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Porst M, von der Lippe E, Wengler A, Leddin J, Anton A, Rommel A. Burden of disease assessment for Germany and its regions – results from the BURDEN 2020 study. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Epidemiological measures such as incidence, prevalence, or deaths are essential for monitoring population health. However, evaluating them in isolation cannot adequately compare and assess the relative importance of different diseases. Assessments of the burden of disease (BoD) are therefore of growing importance in supporting health policy decisions. Using disability-adjusted life years (DALY) as a summary measure of population health, BoD integrates morbidity and mortality in a transparent approach.
Methods
Within BoD methodology, deviations in the health of the population from an ‘ideal’ health status is quantified in the unit of life years. DALY are the sum of years of life lost due to death (YLL) and years lived with disability (YLD). While YLL describe the gap between age at death and statistical life expectancy, the indicator YLD quantifies years lived with a disability or disease. Calculations were based on different primary and secondary data sources for Germany, especially cause-of-death statistics, epidemiological survey data, and statutory health insurance data.
Results
In Germany, there were about 12 million DALY in 2017, the equivalent of 14,584 DALY per 100,000 population. Coronary heart disease contributes the most to the overall burden of disease, followed by lower back pain and lung cancer. In women, headache disorders and dementias account for more DALY as compared to men. Men have a higher burden of disease from lung cancer or alcohol use disorders. Pain disorders and alcohol use disorders lead the DALY rankings for both sexes in younger adulthood. The burden due to cardiovascular disease, COPD, and diabetes mellitus increases with age and also varies by region.
Conclusions
The results suggest age- and gender-specific prevention as well as regional health care needs. BoD studies therefore provide comprehensive data for population health surveillance and can support health policy decisions.
Key messages
• The importance of specific diseases as measured by DALY differs greatly by age and gender, highlighting the need for targeted prevention measures.
• Regional patterns emerge for cardiovascular disease, COPD, and depressive disorders, among others, which may indicate health care needs.
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Affiliation(s)
- M Porst
- Epidemiology and Health Monitoring, Robert Koch-Institute , Berlin, Germany
| | - E von der Lippe
- Epidemiology and Health Monitoring, Robert Koch-Institute , Berlin, Germany
| | - A Wengler
- Epidemiology and Health Monitoring, Robert Koch-Institute , Berlin, Germany
| | - J Leddin
- Epidemiology and Health Monitoring, Robert Koch-Institute , Berlin, Germany
| | - A Anton
- Epidemiology and Health Monitoring, Robert Koch-Institute , Berlin, Germany
| | - A Rommel
- Epidemiology and Health Monitoring, Robert Koch-Institute , Berlin, Germany
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Saß AC, Rommel A, Starker A, Prütz F, Tolksdorf K, Pöge K. Erhebung geschlechtlicher Diversität in der Studie
„Gesundheit in Deutschland aktuell“ des Robert Koch-Insituts
– Ziele, Vorgehen und Erfahrungen. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- A-C Saß
- Robert Koch-Institut, Abteilung für Epidemiologie und
Gesundheitsmonitoring, Berlin, Deutschland
| | - A Rommel
- Robert Koch-Institut, Abteilung für Epidemiologie und
Gesundheitsmonitoring, Berlin, Deutschland
| | - A Starker
- Robert Koch-Institut, Abteilung für Epidemiologie und
Gesundheitsmonitoring, Berlin, Deutschland
| | - F Prütz
- Robert Koch-Institut, Abteilung für Epidemiologie und
Gesundheitsmonitoring, Berlin, Deutschland
| | - K Tolksdorf
- Robert Koch-Institut, Abteilung für Epidemiologie und
Gesundheitsmonitoring, Berlin, Deutschland
| | - K Pöge
- Robert Koch-Institut, Abteilung für Infektionsepidemiologie,
Berlin, Deutschland
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Ito Y, Yamamoto T, Miyai K, Take J, Scherthan H, Rommel A, Eder S, Steinestel K, Rump A, Port M, Shinomiya N, Kinoshita M. Ascorbic acid-2 glucoside mitigates intestinal damage during pelvic radiotherapy in a rat bladder tumor model. Int J Radiat Biol 2021; 98:942-957. [PMID: 34871138 DOI: 10.1080/09553002.2021.2009145] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Ascorbic acid is a strong antioxidant and has potent radioprotective effects on radiation injuries. Ascorbic acid 2-glucoside (AA2G) is a stabilized derivative of ascorbic acid and rapidly hydrolyzed into ascorbic acid and glucose. Since there is the possibility that AA2G treatment interferes with the antitumor activity of radiotherapy, we investigated the effect of AA2G treatment during radiotherapy on acute radiation enteritis and antitumor activity of radiotherapy in rats. MATERIALS AND METHODS AY-27 rat bladder tumor cells were used to induce bladder tumors in rats. Two weeks after inoculation rats received fractionated pelvic radiotherapy in eight fractions for 4 weeks totaling 40 Gy. During radiotherapy, one group of rats received per os AA2G (ascorbic acid: 250 mg/kg/day) and its bolus engulfment (ascorbic acid: 250 mg/kg) 8 h before each X-irradiation fraction. Seven days after the last X-irradiation, we studied histology, DNA double strand break (DSB) damage (by 53BP1 foci staining), and the M1/M2 macrophage response by immunohistochemistry of paraffin-fixed bladder and intestinal tissues. RESULTS AA2G treatment reduced the intestinal damage (shortening of villi) but did not reduce antitumor effectiveness of radiotherapy against bladder tumors. Like the controls, AA2G-treated rats showed no residual tumor lesions in the bladder after X-irradiation. Both AA2G-treated and control groups showed similar persistent DSB damage (53BP1 foci) both in bladders and ilea seven days after radiotherapy. Radiotherapy tended to reduce CD163+ M2 macrophages, which are considered as an anti-inflammatory subtype favoring tissue repair, in the bladders. X-irradiation also reduced the occurrence of M2 macrophages in the ilea. AA2G treatment significantly increased CD163+/CD68+ macrophage ratio in the ilea of rats after pelvic irradiation in comparison to the sham irradiated control rats. AA2G treatment increased, albeit not significantly, the CD163+/CD68+ macrophage ratio in the irradiated bladders relative to the control irradiated rats. On the other hand, bladders and ilea of the irradiated rats with and without AA2G treatment showed similar frequencies of CD68+ macrophages. CONCLUSIONS AA2G treatment mitigated radiation-induced intestinal damage without reducing antitumor activity after fractionated pelvic radiotherapy against bladder tumors in rats. The beneficial effect of AA2G treatment seems to promote a restoration of the M2 answer as well as tissue remodeling and wound healing. Similar residual DNA damage in bladders and ilea seven days post-irradiation is consistent with tumor control in both groups.
