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Background: Loneliness represents a significant health risk and is associated with numerous mental and physical conditions. The aim of this paper was to describe the prevalence of loneliness in Bavaria before and during the COVID-19 pandemic with respect to socio-demographic attributes., Methods: Data sources were the German Ageing Survey (DEAS) and the Socio-Economic Panel (SOEP). Univariate statistical analyses were carried out for different socio-demographic attributes, such as age, gender, type of household, education, and financial resources., Results: According to the SOEP, the proportion of adults who are often or very often lonely increased from 2.3% in 2017 to 16.2% in 2021. In 2021, women had a higher prevalence of loneliness than men (21.0% vs. 11.3%), and younger adults had the highest prevalence of loneliness (18 to 25 years: 31.7%) compared to the other age groups., Discussion and Conclusions: During the COVID-19 pandemic, loneliness increased in almost every population subgroup in Bavaria. Further studies are needed to examine whether this development is temporary or represents a long-term effect even after the measures to prevent the spread of COVID-19 have been lifted., (© 2024. Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature.)

Background: Bavaria is currently embarking on the endeavour of building up systematic prevention reporting. Prevention reporting is meant to support the implementation of the Bavarian Prevention Plan and the German Prevention Law and to further the ongoing development in the field of health promotion and health-related prevention in Bavaria., Goals: Prevention reporting in Bavaria aims to draw on general health reporting and complement it with specific prevention-related data taking into special consideration the Bavarian Prevention Plan. Particularly, data on prevention-amenable health determinants, prevention interventions, prevention spending and on indicators related to the targets of the Bavarian Prevention Plan are meant to be included. Periodic reporting will allow ongoing monitoring and the observation of trends. The reporting system will encompass shorter publications for the general public as well as more extensive reports for an expert audience. Where possible, data will be reported not only Bavaria wide but also on a smaller regional level to support local action., Implementation and First Results: An extensive stocktaking of prevention and health promotion activities in Bavaria in 2014/2015 as well as a survey of the partner organisations in the Bavarian Prevention Alliance in 2016 presented an overview of the prevention scene in Bavaria. A core indicator set to support the implementation of the Bavarian Prevention Plan was developed in 2016 and a first short data brochure for the public was published. A comprehensive compilation of prevention-related data and a Bavarian prevention report are planned for 2017 and 2018., Conclusions: Like health reporting, prevention reporting, as conceptualised in Bavaria, presents overview data and thus allows a monitoring of prevention. For specific planning or evaluation purposes, it needs to be supplemented by more in-depth analyses. Current challenges include the development of valid, prevention-specific indicators, the generation of an empiric database and the attempt of a coordinated approach amongst the federal states within Germany., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

For a large territorial state like Bavaria only a decentralised cancer registration structure promises successful results: in the form of regional clinical cancer registries and--using the clinical registration as a base--one population-based registry. After ten years of epidemiological cancer registration in Bavaria it can now be shown that the chosen registration concept has proved itself. Currently the completeness of cancer notifications exceeded the international recommended threshold of 90%. A largely complete data stock is available for the years of diagnosis from 2004 to 2005. The task sharing between clinical and population-based cancer registries avoids double registration of data. Both types of registries are supporting physicians and hospitals with a wide palette of services. Together they enable transparency of cancer occurrence as well as transparency of health care for tumour patients.

Objectives: There are regional differences in mortality in Bavaria. Although these regional dif-ferences in mortality were associated with behavioural risk factors and socioeconomic factors in a study conducted for this reason, the quantitative effect of behavioural risk factors and socio-economic factors as well as the regional structure on the individual health as a predictor of mortality were not known., Methods: Persons between the age of 18 and 80 were interviewed with the Behavioral Risk Factor Surveillance System (BRFSS) in two Bavarian regions with high mortality, two Bavarian regions with low mortality and in the capital of Bavaria, Munich. For regional structural data, the INKAR database was used. Data were analysed descriptively, with a multivariable-adjusted logistic regression and with a multilevel analysis., Results: There were lower proportions of persons with a good or very good state of health as well as adverse results for overweight/adipositas, the behavioural risk factors for doing sports, smoking and consuming fruits and vegetables and the socioeconomic factors education and unemployment in the two regions with high mortality "Ostbayerische Grenzregion" and "Oberfranken". In a multivariable adjusted logistic regression, the body mass index, smoking, doing sports, climbing stairs, consuming alcohol, being satisfied with the job and the interaction between education and marital status were found to have an influence on the individual health. The small remaining regional component could be explained in the multilevel analysis by different variables which describe the economical situation of the regions., Conclusions: In accordance with the study hypotheses, a consistency between behavioural risk factors and regional differences in mortality could be observed. Socioeconomic influences and a small regional component are involved. In addition to specific prevention programmes for the target groups, structural support is also meaningful with regard to its potential health impact.

