In the rehabilitation patient population, the prevalence rates of MRSA and ESBL were found to be in the range of rates encountered in the general population (reported rates for MRSA, 0.5%, and ESBL, 6.3%). The known risk factors for MRSA such as skin lesions, medical devices and previous history for MRSA were also confirmed among this patient population. Direct transfer from an acute care hospital, antimicrobial treatment during the past 3 months, and wounds proved significant risk factors for ESBL colonization. Patients of neurologic rehabilitation and geriatric patients showed the highest rates of risk factors and the highest prevalence rates of multidrug-resistant organisms. It appears to be of importance for rehabilitation hospitals to be geared to the needs of patients with multidrug-resistant organisms, and prevent the transmission of these pathogens by appropriate hygiene measures.

No abstract

Lower excess mortality could be seen in Frankfurt am Main during heat waves following the implementation of HHAP and the heat warning system. This might be an effect of the measures implemented by the HHAP to reduce heat mortality. However, it cannot be ruled out that this might also be an effect of shorter heat wave periods and lower air pollution in the subsequent years. Therefore, further efforts are needed to improve the resilience of the population, especially the elderly population, to better cope with heat waves.

The humanitarian consultation-hour is an important offer provided by the Public Health Department of the City of Frankfurt am Main and is used by a large number of people who are seeking help. In particular, people from South Eastern Europe are increasingly visiting the consultation-hour. Activities such as the humanitarian consultation-hour can take over subsidiary activities for a transitional period, however long-term structural solutions must be provided to ensure access to health care for this vulnerable group.

Risk analysis according to KRINKO showed that in rehabilitation facilities with internal medicine or orthopedics specialties, there was a comparably lower risk for transmission, colonization, and/or infection with multidrug-resistant pathogens, as against institutions with neurologic or geriatric specialty. It appears that in the first type of rehabilitation facilities, consistently carried out basic hygiene measures are sufficient while in neurologic or geriatric rehabilitation hospitals, these measures should be supplemented with additional hygiene measures based on medical risk analysis. Furthermore, for infection control purposes in rehabilitation facilities, patient isolation will be rarely necessary or appropriate. These analyses suggest that in the future, rehabilitation programs for MRSA/ESBL-colonized patients will be more successful.

The focus of the lateral entrance examination is a school-related health status. On the basis of experience gained in Frankfurt am Main, it should be pointed out that investigations by the lateral entrants from other countries seem necessary, in particular visual and hearing screening, physical examination and checking the vaccination status, possibly in combination with vaccination. On the other hand, a detailed developmental screening does not appear to be urgent in the case of pupils who will be starting compulsory school, in whom there is no chance for additional encouragement before the start of school.

Many studies have shown urgent need in improving oral health hygiene in nursing home residents. Deficits in the knowledge of the personnel in dental and oral hygiene are often cited as one of the causes. Therefore in the spring of 2007 the nursing personnel of three nursing homes attended an oral health education programme. This programme was evaluated by examining the oral and dental health status of the residents, prior to and up to 12 months after the hygiene education. In three nursing homes in the Frankfurt am Main area, the oral health status of 113 residents was examined by a dentist with special education in geriatric dentistry, after receiving informed consent. Mean age was 80+/-9,2 years (49-97 years, 91 women, 40 men). Before, and 4, 8, and 12 months after education of the caregivers, the following data were recorded in the residents: DMF-T index (decayed, missed, filled teeth), plaque index, sulcus bleeding index (SBI), denture hygiene index (DHI), coating of the tongue. Two-thirds of the residents were dependent on caregivers' support for dental care. Initially, in two-thirds of the residents, a high plaque index (PLI>2) and denture hygiene index (DHI>4) was found, in 90% of the residents SBI was > 50%, in 74% of them the tongue was partly or totally coated. In 45% of the residents restorative treatment was required. After the education programme for the personnel, good improvement in oral health of the residents could be stated, with 43% residents exhibiting PLI>2 and 77% showing SBI > 50%. The percentage of clean and well cared for dental prostheses had increased from ca. 30% up to 70%. Within the 4 months 29 of 57 residents with recommendations for dental therapy had been seen by the dentist, 12 months after the first examination, dental therapy had to be recommended to only 19 residents. Education of the nursing staff in nursing homes is effective in improving oral health of the residents. Therefore, all residential homes will be offered regular and free education programmes in oral health for their personnel; this programme will be offered by the chamber of dentists in Hessen, Germany, and the public health services, Frankfurt/Main, Germany.

RESUMOO objetivo do presente trabalho foi avaliar as características morfométricas de equinos utilizados no patrulhamento ostensivo pertencentes aos Esquadrões de Polícia Montada localizados nos municípios de Lages, Joinville e Florianópolis -SC. Foram utilizados 101 animais (78 machos castrados, um garanhão e 22 fêmeas), com idade média de 11,9 anos e massa corpórea de 490,82±53,51kg. Foram tomadas 20 medidas lineares individuais, por meio das quais foram determinados 13 índices zootécnicos. Os dados foram avaliados segundo análise descritiva, e a comparação simples entre médias pelo teste t de Student (P<0,05). Houve diferença significativa entre machos e fêmeas com relação ao comprimento de garupa, largura da anca, perímetro da canela e IDT nos animais pertencentes ao Esquadrão de Florianópolis. Conclui-se que os equinos dos três Esquadrões avaliados são, em geral, animais baixos de frente, "longe de terra", eumétricos e longilíneos, e classificados entre animais de tração ligeira e de tração pesada.