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Valcárcel Jiménez M, Yumus M, Schiele T, Mues A, Niklas F. Preschool emergent literacy skills as predictors of reading and spelling in Grade 2 and the role of migration background in Germany. J Exp Child Psychol 2024; 244:105927. [PMID: 38678807 DOI: 10.1016/j.jecp.2024.105927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 05/01/2024]
Abstract
Children's emergent literacy skills are essential for the development of later literacy abilities and school success. However, children with migration background often show poorer language skills in the majority language and are at a greater risk of developing literacy deficits. In addition, there is evidence for the predictive role of emergent literacy skills in reading comprehension, but there has been relatively little research concerning the association between preschool emergent literacy skills and word reading and spelling in Germany, especially for children with migration background. This study examines the associations of emergent literacy skills (vocabulary, phonological awareness [PA], letter knowledge, and rapid naming) with word reading and spelling from kindergarten to the end of Grade 2 and evaluates the role of migration background (i.e., use of the majority or minority language at home) in these associations. Data from 187 preschool children were obtained before school entry (Mage = 63.58 months, SD = 4.45). The results show that vocabulary and letter knowledge were strong predictors of word reading, whereas letter knowledge and PA were significant predictors of spelling. Furthermore, children's migration background was negatively associated with preschool vocabulary and PA. For children with migration background, vocabulary was a significant predictor of word reading, whereas letter knowledge was the best predictor of word reading for children without migration background. The results reflect the complexity of language development and the relevance of emergent literacy skills as predictors for word reading and spelling. Specific interventions should be developed to promote children's literacy abilities.
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Affiliation(s)
- María Valcárcel Jiménez
- Department of Education and Educational Psychology, Ludwig-Maximilians-Universität München, 80802 Munich, Germany; Department of Educational Science and Psychology, Freie Universität Berlin, 14195 Berlin, Germany.
| | - Melike Yumus
- Carl von Ossietzky Universität Oldenburg, 26129 Oldenburg, Germany
| | - Tina Schiele
- Department of Education and Educational Psychology, Ludwig-Maximilians-Universität München, 80802 Munich, Germany
| | - Anna Mues
- Department of Education and Educational Psychology, Ludwig-Maximilians-Universität München, 80802 Munich, Germany
| | - Frank Niklas
- Department of Education and Educational Psychology, Ludwig-Maximilians-Universität München, 80802 Munich, Germany
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Muller DP, Verdonk P, van de Grift TC, de Koning MB. "As a psychiatry resident I am invited to explore my identity. But when I accept that invitation, I still encounter a wall." A qualitative study on inclusion experienced by psychiatry residents with a migration background, sexual minority identity and/or working-class background. Adv Health Sci Educ Theory Pract 2023; 28:1633-1656. [PMID: 37227542 DOI: 10.1007/s10459-023-10236-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 04/30/2023] [Indexed: 05/26/2023]
Abstract
Diversity in terms of class, sexual identity and migration background among medical students in high income countries has increased greatly in recent decades. Some research into the experiences of these new groups of doctors has been performed. However, no previous research into the experiences of psychiatry residents specifically, is known. This qualitative study investigates how psychiatry residents, from these minoritized groups, experience their training regarding inclusion. Inclusion is defined as the degree to which one's needs for connection and for being valued in one's uniqueness, is satisfied. In-depth interviews with 16 psychiatry residents were conducted. These interviews were transcribed and coded using MaxQDA software. Initial themes that were constructed, were explored further in subsequent interviews and linked to literature. Finally, the developed themes were ordered in a model conceptualizing inclusion. Participants reported high belongingness within psychiatry training. Their experienced value in uniqueness, however, was generally quite low. Participants reported to experience little interest in and sensitivity for their perspectives and lived experiences from their co-workers. When faced with stigmatization and discrimination, participants reported lack of support from their colleagues. Assimilation was found to be the most frequently used coping strategy in dealing with diversity. Participants seemed to conform to the 'neutral' norm and experienced barriers in expressing themselves. Through this mechanism of assimilation, the added value that participants might bring with their unique knowledge and lived experiences was not used, both in patient care and in creating an inclusive climate within the organization. Moreover, assimilation is associated with psychological strain.
