Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz最新文献

Introduction: The new normal following the COVID-19 pandemic is characterized by uncertainty for employees in the public health service (ÖGD), shaped by challenges such as geopolitical threats, climate change, potential future pandemics, and structural changes driven by digitalization. The present qualitative study examines work-related psychological stress factors among public health office employees during and after the COVID-19 pandemic as well as the effectiveness of measures implemented to counter these stressors.

Methods: In a participatory process between Bielefeld University and seven public health offices, 15 qualitative interviews conducted in autumn and winter 2023/2024 were analyzed using Mayring's qualitative content analysis. The public health employees were asked about stress factors in their daily work during and after the COVID-19 pandemic and were then invited to identify employer-initiated measures aimed at reducing these burdens and to assess their effectiveness.

Results: The main stressors identified were excessive workload and tasks outside the employees' professional expertise that had emerged in the context of the pandemic. The measures implemented by employers were generally not well aligned with these burdens and therefore did not reduce them sustainably. Many respondents felt insufficiently prepared to act appropriately in future crises. However, expressions of authentic appreciation were consistently rated positively and perceived as relieving.

Discussion: Given the likelihood of future crises and ongoing transformations, the results highlight an urgent need for improved preparedness. Such efforts should place particular emphasis on addressing the needs and perspectives of employees within the ÖGD.

Introduction: In Germany, hospitals undergo routine inspections (RIs) by public health authorities in an occasion-independent manner for infection prevention and control (IPC). Structure and organization of RIs is at the discretion of respective public health authorities (PHAs) and can therefore differ between districts. This work aims to provide the first representative overview of structure, organization, and content of RIs by German PHAs.

Methods: As part of the PRO-OEGD project, representative data collection among all German PHAs was conducted between December 2023 and May 2024. Statistical analysis was performed using the chi-square, Fisher's, Mann-Whitney-, and Pearson-correlation tests.

Results: The response rate was 66% (248 of 377 PHAs). Results show many similarities despite different federal structures, for example, with regard to rating of content and hospital departments being particularly relevant for IPC. Medical professionals, hygiene inspectors, and hygiene specialists are usually involved in RIs. Maximum care providers, more often than non-maximum care providers, are inspected several times a year. Mostly (90%), hospitals are informed of the RI in advance. Two thirds of PHAs use standardized checklists. Few PHAs (3%) perform a systematic evaluation of the RI results and give feedback to the hospital.

Discussion: Based on the results, a nationwide standardization of RIs using jointly agreed checklists is being pursued. Practical examples show that the use of checklists helps ensure efficient use of personnel resources before and during RIs. Standardized checklists facilitate the implementation of future digitalization initiatives while also enabling comparability of RI results.

Background: Physical activity is an important behavioural determinant of health that can be influenced by designing a physical activity-friendly environment. The aim of this work was to develop survey instruments for walkability and bikeability for the prevention reporting of the federal states.

Methods: As part of the project "Monitoring physical activity and promoting exercise - developing indicators for the federal states' prevention indicator system in Germany (KAB-Mon)" (01/05/2023-30/04/2026), the development and review of two instruments designed to subjectively assess the two prevention indicators walkability and bikeability were carried out in three steps. In Step 1, a systematic literature review was conducted. In Step 2, an expert survey followed in which 9 and 7 experts from 6 disciplines evaluated the items of both instruments using the specific criteria in an online survey. Step 3 involved cognitive testing through guided interviews with a total of 18 participants. The expert survey was analysed using mean comparisons, while the cognitive interviews were evaluated descriptively.

Results: Based on the expert feedback, the walkability instrument was shortened from 16 to 13 items, and the bikeability instrument from 19 to 14 items. Following the cognitive testing, both instruments were supplemented with a fifth response option ("don't know/no answer").

Discussion: The instruments developed through this project provide a solid scientific approach for the subjective assessment of walkability and bikeability in the German-speaking context.

Introduction: German public health authorities (PHAs) bear a specific responsibility in scientific and population-based medicine, requiring specialist medical doctor and public health expertise in order to assess risks and implement measures. The data-driven verification of interventions is fundamental to their legitimacy and efficient resource allocation. This study aims to provide an overview of the international research output of German PHAs and to delineate their networks.

Methods: Methodologically, an empirical-descriptive analysis of bibliometric PubMed data was conducted. Systematic searches identified publications with PHA affiliations, followed by data cleaning and network analyses at the institutional level, differentiated according to the inclusion of state-level institutions.

Results: A total of 458 publications (excluding those with affiliations solely to state-level institutions) with a direct PHA connection were identified. PHA publication rates increased from approximately 2014, peaked during the COVID-19 pandemic and are currently declining. Research activities are heavily concentrated in a few PHAs, notably Frankfurt on the Main, Cologne, Stuttgart, Berlin and Regensburg, which are often well-networked, whilst the majority of the over 380 PHAs publish infrequently.

Discussion: The findings confirm research activities within PHAs, albeit highly centralized. For enhanced visibility and the strengthening of research, a standardised affiliation designation ("Gesundheitsamt") and the establishment of teaching and research public health authorities are recommended to systematically integrate practice, teaching and research. Strengthening research capacities and networks is essential. Limitations include the focus on PubMed and the restriction to PHA affiliations.

Introduction: Assisted suicide (AS) is permitted in Germany under certain conditions. To date, figures on AS in Germany are only available from Munich. The aim of this study is to collect data on AS cases involving residents of Bavaria, including sociodemographic characteristics, existing medical conditions, and drugs used.

