Kunze U.,Institute of Social Medicine
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. © 2016 Elsevier GmbH.
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.
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.
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.
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.