Direct Measurement of Resonances in

We have performed the first direct measurement of two resonances of the ^{7}Be(α,γ)^{11}C reaction with unknown strengths using an intense radioactive ^{7}Be beam and the DRAGON recoil separator. We report on the first measurement of the 1155 and 1110 keV resonance strengths of 1.73±0.25(stat)±0.40(syst) eV and 125_{-25}^{+27}(stat)±15(syst) meV, respectively. The present results have reduced the uncertainty in the ^{7}Be(α,γ)^{11}C reaction rate to ∼9.4%-10.7% over T=1.5-3 GK, which is relevant for nucleosynthesis in the neutrino-driven outflows of core-collapse supernovae (νp process). We find no effect of the new, constrained reaction rate on νp-process nucleosynthesis.

Area-level and individual correlates of active transportation among adults in Germany: A population-based multilevel study.

This study aimed at estimating the prevalence in adults of complying with the aerobic physical activity (PA) recommendation through transportation-related walking and cycling. Furthermore, potential determinants of transportation-related PA recommendation compliance were investigated. 10,872 men and 13,144 women aged 18 years or older participated in the cross-sectional 'German Health Update 2014/15 - EHIS' in Germany. Transportation-related walking and cycling were assessed using the European Health Interview Survey-Physical Activity Questionnaire. Three outcome indicators were constructed: walking, cycling, and total active transportation (≥600 metabolic equivalent, MET-min/week). Associations were analyzed using multilevel regression analysis. Forty-two percent of men and 39% of women achieved ≥600 MET-min/week with total active transportation. The corresponding percentages for walking were 27% and 28% and for cycling 17% and 13%, respectively. Higher population density, older age, lower income, higher work-related and leisure-time PA, not being obese, and better self-perceived health were positively associated with transportation-related walking and cycling and total active transportation among both men and women. The promotion of walking and cycling among inactive people has great potential to increase PA in the general adult population and to comply with PA recommendations. Several correlates of active transportation were identified which should be considered when planning public health policies and interventions.

Prognostic factors in stereotactic body radiotherapy of lung metastases.

PURPOSE: The aim of this study was to evaluate prognostic factors in patients with lung metastases who undergo lung stereotactic body radiotherapy (SBRT). MATERIALS AND METHODS: A total of 87 patients with 129 lung metastases who underwent SBRT between November 2004 and May 2012 were enrolled in this retrospective study. The patient collective consisted of 54 men (62.1%) and 33 women (37.9%); the median age was 65 years (range 36-88). The Karnofsky performance index was ≥70% (median 90%) for all cases, but one (60%). Adverse effects were categorized using the CTCAE 4.0 classification system. Retrospective analyses regarding patients' characteristics, progression-free survival (PFS), overall survival (OS), disease-specific survival (DSS), and local tumor control rates (LTC) were performed. RESULTS: On univariate and multivariate analysis OS, DSS, and PFS were significantly (p < 0.05) better for patients with ≤3 lung metastases; no extrathoracic metastases at the time of the SBRT; a gross tumor volume (GTV) <7.7 cm3 and patients that received a staging that included positron emission tomography with fluorine 18 fluorodeoxyglucose/computed tomography (FDG-PET/CT) imaging. Furthermore, a longer OS was observed if newly diagnosed metastases during follow-up were limited to the lung (median survival: 43.7 months versus 21.7 months; p = 0.023). CONCLUSION: The number and pattern of metastases, and the size of the target volume are strong predictors for the outcome of patients receiving SBRT of lung tumors. FDG-PET/CT should be part of pretherapeutic staging before SBRT.

Has aerobic exercise effect on pain perception in persons with migraine and coexisting tension-type headache and neck pain? A randomized, controlled, clinical trial.

