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At least 19 recordsLinked to original sources
PubMed2006

[Geriatrics in Bavaria-Database (GiB-DAT): Basic data analysis of geriatric rehabilitation in Bavaria and analysis of inter-clinic variability (part II)].

OBJECTIVE: Presentation and comparison of basic data from geriatric rehabilitation in Bavaria with analysis of statistical influences on characteristic values like length of stay and Barthel Index. Are differences between participating clinics due to patient characteristics? SETTING: There were a total of 21 656 data records of the Geriatrics in Bavaria- Database (GiB-DAT) collected by 35 clinics within 1 year. RESULTS (PERCENTAGE OR MEAN): 70.6% female patients, age 80.0 years, 95.9% enrollment from acute care hospitals, length of stay in previous hospitals 24.3 days, length of stay in geriatric rehabilitation 24.6 days. DIAGNOSIS: 41.7% orthopedics, 24.9% neurological, 33.4% others. Barthel Index on admission 44.1 points, on discharge 65.8 points (difference 21.8 points). We found a large variance of all items between participating clinics. Variance for Barthel Index and length of stay is partly cleared up by regression analysis (multinomial logistic) and is mostly due to patient characteristics. CONCLUSIONS: Basic data of Bavarian geriatric rehabilitation clinics is matching with nationwide reference statistics. Differences exist for the lower rate of stroke and direct enrollment of outpatients. A simple ranking of outcome parameters (e. g. Barthel Index) does not make sense due to multiple influencing factors.

Aged↗
PubMed1992

[Cause of blindness in Bavaria. Evaluation of a representative sample from blindness compensation records of Upper Bavaria].

Blindness certificates from the region of Oberbayern were studied to obtain data for the prevalence, incidence and the causes of blindness in Bavaria. This investigation reveals increasing rates for the prevalence and incidence of blindness. Most (60% of the prevalence and 70-80% of the incidence) of the blind are older than sixty years of age. The prevalence (2.5%) and incidence rate for children (blind before 18 years of age) are low. Macular degeneration (15.4%) has the highest prevalence rate followed by glaucoma (14.3%), retinopathia pigmentosa (10.3%), high myopia (11.5%) and optic atrophy (8%). Blindness from diabetic retinopathy accounts for 7.1% of cases. Macular degeneration is also the leading cause of blindness when incidence rates (28%) for all ages are calculated. Lower incidence rates are found for glaucoma (17%) and diabetic retinopathy (13%). For blind children malformations of the eyes (18.7%) are found to be the leading cause of blindness in regard to prevalence figures. The retinopathy of prematurity (17.2%) and complex cerebral disturbances (16.1%) do present with similar figures.

Adolescent↗
PubMedDate not supplied

Epidemiology of alveolar echinococcosis in southern Germany (Bavaria).

Alveolar echinococcosis is considered to be the most dangerous endemic parasitic disease for man in Central Europe. In Germany, unlike the neighbouring countries of Switzerland, Austria and France, only limited data on the prevalence and incidence of echinococcosis are available. Therefore, a retrospective cross-sectional study was conducted in order to investigate the epidemiology of echinococcosis in Bavaria, one of the two southern states of Germany. A standardised questionnaire was sent to all hospitals in Bavaria requesting information about patients seen from 1985 to 1989. In a second step a team of reviewers was sent to all relevant hospitals for active case finding in hospital statistics and medical records. A total of 216 patients with echinococcosis were detected of whom 58 had alveolar echinococcosis. According to these data, the prevalence in Bavaria was calculated to be 0.5 per 100,000 inhabitants with peak values in the counties of Swabia (2.4) and Upper Bavaria (0.6). The annual mean incidence of newly diagnosed cases amounted to 0.03 per 100,000. The distribution of prevalence in man was closely correlated to the infection rates in foxes throughout Bavaria (p < 0.05). Farmers are the occupational group with the highest risk to acquire echinococcosis with a prevalence/odds ratio of 14.6 for Swabia and 8.8 for Upper Bavaria, when compared to the general rural population.

Adult↗
PubMed1995

Birth prevalence of congenital malformations in Bavaria, Germany, after the Chernobyl accident.

This study considers whether or not exposure to radioactive fallout from the Chernobyl accident led to an increased prevalence of congenital malformations in infants born in Bavaria, the German state with the highest levels of contamination after the accident. The odds ratios for major malformations after the accident relative to before were used as indicators for adverse health effects. Since measurements of caesium in soil showed that contamination was considerably higher in Southern Bavaria than in Northern Bavaria, the odds ratios were calculated for both regions separately. Analysis did not show a significant increase in any of the odds ratios of the selected malformations in Southern Bavaria as compared to Northern Bavaria. Consequently, this study provides no evidence that radiation from Chernobyl caused an increase in the birth prevalence of major congenital malformations.

