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H Bräuer

Publications and source records attributed to H Bräuer.

At least 19 recordsLinked to original sources
PubMed2005

[Subtainable health promotion via organisational development--a model project for teachers in professional training schools].

The goal of this project is the development, implementation and evaluation of a concept designed for sustainable health promotion among occupational and trade school teachers. We assume that for sustainable health promotion -- along with a behavioral prevention program -- a change is necessary in the structure, as well as, the working and communication processes within schools. The realization of early teacher participation and self regulated cooperative groups initiates comprehensive and goal-oriented developmental processes in the project schools. The organizational development process was accomplished in the following way: At the beginning we conducted a diagnosis of school-specific and individual health risks and the resources available to the project schools. The results were reported for both the individual and for the teacher group. This was intended to clarify the potential for improvement and, thus, strengthen the teachers' motivation toward processes of change. Following the diagnosis, the teachers chose areas of stress-related strain and then worked in groups to develop and implement behaviour and working condition-oriented intervention strategies for health promotion. The diagnosis results confirm the necessity of school-specific health promotion: the schools demonstrate very different demand and resource profiles. Furthermore, is has become evident that the central success factor for health promotion in schools is the teachers' willingness for change. The individual and group reports of the diagnosis results seem to have made clear how essential individual and organisational changes are.

Education, Professional↗
PubMed2001

[Compliance with hand hygiene in intensive care units].

INTRODUCTION: Nosocomial infections are an important problem in modern hospitals. The prevalence in German intensive care units is 15.3%. Hand washing or hand disinfection is believed to be the most important means of preventing nosocomial infections. We wished to answer the following questions: 1. How good is the compliance of hand hygiene on intensive care units? 2. Is compliance associated with the patient/nurse-ratio? METHOD: In a study of 8 intensive care units the compliance of hand hygiene was observed on two occasions, once in May 1996 and again in November 1997. The prime necessity for hand disinfection occurred when handling ventilation devices, intravascular catheters, urinary catheters and dressings. In addition the patient/nurse-ratio was calculated. RESULTS: A total of 1,879 infection-relevant handlings were observed. The compliance of hand hygiene ranged from 25.7 to 83.2% (mean 55.2%). The most commonly observed handlings were the manipulation of venous catheters (52.7%), the highest compliance was observed with the manipulation of ventilation equipment (91.8%). With a better patient nurse ratio the compliance did not improve but remained the same or was even reduced. DISCUSSION: The compliance of hand disinfection is similar to other study results, but on some intensive care units there was considerable room for improvement. In this study the compliance of hand hygiene is more of a constant factor in individual intensive care units than associated with the patient/nurse-ratio.

Attitude of Health Personnel↗
PubMed2001

Converting incidence and prevalence data of nosocomial infections: results from eight hospitals.

OBJECTIVE: To investigate the use of the formula of Rhame and Sudderth for the interconversion of prevalence and incidence data on the frequency of nosocomial infections. DESIGN: Comparison of observed and calculated incidence data and prevalence data. SETTING: One 8-week incidence investigation in the surgical and intensive care units of eight medium-sized hospitals; three separate point-prevalence studies in the same units. RESULTS: The overall prevalence observed after the three prevalence studies in 2,169 patients was 6.8% (95% confidence interval [CI95], 5.7-8.0). In 2,882 discharged patients observed during the incidence study, the mean hospitalization was 9.8 days; patients with one or more nosocomial infection had a mean hospitalization time of 22.3 days and a mean interval of 8.2 days from admission to the first day of infection. Based on these data, the overall calculated incidence was 4.7%, whereas the observed incidence was 4.3% (CI95, 3.6-5.2). Vice versa, an overall prevalence of 6.2% was found when calculated from the observed incidence data. The incidence data calculated from prevalence data also were within the confidence interval of the incidences observed for urinary tract infections and surgical-site infections. (However, it was not possible to convert the data for two of the eight hospitals.) CONCLUSION: The approximate mathematical relationship between the prevalence and incidence data of nosocomial infection is confirmed by this study. However, although it is theoretically possible, we would not recommend the conversion of prevalence into incidence data or vice versa.

Cross Infection↗
PubMed2001

Surveillance of nosocomial infections in ICUs: is postdischarge surveillance indispensable?