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Affiliation(s)
| | - Petra Verdonk
- Department of Ethics, Law & Humanities, Amsterdam UMC, location VUmc, APH Research Institute, Amsterdam, the Netherlands.
| | - Timotheüs Cornelis van de Grift
- Department of Ethics, Law & Humanities, Amsterdam UMC, location VUmc, APH Research Institute, Amsterdam, the Netherlands
- Zaans Medisch Centrum, Zaandam, the Netherlands
| | - Mariken Beatrijs de Koning
- Arkin Mental Health Care, Amsterdam, the Netherlands
- Department of Psychiatry, Amsterdam University Medical Centre, location Academic Medical Centre, Amsterdam, The Netherlands
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Delaruelle K. Migration-related inequalities in loneliness across age groups: a cross-national comparative study in Europe. Eur J Ageing 2023; 20:35. [PMID: 37612470 PMCID: PMC10447780 DOI: 10.1007/s10433-023-00782-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 08/25/2023] Open
Abstract
This study aims to contribute to the growing interest in the consequences of migration for loneliness by investigating the role of generational status across various age groups in countries with differing integration policies and attitudes towards immigrants. Using data from rounds 5, 6 and 7 of the European Social Survey, I conducted logistic multilevel models on a sample of 121,835 respondents aged 18 years and older, residing in 26 countries. Loneliness was assessed based on a single-item item question from the Center for Epidemiologic Studies of Depression scale. The findings suggest that individuals with a migration background are more likely to experience loneliness than those without. Within this group, I found that first-generation immigrants who arrived after the age of 18 are more vulnerable to loneliness than those who arrived earlier, although the latter still reported more loneliness than second-generation immigrants. Furthermore, migration-related inequalities in loneliness were greater among the youngest age group (18-34 years) and in countries with a more positive public stance towards immigrants. In sum, this study highlights the persistent challenges that migration poses for loneliness across generations and age groups, and emphasizes the need to extend research in this area beyond older adults. Moreover, it suggests that promoting a welcoming culture towards immigrants may have unintended consequences for loneliness gaps, but further research is needed to explain this observation.
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Özlü-Erkilic Z, Diehm R, Wenzel T, Bingöl Ҫağlayan RH, Güneş H, Üneri ÖŞ, Winter S, Akkaya-Kalayci T. Transcultural differences in suicide attempts among children and adolescents with and without migration background, a multicentre study: in Vienna, Berlin, Istanbul. Eur Child Adolesc Psychiatry 2022; 31:1671-1683. [PMID: 34050830 PMCID: PMC9666344 DOI: 10.1007/s00787-021-01805-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 05/15/2021] [Indexed: 10/21/2022]
Abstract
While suicide can occur throughout the lifespan, worldwide suicide is the second leading cause of death among young people aged between 15 and 29 years. The aim of this multicentre study, conducted in Austria, Germany and Turkey, is to investigate the transcultural differences of suicide attempts among children and adolescents with and without migration background. The present study is a retrospective analyses of the records of 247 young people, who were admitted after a suicide attempt to Emergency Outpatient Clinics of Departments of Child and Adolescent Psychiatry of the collaborating Universities including Medical University of Vienna, Charité University Medicine Berlin and Cerrahpaşa School of Medicine and Bakirkoy Training and Research Hospital for Mental Health in Istanbul over a 3-year period. The results of the present study show significant transcultural differences between minors with and without migration background in regard to triggering reasons, method of suicide attempts and psychiatric diagnosis. The trigger event "intra-familial conflicts" and the use of "low-risk methods" for their suicide attempt were more frequent among patients with migration background. Moreover among native parents living in Vienna and Berlin divorce of parents were more frequent compared to parents living in Istanbul and migrants in Vienna. These results can be partly explained by cultural differences between migrants and host society. Also disadvantages in socio-economic situations of migrants and their poorer access to the healthcare system can mostly lead to acute and delayed treatments. Larger longitudinal studies are needed to understand better the impact of migration on the suicidal behaviour of young people.
