Justus

2013-01-01

In many countries, suicide is the most frequent cause of prison deaths; moreover, the respective national penal suicide rates are consistently several times higher than the suicide rates in the general population. To assess the situation in German prisons, an assessment of all suicides in German prisons by means of a survey was carried out for the time from 2000 to 2011. The mean rate per year of prison suicides in Germany from 2000 to 2011 was 105.8 per 100,000 male inmates and 54.7 per 100,000 female inmates. Male prisoner suicide rates significantly declined during the period under investigation; no significant trend was evident for female prisoners in pre-trial detention but a noteworthy increase was apparent in the suicide rate of female sentenced prisoners. A significant positive relationship can be demonstrated between occupation density and the suicide rate for both men and women. These results should be taken as a challenge for further research on the reasons for the unexpected increase of suicide rate in female sentenced prisoners and as well on the effect of population density on prison suicide rate. Copyright © 2013. Published by Elsevier Ltd.

Assessing age stereotypes in the German population in 1996 and 2011: socio-demographic correlates and shift over time.

PubMed

Spangenberg, Lena; Zenger, Markus; Glaesmer, Heide; Brähler, Elmar; Strauss, Bernhard

2018-03-01

The present study aimed to extend the knowledge regarding dimensionality, socio-demographic correlates and shifts in age stereotypes over the past 15 years using a time-sequential design. In 1996 and 2011, we assessed age stereotypes in two independent samples of the German population aged ≥ 45 years ( N  = 970 in sample 1, N  = 1545 in sample 2). Three scales with six items each were assessed. Two scales cover negative (i.e., rigidity/isolation, burden), and one scale covers positive age stereotypes (wisdom/experience). Dimensionality of the scale, associations with socio-demographic variables and whether the stereotypes have shifted were tested using confirmatory factor analyses, structural equation modeling and analyses of variances. Three dimensions were identified and replicated following an exploratory as well as a confirmatory approach. Age stereotypes did shift between 1996 and 2011 in the dimension burden (i.e., becoming more negative). Our results further underpin the finding that age stereotypes are multifaceted and suggest that dimensions do not change over time. Additionally, our data provide some evidence that societal age stereotypes partly change over time.

Marlene Dietrich in the German Classroom: A German Film Project--Humanities through the Golden Age of German Cinema.

ERIC Educational Resources Information Center

Flippo, Hyde

1993-01-01

Marlene Dietrich and other classic performers of German cinema can serve to open up a whole new realm for students of German, at secondary and postsecondary levels. By researching and viewing German and American film classics, students have opportunity to learn more about German language and an important element of German culture that has had…

Seroprevalence of Chlamydophila Psittaci among Employees of Two German Duck Farms

PubMed Central

Lugert, Raimond; Groß, Uwe; Masanta, Wycliffe O.; Linsel, Gunter; Heutelbeck, Astrid; Zautner, Andreas E.

2017-01-01

Psittacosis is a zoonotic infectious disease that is caused by Chlamydophila psittaci. To determine the occupational risk of getting the infection, we investigated the seroprevalence of C. psittaci among employees of two German duck farms and two slaughterhouses according to their level of exposure to the pathogen during the years 2010, 2007, and 2004. In summary, we found low seroprevalence (≈ 8%) throughout the study population almost irrespective of the duty of a given worker. Surprisingly, in 2010, the anti-C. psittaci-specific antibody prevalence in the group of slaughterer (38.9%) was significantly increased in comparison to the non-exposed employees (p = 0.00578). This indicates that individuals in the surrounding of slaughterhouses exposed especially to aerosols containing C. psittaci elementary bodies bear a greater occupational risk of getting infected. PMID:29403654

Sex preference for children in German villages during the fertility transition.

PubMed

Sandström, Glenn; Vikström, Lotta

2015-01-01

In the past, parents' sex preferences for their children have proved difficult to verify. This study used John Knodel's German village genealogies of couples married between 1815 and 1899 to investigate sex preferences for children during the fertility transition. Event history analyses of couples' propensity to progress to a fifth parity was used to test whether the probability of having additional children was influenced by the sex composition of surviving children. It appears that son preference influenced reproductive behaviour: couples having only girls experienced significantly higher transition rates than those having only boys or a mixed sibset. However, couples who married after about 1870 began to exhibit fertility behaviour consistent with the choice to have at least one surviving boy and girl. This result represents a surprisingly early move towards the symmetrical sex preference typical of modern European populations.