BACKGROUND: A large subset of persons with migraine suffers from coexisting tension-type headache and neck pain which may adversely affect the prognosis of migraine. Aerobic exercise has been shown to decrease migraine burden in these persons. Therefore, the aim of this study was to investigate whether the effect of aerobic exercise in persons with migraine and coexisting tension-type headache and neck pain can be explained by changes in pain perception. METHOD: Seventy consecutively recruited persons with migraine and coexisting tension-type headache and neck pain were randomized into exercise group or control group. Aerobic exercise consisted of bike/cross-trainer/brisk walking for 45 min, three times/week for 3 months. Controls continued their usual daily activities. Pericranial tenderness, pain thresholds, supra-thresholds and temporal summation were assessed at baseline, after treatment and at follow-up (6 months from baseline). RESULTS: Fifty-two persons with migraine and coexisting tension-type headache and neck pain completed the study. Aerobic exercise did not induce consistent changes in nociceptive pathways measured by pericranial tenderness, pressure pain thresholds and sensitivity to electrical stimulation. CONCLUSION: The effect of aerobic exercise cannot be explained by measurable effects on the pain modulation system. Thus, the positive effect on migraine burden may rather be explained by positive alteration of avoidance behaviour. Aerobic exercise can be recommended as a safe and inexpensive migraine treatment strategy. SIGNIFICANCE: This study adds further knowledge about the positive effect of aerobic exercise for persons with migraine and coexisting tension-type headache and neck pain. This effect cannot be measured by changes in pain modulation, but may rather be explained by positive alteration of avoidance behaviour.

Design of nanostructured hybrid materials: twin polymerization of urethane-based twin prepolymers.

Organic-inorganic hybrid materials with urethane functionalities were obtained by simultaneous twin polymerization of twin prepolymers in combination with the ideal twin monomer 2,2'-spirobi[4H-1,3,2-benzodioxasiline]. The twin prepolymers consist of a urethane-based prepolymer with reactive terminal groups which can react during the twin polymerization process. Nanostructured hybrid materials with integrated dialkylsiloxane crosslinked urethane structures, phenolic resin and SiO2 are obtained in a one pot process. The effects of the polymerization temperature as well as those of various catalysts and reagent ratios on the polymerization behavior were investigated. The molecular structures of the obtained materials were determined by 13C- and 29Si-{1H}-CP-MAS NMR spectroscopies. HAADF-STEM-measurements were performed to prove the distribution of silicon in the hybrid material.

International consensus on the most useful physical examination tests used by physiotherapists for patients with headache: A Delphi study.

BACKGROUND: A wide range of physical tests have been published for use in the assessment of musculoskeletal dysfunction in patients with headache. Which tests are used depends on a physiotherapist's clinical and scientific background as there is little guidance on the most clinically useful tests. OBJECTIVES: To identify which physical examination tests international experts in physiotherapy consider the most clinically useful for the assessment of patients with headache. DESIGN/METHODS: Delphi survey with pre-specified procedures based on a systematic search of the literature for physical examination tests proposed for the assessment of musculoskeletal dysfunction in patients with headache. RESULTS: Seventeen experts completed all three rounds of the survey. Fifteen tests were included in round one with eleven additional tests suggested by the experts. Finally eleven physical examination tests were considered clinically useful: manual joint palpation, the cranio-cervical flexion test, the cervical flexion-rotation test, active range of cervical movement, head forward position, trigger point palpation, muscle tests of the shoulder girdle, passive physiological intervertebral movements, reproduction and resolution of headache symptoms, screening of the thoracic spine, and combined movement tests. CONCLUSIONS: Eleven tests are suggested as a minimum standard for the physical examination of musculoskeletal dysfunctions in patients with headache.

Immediate and extended effects of abrasion on stratum corneum natural moisturizing factor.

BACKGROUND: Natural moisturizing factor (NMF), principally comprised of hygroscopic amino acids and derivatives that absorb moisture from the surrounding environment, serves as the primary humectant of the stratum corneum (SC). Acute barrier disruption has been shown to differentially affect the concentration of NMF in the SC. This study measured the recovery kinetics of NMF after mechanical damage of the SC, which is not well understood. METHODS: The study population included 20 healthy female volunteers (18-72-year old) with no history of dermatological disorders. Transepidermal water loss (TEWL), erythema, and SC water and NMF were measured at all sites before abrasion, 30 min following abrasion, and 1-3, 6, 8, and 10 days following abrasion. Measurements obtained from the abraded site were compared with those obtained from an untreated site. RESULTS: As expected, both TEWL and erythema increased significantly with abrasion. Erythema and TEWL values remained higher at the abraded site for 2 and 6 days, respectively, after abrasion. No changes in NMF component levels in the SC were observed at 30 min after abrasion. One day following abrasion, reduced levels of glycine, histidine pH4, trans-urocanic acid (tUca) pH4, and tUca pH8 were observed. In addition, a significantly lower level of serine was observed at the abraded site 2 and 6 days following abrasion. Within 8 days after abrasion, these components returned to levels comparable to those observed in untreated skin. Throughout the study, no differences were observed in the level of water in the SC. CONCLUSION: These results demonstrate that acute barrier disruption induced by mechanical abrasion has relatively little impact on biochemical events responsible for NMF generation. Though reductions in certain NMF components were observed, abrasion had no measureable effect on SC water content over the duration of the study. This implies that the reduced NMF components may not contribute substantially to water retention in the SC. The reduced components belong to a group of NMF molecules thought to be principally derived through degradation of S-100 proteins in the epidermis. NMF components measured in this study that are derived from sweat and/or urea cycling were not impacted. These data imply that while abrasion elicits clinical signs of barrier disruption within the SC, effects on its biochemical constituents and ability to retain water are relatively minor.