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Affiliation(s)
- Yasutoshi Ito
- Military Medicine Research Unit, Test and Evaluation Command, Ground Self-Defense Force, Setagaya, Japan
| | - Tetsuo Yamamoto
- Military Medicine Research Unit, Test and Evaluation Command, Ground Self-Defense Force, Setagaya, Japan.,NBC Counter Medical Unit, Ground Self-Defense Force, Setagaya, Japan
| | - Kosuke Miyai
- Military Medicine Research Unit, Test and Evaluation Command, Ground Self-Defense Force, Setagaya, Japan.,Department of Pathology, Self-Defense Forces Central Hospital, Setagaya, Japan
| | - Junya Take
- Department of Pediatrics, National Defense Medical College, Tokorozawa, Japan
| | | | - Anna Rommel
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - Stefan Eder
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | | | - Alexis Rump
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - Matthias Port
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | | | - Manabu Kinoshita
- Department of Immunology and Microbiology, National Defense Medical College, Tokorozawa, Japan
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Anton A, Fleckenstein T, Von der Lippe E, Rommel A. Burden 2020: The German Burden of Disease Study Informative, comprehensive, appealing and digital: Providing health data to users. Accessibility of scientific results in the burden context. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
The aim of the BURDEN 2020 project is to calculate the Burden of Disease for Germany at the national and regional level. Based on the methods of the Global Burden of Disease study, the results will assess the impact of diseases on population health thus providing a freely accessible information basis for policy making and health care planning. How can the transfer from science to society take place on a low-threshold basis? We will talk about our strategy reaching out to decision-makers within health care planning in Germany and Europe. In addition, it will be examined how we wanted our results to be accessible, which possibilities of publication we choose beyond scientific articles and what options we had when talking about research marketing. We will also have a closer look on our demands for data visualization and transparency. In an ongoing process, two things were at stake: how do we define our target groups and how we address them. It has been proven to be a good strategy to continuously build up (international) networks, to share our knowledge and implement feedback. When publishing scientific results, it has turned out to be helpful for the project to approach a well-known bi-lingual journal with a wide range of coverage. We aimed to present the pilot project online with an appealing data visualization and graphic formats. This type of presentation made it easier to approach members of the press. Also, the inclusion of current topics such as COVID-19 helped to increase the media response. There are plans to include the use of the data in media formats such as webinars. Burden of Disease assessments can be challenging in implementation and communication. Before the start, the use of the metrics for Germany had to be thoroughly explained to national stakeholders. Within the project, we had to discuss how our data should be communicated to the public, to explain strength and weaknesses, and to produce publication formats that suit different target groups.
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Affiliation(s)
- A Anton
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - T Fleckenstein
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - E Von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - A Rommel
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Kohlasch KL, Cioffredi LA, Lenninger C, Stewart E, Vatalaro T, Garavan H, Graham A, Heil SH, Krans EE, Robakis T, Rommel A, Sullivan EL, Thomason M, Potter A. Factors associated with parent views about participation in infant MRI research provide guidance for the design of the Healthy Brain and Child Development (HBCD) study. Dev Cogn Neurosci 2021; 50:100986. [PMID: 34242880 PMCID: PMC8267558 DOI: 10.1016/j.dcn.2021.100986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 06/04/2021] [Accepted: 07/01/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The National Institutes of Health announced the Healthy Brain and Child Development (HBCD) study to further understanding of infant brain development. This study examined perceptions and knowledge about research among the demographic groups to be studied in HBCD. METHOD 1164 participants (n = 548 pregnant people and 616 mothers of infants < 12 months) completed anonymous, on-line surveys. Domains included research literacy, MRI knowledge, and attitudes about research incentives and biospecimen collection. Logistic regression was used to examine factors related to outcome variables. RESULTS Knowledge of MRI safety was low and research literacy was high across participants. Likelihood of participation given various incentives differed between participants. Those with lower education were less likely to rate any items as increasing likelihood of participation. Substance use during pregnancy improved the model fit only for items about alternate visit structures (home and telephone visits) and confidentiality. CONCLUSION Overall results support the feasibility of infant imaging studies, such as HBCD with respondents having high research literacy and interest in learning about their baby's development. Educating potential participants about MRI safety and providing flexible incentives for participation will improve the success of infant MRI studies.
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Affiliation(s)
- Kaelyn L Kohlasch
- The University of Vermont, Department of Psychiatry, 1 South Prospect Street, Arnold 6, Burlington, VT 05401, United States.
| | - Leigh-Anne Cioffredi
- The University of Vermont, Department of Psychiatry, 1 South Prospect Street, Arnold 6, Burlington, VT 05401, United States.
| | - Carly Lenninger
- New York University Langone Health, One Park Avenue, New York, NY 10016, United States.
| | - Ellen Stewart
- Magee-Womens Research Institute, 204 Craft Avenue, Pittsburgh, PA 15213, United States.
| | - Tessa Vatalaro
- New York University Langone Health, One Park Avenue, New York, NY 10016, United States.
| | - Hugh Garavan
- The University of Vermont, Department of Psychiatry, 1 South Prospect Street, Arnold 6, Burlington, VT 05401, United States.
| | - Alice Graham
- Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States.
| | - Sarah H Heil
- Vermont Center on Behavior and Health, Departments of Psychiatry and Psychological Science, UHC MS #482, 1 South Prospect Street, Burlington, VT 05401, United States.
| | - Elizabeth E Krans
- Magee-Womens Research Institute, 204 Craft Avenue, Pittsburgh, PA 15213, United States; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, 300 Halket Street, Pittsburgh, PA 15213, United States.
| | - Thalia Robakis
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School, 1 Gustave L. Levy Pl, New York, NY 10029, United States.
| | - Anna Rommel
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai School, 1 Gustave L. Levy Pl, New York, NY 10029, United States.
| | - Elinor L Sullivan
- Department of Psychiatry, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States; Department of Behavioral Neuroscience, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United States; Division of Neuroscience, Oregon National Primate Research Center, 505 N W 185th Avenue, Beaverton, OR 97006, United States.
| | - Moriah Thomason
- New York University Langone Health, One Park Avenue, New York, NY 10016, United States.
| | - Alexandra Potter
- The University of Vermont, Department of Psychiatry, 1 South Prospect Street, Arnold 6, Burlington, VT 05401, United States; Vermont Center on Behavior and Health, Departments of Psychiatry and Psychological Science, UHC MS #482, 1 South Prospect Street, Burlington, VT 05401, United States.
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König H, Rommel A, Baumert J, Schmidt C, König HH, Brettschneider C, Konnopka A. Excess costs of type 2 diabetes and their sociodemographic and clinical determinants: a cross-sectional study using data from the German Health Interview and Examination Survey for Adults (DEGS1). BMJ Open 2021; 11:e043944. [PMID: 33883150 PMCID: PMC8061816 DOI: 10.1136/bmjopen-2020-043944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES The objectives of this study were to estimate the direct and indirect excess costs of type 2 diabetes mellitus (T2D) using data representative for the German adult population and to investigate the association of sociodemographic and clinical determinants with these excess costs. SETTING We calculated mean annual costs for individuals with T2D and a control group without diabetes, using data on healthcare utilisation and productivity losses from the cross-sectional German Health Interview and Examination Survey for Adults. We adjusted for group differences using entropy balancing and estimated excess costs for total, direct, indirect costs and additional cost categories using generalised linear models. We performed subgroup analyses to investigate the association of sociodemographic (age, sex and education) and clinical determinants (diabetes duration, glycaemic index and complications) with excess costs. PARTICIPANTS The final study sample included n=325 individuals with T2D and n=4490 individuals without diabetes in the age between 18 and 79 years. RESULTS Total excess costs amounted to €927, of which €719 were attributable to direct and €209 to indirect excess costs. Total costs were significantly increased by 28% for T2D compared with controls. Group differences in direct, outpatient and medication costs were statistically significant. Medication costs were 88% higher for T2D and had the highest share in direct excess costs. With respect to specific determinants, direct excess costs ranged from €203 for 4-10 years diabetes duration to €1405 for diabetes complications. Indirect excess costs ranged from €-544 for >10 years diabetes duration to €995 for high education. CONCLUSIONS T2D was associated with high costs, mainly due to direct costs. As pointed out by our results, diabetes complications and comorbidities have a large impact on the costs, leaving medication costs as main contributor of T2D excess costs.
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Affiliation(s)
- Hannah König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Rommel
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jens Baumert
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christian Schmidt
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexander Konnopka
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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7
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Merz S, Jaehn P, Mena E, Pöge K, Strasser S, Saß AC, Rommel A, Bolte G, Holmberg C. Why should gender-sensitive health reports be intersectional? Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
A key focus of both epidemiology and PHMR is the identification of health inequity between population groups and its determinants. However, scholars in the social sciences have criticised prevalent approaches of describing health differences according to single social categories like sex/gender or race/ethnicity, glossing over significant heterogeneity within and relations between presumed population groups. Applying these critiques to the field of PHMR, we would argue that intersectionality scholarship offers vital impulses for the study of health inequity by focusing on several, interrelated social categories and emphasising the structural determinants affecting unique population subgroups differently.
