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Purpose of the study: The study investigates the extent to which medical assistants can support primary prevention measures in family practices as prevention advisors.

Methods: Between July 2019 and December 2020, preventive measures were implemented by trained prevention counselors in general practitioners' practices in a rural region in Brandenburg. They consisted of longer-term support for individuals in lifestyle changes in the areas of "nutrition", "exercise" and "relaxation". The accompanying process and outcome evaluation included pre-post comparisons of selected medical parameters as well as the investigation of possible changes in health literacy and health-related quality of life using standardized questionnaires (HeiQ-Core, SF-12v2). Furthermore, thematic analyses of training documents, participant surveys using a questionnaire, two focus groups with prevention counselors, and five interviews with study participants were conducted.

Results: Four primary care practices and two health care facilities were recruited and seven health care workers were trained as prevention counselors. Thirty-eight individuals were enrolled in the prevention program. Although overall counseling sessions were conducted according to training specifications, various individual as well as structural barriers ensured low uptake of the intervention.

Conclusions: The extent to which preventive measures adapted to the individual can be successfully established in primary care practices with the help of health care workers trained as prevention counselors depends strongly on the respective practice structures as well as the patient clientele. Temporal integration and coordination of the activities of prevention advisors in the daily practice routine seems to be likely to lead to success in interventions of the kind evaluated here.

Background: Low back pain is a very common condition that affects most people at some point in their lives. It represents a burden on those affected, reducing their ability to participate in activities of normal life; at the same time, dealing with it increases the economic costs of healthcare.

Aim:  The aim of this guideline was to contribute to WHO activities for reducing the impact of low back pain in adults and to support the WHO approach to integrated care for older people in primary care.

Methods: In December 2023, the World Health Organization (WHO) published the "WHO guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings". It was developed following the process according to the WHO handbook for guideline development. The team at the WHO Collaborating Centre for Evidence-Based Medicine at the University for Continuing Education Krems (Austria) translated the summary of this guideline for its application in German-speaking countries.

Results/conclusion: The guideline addresses 37 interventions for the treatment of chronic primary low back pain in primary care and provides 24 recommendations and one good practice statement. No recommendations were made regarding twelve interventions due to equivocation or lack of sufficient evidence. The recommended interventions are intended to provide a range of options to support and personalize care for adults with chronic primary low back pain.

Aim: Addressing the global nursing shortage is crucial to both national and international public health efforts. This paper aims to highlight the importance of resilience and its impact on primary care nurses' job satisfaction and intentions to quit, especially in the face of current challenges.

Methods: The study utilized a mixed methods design involving nurses in intensive care units of a university hospital in Austria. In the first phase of data collection, qualitative focus group interviews were conducted to gather insights on the current challenges and stressors faced by nursing professionals. Building on relevant literature, a quantitative survey was then administered to all nurses, using scales measuring resilience, intention to quit, and job satisfaction in order to examine the relationships between these variables. In addition, a data structuring of the resilience scale by factors was achieved with the help of confirmatory factor analysis. Subsequently, the correlations of the resilience factors with the other variables were examined by means of an additional correlation, regression and mediation analysis.

Results: The results showed negative correlations with regard to resilience and intention to quit as well as with regard to job satisfaction and intention to quit. In contrast, job satisfaction and resilience correlated significantly positively with each other. The negative correlation between resilience and the intention to quit was confirmed, but only for the factors "goal focus" and "pride and commitment". A closer examination of the two factors and their associated items revealed a connection to both professional identity and organizational identity.

Conclusion: This study provides valuable insights for health care leaders and health care decision makers to effectively lead, develop, and thereby retain primary care nurses. The authors argue that improving resilience and strengthening organizational identity are important influencing factors in increasing job satisfaction and reducing nurses' intention to quit.

Based on the UN Convention on the Rights of the Child, children and young people have the right to participate in all matters and decisions that affect them. This applies in particular when they are patients in a children's hospital. In the international context, established formats for the participation of young patients regarding health issues already exist, for example "Children's Councils" or "Young Person's Advisory Groups". In Germany, such approaches are still mostly lacking. It thus remains important to develop suitable formats that enable meaningful and effective participation of young patients in the health system. These formats must be chosen in such a way that they can realistically be implemented in clinical settings as well as in pediatric research, and that they can be sustained in the long term. In order to strengthen the consideration of children's rights in the health system, the advancement of such participatory formats as well as their sustainable implementation and evaluation are desirable.

Background: During the first wave of the SARS-CoV-2 pandemic, Weiden Hospital was a hotspot and was thus in an exceptional medical situation. This study deals with the question of whether the recognized risk factors for a severe course of COVID-19 also apply to the patients treated in Weiden Hospital during this time or whether other factors could have influenced patient outcomes.