Abnormalities, Radiation-Induced↗
PubMedDate not supplied

[Regional mortality differences in Bavaria].

OBJECTIVE: In completion of a decision of the Bavarian Parliament we examined the regional mortality differences within Bavaria. DATA: The analysis was based on the number of deaths in Bavaria in the years of 2000-2002. Data on regional demographic and socioeconomic indicators were used to identify potential associations. METHODS: Deaths were analysed by cause of death and region. Crude and age standardised mortality rates were calculated. Additionally, we assessed the potential years of life lost in order to obtain some indication of the potential effects of preventive action. The association with likely explanatory factors was investigated on an ecological level. RESULTS: The regional mortality differences in Bavaria show a northeast-southwest gradient favouring the southwest, which reflects the socioeconomic situation within Bavaria. This may be due to the economic disadvantage northeast Bavaria had to endure as a result of its marginal location within a divided Europe. We found strong bivariate correlations of the mortality rate with individual socioeconomic factors (e. g. with available income: -0.582; with unemployment: +0.416; with the immigration rate: -0.473). Exploratory analysis suggest that about 50 % of the regional variation in mortality could be explained by socioeconomic factors. DISCUSSION: The results for cause of death indicate that behavioural factors in relation to socioeconomic aspects may well play a role in the mortality gradient. This will be the focus of a future piece of research of our unit.

Adolescent↗
PubMed2006

[Geriatrics in Bavaria-Database (GiB-DAT): Conception, structure and results of implementation (part I)].

In the year 2000, a database was implemented in Bavaria, covering the majority of geriatric clinics. Benchmarking statistics are generated in quarterly periods and scientifically analyzed. Actually, 41 of the 57 geriatric clinics in Bavaria participate in the project 'Geriatrics in Bavaria-Database' (GiB-DAT). For geriatric rehabilitation, the coverage is 82.4%. In addition, all 7 geriatric day clinics participate; thus, a total of 24,000 cases are documented each year. Therefore, GiB-DAT is the largest database for geriatric rehabilitation in Germany and Europe. To make documentation more effective and easy, new software (GERIDOCTM) has been generated which is integrated in the process of daily treatment. GiB-DAT offers good data quality, especially concerning completeness of items. This manuscript describes conception and construction of GiB-DAT and identifies differences compared to the Geriatric Minimum-Dataset (GEMIDAS), a nationwide geriatric database in Germany.

Aged↗
PubMed2000

[Model project for updating neonatal screening in Bavaria: concept and initial results].

The newborn screening programme in Bavaria was confronted with several problems. Number of disorders and process quality no longer complied with screening guidelines. Mixed financing, distributed between the state (PKU, galactosaemia) and health insurances (hypothyroidism) had promoted an increasing dissipation of the system. Notified participation rates had dropped to < 80%. Increasing need for a second screening due to early discharge was an additional challenge. To overcome these problems, and considering the availability of improved screening methodology (tandem mass spectrometry) the programme was reorganised. The project, which started on Jan 1, 1999, is based on a cooperation model between laboratory (logistics, analysis), universities (treatment, scientific evaluation), and public health services (coordination, tracking). Time of blood sampling was predated to the third day of life. Screening was extended to biotinidase deficiency, congenital adrenal hyperplasia (CAH) and by introduction of tandem mass spectrometry for screening of many other disorders (besides PKU). Insurances now finance complete laboratory analysis which was transferred to the private sector. To enable all newborn to participate, the names of screened children are matched against birth lists by public health services on a regional basis. Recalls and conspicuous results are consistently followed up until disorders are either excluded or confirmed. Two clinical hotlines were established in the children's hospitals of the universities in Munich (Southern Bavaria) and in Erlangen (Northern Bavaria). Written consent is required for participation in the programme. Participation in the new programme could be continually increased; coverage is > 95% since April. In several cases screening was made up for not tested children by contacting their parents. Omitted screening was mostly due to misunderstandings regarding testing responsibility or lost samples. Altogether 52 cases of disorder were found in the 87,000 newborn screened until August 1999. Hence, the detection rate of children affected by inborn errors of metabolism was about twice as high than before changes. Among the newly screened diseases CAH was detected most often (11 cases). In 22 cases diagnosis was based on the use of tandem mass spectrometry. Among these (besides PKU, 9 cases) MCAD deficiency (6 cases) was detected most frequently. Whereas recall rates of most disorders were < 0.1%, screening for CAH still revealed a high recall rate, particularly in premature births. Second screening due to early discharge (< 48 h) was required in 1.3%. About 20% of pending recalls required contacting birth hospitals, doctors, midwives or parents. So far all affected children could be brought to treatment in time.

Female↗
PubMed2002

[Capacitive requirement for acute in-patient care of patients with psychosomatic diseases in bavaria].

