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Background Prevalence of overweight and obesity in Germany is increasing. High body weight can affect children's growth and development. This paper aimed to determine the association between body mass index (BMI) and visual impairment among preschool children and explore the potential role of obesity in predicting visual developmental disorder. Methods Six consecutive years of data from the School Entry Examination were collected for all preschool children aged from 4 to 6 years residing in Rhine-Neckar County and the City of Heidelberg, Germany from 2013 to 2018. Univariate and multivariate regression were used to analyze the complete data, multiple imputation was used to deal with missing data. Results Among the group with an immigrant background, children with obesity [OR = 1.20, 99% (1.02–1.42)] were more likely to have visual impairment compared to those with normal body weight (P  <   0.01) after adjusting for survey year, age, and gender of children, education and occupation of parents, screen time-frequency, whether a television was in their bedroom, and quality of preschool outdoor environment. Conclusion There were significant associations between obesity and visual impairment among German preschool children with immigrant backgrounds. Strategies to support vulnerable groups were needed across all regional schools. [ABSTRACT FROM AUTHOR]

Background The Robert-Koch-Institute reports that during the summer holiday period a foreign country is stated as the most likely place of infection for an average of 27 and a maximum of 49% of new SARS-CoV-2 infections in Germany. Methods Cross-sectional study on observational data. In Germany, summer school holidays are coordinated between states and spread out over 13 weeks. Employing a dynamic model with district fixed effects, we analyze the association between these holidays and weekly incidence rates across 401 German districts. Results We find effects of the holiday period of around 45% of the average district incidence rates in Germany during their respective final week of holidays and the 2 weeks after holidays end. Western states tend to experience stronger effects than Eastern states. We also find statistically significant interaction effects of school holidays with per capita taxable income and the share of foreign residents in a district's population. Conclusions Our results suggest that changed behavior during the holiday season accelerated the pandemic and made it considerably more difficult for public health authorities to contain the spread of the virus by means of contact tracing. Germany's public health authorities did not prepare adequately for this acceleration. [ABSTRACT FROM AUTHOR]

Background There is little evidence about the utilisation of healthcare services and disease recognition in the older population, which was urged to self-isolate during the COVID-19 lockdown. Objectives We aimed to describe the utilisation of physician consultations, specialist referrals, hospital admissions and the recognition of incident diseases in Germany for this age group during the COVID-19 lockdown. Design Cross-sectional observational study. Setting 1,095 general practitioners (GPs) and 960 specialist practices in Germany. Subjects 2.45 million older patients aged 65 or older. Methods The number of documented physician consultations, specialist referrals, hospital admissions and incident diagnoses during the imposed lockdown in 2020 was descriptively analysed and compared to 2019. Results Physician consultations decrease slightly in February (−2%), increase before the imposed lockdown in March (+9%) and decline in April (−18%) and May (−14%) 2020 compared to the same periods in 2019. Volumes of hospital admissions decrease earlier and more intensely than physician consultations (−39 versus −6%, respectively). Overall, 15, 16 and 18% fewer incident diagnoses were documented by GPs, neurologists and diabetologists, respectively, in 2020. Diabetes, dementia, depression, cancer and stroke were diagnosed less frequently during the lockdown (−17 to −26%), meaning that the decrease in the recognition of diseases was greater than the decrease in physician consultations. Conclusion The data suggest that organisational changes were adopted quickly by practice management but also raise concerns about the maintenance of routine care. Prospective studies should evaluate the long-term effects of lockdowns on patient-related outcomes. [ABSTRACT FROM AUTHOR]

Background Since the first cases of the novel coronavirus disease SARS-CoV-2 were reported in December 2019 in China, the virus has spread in most countries. The aim of the present study was to assess initial data on the mental health burden of the German public during the COVID-19 pandemic. Methods A cross-sectional study was conducted in Germany and collected complete datasets from 15 704 German residents aged 18 years and over. Besides demographics, generalized anxiety (GAD-7), depression (PHQ-2) and psychological distress (DT) were assessed. Furthermore, COVID-19-related fear, trust in governmental actions to face COVID-19 and the subjective level of information regarding COVID-19 were covered. Results Significantly increased symptoms were highly prevalent in all dimensions: generalized anxiety (44.9%), depression (14.3%), psychological distress (65.2%) and COVID-19-related fear (59%). Females and younger people reported higher mental burden. Trust in governmental actions to face COVID-19 and the subjective level of information regarding COVID-19 are negatively associated with mental health burden. However, the subjective level of information regarding COVID-19 is positively associated with increased COVID-19-related fear. Conclusions The provision of appropriate psychological interventions for those in need and the provision of transparency and comprehensible information are crucial during the current pandemic. [ABSTRACT FROM AUTHOR]