Effects of tail docking on behavior of confined feedlot cattle.

Tail tip injuries occur in some feedlot cattle housed in slatted-floor facilities typically found in the midwestern United States. The practice of tail docking cattle on entry into these feedlot facilities was initiated to prevent tail injuries. Tail docking is a welfare concern from the standpoint that an important method of fly avoidance is removed and the tail docking procedure is painful and often excludes local anesthesia or extended analgesia. The primary objective of this study was to describe the behavioral responses of feedlot cattle following tail docking. Thirty-six heifers were randomly assigned to 1 of 2 treatment groups: docked (DK) or control (CN). All calves received an epidural following surgical preparation of the sacrococcygeal area and postoperative intravenous flunixin meglumine. A portion of the tail of DK calves was removed using pruning shears. An elastrator band was placed near the tail tip for hemostasis and tail tips were sprayed with fly spray. IceQube accelerometers collected step counts, motion index, lying time, lying bouts, and lying bout duration during d -4 through 13. Direct observations of cattle behavior were performed on d 0, 1, and 2. Step counts of DK calves were increased (P < 0.05) on d 0, 2, 3, 4, 6, 9, 10, and 13, and motion index of DK calves was also increased (P < 0.05) on d 0, 3, 4, 9, 10, 11, and 13. Docked cattle performed rear foot stomp behavior more (P < 0.001) than CN on d 0, 1, and 2. Forty-eight hours after tail docking, DK calves had increased lying bouts per hour (1.7 vs. 0.9 on d 0; P < 0.001; 1.1 vs. 0.8 on d 1; P < 0.01) but reduced lying bout durations (12.6 vs. 47.1 min on d 0; P < 0.001; 22.6 vs. 44.7 min on d 1; P < 0.001). On d 0, DK calves twitched tails more (P < 0.05) and ruminated less (P < 0.001). Despite provision of perioperative and postoperative analgesia, we identified altered behavior in DK cattle that may reflect a compromised welfare state for tail-docked feedlot cattle. We recommend that alternative strategies to reduce tail tip injury be explored.

Effects of tail docking on health and performance of beef cattle in confined, slatted-floor feedlots.

Tail docking of feedlot cattle is a management practice used in some confined, slatted-floor feedlots of the midwestern United States. Justification for tail docking in these management systems is to reduce tail injuries and their sequelae and improve performance, but limited evidence exists to support these claims. The primary objective of this study was to determine the effect of tail docking on performance, carcass traits, and health parameters after tail docking in feedlot cattle raised in slatted-floor feedlots. Three separate trials were performed. Trial 1 consisted of 140 Angus-cross (370-kg) yearling steers that spent 144 to 160 days on feed (DOF). Trial 2 consisted of 137 Angus-cross (255-kg) weaned steers that spent 232 DOF. Trial 3 consisted of 102 Holstein steers (370 kg) that spent 185 to 232 DOF. Cattle were randomly assigned to 1 of 2 treatment groups: docked (DK) or control (CN). All steers received an epidural following surgical preparation of the sacrococcygeal area and postoperative intravenous flunixin meglumine. Approximately two-thirds of the tail of DK calves was removed and an elastrator band was placed near the tail tip for hemostasis. Performance parameters collected included daily gain, final weight, feed intake, and feed efficiency. Carcass data included HCW, subcutaneous fat thickness, LM area, KPH percent, marbling, USDA yield grade, and USDA quality grade. Morbidity, mortality, incidence of lameness, and incidence of tail lesions were recorded. Across all 3 trials, there was no significant effect (P < 0.05) of treatment on performance parameters, carcass traits, or health parameters. In all 3 trials, tail tip injuries occurred in 60 to 76% of undocked (CN) calves, developed while living in the slatted-floor environment, compared to 100% of DK calves, whose injuries were a result of the tail docking procedure. We were unable to identify a performance or significant health advantage to tail docking. However, tail tip injuries still occur in cattle raised in slatted-floor facilities. Because of the animal welfare issues associated with tail docking and tail injuries, we recommend pursuing alternative solutions to reducing the incidence of tail tip injury in feedlot cattle housed in confined slatted-floor facilities.

