Geriatrische Gesundheitszentren

In 2014, we reported rising hip arthroplasty utilization across Organization for Economic Co-operation and Development (OECD) countries, particularly among younger patients. Since then, healthcare systems have evolved, demographic shifts are continued, and procedures were impacted by the COVID-19 pandemic. This study aims to reassess these trends through 2022. We analyzed hip arthroplasty data from the OECD Health Statistics, U.S. Nationwide Inpatient Sample, and World Bank for 27 countries (2005-2022). We compared relative (compound annual growth rates (CAGR)) and absolute (i.e., mean annual differences (MAD)) procedure numbers, stratified by age (≤64 vs. ≥65), and examined associations with GDP, health expenditure, and life expectancy. Sensitivity analyses were performed to account for uncertainty in U.S. Between 2011 and 2022, hip arthroplasty utilization grew more slowly than 2005-2011 (CAGR: 1.00% vs. 2.03%; MAD: 1.78 vs. 2.03). Growth from 2011 to 2022 was concentrated among patients aged ≤64 (CAGR 3.08%; MAD: 3.11), while utilization declined among those ≥65 (CAGR: -2.27%; MAD: -12.46). Country-level variation narrowed, with the highest-to-lowest ratio falling from 6.65 (2005) to 2.96 (2022). Despite a sharp drop in 2020 due to COVID-19, most countries recovered by 2022. Sensitivity analyses confirmed the robustness of observed OECD trends. BRIC nations showed faster growth, but data limitations hindered comparisons. Hip arthroplasty utilization continues to increase among younger patients but has declined in older ones. Continued demographic pressure and recovery from COVID-19 disruptions are expected to drive further increases in procedure volume.

A balanced diet is a key component of a healthy lifestyle and contributes significantly to healthy aging. In advanced age, numerous challenges can hinder nutritional intake, and informal caregivers also often experience substantial burdens that may negatively affect their eating habits. This study aimed to explore the barriers, facilitators and support needs for maintaining a healthy diet among community-dwelling older adults in need of care and their informal caregivers. A descriptive qualitative study with 24 participants was conducted using non-probability sampling. Individual interviews were conducted with 17 informal caregivers and 7 older persons in need of care using a semi-structured interview guide. Data analysis was performed using qualitative content analysis. The COREQ checklist was used for reporting. Several subthemes emerged within the three main categories (1) barriers, (2) facilitators, and (3) needs. Barriers included lack of knowledge, poor communication between care-recipients and caregivers, inappropriate meals, health issues associated with eating and drinking, negative attitudes, and, specifically in informal caregivers, limited resources and environmental constraints. Facilitators included social support, access to healthy food, positive environmental factors, sufficient resources, meal planning, high nutritional knowledge, and positive attitudes. Both older adults and informal caregivers expressed a need for further nutritional support and information. The lack of nutritional knowledge, coupled with a strong desire for more information, highlights the urgent need for targeted, high-quality nutrition education and training with respect to these groups. Such education should integrate behaviour change strategies to help individuals adopt and maintain healthier eating habits.

<br /> The primary objective of this study is to identify the linguistic and pedagogical challenges faced by students of Turkish origin who live in Germany and whose native language is German, while learning Turkish. Qualitative research was employed, and semi-structured interviews were used for data collection. The participant group consisted of 10 students aged between 11 and 16, residing in the German state of North Rhine-Westphalia, and receiving Turkish instruction at least one day a week. Descriptive analysis and thematic coding were used in data analysis. Findings from the participants' opinions indicate that the areas where students face the most difficulties include the use of letters specific to the Turkish alphabet (ç, ğ, ş, ö, ü), vowel harmony, spelling compound words, and the use of uppercase and lowercase letters. Furthermore, the direct transfer of spoken language habits to written language frequently leads to errors in students' written expression skills. In addition to linguistic difficulties, pedagogical difficulties have also been identified, including students' lack of understanding of the course content, leading to a loss of interest in the course, and in some cases, teaching methods that are inappropriate for their age and language level. Many students stated that they used Turkish only as a daily language spoken at home with their parents, limiting their academic language development. The lack of German-based materials used by educators or their incompatibility with the students' social context further complicates the learning process. Consequently, German-speaking Turkish students appear to experience various difficulties in learning Turkish, both with technical spelling rules and pedagogical proficiency.

