Results from the National Strategy for improvement of iodine nutrition in Bulgaria: a study of children and pregnant women living in an iodine-deficient area
Autor/in:
Gatseva, Penka D.; Bivolarska, Anelia V.; Argirova, Mariana D.
Quelle: Journal of Public Health, 19 (2010) 3, S 237-240
Inhalt: Background: A significant part of Bulgaria is considered an iodine-deficient area. The National Strategy for Prevention and Control of Iodine Deficiency Disorders (IDD) was developed in 1994, and regular surveys undertaken in 2000–2003 indicated a normalization of the iodine supply in the Bulgarian population, including some at-risk population groups (children, schoolchildren, pregnant women). Despite the results achieved, mandating periodic cohort surveys for tracking the elimination of iodine deficiency is necessary. Objective: The aim of this study was to evaluate the results of the the national strategy for improvement of iodine nutrition in children and pregnant women living in an iodine-deficient area in Bulgaria 15 years after its update. Subjects and methods: Study subjects were 73 children aged 9.21 ± 2.07 years (29 boys and 44 girls) and 16 pregnant women living in the town of Asenovgrad. Urinary iodine concentration was measured and used as an index of iodine intake. Results: The median urinary iodine of the inspected children was between 100–199 μg/l, which is an indicator of optimal iodine nutrition. Almost 1/3 of the children (31.5%) had iodine deficiency. The median urinary iodine concentration of the 16 pregnant women investigated was 127.0 μg/l, which is an indicator of insufficient iodine intake. Conclusion: Despite the normalization of the iodine supply in the past years in the at-risk population groups of children and pregnant women, a considerable portion of them still has iodine deficiency. Recommendations for improving health education and iodine nutrition in at-risk population groups were made.
Involvement of first-time mothers with different levels of education in the decision-making for their delivery by a planned Caesarean section: women's satisfaction with information given by gynaecologists and midwives
Autor/in:
Kolip, Petra; Büchter, Roland
Quelle: Journal of Public Health, 17 (2009) 4, S 273-280
Inhalt: Aims: We investigated the involvement of first-time mothers, who had a planned Caesarean section, in the decision to have a Caesarean section, taking into account their different educational levels. Subjects and methods: A self-assessment questionnaire was sent in July 2005 to women who had undergone a Caesarean section in 2004. Participants were 2,685 members of a statutory health insurance fund who had given birth by Caesarean section (response rate: 48.0%). Included were primiparae with planned Caesarean section (n = 352). Results: The women in this cross-sectional study felt well informed about the procedure of a section but not its consequences. They used several sources of information and were most satisfied with the information provided by doctors and midwives. Of the women in this study 20% did not have a midwife. No major differences were observed between different educational levels. Conclusion: Although most women were satisfied with their decision, they felt that they did not receive enough information about the consequences of a Caesarean section. This information need could be met by a further involvement of midwives in maternity care.
Schlagwörter:Caesarean section; Shared decision-making; Information needs; Birth
Predictors of work ability in occupations with psychological stress
Titelübersetzung:Vorhersage der Arbeitsfähigkeit in Berufen mit psychologischem Stress
Autor/in:
Seibt, Reingard; Spitzer, Silvia; Blank, Matthes; Scheuch, Klaus
Quelle: Journal of Public Health, 17 (2008) 1, S 9-18
Inhalt: Aim: This study aimed to detect health- and work-related predictors of poor and good work ability in teachers (TE) and office workers (OW). Method: Work ability and its influence factors were analyzed in 100 female TE and 60 female OW aged between 25 and 60 years. The work ability was evaluated with the work ability index questionnaire and the health status with the vitality measurement system®. In addition, cardiac risk factors, burnout risk, as well as the working demands and effort-reward ratio were taken into account. Predictors of work ability were analyzed by using a CHAID analysis. The number of complaints represents the best predictor to divide both occupational groups into subgroups with different work abilities (criterion variable). Results: Poor work ability is caused by many complaints and cardiovascular risk factors. By contrast, excellent work ability is associated with few complaints, the occupation “office workers,” a younger vital functional age, and the absence of burnout symptoms, which means in comparison with OW, TE have a 1.6 times higher risk for impaired work ability. Furthermore, the absence of burnout symptoms is a resource of TE, whereas OWs tend to have a younger vital functional age compared to their calendrical age. Although this analysis is able to explain 61.2% of the influence on impaired work ability, research for further causes must be undertaken. Conclusion: The results reflect the positive effect of a high educational level and a challenging job on the preservation of good work ability. Moreover, they draw the attention to the psychological and psychosocial strains of TE. TEs are exposed more frequently to feeling overstrained; this probably effects a higher retirement rate due to illness.
Changes in secondary pharmacological prevention of acute coronary syndromes and stroke after hospital discharge: a 6-month follow-up study of German primary care patients
Quelle: Journal of Public Health, 17 (2008) 1, S 3-7
Inhalt: Aim: This study examined modifications in secondary preventive medication between the time of hospital discharge (HD) and during a 6-month follow-up treatment of outpatients with acute coronary syndromes (ACS) and stroke. Subjects and methods: During a 6-month period, a health diary was completed on a weekly basis by 98 patients who were initially hospitalised with ACS and 29 patients with strokes in the Cologne area (Germany). Changes in medication between the time of HD and follow-up treatment (weeks 2, 12, and 24) were recorded. Results: On average, patients with ACS took six medications, whereas patients with stroke took five medications per day. ACS patients received beta-blockers (96%), lipid-lowering agents (80%), and angiotensin-converting enzyme (ACE) inhibitors (64%) at HD, and no changes in medication were made during follow-up treatment. However, there was a significant decrease in prescriptions of clopidogrel among ACS patients within 6 months, and about 13% of ACS patients did not receive an antiplatelet agent at any time. Stroke patients received beta-blockers (50%), lipid-lowering agents (67%), and antiplatelet agents, such as acetylsalicylic acid (57%) or clopidogrel (27%), at the time of HD, and no significant changes in medication were instituted during follow-up treatment. Conclusion: Treatment of ACS patients with the combination of acetylsalicylic acid and clopidogrel was insufficient, although it has been shown that this combination is highly effective in secondary prevention of ACS. Besides medical reasons, the cost-containment restrictions (“medication budget”) for German physicians might explain the observed failure of guideline-oriented medication. Furthermore, no changes in medications occurred regarding blood-pressure- and lipid-lowering agents.
Arzneimittelversorgung von Frauen und Männern im höheren Lebensalter
Autor/in:
Glaeske, Gerd
Quelle: ZeS Report, 11 (2006) 1, S 11-13
Inhalt: "Die Arzneimittelversorgung von Frauen und Männern im höheren Lebensalter ist Gegenstand des Beitrags von Gerd Glaeske, in dem die Einflüsse von Alter und Geschlecht auf die Arzneimittelversorgung untersucht werden." [Autorenreferat]
Schlagwörter:medizinische Versorgung; gender; health care delivery system; medical care; Gesundheitswesen; health care; Alter; Gesundheitsversorgung; Gesundheitspolitik; Mann; woman; Einfluss; old age; influence; man; age; health policy; Lebensalter