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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  54. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds); 20090907-20090910; Essen; DOC09gmds063 /20090831/
    Publication Date: 2009-08-31
    Keywords: Diabetes Typ 2 ; Krankheitsmanagement ; Versorgungsqualität ; Zeittrends ; KORA ; ddc: 610
    Language: German
    Type: conferenceObject
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  • 2
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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; DOC11gmds290 /20110920/
    Publication Date: 2011-09-20
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 3
    Keywords: RISK-FACTORS ; HEALTH ; smoking ; MYOCARDIAL-INFARCTION ; HYPERTENSION ; GENERAL-POPULATION ; PRIMARY-CARE ; SOUTHERN GERMANY ; METABOLIC-SYNDROME ; POMERANIA SHIP
    Abstract: Diabet. Med. 29, e88-e95 (2012) ABSTRACT: Aim In Germany, regional data on the prevalence of Type 2 diabetes mellitus are lacking for health-care planning and detection of risk factors associated with this disease. We analysed regional variations in the prevalence of Type 2 diabetes and treatment with antidiabetic agents. Methods Data of subjects aged 45-74 years from five regional population-based studies and one nationwide study conducted between 1997 and 2006 were analysed. Information on self-reported diabetes, treatment, and diagnosis of diabetes were compared. Type 2 diabetes prevalence estimates (95% confidence interval) from regional studies were directly standardized to the German population (31 December 2007). Results Of the 11 688 participants of the regional studies, 1008 had known Type 2 diabetes, corresponding to a prevalence of 8.6% (8.1-9.1%). For the nationwide study, a prevalence of 8.2% (7.3-9.2%) was estimated. Prevalence was higher in men (9.7%; 8.9-10.4%) than in women (7.6%; 6.9-8.3%). The regional standardized prevalence was highest in the east with 12.0% (10.3-13.7%) and lowest in the south with 5.8% (4.9-6.7%). Among persons with Type 2 diabetes, treatment with oral antidiabetic agents was more frequently reported in the south (56.9%) and less in the northeast (46.0%), whereas treatment with insulin alone was more frequently reported in the northeast (21.6%) than in the south (16.4%). Conclusion The prevalence of known Type 2 diabetes showed a southwest-to-northeast gradient within Germany, which is in accord with regional differences in the distribution of risk factors for Type 2 diabetes. Furthermore, the treatment with antidiabetic agents showed regional differences.
    Type of Publication: Journal article published
    PubMed ID: 22248078
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  • 4
    Keywords: MORTALITY ; RISK ; ATHEROSCLEROSIS ; GLUCOSE ; INDIVIDUALS ; PREVALENCE ; MELLITUS ; CORONARY-HEART-DISEASE ; SOUTHERN GERMANY ; METABOLIC-SYNDROME
    Abstract: BACKGROUND: Population-based data are paramount to investigate the long-term course of diabetes, for planning in healthcare and to evaluate the cost-effectiveness of primary prevention. We analysed regional differences in the incidence of self-reported type 2 diabetes mellitus in Germany. METHODS: Data of participants (baseline age 45-74 years) from five regional population-based studies conducted between 1997 and 2010 were included (mean follow-up 2.2-7.1 years). The incidence of self-reported type 2 diabetes mellitus at follow-up was compared. The incidence rates per 1000 person-years (95% CI) and the cumulative incidence (95% CI) from regional studies were directly standardised to the German population (31 December 2007) and weighted by inverse probability weights for losses to follow-up. RESULTS: Of 8787 participants, 521 (5.9%) developed type 2 diabetes mellitus corresponding to an incidence rate of 11.8/1000 person-years (95% CI 10.8 to 12.9). The regional incidence was highest in the East and lowest in the South of Germany with 16.9 (95% CI 13.3 to 21.8) vs 9.3 (95% CI 7.4 to 11.1)/1000 person-years, respectively. The incidence increased with age and was higher in men than in women. CONCLUSIONS: The incidence of self-reported type 2 diabetes mellitus shows regional differences within Germany. Prevention measures need to consider sex-specific differences and probably can be more efficiently introduced toward those regions in need.
