Leibniz Institute for Prevention Research and EpidemiologyBIPS

Bremen, Germany

Leibniz Institute for Prevention Research and EpidemiologyBIPS

Bremen, Germany
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Pohlabeln H.,Leibniz Institute for Prevention Research and EpidemiologyBIPS | Rach S.,Leibniz Institute for Prevention Research and EpidemiologyBIPS | de Henauw S.,Ghent University | Eiben G.,Gothenburg University | And 7 more authors.
European Child and Adolescent Psychiatry | Year: 2017

The aim of this study is to investigate whether in addition to established early risk factors other, less studied pre-, peri-, and postnatal influences, like gestational hypertension or neonatal respiratory disorders and infections, may increase a child’s risk of developing attention-deficit/hyperactivity disorders (ADHD). In the IDEFICS study more than 18,000 children, aged 2–11.9 years, underwent extensive medical examinations supplemented by parental questionnaires on pregnancy and early childhood. The present analyses are restricted to children whose parents also completed a supplementary medical questionnaire (n = 15,577), including the question whether or not the child was ever diagnosed with ADHD. Multilevel multivariable logistic regression was used to assess the association between early life influences and the risk of ADHD. Our study confirms the well-known association between maternal smoking during pregnancy and a child’s risk of ADHD. In addition, our study showed that children born to mothers younger than 20 years old were 3–4 times more likely to develop ADHD as compared to children born to mothers aged 25 years and older. Moreover, we found that children whose mothers suffered from pregnancy-induced hypertension had an approximately twofold risk of ADHD (OR 1.95; 95% CI 1.09–3.48). This also holds true for infections during the first 4 weeks after birth (OR 2.06; 95% CI 1.05–4.04). In addition, although not statistically significant, we observed a noticeable elevated risk estimate for neonatal respiratory disorders (OR 1.76; 95% CI 0.91–3.41). Hence, we recommend that these less often studied pre-, peri, and postnatal influences should get more attention when considering early indicators or predictors for ADHD in children. However, special study designs such as genetically sensitive designs may be needed to derive causal conclusions. © 2017 Springer-Verlag Berlin Heidelberg


Brand T.,Leibniz Institute for Prevention Research and EpidemiologyBIPS | Samkange-Zeeb F.,Leibniz Institute for Prevention Research and EpidemiologyBIPS | Ellert U.,Robert Koch Institute | Keil T.,Charité - Medical University of Berlin | And 10 more authors.
International Journal of Public Health | Year: 2017

Objectives: We assessed the association between acculturation and health-related quality of life (HRQoL) among persons with a Turkish migrant background in Germany. Methods: 1226 adults of Turkish origin were recruited in four German cities. Acculturation was assessed using the Frankfurt Acculturation Scale resulting in four groups (integration, assimilation, separation and marginalization). Short Form-8 physical and mental components were used to assess the HRQoL. Associations were analysed with linear regression models. Results: Of the respondents, 20% were classified as integrated, 29% assimilated, 29% separated and 19% as marginalized. Separation was associated with poorer physical and mental health (linear regression coefficient (RC) = −2.3, 95% CI −3.9 to −0.8 and RC = −2.4, 95% CI −4.4 to −0.5, respectively; reference: integration). Marginalization was associated with poorer mental health in descendants of migrants (RC = −6.4, 95% CI −12.0 to −0.8; reference: integration). Conclusions: Separation and marginalization are associated with a poorer HRQoL. Policies should support the integration of migrants, and health promotion interventions should target separated and marginalized migrants to improve their HRQoL. © 2017 Swiss School of Public Health (SSPH+)


Hebestreit A.,Leibniz Institute for Prevention Research and EpidemiologyBIPS | Intemann T.,Leibniz Institute for Prevention Research and EpidemiologyBIPS | Siani A.,National Research Council Italy | Dehenauw S.,Ghent University | And 12 more authors.
Nutrients | Year: 2017

