Cultural differences in postnatal quality of life among German-speaking women - a prospective survey in two countries.

Assessment of quality of life after childbirth is an important health-outcome measurement for new mothers and is of special interest in midwifery. The Mother-Generated Index (MGI) is a validated instrument to assess postnatal quality of life. The tool has not been applied for making a cross-cultural comparison before. This study investigated (a) responses to the MGI in German-speaking women in Germany and Switzerland; and (b) associations between MGI scores on the one hand and maternity and midwifery care on the other

Extreme right-wing voting in Western Europe

In this study we explain extreme right-wing voting behaviour in the countries of the European Union and Norway from a micro and macro perspective. Using a multidisciplinary multilevel approach, we take into account individual-level social background characteristics and public opinion alongside country characteristics and characteristics of extreme right-wing parties themselves. By making use of large-scale survey data (N = 49,801) together with country-level statistics and expert survey data, we are able to explain extreme right-wing voting behaviour from this multilevel perspective. Our results show that cross-national differences in support of extreme right-wing parties are particularly due to differences in public opinion on immigration and democracy, the number of non-Western residents in a country and, above all, to party characteristics of the extreme right-wing parties themselves

EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies), 2013 . Scientific O pinion on Dietary Reference Values for molybdenum

Following a request from the European Commission, the Panel on Dietetic Products, Nutrition and Allergies (NDA) derived Dietary Reference Values (DRVs) for molybdenum. Molybdenum is efficiently and rapidly absorbed at a wide range of intakes, and the body is able to maintain homeostasis through the regulation of excretion via the urine. Molybdenum deficiency in otherwise healthy humans has not been observed and there are no biomarkers of molybdenum status. Various metabolic balance studies have been performed to establish molybdenum requirements. However, only one balance study, which was performed with a constant diet and under controlled conditions in adult men, was considered to be of sufficient duration. In this small study, balance was reported to be near zero when molybdenum intakes were 22 µg/day. Biochemical changes or symptoms suggestive of molybdenum deficiency were not observed, and it is possible that humans may be able to achieve molybdenum balance at even lower intakes. Data on molybdenum intakes and health outcomes were unavailable for the setting of DRVs for molybdenum. As the evidence required to derive an Average Requirement and a Population Reference Intake was considered insufficient, an Adequate Intake (AI) is proposed. Observed molybdenum intakes from mixed diets in Europe were taken into consideration in setting this value. An AI of 65 µg/day is proposed for adults; a figure that is based on molybdenum intakes at the lower end of the wide range of observed intakes. It is suggested that the adult AI also applies to pregnant and lactating women. An AI is also proposed for infants from seven months and for children based on extrapolation from the adult AI using isometric scaling and the reference body weights of the respective age groups

"Kultur" als Form symbolischer Gewalt: Grenzziehungsprozesse im Kontext von Migration am Beispiel der Schweiz

Die Schweiz gilt international als Modell eines gelungenen Multikulturalismus, dann nämlich wenn es das Zusammenleben der vier Sprachgruppen (Romands, DeutschschweizerInnen, TessinerInnen, RäteromanInnen) betrifft. Ein sprachlicher wie auch religiöser Pluralismus ist und war stets ein Grundbaustein des Selbstverständnisses der „Willensnation“ Schweiz. Geht es aber um MigrantInnen präsentiert sich die Geschichte anders, denn in diesem Falle erscheinen religiöse und ethnisch-kulturelle Pluralität vorwiegend als problematisch. MigrantInnen gehören entsprechend den öffentlichen und politischen Diskursen nicht zum multikulturellen Staat, vielmehr sind Prozesse kollektiver Grenzziehungen und damit Schließungsmechanismen zu beobachten, in denen Ethnizität, Religion und Kultur zu den wichtigsten Differenzierungsmerkmale werden, wie Gemeinsamkeiten gegen innen (SchweizerInnen) und Barrieren gegen außen (Ausländer, Migranten, Muslims, etc.) hergestellt werden. Ich argumentiere in diesem Kapitel, dass sich dieser „Kulturdiskurs“ im letzten Jahrzehnt verstärkt hat und gleichzeitig semantischen Verschiebungen unterworfen war. Mittels der Grenzziehungsperspektive wird historisch nachvollzogen, wie Zuwanderung und Integration in politischen Debatten und Gesetz zunehmend kulturalisiert und ethnisiert wurden. Ein Fallbeispiel aus der Forschung dient mir anschließend der Veranschaulichung dieser theoretischen Perspektive und dieses „neuen“ Essentialismus

