[Implementation of the influenza vaccination recommendation in nursing homes in Germany : results of a survey as part of the national influenza immunization campaign]. / Umsetzung der Influenzaimpfempfehlung in Alten- und Pflegeheimen : Ergebnisse einer Erhebung im Rahmen der nationalen Influenza-Impfaufklärungskampagne.

Residents and staff of nursing homes are important target groups for influenza vaccination in Germany. The aim of this study was to gain the first insights into whether nursing homes organize activities with respect to vaccination against influenza and whether there is a demand for further information. In the context of the national influenza immunization campaign-which is jointly carried out by the Robert Koch Institute (RKI) and the Federal Centre for Health Education (BZgA) on an annual basis-influenza information kits were sent to the management of 10,700 nursing homes in September 2013. Along with the information material, the institutions also received a questionnaire to which they were able to respond via mail, fax, or online. Data from 988 homes were included in the analysis. The majority of institutions informed both residents (88.9 %) and nursing staff (81.2 %) about influenza vaccination. However, only 64.7 % of nursing homes carried out specific immunization activities for their residents and only half (49.3 %) offered a flu shot to their staff. When asked why the institutions do not provide influenza-specific information and vaccination to their staff, the majority had the opinion that this is the responsibility of each individual's general practitioner. Overall, only 4.9 % of nursing homes assessed influenza vaccination coverage among their staff annually. A third of all surveyed institutions (33.6 %) expressed a demand for additional influenza vaccine-related information. In conclusion, improved health education is needed to raise awareness about the importance of influenza vaccination among residents and employees of nursing homes in Germany so as to prevent influenza-associated morbidity and mortality in this risk group.

[Knowledge, attitude, and practice concerning measles vaccination. Approaches for national vaccination education]. / Wissen, Einstellung und Verhalten zur Masernimpfung. Ansätze für eine nationale Impfaufklärung.

Achievement of the goal to eliminate measles by 2015 set by the European region of the World Health Organization (WHO) necessitates an increase in the willingness of German nationals to get vaccinated. To identify influential factors on vaccination behavior as the basis for communication measures specific to target groups, the Federal Centre for Health Education (BZgA) has conducted two representative surveys on attitude, knowledge, and practice concerning vaccination among parents of children between 0 and 13 years as well as among adolescents and adults. The parents' survey (n = 3,002) revealed that more than one-third see measles as a harmless disease. The survey of adolescents and adults (n = 4,483, 16-85 years) also shows that about one-quarter of the interviewees between 16 and 44 years regarded vaccination against measles as not very important. Moreover, 81 % of adults born after 1970 without sufficient existing vaccine protection were not aware of the new measles vaccination recommendation for this age group. Personal consultation with the physician was regarded as the major source of vaccination information in both surveys. About half of all persons interviewed intended to obtain information about vaccinations on the Internet. The results of these studies were used for the development of a nationwide multilevel BZgA campaign on vaccination protection against measles, its goal being to support medical professionals with comprehensive information and to enable adolescents and young adults via different communication measures to make well-informed vaccination decisions.

[Memorandum prevention research - research areas and methods]. / Memorandum zur Präventionsforschung - Themenfelder und Methoden (Langfassung).

From 2004 to 2012, the German Ministry of Education and Research (BMBF) established its first funding programme for the promotion of prevention research. 60 projects on primary prevention and health promotion and the meta-project entitled "Cooperation for Sustainable Prevention Research" (KNP) received BMBF grants under this programme during this period. The experience and knowledge gained and recommendations arising from the research funded under this programme are compiled in memorandum format. The "Memorandum on Prevention Research - Research Areas and Methods" highlights 5 research areas that are considered to be especially relevant from the perspective of the involved scientists and practice partners.The promotion of structural development and sustainability enhancement in disease prevention and health promotion are central areas that should branch out from existing nuclei of crystallization. Improving the health competence of the population and of specific subpopulations is another major area. Research in these areas should contribute to the development of theoretical concepts and to the empirical testing of these concepts. The transfer of knowledge for effective use of developed disease prevention and health promotion programmes and measures is still a scarcely researched area. Among other things, studies of the transfer of programmes from one context to another, analyses of the coop-eration between politics and science, and the continued theoretical and conceptual development of transfer research are needed. Long-term data on the effects of intervention studies are also needed for proper evaluation of sustainability. The latter dem-onstrates the importance of method development in disease prevention and health promotion research as an area that should receive separate funding and support. This research should include, in particular, studies of the efficacy of complex interventions, health economic analyses, and participative health research.

[Memorandum - research funding of prevention]. / Memorandum - Forschungsförderung Prävention.