Methods
We mapped existing approaches to describing population differences in health. We also conducted a literature review on intersectionality scholarship in public health and then synthesised results to develop a conceptual framework for deploying intersectionality to epidemiology and PHMR.
Findings
We identified four key principles through which the reporting on subgroup differences could be strengthened: addressing the internal heterogeneity of population groups; contextualising inequities and focusing on societal power relations rather than individual characteristics; deploying novel multivariable modelling approaches in data analysis; and aiming towards the empowerment of population groups rather than deploying deficit-oriented and paternalistic models.
Discussion
To be discussed are the unique contributions of intersectionality to PHMR compared to other approaches, for example from social epidemiology or medical anthropology.
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Affiliation(s)
- S Merz
- Brandenburg Medical School, Institute of Social Medicine and Epidemiology, Brandenburg an der Havel, Germany
| | - P Jaehn
- Brandenburg Medical School, Institute of Social Medicine and Epidemiology, Brandenburg an der Havel, Germany
| | - E Mena
- University of Bremen, Institute of Public Health and Nursing Research, Bremen, Germany
- University of Bremen, Health Sciences Bremen, Bremen, Germany
| | - K Pöge
- Robert Koch-Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany
| | - S Strasser
- Robert Koch-Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany
| | - A C Saß
- Robert Koch-Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany
| | - A Rommel
- Robert Koch-Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany
| | - G Bolte
- University of Bremen, Institute of Public Health and Nursing Research, Bremen, Germany
- University of Bremen, Health Sciences Bremen, Bremen, Germany
| | - C Holmberg
- Brandenburg Medical School, Institute of Social Medicine and Epidemiology, Brandenburg an der Havel, Germany
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Mena E, Jaehn P, Merz S, Pöge K, Strasser S, Saß AC, Rommel A, Holmberg C, Bolte G. Suggestions for a gender-sensitive and intersectional practice of health monitoring and reporting. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Health reports summarize the evidence basis on disease burden and its causes and are intended to inform decisions of policy makers. By focusing on health needs of social groupings according to sex/gender or race/ethnicity, PHMR crucially contributes to achieving health equity. In order to realise its aims, PHMR relies on the availability of high-quality data, appropriate analysis methods and intuitive presentation of results.
Methods
The joint project AdvanceGender used mixed methods to translate principles of intersectionality into new methods for recruitment, data analysis and health reporting. A review of descriptions of representativeness in epidemiological studies was conducted to investigate how an intersectional perspective can inform recruitment. To evaluate intersectional and gender-sensitive data analysis, we reviewed and applied recently developed methods such as classification and regression tree analysis (CART) and multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA).
Findings
An intersectional perspective on representativeness unravelled that study participation of women and men might be differential according to further social categories such as civil status or educational level. CART analysis might help to identify intersectional groupings differing in health behaviours or outcomes by exploring a multitude of social dimensions without facing the risk of stereotyping with predefined categories. MAIHDA depicts an alternative method that is suited for descriptive analyses of health-related outcomes among intersectional strata. In contrast to analysing supposedly static features such as sex, a focus on solution-linked variables like social support might be a fertile ground to identify areas for public health action.
Discussion
Principles of intersectionality open up new perspectives for recruitment and data analysis that might be fruitful for population health research and ultimately for PHMR.
Greta Bauer
Schulich School of Medicine & Dentistry, Western University, London, Canada
Contact: gbauer@uwo.ca
Olena Hankivsky
University of Melbourne, Centre for Health Equity, Melbourne, Australia Institute for Intersectionality Research, School of Public Policy, Simon Fraser University, Burnaby, Canada
Contact: o.hankivsky@unimelb.edu.au
Nicole Rosenkötter
NRW Centre for Health, Division of Health Reporting, Bielefeld, Germany
Contact: Nicole.Rosenkoetter@lzg.nrw.de
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Affiliation(s)
- E Mena
- University of Bremen, Institute of Public Health and Nursing Research, Bremen, Germany
- University of Bremen, Health Sciences Bremen, Bremen, Germany
| | - P Jaehn
- Brandenburg Medical School, Institute of Social Medicine and Epidemiology, Brandenburg an der Havel, Germany
| | - S Merz
- Brandenburg Medical School, Institute of Social Medicine and Epidemiology, Brandenburg an der Havel, Germany
| | - K Pöge
- Robert Koch-Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany
| | - S Strasser
- Robert Koch-Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany
| | - A C Saß
- Robert Koch-Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany
| | - A Rommel
- Robert Koch-Institute, Department of Epidemiology and Health Monitoring, Berlin, Germany
| | - C Holmberg
- Brandenburg Medical School, Institute of Social Medicine and Epidemiology, Brandenburg an der Havel, Germany
| | - G Bolte
- University of Bremen, Institute of Public Health and Nursing Research, Bremen, Germany
- University of Bremen, Health Sciences Bremen, Bremen, Germany
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Rommel A. Determinants of frequent use of primary care in the German healthcare system. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
In Germany, patients are consulting general practitioners increasingly frequently, resulting in a high burden on the healthcare system. This study aimed to identify factors associated with frequent primary care attendance in the German healthcare system.
Methods
The German Health Interview and Examination Survey for Adults (DEGS) is part of Germany’s national health monitoring, and includes a large representative sample of the German population aged 18-79 years. We defined the 10% of participants with the highest number of physician contacts in the preceding 12 months as frequent attenders. Binary logistic regression models with average marginal effects were used to identify determinants for the frequent use of primary care services.
Results
The sample comprised 7,956 participants. Significant effects on frequent use of primary care were observed for low socioeconomic status, stressful life events, and factors related to objective need for medical care and subjective health status. In the full model, the number of non-communicable diseases and subjective health status had the strongest effect on frequent primary care use. We found an interaction effect between subjective health status and number of non-communicable diseases, indicating the association of disease with frequent use was highly moderated by subjective perception of health.
Conclusions
We observed strong associations between frequent primary care attendance and objective and subjective health-related factors. These findings suggest that better coordination of care may be a preferred method to manage health services utilization behaviour and avoid redundant examinations and uncoordinated clinical pathways. Further research is needed to clarify moderating and mediating factors contributing to high utilization of primary care services.
Key messages
The number of NCDs diseases and subjective health had the strongest effect on frequent primary care use. The findings suggest that better coordination of care may be the preferred method to manage health services utilization.
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Affiliation(s)
- A Rommel
- Robert Koch-Institute, Berlin, Germany
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Koschollek C, Bartig S, Rommel A, Lampert T, Santos-Hövener C. Health of adolescents with migration background in Germany: cross-sectional results from KiGGS wave 2. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Although 36.5% of minors in Germany had a migration background (MB) in 2017, data on their health situation is scarce. The project ‘Improving Health Monitoring in Migrant Populations’ (IMIRA) initiated in 2016 aims to expand health reporting on the health situation of people with MB, for which a core indicator set was developed. We are describing the health situation of adolescents based on selected core indicators.
Methods
Data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS wave 2) (2014-2017) are used; adolescents from 11 to 17 years are considered. Prevalences and 95% confidence intervals are calculated for the following indicators: General health status, overweight, hazardous alcohol consumption and use of pediatric or general practitioner’s services. These indicators are stratified along socio-demographic (gender, age, socio-economic status (SES)) and migration-related characteristics (MB, parents’ duration of stay, language spoken at home).
