Das Gesundheitswesen
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In the international context drug policy is defined as a prohibitive control regime equipped with government functions. A possible extension has led to conflicts within the member states of the international drug control, resulting in two opposite positions: (1) A prohibitive line adhering to a ban of narcotic drugs, applying prosecution not only against dealers but also consumers and organizing help for drug addicts only to end drug abuse and not for any controlled consumption; (2) a permissive line aiming at a more or less controlled liberation of the use of narcotic drugs, limiting prosecution at the most to organized drug dealing, generally attempting to "decriminalize" the consumption, and finally to define heroine as a possible legal help for drug-addicts. The conflict concerning a new definition of national politics on drugs finds most public attention in Switzerland, where the government (Bundesrat) tries to follow a middle-of-the-road policy. Present German policy of the leftist federal government favors the Swiss paradigm; but Federal states like Bavaria under a conservative government still oppose this attitude.
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Das Gesundheitswesen · Jun 1999
Review[Perspectives in public health care for refugees in Germany].
Germany in fact became an immigration country during the last 25 years. The German public health service for refugees aims at avoiding epidemic diseases and protecting the local population. In spite of the internationally recognised high capability of the German health system it is open to question whether sufficient health care for refugees who are regarded as highly vulnerable is guaranteed. ⋯ Health as well as the health care of refugees appears to be fragmented. Three possible scenarios of the health care of refugees are discussed: Compartmentalisation of general health care, incorporation of health care through the communities of migrants as well as stronger integration in the German health care system. The article bases on a research of present scientific work about health and illness of refugees as well as on empirical data of a feasibility study in an area in south-west Germany on the health and primary health care for refugees.
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Das Gesundheitswesen · May 1999
Review[Problem orientation in social medicine--participation in social medicine].
Problem-oriented learning is gaining increasing importance in medical education. The current discussion on reforming medical education in the medical schools in Austria reflects this importance. At the medical school in Graz for many years teaching the core module "social medicine" has been problem-oriented. ⋯ The students are not familiar with problem-based learning and have difficulties in adapting. To be better prepared for the coming changes in the discipline of medicine, the social dimension should be integrated earlier into medical education. The most efficient way of doing so should be clarified in the discussion of the reform in medical education.
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Das Gesundheitswesen · Apr 1999
[Transmission of infectious diseases during imprisonment--results of a study and introduction of a model project for infection prevention in Lower Saxony].
The increasing imprisonment rate of drug users is linked to a spread of infectious diseases in prisons (HIV and Hepatitis B and C). Several studies indicate a close correlation of imprisonment and transmission of infectious diseases. An analysis of international studies showed that worldwide in several cases transmissions of HIV-infection during imprisonment have been discovered. ⋯ As the first provencial government, the state of Lower Saxony in Germany has started to develop infection prophylaxis offers in two prisons (in the women's prison in Vechta since April 15th 1996 and in the men's prison of Lingen I, department Gross Hesepe since July 15th 1996) in 1996. These offers include the provision of sterile injection equipment to intravenous drug addicts (ivDA). Modalities of the practice and first experiences documented by the schientific evaluation are presented.
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Using the method of multistate life-tables, the article presents results on active life expectancy on the basis of the German Socio-Economic Panel Survey (SOEP). Different determinants of mortality and morbidity are revealed by event-history analysis. Results show that men live a greater proportion of their lives without disability than do women. Results on the association between mortality/morbidity and socio-economic factors suggest that studies which usually focussed either on mortality or on morbidity cannot fully explain differences in active life expectancy.