Non-cancer diseases requiring admission to hospital among German seafarers

Background: This study estimated the discharge diagnosis due to non-cancer diseases of German seamen employed on German vessels in comparison to the general German male population. Materials and methods: In a database, the German health insurance company for seafarers determined the discharge diagnoses from hospital for all German seafarers. In the time period from January 1997 to December 2007, this database encompassed on average more than 21,000 German seamen per year. It served as a source for comparison with the official national database on discharge diagnoses from the general German population. Thus, the standardised hospitalisation ratio (SHR) could be calculated. Results: During the above mentioned time period, the most prominent non-cancer diagnoses among seafarers were diseases of the circulatory system, diseases of the digestive system, diseases of the musculoskeletal system, as well as injury and poisoning. Compared to the reference population, decreased SHRs were observed for almost all examined diseases with the exception of asbestosis (SHR: 1.79; 95% CI 0.65–3.90). In contrast to the deck and engine room crew, the galley staff demonstrated an increased SHR for almost all examined diseases, particularly for lifestyle-related diseases. Conclusions: Although the presented data are likely biased by the healthy worker effect and by underreporting due to treatment on board or abroad, an elevated SHR for (lifestyle-related) diseases was observed in the galley staff. Therefore, especially this occupational group seems to need specific advice on healthy behaviours both on board and ashore

Lung function in asbestos-exposed workers, a systematic review and meta-analysis

<p>Abstract</p> <p>Background</p> <p>A continuing controversy exists about whether, asbestos exposure is associated with significant lung function impairments when major radiological abnormalities are lacking. We conducted a systematic review and meta-analysis in order to assess whether asbestos exposure is related to impairment of lung function parameters independently of the radiological findings.</p> <p>Methods</p> <p>MEDLINE was searched from its inception up to April 2010. We included studies that assessed lung function parameters in asbestos exposed workers and stratified subjects according to radiological findings. Estimates of VC, FEV₁and FEV1/VC with their dispersion measures were extracted and pooled.</p> <p>Results</p> <p>Our meta-analysis with data from 9,921 workers exposed to asbestos demonstrates a statistically significant reduction in VC, FEV₁and FEV₁/VC, even in those workers without radiological changes. Less severe lung function impairments are detected if the diagnoses are based on (high resolution) computed tomography rather than the less sensitive X-ray images. The degree of lung function impairment was partly related to the proportion of smokers included in the studies.</p> <p>Conclusions</p> <p>Asbestos exposure is related to restrictive and obstructive lung function impairment. Even in the absence of radiological evidence of parenchymal or pleural diseases there is a trend for functional impairment.</p

Spirituality in general practice

In a pluraIist and secular society, as well as in a medical world which is becoming increasingly evidence-based, making a case for consideration of spirituaIity in general practice may seem futile and irrelevant. Notwithstanding such an apparent paradoxical proposal, developments occurring in other specialties 1 as well as in general practice abroad reveal that it is high time that this theme is addressed academically and impIications appIied in local practice.peer-reviewe

Quality criteria/key components for high quality of diabetes management to avoid diabetes-related complications

&lt;jats:title&gt;Abstract&lt;/jats:title&gt;&lt;jats:sec&gt;&lt;jats:title&gt;Aim&lt;/jats:title&gt;&lt;jats:p&gt;The aim of this review shoud be to map data and to identify quality indicators for good practices for diabetes management and secondary prevention, specifically of type 2 diabetes.&lt;/jats:p&gt;&lt;/jats:sec&gt;&lt;jats:sec&gt;&lt;jats:title&gt;Methods&lt;/jats:title&gt;&lt;jats:p&gt;To achieve this aim we performed the following steps: (i) a literature review on evaluation criteria, (ii) selection of quality criteria and key components for high quality of care, (iii) creation of a checklist to identify the best practice of diabetes management based on the detected criteria.&lt;/jats:p&gt;&lt;/jats:sec&gt;&lt;jats:sec&gt;&lt;jats:title&gt;Results&lt;/jats:title&gt;&lt;jats:p&gt;The literature search about the quality indicators for diabetes care resulted in the following: identifying of key components and quality indicators for structure, process and outcome quality.&lt;/jats:p&gt;&lt;/jats:sec&gt;&lt;jats:sec&gt;&lt;jats:title&gt;Conclusions&lt;/jats:title&gt;&lt;jats:p&gt;The set of quality criteria will be discussed and used to identify the best practice diabetes management programs for secondary prevention of type 2 diabetes.&lt;/jats:p&gt;&lt;/jats:sec&gt

