Background Recent crises have shown how complex threats to population health have become. Disease outbreaks, climate-related disasters, geopolitical tensions and disruptions to critical infrastructure do not occur in isolation: they overlap and reinforce one another, straining existing preparedness systems. In Germany, municipal public health authorities (“Gesundheitsämter”) are central to crisis response, yet their operational preparedness requirements are not clearly defined. Objectives We aimed to identify cross-cutting preparedness needs of German municipal public health authorities based on expert contributions presented at the 2025 DGÖGB symposium on Population Health Preparedness for Crisis (“Bevölkerungsmedizinische Vorbereitungen auf die Krise”). Sample and Methods We qualitatively analysed submissions from eight of the nine symposium speakers, extracting each contribution's main argument, thematic focus, and operational recommendations, checking AI-assisted summaries against the original documents and grouping recurring themes relevant to German municipal public health authorities. A post hoc step mapped the emergent domains onto the 2026 WHO/IANPHI framework. Results We identified five cross-cutting domains: governance and health security; institutional coordination and a common operating picture; critical infrastructure and digital resilience; workforce capacity and operational readiness; and continuity of essential health services and protection of vulnerable populations. Mapping showed the strongest alignment for legal authority, coordination, emergency management, workforce development, public health and social measures, and clinical care guidance. Conclusions Population health crisis preparedness requires a systemic approach integrating public health, civil protection, healthcare delivery, and critical infrastructure resilience, all domains involving municipal public health authorities. Strengthening their institutional capacity should therefore be central to German health security policy.
Background Preterm births not only increase the immediate morbidity and mortality of newborns but also have long-term consequences. An analysis of the risk factors is therefore of great interest from a public health perspective. Objectives The aim of this study was to analyze sex-specific differences in the association between parity and the risk of preterm birth in singleton births. Methods 6,109 female and 6,505 male neonates born at the Donaustadt Clinic in Vienna between 2010 and 2020 were included in the study. The association between sex and preterm birth in the different parity groups was analyzed using binary logistic regressions, corrected for maternal parameters and the type of conception. Within each sex, the preterm birth rates for first, third and at least fourth births were compared with those for second births (reference group). Results Only in first-born children biological sex appears to be a significant predictor of the risk of preterm birth, with biological males showing a 36.4% higher risk than biological females. When comparing within each sex, firstborn girls had a 1.844 times higher risk of preterm birth than second-born ones, and firstborn boys had a 1.740 times higher risk than second-born ones. Girls who were at least the fourth child had a 2.438 times higher risk than second-born girls. Conclusion There are sex-specific differences in the association between preterm birth and parity.
Background A decrease of external skeletal robustness in children and adolescents over the last decades has been documented. This has mainly been attributed to a lack of movement during childhood and adolescence. Objectives This paper aims to determine whether this decrease of external skeletal robustness continues into adulthood. Sample and methods The elbow breadth, absolute and relative pelvic breadth, Frame index and the thoracic index were analysed in 1836 women between the ages of 18 and 29 years in two cohorts (birth years 1951–1994, 1995–2005). The means, standard deviations, minima and maxima as well as selected percentiles were calculated for each of the above-named measurements of both cohorts. The results were tested for significance using a Kolmogorov-Smirnov test. The samples were collected in Germany. Results Young women born after 1995 have lower mean values (p<0.05) for absolute pelvic breadth (27.3cm vs. 28.2cm), relative pelvic breadth (0.16 vs. 0.17), elbow breadth (5.9cm vs. 6.1cm), frame index (35.25 vs. 36.81), and thoracic index (67.87 vs. 69.46) than women born between 1951–1994. Conclusions The trend toward a reduced external skeletal robustness observed in modern children and adolescents seems to continue into adulthood. The changes in the thoracic index appear to be due to the secular trend in growth.
