Gesundheitswesen最新文献

Not all individuals or population groups can participate equally in digital transformation due to varying levels of (e)HL and their socioeconomic conditions. This disparity is known as the "digital divide." A lower socioeconomic status and older age appear to be associated with lower eHL. In the interest of reducing health inequalities, targeted efforts to promote dGK among disadvantaged groups should be pursued. This paper by the members of the working group Digital Health of the German Network for Health Services Research (Deutsches Netzwerk Versorgungsforschung e.V. (DNVF)) therefore addresses the importance of eHealth Literacy (eHL) for health services research and practice in Germany, with an emphasis on measures to enhance eHL. Building on a theory-based definition of eHL established in the first publication (Relevance of eHealth Literacy (eHL) for health services research and practice - Part I), the current state of eHL in Germany and the effects of low eHL are examined. Guided by the Delphi study conducted by the DNVF working group Digital Health and the guidelines of the German Advisory Council on Health and Care (Sachverständigenrat zur Begutachtung der Entwicklung im Gesundheitswesen und in der Pflege (SVR)), the digital divide is addressed and analyzed. Specific proposals for enhancing eHL are presented, with a focus on theory-driven interventions co-developed with users. Evaluation and implementation aspects of such interventions are also considered.

As digitization progresses, citizens, patients and providers increasingly encounter digital or hybrid prevention or care services and digitally supported health information. Under these circumstances, electronic health literacy (eHL) as an extension of health literacy (HL) is a crucial skill that entails searching, finding, understanding, evaluating and applying health information based on digital sources when encountering challenges to health. There are currently multiple definitions that do not take into account newer digital applications in particular. The aim of part I of this article by the members of the Digital Health working group of the German Network for Health Services Research (DNVF) is to derive a working definition of eHL which is founded on known definitions of (e-)health literacy and on dimensions of relevant framework models and theories. Particular attention is paid to the delimitation and similarities between HL and eHL. Also, this article looks at the operationalization of eHL in the context of internationally proven approaches. Here, eHL is viewed as a relational construct that can be approached via multidimensional operationalization at the individual, interaction-related and system levels.

Theda Borde, recipient of the 2025 Salomon Neumann Medal of the German Society for Social Medicine and Prevention (DGSMP), holds a degree in political science and a doctorate in Public Health. She served as Professor and, for a period, as Rector at the Alice Salomon University of Applied Sciences Berlin. Her research and teaching focus on the social determinants of health, gender and health, interprofessional collaboration in healthcare, and migration and health. Four core principles that shaped the work of Salomon Neumann also characterize Theda Borde's scholarly contributions: addressing the needs of socioeconomically disadvantaged populations, generating scientific evidence on their health status, translating research findings into practice, and taking a public stance - particularly in times of populist resistance. Theda Borde's work, however, extends beyond Neumann's historical framework: participation and co-creation are central to her understanding of health equity and the advancement of social justice.

Children and adolescents with special support needs, i. e. with disabilities, special educational needs and impairments, are a heterogeneous group with different health situations and needs. This article examines to what extent these health-related needs are reflected in the self-reported utilisation of dental and medical care, also in comparison to children and adolescents without special support needs.The database for this work is the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2, 2014-2017). The following utilisation indicators were used for the analyses: dental check-up, orthodontic treatment, dental services overall, pediatrics, internal medicine, ophthalmology, otolaryngology, orthopedics, as well as psychiatric, psychotherapeutic and psychological services. Prevalences, univariable and multivariable prevalence ratios were calculated, which were controlled for sex, age and socioeconomic status of the family, as well as p-values from Poisson regressions.The analyses were based on data of 779 children and adolescents with and 9,943 children and adolescents without special support needs. Children and adolescents with special support needs showed lower utilisation of dental services compared to children and adolescents without special support needs (e. g. dental check-ups: 72.8% and 79.4%, respectively; univariable p=0.011), although the differences did not persist in the multivariable model (p>0.05). In contrast, children and adolescents with special support needs were significantly more likely to receive specialist somatic (e. g. ophthalmology: 43,6% and 32.1%, respectively), psychiatric (18.7% and 4.2%, respectively) and psychological care (13.0% and 2.5%, respectively) compared to children and adolescents without special support needs (p<0.001).Among children and adolescents with special support needs, the utilisation of medical care was significantly higher than among children and adolescents without special support needs, while there were hardly any differences in the utilisation of dental services. In order to improve the oral health of children and adolescents with special support needs, target group-specific health care and support services in close interdisciplinary co-operation seem to be necessary.