    Type of Publication: Journal article published
    PubMed ID: 25073594
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  • 5
    Keywords: POPULATION ; RISK ; HEALTH ; HYPERTENSION ; PREVALENCE ; MANAGEMENT ; GUIDELINES ; MELLITUS ; CARDIOVASCULAR-DISEASE ; PULSE PRESSURE
    Abstract: BACKGROUND: Hypertension is a very common comorbidity and major risk factor for cardiovascular complications, especially in people with Type 2 Diabetes (T2D). Nevertheless, studies in the past have shown that blood pressure is often insufficiently controlled in medical practice. For the DIAB-CARE study, we used longitudinal data based on the German DIAB-CORE Consortium to assess whether health care regarding hypertension has improved during the last decade in our participants. METHODS: Data of the three regional population-based studies CARLA (baseline 2002-2006 and follow-up 2007-2010), KORA (baseline 1999-2001 and follow-up 2006-2008) and SHIP (baseline 1997-2001 and follow-up 2002-2006) were pooled. Stratified by T2D status we analysed changes in frequencies, degrees of awareness, treatment and control. Linear mixed models were conducted to assess the influence of sex, age, study, and T2D status on changes of systolic blood pressure between the baseline and follow-up examinations (mean observation time 5.7 years). We included 4,683 participants aged 45 to 74 years with complete data and accounted for 1,256 participants who were lost to follow-up by inverse probability weighting. RESULTS: Mean systolic blood pressure decreased in all groups from baseline to follow-up (e.g. - 8.5 mmHg in those with incident T2D). Pulse pressure (PP) was markedly higher in persons with T2D than in persons without T2D (64.14 mmHg in prevalent T2D compared to 52.87 mmHg in non-T2D at baseline) and did not change much between the two examinations. Awareness, treatment and control increased considerably in all subgroups however, the percentage of those with insufficiently controlled hypertension remained high (at about 50% of those with hypertension) especially in prevalent T2D. Particularly elderly people with T2D often had both, high blood pressure 〉/=140/90 mmHg and a PP of 〉/=60 mmHg. Blood pressure in men had improved more than in women at follow-up, however, men still had higher mean SBP than women at follow-up. CONCLUSION: Blood pressure management has developed positively during past years in Germany. While hypertension prevalence, awareness and treatment were substantially higher in participants with T2D than in those without T2D at follow-up, hypertension control was achieved only in about half the number of people in each T2D group leaving much room for further improvement.
    Type of Publication: Journal article published
    PubMed ID: 26221962
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  • 6
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  GMS Journal for Medical Education; VOL: 35; DOC45 /20181115/
    Publication Date: 2018-11-15
    Description: Objectives: Qualitative health research can contribute to knowledge building in public health and medicine, but there is a lack of research-oriented training of qualitative methods at universities with public health programs and in medical schools. The aim of this paper is to describe our experiences in conceptualising, implementing and evaluating an elective on qualitative methods in the Master of Public Health (MPH) programme at the Medical Faculty of the Ludwig-Maximilians-University (LMU) Munich.Methods: A new research-oriented elective (3 Credit Points) was developed and delivered to MPH and medical students in summer 2016. This elective consisted of three blocks that were complemented by two practice sessions. The students worked in small groups. These groups developed a research question and a qualitative study design addressing the thematic focus of vaccinations. Each student conducted two semi-structured interviews with a semi-structured interview grid. Students transcribed the interviews, analysed them according to content analysis and presented the results collaboratively. Results: In that semester, 16 students successfully completed the elective. Groups of two to three students worked on their respective research questions, presented, and reflected on their research results. The participants evaluated the module as very good, particularly with regard to the structure and consistency of the blocks. To facilitate individualised mentoring and guidance, a high student-lecturer ratio is required. Timeframe and workload should pay tribute to the module's credit points.Conclusions: We successfully implemented a research-oriented elective providing a first-hand experience with qualitative health research methods. Students were able to learn about the theory and practical application of qualitative research in the field of medicine and public health.
    Description: Ziele: Qualitative Forschung kann zur Wissensgenerierung in den Fächern Public Health und Medizin beitragen. Es fehlt jedoch vielerorts eine forschungsorientierte Vermittlung qualitativer Methoden, sowohl an Universitäten, die Public Health Programme anbieten, als auch an Medizinischen Fakultäten. Ziel dieses Artikels ist es, Erfahrungen bei der Konzeption, Durchführung und Evaluation eines Seminars zur Lehre qualitativer Methoden in diesen Fächern zu beschreiben. Das Seminar ist als Wahlpflichtmodul im Masterstudiengang Public Health an der Medizinischen Fakultät der Ludwig-Maximilians-Universität München (LMU) verankert.Methoden: Im Sommersemester 2016 wurde ein neues, forschungsorientiertes Seminar als Wahlpflichtmodul (3 ECTS-Anrechnungspunkte) entwickelt und für Public Health- und Medizin-Studierende angeboten. Dieses Wahlpflichtmodul bestand aus drei Blöcken, die durch zwei Praxisphasen ergänzt wurden. In den Praxisphasen arbeiteten Studierende in Kleingruppen, in denen sie eine Forschungsfrage und ein qualitatives Studiendesign zum Thema Impfen entwickelten. Jede*r Student*in führte anhand eines semi-strukturierten Interviewleitfadens zwei halb-offene Interviews. Die Studierenden transkribierten die Interviews, analysierten sie inhaltsanalytisch und präsentierten die Ergebnisse gemeinschaftlich. Ergebnisse: Insgesamt haben in diesem Semester 16 Studierende das Modul erfolgreich abgeschlossen. Gruppen von zwei bis drei Studierenden arbeiteten an ihren jeweiligen Forschungsfragen, präsentierten und reflektierten ihre Ergebnisse. Die Teilnehmer*innen evaluierten das Modul als 'sehr gut', besonders im Hinblick auf die Struktur und Konsistenz der Blöcke. Um in einem solchen Seminar eine studierendenzentrierte Betreuung und Anleitung zu ermöglichen, ist ein hoher Betreuungsschlüssel erforderlich. Die Anrechnungspunkte sollten dem zeitlichen Arbeitsaufwand entsprechen, weshalb sie im darauffolgenden Semester erhöht wurden. Zusammenfassung: Wir haben erfolgreich ein forschungsorientiertes Wahlpflichtseminar durchgeführt, in dem wir Studierenden eigene Erfahrungen mit qualitativen Forschungsmethoden im Gesundheitsbereich ermöglicht haben. Dadurch hatten Teilnehmende die Gelegenheit, sowohl etwas über die theoretische als auch die forschungspraktische Anwendung qualitativer Forschung auf dem Gebiet der Medizin und Public Health zu erlernen.