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Affiliation(s)
- Zeliha Özlü-Erkilic
- Department of Child and Adolescent Psychiatry, Outpatient Clinic of Transcultural Psychiatry and Migration Induced Disorders in Childhood and Adolescence, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Robert Diehm
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Thomas Wenzel
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - R Hülya Bingöl Ҫağlayan
- Department of Child and Adolescents Psychiatry, Cerrahpaşa School of Medicine, İstanbul University-Cerrahpaşa, Kocamustafapasa Cd. No: 53, Fatih, Istanbul, Turkey
| | - Hatice Güneş
- Department of Psychology, İstanbul Gelisim University, Cihangir Mahallesi Şehit Jandarma Komando Er Hakan Oner Sk. No:1, Avcilar, Istanbul, Turkey
- Department of Child and Adolescent Psychiatry, Bakirkoy Training and Research Hospital for Mental Health and Neurological Disorders, Zuhuratbaba Mah. Dr Tevfik Sağlam Cad. No:25/2, Bakirköy, Istanbul, Turkey
| | - Özden Şükran Üneri
- Department of Child and Adolescents Psychiatry, Ankara City Hospital, AYBÜ Ankara Şehir Hastanesi Çocuk Hastanesi 06800 Bilkent, Ankara, Turkey
| | - Sibylle Winter
- Departement of Child and Adolescent Psychiatry, Psychsomatics and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Virchow, Augustenbruger Platz 1, 13353, Berlin, Germany
| | - Türkan Akkaya-Kalayci
- Department of Child and Adolescent Psychiatry, Outpatient Clinic of Transcultural Psychiatry and Migration Induced Disorders in Childhood and Adolescence, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
- Postgraduate University Program Transcultural Medicine and Diversity Care, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
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Guetto R, Zanasi F, Carella M. Non-intact Families and Children's Educational Outcomes: Comparing Native and Migrant Pupils. Eur J Popul 2022; 38:1065-94. [PMID: 36853361 DOI: 10.1007/s10680-022-09638-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 08/10/2022] [Indexed: 12/15/2022]
Abstract
This study explores whether the association between living in a single-parent household and children's educational outcomes differs by migration background through comparing natives with first- and second-generation migrant pupils from different areas of origin. While there is strong evidence of an educational gap between migrant and native pupils in Western countries-and particularly in Italy-the interaction with family structure has been under-investigated. We suggest that native children have more socioeconomic resources to lose as a consequence of parental breakups, and thus may experience more negative consequences from living in a single-parent household compared to migrant children, who tend to have poorer educational outcomes regardless of family disruptions. Moreover, for migrant children, family disruption could result from parents' migratory project (transnationalism) rather than separation or divorce, thus not necessarily implying parental conflict and a deteriorating family environment. Empirical analyses of data from the ISTAT 'Integration of the Second Generation' survey (2015) show that native Italian pupils from single-parent households in lower secondary schools are more strongly penalised in terms of grades, and less likely to aspire to the most prestigious upper secondary tracks when compared to second- and, especially, first-generation children. Indeed, the latter have been found to experience virtually no negative consequences from parental absence. Contrary to expectations, we found no substantial differences in the non-intact penalty based on the reason for parental absence (transnationalism vs divorce), nor by migrants' area of origin.