[Measurement of socioeconomic status in the KiGGS study: first follow-up (KiGGS Wave 1)]. / Messung des sozioökonomischen Status in der KiGGS-Studie : Erste Folgebefragung (KiGGS Welle 1).

This article describes the measurement of socioeconomic status in the first follow-up of the KiGGS study (KiGGS Wave 1) conducted from 2009 to 2012. A multidimensional index score was used. The score is the sum of three metric components: Education and Occupational Qualification, Occupational Status, and Net Income. Compared with the approach in the KiGGS baseline study, some modifications were made in accordance with changes in the other components of the health-monitoring program at the Robert Koch Institute, i.e., the German Health Update (GEDA) and the German Health Interview and Examination Survey for Adults (DEGS1). These changes facilitate the analysis of temporal developments and trends, ensure international comparability of the data, and support the transfer of the results into politics and practice. In order to demonstrate the application of the revised instrument, we report on exemplary results of KiGGS Wave 1 regarding the relationship between socioeconomic status and the general health status of children and adolescents aged 3-17 years.

[Health-related quality of life of overweight and obese adolescents: what differences can be seen by socio-economic status and education?]. / Gesundheitsbezogene Lebensqualität von übergewichtigen und adipösen Jugendlichen : Welche Unterschiede zeigen sich nach Sozialstatus und Schulbildung?

In the present study the relation between overweight/obesity and health-related quality of life (HRQoL) in adolescence is analysed. Of special interest is the question, to what extent this relation varies by socio-economic status (SES) and education. Data base is a subsample of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS, n = 6,813, 11-17 years). For the assessment of overweight and obesity, body mass index (BMI) was calculated based on standardised body height and weight measurements. The HRQoL was collected using the KINDL-R-questionnaire, which allows statements concerning a total rating as well as 6 dimensions: physical well-being, emotional well-being, self-worth, family well-being, well-being in relation to friends/peers and school well-being. SES and education are analysed as moderating factors. The results show that obese boys as well as overweight and obese girls have a diminished HRQoL compared to normal weight peers. The analyses according to SES and education suggest that in girls this finding applies for all considered subgroups. Thus, in girls neither SES nor education has a moderating impact on the relation between overweight/obesity and HRQoL. In boys, only SES has a moderating impact on the relation between overweight and HRQoL in favour of the low status group. In terms of the relation between obesity and HRQoL, in boys also only SES has a moderating impact on the analysed relation, but here in favour of the high status group. Altogether, the results show that overweight and especially obese adolescents are affected in their HRQoL, this being almost independent of SES and education. Interventions to improve the HRQoL of overweight and obese adolescents should be independent of SES and education.

Immediate and extended effects of sodium lauryl sulphate exposure on stratum corneum natural moisturizing factor.

OBJECTIVES: Natural moisturizing factor (NMF) serves as the primary humectant of the stratum corneum (SC), principally comprised of hygroscopic amino acids and derivatives that absorb moisture. Barrier disruption has been shown to differentially affect the levels of specific NMF components, though the kinetics of NMF component restoration following disruption have not been examined. Here, we investigated the impact of barrier disruption caused by surfactant exposure on a subset of NMF components immediately following exposure and out to 10 days post-exposure. METHODS: Volunteers wore patches containing either 1% w/v sodium lauryl sulphate (SLS) or distilled water on their forearms for 24 h. Measurements of transepidermal water loss, erythema, SC water content and a subset of SC NMF and lipid components were obtained at both sites before treatment, the day of patch removal, and 1, 2, 3, 6, and 10 days following treatment. RESULTS: Most measured NMF components decreased in response to SLS exposure. Exceptions were increases in lactate, ornithine and urea, and no difference in proline levels. In the days following exposure, reduced levels of several NMF components continued at the SLS site; however, all measured NMF components demonstrated equivalence to the vehicle control within 10 days. Histidine pH 7, lactate, ornithine and urea were the first to achieve levels equivalent to the vehicle control site, normalizing within 1 day after patch removal. CONCLUSION: Results imply that NMF components derived from sweat and urea cycling are least impacted by SLS exposure whereas NMF components derived from degradation of filaggrin and/or other S-100 proteins are most impacted. This implies the restoration of the processes responsible for S-100 protein processing into free amino acids takes several days to return to normal. Further examination of the enzymes involved in S-100 protein processing following barrier disruption would provide insight into the pathway(s) for NMF restoration during SC recovery.

