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Copyright of Der Unfallchirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Disease prevention and health promotion in and for old age have become increasingly more important. Nevertheless, more (national) research and implementation in practice is needed, as the international comparison shows., Objective: To develop guiding principles for research and practice on prevention and health promotion in and for old age., Material and Methods: As part of an iterative process, members of the German Society of Gerontology and Geriatrics came together in workshops and symposia to formulate key guiding principles and fields of action for prevention and health promotion., Results: The following were worked out: 1) prevention and health promotion are useful and possible up to oldest age, 2) prevention and health promotion for advanced age should start early, 3) prevention and health promotion must take into account the diversity and heterogeneity of the life situations of old people, 4) prevention and health promotion promote and demand self-determination and participation, 5) prevention of multiple illnesses must be given greater attention, 6) prevention of the need for long-term care and prevention in long-term care must be treated equally, 7) prevention and health promotion must be thought of in terms of life worlds and across sectors, paying particular attention to aspects of social inequality and a focus on resources, 8) prevention and health promotion and the related research must be interdisciplinary and transdisciplinary and be applied at different levels, from molecular to societal., Discussion: The guiding principles outline the focal points of future-oriented ageing, health and healthcare research and open up fields of action but also show the limits of this approach for political decision-makers, researchers and practitioners., (© 2023. The Author(s).)

Purpose: Survival rates after severe multiple trauma have continually increased in the last decades. Return to work (RTW) of persons affected by severe multiple trauma is important to assure their quality of life and social participation. Therefore, knowledge about aspects associated with RTW is essential for acute and rehabilitative care and treatment. Aim of the study is to analyze RTW in patients with multiple trauma and to identify predictors for RTW., Methods: To identify aspects that predict RTW, 84 patients in working age and with ISS ≥ 25 were included in a mono-center study. Data were collected by using routine data of the German TraumaRegister DGU ® and POLO chart, a standardized patient-reported outcome assessed during follow-up. Bivariate analyses (Chi-Quadrat-test, Wilcoxon Mann-Whitney-test, t-test) were used to test for associations with RTW. Selected variables were included in a logistic regression model to predict RTW., Results: In total, 58% of patients returned to work during follow-up. Age, duration of treatment in ICU and time between admission and follow-up were selected as predictors for RTW. Self-reported general health was also crucial for RTW in patients, whereas pre-existing comorbidities or other stressful events do not contribute to the prediction of RTW., Conclusion: RTW of patients with severe multiple trauma is determined by several factors. Older patients with low general health have problems to return to previous work., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Demographic and social transformation occur due to changes in the structure of the population and employment especially of women, increasing cultural diversity, unequal educational opportunities for children and adolescents, and regional variation in the provision of services. Meeting the challenges requires flexible, responsive and integrated social and health care systems that allow participation of individuals and groups concerned and recognition of their views and perspectives. Health monitoring and knowledge management is adjusted to the needs of the population and transfers high quality, evidence-based knowledge into all policy areas (health in all policies strategy)., Competing Interests: Interessenkonflikt: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: For the treatment of proximal humeral fractures two major therapeutic principles can be employed: intramedullary nailing (PHN) or locking plate osteosynthesis. The aim of this study was to evaluate and compare clinical and radiological long-term outcome of proximal humeral fracture stabilization using PHN or angular stable plating., Materials and Methods: In a retrospective study between March 2009 and March 2010, we analyzed 72 out of 118 patients with unified proximal humeral fracture who had been treated at least 3 years previously using PHN (44 patients) or angular stable plating (28 patients) in a level 1 trauma center. Functional and radiological outcomes were assessed at least 3 years after trauma using the Constant and Murley score and SF-36 score., Results: According to the Neer classification, there were 31 3-part fractures (PHN: 23; plate: 8) and 41 4-part fractures (PHN: 21; plate: 20), respectively. No clinical symptoms after 3 years were observed in 42 patients, whereas in 30 patients clinical symptoms were evaluated related to pain and/or loss of function. Functional outcome using the Constant and Murley score demonstrated a total score of 73 points (ipsilateral side) vs. 88 points (contralateral side) in all evaluated patients, on average., Conclusion: Both PHN and angular stable plating are adequate treatment options for proximal humeral fractures. Both systems require precise preoperative planning and advanced surgical experience. No significant differences in long-term clinical and radiological outcome between implants regarding fracture classification, age of patient, and choice of implant were found.

Unlabelled: BACKGROUND AND RESEARCH QUESTIONS: In the current paper, it is analyzed whether the extent of loneliness of adults in the second half of their lives has changed between 1996 and 2008 in Germany. Because patterns of objective social integration have evolved differently in different birth cohorts (familial integration in earlier birth cohorts more fragile, more solid in later birth cohorts), we expected different trends in the extent of loneliness in different birth cohorts., Design and Methods: The three waves of the German Ageing Survey (DEAS) constitute the database for the analysis: 1996 (n = 3,979), 2002 (n = 2,766) and 2008 (n = 4,392). Loneliness was measured with the de Jong Gierveld Loneliness Scale. The German Ageing Survey (DEAS) is a nationwide representative survey of the German population aged 40-85 years., Results: Only a minority of people report being very lonely in the second part of life. Between 1996 and 2008, there is a positive trend in the extent of loneliness in the second half of life, i.e., the prevalence of loneliness decreased during this period of time. From 1996 to 2008, the youngest respondents (40-54 years of age) and the middle aged respondents (55-69 years) demonstrated a decline from 1996 to 2002 followed by an increase in loneliness between 2002 and 2008. The oldest respondents (70-85 years of age) experienced a steady decline in loneliness. Gender differences (men are somewhat lonelier than women) remain stable between 1996 and 2008., Discussion and Conclusion: While people who are currently old are socially well integrated and, hence, experience loneliness only to a small degree, there is a higher risk for persons who are currently in middle adulthood because their social networks have become increasingly more fragile. Further changes have to be observed.

