Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz最新文献

{"title":"[Ten years of the Federal Participation Act: continuities, conflicts, and perspectives on participation].","authors":"Matthias Morfeld, Uwe Koch-Gromus, Anke-Christine Saß","doi":"10.1007/s00103-026-04269-9","DOIUrl":"10.1007/s00103-026-04269-9","url":null,"abstract":"","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":"69 8","pages":"841-842"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599442","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":"[Applying the German demand planning guideline to maternity care provision: regional and socioeconomic disparities].","authors":"Anne Griese, Frank Schüssler, Tania Fleming, Julia Leinweber","doi":"10.1007/s00103-026-04270-2","DOIUrl":"https://doi.org/10.1007/s00103-026-04270-2","url":null,"abstract":"<p><strong>Introduction: </strong>Midwifery care in Germany is currently neither systematically monitored nor managed. A central register and a standardized planning framework are lacking, resulting in limited reliable data on the actual provision of care. Regional analyses also indicate substantial differences in access to midwifery care. The aim of this study was to apply the methodology of the German Demand Planning Guideline (BPL-RL) to midwifery care and to conduct a nationwide small-area analysis of regional and social disparities.</p><p><strong>Methods: </strong>Address data from the German Midwives Association (DHV; August 2024) were geocoded using postal codes and aggregated at district level. Based on the BPL-RL framework, supply levels were calculated for women of reproductive age (15-49 years), adjusted using the German Index of Socioeconomic Deprivation (GISD, 2022), and supplemented by travel-time analyses.</p><p><strong>Results: </strong>The analyses revealed pronounced socio-spatial inequalities. Overall, 23.8% of districts were (potentially) undersupplied (supply level < 75%), 45.8% were within the reference range of the BPL-RL framework (75-110%), and 30.5% showed high supply levels (> 110%), including 7.5% with substantial oversupply (> 140%). The average travel time to the nearest midwife was 9.6 min; longer travel times were concentrated in sparsely populated regions with high levels of deprivation.</p><p><strong>Discussion: </strong>Applying the BPL-RL to midwifery care enables a structured and data-driven assessment of service provision in Germany. The findings highlight regional and social inequalities and provide an empirical basis for value-based, socially equitable, and systematically managed demand planning for midwifery care.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374761","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":"[State-sponsored doping in GDR elite sport: health consequences, reappraisal, and questions of legal compensation].","authors":"Carsten Spitzer, Burkhard Bley","doi":"10.1007/s00103-026-04238-2","DOIUrl":"10.1007/s00103-026-04238-2","url":null,"abstract":"<p><p>Against the backdrop of the ideological rivalry between communism and capitalism, sport in the GDR was exploited for political ends. This was evident, among other things, in a state-directed, controlled, hierarchically organized and, in parts, totalitarian competitive sports system. A key component was a conspiratorial, state-controlled program of compulsory doping, which was systematically implemented from the 1970s onwards and affected an estimated 15,000 underage athletes. Performance-enhancing substances, primarily anabolic-androgenic steroids, were administered covertly, without the knowledge, information, or consent of those affected, often before puberty and despite known health risks. In addition to the effects of the doping substances, which enabled training loads beyond physiological limits, there was discipline, pressure to perform, surveillance, isolation, and abuse by sports officials. The resulting impairments to biopsychosocial development are still evident today in the form of serious health damage. Alongside disruptions to hormonal regulatory systems, growth and organ damage, cardiovascular diseases, tumors and degenerative diseases of the musculoskeletal system, and mental disorders with a lifetime prevalence of up to 98% are of particular concern, especially depressive, phobic, and somatoform pain disorders. Despite the laws providing assistance to victims of doping, the political and legal management of this particular injustice perpetrated by the SED remains unsatisfactory. Furthermore, society rarely acknowledges the violation of the human rights of former competitive athletes in the GDR who were forcibly doped as minors and continue to suffer from severe physical and psychosocial consequences to this day.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"759-766"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763392","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":"[Effects of the cannabis act on supply channels, attitudes, and perceptions of users].","authors":"Larissa Steimle, Bernd Werse, Anke Stallwitz","doi":"10.1007/s00103-026-04258-y","DOIUrl":"10.1007/s00103-026-04258-y","url":null,"abstract":"<p><strong>Background: </strong>With the Cannabis Act (CanG), the German government aimed to improve health protection and to curb the illegal cannabis market. A partial success of the CanG would be evident in the shift from illegal to legal supply channels. The following questions were central: How did sources of cannabis supply change overall and across different groups due to the Cannabis Act? Which groups subjectively benefit the most from the Cannabis Act?</p><p><strong>Methods: </strong>To address these research questions, a non-representative, quantitative online survey was conducted from 24 March 2025 to 10 June 2025 among cannabis users aged 14 and older. Participants were asked about their sources of supply before and after the Cannabis Act took effect as well as the subjectively perceived effects. The sample included N = 11,471 participants.</p><p><strong>Results: </strong>Since the CanG came into effect, a shift from illegally to legally produced cannabis has been observed among adults overall, particularly among men and people in rural areas, as home cultivation and pharmacy purchases have increased significantly. In contrast, little change was observed among adolescents. Participants reported predominantly positive subjective effects of the law. Gender and regional differences showed that men and residents of major cities-particularly Berlin and Hamburg-more frequently perceived positive subjective effects.