Kosovska Mitrovica, Serbia
Kosovska Mitrovica, Serbia

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Buchtemann D.,Lüneburg University | Buchtemann D.,Institute of Social Medicine | Luppa M.,Institute of Social Medicine | Bramesfeld A.,Lüneburg University | And 2 more authors.
Journal of Affective Disorders | Year: 2012

Background: In the past years, many studies have examined the prevalence of late-life depression. However, incidence studies, especially those including the oldest age groups, remained rare. The objective of this article is therefore to provide a systematic review on incidence of depressive disorders in latest life. Methods: A systematic search of the literature published between 1985 and 2011 was conducted using MEDLINE, Web of Science, PsycInfo and Cochrane databases. Inclusion criteria were: incidence specified for persons aged≥70 years at baseline, population-based sample or primary care sample. Incidence rates or risks were extracted or calculated. Results: We found 20 studies reporting incidence according to categorical (n=14) or dimensional diagnoses (n=6). The incidence of depressive disorders varied considerably. Major Depression (MD) was found to occur less often than Minor Depression (MinD), whereas clinically relevant depressive symptoms are at least as frequent as MinD. The incidence rate of MD was 0.2-14.1/100 person-years, and incidence of clinically relevant depressive symptoms was 6.8/100 person-years. Female incidence was mostly higher than male. Associations between age and incidence revealed to be rather inconsistent between studies. Limitations: Methodological diversity of the studies concerning diagnostics, data collection methods, incidence definitions and sampling make the results difficult to interprete. Conclusions: This review is the first to have focused on incidence studies on depression in latest life. The frequent occurrence of clinically relevant depressive symptoms will have to be considered in future health care planning. Physical health and psychosocial influences appear to be key variables in depression prevention. © 2012 Elsevier B.V.


Tick-borne encephalitis (TBE) has been a growing public health problem in Europe and other parts of the world for the past 20 years. In 1999, in order to encourage the control of TBE, international experts created a new body: The International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE). This Working Group has been composed of internationally recognized scientific experts from tick-borne encephalitis virus (TBEv)-endemic and non-endemic regions with extensive personal expertise in the field and a high level of commitment to improve the knowledge of TBE and to increase the public awareness of TBE. Since the foundation of the Working Group, ISW-TBE members meet annually. Every meeting is dedicated to a specific topic, and since 2004 a yearly conference report has been published to inform the scientific community about the latest developments. Among the specific issues that have been extensively discussed over the years were the following: clinical aspects of the disease, TBE in children and golden agers, epidemiology, possible causes for the increase in TBE incidence in Europe, TBE and awareness, TBE and travel, (low) vaccination rates, and the cooperation with the European Centre for Disease Prevention and Control (ECDC). This paper gives an overview of the most important activities and achievements of the ISW-TBE over the past 17 years. © 2016 Elsevier GmbH.


Stein J.,Institute of Social Medicine | Luppa M.,Institute of Social Medicine | Konig H.-H.,University of Hamburg | Riedel-Heller S.G.,Institute of Social Medicine
International Psychogeriatrics | Year: 2014

Background: The current demographic and social developments in our society will lead to a significant increase in treatment and healthcare needs in the future, particularly in the elderly population. The Camberwell Assessment of Need for the Elderly (CANE) was developed in the United Kingdom to measure physical-, psychological-, and environment-related treatment as well as healthcare needs of older people in order to identify their unmet needs. So far, the German version of the CANE has not been established in health services research. Major reasons for this are a lack of publications of CANE's German version and the missing validation of the instrument. Methods: The aims of the present study were to evaluate the currently available German version of the CANE in a sample of older primary care patients. Descriptive statistics and inference-statistical analyses were calculated. Results: Patients reported unmet needs mostly in CANE's following sections: mobility/falls, physical health, continence, company, and intimate relationships. Agreement level between patients' and relatives' ratings in CANE was moderate to low. Evidence for the construct validity of CANE was found in terms of significant associations between CANE and other instruments or scores. Conclusions: The study results provide an important basis for studies aiming at the assessment of met and unmet needs in the elderly population. Using the German version of the CANE may substantially contribute to an effective and good-quality health and social care as well as an appropriate allocation of healthcare resources in the elderly population. Copyright © International Psychogeriatric Association 2013.