Background Research increasingly suggests that vitamin D plays a significant role in the development and severity of allergic diseases. However, less is known about how vitamin D status and allergic sensitization may jointly influence bone health. Objective The aim of this study was to investigate the relationship between allergies, vitamin D levels and bone quality and quantity in a Slovak adult population. Sample and Methods The sample consisted of 198 participants aged 19–57, 53 men with a mean age of 36.6±9.6 years (16 without allergy, 37 with allergy) and 145 women with a mean age of 36.1±10.0 years (48 without allergy, 97 with allergy). Allergy diagnosis was confirmed by a physician in an immunoallergology outpatient clinic. Health data (medical history, lifestyle, allergy history/treatment and vitamin supplementation) were collected by questionnaire and bone tissue quality and quantity parameter (T-score, Z-score) were assessed using a Sunlight MiniOmni ultrasound densitometer. Results Among women, Mann–Whitney U tests showed lower vitamin D with grass (p=0.006; rrb=0.375) and animal allergy (p=0.011; rrb=0.453). Moreover, in t tests, Z-scores were lower in women with animal allergy (p=0.047; 0.26 vs 0.76). Among men, animal allergy was associated with reduced T- and Z-scores (p=0.035 for both) and showed negative correlations with T-score (p=0.035; r=−0.297) and Z-score (p=0.035; r=−0.296). Conclusions Specific allergic conditions may be associated with lower vitamin D levels and reduced bone tissue quality and quantity, with notable sex-specific patterns.
Assessing the velocity of growth in height is essential for preventive health care and the clinical evaluation of growth. We provide practical tables with common centiles for annual changes in the height-for-age z-scores (HAZ), and correction factors for assessing short-term changes in HAZ depending on the time interval between two successive measurements (ranging from 42 to 170 days), and for series of multiple measurements of height.
Humans are social. They live and grow within their communities. Yet, despite similar genetic makeup and comparable physical living conditions, communities that do not share the same socio-cultural background often differ greatly in height. Evidence suggests that growth is substantially influenced by the social community (community effects on height) which narrows the spectrum of the potential variation in height by at least 50%. Strategic growth adjustments within social networks reflect the social position with physical size being a potent signal of dominance supported by a variety of accessory social and cultural signals and symbols among humans. The concept of Socio-Economic-Political- Emotional (SEPE) influences on growth describes growth as a mirror that signals the emotional balance between the socio-cultural exposome, the personal perception of this exposure and its translation via hypothalamic neuropeptides into the metabolome, and ultimately, into the physical signal of body size to be returned to the social community. The strong conservation of this complex signaling pathway since more than 400 million years in the vertebrate line suggests substantial evolutionary relevance, and is strongly supported by recent considerations on self-organizing processes found in both random network systems and in the social networks of a variety of social vertebrates.
Background: Globally, declining physical activity (PA) and health-related physical fitness (HRPF) levels among adolescents, if not intervened, may increase the risk of developing metabolic syndrome (Mets). Aim: We aimed to determine the relationship between PA, HRPF, and MetS markers in adolescents enrolled in the Physical Activity and Health Longitudinal (PAHL)-study. Subjects and Methods: This cross-sectional study included 215 adolescents from the 2011 data point of the PAHL-study in South Africa. We measured PA with the short form of the International Physical Activity Questionnaire, HRPF with the EUROFIT fitness tests, and blood lipid profiles. Participants were classified as having MetS markers to according to the International Diabetes Federation and the National Cholesterol Education Program Adult Treatment Panel. Multiple regression analysis was performed to report the associations between PA, HRPF and MetS markers Results: Multivariable regression analysis for the total group showed that waist circumference had significant (p<0.001) negative associations with standing broad jump (β=-0.29), bent arm hang (β=-0.45), sit-ups (β=-0.14), and predicted V̇O2max (β=-0.36). Conclusion: High abdominal fatness was evident in the South African adolescent and associated with poor HRPF. Based on these findings, HRPF interventions should be explored as a cost-effective strategy to mitigate MetS risk in adolescents.