Methods: The retrospective analysis for the years 2020 to 2023 is based on the information provided in the death certificate, which leads to the official cause of death statistics of the Bavarian State Office for Statistics and represents the total of all deceased persons residing in Bavaria.

Results: A total of 316 AS cases were identified in Bavaria. The AS rate increased from 0.1 to 1.3 deaths per 100,000 inhabitants during the study period. In 2023, AS accounted for almost 1 in 10 suicides in Bavaria and for 0.1% of all deaths. Almost two thirds of AS cases were female. Around half were between 65 and 84 years old. Almost a third suffered from neurodegenerative diseases and around a quarter from cancer. In addition, mental illness was documented in 7% of AS cases, with dementia and affective disorders being present in a third of these cases, respectively. AS in neurodegenerative diseases had a low mean age at death of 70.9 years. At 88.6%, thiopental was the most commonly used drug. Chloroquine, propofol, or phenobarbital were used less frequently.

Discussion: The number of AS cases in Bavaria is constantly increasing and now accounts for 0.1% of all deaths, which underlines the relevance of the topic for society as a whole. As AS seems to be of particular importance for patients with neurodegenerative and cancer diseases, suicide prevention should focus on these vulnerable groups.

Background: Young people and adults increasingly obtain information about pregnancy termination (PT) through social media. Against this background, the aim of this study is to investigate, for the first time, the content and quality of German-language PT videos on YouTube, Instagram, and TikTok. Research questions on provider types (research question 1: RQ1), content (RQ2), and quality of PT videos (RQ3) as well as audience reactions (RQ4) will be answered.

Methods: A sample of N = 500 popular PT videos was drawn from YouTube (150), Instagram (150), and TikTok (200). For each video, up to 20 of the most liked topic-related audience comments were included in the sample (N = 4761). The videos and comments were analyzed using reliability-tested codebooks. Data analysis was conducted with R. The study is preregistered, and all data, materials, and analysis scripts are publicly available.

Results: The PT videos predominantly originated from media professionals (49%) and only rarely from healthcare professionals (6%; RQ1). In terms of content, the majority of the videos represented a pro-choice position (54%) and frequently addressed medical care as well as psychological and physical experience (RQ2). According to quality criteria for health information, clear deficits were identified, with YouTube videos performing best in comparison (RQ3). TikTok videos, by contrast, led in audience engagement, recording the highest numbers of views, likes, and comments. Viewers used comment sections to express political positions and share personal experiences (RQ4).

Discussion: Future research as well as practice interventions are needed to further assess the quality of social media videos on pregnancy termination and improve it in a more targeted way.

Background: Since 1962, suicide cases in Hamburg's penal system have been scientifically analyzed with regard to causes and risk factors in order to improve suicide prevention measures. The present study builds on this long-term research tradition and examines suicides occurring between 2013 and 2022. Additionally, interviews with inmates and staff provide insights into the challenges of suicide prevention in custody.

Methods: The study followed a mixed-methods approach. For suicide cases from 2013 to 2022, forensic autopsy reports as well as inmate personnel and health records were quantitatively and descriptively analyzed. Additionally, between September and October 2022, qualitative guideline-based interviews were conducted with staff and inmates of the pre-trial detention center regarding their experiences and approaches to suicide. The qualitative data were analyzed using content analysis based on a deductive-inductive category system.

Results: During the study period, 20 suicides were recorded, with the highest prevalences observed in 2017, 2020, and 2021 (four cases each). No direct link to the pandemic could be established. Twelve suicides (60%) occurred in pre-trial detention, and 18 (90%) involved men. The most common method was strangulation (18 cases, 90%). The interviews indicate potentially suicide-relevant aspects of working and detention conditions.

Discussion: Compared to earlier surveys, the annual number of suicides has slightly decreased. The findings indicate that suicides in the (Hamburg) penal system remain a persistent challenge. Preventive measures such as suicide screenings, psychological support, training, and further education for staff, as well as structural and architectural adjustments, may reduce risk factors for suicide.

Video consultations enable guideline-based and continuous medical care under the structurally challenging conditions of correctional facilities. This article presents the model of team-based telemedicine using concrete fields of application such as tele-general medicine, telepsychiatry, tele-substitution therapy, and teledermatology. Special attention is given to technical requirements, quality assurance measures, and the challenges and opportunities in correctional healthcare delivery. The approaches described are based on the experiences of the "Videoclinic" in more than 120 correctional institutions. In addition, the results of an initial empirical analysis of telemedicine routine care data (January 2023 to March 2025) and a satisfaction survey of medical and nursing staff (March 12 to 9 April 2024) are presented, which provide insights into the realities of healthcare delivery, the disease spectrum of inmates, and indications regarding the effectiveness and acceptance of telemedicine care in correctional settings.

Substance use disorders are often associated with antisocial behaviour and criminality. Consequently, alcohol and drug use disorders are frequently noticed in prisoners and many of them require treatment in prison. Adequate management and therapy of affected individuals include diagnosis of substance use and comorbid disorders, management of withdrawal symptoms and implementation of follow-up therapy. However, there are no established specific treatment interventions in prison.For opioid use disorders, opioid maintenance treatment is the established first-line treatment, and its effectiveness has also been documented in correctional settings. The range of oral and depot preparations available should be further expanded. To date, there has been a significant lack of treatment options for convicted individuals with alcohol use disorder. Some diagnostic and therapeutic advice is provided by external counsellors and social workers. Key principles of treatment in substance use disorders in prisoners are reviewed in this article.