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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  Mainz//2011; 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi); 20110926-20110929; Mainz; DOC11gmds168 /20110920/
    Publication Date: 2011-09-20
    Keywords: neighbourhood SES ; cardiovascular risk factors ; ddc: 610
    Language: English
    Type: conferenceObject
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  • 2
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  53. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds); 20080915-20080919; Stuttgart; DOCINT1-6 /20080910/
    Publication Date: 2008-09-11
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
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    German Medical Science; Düsseldorf, Köln
    In:  50. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 12. Jahrestagung der Deutschen Arbeitsgemeinschaft für Epidemiologie; 20050912-20050915; Freiburg im Breisgau; DOC05gmds067 /20050908/
    Publication Date: 2005-09-09
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 4
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  GMS Zeitschrift für Medizinische Ausbildung; VOL: 28; DOC17 /20110204/
    Publication Date: 2011-02-05
    Description: Objective: The interdisciplinary topic "prevention and health promotion" (Q10) was introduced into the medical training in Germany by the new medical licensing regulations in 2004. For the conception of an effective curriculum, it is helpful to know student preferences concerning teaching-formats, attitudes and self-estimated previous knowledge. Little is known concerning student perception of "prevention and health promotion" in Germany. Thus, this explorative cross-sectional study aims to provide a first step for closing this gap.Methods: Medical students (n=220) in the fifth academic year were asked to fill in a standardized questionnaire prior to the Q10 curriculum. Questions focused on preferences for teaching and testing formats and self-estimated previous knowledge as well as on rating the importance of prevention topics and health risks. The questions were multiple choice, five-point Likert scales and open-ended questions. Results: A total of 94 students filled questionnaires (42% response rate). Prevention and health promotion was rated as "important" or "very important" for their "own medical professionalism" by 68% of students. Ratings showed preferences for self-directed teaching and learning strategies, including case-based learning, and 78% wished for predominantly oral examinations. The self-estimated knowledge about prevention and health promotion is rated as "rather poor". The most favored training aim was "decision making within the physician-patient-relationship". Regarding medical health consultation, students frequently estimate "lifestyle factors" and "psychological disease" as being "very important". Conclusion: Students' self-estimated poor previous knowledge of prevention and health promotion creates special challenges for curriculum development. High ratings of relevance assigned to prevention-related topics point to a motivational potential which should be utilized through suitable selection of teaching and testing formats to achieve effective and practice-relevant instructional content.
    Description: Einleitung: Der interdisziplinäre Querschnittsbereich "Prävention und Gesundheitsförderung"(Q10) wurde durch die neue Ärztliche Approbationsordnung 2004 in die medizinische Ausbildung eingeführt. Für eine effektive Unterrichtskonzeption sind Bestands- und Bedarfsanalysen der Zielgruppe erforderlich. Bisher ist jedoch zu präventionsbezogenen studentischen Präferenzen für Unterrichtsformate, Haltungen und selbst eingeschätzten Vorkenntnissen im deutschen Sprachraum wenig bekannt. Unsere explorierende Querschnitts-Erhebung bietet hierzu erste Daten.Methoden: Medizinstudierende (n=220) des fünften Studienjahres an der Martin-Luther-Universität Halle-Wittenberg wurden vor Absolvierung des Q10-Curriculums mittels standardisierter Fragebögen befragt. Schwerpunkte der Befragung waren Selbsteinschätzungen von fachspezifischen Vorkenntnissen, bevorzugte Unterrichts- und Leistungsnachweisformen sowie Bedeutungseinschätzungen von Präventionsthemen und Gesundheitsrisiken. Die Erhebungsinstrumente umfassten Mehrfachantwortmöglichkeiten, 5-Punkt-Likert-Skalen und offene Fragen. Ergebnisse: Es konnten 94 Fragebögen (42% Rücklauf) ausgewertet werden. Prävention und Gesundheitsförderung wurden von 68% als "wichtig" oder "sehr wichtig" für die eigene ärztliche Tätigkeit gehalten. Die Befragten bevorzugten selbst bestimmte Lehr- und Lernstrategien und fallbezogene Unterrichtskonzepte und wünschten zu 78% überwiegend mündliche Leistungsnachweise. Eigene Vorkenntnisse zu präventionsrelevanten Themengebieten wurden niedrig eingeschätzt. Favorisiertes Lernziel war die Entscheidungsfindung im Arzt-Patienten-Verhältnis. Für die ärztliche Gesundheitsberatung wurden Lebensstilrisiken aus dem Bereich der Primärprävention und psychische Erkrankungen besonders häufig als "sehr wichtig" eingeschätzt. Fazit: Die studentische Relevanzeinschätzung des Themengebietes weist auf ein Motivationspotential hin, das durch eine geeignete Auswahl von Lehr- und Prüfungsformen für die effektive und praxisrelevante Vermittlung von Lehrinhalten nutzbar ist. Geringe Vorkenntnisse in der Selbsteinschätzung der Studierenden stellen besondere Anforderungen an die Unterrichtsentwicklung.