In the second part of this tutorial series, we will discuss the foundations of univariate statistics. We will define statistical terms such as p-value, confidence interval, and effect size. The latter two are often neglected, but they are more informative than the commonly overinterpreted p-value. A p-value expresses the likelihood of observing a difference, or a larger, between a sample and a population parameter, or between two groups, assuming they share the same distribution. In univariate statistics, this difference is between a sample and a known population value. The assumption of equal distributions is the null hypothesis, which may be rejected if the p-value is very small. Importantly, the p-value depends not only on the difference itself but also on the sample size. Large samples can yield very small, highly significant p-values even when the effect size is trivial. In contrast, a confidence interval provides a range for the population parameter based on the sample, giving insight into precision beyond statistical significance. The effect size conveys the magnitude of an effect, which simplifies interpretation and allows to assess the relevance of observed differences. In this review, we explain these terms in the context of univariate statistics, comparing variables of interest from sample data against a known population value such as a mean or proportion. Relevant measures and visualizations include the mean, standard deviation, coefficient of variation, and histograms, barplots, along with effect size measures like Cohen’s d for numerical data and Cohen’s w for categorical data.
Background Anterior cruciate ligament rupture (ACL-R) is a common sports injury influenced by biomechanical, anthropometric, environmental, and genetic factors. Collagen gene polymorphisms have been implicated in ACL-R, with a whole-genome sequencing twin study highlighting COL12A1 rs970547 C>T as a variant of interest. However, the additive impact of the anthropometric traits and COL12A1 on ACL-R susceptibility remains unexplored. Objectives To investigate the additive effect of anthropometric traits and COL12A1 rs970547 C>T on ACL-R susceptibility in an Australian and South African cohort with the a priori hypothesis that female T/T carriers were at an increased risk. Sample and Methods The study included ACL-R cases (Australia n = 354; South Africa n = 252) and controls (Australia n = 84; South Africa n = 232). COL12A1 rs970547 C>T SNP was genotyped using TaqMan® assays. Anthropometric traits were sex-stratified/standardised. Logistic regression and principal component analyses were assessed. Results No significant genetic associations were found for COL12A1 rs970547 C>T in the i) individual/combined and ii) male/female cohorts. PCA revealed clustering of anthropometrics in PC1–PC2, with PC3 being driven exclusively by rs970547 in each cohort. Conclusion No associations were noted between the COL12A1 rs970547 T/T genotype and ACL-R risk. PCA, however, indicated that rs970547 may hold biological significance in ACL-R susceptibility, highlighting the complex interplay of genetic and anthropometric traits.
Background The study of bone health in younger individuals is less explored than in older populations but may offer insights into preventing future bone conditions. Objectives This study analyzes the link between bone quality and energy drink consumption while considering factors like physical activity and body composition. Sample and Methods The sample comprised 911 Slovaks, male and female, aged 18–30 (21.53 ± 2.27). Bone mineral density was measured using a quantitative ultrasound device (Sunlight MiniOmni™), yielding speed of sound (SOS; m/s) data. Body composition variables, including Lean Body Mass (LBM; kg) and Percent Body Fat (PBF; %), were assessed with the bioimpedance analyzer InBody 770. Additional behavioural factors were gathered via a questionnaire based on the WHO Steps 2014. Results Sex was found to be a significant predictor of SOS [F(11,899 = 4.01), p < 0.001, R2 = 0.047], with females showing higher SOS than males (p < 0.001), whereas physical activity (p = 0.594) was not a significant predictor. Although energy drink consumption did not show a direct impact on SOS according to the Saint Nicholas House Analysis (SNHA), it was a significant predictor in those who drank 1–2 days/week (p = 0.009) and those who drank less than once a month (p=0.023) with these individuals exhibiting lower SOS than non-consumers, thus poorer bone tissue quality. Conclusion In summary, energy drinks consumed 1–2 days/week and less than once a month are associated with bone tissue quality in young adults, albeit not directly posing a potential adverse effect on bone health.
Statistics is the key skill required by reseachers to answer scientific questions based on often complex data sets. 9 students and young researchers from Indonesia, South Africa, Spain, Slovakia, and Germany were educated and trained on their own data sets with the aim to publish these results at the 7th International Students Summer School on Human Growth - Data Analysis and Statistics at the Ecological Station Gülpe of the University of Potsdam from July 3rd to 11th 2024.