Background: Colorectal neoplasia and diverticulosis are common findings on colonoscopies. While adenomas are precursors to colorectal cancer, diverticulosis is usually asymptomatic but can lead to diverticulitis. Despite their prevalence and coexistence, the relationship between these conditions remains unclear. This study investigates whether diverticulosis is associated with adenomas, considering shared risk factors and potential inflammation-driven mechanisms. Methods: We examined 6154 asymptomatic individuals undergoing colorectal cancer screening in Austria. Diverticulosis and colorectal neoplasia were documented during screenings based on macroscopic definitions. Advanced neoplasia was defined as polyps >1 cm or high-grade dysplasia. Associations between diverticulosis and neoplastic findings were assessed using univariate and multivariable logistic regression models. Results: Although the overall incidence of any polypoid lesion was higher in the diverticulosis group (37% vs. 30%), statistical analysis revealed a comparable rate of advanced neoplasms in both groups. Importantly, no significant link between diverticulosis and advanced neoplasms was found (OR 1.125; 95% CI: 0.933 to 1.357, p = 0.218) even after adjusting for confounding factors. In a univariate analysis, a statistically significant association between diverticulosis and the presence of any colorectal polyps was identified (OR 1.388; 95% CI: 1.244-1.549, p < 0.0001). However, after adjusting for confounding factors in model 2 (OR 1.065, 95% CI: 0.942 to 1.204, p = 0.314) and model 3 (OR 1.071, 95% CI: 0.925 to 1.239, p = 0.360), this effect was also not statistically significant. Conclusions: Patients with diverticulosis share demographic and clinical features with those at risk of colorectal neoplasia, such as older age, male gender, and higher cardiometabolic risk. However, diverticulosis does not independently increase the risk of advanced colorectal neoplasia or unspecified polypoid lesions.

M ittels einer Befragung wurden Herausforderungen erhoben, mit denen die Mitarbeiterinnen und Mitarbeiter täglich rund um das Thema Ernährung konfrontiert sind. Es ging hervor, dass das Thema Ernährung nicht nur in der Versorgung von Patientinnen und Patienten und Bewohnerinnen und Bewohnern, sondern auch privat für die Mitarbeiterinnen und Mitarbeiter einen erkennbaren Schwerpunkt darstellt. Aus diesem Grund wurden fünf multiprofessionelle Arbeitsgruppen gegründet, um die verschiedenen Themen zielgerichtet bearbeiten zu können.

BackgroundWidespread inappropriate use of antimicrobial substances drives resistance development worldwide. In long-term care facilities (LTCF), antibiotics are among the most frequently prescribed medications. More than one third of antimicrobial agents prescribed in LTCFs are for urinary tract infections (UTI). We aimed to increase the number of appropriate antimicrobial treatments for UTIs in LTCFs using a multi-faceted antimicrobial stewardship intervention.MethodsWe performed a non-randomized cluster-controlled intervention study. Four LTCFs of the Geriatric Health Centers Graz were the intervention group, four LTCFs served as control group. The main components of the intervention were: voluntary continuing medical education for primary care physicians, distribution of a written guideline, implementation of the project homepage to distribute guidelines and videos and onsite training for nursing staff. Local nursing staff recorded data on UTI episodes in an online case report platform. Two blinded reviewers assessed whether treatments were adequate.Results326 UTI episodes were recorded, 161 in the intervention group and 165 in the control group. During the intervention period, risk ratio for inadequate indication for treatment was 0.41 (95% CI 0.19–0.90), p = 0.025. In theintervention group, the proportion of adequate antibiotic choices increased from 42.1% in the pre-intervention period, to 45.9% during the intervention and to 51% in the post-intervention period (absolute increase of 8.9%). In the control group, the proportion was 36.4%, 33.3% and 33.3%, respectively. The numerical difference between intervention group and control group in the post-intervention period was 17.7% (difference did not reach statistical significance). There were no significant differences between the control group and intervention group in the safety outcomes (proportion of clinical failure, number of hospital admissions due to UTI and adverse events due to antimicrobial treatment).ConclusionsAn antimicrobial stewardship program consisting of practice guidelines, local and web-based education for nursing staff and general practitioners resulted in a significant increase in adequate treatments (in terms of decision to treat the UTI) during the intervention period. However, this difference was not maintained in the post-intervention phase. Continued efforts to improve the quality of prescriptions further are necessary.Trial registrationThe trial was registered at ClinicalTrials.gov NCT04798365.

In order to gain an overview of the current state of the discussion on PIDs and for the identification of use cases for the initiation phase of a PID service within the NFDI basic services, the working group Persistent Identifier of the Section <em>Common Infrastructures</em> of the NFDI hosted an online workshop in January 2023. In the course of the workshop, members of nine different NFDI consortia presented the current application of PIDs in their consortia.

DGK and its contribution to GGOS