Gesundheitswesen最新文献

{"title":"[Access to and Transitions within the Medical Care Process of Persons with Down Syndrome and Dementia: A Qualitative Analysis].","authors":"Anke Walendzik, Milena Weitzel, Godwin D Giebel, Pascal Raszke, Jürgen Wasem, Johannes Levin, Olivia Wagemann, Elisabeth Wlasich, Georg Nübling, Johannes Pantel, Valentina A Tesky, Arthur Schall, Theresa Hüer","doi":"10.1055/a-2486-6360","DOIUrl":"https://doi.org/10.1055/a-2486-6360","url":null,"abstract":"<p><p>Compared to the general population, individuals with Down syndrome carry a much higher genetic risk of developing early onset Alzheimer's dementia. This leads to unique challenges and the need for a targeted patient journey.In a qualitative interview study with medical professionals, patient organisations and formal and informal care persons, we assessed barriers within the medical care process of this patient group as well as current approaches to overcome these problems. The study is one module of a multi-method project founded by the Innovation Fund of the German Joint Commission. The results presented here focus on access to and transitions within the medical care process. 14 guided interviews were conducted by a team of moderators by video conference, recorded and transcribed. The analysis of the results was carried out as a qualitative content analysis based on the methods of Mayring.Given the varying degree of premorbid intellectual disability, difficulties recognizing dementia symptoms were reported leading to delays in initiating the diagnostic process. Limited knowledge of the special disease risk and symptom manifestation in routine medical care as well as the lack of specialized medical institutions were identified as additional hurdles. Insufficient dissemination of information about existing specialised institutions to regular physicians and caregivers was criticized. All stakeholder groups drew attention to limitations in access to occupational and speech therapy because of the inadequate number of specialized therapists. Improvements suggested by the interview partners focussed on topics such as the implementation of guidance of the patient journey to and within the medical care process by one institution, easily accessible information for patients and caregivers as well as optimised training for physicians in routine care.Barriers such as insufficient availability of specialised service providers and information deficits about the specific disease risks and symptoms of the population have also been identified in international literatur; in addition, management and coordination deficits in the fragmented German health care system represent well known additional barriers. Approaches to improve the situation can be seen, on the one hand, in improved information and training offers for caregivers and service providers, and, on the other hand, in the expansion of the range of specialized service providers, in particular the Medical Centres for Adults with Disabilities. Informed by these study results and the results of other project modules, health policy recommendations for the improvement of the patient journey of patients with Down syndrome and dementia will be developed in the last project module.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014067","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":"[Distribution of Health Science Experts and Public Health Professionals in Public Health Departments in Germany].","authors":"Janine Kleinschmidt, Benjamin Ewert, Wolfgang Lenz, Jasper Plath","doi":"10.1055/a-2304-5201","DOIUrl":"10.1055/a-2304-5201","url":null,"abstract":"<p><strong>Background: </strong>There is limited data on the number and distribution of academically qualified professionals in the field of Public Health at the lower level of health authorities. The aim of this study was to analyze the distribution of Public Health Professionals in Public Health Authorities in Germany.</p><p><strong>Method: </strong>An online survey was conducted with the directors of the 376 German Public Health Authorities regarding the presence of Public Health Professionals and their views on personnel needs. The term Public Health Professionals was operationalized. The survey took place starting in 06/2023 over a period of 14 weeks. The results were descriptively analyzed.</p><p><strong>Results: </strong>The participation rate in the survey was 40.4% (n=152). On average, the participating Public Health Authorities employed 2.6 (SD 3.85, MD 2) Public Health Professionals. 28.3% (n=43) of directors reported not employing any Public Health Professionals. 78.3% (n=119) of the leadership reported needing more staff. Additionally, 65.1% (n=99) expressed the need for more personnel with a degree or those with additional training in the field of Public Health.</p><p><strong>Conclusion: </strong>Personnel from the field of Public Health are not yet represented in all Public Health Authorities in Germany. Both the distribution of Public Health Professionals in the participating Public Health Authorities and the views of the department heads regarding the needs of this professional group in their own Public Health Authorities are heterogeneous. In summary, there is a clear need to strengthen collaboration between academic Public Health Professionals and the Public Health Authorities.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"54-56"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761678","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}