van den Bergh R.C.N.,Erasmus Medical Center | Essink-Bot M.-L.,Erasmus Medical Center | Essink-Bot M.-L.,Institute of Social Medicine | Roobol M.J.,Erasmus Medical Center | And 3 more authors.
Journal of Urology | Year: 2010

Purpose: Anxiety and distress may be present in patients with low risk prostate cancer who are on active surveillance. This may be a reason to discontinue active surveillance. Materials and Methods: A total of 150 Dutch patients with prostate cancer on active surveillance in a prospective active surveillance study received questionnaires at study inclusion and 9 months after diagnosis. We assessed changes in scores on decisional conflict with the decisional conflict scale, depression with the Center for Epidemiologic Studies Depression Scale, generic anxiety with the State Trait Anxiety Inventory, prostate cancer specific anxiety with the Memorial Anxiety Scale for Prostate Cancer and the self-estimated risk of progression. We explored scores 9 months after diagnosis vs those at study inclusion for physical health (SF-12® physical component summary), personality (Eysenck Personality Questionnaire), shared decision making, prostate cancer knowledge, demographics, medical parameters and prostate specific antigen doubling time during followup. Results: Questionnaires at study inclusion and 9 months after diagnosis were completed by 129 of 150 (86%) and 108 of 120 participants (90%) a median of 2.4 and 9.2 months after diagnosis, respectively. Anxiety and distress at study inclusion were previously found to be generally favorable. Significant but clinically irrelevant decreases were seen in mean scores of the State Trait Anxiety Inventory (p = 0.016), Memorial Anxiety Scale for Prostate Cancer fear of progression subscale (p = 0.005) and the self-estimated risk of progression (p = 0.049). Anxiety and distress 9 months after diagnosis were mainly predicted by scores at study inclusion. Higher Eysenck Personality Questionnaire neuroticism score and an important role of the physician in the treatment decision had additionally unfavorable effects. Good physical health, palpable disease and older age had favorable effects. No association was seen for prostate specific antigen doubling time. Nine men discontinued active surveillance, including 2 due to nonmedical reasons. Conclusions: Anxiety and distress generally remain favorably low during the first 9 months of surveillance. © 2010 American Urological Association Education and Research, Inc.


Donev D.,Institute of Social Medicine | Karadzovski Z.,Institute of Social Medicine | Kasapinov B.,Institute of Social Medicine | Lazarevik V.,Institute of Social Medicine
Prilozi / Makedonska akademija na naukite i umetnostite, Oddelenie za biološki i medicinski nauki = Contributions / Macedonian Academy of Sciences and Arts, Section of Biological and Medical Sciences | Year: 2010

AIM: To analyze and present epidemiological patterns of human brucellosis cases and the main factors for the appearance and spread of B. melitensis infection among animals and humans in R. Macedonia in the period from 1980 to 2009.METHODS: Retrospective study based on the epidemiological reports and official data on brucellosis cases from the Institute for Public Health in Skopje and other institutions from the health and veterinary sectors in R. Macedonia, and a review of the relevant literature.RESULTS: From 1980 until December 2009, a total of 11,451 brucellosis cases were reported in R. Macedonia, with a mean annual incidence rate of 18.9/100,000. The highest morbidity rate during this period was recorded in 1992 (922 cases and an incidence rate of 47.6/100,000), and the lowest one in 1983 (12 cases and an incidence rate of 0.6/100,000). From the total number of cases reported in R. Macedonia from 1980 to 2009, 66.2% were males and 33.8% were females. Only 7.2% of patients were under the age of 10, and the most of the patients were from the age group 20-39 (31.9%). Seasonal characteristics of the disease were expressed with the highest occurrence in May (15.9%), June (16.3%) and July (15.1%). Within the total number of 3,284 brucellosis cases in the period 2001-2009, 2320 (70.6%) were from rural settlements and 964 (29.4%) from urban areas. 385 of all cases of brucellosis (8.4%) reported in the period 1998-2009 were from the ranks of professional staff.CONCLUSION: Brucellosis was, currently is and will be a significant disease problem and concern in R. Macedonia which should be approached in a more comprehensive and organized way in the coming years. There is a need to establish intersectoral collaboration by joint efforts of all relevant factors in the prevention and eradication of brucellosis, as well as collaboration between all countries in the SEE region.