Background Resource disparities are common in social networks, often driven by competitive interactions. Exploring how interventions like taxation influence these inequalities can reveal mechanisms for more balanced distributions. Objectives This study investigates the effects of a 10% tax rate and redistribution on inequality and resource stability within two network models: the ‘Winner-Loser Model’ which intensifies hierarchies through competitive interactions, and the ‘Null Model’, simulating equal opportunity exchanges. Sample and Methods We used Monte Carlo simulations with agents starting at equal resource levels, interacting under the rules of each model. Taxation effects were measured through Gini coefficients and Lambda stability scores across various network sizes. Results Taxation reduced Gini coefficients in both models, promoting more balanced distributions. Lambda values indicated that taxation improved stability, especially within the ‘Winner-Loser Model’, by diminishing extreme resource accumulation. Conclusions The study demonstrates that while competitive dynamics naturally drive inequality, taxation and redistribution mechanisms can stabilize and reduce disparities. These findings suggest that even simple redistribution can reduce hierarchical resource concentration and counteract extreme inequalities in networked settings.
Syphilis, a deadly sexually transmitted infection (STI), lost its terror with the introduction of antibiotics. Recent epidemiological data, however, revealed a reemergence of syphilis in Europe, despite the availability of inexpensive and effective treatments. In Austria, the epidemiological data are incomplete due to limited reporting requirements. Nevertheless, Austrian mass media reported increasing syphilis rates, as documented for other European countries. This study provides an epidemiological overview of syphilis cases in Austria from 1921–2021 and tested the hypothesis that in Austria syphilis rates increase as observed across Europe. Data on syphilis cases from 1921–2019 in Austria were gathered from statistical yearbooks and reports. Additional sex-specific data for 1998–2021 was provided by the Vienna Health Service. Syphilis incidences were highest in the 1920s and declined steadily until 1993. Since then, cases have increased slightly, peaking in 2009 and 2018 at seven cases per 100,000 residents, the highest incidence syphilis rate since 1975. This increase is comparable to that seen in other European countries, consequently this hypothesis was verified. Men living in Vienna were nine times more likely to be infected with syphilis than women of comparable age. The rising syphilis infection rates in Vienna over the last 30 years correspond to those in other Austrian provinces, but also to those in other European countries. From the viewpoint of public health, the introduction of an obligatory reporting system of all diagnosed syphilis cases in Austria is recommended. In addition, regular screenings, treatment, and efforts to reduce discrimination and stigma against sexual minorities may help to prevent rising syphilis rates.
Background Anterior cruciate ligament (ACL) ruptures are common musculoskeletal injuries, influenced by extrinsic and intrinsic factors such as genetic variations and anthropometric traits. While these factors contribute to ACL rupture susceptibility, their interactions are underexplored. Objectives To investigate the relationship between HSPG2 variants and anthropometric traits in participants from an ACL study from Poland and Sweden. Hypothesis Genetic variability within HSPG2 loci along with height variability may collectively contribute to ACL rupture susceptibility. Sample and methods A genetic case-control association study was conducted with two cohorts from Poland and Sweden and a combined cohort. Participants were self-reported Caucasian and physically active. The combined cohort consisted of 265 asymptomatic controls (POL-CON=150; SWD-CON=116); 237 ACL rupture cases (POL-ACLR=141; SWD-ACLR=95) and a subgroup of 135 non-contact ACL ruptures (POL-NON=54; SWD-NON=79). Participants were genotyped for rs2291826 A>G and rs2291827 G>A and data were analysed using R, with p<0.05. Results Strong correlations were found between mass and BMI across all cohorts (r=0.78–0.81), suggesting these traits may influence injury risk. Sex-mass and sex-height correlations were consistent, with a strong negative correlation between sex and height in the Swedish cohort (r=-0.75). No positive correlations were found between the HSPG2 variants and anthropometric traits, except a moderate negative correlation between rs2291826A>G and height in the Swedish cohort (r=-0.019, p<0.009), suggesting possible genotype effect on height. Conclusion Mass and BMI were highlighted as potential risk factors for ACL rupture. Height-mass relationships varied by sex and population, suggesting both genetics and environment impact injury patterns. Further testing of the variants may clarify their role in ACL injury variability.