{"title":"[Impact of Critical Events During Deployments on the Mental Health of Military Personnel].","authors":"Lucas Konhäuser, Karl-Heinz Renner, Hubertus Himmerich, Gerd Willmund, Peter Lutz Zimmermann, Jan Philipp Krüger, Ulrich Wesemann","doi":"10.1055/a-2448-3968","DOIUrl":"10.1055/a-2448-3968","url":null,"abstract":"<p><strong>Introduction: </strong>Deployments abroad pose an occupational risk for mental disorders and reduced quality of life among military personnel. This study examines the question of whether a relevant predictor for the frequency of mental disorders after deployments abroad can be found. It is postulated that soldiers who experience a military-specific critical event develop more symptoms and their quality of life decreases.</p><p><strong>Methods: </strong>This study included n=370 combat troops deployed to Afghanistan as part of the International Security Assistance Force (ISAF) operation. Using questionnaires, data on psychological symptoms and quality of life were collected before and after deployment. The discriminator was whether a critical military-specific event, defined as a type A criterion of PTSD according to ICD-10 (F43.1), was experienced during the deployment.</p><p><strong>Results: </strong>It was shown that soldiers who experienced a critical event (n=81; 21.9%) developed significantly more depressive, somatic and stress symptoms. When evaluating the questionnaires on the quality of life, significant deteriorations were found in all areas, apart from environmental quality of life. In the study group without a critical event, there were significant improvements in stress experience and environmental quality of life after deployment. When the entire group was included, a time x group interaction effect was found with deterioration in soldiers with critical events in all of the above-mentioned areas, apart from the environmental quality of life.</p><p><strong>Conclusion: </strong>In summary, it can be postulated that critical events during a deployment abroad have a significant impact on the mental health and quality of life of soldiers. This can be used for more specific pre- and post-operation measures as well as for de-stigmatization programs.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"21-26"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510413","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}

{"title":"[Interdisciplinary Recommendations for the Development of Health Kiosks as Low-Threshold, Community Care Structures.]","authors":"Geraldine Kutschke, Lea Kutschke, Lena Sauder, Alice James, Stefan Woelwer, Sinje Gehr","doi":"10.1055/a-2403-1703","DOIUrl":"10.1055/a-2403-1703","url":null,"abstract":"<p><p>In a termsheet released on 31st of August 2022, the Federal Ministry of Health in Germany proclaimed its intention to establish 1,000 health kiosks across the country. The aim of this innovation was to improve and coordinate access to healthcare, especially for people with higher requirements for support and in rural areas. Communes hold the right to initiate the local establishment of health kiosks while being funded mainly by health insurance companies. However, ways of regional implementation of these health kiosks are yet to be sorted out. In the following interdisciplinary mixed-methods research project, health-related social work and design sciences examine how health kiosks can be arranged under current conditions. Our study provides local authorities with a catalogue of methods for promoting interdisciplinary cooperation as well as practical recommendations and prototype design proposals in the form of a blueprint for the independent development and implementation of locally adapted health kiosks.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"47-53"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477666","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}

{"title":"[Ensuring Future Primary Care from a Municipal Perspective].","authors":"Philip Schillen, Jürgen In der Schmitten, Johanna Bolland, Benjamin Borchardt","doi":"10.1055/a-2320-2740","DOIUrl":"10.1055/a-2320-2740","url":null,"abstract":"<p><strong>Background: </strong>In view of the continuing shortage of general practitioners, ensuring access to (primary) medical care close to home is also becoming increasingly important for local authorities. The aim of the present study was to analyse the current and future provision of primary care from the viewpoint of the municipalities in North Rhine-Westphalia (NRW). From the results, it should be possible to derive future health policy design of a needs-based primary care close to home.</p><p><strong>Methods: </strong>In an online survey in spring 2023, we surveyed the mayors or representatives of health departments of all 427 municipalities (396 cities and communities, 31 districts) in NRW in cooperation with the NRW Association of Cities and Municipalities, the NRW Association of Counties and the NRW Association of Cities. The items of the questionnaire (n=28) were developed on the basis of two other surveys on medical care in Lower Saxony and Baden-Württemberg, each with a municipal policy target group. They were tested in repeated pretests.</p><p><strong>Results: </strong>In total, 192 municipalities participated in the survey (response rate: 45.0%). The majority of the municipalities (86.6%) considered the local provision of primary care to be (rather) not ensured within the next 10 years. The municipalities expressed the wish for more opportunities to exert their own influence (79.5% yes or rather yes), but nevertheless considered a stronger commitment, especially of the Associations of Statutory Health Insurance Physicians (85.4%), as well as an intensification of assumption of responsibility by the federal states (72.4%) to be necessary for ensuring primary care.</p><p><strong>Conclusion: </strong>The survey shows that municipalities are quite aware of the problem of future deficits in the supply of general practitioners at the local level. The results also indicate that, in view of increasing supply shortfalls, the municipalities see obligations for the Associations of Statutory Health Insurance Physicians and the federal states to take responsibility and to exert greater political pressure in the future. The municipal perspective is an essential building block in considerations of how primary care can be ensured in the future. The responsible stakeholders should therefore involve the municipal level in the planning and measures to secure primary care more closely than in the past.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"38-46"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861068","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}