Methods: In a retrospective analysis, data on 669 patients of Weiden Hospital with proven SARS-CoV-2 infections in the first year of the pandemic were evaluated. Risk factors for a severe case of COVID-19 were determined from medical and demographic information in a univariate analysis and subjected to logistic regression. The logistic regression analysis was performed for the overall collective as well as separately for patients from Wave 1 (3-6/2020) and 2 (7-12/2020).

Results: Looking at all of 2020, significant risk factors for severe COVID-19 included being male, being a smoker, being 71 years or older, and a history of depression. All other commonly recognized risk factors were not applicable for the Weiden collective. When looking at both waves separately, in Wave 1 age was not a significant risk factor, whereas in Wave 2 an age of 61 years or older was associated with an increased risk of severe progression. For patients who were admitted to hospital in Wave 2, the risk of severe progression was reduced almost by half.

Conclusion: It can be assumed that patient outcomes in Weiden's hotspot collective were predominantly determined by non-individual factors, like the difficult care situation in a hotspot clinic at the beginning of the pandemic. In preparation for future pandemics, provision of sufficient resources might significantly contribute to better patient outcomes.

Introduction: Following rehabilitation, patients are often unable to continue with the behavioral changes they had learned there in the long term. It is therefore important to offer aftercare services to improve self-management. Internet-based and telephone aftercare concepts in particular are low-cost and flexible in application, and offer an opportunity to significantly increase the use of aftercare measures. In, the"Tele-FANT" project, obese patients were supported by an aftercare therapist over a period of 12 months following their inpatient rehabilitation stay by regular telephone or video consultations.

Method: A one-group pre-post design was used for the formative evaluation. Participants took part in a written survey at the start of rehabilitation, at the end of rehabilitation and 4, 8 and 12 months after rehabilitation. As a key variable, body weight (external measurement by the family doctor) was also recorded at all measurement times to calculate the percentage weight loss from the start of rehabilitation. Descriptive parameters were calculated at the beginning, as well as mean differences and standardized effect sizes (SES) at the post-measurement time points.

Results: A total of 47 obese rehabilitation patients (mean BMI=44.56, SD=7.23) from the Frankenlandklinik Bad Windsheim were recruited to participate in the aftercare program. The complete program up to the 12-month follow-up was completed by 30 participants (drop-out: 36.2%). The remaining participants showed a high level of acceptance for both the structural processes and the content of the aftercare program. A weight loss of at least 10% was achieved by 13 participants (50%) at the 12-month follow-up, a further 4 participants (15.4%) had lost 5 to 10%. The participants were able to reduce their BMI by an average of 4.45 BMI points from 43.69 (SD=7.25) to 39.24 (SD=7.25) since the start of rehabilitation (mean effect size: SES=0.61).

Conclusion: In the formative evaluation, the "Tele-FANT" aftercare program shows good feasibility and promising results with regard to the goal of weight reduction/stabilization. However, the high drop-out rate indicates that some of the participants were not satisfied with the program or were unable to achieve the desired outcome. The next step would be to test the effectiveness of the "Tele-FANT" aftercare concept in a randomized control group study.

This exploratory study analyses the impact of mandatory COVID-19 vaccination on the perceptions of and dynamics in nursing teams. The 27 guided interviews with nurses revealed that the pressure to vaccinate and the introduction of mandatory vaccination in healthcare led to divisions and conflictual interactions between vaccinated and unvaccinated team members. These conflicts had a negative impact on the quality of work and team awareness, resulting in an increase in the number of nurses who resigned and thus placing even greater stress on the rest of the nursing teams.

Introduction: The availability of highly qualified surgical staff in Germany has been a challenge for years. Despite various initiatives to increase the attractiveness of surgical training programs, there are still problems in attracting motivated and qualified doctors to surgery. In order to develop customized offers for recruiting junior staff, the decision-making factors must be known.

Objective: To present the gender-specific and cross-gender reasons for choosing a surgical specialist training program.

Method: As part of a scoping review, studies were identified using PubMed and a subsequent reverse search to answer the research question. Data extracted from the studies were summarized narratively and categories were defined.

Results: The analysis of 12 studies revealed that men and women wanted to become a surgeon based on the characteristics of the surgical specialty, personal factors and factors related to the training position. Gender-specific differences were also identified.

Conclusion: Specific measures are proposed to promote the next generation of surgeons.

Difficulties in diagnosing the cause of death have been widely discussed in the literature. However, studies on the quality assurance of the determination of the manner of death and the results of public prosecutor investigations are rare. In this study, data from six public health departments in Baden-Württemberg on all deaths from 2016-2018 were analyzed. Significant differences were found between the individual public prosecutor's districts with regard to the type of death determined during the medical post-mortem examination. In 6.3 [4.5-7.4]% of all deaths, the public prosecutor's offices initiated investigations. In 6.0 [4.3-8.5]% of these investigations, an autopsy was performed. A significant difference between the public prosecutor's districts could not be demonstrated in this regard.