Study protocol epidemiology of inflammatory bowel disease in childhood and adolescence: a systematic review

Introduction The incidence and prevalence of chronic inflammatory bowel diseases in childhood and adolescence is increasing and varies internationally. The systematic literature review aims to describe international epidemiological trends of chronic inflammatory bowel diseases in the child and adolescence age. A period from 1970 to 2019 will be taken into account when searching for suitable studies as well as geographical differences in the development of incidences will be presented.Methods and analysis The literature databases PubMed and Embase will be searched for the period from 01 January 1970 to 31 December 2019 using linked keywords. A manual search in bibliographies of already published and relevant systematic reviews will complete the systematic literature search. The included studies will be combined in a qualitative and quantitative synthesis and statistically evaluated.Ethics and dissemination Ethical approval is not required for this study as it is a systematicreview. The results will be submitted to peer-reviewed journals and presented in national andinternational meetings. This research received no specific grant from any funding agency inthe public, commercial or not-for-profit sectors. This systematic review protocol was registeredwith the International Prospective Register of Systematic Reviews (PROSPERO-NR:CRD42020168644)

Ketoacidosis at onset of type 1 diabetes in children up to 14 years of age and the changes over a period of 18 years in Saxony, Eastern-Germany: A population based register study.

ObjectiveThe aim of this study was to examine the incidence trends of type 1 diabetes diagnosed with ketoacidosis in Saxony, Germany from 1999 to 2016.MethodsThe population based Childhood Diabetes Registry of Saxony comprising valid data for all children aged 0-14 years diagnosed with type 1 diabetes from1999 to 2016 were used for the analyses. Direct age-standardized incidence rates were calculated and the effects of age, sex, calendar year, home districts and family history of any types of diabetes on the incidence were modelled using Poisson regression. Trend analyses for standard rate ratios of children with moderate and severe diabetic ketoacidosis versus children with type 1 diabetes with non-diabetic ketoacidosis were performed using join point regression.ResultsThe rate of ketoacidosis at the time of the type 1 diabetes diagnosis was high with 35.2% during the entire observation period in Saxony. The Poisson regression analysis indicated a statistically significant increased occurrence of diabetic ketoacidosis for younger age-groups, but no statistically significant differences between boys and girls. The join point trend analyses show that the proportion of severe and moderate ketoacidosis is increasing disproportionally to the increase in incidence of type 1 diabetes over the years.ConclusionDue to the observed increasing incidence of diabetes as well of diabetic ketoacidosis, an educational prevention campaign is needed in Saxony as soon as possible to aid pediatricians, general physicians as well as general public to identify the early signs of type 1 diabetes

Chronic Diseases and Employment: Which Interventions Support the Maintenance of Work and Return to Work among Workers with Chronic Illnesses? A Systematic Review

The increase of chronic diseases worldwide impact quality of life, cause economic and medical costs, and make it necessary to look for strategies and solutions that allow people with chronic diseases (PwCDs) to lead an active working life. As part of the CHRODIS Plus Joint European Action project, a systematic review was conducted to identify studies of interventions that support the maintenance of work and return to work (RTW) among workers with chronic illnesses. These interventions should target employees with the following conditions: diabetes, cardiovascular diseases, metabolic vascular syndrome, respiratory diseases, musculoskeletal disorders, mental disorders, and neurological disorders. An extensive search was performed in PubMed, EMBASE, and PsycINFO for English language studies. Included in this review were 15 randomized controlled trials (RCT) for adult employees (aged 18+). We found that workplace-oriented and multidisciplinary programs are the most supportive to RTW and reducing the absence due to illness. In addition, cognitive behavioral therapies achieve positive results on RTW and sick leave. Finally, coaching is effective for the self-management of chronic disease and significantly improved perceptions of working capacity and fatigue