Background: excess weight is a risk factor for numerous co-morbidities that predominantly occur in later life. This study's purpose was to analyse the association between excess weight and health service use/costs in the older population in Germany. Methods: this cross-sectional analysis used data of n = 3,108 individuals aged 58--82 from a population-based prospective cohort study. Body mass index (BMI) and waist-to-height ratio (WHtR) were calculated based on clinical examinations. Health service use was measured by a questionnaire for a 3-month period. Corresponding costs were calculated applying a societal perspective. Results: 21.8% of the sample were normal weight, 43.0% overweight, 25.5% obese class 1 and 9.6% obese class ≥2 according to BMI. In 42.6%, WHtR was ≥0.6. For normal weight, overweight, obese class 1 and obese class ≥2 individuals, mean costs (3-month period) of outpatient care were 384€, 435€, 475€ and 525€ (P < 0.001), mean costs of inpatient care were 284€, 408€, 333 € and 652€ (P= 0.070) and mean total costs 716€, 891€, 852€ and 1,244€ (P= 0.013). For individuals with WHtR <0.6 versus ≥0.6, outpatient costs were 401€ versus 499€ (P< 0.001), inpatient costs 315€ versus 480€ (P= 0.016) and total costs 755€ versus 1,041€ (P< 0.001). Multiple regression analyses controlling for sociodemographic variables showed a significant effect of obesity on costs of outpatient care (class 1: +72€; class ≥2: +153€) and total costs (class ≥2: +361€) while the effect of overweight was not significant. WHtR ≥0.6 significantly increased outpatient costs by +79€ and total costs by +189€. Conclusions: excess weight is associated with increased service use and cost in elderly individuals, in particular in obese class ≥2 individuals. [ABSTRACT FROM AUTHOR]

We compared alcohol use among adolescents with and without hearing loss. Adolescents with hearing loss reported consuming less alcohol, less binge drinking, fewer episodes of drunkenness, and a higher age at first drunkenness than their hearing peers. Alcohol use did not vary between students who were deaf or hard of hearing or between students with congenital versus acquired hearing loss. Although higher age, male gender, and larger friend networks predicted higher alcohol consumption among adolescents with and without hearing loss, worse grades at school were associated only with alcohol use among hearing students. Lower alcohol use among students with hearing loss when compared with hearing peers was, in part, explained by their lower level of peer-group integration. Although alcohol use is a less serious problem among students with hearing loss, a minority with risky consumption would benefit from interventions aimed at reducing alcohol use. [ABSTRACT FROM PUBLISHER]

Objective This study investigated the incidence and determinants of chronic postsurgical pain ( CPSP) in a general surgical patient population. Design This is a prospective cross-sectional study at a university-affiliated clinic/level 1 trauma center. Patients were followed at least 1 year postoperatively. By surgical discipline, procedures were 50% orthopedic/trauma, 33% general (abdominal/visceral), and 17% vascular. Setting All patients admitted during one year ( N = 3020) were eligible. Exclusion criteria were cognitive impairment, communication/language barrier, nonoperative treatment, and refusal to participate. A CPSP questionnaire was completed. Step-by-step analysis followed with a 2nd questionnaire to detect CPSP with numeric rating scale ( NRS) pain intensity ≥3. Finally, individual follow-up examinations were performed. Results 911 patients responded (30.2%). 522 complained of pain intensity ≥3 on NRS (scale 0-10). The second step identified 214 patients with chronic pain ( NRS ≥3, mean 29 months postoperatively). On final examination, 83 CPSP patients (14.8%) were identified. By surgical discipline, 28% were general, 15% vascular, and 57% trauma/orthopedic surgery. Most oftenly cited pain sites were joint (49.4%), incisional/scar (37.7%), and nerve pain (33.7%). By procedure, patients underwent pelvic surgery, colon surgery, laparoscopies, inguinal herniorrhaphies, arthroscopies, and hardware extractions. All patients in the 'laborer' and 'unemployed' categories reported chronic pain. Conclusion Bias due to study design and/or heterogeneity of patients is possible, but there was a high CPSP rate after 2 years both generally and particularly in orthopedic/trauma (57%) patients. Both 'major' and 'minor' surgical procedures led to CPSP. [ABSTRACT FROM AUTHOR]

