Urban environments are important determinants of human health. The term walkability summarizes features of the urban built environment that promote walking and other types of physical activity. While ...the beneficial effects of active and public transport have been well established, the health impact of other features of walkability are less well documented.
We conducted a systematic review of health impact assessments (HIAs) of walkability. Studies were identified through PUBMED and Science Direct, from two German websites related to urban health and reference tracking. Finally, 40 studies were included in the present review. We applied qualitative thematic analysis to summarize the major results from these studies.
Most of the HIAs (n = 31) reported the improvement of health or health behaviour resulting from an investigated project or policy. However, three HIAs reported a lack of improvement or even a decrease of health status. In parallel, 13 HIAs reported a gain in economic value, whereas one reported a lack or loss of economic effects. Moreover, three HIAs reported on social effects and six HIAs gave additional recommendations for policies or the implementation of projects or HIAs.
Most HIAs investigate the impact of increasing active or public transport. Other features of walkability are less well studied. With few exceptions, HIAs document beneficial impacts of improving walkability on a variety of health outcomes, including reductions of mortality and non-communicable diseases.
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•Physiotherapists perceive SDM to be an appropriate concept in physical therapy.•Knowledge on the theoretical concept of SDM amongst physiotherapists was low.•Despite overall positive attitudes, ...self-reported use of SDM was moderate only.•Having knowledge on SDM did neither predict attitudes nor self-reported use of SDM.•System related barriers were the most relevant ones to the implementation of SDM.
This study aimed a) to investigate knowledge, attitudes, and self-reported use of shared decision-making (SDM) among physiotherapists in Germany, b) to explore their association with demographic characteristics, and c) to assess barriers to the implementation of SDM.
We assessed above mentioned domains using an online survey. Two-level logistic regression models were used to examine factors associated with knowledge, attitudes and self-reported use of SDM.
60.5% of a total sample of 357 participants reported to have had no knowledge on SDM before participating in the survey. Attitudes towards SDM were mostly positive, half of all participants expressed a preference for SDM. About two thirds of all participants reported to use a rather paternalistic approach in routine care. Knowledge, attitudes, and self-reported use of SDM were associated with several demographic characteristics.
SDM was perceived as an appropriate concept in physiotherapy. However, missing knowledge and limited self-reported use of SDM in routine care on the one hand and positive attitudes towards SDM on the other hand indicate a need for action.
In order to emphasize the use of SDM in physiotherapy efforts need to be undertaken in research, clinical practice and health policy.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Disordered eating is highly prevalent among children and adolescents. Since the outbreak of the COVID-19 pandemic, hospitalizations due to eating disorders have peaked and overweight has risen. The ...aim of this study was to determine differences in the prevalence of eating disorder symptoms among children and adolescents in Germany before and after the onset of the COVID-19 pandemic and to identify associated factors.
Eating disorder symptoms and associated factors were examined in a sample of
= 1,001 participants of the nationwide population-based COPSY study in autumn 2021. Standardized and validated instruments were used to survey 11-17-year-olds along with a respective parent. To identify differences in prevalence rates, logistic regression was used to compare results with data from
= 997 participants of the prepandemic BELLA study. Multiple logistic regression analyses were performed to examine associations with relevant factors in the pandemic COPSY sample.
Eating disorder symptoms were reported by 17.18% of females and 15.08% of males in the COPSY study. Prevalence rates were lower overall in the COPSY sample compared to before the pandemic. Male gender, anxiety, and depressive symptoms were associated with increased odds for eating disorder symptoms in the pandemic.
The pandemic underscores the importance of further research, but also prevention and intervention programs that address disordered eating in children and adolescents, with a focus on age - and gender-specific differences and developments. In addition, screening instruments for eating disorder symptoms in youths need to be adapted and validated.
The digitization of German hospitals is proceeding continuously, leading to the implementation of new digital technologies, such as electronic health records (EHRs) or other technologies, used for ...the purpose of medical documentation tasks. Even though the replacement of paper documentation through digitized documentation in general promises to come along with plenty of benefits, the daily utilization of technologies might also lead to stresses and strains among the medical staff, eventually possibly leading to the development of different negative work and health-related outcomes. This study, therefore, aims at identifying persisting digitization-associated stressors and resources among medical hospital staff, examining their influences on different work and health-related outcomes, and finally, identifying potential needs for preventive measures. A quantitative study in the form of an online questionnaire survey was conducted among physicians working in the medical field of neuro- and vascular surgery in German hospitals. The study was carried out between June and October 2022 utilizing an online questionnaire based on several standardized scales, such as the technology acceptance model (TAM) and the technostress model, as well as on several scales from the Copenhagen Psychosocial Questionnaire (COPSOQ). The study found medium levels of technostress among the participating physicians (n = 114), as well as low to medium levels of persisting resources. The queried physicians, on average, reported low levels of burnout symptoms, generally described their health status as good, and were mostly satisfied with their job. Despite the prevalence of technostress and the low levels of resources among the surveyed physicians, there is little awareness of the problem of digital stress, and preventive measures have not been widely implemented yet in the clinics, indicating a needs gap and the necessity for the strategic and quality-guided implementation of measures to effectively prevent digital stress from developing.