{"title":"[Early Detection Of Type 1 Diabetes By Islet Autoantibody Screening: A Position Paper Of The Fr1daplex Project Leaders And Training Centres, Bvkj Bavaria And Paednetz (Registered) Bavaria].","authors":"Peter Achenbach, Reinhard Berner, Ezio Bonifacio, Susanne Brämswig, Sonja Braig, Desiree Dunstheimer, Uwe Ermer, Dominik Ewald, Gita Gemulla, Julia Hauer, Florian Haupt, Gabi Haus, Michael Hubmann, Sandra Hummel, Michael Kandler, Olga Kordonouri, Karin Lange, Otto Laub, Anja Lorrmann, Nicole Nellen-Hellmuth, Marina Sindichakis, Thekla von dem Berge, Katharina Warncke, Leonie Weber, Christiane Winkler, Philip Wintermeyer, Anette-Gabriele Ziegler","doi":"10.1055/a-2320-2859","DOIUrl":"10.1055/a-2320-2859","url":null,"abstract":"<p><p>This position paper is based on the authors' many years of clinical experience and basic science research on the diagnosis and treatment of children and adolescents with a presymptomatic early stage of type 1 diabetes. The benefits as well as potential disadvantages of early detection of type 1 diabetes by islet autoantibody screening are critically discussed. In addition, the perspectives of delaying the onset of the clinical metabolic disease through treatment with teplizumab are addressed. Today, we see the chance for a relevant improvement in therapeutic options and life perspectives of affected children and adolescents. Important next steps for the implementation of islet autoantibody screening in Germany are the training of pediatricians who should inform families about the screening, establishment of a few transregional laboratories that carry out the test, and expansion of regional capacities for the training and care of children with an early stage of type 1 diabetes.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"27-37"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867829","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}

{"title":"[Findings from the Implementation of the Measles Protection Act after the First Three Years of its Introduction - Data from Darmstadt Dieburg (Hesse)].","authors":"Katrin Simone Steul, Regina Fertig, Raphaela Heinrich, Roswitha Reisert, Jürgen Krahn","doi":"10.1055/a-2365-1400","DOIUrl":"10.1055/a-2365-1400","url":null,"abstract":"<p><strong>Background: </strong>When the Measles Protection Act as part of the Infection Protection Act came into force 2020, various types of facilities were obliged to report. The public health department of the city of Darmstadt and the district of Darmstadt Dieburg aimed to find out to what extent these facilities have complied with the reporting obligation and whether any conclusions could be derived from the data on the vaccination status of the respective group of people.</p><p><strong>Method: </strong>Reports from the facilities and the feedback from those affected (or their legal guardians) were reviewed and evaluated descriptively. They were divided into groups (1) schoolchildren, (2) children from other childcare facilities, (3) those in municipal accommodation for refugees and (4) those employed in one of these or in a medical facility (§§23, 33, 36 German Infection Protection Act).</p><p><strong>Results: </strong>1,527 children (2.5% of all pupils in Darmstadt Dieburg) with incomplete or unknown immunity to measles were reported from 138 schools. 70% of these provided documentation of sufficient immunity after receivng the letter from the public health department, so that it can be concluded that less than 1% (0.76%) of children were without measles protection. 17 children with incomplete vaccination status were reported from the other childcare facilities. 3,986 people with incomplete vaccination status were reported from the refugee accommodation facilities, of which 566 (14.2%) submitted complete proof after receiving a letter from the public health department. A total of 17 employees were reported from the facilities according to §§23, 33 and 36 Infection Protection Act.</p><p><strong>Conclusion: </strong>The reporting obligation was met in very different ways by different facilities. No statement could be made about the vaccination status of the various groups of people affected by the Measles Protection Act, as it could not be assumed with certainty that the facilities had reported comprehensively.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"62-68"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141601918","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}