Background: there is ample literature showing pain and depression are related. However, different dimensions of pain have been used in former studies.Objective: the objective of the study was to compare the strength of the association of different pain dimensions with depression in older adults.Methods: assessments including evaluation of pain (severity, frequency, chronicity, quality, pain medication, painful body sites) and depression (measured by the Hospital Anxiety and Depression Scale) were performed in an observational study in community dwelling older adults (sample mean age 76, n = 1130) in Germany. The associations of different dimension of pain with depression were assessed using descriptive and multivariate methods.Results: the number of painful body areas was most significantly associated with self-reported late life depression (OR 1.20, CI 1.11–1.31). Pain severity and frequency (OR 1.12, CI 1.01–1.23 and OR 1.18, CI 1.01–1.37) were also associated with depression; quality and duration were not. Except for severity (OR 1.12, CI 1.02–1.24) associations of pain dimensions were strongly reduced when controlling for relevant confounders and gender was an effect modifier.Conclusions: multisite pain, pain severity and frequency were the best predictors of late life depression. Clinicians should be especially aware of depressive disorders when older patients are complaining of pain in multiple areas across the body. [ABSTRACT FROM AUTHOR]

The purpose of the present literature review was to investigate and summarize the current evidence on associations between dietary patterns and biomarkers of inflammation, as derived from epidemiological studies. A systematic literature search was conducted using Pub Med, Web of Science, and EMBASE, and a total of 46 studies were included in the review. These studies predominantly applied principal component analysis, factor analysis, reduced rank regression analysis, the Healthy Eating Index, or the Mediterranean Diet Score. No prospective observational study was found. Patterns identified by reduced rank regression as being statistically significantly associated with biomarkers of inflammation were almost all meat-based or 'Western' patterns. Studies using principal component analysis or a priori-defined diet scores found that meat-based or 'Western-like' patterns tended to be positively associated with biomarkers of inflammation, predominantly C-reactive protein, while vegetable- and fruit-based or 'healthy' patterns tended to be inversely associated. While results of the studies were inconsistent, interventions with presumed healthy diets resulted in reductions of almost all investigated inflammatory biomarkers. In conclusion, prospective studies are warranted to confirm the reported findings and further analyze associations, particularly by investigating dietary patterns as risk factors for changes in inflammatory markers over time. [ABSTRACT FROM AUTHOR]

Objectives. We tested whether formal volunteering, in terms of its associations with mental health, compensates for the absence of major work and family roles among older adults or rather complements such roles among both younger and older adults. Method. Two cross-sectional samples of younger (aged 18–42 years, N = 2,346) and older (aged 56–75 years, N = 1,422) German adults were used. We regressed mental health indicators on control variables, 2 indicators of formal volunteering (participation in voluntary organizations and volunteer work), and their interactions with employment/partnership status. Results. Participation in voluntary organizations was associated with higher positive affect, higher life satisfaction, and fewer depressive symptoms in younger adults. In older adults, it was related to higher life satisfaction only among working individuals, although the difference from nonworking individuals was not significant. Volunteer work was associated with higher positive affect in both age groups. In younger adults, it had no relation to life satisfaction and depressive symptoms. In older adults, it was related to higher life satisfaction among nonworking individuals and to fewer depressive symptoms among those without a steady partner. Discussion. Volunteer work but not participation in voluntary organizations yielded compensatory effects on mental health among older adults. [ABSTRACT FROM PUBLISHER]

Background: Despite the ban on misleading descriptors such as light or mild cigarettes in Europe, there are still widespread misperceptions of the relative harmfulness of different brands of cigarettes among smokers. This study examined the extent to which smokers in three European countries believed that some cigarette brands are less harmful and why, using data from the International Tobacco Control (ITC) Europe surveys. Methods: Cross-sectional analyses were completed among nationally representative samples of 4,956 current smokers (aged ≥ 18) from Germany (n = 1,515), France (n = 1,735) and the United Kingdom (n = 1,706) conducted between September 2006 and November 2007. Logistic regression models examined whether outcomes, including beliefs that some cigarettes could be less harmful than others, varied by socio-demographic and country of residence. Findings: Around a quarter of smokers in the UK and France, and a third in Germany believed some cigarettes are less harmful than others. Overall, of smokers who falsely believed that some cigarettes are less harmful, 86.3% thought that tar/nicotine yields, 48.7% taste, and 40.4% terms on packs such as ‘smooth’ or ‘ultra’ indicated less harmful brands. About a fifth of smokers across all countries chose their brand based on health reasons, and a similar proportion gave tar yields as a reason for choosing brands. Conclusions: Our research suggests that the current European Tobacco Products Directive is inadequate in eliminating misperceptions about the relative risk of brand descriptors on cigarettes. There is therefore an urgent need to protect smokers in Europe from these misperceptions via stronger measures such as plain packaging regulations. [ABSTRACT FROM AUTHOR]