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Liu W, He MZ, Dambach P, Schwertz R, Chen S, Yu F, Marx M. Trends of overweight and obesity among preschool children from 2013 to 2018: a cross-sectional study in Rhine-Neckar County and the City of Heidelberg, Germany. BMC Public Health 2022; 22:941. [PMID: 35538526 PMCID: PMC9092815 DOI: 10.1186/s12889-022-13302-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 04/20/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Early childhood overweight and obesity is a growing public health concern worldwide. Few recent studies have addressed how time trends varied by sociodemographic characteristics at the regional level using large and high-quality data. This study determines how time trends vary in the prevalence of early childhood overweight and obesity by age, gender, and migration background at the regional level. METHODS We used a Kernel-density curve to describe the BMI distribution, and evaluated the trends of overweight and obesity by age, gender, and migration background using logistic regression. RESULTS Mean BMI and the overall prevalence of overweight and obesity increased among preschool children aged 4-6 years in the Rhine-Neckar County and the City of Heidelberg. After adjusting for age, sex, and migration background, trends of overweight significantly increased only among male children in the age 5 year group with migration background (P < 0.05), and an upward trend of obesity was observed only among male children in the age 5 year group and female children in the age 6 year group with migration background (P < 0.05). CONCLUSIONS BMI distribution as well as general prevalence of overweight and obesity are still increasing among preschool children. Children with migration backgrounds, particularly male children in the age 5 year groups and female children in the age 6 year group should be prioritized. Health promotion strategies for children with migration backgrounds will help address this challenge.
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Affiliation(s)
- Weina Liu
- grid.7700.00000 0001 2190 4373Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Im Neuenheimer Feld 130, Heidelberg, Germany ,Jiangsu Province Center for Disease Control and Prevention, Nanjing, China
| | - Mike Z. He
- grid.59734.3c0000 0001 0670 2351Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Peter Dambach
- grid.7700.00000 0001 2190 4373Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Im Neuenheimer Feld 130, Heidelberg, Germany
| | - Rainer Schwertz
- Public Health Authority of Rhein-Neckar-Kreis, Heidelberg, Germany
| | - Simiao Chen
- grid.7700.00000 0001 2190 4373Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Im Neuenheimer Feld 130, Heidelberg, Germany ,grid.506261.60000 0001 0706 7839Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fengyun Yu
- grid.7700.00000 0001 2190 4373Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Im Neuenheimer Feld 130, Heidelberg, Germany ,grid.506261.60000 0001 0706 7839Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Michael Marx
- grid.7700.00000 0001 2190 4373Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Im Neuenheimer Feld 130, Heidelberg, Germany
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Fauser D, Banaschak H, Zimmer JM, Golla A, Schmitt N, Mau W, Bethge M. Rehabilitation utilization of non-migrant and migrant persons with back pain: A cohort study using different definitions of migrant background. EClinicalMedicine 2022; 46:101351. [PMID: 35330800 PMCID: PMC8938875 DOI: 10.1016/j.eclinm.2022.101351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/17/2022] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Medical rehabilitation (MR) by the German Pension Insurance is approved to maintain and to restore work ability and to avoid disability pensions. Studies on the rehabilitation utilization by people with a migration background (PMB) compared to people without a migration background (non-PMB) showed heterogeneous results, which may be partly due to different definitions of migration status. The aim of this paper was to test whether there are differences in utilization of MR between employed PMB and non-PMB with self-reported back pain. METHODS We used data from a large German cohort study that analyzed the effectiveness of MR for individuals with back pain and was conducted between 1st January 2017 and 31st December 2019. Employees aged 45 to 59 years who reported back pain in the last three months completed the baseline questionnaire in 2017. We used four definitions of migration background (MB) to differentiate by first- and second-generation migration, by one- and two-sided migration background, by language, or by nationality. Data on rehabilitation utilization was extracted from administrative records covering the period until the end of 2018. FINDINGS Data of 6,713 participants were included, and 514 individuals utilized MR during follow-up. Adjusted analyses showed a decreased risk of rehabilitation utilization in people with a first-generation MB (HR = 0·46; 95% CI 0·29; 0·72), people with a two-sided MB (HR = 0·47; 95% CI 0·31; 0·72), people whose native language was not German (HR = 0·52; 95% CI 0·30; 0·91), and people without German nationality (HR = 0·29; 95% CI 0·12; 0·72) when compared to non-PMB. INTERPRETATION This study showed that employees with a MB reporting back pain had a significantly reduced risk for utilization of rehabilitation services. This underutilization could be observed considering different definitions of MB. Future research on rehabilitation utilization by PMB should consider the impact of different definitions on the results. FUNDING The study was funded by the German Research Foundation (grant numbers: BE 5885/2-1; MA 6981/2-1). The German Research Foundation functions as a self-governing institution for the promotion of science and research in Germany.
