Gesundheitswesen最新文献

{"title":"[WHO-Guideline Policies and Interventions to Create Healthy School Food Environments].","authors":"Sigrid Moick, Isolde Sommer, Gerald Gartlehner","doi":"10.1055/a-2923-9047","DOIUrl":"https://doi.org/10.1055/a-2923-9047","url":null,"abstract":"<p><strong>Background: </strong>Healthy nutrition in childhood and adolescence is essential for health and well-being and can be purposefully promoted through a healthy school food environment. The present WHO guideline includes policies and interventions that influence the school food environment and formulates evidence-informed recommendations towards the same goal.</p><p><strong>Methods: </strong>Guideline development followed standardized WHO procedures, involving the WHO Nutrition Guidance Expert Advisory Group (NUGAG) and assessing the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation System (GRADE). The evidence base comprised a scoping review, a systematic literature review (literature search conducted in 04-05/2020), and a rapid review update of the literature up to 10/2023 covering three intervention areas: direct school food provision, nutrition standards and regulations, and nudging interventions. No eligible studies were identified for interventions on marketing restrictions or pricing policies.</p><p><strong>Results: </strong>WHO recommends using food provision at schools to increase the consumption of foods and beverages that contribute to a healthy diet. WHO also recommends setting and using nutrition standards or rules to increase the availability, purchase and consumption of foods and beverages at schools that contribute to a healthy diet and to decrease the availability, purchase and consumption of foods and beverages at schools that do not contribute to a healthy diet. Nudging interventions that modify the food environment at schools to increase the selection, purchase and consumption of foods and beverages that contribute to a healthy diet should be implemented, ideally through the simultaneous implementation of multiple nudging interventions. The implementation of this guideline should take into account local factors such as the country's nutrition situation, the socio-cultural and socio-economic context, regionally available foods, food security, climate change, dietary habits, available infrastructure, resources, political and legal frameworks, and governance structures of the WHO Member State. Furthermore, a coordinated approach with other relevant guidelines and recommendations should be pursued.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Between claim and reality: Why WHP offers often go unused and how managers can change this].","authors":"Katharina Flaig, Madeleine Renyi, Kirsten Steinhausen, Nathalie Haas","doi":"10.1055/a-2918-6596","DOIUrl":"https://doi.org/10.1055/a-2918-6596","url":null,"abstract":"<p><strong>Background: </strong>Workplace health promotion (WHP) is essential to counter rising work-related stress, yet participation remains low. This study aimed to identify barriers and facilitators for WHP uptake and derive actionable recommendations.</p><p><strong>Methods: </strong>Mixed-methods design combining an online survey (n=103) and three workshops (n=23).</p><p><strong>Results: </strong>Lack of time, inflexible programmes and insufficient managerial support emerged as key barriers. Employees preferred flexible, working-time-integrated offers, company fitness, bonus schemes and digital formats.</p><p><strong>Conclusion: </strong>Managers are pivotal; a combined action bundle including incentives, leadership training and tailored programmes is recommended.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Technologies in Line with Humanistic Values.","authors":"Gunther Reisinger","doi":"10.1055/a-2894-2608","DOIUrl":"https://doi.org/10.1055/a-2894-2608","url":null,"abstract":"<p><strong>Background: </strong>Climate change, demographic change and digitalisation jointly influence public health and health-care systems. Older people are particularly vulnerable to climate-related health risks and are also more frequently affected by digital exclusion.</p><p><strong>Objective: </strong>This article presents the KliMATE project as an applied example to show how digital and analogue interventions can promote climate, health and digital literacy. In addition, key design principles are discussed in the context of Digital Humanism.</p><p><strong>Methods/approach: </strong>Conceptual analysis combined with project-based experience from developing an intervention consisting of a Progressive Web App and participatory formats.