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Dortmund, Germany

Background: The body mass index (BMI) of children and adolescents has significantly increased in the last 20 years. Aim: The purpose of this article is to examine the trend in BMI and analyze the influencing factors. Materials and methods: Data of the school entrance examination of the city Dortmund (Germany) for the years 2008–2012 (data from 24,167 children) were included. Results: The BMI did not systematically change over the years 2008–2012: 80.6 % of the children were of normal weight, 8 % of the children were overweight, and 6 % were obese. Factors identified as having an influence were social area cluster, education levels of mother and father, and migration. The education level of the mother and migration are identified as structural characteristics. Factor analysis shows that the educational factors load on one factor, while social area cluster and native language load to a second factor. The education level of the mother represents an important predictor for a child being overweight. © 2015, Springer-Verlag Berlin Heidelberg.

Background: Patients colonized with methicillin resistant Staphylococcus aureus (MRSA) and other multidrug-resistant organisms (MDRO) are entitled to medical rehabilitation similarly to other patients. Some MDRO networks have published recommendations for hygiene management in rehabilitation units. According to the current guideline of the German commission on hospital hygiene and infection prevention (KRINKO), a medical risk analysis is required to establish individual infection control management. Rehabilitation facilities are commissioned to achieve an opti-mal compromise between prevention of transmission of MDROs and enabling the medical rehabilitation of patients colonized with MDRO. Material and method: Medical risk analysis according to KRINKO guidelines is presented, based on two recent studies on MDRO in nursing homes and rehabilitation facilities in the Rhine-Main region. Results: Residents of nursing homes were more often colonized with MRSA (9.2 vs 1.8%) than patients in rehabilitation facilities (excluding neurological rehabilitation). More than one third of the residents exhibited risk factors for MRSA compared to 5% of the patients. Furthermore, 66% of the residents were disoriented or incontinent, leading to the assumption of insufficient personal hygiene - compared to < 1% patients. Conclusion: Implementation of the medical risk analysis shows that the rehabilitation patients (orthopedics, cardiology, surgery) have a low risk for colonization or infection with MDRO. Our analysis did not comprise patients from neurological or geriatric rehabilitation facilities, so that no statement concerning these patients is available.

The long-term aim for the German public health service during National Socialism was a hereditary and racial welfare. Several following legal regulations contributed to the implementation of a specific national socialist population policy on the basis of racial hygiene and gave immense power to health officers. Especially with the Law for the Prevention of Hereditarily Sick Offspring, compulsory sterilisation was legalised and caused about 400 000 victims up to 1945. The central force in this new system was the public health office. The work of two health officers in neighbouring offices in upper Bavaria is compared. Results show that health officers had a large flexibility in their individual estimation. The restrictive interpretation of their duties did not necessarily cause any sanctions by the superior authority © Georg Thieme Verlag KG Stuttgart New York.

Diel R.,Universitares Lungenzentrum Nord | Priwitzer M.,Gesundheitsamt | Niemann S.,Nationales Referenzzentrum fur Mykobakterien
Atemwegs- und Lungenkrankheiten | Year: 2016

Detection of latent tuberculosis infection (LTBI) requires optimal test accuracy and a high prevalence of Mycobacterium tuberculosis (MTB) in the group of persons to be tested for gaining a high positive predictive value (PPV). Thus, effectiveness of contact investigations may be improved markedly by a better preselection of contact persons who have probably been exposed. In contrast, mass routine screening may produce a higher number of false positive test results. Contact investigations detect a considerable amount of active TB cases especially in children and adolescents < 15 years in Germany. Only a small portion of health care workers will be tested periodically for LTBI due to the generally low PPV. Performing a preventive therapy given LTBI needs a stable organizational structure to ensure clinical monitoring and to recheck the individual adherence. Next generation sequencing ("NGS") of MTB strains, a recently developed method of molecular epidemiology, may contribute to a better detection of direct transmissions of strains which were classified to be identical in conventional fingerprinting. © 2016 Dustri-Verlag Dr. Karl Feistle.

Rissland J.,Universitatsklinikum des Saarlandes | Kielstein J.T.,Klinik fur Nieren und Hochdruckerkrankungen | Stark K.,Robert Koch Institute | Wichmann-Schauer H.,Fachgruppe Pravention und Aufklarung Lebensmittelbedingter Ausbruche | And 2 more authors.
Gesundheitswesen | Year: 2013

The EHEC O104:H4 outbreak 2011 in Germany provided numerous insights into the recognition and control of such epidemic situations. Food-borne outbreaks and their related dynamics may lead to a critical burden of disease and an eventual capacity overload of the medical care system. Possible difficulties in the microbiological diagnostics of new or significantly altered infectious agents may result in a delayed detection of the outbreak as well as the launching of interventional measures. Besides an early notification of the local public health office by the affected institutions, in which a complete electronic procedure and additional sentinel or surveillance instruments (e. g., in emergency departments of hospitals) may be of great help, an interdisciplinary cooperation of the local public health and food safety agencies is the key to an effective outbreak control. Corresponding organizations on the state and federal level should support the investigation process by microbiological diagnostics and advanced epidemiological analysis as well as examination of the food chains. Finally, successful crisis communication relies on "speaking with one voiceo" (not necessarily one person). Immediate, transparent, appropriate and honest information of the general public concerning the reasons, consequences and (counter-) measures of a crisis are the best means to keep the trust of the population and to counteract the otherwise inevitable speculations. © Georg Thieme Verlag KG Stuttgart · New York.

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