The memorandum of the research funding of prevention has been devised within the framework of the Prevention Research Funding Programme of the Federal Ministry of Education and Research. It consists not only of the obtained findings of the research-practice co-operation but also of recommendations for the implementation of prospective, innovational, effective, practice-oriented and sustainable research. The respective knowledge has been acquired from quantitative surveys on the experiences of scientists and practice partners within the prevention research funding project as well as from extensive qualitative methods of structured group evaluation. A participatory co-operation between research and practice based on mutual respect, trust and recognition is seen as mandatory for the further development of both prevention and health promotion research. Research and practice partners are required to engage in an ab initio collaboration starting from the conception phase, whereby it is advisable to encourage and fortify the communication between research, practice and funding partners by systematic surveillance in form of a meta-project. In addition, the inclusion of the target population from the outset and on a collaborative basis is considered as beneficial in order to ensure the practical application of the research findings. Furthermore, innovatory research designs which are able to provide a framework for internal flexibility, continuous re-assessment and adjustment are fundamental for the implementation of practice-oriented research. Moreover, a dynamic co-operation between different groups of interest not only depends on sharing responsibility but also on sufficient funding for both research and practice, which is particularly important for the transfer and communication of the attained findings. With regard to the evaluation of both effectiveness and sustainability of interventions, a research funding project is required which makes long-term results possible through the utilization of regulated monitoring and guarantees quality and continuous effectiveness. Furthermore, in order to stimulate progress within the basic theories of prevention and health promotion, it is also essential for a funding project to focus on elementary concepts. Additionally, for the efficient and sustainable development of health within a population it is advisable to apply both self-contained research and the involvement of primary prevention and health promotion to research projects concerning health, social affairs, education, work and environment.

[Challenges facing health promotion during early childhood]. / Herausforderungen bei der Gesundheitsförderung im frühen Kindesalter.

The issue of health promotion during the early childhood years is primarily geared towards parents. They should be assisted while developing their health care and educational skills so that they can promote the healthy development of their children. It is also important to strengthen communicators in their work with families. Most children nowadays are physically healthy, but certain health-related risks have increased. Children from families with a low social status are affected the most. Furthermore, early childhood intervention programs have been set up which are aimed at the early and long-term improvement of development opportunities for children and families. These also contribute to ensuring that children enjoy a healthy upbringing and safeguard their rights to protection, support, and participation. Health promotion offers range from education to counseling and extend to outreach work. Among the challenges are the widespread education of parents, promotion of participation, the advancement of key player networking, and improved quality assurance.

[First exchange of experiences concerning the H1N1 pandemic in Germany 2009/2010: report on a workshop held March 22-23, 2010, in Berlin]. / Erster Erfahrungsaustausch zur H1N1-Pandemie in Deutschland 2009/2010: Bericht über einen Workshop am 22. und 23. März 2010 in Berlin.

In April 2009 the first pandemic of the 21st century developed within a few weeks starting from Mexico. Its first wave reached Germany in autumn 2009 and was responsible for 1.8-3.5 million additional medical consultations. For the public health sector, this pandemic was one of the largest challenges of the last few decades. As a contribution to broader evaluations on national and international level, the Robert Koch Institute invited representatives from different professions involved in the pandemic response to participate in a workshop on 22-23 March 2010. This workshop was structured in short presentations, group work, and plenary discussions. Main experiences were that (a) pandemic preparedness was helpful, (b) the early warning systems were reliable, (c) vaccines were available within a few months, however, in limited amounts. Need for improvement was discussed for (a) effectiveness of vaccination logistics, (b) mechanisms for the reimbursement of the cost of vaccination, (c) availability of surveillance and monitoring systems, (d) integration of physicians in decision-making processes and health education, and (e) proactive communication strategies. Investments in the above mentioned areas can help to improve public health protection in the future.

[AIDS prevention in Germany]. / AIDS-Prävention in Deutschland.