Background Historical evidence highlights links between height and environmental factors, with geographic isolation playing a crucial role. The Kangean Island, one of Indonesia’s small, isolated islands, offers a unique context for research on growth. Objectives The study aims to compare the height of 15-17-year-old girls in Malang, Java, with those of the same age on Kangean. It also compares the height of boys and girls aged 1 month–12 years old from Arjasa and Kangayan locations over two hours away from the port on the Kangean Island. Sample and Methods We studied 2 groups with a total of 393 participants: girls aged 15–17 years from Malang (n=91); and Kangean (n=94), children aged 1 month–12 years from the Kangean Island (n=208); we measured the participants’ height, weight, and BMI, converted them based on the WHO-reference SDS values from 2007, and then analyzed the data using SPSS. Results Compared with Malang, female adolescents on Kangean were shorter (-1.42±0.79 vs. -0.88±0.79, p<0.001), had lower weight (-1.84±1.40 vs. -0.50±1.18, p=0.00), and lower BMI (-0.84±1.29 vs. 0.069±1.02, p<0.001). Kangayan boys were shorter than those in Arjasa (-1.67±1.00 vs. -0.83±1.36; p<0.001), while Kangayan girls were similar to their counterparts in Arjasa. There were no significant differences in weight between all the Kangan and Arjasa groups, but Kangayan’s children had a higher mean BMI-SDS than Arjasa’s (boys: -0.55±1.45 vs. -1.32±1.52; p=0.009; girls: -0.54±0.94 vs. -1.12 ± 1.04; p=0.01). Conclusion Living on a small island and the distance from its port differently affect the growth of children and adolescents.
Background Investigating migration is crucial for understanding population changes and their impact on growth. Migration and its associated Social-Economic-Political-Emotional (SEPE) factors can influence height, aligning with the theory of “developmental plasticity”, which suggests that environmental stimuli affect growth patterns. Objective This study aims to analyse the impact of migration and associated stress on the growth and development of first- and second-generation migrant children in Germany. Sample and Methods The analysis utilized the KiGGS (German Health Interview and Examination Survey for Children and Adolescents) dataset, collected by the RKI (Robert Koch-Institut, the central public health institute in Germany) between 2003 and 2006. The baseline survey included anthropometric, demographic, and social data from 8,986 males and 8,654 females, aged 0–17 years across 167 cities in Germany. Height data from first- and second-generation Turkish-origin children and their German-origin peers were analysed to assess differences in growth patterns. Results Differences in height were observed between first- and second-generation immigrant children of Turkish origin compared to German-origin peers. Second-generation boys aged 3–10 (heightSDS=-0.29) were shorter than German-origin peers (heightSDS=0.04). First-generation boys in this group were even shorter (heightSDS=-0.19). In the 11–17 group, second-generation boys showed a heightSDS of 0.12, above their German-origin counterparts (height SDS=0.06), while first-generation boys were notably shorter (heightSDS=-0.54). For children (aged 3–10) and adolescents (aged 11–17) of both sexes, no significant differences were found between the first and second generations. Conclusion Migration and associated environmental factors impact children’s height, highlighting the complexity of generational shifts in physical growth.
Sixteen scientists met for the annual Auxological conference held at Krobielowice, Poland, to discuss plasticity of child and adolescent growth in historical and contemporary populations. Secular trends in body height and trends in the distribution of body weight and body mass index were discussed both in view of concurrent trends in economic variables, health, nutrition, and education, and, in view of more recent evidence of body height, as a social signal. Post-war periods of political instability associated with visions of future independence and prosperity favor upward body height trends independent of the economic and almost independent of the nutritional situation. Body height relates to social mobility and depends on education. A study on the relationship of social status, somatic characteristics of frequent horse riding, number of weapons, and body height in 6th to 8th century Avars emphasized the relevance of height as a social signal also in a nomadic medieval population. Migrants are particularly prone to plasticity in height, as the associated socio-economic-political and emotional (SEPE) burden of migration significantly interferes with the regulation of growth. Different patterns were observed in indigenous Hadza where body height does not seem to be an important social signal that influences preferences regarding both in-camp and out-of-camp activities. Indigenous populations are vulnerable and prone to notable decline in their health status. Taking a decolonial view on the historical well-being of the Xavante, the overall health status of this Brazilian population has significantly worsened despite changes in the administrative frameworks, including reductions in mortality rates and increased hospital service usage. In addition to height, the alterations in body weight, the effects of fat mass on physical fitness, lifestyle, sports, and general health in Polish, Czech, and Turkish populations were discussed. Modern body weight distributions are skewed, but the weight of historical urban and contemporary rural populations of developing countries is symmetrically distributed. The skewness of the contemporary weight references leads to underestimating overweight and overestimating the prevalence of wasting. Seasonality was an important factor for growth outcome and health in historical populations. The session was terminated with contributions on body proportion charts, and nutrition in autism spectrum disorders.
