@article{HelassHaagBankstahletal.2023, author = {Helaß, Madeleine and Haag, Georg Martin and Bankstahl, Ulli Simone and Gencer, Deniz and Maatouk, Imad}, title = {Burnout among German oncologists: a cross-sectional study in cooperation with the Arbeitsgemeinschaft Internistische Onkologie Quality of Life Working Group}, series = {Journal of Cancer Research and Clinical Oncology}, volume = {149}, journal = {Journal of Cancer Research and Clinical Oncology}, number = {2}, doi = {10.1007/s00432-022-03937-y}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-324446}, pages = {765-777}, year = {2023}, abstract = {Purpose Oncologists are at an increased risk of developing burnout, leading to negative consequences in patient care and in professional satisfaction and quality of life. This study was designed to investigate exhaustion and disengagement among German oncologists and assess the prevalence of burnout among oncologists within different professional settings. Furthermore, we wanted to examine possible relations between sociodemographic factors, the oncological setting, professional experience and different aspects of burnout. Methods In a cross-sectional study design, an Internet-based survey was conducted with 121 oncologists between April and July 2020 using the Oldenburg Burnout Inventory, which contains items on exhaustion, disengagement, and burnout. Furthermore, sociodemographic data of the participants were assessed. The participants were members of the Working Group Medical Oncology (Arbeitsgemeinschaft Internistische Onkologie) within the German Cancer Society. Results The survey showed a burnout prevalence of 43.8\%, which correlated with age and professional experience; that is, the prevalence is particularly high among younger oncologists. Exhaustion is closely related to employment status; that is, it was significantly higher among employed oncologists. There were remarkably low levels of disengagement among oncologists, highlighting the own demand to fulfil job requirements despite imminent or actual overburdening in daily work. Conclusion More support is necessary to mitigate the professional stressors in the healthcare system. To ensure quality medical care, employees should be offered preventive mental health services early in their careers.}, language = {en} } @article{ScheinerGrashoffKleindienstetal.2022, author = {Scheiner, Christin and Grashoff, Jan and Kleindienst, Nikolaus and Buerger, Arne}, title = {Mental disorders at the beginning of adolescence: Prevalence estimates in a sample aged 11-14 years}, series = {Public Health in Practice}, volume = {4}, journal = {Public Health in Practice}, doi = {10.1016/j.puhip.2022.100348}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-300404}, year = {2022}, abstract = {Objectives This study aims to provide a deeper insight into mental disorders in early adolescence. We report prevalence rates (mental health problems, depressive symptoms, eating disorders, NSSI, STBs) to be used in future studies and clinical ventures. We also expected to find gender differences, with girls being be more affected than boys are. Study design 877 adolescents (M = 12.43, SD = 0.65) from seven German high schools completed a series of questionnaires assessing their mental health (SDQ, PHQ-9, SEED, DSHI-9, Paykel Suicide Scale, FAS III). Methods We calculated cut-off-based prevalence estimates for mental health issues for the whole sample and compared estimates between genders. Results 12.5\% of the sample reported general mental health problems. The estimated prevalence of depressive symptoms lay at of 11.5\%. Additionally, 12.1\% and 1.3\% of the participants displayed relevant symptoms of anorexia or bulimia nervosa, respectively. A total of 10.8\% reported engaging in non-suicidal self-injury (NSSI) at least once in their lifetime, of whom 5.6\% reported repetitive NSSI. 30.1\% of the participants described suicidal thoughts, 9.9\% suicide plans, and 3.5\% at least one suicide attempt. Girls were generally more affected than boys, except for bulimia nervosa, suicidal behavior, and partly NSSI. Conclusion Our findings corroborate the established relevance of early adolescence for the development of mental health problems and suggest that a substantial proportion of young adolescents suffer from such problems early on. Considering the ongoing COVID-19 pandemic and reported negative mental health consequences, the current findings underline the importance of preventive interventions to avoid the manifestation of mental disorders during adolescence.}, language = {en} } @article{JuddHofBeladdaleetal.2022, author = {Judd, L. and Hof, L. and Beladdale, L. and Friederich, P. and Thoma, J. and Wittmann, M. and Zacharowski, K. and Meybohm, P. and Choorapoikayil, S.