The aim of this study was to determine whether an association exists between children’s and parental dietary patterns (DP), and whether the number of shared meals or soft drink availability during meals strengthens this association. In 2013/2014 the I. Family study cross-sectionally assessed the dietary intakes of families from eight European countries using 24-h dietary recalls. Usual energy and food intakes from six-to 16-year-old children and their parents were estimated based on the NCI Method. A total of 1662 child-mother and 789 child-father dyads were included, DP were derived using cluster analysis. We investigated the association between children’s and parental DP and whether the number of shared meals or soft drink availability moderated this association using mixed effects logistic regression models. Three DP comparable in children and parents were obtained: Sweet & Fat, Refined Cereals, and Animal Products. Children were more likely to be allocated to the Sweet & Fat DP when their fathers were allocated to the Sweet & Fat DP and when they shared at least one meal per day (OR 3.18, 95% CI 1.84, 5.47). Being allocated to the Sweet & Fat DP increased when the mother or the father was allocated to the Sweet & Fat DP and when soft drinks were available (OR 2.78, 95% CI 1.80, 4.28 or OR 4.26, 95% CI 2.16, 8.41, respectively). Availability of soft drinks and negative parental role modeling are important predictors of children’s dietary patterns. © 2017 by the authors; licensee MDPI, Basel, Switzerland.


Forberger S.,Leibniz Institute for Prevention Research and EpidemiologyBIPS | Bammann K.,University of Bremen | Bauer J.,University of Heidelberg | Boll S.,Carl von Ossietzky University | And 10 more authors.
International Journal of Environmental Research and Public Health | Year: 2017

The paper introduces the theoretical framework and methods/instruments used by the Physical Activity and Health Equity: Primary Prevention for Healthy Ageing (AEQUIPA) prevention research network as an interdisciplinary approach to tackle key challenges in the promotion of physical activity among older people (65+). Drawing on the social-ecological model, the AEQUIPA network developed an interdisciplinary methodological design including quantitative/qualitative studies and systematic reviews, while combining expertise from diverse fields: public health, psychology, urban planning, sports sciences, health technology and geriatrics. AEQUIPA tackles key challenges when promoting physical activity (PA) in older adults: tailoring of interventions, fostering community readiness and participation, strengthening intersectoral collaboration, using new technological devices and evaluating intervention generated inequalities. AEQUIPA aims to strengthen the evidence base for age-specific preventive PA interventions and to yield new insights into the explanatory power of individual and contextual factors. Currently, the empirical work is still underway. First experiences indicate that the network has achieved a strong regional linkage with communities, local stakeholders and individuals. However, involving inactive persons and individuals from minority groups remained challenging. A review of existing PA intervention studies among the elderly revealed the potential to assess equity effects. The results will add to the theoretical and methodological discussion on evidence-based age-specific PA interventions and will contribute to the discussion about European and national health targets. © 2017 by the authors. Licensee MDPI, Basel, Switzerland.


Bogl L.H.,University of Helsinki | Bogl L.H.,Leibniz Institute for Prevention Research and EpidemiologyBIPS | Silventoinen K.,University of Helsinki | Hebestreit A.,Leibniz Institute for Prevention Research and EpidemiologyBIPS | And 15 more authors.
Nutrients | Year: 2017

Information on familial resemblance is important for the design of effective family-based interventions. We aimed to quantify familial correlations and estimate the proportion of variation attributable to genetic and shared environmental effects (i.e., familiality) for dietary intake variables and determine whether they vary by generation, sex, dietary quality, or by the age of the children. The study sample consisted of 1435 families (1007 mothers, 438 fathers, 1035 daughters, and 1080 sons) from the multi-center I.Family study. Dietary intake was assessed in parents and their 2–19 years old children using repeated 24-h dietary recalls, from which the usual energy and food intakes were estimated with the U.S. National Cancer Institute Method. Food items were categorized as healthy or unhealthy based on their sugar, fat, and fiber content. Interclass and intraclass correlations were calculated for relative pairs. Familiality was estimated using variance component methods. Parent–offspring (r = 0.11–0.33), sibling (r = 0.21–0.43), and spouse (r = 0.15–0.33) correlations were modest. Parent–offspring correlations were stronger for the intake of healthy (r = 0.33) than unhealthy (r = 0.10) foods. Familiality estimates were 61% (95% CI: 54–68%) for the intake of fruit and vegetables and the sum of healthy foods and only 30% (95% CI: 23–38%) for the sum of unhealthy foods. Familial factors explained a larger proportion of the variance in healthy food intake (71%; 95% CI: 62–81%) in younger children below the age of 11 than in older children equal or above the age of 11 (48%; 95% CI: 38–58%). Factors shared by family members such as genetics and/or the shared home environment play a stronger role in shaping children’s intake of healthy foods than unhealthy foods. This suggests that family-based interventions are likely to have greater effects when targeting healthy food choices and families with younger children, and that other sorts of intervention are needed to address the intake of unhealthy foods by children. © 2017 by the authors. Licensee MDPI, Basel, Switzerland.


