Peter Kriwy

Four-year follow-up of school-based intervention on overweight children: the KOPS study.

Objective: To evaluate the 4‐year outcome of a school‐based health promotion on weight status as part of the Kiel Obesity Prevention Study (KOPS).

The Biological Standard of Living in the Two Germanies

Abstract Physical stature is used as a proxy for the biological standard of living in the two Germanies before and after unification in an analysis of a cross-sectional sample (1998) of adult heights, as well as among military recruits of the 1990s. West Germans tended to be taller than East Germans throughout the period under consideration. Contrary to official proclamations of a classless society, there were substantial social differences in physical stature in East Germany. Social differences in height were greater in the East among females, and less among males than in the West. The difficulties experienced by the East German population after 1961 is evident in the increase in social inequality of physical stature thereafter, as well as in the considerable gap relative to the height of the West German population. After unification, however, there is a tendency for East German males, but not of females, to catch up with their West German counterparts.

Social status and adult heights in the two Germanies

Background : Lack of evidence prevented hitherto the systematic comparison of physical stature across East and West Germany. Aim : The aim of this study is to compare heights by social status in the two Germanies with very different socio-economic and political systems prior to unification. Data : The German Federal Health Survey of 1998 (Public Use File BGS98), a cross-sectional random sample of 7124 adult males and females between ages 18 and 79 (birth cohorts of 1919-1980) is used in the analysis. Results : There are considerable and persistent differences by social status in both East and West Germany over time. The West German height advantage among men increases with social status, whereas among women the opposite is the case. East German men born after the Berlin Wall was built became significantly shorter, but East Germans regained equality with West Germans after unification. In contrast, East German females were markedly shorter than their West German counterparts throughout the period considered. Conclusions : The West German capitalistic welfare state provided a more propitious environment for the physical growth of the human organism than did the socialist East German government. There were substantial social differences in height in the officially classless German Democratic Republic.

Similarity of parents and physicians in the decision to vaccinate children against measles, mumps and rubella

ObjectivesThis study investigates parental decisions to vaccinate their children against measles, mumps and rubella (MMR). Parent and provider survey data allow the analysis of interactions between these major players in decision making.MethodsThree datasets are used for analysis: (a) the basic population of the school entry-level health checkup in Munich, Germany; (b) a face-to-face survey with parents of children taking the school entry-level health checkup; (c) a face-to-face survey of the physicians treating these children. Logistic, OLS and multilevel regressions were applied.ResultsHomophily due to similar ages of parents and physicians boosts the decision to vaccinate children against MMR. Also in relation to parent–physician interaction, the fact that a physician may be homeopathic has no effect on a parents’ decision to immunize, although vaccination-skeptical parents choose physicians who are trained in homeopathy.ConclusionsEfforts to improve the number of parental decisions for vaccination should focus on the educational level of the parents as well as homophily of parents and physicians. Notably, homogeneity of parents and providers concerning age changes decisions in favor of vaccinating.

Einstellungen zu einer gerechten Organallokation

OBJECTIVE Organ donation is widely discussed due to the lack of willingness among the public to be an organ donor and the resulting lack of organs destined for organ procurement. Criteria for the allocation of organs are analysed here from the view of laypersons. METHODOLOGY In a factorial survey, graduate students have been challenged to waitlist a fictive population of organ recipients. RESULTS The results of the multi-level analysis show that recipients with a high chance of survival and a high level of acuteness are favoured together with young recipients and people with children living in the same household. The attributes gender, marital status and children living outside the household of the organ recipients have no effect. In addition to factorial attributes, characteristics of the respondents have been analysed as well. Older respondents distribute more favourable places on the waiting list. Fictive recipients similar to the respondents (due to relative same age, gender and health status) were not preferred by the interviewees. CONCLUSIONS Even if official criteria for the allocation of organs account for medical or predominantly medical aspects, the results of the survey show that laypersons have further considerations in mind. In general, laypersons adjudicate organ procurement in a completely rational way. They maximise successful interventions and the survival time of the fictive patients.