</p><p><strong>Results/implications: </strong>Initial experience shows that low-threshold access, the combination of digital and social formats, and participatory development are crucial for acceptance. Project materials also indicate that KliMATE purposefully links physical activity, climate-adapted training planning, social commitment and low-threshold digital support.</p><p><strong>Conclusion: </strong>Digital technologies can contribute to preventing climate-related health risks if they are designed in a user-centred, transparent and inclusive manner. Digital Humanism provides a suitable ethical framework for this purpose.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Asylum seekers at the reception centre \"Oldentruper Hof\" Bielefeld: First measles vaccination dose rate of 90.3% after vaccination offer as part of the first medical assessment].","authors":"Rick van den Heuvel, Ulrich Linke","doi":"10.1055/a-2918-6372","DOIUrl":"https://doi.org/10.1055/a-2918-6372","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study is to identify demographic data, the \"first measles vaccination dose rate after vaccination offer as part of the first medical assessment\" (EMID rate) and barriers to measles vaccination among asylum seekers in the reception centre \"Oldentruper Hof\" Bielefeld (EAE OTH) in 2024.</p><p><strong>Methodology: </strong>This study is a retrospective data analysis. Demographic data and vaccination data are taken from the administrative Excel sheets and the vaccination lists of the EAE OTH.</p><p><strong>Results: </strong>Data from 3213 asylum seekers in the EAE OTH were analysed for the year 2024. Most were young and male. The ten most frequent countries of origin in descending order were: Syria, Afghanistan, Turkey, Iraq, Iran, Serbia, (North) Macedonia, China, Algeria and both Angola und Azerbaijan (there were as many asylum seekers from Angola as from Azerbaijan). 3047 of them were of an age at which they needed to be immunised against measles. 6.3% of the 3047 were able to present a measles immunisation document from outside the EAE OTH. 84.0% of the 3047 had no external proof of measles immunisation and received their first measles vaccination dose in the EAE OTH. The EMID rate was therefore 90.3%. 9.7% had neither an external measles vaccination certificate nor did they receive their first measles vaccination dose at the EAE OTH. The following reasons were identified for this non-vaccination: Refusal by 1.5%, illness by 1.2%, pregnancy by 2.6%, 'other' by 4.3%.</p><p><strong>Conclusion: </strong>Overall, the EMID rate of the EAE OTH in 2024 was found to be high at 90.3%. Efforts must continue to further optimise this vaccination rate. Further studies in the different asylum reception centres and beyond are needed to obtain more research data on asylum seekers in Germany.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Application-accompanying performance measurement for Digital Health Applications: Optimisation from a healthcare research perspective for targeted and healthcare-relevant performance measurement].","authors":"Ursula Kramer, Theresa Sophie Busse, Nikolas Dietzel, Ria Heinrich, Pascal Kemmerer, Anna Niemeyer, Jutta G Richter, Susanne Singer, Michael Zeiler, Madlen Scheibe","doi":"10.1055/a-2907-9867","DOIUrl":"10.1055/a-2907-9867","url":null,"abstract":"<p><strong>Objective: </strong>Digital health applications (DHA) are part of standard care in Germany. With the Digital Act, application-accompanying performance measurement (German: Anwendungsbegleitende Erfolgsmessung, AbEM) will become mandatory in 2026 for evaluating the use and effectiveness of DHA under everyday conditions. The aim of this position paper was to formulate requirements for AbEM that would enable a valid and practice-relevant evaluation. In addition, proposals for the practical implementation of these requirements were developed.</p><p><strong>Methodology: </strong>AbEM was discussed and evaluated in 24 meetings of experts from healthcare research, medicine and digital health. Existing concepts for quality measurement and patient-reported outcome and experience measures (PROMs, PREMs) were reviewed and assessed for their transferability. Furthermore, specific requirements for data collection and evaluation in AbEM were identified.