}, title = {Prevalence of pre-operative anaemia in surgical patients: a retrospective, observational, multicentre study in Germany}, series = {Anaesthesia}, volume = {77}, journal = {Anaesthesia}, number = {11}, doi = {10.1111/anae.15847}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-318199}, pages = {1209 -- 1218}, year = {2022}, abstract = {Anaemia is a risk factor for several adverse postoperative outcomes. Detailed data about the prevalence of anaemia are not available over a long time-period in Germany. In this retrospective, observational, multicentre study, patients undergoing surgery in March in 2007, 2012, 2015, 2017 and 2019 were studied. The primary objective was the prevalence of anaemia at hospital admission. The secondary objectives were the association between anaemia and the number of units of red blood cells transfused, length of hospital stay and in-hospital mortality. A total of 23,836 patients were included from eight centres. The prevalence of pre-operative anaemia in patients aged ≥ 18 years decreased slightly from 37\% in 2007 to 32.5\% in 2019 (p = 0.01) and increased in patients aged ≤ 18 years from 18.8\% in 2007 to 26.4\% in 2019 (p > 0.001). The total amount of blood administered per 1000 patients decreased from 671.2 units in 2007 to 289.0 units in 2019. Transfusion rates in anaemic patients declined from 33.8\% in 2007 to 19.1\% in 2019 (p < 0.001) and in non-anaemic patients from 8.4\% in 2007 to 3.4\% in 2019 (p < 0.001). Overall, the mortality rate remained constant over the years: 2.9\% in 2007, 2.1\% in 2012, 2.5\% in 2015, 1.9\% in 2017 and 2.5\% in 2019. In the presence of anaemia, mortality was significantly increased compared with patients without anaemia (OR 5.27 (95\%CI 4.13-6.77); p < 0.001). Red blood cell transfusion was associated with an increased risk of mortality (OR 14.98 (95\%CI 11.83-19.03); p < 0.001). Using multivariable linear regression analysis with fixed effects, we found that pre-operative anaemia (OR 2.08 (95\%CI 1.42-3.05); p < 0.001) and red blood cell transfusion (OR 4.29 (95\%CI 3.09-5.94); p < 0.001) were predictors of mortality but not length of stay (0.99 (95\%CI 0.98-1.00) days; p = 0.12) and analysed years (2007 vs. 2019: OR 1.49 (95\%CI 0.86-2.69); p = 0.07). Pre-operative anaemia affects more than 30\% of surgical patients in Germany and multidisciplinary action is urgently required to reduce adverse outcomes.}, language = {en} } @article{WillekeJansonZinketal.2021, author = {Willeke, Kristina and Janson, Patrick and Zink, Katharina and Stupp, Carolin and Kittel-Schneider, Sarah and Bergh{\"o}fer, Anne and Ewert, Thomas and King, Ryan and Heuschmann, Peter U. and Zapf, Andreas and Wildner, Manfred and Keil, Thomas}, title = {Occurrence of mental illness and mental health risks among the self-employed: a systematic review}, series = {International Journal of Environmental Research and Public Health}, volume = {18}, journal = {International Journal of Environmental Research and Public Health}, number = {16}, issn = {1660-4601}, doi = {10.3390/ijerph18168617}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-245085}, year = {2021}, abstract = {We aimed to systematically identify and evaluate all studies of good quality that compared the occurrence of mental disorders in the self-employed versus employees. Adhering to the Cochrane guidelines, we conducted a systematic review and searched three major medical databases (MEDLINE, Web of Science, Embase), complemented by hand search. We included 26 (three longitudinal and 23 cross-sectional) population-based studies of good quality (using a validated quality assessment tool), with data from 3,128,877 participants in total. The longest of these studies, a Swedish national register evaluation with 25 years follow-up, showed a higher incidence of mental illness among the self-employed compared to white-collar workers, but a lower incidence compared to blue-collar workers. In the second longitudinal study from Sweden the self-employed had a lower incidence of mental illness compared to both blue- and white-collar workers over 15 years, whereas the third longitudinal study (South Korea) did not find a difference regarding the incidence of depressive symptoms over 6 years. Results from the cross-sectional studies showed associations between self-employment and poor general mental health and stress, but were inconsistent regarding other mental outcomes. Most studies from South Korea found a higher prevalence of mental disorders among the self-employed compared to employees, whereas the results of cross-sectional studies from outside Asia were less consistent. In conclusion, we found evidence from population-based studies for a link between self-employment and increased risk of mental illness. Further longitudinal studies are needed examining the potential risk for the development of mental disorders in specific subtypes of the self-employed.