Estimations of the requirement for acute in-patient care of patients with psychosomatic diseases in Bavaria have to rely on respective data on their incidence and prevalence as valid requirement data are missing. The required capacity of in-patient beds depends on several, inconsistently figured parameters: hospitalization rate, length of stay, occupancy rate. Based on conservative assumptions the hospitalization rate was calculated to be at least 1.3 admissions per 1000 and for adequate treatment the average length of stay should not be limited to less than 50 days. In order to avoid unnecessary delay of treatment a realistic occupancy rate has to be 90 %. Thus the minimal capacity for in-patient care is assessed to be 2453 beds. At present patients with psychosomatic diseases in Bavaria receive in-patient treatment in psychosomatic departments of general hospitals, hospitals and rehab clinics of psychosomatic and psychotherapeutic medicine, and in hospitals of psychiatry and psychotherapy, in each with a different focus. When the expertise was drafted these acute care and rehab hospitals provided some 2500 beds - with only 76 beds in general hospitals. For quality assessment of the available beds for in-patient care and future planning minimal standards of structural quality have to be consented. At present it is not possible to make a clear and substantial distinction between the treatment for patients with psychosomatic diseases in acute-care hospitals and in psychosomatic rehab clinics respectively. Thus, the necessary in-patient rehab capacity can only be assessed roughly. The existing pluralism of the in-patient care providing system for patients with psychosomatic diseases is considered to be appropriate for different needs of this patient group. In the future excellent care for this patient group will acknowledge options for a more flexible and interconnected care-providing system. This is a publication of the complete expertise by the project group "Acute In-patient Care for Patients with Psychosomatic Diseases in Bavaria" which has been handed to the Bavarian Ministry of Social Affairs in December 1999.

Delivery of Health Care↗
PubMed1995

[Epidemiology of echinococcosis in Bavaria].

OBJECTIVE: There are few and incomplete data about the epidemiology of echinococcosis in Germany. The aim of this retrospective study was to collect informations about frequency and distribution of this parasitosis in one of the main endemic regions (Bavaria). PATIENTS AND METHODS: Standardized questionnaires were sent to all Bavarian hospitals, requesting (anonymous) information about all patients with echinococcosis seen between 1985 and 1989. In addition, hospital statistics and archives were searched for echinococcosis cases. A total of 216 cases were found; sufficient data were available for 181 (87 males, 94 females; mean age 41 [4-79] years). There were 123 patients with cystic echinococcosis (infection with the larval stage of Echinococcus granulosus), 58 with the alveolar form (larval stage of Echinococcus multilocularis). In the remaining 35 the available information was inadequate for reliable differentiation. RESULTS: The data indicate a prevalence of echinococcosis in Bavaria of 1.9 per 100,000 inhabitants, 1.1 for Echinococcus granulosus and 0.5 for Echinococcus multilocularis. The mean annual incidence was 0.22 (Echinococcus granulosus 0.15; Echinococcus multilocularis 0.03). Dividing the patients by country of origin, 86.2% of those with Echinococcus multilocularis were German, while 68.3% of those with Echinococcus granulosus originated from outside Germany, mostly the Mediterranean area. The prevalence of Echinococcus multilocularis infection was highest in the District of Swabia (2.4/100,000) and Upper Bavaria (0.6/100,000). These are regions in which there is a proven significantly higher infestation of echinococcosis in foxes. Farmers were most at risk of being infected with alveolar echinococcosis.

Adolescent↗
PubMed2002

Fertility transition in a rural, Catholic population: Bavaria, 1880-1910.

The decline of human fertility that occurred in Europe and North America in the nineteenth century, and elsewhere in the twentieth, remains a topic of debate largely because there is no accepted explanation for the event. This paper uses district-level data from Bavaria to study the correlates of the decline of fertility in that German kingdom in the nineteenth century. Bavaria's fertility transition was later and less dramatic than in other parts of Germany. Our results for Bavaria indicate that the European Fertility Project was right about the role of religion and secularization, but missed an important role for the economic and structural effects stressed by economic historians.

Catholicism↗
PubMed1975

[History of vaccination in Bavaria].

From the history of vaccination in Bavaria: The development of smallpox vaccination is described in the book "Smallpox Vaccination in Bavaria" by Dr. Giel, the first Bavarian doctor to practise it. Difficulties were exposed which were of a local nature at first, until a permanent vaccination room was established in the Munich Town Hall in 1809, under King Maximilian of Bavaria. Futher difficulties were caused by the vaccination serum itself, which lost its effectiveness as a result of serial vaccination from person to person. It was also noticed that no absolute protection from smallpox was guaranted by a single vaccination in childhood. Also, conservation and delivery of the serum were problematic. Pecuniary limitations did not make the business of vaccination easy. Dr. Giel fulfilled his very responsible office for 30 years.