    Keywords: Curriculum ; health promotion ; prevention ; interdisciplinary teaching ; evaluation ; Curriculum ; Gesundheitsförderung ; Prävention ; interdisziplinäre Lehre ; Evaluation ; ddc: 610
    Language: German
    Type: article
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  • 5
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  HEC 2016: Health - Exploring Complexity; Joint Conference of GMDS, DGEpi, IEA-EEF, EFMI; 20160828-20160902; München; DOCAbstr. 272 /20160808/
    Publication Date: 2016-08-11
    Keywords: Cardiovascular and metabolic disease ; ddc: 610
    Language: German
    Type: conferenceObject
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  • 6
    Keywords: MORTALITY ; antibodies ; FUNCTION TESTS ; EXCRETION ; HORMONE CONCENTRATIONS ; REFERENCE INTERVALS ; UNITED-STATES POPULATION ; THYROTROPIN ; EXTREME LONGEVITY ; IODINE INTAKE
    Abstract: BACKGROUND: Age and gender may be involved in the regulation of TSH and thyroid hormones. Reliable investigations concerned with the matter of whether or not these factors are of importance for diagnostic evaluation of the thyroid function are scarce. We used serum values of the CARLA study to calculate reference intervals for TSH, FT3, and FT4 and examine these parameters for their association with age or gender. METHODS: The CARLA study included 967 men and 812 women aged 45 to 83 years. We defined a reference group of 1002 subjects that were free of thyroid disease for data analysis by laboratory analysis and questionnaire, calculated age-dependent moving percentiles (2.5th/97.5th) for TSH, FT4, and FT3 and tested this data set for the confounding factors age and gender. Thereafter, the results were compared to data from the Leipzig Blood Donor study established in 2005. RESULTS: TSH (significant in trend (p = 0.064)) and FT3 (p = 0.001) were inversely associated with age. The correlation of FT3 with age was furthermore influenced by gender (p 〈 0.001). Neither gender nor age influenced values of FT4. CONCLUSIONS: The decreased TSH and FT3 levels with increasing age suggest a diagnostically relevant modification in the feed back regulation of thyroid function of the elderly. FT3 data should thus be interpreted gender-dependent and even age-dependent for males. These findings should be considered for the diagnostic examination of older patients with suspected disorders of thyroid function.
    Type of Publication: Journal article published
    PubMed ID: 25291952
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  • 7
    Keywords: OBESITY ; CARDIOVASCULAR-DISEASE ; ARTERIAL-HYPERTENSION ; MASS ; RECOMMENDATIONS ; HYPERTENSIVE PATIENTS ; CHAMBER QUANTIFICATION ; ELECTROCARDIOGRAPHIC CRITERIA ; LOSARTAN INTERVENTION ; ECG
    Abstract: BACKGROUND: Arterial hypertension is a common disease with high prevalence in the general population. Left ventricular hypertrophy (LVH) is an independent risk factor in arterial hypertension. Electrocardiographic indices like the Sokolow-Lyon index (SLI) are recommended as diagnostic screening methods for LVH. We assessed the diagnostic performance of the SLI in a cohort of a large general population. METHODS: We used electrocardiographic and echocardiographic data from the prospective, population-based cohort study CARdio-vascular Disease, Living and Ageing in Halle (CARLA). Linear and logistic regression models were used to assess the association of SLI with LVH. To assess the impact of the body-mass-index (BMI), we performed interaction analyses. RESULTS: AUC of SLI to predict LVH was 55.3 %, sensitivity of the SLI was 5 %, specificity 97 %. We found a significant association of SLI after covariate-adjustment with echocardiographically detected LVH (increase of left-ventricular mass index, LVMI 7.0 g/m(2) per 1 mV increase of SLI, p 〈 0.0001). However, this association was mainly caused by an association of SLI with the left-ventricular internal diameter (LVIDd, increase of 0.06 cm/m(2) per 1 mV increase of SLI, p 〈 0.0001). In obese (BMI 〉 30 kg/m(2)) we found the strongest association with an increase of 9.2 g/m(2) per 1 mV. CONCLUSIONS: Although statistically significant, relations of SLI and echocardiographic parameters of LVH were weak and mainly driven by the increase in LVIDd, implicating a more eccentric type of LVH in the collective. The relations were strongest when obese subjects were taken into account. Our data do not favour the SLI as a diagnostic screening test to identify patients at risk for LVH, especially in non-obese subjects without eccentric LVH.