Ungleichheit und Gesundheit von Kindern und Jugendlichen

Die Gesundheitschancen von Kindern und Jugendlichen in den verschiedenen Landern der Erde unterscheiden sich immens. Die Sterblichkeitsrate von Kindern unter funf Jahren betragt in Landern wie Niger und Sierra Leone 260 bis 285 Kinder pro 1000 Geborenen, wahrend die Kindersterblichkeitsrate in Industrielandern wie z.B. Schweden, Deutschland oder Japan nur bei drei bis funf Kindern liegt (Deutsches Komitee fur UNICEF 2003: 152–155). Die Lebenserwartung bei Geburt betrug im Jahr 2002 in den afrikanischen Landern sudlich der Sahara nur 60% der Lebenserwartung in Industriestaaten (46 Jahre gegenuber 78 Jahren). Die benachteiligten Lander haben ein sehr niedriges Bruttosozialprodukt und eine hohe Ungleichverteilung des Einkommens (Deutsches Komitee fur UNICEF 2003: 164–165). Dies ist begleitet mit erheblichen Mangeln in der Infrastruktur, wie der Versorgung mit sauberem Trinkwasser und dem Zugang zu Sanitareinrichtungen (Deutsches Komitee fur UNICEF 2003: 184–185). In den Landern sudlich der Sahara sind durchschnittlich 9% der erwachsenen Bevolkerung mit HIV infiziert oder an AIDS erkrankt. Dieser Anteil steigt in einzelnen Landern bis auf Werte von uber einem Drittel der 15- bis 49-jahrigen (Botswana 39%, Simbabwe 34%, Swasiland 33% und Lesotho 31%; Deutsches Komitee fur UNICEF 2003: 186–195), sodass in diesen Landern erhebliche Folgen fur die Lebens- und Gesundheitschancen von verwaisten Kindern, aber auch fur die Leistungsfahigkeit der Volkswirtschaften auftreten. Dass sich die Schere zwischen den Industrielandern und den benachteiligten Landern immer weiter offnet, zeigt die durchschnittliche jahrliche Senkung der Kindersterblichkeitsrate. Sie betrug in den sudlichen afrikanischen Landern im Zeitraum 1960 bis 1990 noch 1,3% und von 1990 bis 2002 nur noch 0,3%, wahrend die Kindersterblichkeitsrate in den Industrielandern im Zeitraum 1960 bis 1990 jahrlich um 4,5% und im Zeitraum 1990 bis 2002 immerhin noch um 3% sank (Deutsches Komitee fur UNICEF 2003: 250).

Kleine Fallzahlen in der empirischen Sozialforschung

Die Einleitung zum vorliegenden Sammelband soll dazu dienen, Antworten auf folgende Fragen zu liefern: Welche Rolle spielen Fallzahlen bei der Teststarkenanalyse (Abschnitt 1)? Was sind die Besonderheiten beim Umgang (Datenerhebung, -analyse, -interpretation und nicht zu vergessen die Theoriearbeit) mit kleinen Fallzahlen (Abschnitt 2)? Was ist uberhaupt „ein Fall“ (Abschnitt 3)? Abschliesend gehen wir auf den Aufbau dieses Bandes ein (Abschnitt 4).1

Die richtige Mischung? Ein randomisiertes Experiment zur Datenqualität bei der Kombination von Telefon- und Onlineerhebung in der empirischen Sozialforschung

Zusammenfassung: Der Beitrag untersucht die Datenqualität einer kombinierten Telefon- und Onlinebefragung. Solche Mixed-Mode-Designs werden in der deutschen akademischen Sozialforschung noch relativ selten eingesetzt, obwohl damit eine Reihe von Vorteilen verbunden sein kann. Allerdings können sich auch negative Effekte aus einer Kombination von Daten aus verschiedenen Quellen ergeben. Im Rahmen eines randomisierten Experimentes werden eine Single-Mode-Telefonbefragung und eine Mixed-Mode-Telefon-/Onlinebefragung hinsichtlich mehrerer Indikatoren der Datenqualität untersucht. Vorteilhafte Effekte zeigt die Mixed-Mode-Erhebung bezüglich einer erhöhten Responserate. Zudem liegen die soziodemographischen Merkmale der Befragten näher an der Grundgesamtheit und Antworten auf sensitive Fragen weisen geringere Messfehler auf. Andererseits erhöht sich die Antwortverweigerung, allerdings nur unter sehr spezifischen (und vermeidbaren) Bedingungen.

Psychosocial outcome in epilepsy after extratemporal surgery

OBJECTIVE Only limited data exist on psychosocial long-term outcome after epilepsy surgery in patients with extratemporal epilepsy. The aim of this study was to investigate psychosocial outcome after extratemporal epilepsy surgery and to assess factors predicting favorable outcome. METHOD Sixty-five out of 104 eligible patients who had undergone extratemporal epilepsy surgery at our epilepsy center between 1990 and 2015 (mean age: 42.2. years; 75% of the resections in the frontal lobe) completed a questionnaire asking about seizure status, employment status, marital and living situation, driving status, depressive symptoms, and quality of life (QOL). Follow-up was on average 9.2years after surgery (range: 1-26years). RESULTS Thirty-eight (58%) patients were free of disabling seizures (Engel class I), and 28 (43%) have not experienced any seizures after surgery (Engel class IA). Employment rate in the primary labor market remained at 45%, but more patients lost employment (14%) than gained employment (8%). Postoperative employment was predicted by preoperative employment (p=.007), seizure freedom (p=.025), older age at seizure onset (p=.018), younger age at follow-up (p=.035), and female gender (p=.048). Seizure-free patients were more likely to be driving; have a partner, particularly in males; and have lower depressive scores. Quality of life at follow-up was best predicted by employment (p=.012), partnership (p=.025), and seizure freedom (p=.025). In contrast, recurrence of seizures and early seizure onset were associated with poor psychosocial outcome, particularly in men. CONCLUSION The study provides support that extratemporal surgery can lead to improved QOL and favorable psychosocial outcome. Seizure freedom is important but not the only determinant of good psychosocial outcome.