}, language = {en} } @article{FrickeAvilaKelleretal.2020, author = {Fricke, Julia and {\´A}vila, Gabriela and Keller, Theresa and Weller, Karsten and Lau, Susanne and Maurer, Marcus and Zuberbier, Torsten and Keil, Thomas}, title = {Prevalence of chronic urticaria in children and adults across the globe: Systematic review with meta-analysis}, series = {Allergy}, volume = {75}, journal = {Allergy}, number = {2}, doi = {10.1111/all.14037}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-213700}, pages = {423 -- 432}, year = {2020}, abstract = {Background and objectives: Urticaria is a frequent skin condition, but reliable prevalence estimates from population studies particularly of the chronic form are scarce. The objective of this study was to systematically evaluate and summarize the prevalence of chronic urticaria by evaluating population-based studies worldwide. Methods: We performed a systematic search in PUBMED and EMBASE for population-based studies of cross-sectional or cohort design and studies based on health insurance/system databases. Risk of bias was assessed using a specific tool for prevalence studies. For meta-analysis, we used a random effects model. Results: Eighteen studies were included in the systematic evaluation and 11 in the meta-analysis including data from over 86 000 000 participants. Risk of bias was mainly moderate, whereas the statistical heterogeneity (I\(^{2}\)) between the studies was high. Asian studies combined showed a higher point prevalence of chronic urticaria (1.4\%, 95\%-CI 0.5-2.9) than those from Europe (0.5\%, 0.2-1.0) and Northern American (0.1\%, 0.1-0.1). Women were slightly more affected than men, whereas in children < 15 years we did not find a sex-specific difference in the prevalence. The four studies that examined time trends indicated an increasing prevalence of chronic urticaria over time. Conclusions: On a global level, the prevalence of chronic urticaria showed considerable regional differences. There is a need to obtain more sex-specific population-based and standardized international data particularly for children and adolescents, different chronic urticaria subtypes and potential risk and protective factors.}, language = {en} } @article{HessMengSchulteetal.2020, author = {Heß, Verena and Meng, Karin and Schulte, Thomas and Neuderth, Silke and Bengel, J{\"u}rgen and Faller, Hermann and Schuler, Michael}, title = {Prevalence and predictors of cancer patients' unexpressed needs in the admission interview of inpatient rehabilitation}, series = {Psycho-Oncology}, volume = {29}, journal = {Psycho-Oncology}, number = {10}, doi = {10.1002/pon.5450}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-228369}, pages = {1549 -- 1556}, year = {2020}, abstract = {Objective The admission interview in oncological inpatient rehabilitation might be a good opportunity to identify cancer patients' needs present after acute treatment. However, a relevant number of patients may not express their needs. In this study, we examined (a) the proportion of cancer patients with unexpressed needs, (b) topics of unexpressed needs and reasons for not expressing needs, (c) correlations of not expressing needs with several patient characteristics, and (d) predictors of not expressing needs. Methods We enrolled 449 patients with breast, prostate, and colon cancer at beginning and end of inpatient rehabilitation. We obtained self-reports about unexpressed needs and health-related variables (quality of life, depression, anxiety, adjustment disorder, and health literacy). We estimated frequencies and conducted correlation and ordinal logistic regression analyses. Results A quarter of patients stated they had "rather not" or "not at all" expressed all relevant needs. Patients mostly omitted fear of cancer recurrence. Most frequent reasons for not expressing needs were being focused on physical consequences of cancer, concerns emerging only later, and not knowing about the possibility of talking about distress. Not expressing needs was associated with several health-related outcomes, for example, emotional functioning, adjustment disorder, fear of progression, and health literacy. Depression measured at the beginning of rehabilitation showed only small correlations and is therefore not sufficient to identify patients with unexpressed needs. Conclusions A relevant proportion of cancer patients reported unexpressed needs in the admission interview. This was associated with decreased mental health. Therefore, it seems necessary to support patients in expressing needs.}, language = {en} } @article{GrabenhenrichTrendelenburgBellachetal.2020, author = {Grabenhenrich, Linus and Trendelenburg, Val{\´e}rie and Bellach, Johanna and Y{\"u}rek, Song{\"u}l and Reich, Andreas and Fiandor, Ana and Rivero, Daniela and Sigurdardottir, Sigurveig and Clausen, Michael and Papadopoulos, Nikolaos G. and Xepapadaki, Paraskevi and Sprikkelman, Aline B. and Dontje, Bianca and Roberts, Graham and Grimshaw, Kate and Kowalski, Marek L. and Kurowski, Marcin and Dubakiene, Ruta and Rudzeviciene, Odilija and Fern{\´a}ndez-Rivas, Montserrat and Couch, Philip and Versteeg, Serge A. and van Ree, Ronald and Mills, Clare and Keil, Thomas and Beyer, Kirsten}, title = {Frequency of food allergy in school-aged children in eight European countries—The EuroPrevall-iFAAM