The epidemiology of pertussis in Germany: past and present

<p>Abstract</p> <p>Background</p> <p>Current and past pertussis epidemiology in the two parts of Germany is compared in the context of different histories of vaccination recommendations and coverage to better understand patterns of disease transmission.</p> <p>Methods</p> <p>Available regional pertussis surveillance and vaccination coverage data, supplemented by a literature search for published surveys as well as official national hospital and mortality statistics, were analyzed in the context of respective vaccination recommendations from 1964 onwards.</p> <p>Results</p> <p>Routine childhood pertussis vaccination was recommended in the German Democratic Republic (GDR) from 1964 and in former West German states (FWG) from 1969, but withdrawn from 1974–1991 in FWG. Pertussis incidence declined to <1 case/100.000 inhabitants in GDR prior to reunification in 1991, while in FWG, where pertussis was not notifiable after 1961, incidence was estimated at 160–180 cases/100.000 inhabitants in the 1970s-1980s. Despite recommendations for universal childhood immunization in 1991, vaccination coverage decreased in former East German States (FEG) and increased only slowly in FWG. After introduction of acellular pertussis vaccines in 1995, vaccination coverage increased markedly among younger children, but remains low in adolescents, especially in FWG, despite introduction of a booster vaccination for 9–17 year olds in 2000. Reported pertussis incidence increased in FEG to 39.3 cases/100.000 inhabitants in 2007, with the proportion of adults increasing from 20% in 1995 to 68% in 2007. From 2004–2007, incidence was highest among 5–14 year-old children, with a high proportion fully vaccinated according to official recommendations, which did not include a preschool booster until 2006. Hospital discharge statistics revealed a ~2-fold higher pertussis morbidity among infants in FWG than FEG.</p> <p>Conclusion</p> <p>The shift in pertussis morbidity to older age groups observed in FEG is similar to reports from other countries with longstanding vaccination programs and suggests that additional booster vaccination may be necessary beyond adolescence. The high proportion of fully vaccinated cases in older children in FEG suggests waning immunity 5–10 years after primary immunisation in infancy. The higher incidence of pertussis hospitalisations in infants suggests a stronger force of infection in FWG than FEG. Nationwide pertussis reporting is required for better evaluation of transmission patterns and vaccination policy in both parts of Germany.</p

Reconstructing the 2003/2004 H3N2 influenza epidemic in Switzerland with a spatially explicit, individual-based model

ABSTRACT: BACKGROUND: Simulation models of influenza spread play an important role for pandemic preparedness. However, as the world has not faced a severe pandemic for decades, except the rather mild H1N1 one in 2009, pandemic influenza models are inherently hypothetical and validation is, thus, difficult. We aim at reconstructing a recent seasonal influenza epidemic that occurred in Switzerland and deem this to be a promising validation strategy for models of influenza spread. METHODS: We present a spatially explicit, individual-based simulation model of influenza spread. The simulation model bases upon (i) simulated human travel data, (ii) data on human contact patterns and (iii) empirical knowledge on the epidemiology of influenza. For model validation we compare the simulation outcomes with empirical knowledge regarding (i) the shape of the epidemic curve, overall infection rate and reproduction number, (ii) age-dependent infection rates and time of infection, (iii) spatial patterns. RESULTS: The simulation model is capable of reproducing the shape of the 2003/2004 H3N2 epidemic curve of Switzerland and generates an overall infection rate (14.9 percent) and reproduction numbers (between 1.2 and 1.3), which are realistic for seasonal influenza epidemics. Age and spatial patterns observed in empirical data are also reflected by the model: Highest infection rates are in children between 5 and 14 and the disease spreads along the main transport axes from west to east. CONCLUSIONS: We show that finding evidence for the validity of simulation models of influenza spread by challenging them with seasonal influenza outbreak data is possible and promising. Simulation models for pandemic spread gain more credibility if they are able to reproduce seasonal influenza outbreaks. For more robust modelling of seasonal influenza, serological data complementing sentinel information would be beneficia

Postnatal quality of life - A content analysis of qualitative results to the Mother-Generated Index.

BACKGROUND: The Mother-Generated Index (MGI) assesses postnatal quality of life (QoL) without providing a predefined checklist, thus offering mothers the opportunity to identify areas of life affected by having a baby. AIM: To identify: (a) details and particularities of areas of life affected after childbirth and thus specific domains defining postnatal quality of life; (b) changes in the importance of domains specifying QoL within the first weeks postpartum; and (c) the potential role of cultural differences with regard to the nature of QoL definitions. METHODS: Prospective, cross-cultural, longitudinal survey. We applied a qualitative content analysis to Mother-Generated Index data collected in Switzerland and Germany using combined deductively and inductively category building. RESULTS: Women participated at three days (n=124) and six and a half weeks (n=82) postpartum. Eleven domains were identified, each with several subdomains: 'physical well-being' (e.g. fatigue), 'psychological well-being' (e.g. happiness, emotional confusion), 'general well-being', 'motherhood' (e.g. bonding with the baby), 'family and partnership' (e.g. time for partner and children), 'social life' (e.g. friends, being isolated), 'everyday life' (e.g. organisation daily routine), 'leisure' (e.g. less time), 'work life' (e.g. worries about job), 'financial issues' (e.g. less money), and further aspects. The most frequently indicated domains were 'motherhood' and 'family and partnership'. Differences between the stages of assessment and countries were identified. DISCUSSION: Mothers faced challenges in defining their new role but welcomed the slowdown in the rhythm of life and experienced overwhelming maternal feelings. CONCLUSION: Our findings suggest that postnatal quality of life is a concept that changes over time and differs between countries