[Measurement of socioeconomic status in the German Health Interview and Examination Survey for Adults (DEGS1)]. / Messung des sozioökonomischen Status in der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1).

Socioeconomic status (SES) constitutes a central analysis category of epidemiological research and health reporting. As part of the German cardiovascular disease prevention study 1984-1991, a multi-dimensional aggregated index was developed for the purpose of measuring SES. This index continues to be used in numerous studies to this day. For the purpose of health monitoring at the Robert Koch Institute (RKI), the index was fundamentally revised following critical assessment. This article describes the basic concepts underlying the revision and how they were implemented in relation to the "German health interview and examination survey for adults" (DEGS1). In addition, the results of the age and sex-specific distribution of the values of the revised SES index and those relating to the connection with other measurements of socioeconomic status are reported. The results are based on the data of DEGS1 2012 and the German national health interview and examination survey 1998 (GNHIES98). An English full-text version of this article is available at SpringerLink as supplemental.

[Socioeconomic status and health: results of the German Health Interview and Examination Survey for Adults (DEGS1)]. / Sozioökonomischer Status und Gesundheit : Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1).

The analysis focuses on the connection between socioeconomic status (SES) and five health outcomes in the 18 to 79-year-old population of Germany. It uses data from the "German Health Interview and Examination Survey for Adults" (DEGS1) which the Robert Koch Institute conducted in the period from 2008 to 2011 (n=8152). Socioeconomic status is recorded via a multidimensional index which includes information on education attainment, occupational status and household income. The results show that persons with a low socioeconomic status have a self-rated health status which is worse than that of persons with a medium or high socioeconomic status, and that they have diabetes more frequently. They also have a higher risk of depressive symptoms, obesity and physical inactivity. The results illustrate that health chances and the risk of illness are still very socially uneven distributed, thus emphasising the significance of political interventions to reduce health inequalities. An English full-text version of this article is available at SpringerLink as supplemental.

[Health Inequality among employed men and women - results of the German health update (GEDA) 2010]. / Gesundheitliche Ungleichheit bei erwerbstätigen Männern und Frauen - Ergebnisse der GEDA-Studie 2010.

BACKGROUND: The study is based on representative data and gives an overview on the extent of health inequalities in working men and women in Germany. METHODS: We use data of the study German Health Update (GEDA) 2010 to analyze health differences by occupational status for men and women. Occupational Status was measured using the "International Socio-, Economic Index of Occupational Status' (ISEI). Outcomes are self-rated health status, work/and commuting accidents, self-assessed health risks at work, days with physical or emotional problems and sick leave from work. RESULTS: Men and women with high occupational status are in a better health situation than those with low status in respect to all outcomes analyzed. The risk for a poor self-rated health status, high health risks at work and for the occurrence of accidents at work is significantly 2.4- to 4.6-fold (men) and 1.8- to 3.3-fold (women) increased after controlling for age and work hours. Further Analyses with regard to self-assessed health risks at work showed that occupational status differences with men and women do not differ significantly. In those analyses, about 50% of the status differences regarding risks at work could be explained for men and women by their qualification, working conditions and health behavior. CONCLUSION: The present findings show that significant and persistent health inequalities among the employed exist in Germany. The relationship proved equally strong in both men and women.

[Self-rated general health by occupation and age in the working population in Germany]. / Selbstberichteter allgemeiner Gesundheitszustand nach Beruf und Alter in der Erwerbsbevölkerung.

In occupations, self-rated general health status was examined under special consideration of age. Data from the GEDA 2009 and 2010 surveys (N = 26,303) were analyzed. Professionals had a low prevalence of poor health, whereas unskilled service workers and-among males-unskilled manual workers had a high prevalence. In older workers the prevalence of poor general health was greater than among younger workers. However, the difference in health between young and old was significantly smaller than the general pattern among male managers and women in skilled commercial and administrative occupations. Among male skilled workers and female unskilled manual workers, the difference in health between young and old was greater. The-with increasing age-growing health gap between occupational groups should receive more attention. In order to understand the relationship between work, age and health, targeted longitudinal sectional studies are needed. It might be misleading to adjust associations between work and health by age, because age might moderate this relationship.