Background
Mental health during the COVID-19 pandemic is of particularly high relevance. Especially for children and adolescents, the pandemic and its restrictions represent a significant burden. The ...present study aims to identify risks and resources for depressive symptoms and anxiety in children and adolescents during the pandemic in Germany.
Materials and Methods
Self-reported data from the first wave of the longitudinal COVID-19 and Psychological Health (COPSY) study were used to investigate risks and resources among
n
= 811 children and adolescents aged 11–17 years. Depressive symptoms and anxiety were measured at the first follow-up 6 months later. Multivariate linear regression analyses were performed to investigate the effects of risks and resources on depressive symptoms and anxiety.
Results
Parental depressive symptoms predicted depressive symptoms and anxiety in children and adolescents 6 months later. Female gender was identified as a risk factor for anxiety during the pandemic. None of the potential resources were associated with depressive symptoms or anxiety at the follow-up.
Conclusion
The findings provide evidence of risk factors for depressive symptoms and anxiety during the COVID-19 pandemic. Children and adolescents who face risk factors need to be identified early and monitored during the pandemic. Family-based intervention programs are needed to help vulnerable children and adolescents cope with the challenges of the pandemic.
Emergency departments (EDs) are high-risk environments for workplace violence. Research into techniques to prevent violence has less frequently explored the influence of leadership. This study aims ...to analyze the association of leadership with the prevention of violence using the concepts of health-oriented leadership (HoL) and the violence prevention climate (VPC). This quantitative cross-sectional study was conducted through online surveys between November 2021 and March 2022 across Germany. A sample of 370 doctors and nurses working in German EDs were recruited. Perceptions towards VPC and HoL were compared between groups divided according to profession and position using independent t-tests or Mann–Whitney U tests. Separate multiple linear regression models for supervisors and employees analyzed the association between different profiles of HoL with VPC. Supervisors and employees showed significant differences in supervisor staff-care and VPC. Regression analysis demonstrated that supervisors’ self-care and employees’ assessment of supervisor’s staff-care positively predicted all dimensions of VPC. This empirical study provides insights into the variable perceptions of different groups and the association of leadership profiles with the perceptivity of VPC. The results of this study can be used to emphasize the importance of HoL training for both employees and supervisors to improve communication and health-promoting behavior.
Abstract
Background
Food choices on board merchant ships are limited and seafarers repeatedly described as being at high risk of developing overweight compared to the general population. Up to date, ...research has not distinguished whether seafarers gain weight on board or at home and whether eating habits differ in both settings.
Methods
As part of the e-healthy ship project, cross-sectional data were collected in two different measurements. In the first investigation on board of three merchant ships of German shipping companies, differences in eating behaviour at home compared to on board ships were assessed for 18 Burmese, 26 Filipino and 20 European seafarers. In a second study, BMI, weight development and location of body weight change of 543 Filipino and 277 European seafarers were examined using an online questionnaire on 68 ships.
Results
According to the board examinations, foods and beverages consumed on merchant ships varied widely from seafarers’ diets in their home country. Burmese, Filipino and European seafarers equally reported to consume more fruit (z = 4.95,
p
< .001,
r =
.62) and vegetables (z = 6.21,
p <
.001,
r =
.79), but less coke (z = −5.00,
p <
.001,
r =
.76) when at home. Furthermore, culturally different changes were found across all other foods and beverages. The online questionnaire revealed that 45.8% of seafarers were overweight (55.4% Europeans vs. 40.8% Filipinos,
p
< .001) and 9.8% obese. Moreover, a higher percentage of Europeans compared to Filipinos reported weight gain over the course of their professional career (50.2% vs. 40.7%,
p
= .007). A sub-analysis of seafarers with weight gain found that more Europeans than Filipinos gained weight at home (43.9% vs. 23.1%,
p
< .001).
Conclusions
Both, home and working on board merchant ships, represent very different living environments which may affect seafarers’ lifestyle and eating habits in various ways and thus could favour or inhibit weight gain. From our results, it appears that the body weight and eating habits of Asian seafarers in particular are adversely affected by the working and living conditions on board. Further prospective studies are required to prove this hypothesis.
•Both migrants and natives scored higher in mental than in physical Health-related Quality of Life.•Mental health scores between migrants and natives significantly differ.•School education was found ...to be a significant predictor of mental health in the migrant group: mental health increases with an increase of school education.
The aim of this observational study was firstly, to assess the Health-related Quality of Life (HrQoL) among migrants and German natives in Hamburg, Germany, using the SF-12 mental and physical summary scores and secondly, to evaluate the contribution of selected sociodemographic and socioeconomic variables to explain the variance in mental and physical HrQoL separately for migrants and natives.