Results
There are hardly any migration-related differences in the general health status and the use of general medical services. While adolescents with MB are more often affected by overweight (without MB: 11.2%, one-sided: 18.9%, both-sided: 19.8%), they show less often risky alcohol consumption (without MB: 14.5%, one-sided: 7.8%, both-sided: 4.4%). There are differences in health behavior according to SES, parents’ duration of stay in Germany and language spoken at home.
Conclusions
Overall, the health of adolescents is good, regardless of their MB, and general medical services are used equally. Differences in health behavior cannot be reduced solely to the (non-)existence of a MB, but need a deeper consideration of more specific migration-related characteristics and the SES.
Key messages
The general health status and health care utilization do not differ between adolescents with and without MB. In contrast, the results on indicators of health behavior vary.
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Affiliation(s)
- C Koschollek
- Department for Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - S Bartig
- Department for Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - A Rommel
- Department for Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - T Lampert
- Department for Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - C Santos-Hövener
- Department for Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Pöge K, Strasser S, Rommel A. Perspectives of LGBTIQ* migrants, refugees and ethnic minorities for the development of a gender-sensitive and intersectional health reporting in Germany. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Pöge
- Epidemiology and Health Reporting, Robert Koch Institute, Berlin, Germany
| | - S Strasser
- Epidemiology and Health Reporting, Robert Koch Institute, Berlin, Germany
| | - A Rommel
- Epidemiology and Health Reporting, Robert Koch Institute, Berlin, Germany
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von der Lippe E, Rommel A, Plass D, Schröder H, Ziese T. The German national Burden of Disease study BURDEN 2020. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - A Rommel
- Robert Koch Institute, Berlin, Germany
| | - D Plass
- German Environment Agency, Berlin, Germany
| | - H Schröder
- Scientific Institute of the AOK, Berlin, Germany
| | - T Ziese
- Robert Koch Institute, Berlin, Germany
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Rommel A, Bretschneider J, Kroll LE, Prütz F, Thom J. Inanspruchnahme psychiatrischer und psychotherapeutischer Leistungen. Individuelle Determinanten und regionale Unterschiede. Psychother Psych Med 2018. [DOI: 10.1055/s-0038-1667953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A Rommel
- Robert Koch-Institut, Berlin, Deutschland
| | | | - LE Kroll
- Robert Koch-Institut, Abt. Epidemiologie und Gesundheitsmonitoring, Berlin, Deutschland
| | - F Prütz
- Robert Koch-Institut, Berlin, Deutschland
| | - J Thom
- Robert Koch-Institut, Berlin, Deutschland
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Schumann M, Santos-Hövener C, Schmich P, Gößwald A, Rommel A, Ziese T, Lampert T. Verbesserung der Informationsgrundlagen zur Gesundheit von Menschen mit Migrationshintergrund – das IMIRA-Projekt. Psychother Psychosom Med Psychol 2018. [DOI: 10.1055/s-0038-1667982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M Schumann
- Robert Koch-Institut, Berlin, Deutschland
| | | | - P Schmich
- Robert Koch-Institut, Berlin, Deutschland
| | - A Gößwald
- Robert Koch-Institut, Berlin, Deutschland
| | - A Rommel
- Robert Koch-Institut, Berlin, Deutschland
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Bartig S, Santos-Hövener C, Lampert T, Rommel A. Menschen mit Migrationshintergrund in der internationalen Gesundheitsberichterstattung. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1667726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- S Bartig
- Robert Koch-Institut, Berlin, Deutschland
| | | | - T Lampert
- Robert Koch-Institut, Berlin, Deutschland
| | - A Rommel
- Robert Koch-Institut, Berlin, Deutschland
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Rommel A, Hoebel J, Starker A. 1.4-O1Utilization of preventive care among people with migrant background. Results from the German Health Interview and Examination Survey for Adults (DEGS). Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Rommel
- Robert Koch Institute, Berlin, Germany
| | - J Hoebel
- Robert Koch Institute, Berlin, Germany
| | - A Starker
- Robert Koch Institute, Berlin, Germany
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Bartig S, Santos-Hövener C, Rommel A. 5.4-O7An international comparison of migration-related health reporting. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky047.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- S Bartig
- Robert Koch Institute, Berlin, Germany
| | | | - A Rommel
- Robert Koch Institute, Berlin, Germany
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Mayer JS, Hees K, Medda J, Grimm O, Asherson P, Bellina M, Colla M, Ibáñez P, Koch E, Martinez-Nicolas A, Muntaner-Mas A, Rommel A, Rommelse N, de Ruiter S, Ebner-Priemer UW, Kieser M, Ortega FB, Thome J, Buitelaar JK, Kuntsi J, Ramos-Quiroga JA, Reif A, Freitag CM. Bright light therapy versus physical exercise to prevent co-morbid depression and obesity in adolescents and young adults with attention-deficit / hyperactivity disorder: study protocol for a randomized controlled trial. Trials 2018; 19:140. [PMID: 29482662 PMCID: PMC5828138 DOI: 10.1186/s13063-017-2426-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 12/18/2017] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The risk for major depression and obesity is increased in adolescents and adults with attention-deficit / hyperactivity disorder (ADHD) and adolescent ADHD predicts adult depression and obesity. Non-pharmacological interventions to treat and prevent these co-morbidities are urgently needed. Bright light therapy (BLT) improves day-night rhythm and is an emerging therapy for major depression. Exercise intervention (EI) reduces obesity and improves depressive symptoms. To date, no randomized controlled trial (RCT) has been performed to establish feasibility and efficacy of these interventions targeting the prevention of co-morbid depression and obesity in ADHD. We hypothesize that the two manualized interventions in combination with mobile health-based monitoring and reinforcement will result in less depressive symptoms and obesity compared to treatment as usual in adolescents and young adults with ADHD. METHODS This trial is a prospective, pilot phase-IIa, parallel-group RCT with three arms (two add-on treatment groups [BLT, EI] and one treatment as usual [TAU] control group). The primary outcome variable is change in the Inventory of Depressive Symptomatology total score (observer-blinded assessment) between baseline and ten weeks of intervention. This variable is analyzed with a mixed model for repeated measures approach investigating the treatment effect with respect to all three groups. A total of 330 participants with ADHD, aged 14 - < 30 years, will be screened at the four study centers. To establish effect sizes, the sample size was planned at the liberal significance level of α = 0.10 (two-sided) and the power of 1-β = 80% in order to find medium effects. Secondary outcomes measures including change in obesity, ADHD symptoms, general psychopathology, health-related quality of life, neurocognitive function, chronotype, and physical fitness are explored after the end of the intervention and at the 12-week follow-up. DISCUSSION This is the first pilot RCT on the use of BLT and EI in combination with mobile health-based monitoring and reinforcement targeting the prevention of co-morbid depression and obesity in adolescents and young adults with ADHD. If at least medium effects can be established with regard to the prevention of depressive symptoms and obesity, a larger scale confirmatory phase-III trial may be warranted. TRIAL REGISTRATION German Clinical Trials Register, DRKS00011666. Registered on 9 February 2017. ClinicalTrials.gov, NCT03371810. Registered on 13 December 2017.