[Age, job groups, and psychological well-being]. / Alter, Berufsgruppen und psychisches Wohlbefinden.

This study examines whether psychological well-being in different job groups is affected by gender and age. Data from the survey 'Gesundheit in Deutschland aktuell' were used, which was carried out during 2009/2010 by the Robert Koch Institute. Information was available for 14,693 employed and unemployed men and women aged 18-64 years. Job groups were differentiated according to the Blossfeld classification. Psychological well-being was measured with the Mental Health Inventory. Men and women in more qualified jobs had better well-being than those in less qualified work. The lowest well-being was found for women in job groups with a high amount of unskilled work. For all job groups, men aged 55-64 years tended to have better well-being than those aged 45-54 years. Among women of older age, there was a tendency for well-being to be lower in the unskilled and semiprofessional groups, but on the same level or better in the more qualified job groups. The reason for this might be the imbalance between the demands of work/personal life and the functional capacity of the individual, which especially applies to women and is further affected by a lack of relief, for example, because of economic pressure. This cumulative strain may be more evident in older working ages.

Workers with a chronic disease and work disability. Problems and solutions.

The prevalence of chronic diseases in the age group 18-65 years is high. Cardiometabolic conditions and musculoskeletal diseases are the most frequent chronic diseases. Depending on disease and comorbidity, the employment rates are considerably lower than for healthy individuals. Chronically ill workers may have problems in meeting job demands, they may experience physical, cognitive or sensory limitations, have fatigue or pain complaints or other disease symptoms. Psychological distress, depressive feelings, feelings of shame or guilt, lack of coping or communicative skills, and non-supportive colleagues and supervisors may add to work-related problems. The ICF Model (International Classification of Functioning, Disability and Health) of the WHO offers a framework for understanding and considering health-related problems at work and finding solutions. Interventions to prevent problems in functioning, sickness absence and work disability may focus on the worker, the workplace, or health care. Multidisciplinary vocational rehabilitation, exercise therapy, cognitive behavioural interventions, workplace interventions and empowerment are interventions with at least some evidence of effectiveness. Future policy could focus more on promotion of workers' health and future research should include the interests and motivations of employers concerning disability management, skills of line managers, the feasibility of interventions to prevent work disability and the context sensitivity of study outcomes.

[Measurement of the socioeconomic status within the German Health Update 2009 (GEDA)]. / Messung des sozioökonomischen Status in der Studie "Gesundheit in Deutschland aktuell" (GEDA).

The socioeconomic status (SES) is a central analytical concept for epidemiologic research and health reporting in Germany. Within the German Cardiovascular Prevention Study (GCP), a multidimensional aggregated index of SES has been developed, which is used to this date. We have revised this index critically and reworked it according to the necessities of German health monitoring at the Robert Koch Institute (RKI). The main changes involve the operationalization and categorization of the status-constituting dimensions education, occupation, and income as well as the categorization of the resulting socioeconomic status groups. This paper explains the steps of the revision process and the ideas behind it. In addition, it provides empirical evidence on the association of the revised index with three important health outcomes (self-rated health, obesity, and smoking) using data of the German Health Update 2009 (GEDA) study. It is planned to apply the revised SES concept in all studies on German health monitoring at the RKI, i.e., not only to GEDA but also to the German Health Interview and Examination Survey for Adults (DEGS) and the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) in the same way.

[Regionalization of health indicators. Results from the GEDA-Study 2009]. / Regionalisierung von Gesundheitsindikatoren. Ergebnisse aus der GEDA-Studie 2009.

The representative health surveys conducted by the Department of Epidemiology and Health Reporting weren't used before to provide estimates for the spatial distribution of health outcomes. We are discussing the possibilities of providing these outcomes using methods for 'Small-Area-Estimation'. In the study we are using data of the "German Health Update 2009" (GEDA) to analyze regional inequalities for self-assessed health status, smoking and obesity on the district level in Germany. The small area estimates are provided by multilevel logistic regression models using additional regional statistical data from the official INKAR 2009 database of regional indicators for Germany. We are mapping the results of our analysis for the district level (NUTS-3) using simple thematic maps. Afterwards we compared the results of our small area models with conventional estimates that were based on the official German small scale census. The results showed that our estimates are in line with the prevalences of the census. Overall the results suggest that Small-Area-Estimation methods have a big potential to provide regionalized health indicators for the health reporting in Germany.