There are still considerable differences in the medication supply for men and women. While the prescription volumes for both men and women have, for some time, been similar or have even risen for the men, there are still characteristic differences between the sexes when it comes to the prescription of certain indication groups. Women are still prescribed clearly more drugs in the field of psychotropic medication, especially antidepressants, hypnotic drugs, and tranquilisers. As the American Beers criteria for quite some time now and, more recently, the German PRISCUS list have shown, the effects of such drugs are potentially dangerous, particularly for older women. The known adverse effects are, apart from dependence problems, restricted cognitive capacities, insecure or instable walking, and badly healing wounds from falling accidents that are followed by patient's nursing care dependency. In secondary prophylaxis after acute myocardial infarction, the characteristic prescription features of the various medicinal products that are used for both men and women (such as platelet aggregation inhibitors, beta-receptor blockers, ACE-inhibitors, statins) have become similar; women's still higher mortality risk appears to go back to the fact that too much time is spent before proper hospital treatment commences. In general, more attention should be paid to the right medication, the right length of treatment, and the right dosage of the medication prescribed to women; the evidence concerning women's supply of medicinal products should also be improved.
Drug supply for children with psoriasis in Germany appears to be inadequate. The consensus guidelines are not sufficiently considered and the use of systemic corticosteroids is still too high, even after adjustment for steroid-dependent indications. The data underline the necessity of guideline-oriented therapy and implementation of current therapeutic evidence in juvenile psoriasis.
Zusammenfassung
Auch in der Coronakrise korrespondiert ein niedriger sozioökonomischer Status (z.B. niedrige Bildung, niedriger beruflicher Status, niedrige Löhne) von Erwerbstätigen mit ungleich schlechteren Gesundheitschancen und größeren Krankheitsrisiken. Überdies sind verschiedene Tätigkeitsgruppen (mit jeweils spezifischen Qualifikationen und Status) unterschiedlichen Gesundheitsrisiken ausgesetzt, generell und im Besonderen, während eine hoch ansteckende Virusinfektion grassiert. Das Infektionsrisiko unterscheidet sich zwischen Berufsgruppen, die Interaktionsarbeit in Kopräsenz ausüben, und solchen, die sie primär technisch vermittelt verrichten. Die wegen der Covid-19-Pandemie von Betrieben zu treffenden Infektionsschutzmaßnahmen haben nicht-intendierte Folgen für die Arbeitsqualität, die abhängig vom Tätigkeitsfeld unterschiedlich ausfallen. Der vorliegende Beitrag analysiert vergleichend das Krisenmanagement und seine gesundheitlichen Herausforderungen bei Unternehmen der sozialen Dienste (Pflege, Hauswirtschaft) und der IT-Services sowie deren Auswirkungen auf die Beschäftigten und ihre Arbeitsqualität. Es wird anhand von Betriebsfallstudien verdeutlicht, dass das betriebliche Krisenmanagement einerseits gesundheitliche Ungleichheit zu begrenzen vermag, andererseits aber auch neue Arbeitsbelastungen hervorbringen kann, die Gesundheitschancen von Beschäftigten verschlechtern können.
Objectives: Aging workforces with increasing numbers of chronic conditions require health initiatives with greater workplace focus. A regional pension insurance introduced a Return To Work (RTW) strategy for insurants with chronic conditions. The objective was to identify the degree of implementation of work related measures in medical rehabilitation and the extent of RTW outcomes. Methods: 5883 insurants were considered. Severe Restriction of Work Ability (SRWA), Work-related Medical Rehabilitation (WMR), and Case Management (CM) were examined for 2008 and 2012. An Index of Employment status (IoE) was used in a logistic regression. Results: Utilization of WMR raised from 12.3% in 2008 to 66.1% in 2012. The proportion of insurants with SRWA and WMR grew from 8% up to 40.1%. In 2008, 14.7% of insurants with SRWA received WMR; in 2012, it grew to 76.6%. On the other hand, in 2012 26% got WMR without SRWA and 12.2% had SRWA and got no WMR. CM was not conducted in 2008 but reached 20.2% in 2012. Across all indications, WMR resulted in positive RTW as measured by IoE: OR = 0.75 (KI-95%: 0.67-0.86). Conclusion: WMR was successfully implemented according to the German guideline. There is a need to optimize the linkage between SRWA and WMR and CM to provide need-based care.
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