Background: The use of evidence and evaluation is rapidly gaining importance in the field of health promotion and prevention. The evidence base, evaluation methods as well as the capacity and required competencies among practitioners are still being developed., Aims: Beyond its specific health-related targets, the health promotion initiative "Healthy Living in Bavaria" aims to integrate the use of evidence and evaluation as key components into project funding as part of a total quality management concept. Another objective is the creation of new evidence for the field of health promotion and prevention., Approach: A core element of the quality management concept is the initiative's multistage evidence and evaluation model which embraces the initiative as a whole as well as the individual projects. The model is operationalized through a set of matching instruments for application, reporting, evaluation, and appraisal., Conclusion: Nationally as well as internationally, evidence and evaluation stand out as central aspects of quality improvement instruments in health promotion and prevention. Characteristic of Bavaria's quality improvement approach is the seamless process from the application to the evaluation under consideration of scientific as well as pragmatic aspects.

Objective: In completion of a decision of the Bavarian Parliament we examined the regional mortality differences within Bavaria., Data: The analysis was based on the number of deaths in Bavaria in the years of 2000-2002. Data on regional demographic and socioeconomic indicators were used to identify potential associations., Methods: Deaths were analysed by cause of death and region. Crude and age standardised mortality rates were calculated. Additionally, we assessed the potential years of life lost in order to obtain some indication of the potential effects of preventive action. The association with likely explanatory factors was investigated on an ecological level., Results: The regional mortality differences in Bavaria show a northeast-southwest gradient favouring the southwest, which reflects the socioeconomic situation within Bavaria. This may be due to the economic disadvantage northeast Bavaria had to endure as a result of its marginal location within a divided Europe. We found strong bivariate correlations of the mortality rate with individual socioeconomic factors (e. g. with available income: -0.582; with unemployment: +0.416; with the immigration rate: -0.473). Exploratory analysis suggest that about 50 % of the regional variation in mortality could be explained by socioeconomic factors., Discussion: The results for cause of death indicate that behavioural factors in relation to socioeconomic aspects may well play a role in the mortality gradient. This will be the focus of a future piece of research of our unit.

Objective: To prevent catheter occlusion, intermittently used central venous catheters are frequently sealed with vitamin C solution or heparin solution between use. The present study was designed to test the effectiveness of this approach and to compare the efficiency of sealing solutions., Design and Setting: Prospective randomized study performed on a 9-bed medical ICU and on medical wards of an academic tertiary care center. PARTICIPANTS. Ninety-nine central venous line placements were prospectively included in the study and randomized into three treatment groups: sodium chloride 0.9%, vitamin C (200 mg/ml) and heparin (5000 IU/ml) sealing solutions., Interventions and Measurements: Catheters were filled with the respective sealing solution and patency was tested once every 2 days using a standardized routine. Catheter patency was compared among the three groups using Kaplan-Meier statistics and log-rank testing., Results: There was a significant difference in catheter patency between the three groups (p<0.03, log-rank test). A comparison of catheter survival between the catheters filled with heparin and those filled with sodium chloride, but not between those filled with vitamin C solution and with sodium chloride solution, exhibited significant differences in catheter patency (p<0.04, log-rank test)., Conclusions: Local anticoagulation of intermittently used central venous catheters prolongs catheter patency. High-dose (5000 IU/ml) heparin solution is a useful anticoagulant for this purpose, while vitamin C solution does not prolong catheter patency.

Aim: To conduct a cohort study of 101 patients with hepatocellular carcinoma (HCC) presenting to a tertiary care medical referral center in Germany between 1997 and 1999., Methods and Results: Data were retrospectively analyzed by chart review. In 95 cases (72 males and 23 females) sufficient data were available for analysis. Twenty five (29%) of 85 patients were HBsAg or anti HBc positive, 21/85 (25%) were anti HCV positive, and 6/85 (7%) were positive for both HBV and HCV-markers. Age was significantly lower in HBV positive patients than in the other two groups. Thirty one (34%) of 90 patients had histories of alcohol abuse. In 79/94 (84%) patients, cirrhosis was diagnosed. Of these cirrhotic patients, 29/79 (37%) belonged to Child Pugh's group (CHILD) A, 32/79 (40%) to CHILD B, and 18/79 (23%) to CHILD C. AFP was elevated in 61/91 (67%) patients. A single tumor nodule was found in 38/94 (40%), more than one nodule in 31/94 (34%), and 25/94 (26%) had a diffusely infiltrating tumor, i.e. the tumor margins could not be seen on imaging procedures. Portal vein thrombosis was present in 19/94 (20%). Imaging data consistent with lymph node metastases were found in 10/92 (11%), while distant metastases were found in 8/93 (9%). According to Okuda 28/94 (30%) were grouped to stage I, 53/94 (56%) were grouped to stage II, and 13/94 (14%) were grouped to stage II. Survival data were available for 83 patients. The Kaplan-Meier estimate for median survival was 8 4 months. Factors influencing survival were the Okuda score, the presence of portal vein thrombosis, and the presence of ascites. The presence of non complicated liver cirrhosis by itself, distant metastases, or infection with hepatitis viruses did not influence survival. AFP positivity by itself did not influence survival, though patients with an AFP value greater than 100 microg/L did experience shortened survival. Treatment besides tamoxifen or supportive care was associated with prolonged survival. The influence of therapy on survival was most pronounced in Okuda stage II patients. There was longer survival in those Okuda stage II patients who were treated with percutaneous ethanol injection., Conclusion: Even in a low incidence area such as Germany, the majority of HCC is caused by viral hepatitis and therefore potentially preventable. Reflecting the high proportion of advanced stage tumors in our patients, the median survival was poor. Patients who received active therapy had a longer survival.