In Germany 427,500 persons per year are injured in traffic accidents. So we analysed in a retrospective study the post-traumatic quality of life of patients suffering from a severe trauma (ISS ≥ 50). Highlights of interest were: (i) pattern of injury, (ii) injured part of the body, (iii) days in ICU, (iv) outcome, (v) actual state of health, (vi) mental health. Between 1/2000 and 12/2005, 1,435 patients with multiple trauma were hospitalised in the Trauma Center Murnau. 88 suffered from a severe trauma with ISS ≥ 50. 23 % of these patients had a good outcome and 36 % died. Actually, more than half of the patients were physically handicapped or suffered from pain. 41 % showed characteristics typical for a post-traumatic stress disorder. In conclusion the patients with severe trauma had a good survival rate, but they showed a poor post-traumatic quality of life. Thus, in the time after trauma it is important to treat the "whole patient" and not only the physical lesions., (© Georg Thieme Verlag KG Stuttgart · New York.)

With advancing age, there is a significant increase in the number of health problems; at the same time, the complexity of the existing impairments increases. In addition to the diagnosed somatic and psychological illnesses, functional disorders and disabilities as well as the self-assessed health of the individual play an important role. Health in old age is an important individual and societal topic today and in the future. In order to plan health politics, mapping of morbidity and prognosis are important. They require representative, valid, current, and comparable data over time. Databases of the health reporting in the area of senior citizens have improved in recent years. However, data are still missing, for example, in the area of not being able to fully take part in daily life. Research is needed, because of the specificity of health problems in the elderly, including the survey methodology and the selection of suitable indicators.

Sentha is an interdisciplinary research team involving the Technical University Berlin, the Berlin Institute for Social Research GmbH (BIS), the German Centre for Research on Ageing at the University of Heidelberg (DZFA), the School of Fine Arts Berlin (HdK), and the Brandenburg Technical University Cottbus (BTU). Building on empirical investigations of the role of everyday household products in the everyday life of older people, product-independent design and assessment guidelines and new products are being developed in an intensive interdisciplinary process in order to better meet the needs of older people and to enhance their autonomous living. The following paper describes the contributions from the participating disciplines and presents initial results of the social sciences subproject, describing the problems arising in living independently in old age and detecting the demands on new technological solutions. Data are based on a representative survey conducted in 1999 and including a stratified sample of 1417 men and women aged 55 and older.

Gross pathologic and histologic changes were investigated in a total of 1000 end-of-lay hens. Thirty animals were drawn from free range stocks, 270 from deep litter stocks, and 700 from caging systems. The following changes were evaluated with regards to housing systems: Pododermatitis, deformation of the keel bone and amputated beaks occurred primarily in free range hens. Deep litter hens also suffered from pododermatitis, keel bone deformation and amputated beaks in addition to pecking wounds. In caged hens severe fatty liver syndromes, injuries of the claws and inflammation of the feather follicles were mainly found. Furthermore, injuries and fractures due to handling and transport were almost exclusively found in caged hens. It has to be concluded that all of the investigated housing systems can predisposed hens to certain lesions. The documented changes--e.g. chronic inflammation, skelettal deformities and injuries--are painful and may lead to permanent alterations. Therefore, these changes should be condemned as conflicting with animal protection regulations.

The pathomorphological study was carried out on a total of 360 broiler chicken which had been random-sampled on days 22 and 35 of the mast period, respectively, from those flocks that were to be compared. Furthermore, 161 animals with evidence of movement disturbance that were slaughtered in the last two mast weeks, were also evaluated. With regard to incidence, severity of movement disturbance and the spectrum of pathomorphological changes of the skeleton there were no differences between the different groups. When histological and morphometrical methods were applied, no differences in the skeleton structure were noted between flocks with conventional housing and flocks with reduced population density. Equally, no differences were ascertained with regard to dry substance and ash content of the bones including the minerals calcium and phosphorus. Furthermore, there were no group differences in serum calcium, phosphorus and alkaline phosphatase. In numerous chicken from all groups a plantar pododermatitis with differing incidence and strongly varying intensity was observed. The lesions were characterized by a papillomatous proliferation of the basal epithelial layers. There was widespread inflammation with loss of the epithelial layer and deep necroses of the sole. A latent infection with papilloma viruses is discussed. About 90% of the random-sampled chicken of all groups showed bending of the vertebral column by 20 degrees at the height of the 6th thoracic vertebra. In numerous chicken the 6th thoracic vertebra was dislocated and slightly rotated which caused encroachment of the vertebral canal. Whether this alteration may be responsible for the frequently observed movement disturbance of broilers in the last third of the mast period can not be decided on the basis of the pathomorphological study. In any case it must be assumed that both the pododermatitis and the bending and encroachment of the vertebral column cause pain. Thus, both lesions should be evaluated from the viewpoint of animal protection.