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Affiliation(s)
- David Fauser
- Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
- Corresponding author.
| | - Hannes Banaschak
- Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
| | - Julia-Marie Zimmer
- Institute for Rehabilitation Medicine, Interdisciplinary Centre of Health Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - André Golla
- Institute for Rehabilitation Medicine, Interdisciplinary Centre of Health Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Nadine Schmitt
- Institute for Rehabilitation Medicine, Interdisciplinary Centre of Health Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Wilfried Mau
- Institute for Rehabilitation Medicine, Interdisciplinary Centre of Health Sciences, Medical Faculty, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Matthias Bethge
- Institute for Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany
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Jäger SC, Filbert AL, Welchowski T, Weltermann B. Effects of the dementia care toolbox on personnel's self-reported confidence in patient care: a CRT in general practices. BMC Fam Pract 2021; 22:231. [PMID: 34789149 PMCID: PMC8597294 DOI: 10.1186/s12875-021-01577-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 11/01/2021] [Indexed: 11/24/2022]
Abstract
Background In rapidly aging populations, general practitioners (GPs) are challenged in dementia care of patients with and without migration background. Uncertainties in treating dementia in migrant patients due to language barriers or information deficits are reported. To address these deficits, we developed the Dementia Care Toolbox which was judged helpful by GP practice personnel. This two-armed cluster-randomised trial (CRT) investigated the effects of this toolbox on German GPs’ and practice assistants’ (PrAs) attitudes and confidence in dementia care, especially in patients with migration background. Methods A total of 32 GP practices were recruited and randomised into intervention (toolbox use for 3 months) and waiting-list control (toolbox after follow-up). After 3 months all participating GPs and PrAs received a standardised questionnaire addressing their levels of self-reported confidence in dementia care for patients with and without migration background. A generalized estimating equation model that took practice cluster effects into account was applied to assess GPs and PrAs self-reported confidence in dementia care in patients with and without migration background. Results Overall, the intervention had no significant effect on self-reported confidence in dementia care. However, the use of the dementia care toolbox showed a tendency for a learning effect on knowledge about local support structures for migrant patients with dementia (odds ratio 1.43; 95% CI 0.68-3.03, p = 0.35) and for less communication difficulties with dementia patients in general (odds ratio 0.72; 95% CI 0.33-1.56; p = 0.40). Moreover, intervention practices showed a tendency towards more awareness of own limitations: less self-confidence regarding answering questions (odds ratio 0.82; 95% CI 0.36-1.86, p = 0.64) and providing information for patients with migration background (odds ratio 0.60; 95% CI 0.25-1.45, p = 0.26). Conclusion The Toolbox Dementia Care increased awareness on the respective topic. Given a small sample size, further studies on its effectiveness in primary care are needed. Trial registration German Clinical Trials Register, DRKS00014632. Registered 02/08/2018.
