Das Gesundheitswesen
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Hydraulic fracturing (fracking) is a technique used to release and promote the extraction of natural gas (including shale gas, tight gas, and coal bed methane) from deep natural gas deposits. Among the German public there is great concern with regard to the potential environmental impacts of fracking including the contamination of ground water, the most important source of drinking water in Germany. In the present article the risks of ground water contamination through fracking are discussed. ⋯ The toxicity of chemical additives of fracking fluids is discussed. It is recommended that in the future environmental impact assessment and approval of fracs should be performed by the mining authorities in close cooperation with the water authorities. Furthermore, it is recommended that hydraulic fracturing in the future should be accompanied by obligatory ground water monitoring.
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Germany is a low-incidence country for tuberculosis, but there is no time for complacency. With an annual incidence of 10 per 100,000 population the City of Munich counts twice as many cases of tuberculosis compared to the national average. Reasons for the concentration of tuberculosis in big cities include the high proportion of migrants from countries with high prevalence of tuberculosis and from socioeconomically disadvantaged populations. ⋯ But duration, cost and side effects of therapy are strong barriers to treatment success. All patients have the right to get adequate diagnostic work-up and effective treatment no matter in which country they reside. To realize this request with cross-border control and care, is a big challenge to the public health service in a global perspective.
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Das Gesundheitswesen · Oct 2013
[Health according to standard or varied health? Management of chronic diseases].
The increasing proportion of people with chronic diseases makes changes in health care necessary. The question arises which socio-cultural, economic and personal factors as well as resources (available to the patient) influence the coping with the disease and the utiliation of health services. Only an analysis of the key factors influencing the management of a (chronic) disease enables us to offer demand-oriented and effective support services.
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Consumer health-care information technology is intended to improve patients' opportunities to gather information about their own health. Ideally, this will be achieved through an improved involvement of existing data bases and an improved communication of information to patients and to care providers, if desired by patients. ⋯ All consumer health-care information technology services are optional and leave patients in control of their medical data at all times. This article reflects the current status of consumer health-care information technology research and suggests further research areas that should be addressed.