Samkange-Zeeb F.,Leibniz Institute for Prevention Research and EpidemiologyBIPS | Samkange-Zeeb F.,University of Bremen | Ernst S.A.,Leibniz Institute for Prevention Research and EpidemiologyBIPS | Klein-Ellinghaus F.,Leibniz Institute for Prevention Research and EpidemiologyBIPS | And 4 more authors.
International Journal of Environmental Research and Public Health | Year: 2015

The Internet offers a new chance for health professionals to reach population groups not usually reached through traditional information channels, for example, migrants. Criticism has, however, been raised that most health information on the Internet is not easy to read and lacks cultural sensitivity. We developed an Internet-based bilingual health assistant especially for Turkish migrants in Germany, tested its acceptance, and evaluated its usability in a participatory research design with families with and without Turkish migrant background. The interactive health assistant covered the following: nutrition, physical activity, overweight, diabetes, as well as pregnancy and pregnancy support. The idea of an Internet-based health assistant was generally accepted by all participants of the evaluation study, as long as it would be incorporated in existing appliances, such as smartphones. The bilingual nature of the assistant was welcomed especially by first generation migrants, but migrant participants also indicated that not all health information needed to be made available in a culture-specific way. The participants were least satisfied with the nutrition component, which they felt should include recipes and ingredients from the culture of origin, as well as specific aspects of food preparation. © 2015 by the authors; licensee MDPI, Basel, Switzerland.


Mall S.,Helmholtz Center for Infection Research | Mall S.,Max Delbrück Center for Molecular Medicine | Akmatov M.K.,Helmholtz Center for Infection Research | Akmatov M.K.,Center for Experimental and Clinical Research | And 8 more authors.
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz | Year: 2014

Background: Incidence of acute respiratory infections (ARI) and gastrointestinal infections (GII) are difficult to assess due to high frequency episodes, limited severity and short duration. Retrospective assessments therefore are particularly prone to recall bias, while prospective assessment with conventional questionnaires requires high discipline from participants which is difficult to maintain over longer time periods. Web-based questionnaires (WQ) allow integration of a recall system and thus carry the potential to prospectively capture acute infections. We investigated the feasibility of a weekly WQ assessing symptoms of ARI and GII among participants of the German National Cohort (GNC).Material and methods: In the study centres Hamburg and Bremen of the GNC participants of the Pretest 1 phase (September to November 2011) were invited to additionally take part in this feasibility study testing the WQ. Every Monday participants received an e-mail, containing a link to the WQ, asking for occurrence of ARI or GII symptoms during the past 7 days. The study took place from the beginning of February until mid-July 2012. We calculated the overall proportion of participation, weekly participation and the number of weekly reports per participant and we estimated incidences of ARI, ILI and GII.Results: Of 200 Pretest 1 participants 171 (86 %) reported having an email address and thus were eligible for the web-based study. A total of 167 (98 %) agreed to participate. Participants of the web-based study were younger and better educated than non-participants. Access to Internet decreased with increasing age. Of the 167 participants in the feasibility study, 144 (86 %) responded at least once during the study period of 23 weeks, 5 persons (3 %) had non-functioning email addresses and 18 (11 %) did not respond at all. The weekly response varied between 62 % and 81 %, the median was 74 % (IQR: 71–77 %). Weekly median reports per person were 20 (IQR: 14–22; range 1–23). More than 90 % of participants responded during the first 3 days. The following mean incidence rates were found: ARI, 12 %; ILI, 0.49 %; and GII, 3 %.Conclusion: Use of WQ in prospective studies seems well possible, as Internet access is frequent among study participants and major technical problems did not occur. We observed high participation during the study period of 6 months and low drop out numbers. Participants of the web-based study were slightly younger and better educated than non-participants, so selection bias is possible and must be kept in mind when discussing generalizability of the results. © 2014, The Author(s).


Douros A.,Charité - Medical University of Berlin | Bronder E.,Charité - Medical University of Berlin | Andersohn F.,Charité - Medical University of Berlin | Klimpel A.,Charité - Medical University of Berlin | And 4 more authors.
International Journal of Molecular Sciences | Year: 2016