Background Several factors directly and indirectly influence child growth. Menarche is the initial menstrual period that is regulated by the hypothalamic-pituitary-gonadal axis. Both growth and menarche are affected by biological, genetic, epigenetic, nutritional, and psychosocial factors. Boarding schools are assumed to encourage responsibility and maturity in children, but boarding schools are also reported to have less sleeping duration. Objectives The current study aims to assess whether there are differences and associations in sleeping duration, physical activity, weight, height, body mass index (BMI), and age of menarche among students in boarding school and regular school. Sample and Methods 123 girls from boarding school and 90 from regular school were selected. Students completed a questionnaire, and data on weight, height, and BMI were collected. Weight, height, and BMI were transformed into standard deviation score (SDS) according to the WHO growth chart. The data were processed using an independent t-test, multiple regression analysis, and St. Nicolas house analysis. Results Independent t-test results showed that there are differences in the median sleep duration (5.36 hours vs. 7.14 hours), weight SDS (-0.09 vs. 0.41), height SDS (-0.65 vs. 0.05), and age of menarche (11.6 vs. 11 years old), respectively, for boarding school and regular school, while there are no differences in physical activity and BMI SDS. Multiple regression analysis and St. Nicolas house analysis showed that sleep duration has a correlation with weight SDS, height SDS, and age of menarche (p < 0.05). Conclusions There is an association between sleep duration, growth, and menarche. Girls with less sleep duration have lower height and weight and are delayed in the age of menarche.
Background Lack of physical activity is associated with various health risks. Yet, instead of indulging their natural urge to move, the majority of today’s preschool children tends to spend a substantial portion of the day in sedentary pursuit. Objective To investigate patterns of motor skills related to age, body size and strength, or to dexterity and movement coordination. Sample and Methods Eight anthropometric measurements and seven motor skill tests were performed in 144 boys and 120 girls aged 2.6 to 4.5 years. Children were measured in Berlin (Germany) in 2001/2002. Results Anthropometric variables and motor skills are multiply interrelated. Yet, there is an almost complete lack of progress in several motor skills between the age of 2.6 and 4.5 years. The indicators of dexterity, such as one-legged stance and backward balancing, show children of all age groups who performed very poorly. . Standing long jump and running speed as indicators of gross physical strength were moderately connected with height (r=0.48 and r=0.41, p<0.001). Conclusion Modern German preschool children show poor motor performance. The general pattern of motor skills that are related to dexterity and movement coordination and depend on practice and training, differ from those which depend on physical strength, such as standing long jump and running. The need for cooperation and mutual promotion of motor development by parents, physicians, and teachers, and the opening up of natural spaces to give room to the physiological urge to move for young children is evident.
Background Serial public health data may or may not reflect living conditions, political background and/or certain targeted health interventions. Yet, the effect of political events and/or health interventions that only last for a few years or a single legislative period may be difficult to analyze as restricting the range of the variables, i.e. the time interval within which the data were obtained, restricts the power of correlation analyzes. Objectives to provide a method to eliminate linear trends from serially obtained data and to visualize agreement between these data. Method We combine information of both the X- and the Y-axis and assess the agreement (coherence) between variables by clockwise (positive correlation) or anticlockwise (negative correlation) rotation of the coordinates. We provide an illustrative historic example of the coherence of infant mortality as an indicator of public health and body height in Germany between 1885 and 1995. Results Calculating coherence between correlating variables eliminates linear trends and leaves residuals that correspond to local correlation coefficients. The substantial changes in the coherence pattern of infant mortality and height exemplify the changes in the interaction between these variables during the transition from late feudalism to modern democracy. Conclusion Assessing coherence patterns enables a sensitive assessment of inhomogeneity and temporal trend changes in serially obtained correlated variables.
