Prevalence and temporal trends of physical activity counselling in primary health care in Germany from 1997–1999 to 2008–2011

Background: For patients, usually the first and most preferred contact person on health issues is still the doctor and most persons see their doctor at least once a year. Therefore, physical activity counselling strategies delivered by a physician seem to be a promising approach for physical activity improvement. The aim of this work is to show prevalence and time trends in physical activity counselling by primary health care physicians from 1997–1999 to 2008–2011 in Germany. Methods: Data from two representative cross-sectional health interview and examination surveys of the Robert Koch Institute were used. Prevalence proportions of physicians’ physical activity counselling and patients’ utilisation of health promotion programmes in relation to physical activity counselling were analysed. Strengths of associations were calculated by using binary logistic regression models. Overall, 11,907 persons aged 18–64 years were included in the analyses. Results: Physical activity counselling prevalence decreased from 11.1 to 9.4 % in men and from 9.3 to 7.7 % in women over ten years. Only persons with accumulated health risks (OR 5.33; 95 % CI 1.89–15.00) and persons with diagnosed diabetes mellitus (OR 3.42; 95 % CI 1.68–6.69) showed significantly higher counselling proportions in 2008–2011 compared to 1997–1999. Men were more often counselled on physical activity than women, but women showed significantly higher participation rates in physical activity promotion programmes in both surveys. In both sexes significantly higher participation rates could be observed in persons who had received some activity counselling by a physician. Conclusion: Although, evidence underlines the positive health effects of regular physical activity; overall, physicians counselling behaviour on physical activity decreased over time. However, it is positive to note that a trend towards a disease-specific counselling behaviour in terms of a tailored intervention could be observed

Die KiGGS-Studie

Von 2003 bis 2006 wurde die KiGGS-Basiserhebung (Baseline) in insgesamt 167 Städten und Gemeinden in Deutschland mit einer geclusterten Zufallsstichprobe von 17.641 Kindern und Jugendlichen im Alter von 0 bis 17 Jahren und ihren Eltern durchgeführt. Dabei wurden die Kinder und Jugendlichen medizinisch-physikalisch untersucht und getestet sowie die Eltern, ab elf Jahren auch die Kinder und Jugendlichen selbst, zu körperlichen, psychischen und sozialen Aspekten ihrer Gesundheit befragt. Im Rahmen des bundesweiten Gesundheitsmonitorings am Robert Koch-Institut (RKI) wird die Studie als prospektive Kohortenstudie mit einem Abstand von etwa fünf Jahren zwischen zwei Messzeitpunkten weitergeführt, wobei die Stichprobe durch die Einbeziehung jüngerer Jahrgänge zu jedem Messzeitpunkt querschnittlich ergänzt wird. Die Erhebung in der Kernstudie basiert auf einem Eckwertekonzept zu wesentlichen Indikatoren der körperlichen, psychischen und sozialen Gesundheit, das durch vertiefende Erhebungen beziehungsweise Untersuchungen an Teilstichproben im Rahmen von Kooperationen mit externen wissenschaftlichen Einrichtungen modular ergänzt wird. Derzeit befindet sich die erste Wiederholungsbefragung (KiGGS Welle 1) als telefonischer Befragungssurvey noch bis Juni 2012 im Feld. Die Feldphase der zweiten Folgeerhebung (KiGGS Welle 2), die wieder ein Untersuchungs- und Befragungssurvey sein wird, beginnt noch 2013. Mit den bundesweit repräsentativen Daten lassen sich wichtige gesundheitspolitische Fragestellungen beantworten, sowohl mit Blick auf gesundheitliche Trends als auch mit Blick auf längsschnittliche Gesundheitsverläufe. Wichtige Aussagen werden unter anderem in Bezug auf Trends in der Prävalenz von Übergewicht und Adipositas, der Inzidenz von atopischen Erkrankungen oder der Persistenz beziehungsweise Remission von psychischen Auffälligkeiten und Störungen erwartet.From 2003 to 2006 the KiGGS Baseline Study was conducted, including a clustered random sample of 167 sample points and 17,641 children and adolescents from 0 to 17 years, as well as their parents in 167 sample points. The children and adolescents were medically and physically examined, and their parents answered questions about physical, psychological and social aspects of their children’s health, as did, from 11 years on, the children and adolescents themselves. Within the framework of the nationwide health monitoring at the Robert Koch Institute, the KiGGS study is being continued as a prospective cohort study with an interval of approximately 5 years between follow-ups. The study sample will be cross-sectionally refilled with younger age groups at each time of measurement. The assessment of the KiGGS core study follows a core indicator concept, which is modularly complemented by external scientific cooperation partners. The field work of the first wave (KiGGS Wave 1), a telephone survey, will continue until June 2012. The second follow-up (KiGGS Wave 2) will again combine examinations and interviews, starting in 2013. On the basis of the nationally representative KiGGS data, important questions about health policy can be answered, such as trends and trajectories of health. Important results are expected, among others concerning trends in overweight and obesity, the incidence of atopic diseases, and the persistency or remission of psychopathological symptoms and disorders

