Practice-related examinations are feasible

The 9th Revision of the German Federal Medical Training Regulations demands a practice-related assessment of medical students. On the way to these new regulations German faculties face as well problems related to a lack of experience of lecturers, tutors, examiners, and students with the required examination procedures as strains of a financial and logistic kind. How to succeed in introducing suitable examinations at short notice and which positive effects can be achieved is shown by the Faculty of Medicine of the university of Tübingen

Income and education predict elevated depressive symptoms in the general population: results from the Gutenberg health study

Abstract Background Socioeconomic status (SES) has a strong association with depression or physical and mental health in general. However, as SES is a multifaceted construct these associations are not easy to explain. Further, there are several indicators and many studies only investigating two or less indicators at the same time. Therefore, this study aims to analyze the cross-sectional and longitudinal association of three defined SES dimensions (education, occupational position and household net-income) with the occurrence of elevated symptoms of depression relative to the impact of important covariates. Methods The study included observational data from 12,484 participants of the Gutenberg Health Study. The outcome was “elevated depressive symptoms” as defined by Patient Health Questionnaire (PHQ-2) ≥ 2 at the 2.5-year follow-up. Regression coefficients were adjusted for baseline covariates (age, sex, partnership, depression, anxiety, medical history of depressive or anxiety disorder and major medical diseases (MMD)) in addition to SES sum score and the three single indicators. We further examined interaction terms of the SES with sex, partnership and major medical diseases. We analyzed the sample stratified by elevated depressive symptoms at baseline, as we expected different trajectories in both subgroups. Results SES, education and household net-income were lower in the group of persons with PHQ-2 ≥ 2 at baseline, and they predicted the occurrence of PHQ-2 ≥ 2 at 2.5 year follow-up in the group of persons without elevated depressive symptoms at baseline after multivariable adjustment (SES: Odds Ratio (OR) 0.96, 0.95–0.98, p <  0.0001; education: OR 0.96, 0.93–0.99, p = 0.036; household net-income: OR 0.96, 0.92–0.99, p = 0.046) but not in the group of persons with elevated depressive symptoms at baseline. Further, we found that the impact of major medical diseases on the development of elevated depressive symptoms was buffered by high income. In addition, living in a partnership buffered the impact of a low occupational position. Conclusions Regarding the SES, the dimensions education and household net-income seem to play the most important role for socioeconomic inequalities in persons in Mid-West Germany with depressive symptoms. Trial registration Reference no. 837.020.07; original vote: 22.3.2007, latest update: 20.10.201

Associations between degree and sub-dimensions of depression and metabolic syndrome (MetS) in the community: results from the Gutenberg Health Study (GHS)

Abstract Background A growing number of studies have associated metabolic syndrome (MetS) and depression, both retrospectively and prospectively. However, it has remained unclear, which degrees, or sub-dimensions of depression are related to MetS and if comorbid depression affects health care utilization. The purpose of the study was to determine the associations of a) somatic and cognitive-affective symptoms to MetS and b) depression and MetS to health care utilization. Methods In a population-based, representative survey of 14.499 participants we studied the associations of the two dimensions of depression with MetS and health care utilization. Depressive symptoms were assessed by the Patient Health Questionnaire (PHQ-9). Results MetS and its components were associated with the degree of depression, particularly with moderately severe/ severe depressive symptoms (PHQ-9 > = 15). There were clear positive associations of somatic-affective depressive symptoms with the presence of MetS and its components. Cognitive-affective symptoms were negatively associated with MetS. At the single item level, disorders of sleep and appetite as well as exhaustion were positively, while trouble concentrating was negatively associated with MetS. Symptoms of depression were related to higher consultations of somatic and mental health care, while the presence of MetS was related to somatic health care utilization. There was an additional interaction of depressive symptoms and MetS with mental health care. Conclusions Somatic affective symptoms of depression are positively associated, while cognitive-affective symptoms are negatively associated with MetS

Bluthochdruck in Deutschland

Hintergrund: Bluthochdruck ist ein zentraler Risikofaktor. In Deutschland gibt es wenige bevölkerungsbezogene Datenerhebungen, die auf standardisierten Blutdruckmessungen beruhen. Methode: Es wurden standardisierte Blutdruckmessungen und Medikamentendaten aus 7 bevölkerungsbasierten Studien mit insgesamt 66 845 Teilnehmenden im Alter von 25–74 Jahren analysiert. Diese Studien waren in Deutschland zwischen 1994 und 2012 durchgeführt worden. Die EPIC-Potsdam-Studie (1994–1998), die KORA-S4-Studie (1999–2001) in Augsburg sowie die Gutenberg Health Study (2007–2012) in und um Mainz wurden für deskriptive Vergleiche herangezogen. Aufgrund gleicher Studienregionen konnten der Bundes-Gesundheitssurvey 1998 mit der Studie zur Gesundheit Erwachsener in Deutschland (2008–2011) sowie die Study of Health in Pomerania (SHIP) in Nordost-Deutschland (1997–2001) mit der SHIP-TREND-Studie (2008–2012) im direkten zeitlichen Vergleich analysiert werden. Alle Blutdruckdaten wurden für gerätespezifische Messwertunterschiede adjustiert. Ergebnisse: Nach Anpassung von studienspezifischen Messgeräteunterschieden waren die mittleren systolischen und diastolischen Blutdruckwerte in den neueren Studien (2007–2012) niedriger als in den älteren Studien (1994–2001); der Anteil behandelter Hypertoniker nahm zu. Den stärksten Rückgang beim mittleren Blutdruckwert (systolisch ≥ 10 mm Hg) gab es bei den 55- bis 74-Jährigen. Bei jungen Männern zwischen 25 und 34 Jahren wurde auf der Grundlage der regionalen SHIP-TREND-Daten ebenfalls ein Rückgang des mittleren systolischen Blutdruckwerts verzeichnet, der sich jedoch in den bundesweit erhobenen DEGS1-Daten nicht widerspiegelte. Schlussfolgerung: Trotz der guten Evidenz für abnehmende Blutdruckwerte in Deutschland in den vergangenen zwei Jahrzehnten bleibt das Präventionspotenzial hoch. Die Aktualisierung der bevölkerungsbezogenen Daten mit besonderem Fokus auf die Blutdruckdaten junger Männer sollte Ziel künftiger Forschungsbemühungen sein