birth cohort}, series = {Allergy}, volume = {75}, journal = {Allergy}, number = {9}, doi = {10.1111/all.14290}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-214746}, pages = {2294 -- 2308}, year = {2020}, abstract = {Background The prevalence of food allergy (FA) among European school children is poorly defined. Estimates have commonly been based on parent-reported symptoms. We aimed to estimate the frequency of FA and sensitization against food allergens in primary school children in eight European countries. Methods A follow-up assessment at age 6-10 years of a multicentre European birth cohort based was undertaken using an online parental questionnaire, clinical visits including structured interviews and skin prick tests (SPT). Children with suspected FA were scheduled for double-blind, placebo-controlled oral food challenges (DBPCFC). Results A total of 6105 children participated in this school-age follow-up (57.8\% of 10 563 recruited at birth). For 982 of 6069 children (16.2\%), parents reported adverse reactions after food consumption in the online questionnaire. Of 2288 children with parental face-to-face interviews and/or skin prick testing, 238 (10.4\%) were eligible for a DBPCFC. Sixty-three foods were challenge-tested in 46 children. Twenty food challenges were positive in 17 children, including seven to hazelnut and three to peanut. Another seventy-one children were estimated to suffer FA among those who were eligible but refused DBPCFC. This yielded prevalence estimates for FA in school age between 1.4\% (88 related to all 6105 participants of this follow-up) and 3.8\% (88 related to 2289 with completed eligibility assessment). Interpretation In primary school children in eight European countries, the prevalence of FA was lower than expected even though parents of this cohort have become especially aware of allergic reactions to food. There was moderate variation between centres hampering valid regional comparisons.}, language = {en} } @article{MahyeraSchneiderHalligerKelleretal.2018, author = {Mahyera, Alexis S. and Schneider, Tamara and Halliger-Keller, Birgit and Schrooten, Katja and H{\"o}rner, Eva-Maria and Rost, Simone and Kress, Wolfram}, title = {Distribution and Structure of DM2 Repeat Tract Alleles in the German Population}, series = {Frontiers in Neurology}, volume = {9}, journal = {Frontiers in Neurology}, number = {463}, issn = {1664-2295}, doi = {10.3389/fneur.2018.00463}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-196252}, year = {2018}, abstract = {Autosomal dominant inherited Myotonic dystrophy type 1 and 2 (DM1 and DM2) are the most frequent muscle dystrophies in the European population and are caused by repeat expansion mutations. For Germany cumulative empiric evidence suggests an estimated prevalence of DM2 of roughly 9 in 100,000, therefore being as prevalent as DM1. In DM2, a (CCTG)n repeat tract located in the first intron of the CNBP gene is expanded. The CCTG repeat tract is part of a complex repeat structure comprising not only CCTG tetraplets but also repeated TG dinucleotides and TCTG tetraplet elements as well as NCTG interruptions. Here, we provide the distribution of normal sized alleles in the German population, which was found to be highly similar to the Slovak population. Sequencing of 34 unexpanded healthy range alleles in DM2 positive patients (heterozygous for a full expansion) revealed that the CCTG repeat tract is usually interrupted by at least three tetraplets which according to current opinion is supposed to render it stable against expansion. Interestingly, only the largest analyzed normal allele had 23 uninterrupted CCTGs and consequently could represent an instable early premutation allele. In our diagnostic history of DM2 cases, a total of 18 premutations were detected in 16 independent cases. Here, we describe two premutation families, one with an expansion from a premutation allele and the other with a contraction of a full expansion down to a premutation allele. Our diagnostic results support the general assumption that the premutation range of unstable CCTG stretches lies obviously between 25 and 75 CCTGs. However, the clinical significance of premutation alleles is still unclear. In the light of the two described families we suggest incomplete penetrance. Thus, as it was proposed for other repeat expansion diseases (e.g., Huntington's disease), a fluid transition of penetrance is more likely rather than a clear cut CCTG number threshold.}, language = {en} } @article{TiffeWagnerRueckeretal.2017, author = {Tiffe, Theresa and Wagner, Martin and R{\"u}cker, Viktoria and Morbach, Caroline and Gelbrich, G{\"o}tz and St{\"o}rk, Stefan and Heuschmann, Peter U.