Seroepidemiological study on the spread of SARS-CoV-2 in Germany:

The SARS-CoV-2 coronavirus has spread rapidly across Germany. Infections are likely to be under-recorded in the notification data from local health authorities on laboratory-confirmed cases since SARS-CoV-2 infections can proceed with few symptoms and then often remain undetected. Seroepidemiological studies allow the estimation of the proportion in the population that has been infected with SARS-CoV-2 (seroprevalence) as well as the extent of undetected infections. The ‘CORONA-MONITORING bundesweit’ study (RKI-SOEP study) collects biospecimens and interview data in a nationwide population sample drawn from the German Socio-Economic Panel (SOEP). Participants are sent materials to self-collect a dry blood sample of capillary blood from their finger and a swab sample from their mouth and nose, as well as a questionnaire. The samples returned are tested for SARS-CoV-2 IgG antibodies and SARS-CoV-2 RNA to identify past or present infections. The methods applied enable the identification of SARS-CoV-2 infections, including those that previously went undetected. In addition, by linking the data collected with available SOEP data, the study has the potential to investigate social and health-related differences in infection status. Thus, the study contributes to an improved understanding of the extent of the epidemic in Germany, as well as identification of target groups for infection protection

SARS-CoV-2 Transmissibility Within Day Care Centers—Study Protocol of a Prospective Analysis of Outbreaks in Germany

Introduction: Until today, the role of children in the transmission dynamics of SARS-CoV-2 and the development of the COVID-19 pandemic seems to be dynamic and is not finally resolved. The primary aim of this study is to investigate the transmission dynamics of SARS-CoV-2 in child day care centers and connected households as well as transmission-related indicators and clinical symptoms among children and adults. Methods and Analysis: COALA (“Corona outbreak-related examinations in day care centers”) is a day care center- and household-based study with a case-ascertained study design. Based on day care centers with at least one reported case of SARS-CoV-2, we include one- to six-year-old children and staff of the affected group in the day care center as well as their respective households. We visit each child's and adult's household. During the home visit we take from each household member a combined mouth and nose swab as well as a saliva sample for analysis of SARS-CoV-2-RNA by real-time reverse transcription polymerase chain reaction (real-time RT-PCR) and a capillary blood sample for a retrospective assessment of an earlier SARS-CoV-2 infection. Furthermore, information on health status, socio-demographics and COVID-19 protective measures are collected via a short telephone interview in the subsequent days. In the following 12 days, household members (or parents for their children) self-collect the same respiratory samples as described above every 3 days and a stool sample for children once. COVID-19 symptoms are documented daily in a symptom diary. Approximately 35 days after testing the index case, every participant who tested positive for SARS-CoV-2 during the study is re-visited at home for another capillary blood sample and a standardized interview. The analysis includes secondary attack rates, by age of primary case, both in the day care center and in households, as well as viral shedding dynamics, including the beginning of shedding relative to symptom onset and viral clearance. Discussion: The results contribute to a better understanding of the epidemiological and virological transmission-related indicators of SARS-CoV-2 among young children, as compared to adults and the interplay between day care and households.Peer Reviewe

The challenge of comprehensively mapping children's health in a nation-wide health survey: Design of the German KiGGS-Study