Korfage I.J.,Erasmus Medical Center | Van Den Bergh R.C.N.,Erasmus Medical Center | Essink-Bot M.-L.,Institute of Social Medicine
European Journal of Cancer | Year: 2010

Purpose of the study: Given that screening for prostate cancer has the potential to reduce prostate cancer mortality at the expense of considerable overdiagnosis and overtreatment, the availability of core consumer information - correct, balanced and supportive of autonomous decision-making - is a must. We assessed the quality of consumer information available through the Internet per November 2009 and its possible contribution to informed decision-making by potential screenees. Methods: Consumer information on PSA-screening was sought through the Internet in November 2009. Materials had to be targeted at potential consumers, offered by not-for-profit organisations, released in 2005 or after, in English or Dutch. Per material 2 of the authors assessed independently from each other whether standardised pre-defined topics were addressed, whether the content was correct and which approach was taken towards the decision-making process about uptake. Results: Twenty-three materials were included, of which 11 were released (shortly) after the results of 2 large randomized-controlled trials (RCTs) that evaluated the effectiveness of screening for prostate cancer had been published in March 2009. That a PSA-test result can be abnormal because of non-cancerous conditions (false positive) and that it may miss prostate cancer (false negative) was not addressed in 2/23 and 8/23 materials, respectively. The risk of overdiagnosis and overtreatment was not mentioned in 6 out of 23. PSA-screening was presented as a usual thing to do in some materials, whereas other materials emphasised the voluntary nature of PSA-screening ('it is your decision'). The content of 19/23 materials was considered sufficiently informative according to the pre-defined criteria, 12/23 materials were considered supportive of informed decision-making by men. Conclusions: Most materials of not-for-profit organizations supplied adequate information about PSA-screening, whilst the degree of persuasion towards uptake reflected variations in opinions on men's autonomy regarding their own health. © 2010 Elsevier Ltd. All rights reserved.


Seidler A.,TU Dresden | Thinschmidt M.,TU Dresden | Deckert S.,TU Dresden | Then F.,Institute of Social Medicine | And 3 more authors.
Journal of Occupational Medicine and Toxicology | Year: 2014

Aims. To analyze the association between psychosocial working conditions and burnout and its core component emotional exhaustion, a systematic literature review was undertaken including cohort studies, case-control studies, and randomized controlled trials. Methods. The literature search in Medline and PsycInfo was based on a defined search string and strict exclusion and inclusion criteria. Evaluation of the 5,599 initially identified search hits by two independent reviewers and a detailed quality assessment resulted in six methodologically adequate cohort studies considering the relationship between psychosocial working conditions and burnout (one study) as well as the burnout core component emotional exhaustion (five studies). Results: The results of our systematic review point to a relationship between psychosocial working conditions and the development of emotional exhaustion/burnout. Particularly high job demands seem to play a role in the development of emotional exhaustion. However, strong intercorrelations between workplace factors, as a matter of principle, make the identification of a single psychosocial workplace factor (being associated with an especially high or low risk of burnout) difficult. Conclusions: Multidimensional approaches including reduction of work demands, enhancement of decision latitude and improving the social climate might be promising for preventing burnout and emotional exhaustion. However, methodologically adequate intervention studies are urgently needed to prove the effectiveness of workplace interventions. © 2014Seidler et al.; licensee BioMed Central Ltd.