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Affiliation(s)
- Jutta S Mayer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstr. 50, 60528, Frankfurt am Main, Germany.
| | - Katharina Hees
- Institute of Medical Biometry and Informatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Juliane Medda
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstr. 50, 60528, Frankfurt am Main, Germany
| | - Oliver Grimm
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Philip Asherson
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Mariano Bellina
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Michael Colla
- Department of Psychiatry, School of Medicine, University of Rostock, Rostock, Germany
| | - Pol Ibáñez
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Elena Koch
- Mental mHealth Lab, Department of Sport and Sport Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Antonio Martinez-Nicolas
- PROFITH "PROmoting FITness and Health through physical activity" research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Chronobiology Research Group, Department of Physiology, Faculty of Biology, University of Murcia. Campus Mare Nostrum. IUIE. IMIB-Arrixaca. Ciber Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Adrià Muntaner-Mas
- PROFITH "PROmoting FITness and Health through physical activity" research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Physical Activity and Exercise Sciences Research Group, University of Balearic Islands, Palma, Spain
| | - Anna Rommel
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Nanda Rommelse
- Department of Psychiatry, Radboudumc, Nijmegen, The Netherlands.,Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Saskia de Ruiter
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands.,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands
| | - Ulrich W Ebner-Priemer
- Mental mHealth Lab, Department of Sport and Sport Science, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | - Meinhard Kieser
- Institute of Medical Biometry and Informatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Francisco B Ortega
- PROFITH "PROmoting FITness and Health through physical activity" research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Johannes Thome
- Department of Psychiatry, School of Medicine, University of Rostock, Rostock, Germany
| | - Jan K Buitelaar
- Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands.,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands
| | - Jonna Kuntsi
- King's College London, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - J Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain.,Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstr. 50, 60528, Frankfurt am Main, Germany
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Bartig S, Santos-Hövener C, Rommel A. Menschen mit Migrationshintergrund in der Gesundheitsberichterstattung: Stand und Analysepotenziale repräsentativer Surveydaten. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rommel A, Giersdorf J, Prütz F. Frequent Attenders: Was sind die Einflussfaktoren einer überdurchschnittlich häufigen Inanspruchnahme ärztlicher Leistungen in Deutschland? Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- A Rommel
- Robert Koch-Institut, Abt. 2 Epidemiologie und Gesundheitsmonitoring, Berlin
| | - J Giersdorf
- Charité Universitätsmedizin, Berlin School of Public Health (MPH-Kandidat), Berlin
| | - F Prütz
- Robert Koch-Institut, Abt. 2 Epidemiologie und Gesundheitsmonitoring, Berlin
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Wengler A, Santos-Hövener C, Rommel A. Die Nutzbarkeit von Routinedaten zur Analyse des Gesundheitszustands von Menschen mit Migrationshintergrund. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rommel A, Kottner J, Suhr R, Lahmann N. [Frequency of falls among clients of home care services : The importance of care-related and social risk factors]. Z Gerontol Geriatr 2017; 52:3-9. [PMID: 28332012 DOI: 10.1007/s00391-017-1215-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 12/21/2016] [Accepted: 03/02/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Among the elderly falls frequently result in injuries, increase the need for long-term care and pose a challenge for the quality assurance in nursing care. We describe the frequency and risk factors of falls among care-dependent persons using home care services in Germany. METHODS The participants of the study "Nursing-related health problems in home care" (n = 880) were recruited based on a list of the officially accredited nursing services. Data collection followed a standardized study protocol. Proportions were calculated and adjusted odds ratios and predicted probabilities were estimated using binary logistic regression. RESULTS Falls are a frequent occurrence among care-dependent persons who are cared for by home care services: Almost every tenth care-dependent person suffers from a fall within a period of 2 weeks. Falls are mainly associated with social and care-related factors. Besides a low educational status this comprises certain living and care arrangements: People living alone or having infrequent contact to their nursing service as well as clients that, according to their carers, should receive more support have a significantly higher chance of falling. Multimorbidity is a medical risk factor while neurological diseases as well as polypharmacy present increased risks only in interaction with living and care arrangements. CONCLUSION Nursing staff and physicians should maintain an overview of the social and health conditions of people in need of long-term care. If care-dependent persons live alone or are infrequently cared for, additional medical problems considerably increase the risk for falling; therefore, preventive interventions and follow-up assessments of actual need levels should be promptly considered if health conditions or living arrangements change.
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Affiliation(s)
- A Rommel
- Abteilung 2: Epidemiologie und Gesundheitsmonitoring, Robert-Koch-Institut, Postfach 65 02 61, 13302, Berlin, Deutschland.
| | - J Kottner
- Klinik für Dermatologie, Venerologie und Allergologie, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - R Suhr
- Stiftung ZQP, Zentrum für Qualität in der Pflege, Berlin, Deutschland
| | - N Lahmann
- Forschungsgruppe Geriatrie, AG Pflegeforschung, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
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Saß AC, Grüne B, Brettschneider AK, Rommel A, Razum O, Ellert U. [Participation of people with migration background in health surveys of the Robert Koch Institute]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 58:533-42. [PMID: 25896496 DOI: 10.1007/s00103-015-2146-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
People with migration background (PMB) make up a huge section of the population with specific health chances and risks. There are only limited data available on the health situation of PMB, since inclusion of PMB in surveys is hindered, e.g. due to language barriers. The present study has examined to what extent the population-based health surveys of the Robert Koch Institute have managed to include a representative extent of PMB, with the aim of deriving recommendations for analysis options and future recruitment strategies. The 2009 microcensus (MC) of the Federal Statistical Office was used as the basis to check whether the sample of KiGGS Wave 1 (2009-2012) and DEGS 1 (2008-2011) are representative regarding socio-demographic and migrant-specific characteristics. 1107 PMB participated in DEGS 1. In comparison to the MC, particular sub-groups are underrepresented in the sample: people who immigrated themselves (first-generation migrants), people with a low education and Turkish citizens. On the other hand, some age groups are overrepresented. In KiGGS Wave 1, 2021 children and adolescents with a migration background participated. Response was lower if parents had a low education. In total, the participation of children and adolescents with a migration background was lower in comparison to the KiGGS baseline survey. The data on PMB in DEGS 1 and KiGGS Wave 1 are appropriate for health analyses of this population group. However, analyses should be stratified according to characteristics like migrant generation, age or education level, or these characteristics should be adjusted for in statistical models. In order to achieve a representative inclusion of people with a migration background, in future surveys sub-group-specific activities to increase participation of PMB are recommended.