<p>Abstract</p> <p>Background</p> <p>From May 2003 to May 2006, the Robert Koch Institute conducted the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Aim of this first nationwide interview and examination survey was to collect comprehensive data on the health status of children and adolescents aged 0 to 17 years.</p> <p>Methods/Design</p> <p>Participants were enrolled in two steps: first, 167 study locations (sample points) were chosen; second, subjects were randomly selected from the official registers of local residents. The survey involved questionnaires filled in by parents and parallel questionnaires for children aged 11 years and older, physical examinations and tests, and a computer assisted personal interview performed by study physicians. A wide range of blood and urine testing was carried out at central laboratories. A total of 17 641 children and adolescents were surveyed – 8985 boys and 8656 girls. The proportion of sample neutral drop-outs was 5.3%. The response rate was 66.6%.</p> <p>Discussion</p> <p>The response rate showed little variation between age groups and sexes, but marked variation between resident aliens and Germans, between inhabitants of cities with a population of 100 000 or more and sample points with fewer inhabitants, as well as between the old West German states and the former East German states. By analysing the short non-responder questionnaires it was proven that the collected data give comprehensive and nationally representative evidence on the health status of children and adolescents aged 0 to 17 years.</p

Seroepidemiologische Studie zur bundesweiten Verbreitung von SARS-CoV-2 in Deutschland: Studienprotokoll von CORONA-MONITORING bundesweit (RKI-SOEP-Studie)

Das Coronavirus SARS-CoV-2 hat sich in kurzer Zeit bundesweit ausgebreitet. In den Meldedaten der Gesundheitsämter zu laborbestätigten Infektionsfällen ist von einer Untererfassung des Infektionsgeschehens auszugehen, da Infektionen häufig unentdeckt bleiben, zum Beispiel weil sie symptomarm verlaufen. In seroepidemiologischen Studien kann der Bevölkerungsanteil mit durchgemachter SARS-CoV-2-Infektion (Seroprävalenz) wie auch der Umfang unentdeckter Infektionen abgeschätzt werden. In der Studie CORONA-MONITORING bundesweit (RKI-SOEP-Studie) werden Bioproben und Befragungsdaten in einer deutschlandweiten Bevölkerungsstichprobe des Sozio-oekonomischen Panels (SOEP) erhoben. Den Teilnehmenden werden Materialien zur selbstständigen Gewinnung einer Trockenblutprobe aus Kapillarblut des Fingers und einer Abstrichprobe aus Mund und Nase sowie ein Fragebogen postalisch zugesendet. Die zurückgesendeten Proben werden auf SARS-CoV-2-IgG-Antikörper und SARS-CoV-2-RNA zur Identifikation einer durchgemachten oder aktuellen Infektion untersucht. Die eingesetzten Methoden ermöglichen es, auch solche SARS-CoV-2-Infektionen zu erkennen, die bislang unentdeckt blieben. Durch die Verknüpfung mit bereits vorhandenen SOEP-Daten hat die Studie das Potenzial, auch soziale und gesundheitsbezogene Unterschiede im Infektionsstatus zu untersuchen. So kann die Studie zu einem verbesserten Verständnis des Ausmaßes der Epidemie in Deutschland wie auch zur Identifikation von Zielgruppen für den Infektionsschutz beitragen

The death-scene investigation

The death-scene investigation is an important and increasingly recognized step in the process of diagnosing Sudden Infant Death Syndrome (SIDS). According to current definitions, information from death-scene investigations is required when SIDS diagnoses are made. Due to differences in national jurisdictions, however, there are differences in the methods used and the professions involved in routinely performed death-scene investigations. Therefore any international comparability of death-scene data is limited. Only a few epidemiological studies have used thorough death-scene investigations in a systematic way, including a standardized, objective observation of the scene in cases and reference data from the general population. These studies gave close insights into the circumstances of infant death, but their complex protocols are mostly not feasible for routine use. For that purpose, manageable death-scene investigation protocols need to be distilled from the ones used in complex studies, taking into account their results. Whilst protocols for post-mortem examinations and definitions for SIDS have been largely standardized and agreed internationally, this step is still missing for death-scene investigations. If routinely obtained death-scene data were standardized and, thus, comparable, this would have a potential of generating new hypotheses that eventually lead to a better understanding of the underlying mechanisms and to more effective measures of prevention