}, title = {Control of cardiovascular risk factors and its determinants in the general population - findings from the STAAB cohort study}, series = {BMC Cardiovascular Disorders}, volume = {17}, journal = {BMC Cardiovascular Disorders}, number = {276}, doi = {10.1186/s12872-017-0708-x}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-159391}, year = {2017}, abstract = {Background: While data from primary care suggest an insufficient control of vascular risk factors, little is known about vascular risk factor control in the general population. We therefore aimed to investigate the adoption of adequate risk factor control and its determinants in the general population free of cardiovascular disease (CVD). Methods: Data from the Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression (STAAB) Cohort Study, a population-based study of inhabitants aged 30 to 79 years from the general population of W{\"u}rzburg (Germany), were used. Proportions of participants without established CVD meeting targets for risk factor control recommended by 2016 ESC guideline were identified. Determinants of the accumulation of insufficiently controlled vascular risk factors (three or more) were assessed. Results: Between December 2013 and April 2015, 1379 participants without CVD were included; mean age was 53.1 ± 11.9 years and 52.9\% were female; 30.8\% were physically inactive, 55.2\% overweight, 19.3\% current smokers. Hypertension, dyslipidemia, and diabetes mellitus were prevalent in 31.8\%, 57.6\%, and 3.9\%, respectively. Treatment goals were not reached despite medication in 52.7\% of hypertensive, in 37.3\% of hyperlipidemic and in 44.0\% of diabetic subjects. Insufficiently controlled risk was associated with male sex (OR 1.94, 95\%CI 1.44-2.61), higher age (OR for 30-39 years vs. 70-79 years 4.01, 95\%CI 1.94-8.31) and lower level of education (OR for primary vs. tertiary 2.15, 95\%CI 1.48-3.11). Conclusions: In the general population, prevalence of vascular risk factors was high. We found insufficient identification and control of vascular risk factors and a considerable potential to improve adherence to cardiovascular guidelines for primary prevention. Further studies are needed to identify and overcome patient- and physician-related barriers impeding successful control of vascular risk factors in the general population.}, language = {en} } @article{ZhaoYuHuetal.2015, author = {Zhao, De-Wei and Yu, Mang and Hu, Kai and Wang, Wei and Yang, Lei and Wang, Ben-Jie and Gao, Xiao-Hong and Guo, Yong-Ming and Xu, Yong-Qing and Wei, Yu-Shan and Tian, Si-Miao and Yang, Fan and Wang, Nan and Huang, Shi-Bo and Xie, Hui and Wei, Xiao-Wei and Jiang, Hai-Shen and Zang, Yu-Qiang and Ai, Jun and Chen, Yuan-Liang and Lei, Guang-Hua and Li, Yu-Jin and Tian, Geng and Li, Zong-Sheng and Cao, Yong and Ma, Li}, title = {Prevalence of Nontraumatic Osteonecrosis of the Femoral Head and its Associated Risk Factors in the Chinese Population: Results from a Nationally Representative Survey}, series = {Chinese Medical Journal}, volume = {128}, journal = {Chinese Medical Journal}, number = {21}, doi = {10.4103/0366-6999.168017}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-138482}, pages = {2843-2850}, year = {2015}, abstract = {Background: Nontraumatic osteonecrosis of the femoral head (NONFH) is a debilitating disease that represents a significant financial burden for both individuals and healthcare systems. Despite its significance, however, its prevalence in the Chinese general population remains unknown. This study aimed to investigate the prevalence of NONFH and its associated risk factors in the Chinese population. Methods: A nationally representative survey of 30,030 respondents was undertaken from June 2012 to August 2013. All participants underwent a questionnaire investigation, physical examination of hip, and bilateral hip joint X-ray and/or magnetic resonance imaging examination. Blood samples were taken after overnight fasting to test serum total cholesterol, triglyceride, and high-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels. We then used multivariate logistic regression analysis to investigate the associations between various metabolic, demographic, and lifestyle-related variables and NONFH. Results: NONFH was diagnosed in 218 subjects (0.725\%) and the estimated NONFH cases were 8.12 million among Chinese people aged 15 years and over. The prevalence of NONFH was significantly higher in males than in females (1.02\% vs. 0.51\%, \(\chi^2\) = 24.997, P < 0.001). Among NONFH patients, North residents were subjected to higher prevalence of NONFH than that of South residents (0.85\% vs. 0.61\%, \(\chi^2\) = 5.847, P = 0.016). Our multivariate regression analysis showed that high blood levels of triglycerides, total cholesterol, LDL-cholesterol, and non-HDL-cholesterol, male, urban residence, family history of osteonecrosis of the femoral head, heavy smoking, alcohol abuse and glucocorticoid intake, overweight, and obesity were all significantly associated with an increased risk of NONFH. Conclusions: Our findings highlight that NONFH is a significant public health challenge in China and underscore the need for policy measures on the national level. Furthermore, NONFH shares a number of risk factors with atherosclerosis.}, language = {en} }