Prävalenz und Inzidenz von Gastritis und Sodbrennen sowie deren Arzneimitteltherapie in der Heinz Nixdorf Recall Studie (HNRS)

Einleitung Die Gastritis und die Gastroösophageale Refluxkrankheit (GERD) sind die häufigsten Erkrankungen des oberen Gastrointestinaltrakts (OGIT) in nordrheinischen, allgemeinmedizinischen Praxen. Sodbrennen/Reflux gehört zu deren Leitsymptomen, welches primär bei 60- bis 69-Jährigen auftritt. Gastritis und GERD schränken die Lebensqualität ein und bieten ein zunehmend karzinogenes Potential. Protonenpumpeninhibitoren (PPI) gelten als das effektivste Arzneimittel zur Behandlung von gutartigen Erkrankungen des OGITs und sind weltweit die meist verschriebene Wirkstoffklasse ihrer gesamten Arzneimittelgruppe „ATC A02“. PPI stehen in der aktuellen Literatur zur Diskussion, aufgrund ihrer nicht abschätzbaren Langzeitwirkungen und dem Potential zur Übernutzung. Der Bevölkerungsanteil potentieller PatientInnen und PPI-AnwenderInnen wächst zudem rapide an. Methode Die Heinz Nixdorf Recall Studie (HNRS) ist eine prospektive, geschlossene, bevölkerungsbasierte, 14-jährige Kohortenstudie, welche die Gesundheit der Bevölkerung des Ruhrgebiets im Alter von 45 bis 76 Jahren im Zeitraum von 2000 bis 2014 erforscht. Die Stichprobe umfasst 3076 ProbandInnen (48.6 Prozent Männer, 51.4 Prozent Frauen) mit einem Durchschnittsalter von 58 Jahren und einem durchschnittlichen BMI von 27.5kg/m² zur Basiserhebung. Berechnet wurde die Lebenszeitprävalenz der Gastritis bis 2002, die kumulative fünf- Jahres Inzidenz der Gastritis von 2000/03 bis 2005/08, die Lebenszeitprävalenz von Reflux/ Sodbrennen bis 2013, die zwölf-Monats Periodenprävalenz von Reflux/Sodbrennen 2013, die Punktprävalenz der A02- und PPI-Therapie 2002, 2007 und 2013 sowie die kumulative zehn-Jahres Inzidenz der A02- und PPI-Therapie. Die Ergebnisse wurden anhand der Referenzpopulation der alten Europastandardbevölkerung WHO 1990 altersstandardisiert und je Geschlecht nach Alter (45-75), Wohnort (Mühlheim, Essen, Bochum), BMI (<18.5 kg/m², ≥18.5-<25 kg/m², ≥25-<30 kg/m², ≥30 kg/m²) und Schulabschluss (kein Abschluss, Haupt-/Volksschule, Realschule/Polytechnische Oberstufe, fachgebundene/ allgemeine Hochschulreife) stratifiziert. Zudem wurde der altersstandardisierte Anteil der ProbandInnen, die eine Kombinationsmedikation aus einem Arzneimittel der ATC A02 Gruppe und einem NSAR oder ASS einnehmen errechnet. Die Auswertung fand mit dem statistischen Analyse-System (SAS) 9.4 statt. Die Missings, die unplausiblen Werte sowie der Non- Responder-Report wurde untersucht und weitere Referenzwerte herangezogen. Ergebnisse 29.4 Prozent der Männer und 33.3 Prozent der Frauen hatten jemals eine Gastritis. Jeweils 14.6 Prozent hatten jemals Sodbrennen/Reflux. 2002 waren 60 Prozent aller A02-Therapien auf PPI zurückzuführen, 2013 betrug der PPI-Anteil bereits 90 Prozent. Insgesamt stieg die Prävalenz der A02-Therapie von rund 6 auf 8 Prozent. Der Anteil der Kombinationsmedikationen liegt im Verlauf der Zeit und Geschlecht zwischen 10 und 20 Prozent. Frauen erkrankten häufiger als Männer und nahmen ebenfalls mehr Medikamente der Arzneimittelgruppe ATC A02 sowie PPI ein. Unterschiede in den einzelnen Strata wurden ersichtlich

Association between Breakfast Skipping and Body Weight-A Systematic Review and Meta-Analysis of Observational Longitudinal Studies