In 1987 the national AIDS prevention campaign "Gib AIDS keine Chance" (Don't give AIDS a chance) was started in Germany. After a very difficult and controversial political debate about a probably successful response to AIDS, in the end a political decision was made in favour of the implementation of a long term "social learning strategy". Thus, since then the Bundeszentrale für gesundheitliche Aufklärung (Federal Centre for Health Education, BZgA) has been running the campaign on behalf of the Federal Ministry of Health. The result of this prevention program is a low rate of infections. In Germany there were 2600 newly diagnosed infections in 2005: 59 % in homosexual men, 16 % by heterosexual contacts, 17 % in people from high prevalence countries and 7 % in i.v. drug users. In comparison to the international situation Germany has a relatively low HIV-prevalence even nowadays. However, Germany has also been confronted with an increasing number of newly diagnosed infections in the last few years. When the prevention program was started it was very important to build new structures for a successful implementation of the campaign. That meant for instance to build up an effective infrastructure for cooperation between the governmental and the nongovernmental sector, including organising the coordinated action among the partners at the federal, regional and local levels. Likewise, international networking was of great importance. A key element, relevant for the success of the campaign was the close cooperation at the federal level between the BZgA and the Deutsche AIDS Hilfe (German AIDS Help, DAH), to combine the highreach intervention in low-prevalence populations with intensive interventions for high prevalence groups. An effective national AIDS prevention campaign must reach the whole population; inform the public about the main risks of infection, about methods of protection and about what is not infectious. Moreover groups with a higher level of risk of infection must be addressed and motivated to adopt protective behaviour more intensely. The campaign thus must comprise closely related and mutually reinforcing elements: mass communication and individual communication measures, aimed at the public at large and at individual subgroups, national and international cooperation, especially the cooperation and task sharing with the DAH aimed at prevention in the epidemiologically most significant target groups, evaluation and quality assurance. The key element in this respect is the BZgA's annual representative survey of information levels, attitudes, motivation and behaviour in the more than 16- year-old population. In addition to the model of the special partnership between the BZgA and the DAH, a range of public-public partnerships, due to the German federalistic system, and public-private partnerships, which support public efforts, are necessary. It is shown that an increasing number of private partners are necessary to reinforce the program in a situation where Germany has to face new challenges. The new challenges are for instance high mobility in a globalizing society. In a world wide spreading epidemic no country will be excluded from the international development; the increase of other sexually transmitted diseases (STDs); a tendency to decreasing protective behaviour caused by the optimism that a definitive cure may soon be available. The conception of evaluation of the campaign comprises an annual monitoring of knowledge, attitude and behaviour in the whole population and in specific target groups. It includes pretests of specific prevention instruments and evaluation of different activities. An indicator system is developed to measure the results of the campaign. By continuous feedback of the evaluation results into the further development of the campaign the steering of the campaign at a high level of quality is ensured.

Medical assessment and legal outcome in child sexual abuse.

OBJECTIVE: To examine the relationship of behavioral symptoms, interview disclosures, and physical examination findings with changing legal outcomes in child sexual abuse. DESIGN: Retrospective case series. SETTING: Hospital- and community-based multidisciplinary child abuse evaluation teams in the same county in 2 periods. PATIENTS: Children ages 0 to 17 years referred for evaluation of sexual abuse. MAIN OUTCOME MEASURES: Substantiation by child protective services, issuance of a warrant by law enforcement authorities, and criminal penalties were compared with reported changes in behavior, disclosure by the child, and physical evidence on examination. RESULTS: Among 497 children evaluated in 1991-1992 and 1995-1996, those with a positive examination finding were 2.5 times more likely to result in a criminal prosecution with a finding of perpetrator guilt (P<.001). Similar rates of disclosure, positive examination findings, child protective services substantiation, and warrant issuance were noted in the 2 periods. Decreasing rates of guilt determination and increasing criminal penalties were identified in 1995-1996 (P<.002). Disclosure of child sexual abuse during medical assessment was significantly associated with a positive physical examination finding, child protective services substantiation, and issuance of a warrant, but not a finding of guilt or criminal penalty. CONCLUSIONS: Medical assessment plays an important role in the overall community response to child sexual abuse. While behavioral symptoms and disclosure are important in medical treatment and child protective services investigation, positive physical findings are associated with a finding of guilt. There is a trend toward less finding of guilt and more years of criminal penalty that is not explained by case characteristics.

[Single dose therapy of uncomplicated urinary tract infections in women. Remission rates with ciprofloxacin in two prospective randomized comparative studies]. / Einmaltherapie von unkomplizierten Harnweginfektionen der Frau. Heilungsraten mit Ciprofloxacin in zwei prospektiven randomisierten Vergleichsstudien.

In a prospective randomized study, the clinical effectiveness of ciprofloxacin at a single dose of 250 mg p.o. was compared with that of two oral doses of 250 mg bid administered for two days in women with urinary tract infection following gynecological procedures. A healing rate of 95% was achieved with both single-dose (n = 62) and two-day treatment (n = 65). In a further prospective randomized multicenter study, single-dose therapy with 250 mg of oral ciprofloxacin in women with uncomplicated urinary tract infection was compared with three days of ambulatory treatment with 2 x 250 mg/day. In the case of these patients, the diagnosis was made and treatment applied in the doctor's office by one of seven specialist gynecologists practicing in the city area of Essen. The healing rate of 78% (n = 46) achieved with single-dose treatment was significantly inferior to the 91% seen with the three-day regimen (n = 53, p < 0.05).

[Demonstration of air inclusions in human hair by light and UV microscopy (author's transl)]. / Die mikroskopische Darstellung von Lufteinschlüssen im menschlichen Haar im Durchlicht und UV-Licht

Cranial hairs of 47 randomly selected probands were examined for the presence of air inclusions by conventional light microscopy and by short-wave ultraviolet-light microscopy. The air inclusions seen in UV light stand out as brightly luminous regions against the surrounding hair substance. Two sorts of air inclusions were observed-strips-like or cleft-like regions running parallel to the longitudinal axis localized inthe cortex of the hair and air containing pores on the hair surface. The presence and amount of the air inclusions is independent of the hair colour.