</p><p><strong>Results: </strong>In addition to the proposed measurement instruments for the AbEM, in particular PROMs and PREMs, and the usage data collected within the DHA, reasons for discontinuation and long-term effects as well as undesirable DHA effects should be collected with pre-defined categories. The patient's assessment of the outcomes should be supplemented by an assessment by the therapist at the end of DHA use. Active discontinuation logic in the applications, standardised collection protocols and an electronic patient record interface through which pseudonymised AbEM data is transferred to a common AbEM data pool and evaluated in a DHA-specific and manufacturer-independent manner could increase the knowledge gained from AbEM and its usefulness as a research resource. Comparisons between different DHAs or with treatment alternatives within the framework of AbEM are currently not recommended due to methodological limitations. In the future, inclusion of medical registries that integrate standardised and interoperable DHA master data sets, or the establishment of independent DHA registries, could improve the usability and knowledge gains of AbEM data from DHA.</p><p><strong>Conclusions: </strong>AbEM offers the opportunity to make DHA use transparent and promote quality-oriented remuneration. This requires methodologically sound, independent and interoperable data collection that focuses on patient-relevant outcomes, incorporates the perspective of prescribers and enables the integration of (routine) data. The current implementation of DHA-AbEM does not yet sufficiently address these key points.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Climate Change and Population Ageing: The Uncomfortable Realities of Our Time and Their Implications for Public Health.","authors":"Thomas E Dorner, K Viktoria Stein","doi":"10.1055/a-2895-4643","DOIUrl":"https://doi.org/10.1055/a-2895-4643","url":null,"abstract":"","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated climate and health policy interventions into everyday life can foster co-benefits for healthier aging and the climate.","authors":"Willi Haas, Linda Gotsmy, André Baumgart, Hans-Peter Hutter, Christina Fastl, Thomas Ernst Dorner","doi":"10.1055/a-2903-6433","DOIUrl":"10.1055/a-2903-6433","url":null,"abstract":"<p><strong>Abstract: </strong>Changes in everyday life have great potential to promote a long and healthy life. At the same time, these changes are also climate-friendly in many areas, as they either reduce emissions or increase resilience to the impacts of climate change. This article provides an overview of everyday life changes in the areas of physical activity, nutrition and housing. It describes the current lifestyles of older adults in Austria based on statistics on health, time use, mobility and nutrition, as well as consumer surveys. However, lifestyle changes are not presented solely as a matter of individual behavior; the article also highlights the critical role of structural aspects such as infrastructure and public access, supply and price structures. We focus on the impact chains, which, based on the scientific literature, illustrate the pathways through which changes in everyday life have a beneficial effect on health and climate protection or for resilience.</p><p><strong>Abstract: </strong>Finally, a secondary effect becomes relevant: A more health-promoting everyday life reduces the number of years spent in ill-health, thereby lowering the demand for medical treatment. This benefits both health and the climate, as hospital stays can strain mental health and carry the risk of secondary diseases. Further, as medical care is carbon-intensive, avoiding hospitalizations reduces greenhouse gas emissions.</p><p><strong>Abstract: </strong>The intensifying impact of climate change increasingly requires a transition in key areas such as mobility, leisure, housing and nutrition. This transition offers an opportunity to make climate-friendly and healthy everyday life the new attractive norm. Health benefits can serve as a compelling argument for climate mitigation, which in turn can act as a lever for creating healthy living conditions in times of inevitable change. As global warming increases, so do the climate risks to human health, and the risk of crop failures, water shortages and damage to settlements and infrastructure. Yet a decisive transition has the potential to promote a good and healthy aging for all.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Bridging Healthcare and Educational Participation: The Role of School Nurses in Empirical Perspective].","authors":"Gabriele Ellsäßer, Johann Böhmann","doi":"10.1055/a-2899-6768","DOIUrl":"10.1055/a-2899-6768","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to provide a differentiated analysis of the uptake, range of activities, and the health and psychosocial needs of students addressed by school health nurses (SNs) within the school setting. Particular focus is on gender- and school type-specific differences, the role of SNs in medical and psychosocial care, and their contribution to educational participation.