    Keywords: research/education ; qualitative research ; qualitative content analysis ; teaching/methods ; curriculum ; Forschung/Ausbildung ; qualitative Forschung ; qualitative Inhaltsanalyse ; Lehrmethoden ; Curriculum ; ddc: 610
    Language: English
    Type: article
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  • 7
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  14. Deutscher Kongress für Versorgungsforschung; 20151007-20151009; Berlin; DOCV83 /20150922/
    Publication Date: 2015-09-23
    Keywords: ddc: 610
    Language: German
    Type: conferenceObject
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  • 8
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  12. Deutscher Kongress für Versorgungsforschung; 20131023-20131025; Berlin; DOCKV13-279 /20131025/
    Publication Date: 2013-10-26
    Keywords: Diabetes ; Selbstmanagement ; Versorgungsqualität ; Mortalität ; ddc: 610
    Language: German
    Type: conferenceObject
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  • 9
    Keywords: MORTALITY ; POPULATION ; SAMPLE ; CARE ; VALIDITY ; MANAGEMENT ; GLYCEMIC CONTROL ; MELLITUS ; ADULTS ; APPRAISAL
    Abstract: AIM: This study compares health-related quality of life (HRQL) in patients with type 2 diabetes (T2DM) across treatment groups and explores gender differences. METHODS: Four regional surveys (KORA, CARLA, SHIP, DHS) and a national survey (GNHIES98) were pooled at individual level. HRQL was assessed with the SF-12/-36v1. Linear regression models were used to assess the effect of T2DM by treatment type (no medication; oral; oral/insulin combination; insulin) on the physical (PCS-12) and mental summary score (MCS-12) and the SF-6D, controlling for age, sex, study and covariates. We also performed an explanatory analysis of single items. RESULTS: PCS-12 scores and treatment type were associated (P-value 0.006), with lowest values for insulin treatment (-4.44 vs. oral; -4.41 vs. combination). MCS-12 scores were associated with treatment type and gender (P-value 〈0.012), with lower scores for women undergoing oral (-4.25 vs. men) and combination treatment (-6.99 vs. men). Similar results were observed for SF-6D utilities and single items, related to mental health, social functioning, vitality and role limitation (emotional). Comorbidities were predictors of lower PCS-12 and SF-6D scores. CONCLUSIONS: T2DM treatment impacts differently on physical and mental HRQL and on women and men. Further studies of gender-specific perceptions of T2DM treatment regimens are needed.
    Type of Publication: Journal article published
    PubMed ID: 25499244
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  • 10
    Abstract: OBJECTIVE: To compare the association between different anthropometric measurements and incident type 2 diabetes mellitus (T2DM) and to assess their predictive ability in different regions of Germany. METHODS: Data of 10 258 participants from 4 prospective population-based cohorts were pooled to assess the association of body weight, body mass index (BMI), waist circumference (WC), waist-to-hip-ratio (WHR) and waist-to-height-ratio (WHtR) with incident T2DM by calculating HRs of the crude, adjusted and standardised markers, as well as providing receiver operator characteristic (ROC) curves. Differences between HRs and ROCs for the different anthropometric markers were calculated to compare their predictive ability. In addition, data of 3105 participants from the nationwide survey were analysed separately using the same methods to provide a nationally representative comparison. RESULTS: Strong associations were found for each anthropometric marker and incidence of T2DM. Among the standardised anthropometric measures, we found the strongest effect on incident T2DM for WC and WHtR in the pooled sample (HR for 1 SD difference in WC 1.97, 95% CI 1.75 to 2.22, HR for WHtR 1.93, 95% CI 1.71 to 2.17 in women) and in female DEGS participants (HR for WC 2.24, 95% CI 1.91 to 2.63, HR for WHtR 2.10, 95% CI 1.81 to 2.44), whereas the strongest association in men was found for WHR among DEGS participants (HR 2.29, 95% CI 1.89 to 2.78). ROC analysis showed WHtR to be the strongest predictor for incident T2DM. Differences in HR and ROCs between the different markers confirmed WC and WHtR to be the best predictors of incident T2DM. Findings were consistent across study regions and age groups (〈65 vs 〉/=65 years). CONCLUSIONS: We found stronger associations between anthropometric markers that reflect abdominal obesity (ie, WC and WHtR) and incident T2DM than for BMI and weight. The use of these measurements in risk prediction should be encouraged.
    Type of Publication: Journal article published
    PubMed ID: 26792214
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