Counseling overweight patients: analysis of preventive encounters in primary care.

OBJECTIVE: The increasing prevalence of obesity requires particularly primary care providers to take action. The aim of this study was to analyze general practitioners (GPs) encounters with overweight and obese patients in primary care to test the hypothesis that patients with a BMI ≥ 30 kg/m² would have longer consultations focusing on lifestyle-related issues like nutrition and physical activity than those with a BMI < 30 kg/m². DESIGN: Cross sectional comparison of audiotaped encounters of patients with a BMI ≥ 30 kg/m² and those with a BMI < 30 kg/m². SETTING: Twelve GP surgeries in Berlin, Germany. PARTICIPANTS: Fifty patients who agreed to have preventive check-up encounters audiotaped. MAIN OUTCOME MEASURES: Based on the Roter Interaction ANALYSIS: System (RIAS) we assessed duration of encounter and the prevalence of GP statements regarding cardiovascular risks, nutrition and physical activity. RESULTS: An increased BMI was found to be a predictor for the length of encounters (P = 0.01), whereas the content of talks was mainly determined by the individual of GP and sex of the GP. Statements regarding cardiovascular risks were most frequent, followed by those regarding nutrition and physical activity. In this study the assessed physiological parameters were not associated with the specific contents of preventive encounters like nutrition or physical activity (P > 0.05). CONCLUSIONS: Our results indicate that GPs rarely use the check-up program to conduct lifestyle consultations with obese patients. Barriers to lifestyle counseling and possible solutions are discussed with a view to promoting individualized and target management of overweight patients.

[Women and smoking. A challenge for the tobacco control policy in Germany]. / Frauen und Rauchen. Herausforderung für die Tabakkontrollpolitik in Deutschland.

In Germany, smoking rates among women have been slightly declining since 2003. However, smoking rates among young women and girls are high and are reaching the smoking rates of their male counterparts. Only about half of pregnant smokers below the age of 25 stop smoking. Women and girls with low education and low level jobs, those who are unemployed, as well as single parents have the highest smoking rates. The tobacco industry promotes smoking behavior of women and girls through marketing campaigns, thus, systematically counteracting smoking prevention activities. Within the framework of the annual conference 2008 of the Federal Drug Commissioner on the theme of "Women and Smoking", recommendations for a gender-specific tobacco control policy in Germany were developed. The main demands relate to the necessity of a targeted policy approach which takes into account the needs and life circumstances of women and girls, the development of integrated prevention programs for pregnant women, improved medical and preventive care, the involvement of women from the media and culture, from health professions and politics to promote a smoke-free culture, gender-specific research, and the improvement of tobacco control legislation. FACT (Frauen aktiv contra Tabak e.V.) actively supports the implementation of these policy recommendations.

[Skin irritating substances in plants]. / Hautschädigende Stoffe in Pflanzen.

A review is given on plants and plant constituents which can cause dermal hurts. There is distinguished between contact dermatitis, phytophoto dermatitis, and contact allergy. The active principles are biogenic amines, lactones, diterpenic esters, furocoumarins, quinones, longchain phenols, and acetylenes frequently.