Seropositivity of Borrelia burgdorferi s.l. in Germany—an analysis across four German National Cohort (NAKO) study sites

Lyme borreliosis (LB) is caused by the transmission of Borrelia burgdorferi s.l. from ticks to humans. Climate affects tick abundance, and climate change is projected to promote shifts in abundance in Europe, potentially increasing human exposure. We analyzed serum samples collected between the years 2014-2019 from German National Cohort (NAKO) participants at four study sites (Augsburg, Berlin, Hanover, Münster) for immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies using an enzyme-linked immunosorbent assay (ELISA) and line blot immunoassay as confirmatory test for positive and equivocal ELISA samples. We reported crude and weighted seropositivity proportions for local estimates. We used mixed model analysis to investigate associated factors, such as age, sex, migration background, or animal contacts. We determined the serostatus of 14,207 participants. The weighted seropositivity proportions were 3.4% (IgG) and 0.4% (IgM) in Augsburg, 4.1% (IgG) and 0.6% (IgM) in northern Berlin, 3.0% (IgG) and 0.9% (IgM) in Hanover, and 2.7% (IgG) and 0.6% (IgM) in Münster. We found higher odds for IgG seropositivity with advancing age (p < 0.001), among males compared to females (p < 0.001) and reduced odds among participants with migration background compared to those without (p = 0.001). We did not find evidence for an association between serostatus and depression, children within the household, or animal contact, respectively. We found low seropositivity proportions and indications of differences across the study locations, although between-group comparisons did not yield significant results. Comparisons to earlier research are subject to important limitations; however, our results indicate no major increases in seropositivity over time. Nevertheless, monitoring of seropositivity remains critical in light of potential climate-related Borrelia exposure

The interplay of family history of depression and early trauma: associations with lifetime and current depression in the German national cohort (NAKO)

INTRODUCTION: Family history of depression and childhood maltreatment are established risk factors for depression. However, how these factors are interrelated and jointly influence depression risk is not well understood. The present study investigated (i) if childhood maltreatment is associated with a family history of depression (ii) if family history and childhood maltreatment are associated with increased lifetime and current depression, and whether both factors interact beyond their main effects, and (iii) if family history affects lifetime and current depression via childhood maltreatment. METHODS: Analyses were based on a subgroup of the first 100,000 participants of the German National Cohort (NAKO), with complete information (58,703 participants, mean age = 51.2 years, 53% female). Parental family history of depression was assessed via self-report, childhood maltreatment with the Childhood Trauma Screener (CTS), lifetime depression with self-reported physician's diagnosis and the Mini-International Neuropsychiatric Interview (MINI), and current depressive symptoms with the depression scale of the Patient Health Questionnaire (PHQ-9). Generalized linear models were used to test main and interaction effects. Mediation was tested using causal mediation analyses. RESULTS: Higher frequencies of the childhood maltreatment measures were found in subjects reporting a positive family history of depression. Family history and childhood maltreatment were independently associated with increased depression. No statistical interactions of family history and childhood maltreatment were found for the lifetime depression measures. For current depressive symptoms (PHQ-9 sum score), an interaction was found, with stronger associations of childhood maltreatment and depression in subjects with a positive family history. Childhood maltreatment was estimated to mediate 7%–12% of the effect of family history on depression, with higher mediated proportions in subjects whose parents had a depression onset below 40 years. Abuse showed stronger associations with family history and depression, and higher mediated proportions of family history effects on depression than neglect. DISCUSSION: The present study confirms the association of childhood maltreatment and family history with depression in a large population-based cohort. While analyses provide little evidence for the joint effects of both risk factors on depression beyond their individual effects, results are consistent with family history affecting depression via childhood maltreatment to a small extent

Data Quality&mdash;Concepts and Problems

Data Quality is, in essence, understood as the degree to which the data of interest satisfies the requirements, is free of flaws, and is suited for the intended purpose. Data Quality is usually measured utilizing several criteria, which may differ in terms of assigned importance, depending on, e.g., the data at hand, stakeholders, or the intended use

Data Quality—Concepts and Problems

Data Quality is, in essence, understood as the degree to which the data of interest satisfies the requirements, is free of flaws, and is suited for the intended purpose. Data Quality is usually measured utilizing several criteria, which may differ in terms of assigned importance, depending on, e.g., the data at hand, stakeholders, or the intended use

Apps zur Förderung von körperlicher Aktivität Einstellungen, Nutzungspräferenzen und Akzeptanz bei Erwachsenen im Alter von 50 Jahren und älter: Ergebnisse von Fokusgruppendiskussionen