{"title":"[Guidelines Within And For Public Health Services: Results Of An Online Survey On Current Practical Needs].","authors":"Laura Arnold, Maria Steinisch, Anna Kuehne, Anna Schwabe, Elke Jakubowski, Anjali Scholten, Jan M Stratil","doi":"10.1055/a-2406-4786","DOIUrl":"10.1055/a-2406-4786","url":null,"abstract":"<p><p>Evidence-based guidelines are recognized and well-established in everyday medical practice. However, in the Public Health Service (PHS), evidence-based guidelines are not yet widely available. To promote the development of guidelines within and for the ÖGD, the Federal Joint Committee (GBA) issued a funding directive in June 2024. This study presents the results of an online survey on the prioritization of guideline topics in the ÖGD, conducted by the German Society for Public Health Services (DGÖG). The survey focused on 17 guideline topics proposed by the GBA, which were divided into six task areas. Out of over 900 participants, comprehensive responses from nearly 500 respondents were analyzed, 85% of whom work in local health departments. The results showed that all 17 guideline topics were assigned high or very high priority. Particularly frequently prioritized were the areas of infection hygiene monitoring, medical expert assessment, and psychosocial emergency care. Additionally, experts highlighted dental screening, health literacy on oral health, and monitoring of drinking and bathing water. The qualitative analysis further identified additional relevant topics, including health reporting and planning, health promotion and prevention, child welfare, as well as crisis management and communication. The survey provides insights into the priority topics for guidelines as perceived by practitioners and ÖGD researchers. The results underscore the significant need for evidence-based guidelines in and for the ÖGD and provide valuable insights for further development and prioritization.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"57-61"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394275","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}

{"title":"Strategien der Prävention.","authors":"Manfred Wildner","doi":"10.1055/a-2419-8655","DOIUrl":"10.1055/a-2419-8655","url":null,"abstract":"","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":"87 1","pages":"17-20"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014077","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}

{"title":"[Physical Activity-Related Health Services in Germany: Relevance and Necessary Framework Conditions - a Position Paper of the DNVF Working Group Physical Activity-Related Health Services Research].","authors":"Andrea Schaller, Christian Thiel, Stefan Peters, Wolfgang Geidl, Klamroth Sarah, Martin Lange, Sabrina Kastaun, Sonja Krupp, Heike Spaderna, Katharina Eckert, Marion Grafe, Claudia Voelcker-Rehage, Gisela Nellessen-Martens, Klaus Pfeifer, Gorden Sudeck, Joachim Wiskemann, Bettina Wollesen, Lars Gabrys","doi":"10.1055/a-2420-8793","DOIUrl":"10.1055/a-2420-8793","url":null,"abstract":"<p><p>Based on the relevance of an established and broad foundation of physical activity in healthcare, this position paper of the DNVF working group Physical Activity-Related Health Services research presents current conceptual approaches to physical activity-related health services in Germany and highlights the need for interprofessional and interdisciplinary approaches. Three central positions are outlined and elaborated in order to integrate the evidence on health benefits of physical activity and exercise more strongly into healthcare and to show that, against the background of the challenges in the German healthcare system, physical activity-related health services can make a cost-effective and high-quality contribution to improve healthcare. These three positions include 1) the integration of all professional groups involved in healthcare into physical activity-related health services, 2) the greater integration of physical activity professions and physical activity interventions into all healthcare contexts and 3) the systematic consideration of physical activity- and exercise-related expertise in clinical guidelines.</p>","PeriodicalId":47653,"journal":{"name":"Gesundheitswesen","volume":" ","pages":"69-78"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11740219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336958","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}