Herb-induced liver injury (HILI) has recently attracted attention due to increasing reports of hepatotoxicity associated with use of phytotherapeutics. Here, we present data on HILI from the Berlin Case-Control Surveillance Study. The study was initiated in 2000 to investigate the serious toxicity of drugs including herbal medicines. Potential cases of liver injury were ascertained in more than 180 Departments of all 51 Berlin hospitals from October 2002 to December 2011. Drug or herb intake was assessed through a standardized face-to-face interview. Drug or herbal aetiology was assessed based on the updated Council for International Organizations of Medical Sciences scale. In ten of all 198 cases of hepatotoxicity included in the study, herbal aetiology was assessed as probable (once ayurvedic herb) or possible (Valeriana five times, Mentha piperita once, Pelargonium sidoides once, Hypericum perforatum once, Eucalyptus globulus once). Mean age was 56.4 ± 9.7 years, and the predominant pattern of liver injury was hepatocellular. No cases of acute liver failure or death were observed. This case series corroborates known risks for ayurvedic herbs, supports the suspected association between Valeriana use and liver injury, and indicates a hepatotoxic potential for herbs such as Pelargonium sidoides, Hypericum perforatum or Mentha piperita that were rarely associated with liver injury before. However, given that possible causality does not prove clinical significance, further studies in this field are needed. © 2016 by the authors; licensee MDPI, Basel, Switzerland.


Ernst S.A.,Leibniz Institute for Prevention Research and EpidemiologyBIPS | Schmitz R.,Robert Koch Institute | Thamm M.,Robert Koch Institute | Ellert U.,Robert Koch Institute
International Journal of Environmental Research and Public Health | Year: 2016

In industrialized countries atopic diseases have been reported to be less likely in children and adolescents with a migrant background compared to non-migrants. This paper aimed at both examining and comparing prevalence of asthma, allergic rhinoconjunctivitis and atopic dermatitis and allergic sensitization to specific IgE antibodies in children and adolescents with and without a migrant background. Using data of the population-based German Health Interview and Examination Survey for children and adolescents (KiGGS; n = 17,450; 0–17 years), lifetime and 12-month prevalence of atopic diseases and point prevalence of 20 common allergic sensitizations were investigated among migrants compared to non-migrants. Multiple regression models were used to estimate the association of atopic disease and allergic sensitization with migrant background. In multivariate analyses with substantial adjustment we found atopic dermatitis about one-third less often (OR 0.73, 0.57–0.93) in participants with a two-sided migrant background. Statistically significant associations between allergic sensitizations and a two-sided migrant background remained for birch (OR 0.73, 0.58–0.90), soybean (OR 0.72, 0.54–0.96), peanut (OR 0.69, 0.53–0.90), rice (OR 0.64, 0.48–0.87), potato (OR 0.64, 0.48–0.85), and horse dander (OR 0.58, 0.40–0.85). Environmental factors and living conditions might be responsible for the observed differences. © 2016 by the authors; licensee MDPI, Basel, Switzerland.


Schultze A.,Helmholtz Center for Infection Research | Akmatov M.K.,Helmholtz Center for Infection Research | Akmatov M.K.,Hannover University of Applied Sciences | Andrzejak M.,Helmholtz Center for Infection Research | And 11 more authors.
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz | Year: 2014

Background: For certain laboratory investigations it is necessary to obtain native stool samples and process them within a narrow time window at the point of contact or a nearby laboratory. However, it is not known whether it is feasible to obtain stool samples from asymptomatic individuals during an appointment in a study center (SC). We therefore compared participants’ preference, feasibility and acceptance of stool sample collection during the appointment at the study center (on-site sampling) to collection at home after the appointment.Methods: The study was conducted at two sites in Northern Germany (Bremen, n = 156; Hannover, n = 147) during the Pretest 2 phase of the German National Cohort (GNC), drawing upon a randomly selected population supplemented by a small convenience sample. In the study center, the participants were given the choice to provide a stool sample during the appointment or to collect a sample later at home and return it by mail.Results: In all, 303 of the 351 participants (86 %) of Pretest 2 at these sites participated in this feasibility study. Only 7.9 % (24/303) of the participants chose on-site collection, whereas 92 % (279/303) chose at-home collection. There were significant differences between the two study sites in that 14 % (21/147) of participants in Hannover and 2 % (3/156) of participants in Bremen chose on-site collection. Compliance was high in both groups, as 100 % (24/24) and 98 % (272/279) of participants in the on-site and at-home groups, respectively, provided complete samples. Both methods were highly accepted, as 92 % of the participants in each group (22/24 and 227/248) stated that stool collection at the respective site was acceptable.Conclusion: When given a choice, most participants in this population-based study preferred home collection of stool samples to collection in the study center. Thus, native stool samples for immediate processing in the study center may potentially be obtained only from a subpopulation of participants, which may lead to selection bias. Home collection, on the other hand, proved to be a highly feasible method for studies that do not require freshly collected native stool. © 2014, The Author(s).

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