HINTERGRUND: International wurden Einstellungen von Erwachsenen ab 50 Jahren bezüglich einer Nutzung von evidenzinformierten Apps zur Bewegungsförderung bereits unter verschiedenen Aspekten untersucht. In Deutschland ist bisher wenig zu Einstellungen bezüglich solcher Apps in dieser Population bekannt. ZIELE DER ARBEIT: Ziel der Fokusgruppeninterviews war es, Einblicke zu Einstellungen, Akzeptanz und Nutzungspräferenzen von Smartphone-Applikationen (Apps) zur Bewegungsförderung in der Altersgruppe ≥50 Jahre zu erhalten. MATERIAL UND METHODEN: Nutzer und Nichtnutzer von Bewegungs- und Fitness- (B&amp;F-)Apps wurden anhand eines Interviewleitfadens befragt. Faktoren, welche die Nutzung beeinflussen, wurden diskutiert sowie Einstellungen zu einer konkreten evidenzinformierten B&amp;F-App (Health Mate). Die Interviews wurden transkribiert und anhand einer strukturierten qualitativen Inhaltsanalyse analysiert. ERGEBNISSE: Personen, die bereits Erfahrungen mit B&amp;F-Apps aufwiesen, bewerteten die Nutzung solcher Apps insgesamt etwas positiver. Beide Gruppen wünschten sich eine leicht zu bedienende App mit wenigen Funktionen zur Bewegungsförderung. Händische Eingabe von Bewegungsdaten wurde eher abgelehnt, eine automatisierte Erfassung präferiert. Feedback zur Selbstkontrolle und soziale Vergleiche wurden als hilfreich für Bewegungsförderung und das Erreichen persönlicher Ziele erachtet. Bei der Datensicherheit gab es Bedenken. Die Funktionen von Health Mate (z. B. Feedback, Badges) wurden von Nutzern und Nichtnutzern unterschiedlich akzeptiert. DISKUSSION: B&amp;F-Apps werden von Personen ab 50 Jahren vorsichtig positiv eingeschätzt. Nutzer als auch Nichtnutzer bevorzugen einfach zu bedienende Apps mit angepasster Anzahl an Funktionen.BACKGROUND: International studies have examined different aspects of attitudes toward the use of evidence-informed applications (apps) for physical activity (PA) promotion among adults aged 50 years and above. In Germany, little is known about attitudes towards such apps in this population. OBJECTIVES: The aim of the focus groups conducted with smartphones owners aged 50 years and above was to gain insights into attitudes, acceptance and utilization preferences regarding smartphone applications (apps) for PA promotion. MATERIALS AND METHODS: Focus groups were conducted with users and non-users of PA and fitness apps following an interview guide. Factors influencing use were discussed, as well as attitudes towards using a specific evidence-informed PA and fitness app (i. e., Health Mate). Interviews were transcribed and analyzed following a structured qualitative content analysis. RESULTS: Overall, experienced users of PA and fitness apps rated the use of such apps slightly more positively than non-users. Users and non-users of PA and fitness apps stated that they would like an app which was easy to use with only few features for PA promotion. Manual entry of PA data was rather disliked and focus group participants preferred automated tracking. Feedback for self-monitoring of PA and social comparisons were considered helpful for PA promotion and for reaching personal PA goals. However, there were concerns about data safety. Features of the evidence-informed app Health Mate (e. g., feedback, badges) were appreciated by different participants to a varying degree. CONCLUSIONS: Physical activity and fitness apps were cautiously appreciated by users and non-users aged 50 years and above. Both groups prefer easy to use apps with a limited number of features

Impact of COVID-19 pandemic and anti-pandemic measures on tuberculosis, viral hepatitis, HIV/AIDS and malaria-A systematic review.