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Affiliation(s)
- Anke-Christine Saß
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Str. 62-64, 12101, Berlin, Deutschland,
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Rommel A. Use of health services in the European Union – Findings from the European Health Interview Survey. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw169.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ziese T, Kroll L, Lampert T, Prütz F, Rommel A, Seeling S, Starker A, Ryl L, Saß A. Gesundheitsberichterstattung am RKI – der neue Gesundheitsbericht und künftige Entwicklungen. Gesundheitswesen 2016. [DOI: 10.1055/s-0036-1586605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Swart E, Bitzer EM, Gothe H, Harling M, Hoffmann F, Horenkamp-Sonntag D, Maier B, March S, Petzold T, Röhrig R, Rommel A, Schink T, Wagner C, Wobbe S, Schmitt J. [A Consensus German Reporting Standard for Secondary Data Analyses, Version 2 (STROSA-STandardisierte BerichtsROutine für SekundärdatenAnalysen)]. Gesundheitswesen 2016; 78:e161. [PMID: 27428525 DOI: 10.1055/s-0042-112008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- E Swart
- Medizinische Fakultät, Institut für Sozialmedizin und Gesundheitsökonomie, Otto-von-Guericke-Universität Magdeburg, Magdeburg
| | - E M Bitzer
- Public Health & Health Education, Pädagogische Hochschule Freiburg, Freiburg
| | - H Gothe
- UMIT-Private Universität für Gesundheitswissenschaften, Medizinische Informatik und Technik GmbH, Department für Public Health & Health Technology Assessment, Hall i.T., Austria
| | | | - F Hoffmann
- Department für Versorgungsforschung, Carl von Ossietzky Universität Oldenburg, Oldenburg
| | | | - B Maier
- Berliner Herzinfarktregister am Fachgebiet Management im Gesundheitswesen, TU Berlin
| | - S March
- Medizinische Fakultät, Institut für Sozialmedizin und Gesundheitsökonomie, Otto-von-Guericke-Universität Magdeburg, Magdeburg
| | - T Petzold
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden
| | - R Röhrig
- Department für Versorgungsforschung, Carl von Ossietzky Universität Oldenburg, Oldenburg
| | - A Rommel
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert-Koch-Institut, Berlin
| | - T Schink
- Leibniz-Institut für Präventionsforschung und Epidemiologie-BIPS, Fachgruppe Arzneimittelrisikoforschung, Bremen
| | | | | | - J Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden
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Swart E, Bitzer EM, Gothe H, Harling M, Hoffmann F, Horenkamp-Sonntag D, Maier B, March S, Petzold T, Röhrig R, Rommel A, Schink T, Wagner C, Wobbe S, Schmitt J. A Consensus German Reporting Standard for Secondary Data Analyses, Version 2 (STROSA-STandardisierte BerichtsROutine für SekundärdatenAnalysen). Gesundheitswesen 2016; 78:e145-e160. [PMID: 27351686 DOI: 10.1055/s-0042-108647] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Although secondary data analyses have been established in recent years in health research, explicit recommendations for standardized, transparent and complete reporting of secondary data analyses do not exist as yet. Therefore, between 2009 and 2014, a first proposal for a specific reporting standard for secondary data analysis was developed (STROSA 1). Parallel to this national process in Germany, an international reporting standard for routine data analysis was initiated in 2013 (RECORD). Nevertheless, because of the specific characteristics of the German health care system as well as specific data protection requirements, the need for a specific German reporting standard for secondary data analyses became evident. Therefore, STROSA was revised and tested by a task force of 15 experts from the working group Collection and Use of Secondary Data (AGENS) of the German Society for Social Medicine and Prevention (DGSMP) and the German Society for Epidemiology (DGEpi) as well as from the working group Validation and Linkage of Secondary Data of the German Network for Health Services Research (DNVF). The consensus STROSA-2 checklist includes 27 criteria, which should be met in the reporting of secondary data analysis from Germany. The criteria have been illustrated and clarified with specific explanations and examples of good practice. The STROSA reporting standard aims at stimulating a wider scientific discussion on the practicability and completeness of the checklist. After further discussions and possibly resulting modifications, STROSA shall be implemented as a reporting standard for secondary data analyses from Germany. This will guarantee standardized and complete information on secondary data analyses enabling assessment of their internal and external validity.
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Affiliation(s)
- E Swart
- Medizinische Fakultät, Institut für Sozialmedizin und Gesundheitsökonomie, Otto-von-Guericke-Universität Magdeburg, Magdeburg
| | - E M Bitzer
- Public Health & Health Education, Pädagogische Hochschule Freiburg, Freiburg
| | - H Gothe
- UMIT-Private Universität für Gesundheitswissenschaften, Medizinische Informatik und Technik GmbH, Department für Public Health & Health Technology Assessment, Hall i.T., Austria
| | | | - F Hoffmann
- Department für Versorgungsforschung, Carl von Ossietzky Universität Oldenburg, Oldenburg
| | | | - B Maier
- Berliner Herzinfarktregister am Fachgebiet Management im Gesundheitswesen, TU Berlin
| | - S March
- Medizinische Fakultät, Institut für Sozialmedizin und Gesundheitsökonomie, Otto-von-Guericke-Universität Magdeburg, Magdeburg
| | - T Petzold
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden
| | - R Röhrig
- Department für Versorgungsforschung, Carl von Ossietzky Universität Oldenburg, Oldenburg
| | - A Rommel
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert-Koch-Institut, Berlin
| | - T Schink
- Leibniz-Institut für Präventionsforschung und Epidemiologie-BIPS, Fachgruppe Arzneimittelrisikoforschung, Bremen
| | | | | | - J Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden
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Kuntz B, Frank L, Manz K, Rommel A, Lampert T. Soziale Determinanten der Schwimmfähigkeit von Kindern und Jugendlichen in Deutschland. Ergebnisse aus KiGGS Welle 1. Dtsch Z Sportmed 2016. [DOI: 10.5960/dzsm.2016.238] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Weber A, Karch D, Thyen U, Rommel A, Schlack R, Hölling H, von Kries R. [Utilization of Physiotherapy Services by Children and Adolescents - Results of the KiGGS- Baseline Survey]. Gesundheitswesen 2016; 79:164-173. [PMID: 27056714 DOI: 10.1055/s-0042-100728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Aim of the study: The use of physical therapy in German children and adolescents has so far solely been analyzed on the basis of health insurance data, which can neither consider case history nor social factors. Using the KiGGS-baseline survey it is possible to examine the use of physical therapy on the basis of parental reported health problems and social factors. Methodology: Identifiable determinants for the use of physical therapy in the last 12 months in the KiGGS-baseline survey were examined bivariate and multivariate in logistic regression models with mutual adjustment. The following determinants were considered: social factors, somatic disorders and psychological abnormalities. The proportion of the use of physical therapy, which can be explained by these determinants, was estimated using population-attributable risk fraction. Results: The frequency of the use of physical therapy in the last 12 months in the 0 to 17-year-olds in the KiGGS-baseline survey was 6,4% with higher use during infancy and adolescence. The socio-economic status of parents was not associated with the use of physical therapy. A migration background decreased the probability of the use of physical therapy, for example, among children aged 0 to 2 years (ORadjusted: 0,5 [95% CI: 0,2-1,0]). In those with scoliosis, the use of physical therapy was almost twice as frequent in infancy as in adolescence (58,4 vs. 34,4%). A maximum of 15% of all children and adolescents with back pain reported the use of physical therapy. When ADHD was diagnosed at preschool age, the probability of using physical therapy was increased (ORadjusted: 5,1 [95% CI: 1,4-18,6]). The health problems, which were assessed in the KiGGS-baseline survey and considered for this analysis could explain 37% of the use of physical therapy in the 0 to 2-year-olds. In the other age groups, 59 to 62% could be explained. Conclusion: Comparison of the KiGGS-baseline survey with health insurance data shows similar frequencies and patterns of the use of physical therapy and can therefore be used for the analysis of healthcare questions on the use of physical therapy. The data point to potential deficits in treatment in population segments and for some conditions. An examination of these hypotheses based on analyses of health insurance data seems to be reasonable.