    Type of Publication: Journal article published
    PubMed ID: 26169782
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  • 8
    Abstract: OBJECTIVES: Aim was to examine the relationship between individually perceived changes in psychosocial stressors associated with German reunification and cardiovascular effects. We hypothesised that higher levels of psychosocial stress related to German reunification were associated with an increase in cardiovascular risk factors and cardiovascular diseases (CVDs). DESIGN: Cross-sectional data from 2 cohort studies in East Germany were used: Cardiovascular Disease, Living and Ageing in Halle Study (CARLA), and Study of Health in Pomerania (SHIP). SETTING: 2 populations in East Germany. PARTICIPANTS: CARLA study: 1779 participants, aged 45-83 years at baseline (812 women), SHIP study: 4308 participants, aged 20-79 years at baseline (2193 women). PRIMARY AND SECONDARY OUTCOME MEASURES: Psychosocial stressors related to reunification were operationalised by the Reunification Stress Index (RSI; scale from 0 to 10). This index was composed of questions that were related to individually perceived changes in psychosocial stressors (occupational, financial and personal) after reunification. To examine the associations between the RSI and each stressor separately with cardiovascular risk factors and CVD, regression models were used. RESULTS: RSI was associated with CVD in women (RR=1.15, 95% CI 1.00 to 1.33). Cardiovascular risk factors were associated with RSI for both men and women, with strongest associations between RSI and diabetes in women (RR=1.10, 95% CI 1.01 to 1.20) and depressive disorders in men (RR=1.15, 95% CI 1.07 to 2.77). The change in occupational situation related to reunification was the major contributing psychosocial stressor. We observed a strong association with CVD in women who experienced occupational deterioration after reunification (RR=4.04, 95% CI 1.21 to 13.43). CONCLUSIONS: Individually perceived deterioration of psychosocial stressors (occupational, financial and personal) related to German reunification was associated with cardiovascular risk factors and CVD. The associations were stronger for women than for men. An explanation for these findings could be that women were more often affected by unemployment after reunification. Morbidity and mortality follow-up of both cohorts could enhance the results.
    Type of Publication: Journal article published
    PubMed ID: 26729378
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  • 9
    Abstract: OBJECTIVE: To study the association between socioeconomic status (SES) and annual relative change in anthropometric markers in the general German adult population. METHODS: Longitudinal data of 56,556 participants aged 18-83 years from seven population-based German cohort studies (CARLA, SHIP, KORA, DEGS, EPIC-Heidelberg, EPIC-Potsdam, PopGen) were analyzed by meta-analysis using a random-effects model. The indicators of SES were education and household income. RESULTS: On average, all participants gained weight and increased their waist circumference over the study's follow-up period. Men and women in the low education group had a 0.1 percentage points greater annual increase in weight (95% CI men: 0.06-0.20; and women: 0.06-0.12) and waist circumference (95% CI men: 0.01-0.45; and women: 0.05-0.22) than participants in the high education group. Women with low income had a 0.1 percentage points higher annual increase in weight (95% CI 0.00-0.15) and waist circumference (95% CI 0.00-0.14) than women with high income. No association was found for men between income and obesity markers. CONCLUSIONS: Participants with lower SES (education and for women also income) gained more weight and waist circumference than those with higher SES. These results underline the necessity to evaluate the risk of weight gain based on SES to develop more effective preventive measures.
    Type of Publication: Journal article published
    PubMed ID: 26833586
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  • 10
    Abstract: BACKGROUND: Disagreement exists on the association between changes in blood pressure and cognitive impairment. We aimed to examine whether 4-year changes in systolic and diastolic blood pressure (SBP and DBP) are associated with cognitive status in a representative sample of older men and women. METHODS: Analysis of longitudinal data from 854 participants of a population-based German sample (aged 60-87 years) was performed with standard cognitive screening and blood pressure measurements. Effects of changes in SBP and DBP (10 mmHg and 5 mmHg respectively as unit of regression effect measure) on cognitive status were evaluated using non-parametric and linear regression modeling. RESULTS: No clear associations were seen between changes in SBP or in DBP and cognitive scores. Small effects were found after stratification for sex and hypertension awareness. Specifically, larger decreases in SBP were associated with higher cognitive scores in those men aware of their hypertension (10 mmHg decrease in SBP, beta = -0.26, 95% CI: -0.51 to -0.02) and men with controlled hypertension (10 mmHg decrease in SBP, beta = -0.44, 95% CI: -0.92 to -0.03). Additionally larger increases in DBP were associated with higher cognitive scores in men with controlled hypertension (5 mmHg increase in DBP, beta = 0.67, 95% CI: 0.19-1.15). For women aware of their hypertension, larger decreases in DBP were associated with higher cognitive scores (5 mmHg decrease in DBP, beta = -0.26; 95%CI: -0.51 to -0.01). CONCLUSIONS: Changes in blood pressure were only weakly associated with cognitive status. Specifically, decreases in SBP were associated with higher cognitive scores in men aware of their hypertension and especially those that were medically controlled.
    Type of Publication: Journal article published
    PubMed ID: 26918011
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