COVID-19 pandemic puts an enormous strain on health care systems worldwide and may have a detrimental effect on prevention, treatment and outcomes of tuberculosis (TB), viral hepatitis, HIV/AIDS and malaria, whose ending is part of the United Nations 2030 Agenda for Sustainable Development. We conducted a systematic review of scientific and grey literature in order to collect wide-ranging evidence with emphasis on quantification of the projected and actual indirect impacts of COVID-19 on the four infectious diseases with a global focus. We followed PRISMA guidelines and the protocol registered for malaria (CRD42021234974). We searched PubMed, Scopus, preView (last search: January 13, 2021) and websites of main (medical) societies and leading NGOs related to each of the four considered infectious diseases. From modelling studies, we identified the most impactful disruptions; from surveys and other quantitative studies (based e.g. on surveillance or program data), we assessed the actual size of the disruptions. The identified modelling studies warned about under-diagnosis (TB), anti-retroviral therapy interruption/decrease in viral load suppression (HIV), disruptions of insecticide-treated nets (ITN) distribution and access to effective treatment (malaria), and treatment delays and vaccination interruptions (viral hepatitis). The reported disruptions were very heterogeneous both between and within countries. If observed at several points in time, the initial drops (partly dramatic, e.g. TB notifications/cases, or HIV testing volumes decreased up to -80%) were followed by a gradual recovery. However, the often-missing assessment of the changes against the usual pre-pandemic fluctuations hampered the interpretation of less severe ones. Given the recurring waves of the pandemic and the unknown mid- to long-term effects of adaptation and normalisation, the real consequences for the fight against leading infectious diseases will only manifest over the coming years

The interplay of family history of depression and early trauma: associations with lifetime and current depression in the German national cohort (NAKO)

IntroductionFamily history of depression and childhood maltreatment are established risk factors for depression. However, how these factors are interrelated and jointly influence depression risk is not well understood. The present study investigated (i) if childhood maltreatment is associated with a family history of depression (ii) if family history and childhood maltreatment are associated with increased lifetime and current depression, and whether both factors interact beyond their main effects, and (iii) if family history affects lifetime and current depression via childhood maltreatment.MethodsAnalyses were based on a subgroup of the first 100,000 participants of the German National Cohort (NAKO), with complete information (58,703 participants, mean age = 51.2 years, 53% female). Parental family history of depression was assessed via self-report, childhood maltreatment with the Childhood Trauma Screener (CTS), lifetime depression with self-reported physician's diagnosis and the Mini-International Neuropsychiatric Interview (MINI), and current depressive symptoms with the depression scale of the Patient Health Questionnaire (PHQ-9). Generalized linear models were used to test main and interaction effects. Mediation was tested using causal mediation analyses.ResultsHigher frequencies of the childhood maltreatment measures were found in subjects reporting a positive family history of depression. Family history and childhood maltreatment were independently associated with increased depression. No statistical interactions of family history and childhood maltreatment were found for the lifetime depression measures. For current depressive symptoms (PHQ-9 sum score), an interaction was found, with stronger associations of childhood maltreatment and depression in subjects with a positive family history. Childhood maltreatment was estimated to mediate 7%–12% of the effect of family history on depression, with higher mediated proportions in subjects whose parents had a depression onset below 40 years. Abuse showed stronger associations with family history and depression, and higher mediated proportions of family history effects on depression than neglect.DiscussionThe present study confirms the association of childhood maltreatment and family history with depression in a large population-based cohort. While analyses provide little evidence for the joint effects of both risk factors on depression beyond their individual effects, results are consistent with family history affecting depression via childhood maltreatment to a small extent

Selbst berichtete Infektionen in der NAKO Gesundheitsstudie: Einordnung in die gegenwärtige Forschungslandschaft

Infectious diseases continue to play an important role for disease perception, health-economic considerations and public health in Germany. In recent years, infectious diseases have been linked to the development of non-communicable diseases. Analyses of the German National Cohort (GNC) may provide deeper insights into this issue and pave the way for new targeted approaches in disease prevention. Objectives The aim was to describe the tools used to assess infectious diseases and to present initial data on infectious disease frequencies, as well as to relate the GNC assessment tools to data collection methods in other studies in Germany. Methods As part of the baseline examination, questions regarding infectious diseases were administered using both an interview and a self-administered touchscreen questionnaire. Data from the initial 101,787 GNC participants were analysed. Results In the interview, 0.2% (HIV/AIDS) to 8.6% (shingles) of respondents reported ever having a medical diagnosis of shingles, postherpetic neuralgia (in cases where shingles was reported), hepatitis B/C, HIV/AIDS, tuberculosis or sepsis if treated in hospital. In the questionnaire, 12% (cystitis) to 81% (upper respiratory tract infections) of respondents reported having experienced at least one occurrence of upper or lower respiratory tract infections, gastrointestinal infections, cystitis or fever within the past 12 months. Outlook The cross-sectional analyses of data and tools presented here – for example on determinants of susceptibility to self-reported infections – can be anticipated from the year 2021 onward. Beyond that, more extensive research into infectious disease epidemiology will follow, particularly once analyses of GNC biological materials have been performed