OBJECTIVE: To determine how many infections are missed if the postdischarge surveillance (PDS) follow-up of intensive care unit (ICU) patients that is required by the National Nosocomial Infection Surveillance System method is not done. DESIGN: ICU patients were followed up and surveillance results with PDS (gold standard) and without PDS were compared. SETTING: Surgical or interdisciplinary ICUs in eight German acute-care hospitals. PATIENTS: All 1,857 patients within a 6-month period in the participating ICUs (a total of 9,129 ICU-patient-days). RESULTS: Without PDS, 45 urinary tract infections (UTIs) were diagnosed, compared with 53 with PDS; thus, 15% of the UTIs were missed if no postdischarge follow-up was performed. Three nosocomial pneumonias (4%) and one bloodstream infection (8%) also were missed if surveillance was carried out without PDS. A total of 198 nosocomial infections (NIs) were recorded with PDS, compared to 175 NIs without PDS. Approximately 12% of all ICU-associated NIs were missed if no follow-up was done. CONCLUSIONS: Since it is very time-consuming to follow patients after their transfer from the ICU, we do not perform a postdischarge follow-up of patients in the course of routine surveillance.

Cross Infection↗
PubMed2000

Repeated prevalence investigations on nosocomial infections for continuous surveillance.

In order to obtain an overview for the planning of further infection control activities, nine repeated prevalence studies were performed at monthly intervals. These occurred in the surgical units of eight medium-sized German hospitals. A total of 4984 surgical patients were investigated, the number of patients observed in each hospital varied from 365 to 913 patients, an average of 69.2 patients per prevalence study per hospital. A total of 212 nosocomial infections were found, the majority being surgical site (43.9%) and urinary tract infection (33.0%). The overall prevalence rate was 4.0%. More than four repeated investigations had only a minor influence on the 95% confidence intervals, and a follow-up of late microbiological reports increased the prevalence rate by only 7.5%. However, it was very useful to record the presence of urinary catheters on the prevalence day and also the preceding days; for instance, a device-associated prevalence of 7.8 urinary tract infections per 100 patients with urinary catheters was found on the day of investigation. In order to evaluate the situation in one's own surgical department by prevalence studies and for reasons of cost-effectiveness, the workload can be limited to four repeated studies in most hospitals. A further follow-up of later microbiological reports is not recommended, and it seems useful to concentrate on patients with indwelling devices.

Cross Infection↗
PubMed1999

How many nosocomial infections are missed if identification is restricted to patients with either microbiology reports or antibiotic administration?

OBJECTIVE: To investigate how many nosocomial infections would be missed if surveillance activities were restricted to patients having either microbiology reports or antibiotic administration. DESIGN: Analysis of data from a large prevalence study on nosocomial infections (Nosocomial Infections in Germany-Surveillance and Prevention). SETTING: A total of 14,966 patients were investigated in medical, surgical, obstetric-gynecologic, and intensive-care units of 72 German hospitals representatively selected according to size. Five hundred eighteen patients (3.5%) had at least one nosocomial infection. Microbiology reports were available for 56.6% of these patients on the prevalence day, and 86.3% received antibiotics. RESULTS: Only 31 nosocomially infected patients (6%) would have been missed by using either microbiology reports or antibiotic treatment as an indicator. These indicators of nosocomial infections had a high diagnostic sensitivity for nosocomial pneumonia (98.8%), urinary tract infections (96.3%), and primary bloodstream infections (95.3%), but a lower sensitivity for wound infections (85.4%). Thus, 97.4% of all nosocomial infections were found with this method in intensive-care units and 96.1% in medicine units, but only 89.7% in surgical departments. In 9 (12.5%) of 72 hospitals, the overall sensitivity would have been <80% using a combination of the two indicators. For this reason, the situation in one's own hospital should be checked before using this method. CONCLUSIONS: After checking the situation in one's own hospital, the "either-or" approach using the two indicators "microbiology report" and "antibiotic administration" can be recommended as a time-saving measure to diagnose pneumonia, urinary tract, and primary bloodstream infections. For wound infections, additional information obtained by changing dressings or participating in ward rounds is necessary to achieve satisfactory sensitivity in the surveillance of nosocomial infections. Of course, it is necessary that the surveillance staff discard all false positives to ensure a satisfactory specificity.

Anti-Bacterial Agents↗
PubMed1986

Ferritin versus ferrous sulphate preparations: a controlled study in sideropaenic patients.

A double-blind study was carried out in 54 patients requiring iron therapy to compare the effects of orally administered bivalent and trivalent iron over a period of 12 weeks. Patients were allocated at random to receive ferrous sulphate (100 mg/day), ferritin (80 mg/day as Fe3+) or a combination of ferritin (80 mg Fe3+/day), folinic acid and vitamin B12 coenzyme. Haematological measurements made before and during treatment showed that, whilst there were significant improvements in all of the parameters studied with both the bivalent and trivalent forms of iron, the results were more progressive and consistent with the two ferritin preparations, indicating that ferritin is clinically effective as a physiological iron donor in sideropaenic conditions.