Wicherski J, Schlesinger S, Fischer F. Association between Breakfast Skipping and Body Weight-A Systematic Review and Meta-Analysis of Observational Longitudinal Studies. Nutrients. 2021;13(1): 272.Globally, increasing rates of obesity are one of the most important health issues. The association between breakfast skipping and body weight is contradictory between cross-sectional and interventional studies. This systematic review and meta-analysis aims to summarize this association based on observational longitudinal studies. We included prospective studies on breakfast skipping and overweight/obesity or weight change in adults. The literature was searched until September 2020 in PubMed and Web of Science. Summary risk ratios (RRs) or beta coefficients with a 95% confidence interval (CI), respectively, were estimated in pairwise meta-analyses by applying a random-effects model. In total, nine studies were included in the systematic review and five of them were included in the meta-analyses. The meta-analyses indicated an 11% increased RR for overweight/obesity when breakfast was skipped on ≥3 days per week compared to ≤2 days per week (95% CI: 1.04, 1.19, n = two studies). The meta-analysis on body mass index (BMI) change displayed no difference between breakfast skipping and eating (beta = -0.02; 95% CI: -0.05, 0.01; n = two studies). This study provides minimal evidence that breakfast skipping might lead to weight gain and the onset of overweight and obesity

Utilisation of medical rehabilitation services by persons of working age with a migrant background, in comparison to non-migrants: a scoping review.

Dyck M, Breckenkamp J, Wicherski J, Schröder CC, du Prel J-B, Razum O. Utilisation of medical rehabilitation services by persons of working age with a migrant background, in comparison to non-migrants: a scoping review. Public health reviews. 2020;41: 17.In Germany, an ageing population is affected by societal and political changes due to demographic transition, e.g. by a prolonged working life for older employees. Demographic change also influences persons of higher working age with a migrant background. In 2018, 25% of all employees in Germany had a migrant background. Those affected by poor health at a higher working age can benefit from medical rehabilitation services, which aim to prevent early retirement and disabilities. So far, the utilisation of medical rehabilitation has been lower among persons of foreign nationality (often the only available proxy for migrant background), compared to that of Germans. The aim of this scoping review is to assess the utilisation of medical rehabilitation services by those with migrant background (PMB) and those without (non-PMB) and to identify the differences between these groups. We included 25 studies in our analysis, which were mainly secondary analyses of routine data and also a small number of primary studies. The results were inconsistent: studies published before 2018 showed a lower use of rehabilitation services for persons of foreign nationality compared to Germans. However, no differences were found between PMB and non-PMB in studies published in 2018 or later. PMB, as well as foreign nationals, showed poorer health before medical rehabilitation utilisation and had a higher chance of occupational disease and a lower education level. We identified a lower work-related performance, as well as barriers (e.g. information deficits) in the utilisation of rehabilitation services for groups of PMB. Our review is limited in that we cannot generalise our results to all PMB living in Germany. This is because of the heterogeneity, the limited number of studies and lack of representativeness in some studies. In many cases, studies only analyse the nationality, but they lack information about the second generation PMB. Future studies should survey the utilisation of medical rehabilitation services by migrant background rather than by nationality and focus on changes in the provision of rehabilitation measures following diversity-centred strategies. © The Author(s) 2020

Experiences Shared by the (Future) Public Health Workforce during the COVD-19 Pandemic in Germany: Results of a Survey on Workload, Work Content, and Related Challenges among Students and Young Professionals

Fischer F, Wicherski J, Tobollik M, McCall T. Experiences Shared by the (Future) Public Health Workforce during the COVD-19 Pandemic in Germany: Results of a Survey on Workload, Work Content, and Related Challenges among Students and Young Professionals. International Journal of Environmental Research and Public Health. 2022;19: 11444.Although previous studies have focused on the adverse effects of the COVID-19 pandemic on various professional groups (particularly in the health and nursing care sector), this study aims to close a research gap by assessing perspectives of students and young professionals in epidemiology and public health in Germany in terms of shifts in workload, work content, and related challenges caused by the pandemic. We conducted a cross-sectional survey between mid-February and mid- March 2022. Quantitative data were analyzed via standardized mean differences. Qualitative data based on answers to open-ended questions were analyzed via a qualitative content analysis. Overall, 172 individuals participated in this survey. Results indicate that students felt burdened the most by lack of exchange with other students and lecturers. Study participants employed in public health experienced changes in their employment because they had changes in their work content- and administration, which was accompanied by a high burden due to the workload. Multiple demands that can have an impact on both acquired skills and mental health during the professional qualification phase were mentioned by the participants. Therefore, more in-depth analyses are needed to investigate the impact the pandemic will have on the (future) public health workforce in the long run