</p><p><strong>Discussion: </strong>The results suggest that certain subgroups face barriers in accessing the legal market, including adolescents, women, and the urban population. For these groups, targeted measures aimed at reducing such barriers could contribute to further curbing illegal sources of supply.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"794-802"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216479","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":"[Performance-related substance use in everyday life and work].","authors":"Sascha Milin, Felix A Ebel, Ingo Schäfer","doi":"10.1007/s00103-026-04254-2","DOIUrl":"10.1007/s00103-026-04254-2","url":null,"abstract":"<p><p>The use of potential performance-enhancing substances in everyday and working life is often linked to an increased workload, time pressure and limited opportunities for rest. This narrative review summarises recent studies on contexts of use, motives, substance groups, prevalence rates, and benefits and risks.The studies show that the use of performance-enhancing substances is primarily intended to support short-term performance demands. It occurs in particular in cases of fatigue, high cognitive demands, stress, emotional strain and physical complaints at work, including in connection with presenteeism. The substances used include stimulants, mood- or sleep-regulating agents, painkillers and dietary supplements. With the exception of the latter, these substances are often prescription-only; some stimulants are illegal. Prevalence figures vary widely due to differing study methods, settings and definitions of performance-enhancing substances. Generally accepted substances are used more frequently.The benefits of these substances are generally described as limited and context dependent. Key risks include the development of tolerance, dependence, residual effects and impairments affecting safety. Short-term benefits are often offset by long-term health and functional costs. In the context of public health and occupational medicine, performance-related substance use may indicate structural stressors. Prevention, care and work design should aim to ensure long-term functional capacity.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"784-793"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148161869","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":"[The institutionalisation of infection prevention and control in Germany: challenges since the \"Gründerzeit\" : A retrospect of over 50 years of KRINKO].","authors":"Barbara Buchberger, Jana Maidhof, Esther E Dirks, Franziska Lexow","doi":"10.1007/s00103-026-04259-x","DOIUrl":"10.1007/s00103-026-04259-x","url":null,"abstract":"<p><p>The protection of public health through structured infection prevention is now firmly established. However, the establishment of independent institutions, evidence-based recommendations and cross-sectoral cooperation in the field of hygiene was not a foregone conclusion, but rather the result of profound historical developments and health crises. The aim of this article is to describe the developments in Germany that have led to the institutionalisation of infection prevention and control (IPC) and the changing challenges it has faced since its inception.Industrialisation and urbanisation in the last third of the 19th century led to problems with water supply and sewage disposal, which in turn led to serious outbreaks of infection. From the 1920s onwards, solutions had to be developed for the health hazards posed by air and soil pollution as a result of technological progress, and after 1950, nosocomial infections became the focus of attention.The establishment of the Royal Research and Testing Institute for Water Supply and Wastewater Disposal in 1901 was a significant step towards the institutionalisation of IPC. The range of tasks was adapted to changing requirements and additional institutes were founded. Under the Infection Protection Act, the Robert Koch Institute and its Commission for Infection Prevention and Hygiene in Healthcare and Nursing are now mandated to perform IPC tasks. At interfaces with other federal institutions responsible for infection control inter-institutional cooperation creates synergies for the protection of the population.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"822-830"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270491","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":"[Recruitment of pediatric practices for an intervention study: strategies, implementation, and insights from the Intervention Study to Increase HPV Vaccination Coverage in Germany (InveSt HPV)].","authors":"Johannes Lachmann, Julia Wilhelm, Yvonne Bichel, Jessica Holstein, Heike Kramer, Andrea Mais, Jule M Schmitz, Selina Teindl, Elisa Wulkotte, Nora Schmid-Küpke, Anja Takla","doi":"10.1007/s00103-026-04256-0","DOIUrl":"10.1007/s00103-026-04256-0","url":null,"abstract":"<p><strong>Introduction: </strong>Recruiting healthcare facilities for intervention studies is a well-documented challenge, yet evidence on effective strategies remains limited. To strengthen this evidence base, we report and discuss the recruitment approach applied in the Intervention Study to Increase HPV Vaccination Coverage in Germany (InveSt HPV).</p><p><strong>Methods: </strong>Pediatric practices in Bremen and selected districts in Bavaria were contacted by mail and through the German Professional Association of Pediatricians (BVKJ). Each participant received incentives of up to € 200.</p><p><strong>Results: </strong>In Bremen, 14 of 39 practices (35.9%) and in Bavaria 25 of 100 practices (25.0%) agreed to participate, resulting in an overall recruitment rate of 28.1%. Within participating practices, engagement exceeded 90% among both physicians and non-physician staff. The most frequently reported recruitment channels at registration were personal and written communication via the BVKJ. Reported motivations for participation included contributing to improved vaccination coverage, interest in the training sessions, and financial incentives. Telephone follow-up calls generated very few additional registrations despite considerable effort. For inquiries, practices preferred direct contact options over fixed consultation hours.