Germany, West↗
PubMed1997

[Epidemiologic and actual importance of entero-hemorrhagic E. coli in Northern Bavaria (1996)].

Following an epidemic occurrence of EHEC infections (1995-1996) Bavaria enacted legislation to survey EHEC. In consequence thereof there was an extraordinary increase in examinations for this pathogen at the Landesuntersuchungsamt für das Gesundheitswesen Nordbayern in Erlangen. Of 2712 stool specimens 2% were positive for EHEC. At first an enzyme immunoassay (EIA) was used in screening for Shiga toxin (Stx) 1 and 2. Because this EIA revealed a lack of specificity the PCR for amplification of sequences derived from Stx genes was set as screening test. Among 53 EHEC strains isolated by colony hybridisation 25 different serotypes could be identified. A complete virulence pattern (formation of Shiga toxins and EHEC haemolysin, presence of the eaeA gene) was detected in 3 of 4 strains from HUS patients (75%), in 14 of 17 enteritis cases (82.4%) and in 17 of 32 persons with asymptomatic carriage (53.1%). Besides the serotypes O157H- and O103H2 strains of the serotype 08 were isolated particularly frequently in certain regions of North Bavaria for limited periods. EHEC infections in North Bavaria are related to many serotypes that are mostly different from the O157 serotype. Especially in adults the clinical course is usually asymptomatic.

Adult↗
PubMed2002

[The use of medical services and the utilization rate in screening programs in relation to social class: results of a representative survey in Bavaria].

OBJECTIVES: This article aims to analyse utilisation of medical services and screening programmes in relation to social class. METHODS: 2051 adults in Bavaria were interviewed using computer-assisted telephone interview (CATI) in 1999/2000. Social class was established from the income-adjusted Winkler social category index. Data were standardised by age and sex. If social class differences were found, separate analyses for education and income effects were conducted. RESULTS: Higher education was found to be associated with visits to specialist and vaccinations. The purchase of over-the-counter medication was related to higher education and family income. Frequency of HIV-tests was higher in higher social classes but not related to higher education or better financial situation. Utilisation rates for screening programmes for various types of cancer were similar in all social classes. CONCLUSIONS: The results show that social class differences in health behaviour in Bavaria prevail. Positive health behaviour is often associated with higher education. Compared to earlier findings social class effects on the utilisation of cancer screening appears less pronounced. Preventive measures seem to have reached all social classes to a similar degree.

Adolescent↗
PubMed2006

[Evidence and evaluation in health promotion and prevention: the example of the health promotion initiative "healthy living in Bavaria"].

BACKGROUND: The use of evidence and evaluation is rapidly gaining importance in the field of health promotion and prevention. The evidence base, evaluation methods as well as the capacity and required competencies among practitioners are still being developed. AIMS: Beyond its specific health-related targets, the health promotion initiative "Healthy Living in Bavaria" aims to integrate the use of evidence and evaluation as key components into project funding as part of a total quality management concept. Another objective is the creation of new evidence for the field of health promotion and prevention. APPROACH: A core element of the quality management concept is the initiative's multistage evidence and evaluation model which embraces the initiative as a whole as well as the individual projects. The model is operationalized through a set of matching instruments for application, reporting, evaluation, and appraisal. CONCLUSION: Nationally as well as internationally, evidence and evaluation stand out as central aspects of quality improvement instruments in health promotion and prevention. Characteristic of Bavaria's quality improvement approach is the seamless process from the application to the evaluation under consideration of scientific as well as pragmatic aspects.

Germany↗
PubMed2006

[Has anything changed in the quality of continuing education in orthopaedic/trauma surgery? Evaluation 1 year after implementation of a new code of practice for resident training in orthopaedic/trauma surgery in Bavaria].

OBJECTIVE: It was the aim of this study to evaluate any changes in the quality of orthopaedic/trauma training 1 year after implementation of the new code of practice for resident training in Bavarian clinics. METHODS: A questionnaire was prepared by the Educational Committee and the Junges Forum of the German Trauma Society and sent to all 120 instructors (and their medical staff) for resident training in Bavaria for general surgery, trauma surgery as well as orthopaedic/trauma surgery on July 26 2005. RESULTS: While 56% of the chairmen claimed to perform a structured, curricular training, only 18% of the residents could verify this. In a similar manner, the majority of chairmen were satisfied with the new code of practice for resident training, while the majority of residents and attendings were not. CONCLUSION: One year after implementation of a new code of practice for resident training in Bavaria, surgical training structures are not well established. There is a large discrepancy in the evaluation of training quality between chairmen and residents. It is therefore imperative to develop recommendations for structuring orthopaedic/trauma training.

Education, Medical, Graduate↗