The demand for GP care is increasing while the number of GPs is decreasing. We investigated how GPs perceive bureaucracy during the process of establishing their own practice and how this perception changes with increasing establishment experience.Physicians who wished to set up a practice or who were in the process of setting up a practice and those who, up to two years and two to five years previously, had set up a GP practice were interviewed digitally following an interview guide. The recordings were transcribed verbatim and analysed using Braun & Clarkes Thematic Analysis.The 18 interviewees identified "bureaucracy" in various areas unrelated to patient care. A habituation effect occurs after the practice has been established. Resources for coping with bureaucratic challenges were mentioned.The participants define bureaucracy as any activity that is distant from the patient. Dealing with this should be made easier despite the habituation that occurs. Electronic processes and support through advice can help to overcome bureaucratic hurdles, and positive examples mentioned should be systematised. GPs view bureaucracy as a hurdle to setting up a practice, but it does not influence their decision to establish their own practice. Therefore, while still relevant, bureaucracy is found to be less important than previous research suggests.

Aim of the study: Summarising the formal and substantive enrolment practice of school entry examinations (SEU) in the German Democratic Republic (GDR).

Methods: Through a systematic literature review using a conventional as well as internet-based sources, specialised literature on specific topics and original documents were made available following selected search terms to capture essential characteristics of SEU in the GDR and to present them in a general context.

Results: In the GDR, regular school enrolment took place at the age of 6, although SEU implementation practice during the 1950s and 1960s was fundamentally inconsistent in terms of form and content. On the basis of mandatory annual screening examinations for children, the medical screening examination at pre-school age of 5-6 years was formally valid as a SEU. On a case-by-case basis, the responsible paediatricians carried out supplementary, but non-standardised developmental tests. From the 1970s onwards, the increasing density of kindergarten in the GDR led to their specialist staff getting more involved in the assessment of pre-school children's competences relevant to schooling. In addition, screening at the age of 4-5 years also became more relevant for developmental diagnostic purposes. While various examination procedures were initially used, a standardised inventory of instruments for assessing learning ability, intellectual development and language development gradually emerged during the 1970s. These two staggered SEUs between the age of 4 and 6 years enabled preschool children to be supported if necessary, so that children with developmental delays could be given adequate developmental and educational opportunities. This concept also enabled an intensifying, partly informal cooperation between the specialist staff in the kindergartens, paediatricians, parents and school headmasters.

Conclusion: Overall, the SEU in the GDR was based on a professionally and a well thought-out concept from the 1970s onwards. At this time, the standardised, staggered and multidisciplinary approach was methodologically superior to school enrolment practice in West Germany.

Ports are the first interface with the local population in the event of infections on board ships. In addition to the health authorities, other stakeholders are also involved in the management of disease outbreaks or are affected by them through their activities at the port. An effective approach to outbreak prevention and management that takes all stakeholders into account is therefore crucial. This qualitative sub-study of the 'GESA - Healthy Ports, Strong Together' project analyses the needs of the stakeholders involved.As part of the GESA study, qualitative interviews were conducted with port medical services, port authorities, fire services, terminal operators, pilots and other relevant stakeholders in order to record structures and processes in five major German ports. Among other things, optimisation opportunities and fields of action were identified. The interviews were analyzed using a qualitative content analysis according to Mayring.A total of 34 interviews were conducted, covering 13 different stakeholders. The needs were primarily expressed in the areas of emergency planning, interdisciplinary exchange, digitalisation, interfaces and information requirements in operations as well as training and further education.The GESA project makes an important contribution to disease prevention and management at ports, as the needs identified are directly incorporated into the development of an idealised process for infection management in German ports. The results will also be taken into account in the development of a training concept for the public health service.

The Berlin anti-Semitism controversy of the 1880s contains numerous elements that have also played a role in connection with the SARS-CoV-2 pandemic and the Querdenken movement. The anti-Semitism controversy is characterized by the spread of false information that has been scientifically refuted. However, this refutation had only a limited effect. This also applies to false narratives on pandemic-related topics that have been and continue to be spread by Querdenkern.

The delegation of medical tasks to Physician Assistants (PAs) is legally permissible in Germany but subject to clear limitations. Potential risks arise particularly from organizational deficiencies.Two fictitious clinical case vignettes are used to analyze liability-relevant situations in which delegation decisions resulted in complications.Case 1 illustrates the risks associated with delayed physician oversight following PA-conducted examinations. Case 2 highlights the legal consequences of inadequately regulated invasive procedures. Both examples demonstrate that primary risks arise mainly from missing standard operating procedures (SOPs), unclear supervision structures, and insufficient documentation.Tasks legally reserved to physicians cannot be delegated. For delegable activities, civil and criminal liability requirements apply to physicians, PAs, and, in particular, to healthcare organizations. Ensuring patient safety requires not only individual responsibility but also clearly defined organizational structures.