Face-to-face interviews were conducted with n=809 participants between May 2018 and July 2019 in six randomly selected statistical districts of Hamburg grouped into four levels of socioeconomic status (SES). The SF-12 questionnaire was used to measure the HrQoL. Socioeconomic (school education, income) and sociodemographic (age, gender, marital status, children) data was recorded, too.
Migrants and natives scored higher in mental (migrants: M=45.77, SD=7.66; natives: M=47.60, SD=6.14) than in physical HrQoL (migrants: M=42.55, SD=5.55; natives: M=42.03, SD=4.71). Natives had a significantly higher (p<0.001) SF-12 mental summary score than migrants. There was a positive association between education and mental HrQoL (β=0.248, p=2.308) in the migrant but not in the native group. Due to limitations of the study the results of the impact of migration on the HrQoL require interpretation.
Differences between migrants and German natives in HrQoL were partially confirmed. Future research should differentiate more strongly between migration contexts as well as other determinants of health (e.g. early life, social support, unemployment) and their policy implications according to the WHO.
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We examined treatment-seeking overweight and obese youths to better understand the gender, age, and treatment modality differences in generic and disease-specific health-related quality of life ...(HRQOL).
This multicenter study included 1,916 patients (mean = 12.6 years; 57% females; mean zBMI = 2.4) who started treatment for overweight and obesity in 48 treatment facilities between July 2005 and October 2006. The facilities offered either inpatient treatment or outpatient programs. Prior to treatment, all participants completed the generic KIDSCREEN-27 HRQOL-questionnaire, the self-perception subscale of the generic KIDSCREEN-52 and the disease-specific obesity module of the KINDLR.The patients' HRQOL was compared to the KIDSCREEN reference sample from the general population by one-way analyses of variance, adjusting for age, gender, and socioeconomic status. Independent t-tests were conducted to compare disease-specific HRQOL scores between patients by gender and age group. Significant mean differences in HRQOL between inpatients and outpatients were explored by one-way analyses of variance, adjusting for age, gender, and zBMI. Effect sizes 'd' were calculated employing the estimated marginal means and the pooled standard deviation (m(treatment) - m(norm)/SD(pooled)).
The patients' HRQOL scores were impaired relative to German norms, with effect sizes up to d = 1.12. The pattern of impairment was similar in boys and girls as well as in children and adolescents. In each of the analyses, at least three of six KIDSCREEN subscales were affected. Regardless of gender and age group, the highest impairments were found in self-perception and physical well-being. Because of the strong decrease in HRQOL in the general population during adolescence, compared to age-specific norms, adolescents were less impaired than were children. However, overweight and obese adolescents (especially females) reported the lowest absolute HRQOL scores. HRQOL varied with the intensity of treatment. Inpatients had significantly lower scores than did outpatients, even after adjusting for age, gender and zBMI.
The results suggest the presence of differences in HRQOL with regard to gender, age, and treatment modality in treatment-seeking overweight and obese youths. Research and clinical practice must consider the particular impairments of inpatients as well as the impairments of (especially female) adolescents.
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Objective: The Sf-36 is the most widely used instrument to measure health-related quality of life (HRQoL) with the most convincing evidence of both internal consistency and test-retest reliability. ...In addition, it is appropriate for use among elderly and minority groups like migrants. The aim of this study is to investigate and compare the reliability and the factorial structure of the Sf-36 in a sample of elderly migrants and natives. The hypothesis is that the construct (the HRQoL consisting of eight dimensions correlated with two components) is the same for elderly Turkish migrants, Polish migrants and German natives. This means that the Sf-36 model shows good psychometric properties and model invariance for the three groups investigated in this study. Methods: The Sf-36 v.2 was forward and backward translated to Turkish and Polish. In this cross-sectional study, interviews were conducted with a sample of elderly migrants from Turkey (n = 100), from Poland (n = 103) and a sample of elderly German natives (n = 101). All data were entered and analysed using SPSS version 21 and AMOS Graphics. Cronbach's α was used to analyse the reliability of the Sf-36. Multi-group confirmatory factor analysis (MGCFA) and structural equation modelling (SEM) were used for the Sf-36 model invariance testing. Results: The reliability of the Sf-36 was good to excellent for all Sf-36 dimensions (α > 0.7) except for General Health (0.55) in the Polish group. Multi-group confirmatory factor analysis (MGCFA) showed non-invariance between the three groups (CMIN: 180.172, df: 51, CMIN/df: 3.533, p < 0.001, CFI: 0.895, RMSEA: 0.092 for the unconstrained model). Model modifications resulted in a good model fit for the Polish group. However, an applicable common Sf-36 model for the three groups was not attained. Conclusion: This study doesn't support the idea that the factorial structure of the Sf-36 with two components and eight dimensions is the same across three ethnically and culturally diverse groups of elderly subjects. Therefore, comparing subscale scores of the Sf-36 between different ethnic groups may be problematic.
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