Vukovic D.S.,Institute of Social Medicine | Nagorni-Obradovic L.M.,Institute for Lung Disease and Tuberculosis | Vukovic G.M.,Center for Emergency Surgery
BMC Public Health | Year: 2010

Background. The study aim was to compare lifestyle behaviors, body mass index (BMI) and perceived health in subjects with and without chronic bronchitis or emphysema, and to explore if these comparisons differed between demographic subgroups. Methods. A stratified two-stage sample of the population of Serbia was used; 14.522 adults aged 20 years were interviewed. Results. Compared with controls, respondents with chronic bronchitis or emphysema reported a 23% increased likelihood of eating fresh vegetables every day (CI 1.02-1.48), 58% increased likelihood of currently smoking (CI 1.32-1.88) and more likely to perceive their health as very bad or bad (OR 4.67, CI 3.64-5.98). After stratification for sex, education, and type of settlement, smoking was significantly associated with chronic bronchitis or emphysema in all subgroups except males. The increased likelihood of very bad or bad perceived health in respondents with chronic bronchitis or emphysema was significant in all subgroups, and was highest for respondents 65 years of age (adjusted OR 6.51; CI 4.87-8.72) and lowest for respondents >65 years of age (adjusted OR 3.25; CI 2.12-4.97). Conclusion. Efforts to enhance perceived health and healthy lifestyle behaviors in subjects with chronic bronchitis or emphysema are necessary. Special attention should be paid to smoking cessation in almost all demographic subgroups. © 2010 Vukovic et al; licensee BioMed Central Ltd.


Then F.S.,Institute of Social Medicine | Then F.S.,University of Leipzig | Luck T.,Institute of Social Medicine | Luck T.,University of Leipzig | And 5 more authors.
Neurology | Year: 2015

Objectives: The aim of the present study was to investigate how different mentally demanding work conditions during the professional life-i.e., enriched environments at work-might influence the rate of cognitive decline in old age. Methods: Individuals (n 1,054) of the Leipzig Longitudinal Study of the Aged, a representative population-based cohort study of individuals aged 75 years and older, underwent cognitive testing via the Mini-Mental State Examination (MMSE) in up to 6 measurement waves. Type and level of mentally demanding work conditions in the participants' former professional life were classified based on the ONET job descriptor database. Results: In multivariate mixed-model analyses (controlling for sociodemographic and health-related factors), a high level of mentally demanding work tasks stimulating verbal intelligence was significantly associated with a better cognitive functioning at baseline (on average 5 MMSE points higher) as well as a lower rate of cognitive decline (on average 2 MMSE points less) over the 8-year follow-up period compared with a low level. The rate of cognitive decline in old age was also significantly lower (on average 3 MMSE points less) in individuals who had a high level of mentally demanding work tasks stimulating executive functions than those who had a low level. Conclusions: The results suggest that a professional life enriched with work tasks stimulating verbal intelligence and executive functions may help to sustain a good cognitive functioning in old age (75+ years). The findings thus emphasize that today's challenging work conditions may also promote positive health effects. © 2015 American Academy of Neurology.


PubMed | Institute of Social Medicine
Type: Journal Article | Journal: Ticks and tick-borne diseases | Year: 2016

Tick-borne encephalitis (TBE) has been a growing public health problem in Europe and other parts of the world for the past 20 years. In 1999, in order to encourage the control of TBE, international experts created a new body: The International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE). This Working Group has been composed of internationally recognized scientific experts from tick-borne encephalitis virus (TBEv)-endemic and non-endemic regions with extensive personal expertise in the field and a high level of commitment to improve the knowledge of TBE and to increase the public awareness of TBE. Since the foundation of the Working Group, ISW-TBE members meet annually. Every meeting is dedicated to a specific topic, and since 2004 a yearly conference report has been published to inform the scientific community about the latest developments. Among the specific issues that have been extensively discussed over the years were the following: clinical aspects of the disease, TBE in children and golden agers, epidemiology, possible causes for the increase in TBE incidence in Europe, TBE and awareness, TBE and travel, (low) vaccination rates, and the cooperation with the European Centre for Disease Prevention and Control (ECDC). This paper gives an overview of the most important activities and achievements of the ISW-TBE over the past 17 years.

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