</p><p><strong>Discussion: </strong>The experiences from InveSt HPV indicate that leveraging existing professional networks in combination with incentives commensurate with the required time investment facilitates the recruitment of pediatric practices. In addition, a recruitment period scheduled outside the infection season and school holidays, as well as the early planning of supplementary measures in case recruitment proves unsuccessful, appear to be essential.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"813-821"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203664","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":"[Doping in chess].","authors":"Thomas E Wessendorf","doi":"10.1007/s00103-026-04251-5","DOIUrl":"10.1007/s00103-026-04251-5","url":null,"abstract":"<p><p>The use of performance-enhancing substances is also possible in chess. Regarding stimulants used for cognitive doping-such as amphetamines, methylphenidate, modafinil, and ephedrine-there is evidence suggesting a slight improvement in performance; however, there is also evidence of negative effects on decision-making processes under time pressure. These substances generally pose a health risk; particularly in cases of overdose, they can strain the cardiovascular system or trigger psychotic symptoms. Furthermore, there is a fundamental risk of addiction or of the substance serving as a \"gateway drug.\"As chess is recognized as an official sport, doping controls are conducted within organized competitions. However, these are limited to elite-level competition and are consequently rare; as a result, few significant doping cases have come to light thus far. In contrast, a higher prevalence is suspected in competitive and amateur chess-among both professionals and amateurs alike. Nevertheless, the greater threat to fair play in chess lies in other fraudulent methods (such as cheating or electronic doping).</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"780-783"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216474","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":"[Legal and societal aspects of doping in sport].","authors":"Heiko Striegel","doi":"10.1007/s00103-026-04255-1","DOIUrl":"10.1007/s00103-026-04255-1","url":null,"abstract":"<p><p>This narrative review provides an overview of the legal and societal aspects of doping in sports phenomenon, which is both complex and multifaceted. Doping is not merely an issue confined to elite and professional sports but also, and especially, a problem within recreational and fitness sports.The legal aspects of doping encompass the legal framework governing the use of doping substances as well as the penalties and sanctions that can be imposed for violations. The sports-law regulations of the World Anti-Doping Agency (WADA) and Nationale Anti-Doping Agentur (NADA) Codes, as well as national anti-doping regulations, are intended to prevent the use of doping substances in sports and protect athletes from the health risks associated with doping. In Germany, a dedicated Anti-Doping Act was enacted in 2015 to address this issue.The societal aspects of doping concern its impact on society and the culture of sport by undermining established values and norms. Doping in sport compromises the fairness, equal opportunities, and integrity of athletic competition. Furthermore, the use of doping substances and methods can lead to serious health problems and injuries.Therefore, preventive anti-doping measures are not only a responsibility of sport itself, but a societal responsibility to protect fairness and transparency, public trust in sport, and the health of athletes. Only through close cooperation among all stakeholders in sport can a sustainable solution to the problem of doping be found.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"744-749"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301195","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":"[Doping in recreational sports].","authors":"Pavel Dietz, Rolf Ulrich, Perikles Simon","doi":"10.1007/s00103-026-04245-3","DOIUrl":"10.1007/s00103-026-04245-3","url":null,"abstract":"<p><p>Doping is commonly perceived as being primarily associated with professional sports rather than recreational sports. This article is a discussion paper and addresses doping in recreational sports from conceptual, methodological, and empirical perspectives. Established doping definitions, particularly those of the World Anti-Doping Agency, are only partially transferable to recreational sports contexts due to their strong focus on organizational affiliation and competitive settings. For large segments of recreational sport, the concept of performance-enhancing substance use therefore provides a more appropriate description.Assessing the prevalence of such use is methodologically challenging due to the sensitive nature of the topic and the lack of control mechanisms. Indirect survey techniques reduce socially desirable responding and yield more realistic estimates. The unrelated question model (UQM) is a randomized response technique that ensures full anonymity and enables robust prevalence estimates of sensitive behaviors at the population level.Empirical findings using the UQM among recreational athletes in endurance, fitness, and bodybuilding contexts indicate that the use of performance-enhancing substances is not a marginal phenomenon. Prevalence estimates suggest a relevant and stable level over time. Strong associations are observed with non-therapeutic use of pain medication and an increasing medicalization of performance optimization. Evidence of access via healthcare structures highlights the structural embedding of this phenomenon. Overall, the use of performance-enhancing substances in recreational sport represents a socially and medically relevant field of action that requires differentiated prevention strategies and greater integration into medical education and training.</p>","PeriodicalId":9562,"journal":{"name":"Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz","volume":" ","pages":"774-779"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13323790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833449","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}