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Affiliation(s)
- A Weber
- Institut für soziale Pädiatrie und Jugendmedizin, Ludwig-Maximilians-Universität, München
| | - D Karch
- Institut für soziale Pädiatrie und Jugendmedizin, Ludwig-Maximilians-Universität, München
| | - U Thyen
- Klinik für Kinder- und Jugendmedizin, Universität Lübeck
| | - A Rommel
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert-Koch-Institut, Berlin
| | - R Schlack
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert-Koch-Institut, Berlin
| | - H Hölling
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert-Koch-Institut, Berlin
| | - R von Kries
- Institut für soziale Pädiatrie und Jugendmedizin, Ludwig-Maximilians-Universität, München
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Weber A, Karch D, Thyen U, Rommel A, Schlack R, Hölling H, von Kries R. Inanspruchnahme von Ergotherapie im Kindesalter – Ergebnisse aus der KiGGS-Basiserhebung. Klin Padiatr 2016; 228:77-83. [DOI: 10.1055/s-0041-111177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- A. Weber
- Institute of Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians-University, Munich
| | - D. Karch
- Institute of Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians-University, Munich
| | - U. Thyen
- Clinic for paediatrics and adolescent medicine, University hospital Schleswig-Holstein, Lübeck
| | - A. Rommel
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin
| | - R. Schlack
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin
| | - H. Hölling
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, Berlin
| | - R. von Kries
- Institute of Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians-University, Munich
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Rommel A. Utilization of preventive care among people with migrant Background. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv171.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Kuntz B, Ellert U, Rommel A, Schmitz R, Gutsche J, Poethko-Müller C, Lampert T. Soziale Determinanten der Schwimmfähigkeit von Kindern und Jugendlichen in Deutschland. Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1563255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Rommel A, Saß A, Born S, Ellert U. Gesundheitliche Lage und Gesundheitsverhalten von Menschen mit Migrationshintergrund. Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1). Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1563313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Saß AC, Poethko-Müller C, Rommel A. [Unintentional injuries in childhood and adolescence: current prevalence, determinants, and trends: results of the KiGGS study: first follow-up (KiGGS Wave 1)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 57:789-97. [PMID: 24950828 DOI: 10.1007/s00103-014-1977-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND In Germany and worldwide, unintentional injuries (UI) are a major health threat for children and adolescents. The first follow-up of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 1, 2009-2012) continued the national UI monitoring that started with the KiGGS baseline study (2003-2006). The present analysis provides updated information and for the first time gives indications on time trends. METHODS KiGGS Wave 1 is a combined nationwide cross-sectional and longitudinal survey by the Robert Koch Institute (RKI) providing information about 12,368 participating children and adolescents (0-17 years old; response rates: 38.8% first time invited, 72.9% reinvited). Parents were asked about their children's UI and poisonings via telephone interviews. Information on UI is available for 11,665 children and adolescents (1-17 years old). The 12-month prevalence rate and 95% confidence interval were calculated, and KiGGS Wave 1 was compared with the KiGGS baseline study. The Rao-Scott chi-square test corrected over the F distribution was used to test for the statistical significance of subgroup differences and trend effects. RESULTS Within the previous 12 months, 15.5% of all children and adolescents aged 1-17 years were medically treated for UI. UI were significantly more prevalent among boys (17.0%) than among girls (14.0%), and 3.4% of the subjects had more than one accident leading to UI. One in eight children and adolescents who suffered UI stayed in hospital (12.3%) for inpatient treatment for at least one night. The home, childcare and educational institutions, and sports facilities/playgrounds were the predominant accident locations. Compared to the baseline study, neither the overall prevalence of UI nor the gender- and age-specific patterns changed significantly. CONCLUSION Since a large proportion of UI is avoidable, knowledge of high-risk subgroups and accident locations is of particular use for prevention. KiGGS Wave 1 makes an important contribution to the comprehension of these issues. The transfer of research into practice is of particular importance for the avoidance of UI.
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Affiliation(s)
- Anke-Christine Saß
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Straße 62, 12101, Berlin, Deutschland,
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Varnaccia G, Saß AC, Rommel A. [Unintentional injuries among children and adolescents in Germany. Data sources and results]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2015; 57:613-20. [PMID: 24863703 DOI: 10.1007/s00103-014-1962-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Compared to adults, children and adolescents run a considerably higher risk of suffering unintentional injuries (UI). To prevent UI, detailed knowledge of the overall accident occurrence and the determinants of UI is needed. This article gives an overview of the data sources covering the occurrence of UI among children and adolescents in Germany. According to the Robert Koch Institute's German Health Interview and Examination Survey for Children and Adolescents (KiGGS), approximately 15.3 % of children and adolescents (1-17 years) in Germany suffer at least one UI within 12 months. Most accidents (60.7 %) occur at home or during leisure-time activities. In 2011, the German Statutory Accident Insurance (DGUV) registered more than 1.4 million accidents among children in day-care facilities and students in educational institutions. According to official statistics, in the same year, more than 50,000 children and adolescents were injured in traffic accidents. Moreover, the Federal Statistical Office registered 260,534 hospital admissions due to injuries and poisonings among children and adolescents. All data sources revealed age- and sex-specific differences. Boys suffer UI more frequently than girls do and they show higher injury rates in adolescence than during childhood. While UI among children mostly happen at home, road traffic and leisure-time accidents increase in occurrence during adolescence. In Germany, there are numerous initiatives dedicated to the prevention of UI in children and adolescents. The creation of target group-specific prevention measures is complicated by the fact that the methodological approaches of existing data sources differ considerably.
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Affiliation(s)
- G Varnaccia
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Str. 62, 12101, Berlin, Deutschland
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Rommel A, Kroll LKE. Social and regional disparities in the utilization of outpatient physical therapy (PT) services in Germany. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku166.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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37
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Rommel A. Unfälle am Arbeitsplatz – Sozialepidemiologische Befunde zum Arbeitsunfallgeschehen in Deutschland. Ergebnisse der Studie „Gesundheit in Deutschland aktuell 2010“. Gesundheitswesen 2014. [DOI: 10.1055/s-0034-1387000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Varnaccia G, Rommel A, Saß AC. [Unintentional injuries in the German adult population. Results of the "German Health Update" survey 2010]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2014; 57:604-12. [PMID: 24863702 DOI: 10.1007/s00103-014-1961-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In Germany, more than 20,000 people were killed in accidents and 8.7 million people suffered nonfatal unintentional injuries (UI) in 2011. This report gives an overview of the occurrence of nonfatal UI in the German adult population. The representative health survey "German Health Update" 2010 (phone survey) collected data on nonfatal accidents in the adult population within a recall period of 12 months (n = 22,050). Interviewees reporting medically treated UI responded to 19 further questions about accident locations, accident mechanisms, injuries, and consequences of up to three UI within 1 year. Overall, detailed data on 2,117 UI were collected. About 7.9 % of the German adult population suffers at least one medically treated UI within 1 year. Men are more often affected than women and young people more frequently than older people. The majority of all UI occurs at home or during leisure-time activities. One in five UI results from accidents on public footways, roads, and squares. Falls account for almost every third UI and about one in five accidents causes fractures. Two thirds of all UI require inpatient treatment. Two in three UI lead to temporary sick leave averaging 29.7 days of absenteeism. Among UI at home and in leisure-time activities, falls have particularly serious consequences. Moreover, falls play an important role in UI among pedestrians and cyclists. UI affect large parts of the German adult population and are clearly patterned by gender, age, and accident location. Therefore, prevention activities should consider target group-specific needs and setting-specific circumstances of UI.
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Affiliation(s)
- G Varnaccia
- Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Straße 62, 12101, Berlin, Deutschland
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Lahmann NA, Heinze C, Rommel A. Stürze in deutschen Krankenhäusern und Pflegeheimen 2006–2013. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2014; 57:650-9. [DOI: 10.1007/s00103-014-1966-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Wiedermann U, Kletecka-Pulker M, Rommel A, Kollaritsch H, Cichoń P, Vetter N, Kautzky-Willer A, Novak-Zezula S, Trummer U, Binder-Fritz C, Akkaya-Kalayci T, Hanschitz AJ, Dachs P, Zehetgruber M, Habersack H, Allesch J, Leitner K, Parrag S. Migration – epidemiologische, soziokulturelle und medizinische Aspekte. Wien Klin Wochenschr 2014. [DOI: 10.1007/s00508-013-0462-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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41
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Rommel A, Varnaccia G, Saß AC. Unintentional injuries and gender – Using CRT to identify specific injury profiles for men and women. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt123.163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Schüler G, Klaes L, Rommel A, Schröder H, Köhler T. Zukünftiger Qualifikationsbedarf in der Pflege. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56:1135-44. [DOI: 10.1007/s00103-013-1754-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rattay P, Butschalowsky H, Rommel A, Prütz F, Jordan S, Nowossadeck E, Domanska O, Kamtsiuris P. Erratum zu: Inanspruchnahme der ambulanten und stationären medizinischen Versorgung in Deutschland. Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013. [DOI: 10.1007/s00103-013-1774-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rommel A. Drogen- und Substanzkonsum bei Männern – Ansatzpunkte für eine gendersensible Prävention – Ergebnisse aus dem Männergesundheitsbericht des Robert Koch-Instituts. Dtsch Med Wochenschr 2012. [DOI: 10.1055/s-0032-1323445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Weilandt C, Rommel A, Eckert J, Gall Azmat R. Gesundheitsmonitoring der Migrationsbevölkerung in der Schweiz. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2006; 49:866-72. [PMID: 16927036 DOI: 10.1007/s00103-006-0020-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
With the health monitoring of the Swiss migrant population, a database was created on migrants' health state, their health behaviour and utilization of health services. Thanks to this database, it is now possible to draw representative conclusions on the health status of migrants compared to the indigenous population. Based on the Swiss Health Survey, a questionnaire was developed and translated into several languages. A survey of the foreign population permanently resident in Switzerland as well as of asylum seekers and those temporarily settled in Switzerland was conducted through phone interviews. The interviewees could choose the survey language: in their mother tongue or one of the Swiss languages. A first description of the data is available. The analyses show that the results found for migrants of West European countries are comparable to those of the Swiss population. All other migrants come off worse with regard to health and social indicators. For example, they assess their self-perceived health state more often as "average" or "bad", they feel emotionally less balanced, or visit a doctor more frequently than the Swiss population does. Significant differences can be found within the data of the surveyed migrant population, for example depending on gender, age, residence status or nationality.