Adolescent↗
PubMed1984

On the therapeutic effects of trivalent and divalent iron in iron deficiency anaemia.

The effectiveness of orally administered iron was investigated using three different iron preparations in a randomized study with 3 patient groups, each consisting of 20 subjects with iron deficiency anaemia. Group A received a ferric(III)-dextrin complex, group B Fe(II)-sulfate, and group C Fe(II)-fumarate with vitamins. For all three preparations the increase in the number of erythrocytes as well as hemoglobin and hematocrit values ran absolutely parallel for a period of 12 weeks. A relevant difference between the trivalent ferric-dextrin complex and the two bivalent iron preparations could not be detected on evaluation of the parameters measured except for a moderate increase in the transaminase values in the patients group who received the Fe(II)-sulfate preparation. No differences were found among the preparations with respect to tolerance. The results are discussed with respect to a possible overloading of the iron transport system by highly absorptive Fe(II)-preparations.

Adult↗
PubMed1981

[Quantitative measurement of 59Fe-absorption. Comparison between iron labelled Parkevit-Fe and an iron-mono-preparation using a wholebody counter (author's transl)].

The intraindividual bioavailability of two iron preparations, resistant to gastric juice, was investigated in 6 healthy volunteers (3 women, 3 men) at the age of about 50 years. They got 59Fe++ labelled preparations. A wholebody-counter with 3 NaJ(T1)-detectors (5 x 4") was used to measure the 59Fe-absorption. 14 days after application the control-preparation showed an 59Fe++-absorption of 1.7 mg and the test-preparation (Parkevit-Fe) showed an absorption of 2.2 mg. This is 100% more than the daily nutritional absorption = 1 mg.

Biological Availability↗
PubMed1980

[Cholesterol deficiency. A pathogenetic factor in chronic anemias? Preliminary report of a study in three states (author's transl)].

It has been shown in several studies that there is a statistically confirmed connection between cholesterol and Hb levels in the sense that hypocholesterolemia and anemia occur together particular frequently. This was demonstrated in an epidemiological cross-section study of 3958 patient data, and also that in a retrospective case control study of 159 anemias there was a concurrent hypocholesterolemia. It is postulated that a causal connection exists which is explained by the fact that cholesterol deficiency leads to rigidity of the erythrocytes.

Adult↗
PubMed1980

[The influence of so-called "diet" fats high in polyene acids on blood constituents, serum cholesterol and organ systems].

The Effect of Various Alimentary Fats, Especially "Diet" Fats With High Proportions of Polyene Acids on the Blood Count, Cholesterol Levels and Organ Systems: This paper describes our observations on the possible toxicity of highly unsaturated fatty acids on the cell systems of the red blood, the liver and kidney. At the same time the necessity of maintaining a normal level of cholesterol in the blood and a stable pool of saturated fatty acids in the serum is pointed out with reference to our own investigations. By means of a reference record histogram, the lower critical point of cholesterol level is verified. A correlation between the low cholesterol level, relatively low hemoglobin values and low erythrocyte count is substantiated., By means of a nutritional physiology study in patients with defined anemias and cholesterol deficit, an attempt was made to establish a causal connection between low cholesterol and anemia. Further, it could be shown that highly unsaturated fatty acids (polyene acids) of the C189:2 cis ("curved fats") type such as occur in diet margarines, thistle oil and other vegetable oils in high concentrations, can cause damage to cell membranes and the cell systems of the red blood, the liver and kidney by excessive ingestion in the food. Biochemical work on the present knowledge of the formation of lipofuscin (the "age pigment") by polymerization products from unsaturated fatty acids is referred to. In a controlled nutritional physiology trial in pigs the facts observed in human medicine were confirmed. So it is postulated that the curative pronouncements claimed by the bottlers of thistle oil and the manufactures of diet margarines are not valid. Taking the Codex Alimentarius of the FAO/WHO, which gives the acceptable daily dosage in mg/kg body weight as a guide, according to the present state of toxicological information, a maximum of 10 g unsaturated fatty acids of the C18:2 cis type can be consumed for a lifetime without suffering noticeable harm. This corresponds to a highly unsaturated fatty acids proportion of less than 8% in the daily diet.

Anemia↗