</p><p><strong>Methods: </strong>Within a mixed-methods approach, routinely collected and software-documented data from 21 public schools in Brandenburg (2024-2025) were analysed. Quantitative analyses (including Poisson regression) were combined with qualitative content analysis of free-text entries to assess not only standardized reasons for consultation but also complex health, psychological, and social problems.</p><p><strong>Results: </strong>A total of 27,778 contacts were documented. More than 70% of students used the service at least once. Acute complaints (approximately two-thirds) and injuries (approximately one-quarter) predominated, whereas psychosocial and complex problems occurred less frequently but increased markedly in higher grade levels. Girls were significantly more likely to use the service, particularly for health-related and psychological complaints.</p><p><strong>Results: </strong>The additional analysis of free-text entries provided differentiated insights into psychosocial problems: in primary schools, externalizing behavioural problems predominated among boys, while girls more frequently presented with internalizing symptoms; in secondary schools, more complex and severe psychological burdens, including crisis situations, were increasingly observed.</p><p><strong>Results: </strong>SNs provided a broad range of interventions, including counselling, emotional support, primary healthcare, and the initiation of further medical and psychosocial care. In approximately 5% of cases, specific recommendations were made. In 85.5% of contacts, a return to class was achieved, underlining the importance of SNs in ensuring educational participation.</p><p><strong>Conclusion: </strong>SNs play a central role as a low-threshold point of care in everyday school life and represent an important interface between the education and health sectors. Standardized, software-supported documentation constitutes a key basis for quality assurance, evidence-based development, and making their contribution visible in health policy.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Bundled payment: A promising approach in reimbursement? Results from the sekTOR-HF project for left-sided heart failure in Germany].","authors":"Matthias Arnold, Sonja Gscheidle, Ann-Kathrin Klähn, Dominik Rottenkolber, Leonore Bovy, Marion Ludwig, Hans-Joachim Conrad, Denise Zehe, Lisa Müller, Bernd Griewing, Sebastian Barth, Harald Auner, Volker Amelung","doi":"10.1055/a-2808-9797","DOIUrl":"10.1055/a-2808-9797","url":null,"abstract":"<p><strong>Introduction: </strong>Reimbursement systems can create significant incentives for service delivery. From a theoretical perspective, the need for reform in reimbursement systems at the interface between outpatient and inpatient care is well established, but practical proposals are lacking. As part of the sekTOR-HF project, a concept for a bundled payment system was developed, and its feasibility in Germany was demonstrated.</p><p><strong>Methods: </strong>The framework for a bundled payment system was developed through a participatory design process. A retrospective analysis of statutory health insurance (GKV) claims data (2018-2019) was used to calculate bundle prices for patients with left-sided heart failure. Generalized linear models with a gamma distribution and link function were applied to estimate prices and identify cost drivers.</p><p><strong>Results: </strong>Four bundled payment scenarios based on NYHA classes were identified. Among 129,262 patients with left-sided heart failure analyzed, the annual reimbursement prices per patient for a bundled payment ranged from €1,928 (NYHA I) to €5,567 (NYHA IV). Several cost-increasing comorbidities (\"bundle breakers\"), such as renal failure, multiple myeloma, and cardiac arrest, were identified.</p><p><strong>Conclusion: </strong>We developed an initial proof of concept for implementing bundled payments in the German healthcare system. Our findings indicate that viable design options can be identified and that price estimation based on existing routine data is feasible.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"526-533"},"PeriodicalIF":1.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wegbereiter der Versorgungsforschung.","authors":"","doi":"10.1055/a-2924-3789","DOIUrl":"https://doi.org/10.1055/a-2924-3789","url":null,"abstract":"","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":"88 8-09","pages":"495-496"},"PeriodicalIF":1.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}