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Affiliation(s)
- C Weilandt
- Wissenschaftliches Institut der Arzte Deutschlands, Bonn, BRD.
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Rommel A. [Migration and rehabilitation of mental diseases -- perspectives and limitations in the reporting of official data of service providers]. Gesundheitswesen 2005; 67:280-8. [PMID: 15856388 DOI: 10.1055/s-2004-813832] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Health and social monitoring are important foundations of political decision making. In order to make statements about populations and subgroups different sources of information are generally used. The potential contribution which aggregated official health data of service providers can make is discussed in the exemplary context of the utilisation of medical rehabilitation of mental diseases. Age specific rates and age standardised ratios show a significantly increased utilisation of services for depression and somatoform disorders amongst women in general and the migrant population in particular. It is demonstrated that the interpretation of such results raises new research questions rather than providing explanations that could prove to be conducive for practical measures. In a methodological discussion it is stated that the reason for this has to be seen in the fact that important structures of action within the care system are concealed by the specific method of collecting and processing official health data. Nevertheless, conceivable interpretations are given regarding the psycho-social living conditions of large parts of the migrant population as well as their difficulties in the interaction with the medical system. This enables the formulation of a hypothetical framework for further research which could help to clarify statistical phenomena found in the official data of service providers.
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Affiliation(s)
- A Rommel
- Wissenschaftliches Institut der Arzte Deutschlands (WIAD) gem. e. V., Bonn.
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Wiedemann G, Haupt M, Rommel A, Rommel KF, Biesenbach R, Schmidt W. [Incidence of pathologic ammonia concentrations in the plasma in children with seizure disorders treated with Convulsofin/Convulex and other anticonvulsants in comparison with children with brain damage and healthy children]. Kinderarztl Prax 1990; 58:21-7. [PMID: 2110274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In healthy children plasma ammonia concentrations show values from 12.3 to 57.2 mumol/l (80%-range) (group I). We also measured plasma ammonia in epilepsy patients with valproate therapy (group II) and epilepsy patients treated with other anticonvulsiva (group III). In a fourth group there were children with various cerebral lesions without episodes and without anticonvulsiva therapy. There were significant differences between group I and group II and group II and group IV respectively. But no significant differences were found between the patients who were treated with valproate and the patients with cerebral lesions. The data does not allow the plasma ammonia concentration to be taken as a control parameter in children treated with valproate. Ammonia estimation at the beginning of therapy, however, may be used as risk indicator.
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Affiliation(s)
- G Wiedemann
- Klinik und Poliklinik für Kindermedizin, Medizinischen Akademie Erfurt
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Lagueny A, Rommel A, Vignolly B, Taieb A, Vendeaud-Busquet M, Doutre MS, Julien J. Thalidomide neuropathy: an electrophysiologic study. Muscle Nerve 1986; 9:837-44. [PMID: 3023998 DOI: 10.1002/mus.880090907] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Thalidomide is effective in the treatment of such disabling dermatologic diseases as aphthosis, discoid lupus erythematosus, and prurigo nodularis, in which other drugs fail. However, its use can induce neuropathy necessitating caution in its administration. It was found in this electrophysiologic study of 13 patients that the data best revealing neuropathy, even when clinical abnormalities were not apparent, were reduction of sensory nerve action potential amplitude on the sural nerve, increase of somatosensory evoked potential latency following sural nerve stimulation, and reduction of sensory action potential amplitude on stimulating the median nerve at the wrist. In two patients, electrophysiologic abnormalities had increased after withdrawal, suggesting a prolonged action of thalidomide. Timely reduction of dosage, after detection of changes indicating the onset of side effects, could reduce the risk of the sometimes rapid emergence of clinical symptoms.
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Rakhit A, Hurley ME, Tipnis V, Coleman J, Rommel A, Brunner HR. Pharmacokinetics and pharmacodynamics of pentopril, a new angiotensin-converting-enzyme inhibitor in humans. J Clin Pharmacol 1986; 26:156-64. [PMID: 3007583 DOI: 10.1002/j.1552-4604.1986.tb02927.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
In a single, ascending-dose tolerance study, nine healthy volunteers were given oral pentopril 50 to 750 mg (CGS 13945) in groups of three each. Disposition characteristics of pentopril and its active metabolite (CGS 13934) were determined using plasma concentration and urinary excretion data. The drug was absorbed rapidly following zero-order kinetics. The drug has an apparent volume of distribution of 0.83 L/kg and an oral clearance of about 0.79 L/hr/kg. Urinary excretions, calculated after 125- and 250-mg doses, showed a dose proportional urinary recovery of 21% (+/- 5%) for pentopril and 40% (+/- 5%) for CGS 13934. In the multiple-dose study of 125 mg orally q12h in six healthy subjects, the plasma concentrations for both drug and metabolite showed no appreciable accumulation of either compound, which was expected from their short pharmacokinetic half-lives (pentopril, less than 1 hr; CGS 13934, approximately 2 hr). In a separate pharmacodynamic study, drug and metabolite concentrations were evaluated against angiotensin-I (AI)-induced changes in blood pressure and plasma angiotensin-converting-enzyme (ACE) activity in healthy volunteers after single oral doses (range, 10-500 mg). The pharmacodynamic half-life for plasma ACE inhibition increased with the dose (10 mg, 1.5 hr; 500 mg, 9.8 hr). There was a close relationship between the plasma level of the metabolite and the inhibition of plasma ACE activity and AI-induced pressor response. A hyperbolic function adequately described the dependence of plasma ACE activity on plasma metabolite concentration with a concentration at half-maximal inhibition of 53 ng/mL.
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Rakhit A, Hurley ME, Redalieu E, Kochak G, Tipnis V, Coleman J, Rommel A. Effect of food on the bioavailability of pentopril, an angiotensin-converting-enzyme inhibitor, in healthy subjects. J Clin Pharmacol 1985; 25:424-8. [PMID: 2997306 DOI: 10.1002/j.1552-4604.1985.tb02870.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Pentopril (CGS 13945) was administered in 125-mg capsules to eight healthy men on two occasions according to a randomized schedule; on one occasion in the fasting state and on the other occasion immediately following the ingestion of a standardized meal. Unlike captopril, a prototype angiotensin-converting-enzyme inhibitor, there was no significant difference in the peak plasma concentration for either the drug or its active metabolite (CGS 13934) between the fasting and the fed states. There was also no appreciable change in the area under the plasma curve for the drug and its metabolite after administration of drug in the presence of food compared with a fasting state. There was, however, a lag time in drug absorption after ingestion of food, which resulted in a significant increase in peak time for the active metabolite in plasma. Food delays the body's absorption of the drug and hence the appearance of its active metabolite in plasma without any significant effect on the relative bioavailability. Because relative bioavailability is not affected in the presence of food, such a delay may not have any therapeutic importance on chronic administration.
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