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Affiliation(s)
- Sabine Christine Jäger
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
| | - Anna-Liesa Filbert
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Thomas Welchowski
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.,Institute of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Birgitta Weltermann
- Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
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Hussenoeder FS, Bodendieck E, Conrad I, Jung F, Riedel-Heller SG. Burnout and work-life balance among physicians: the role of migration background. J Occup Med Toxicol 2021; 16:28. [PMID: 34325705 DOI: 10.1186/s12995-021-00318-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 07/15/2021] [Indexed: 11/17/2022] Open
Abstract
Background We want to analyze the effect of migration background (MB) on physician burnout and work-life balance. Methods In September 2019, physicians from various specialties answered a questionnaire on work and health. We analyzed a subsample of 526 physicians that were working full time in a hospital, 14% with an MB and 47.9% were female. Results Multivariate analysis showed that physicians with an MB exhibit significantly less favorable scores on all three burnout dimensions, and this effect persisted in the regression analysis after adding age, gender, and marital status as control variables. There were no differences with regard to work-life balance. Conclusions To our knowledge, our study is the first one to suggest that MB plays a significant role in physician mental health. Future research will benefit from identifying the factors behind that connection, e.g., problems related to acculturation, communication and social integration, which can then be addressed by policymakers in order to maintain and improve the medical infrastructure.
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Rittsteiger L, Hinz T, Oriwol D, Wäsche H, Santos-Hövener C, Woll A. Sports participation of children and adolescents in Germany: disentangling the influence of parental socioeconomic status. BMC Public Health 2021; 21:1446. [PMID: 34294081 PMCID: PMC8299646 DOI: 10.1186/s12889-021-11284-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 06/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Participation in sports and physical activity (PA) is a critical resource for children's health and social development. This study analyzes how the parental socioeconomic status (SES) of children and adolescents affects their PA in sports clubs (organized sports) and outside of sports clubs (unorganized sports) and tests whether the potential impact of parental SES is mediated by the opportunity structure of their residential area (walkability, infrastructure, etc.) and by family and peer support for PA. Furthermore, PA is analyzed respecting differences by gender and migration background. METHODS Using representative data from the MoMo/KiGGS study (2009-2012 and 2014-2017), we take into account about 8000 measurements from about 7000 subjects. We estimate hurdle regression models to analyze the minutes per week spent on sports activities. RESULTS Results show that children with a higher parental SES, children living in areas with many opportunities for PA, and children receiving family and peer support are more physically active than children without these features. Controlled for opportunities and support, status effects are small but visible. The differences regarding parental SES are much more apparent for organized sports than for unorganized sports, indicating the relevance of economic resources. Boys are more active than girls, whereas there is no clear effect of migration background. CONCLUSIONS The coefficient of parental SES on organized sports most probably relates to the resources needed to participate in sports clubs, including fees and equipment. Lower membership fees might potentially help to integrate children with low parental SES into sports clubs and thereby make organized sports more accessible to all social classes.
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Affiliation(s)
- Lea Rittsteiger
- Karlsruhe Institute of Technology (KIT), Institute of Sports and Sports Science (IfSS), Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Thomas Hinz
- Department for History and Sociology, University of Konstanz, Konstanz, Germany
| | - Doris Oriwol
- Karlsruhe Institute of Technology (KIT), Institute of Sports and Sports Science (IfSS), Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Hagen Wäsche
- Karlsruhe Institute of Technology (KIT), Institute of Sports and Sports Science (IfSS), Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | | | - Alexander Woll
- Karlsruhe Institute of Technology (KIT), Institute of Sports and Sports Science (IfSS), Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
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Orth B, Merkel C. [Changes in binge drinking among adolescents and young adults in Germany depending on educational level and migration background]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:660-670. [PMID: 34023932 PMCID: PMC8187177 DOI: 10.1007/s00103-021-03332-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/14/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Studies show that the prevalence of binge drinking among young people in Germany is declining overall. This change is usually studied in more detail based on age and gender. This paper expands on these analyses and examines whether the decline in binge drinking among young people differs as a function of educational level and migration background. METHODS Based on representative surveys conducted by the Federal Center for Health Education (BZgA), 30-day prevalences of binge drinking were determined for Germany between 2008 and 2019 for male and female 12- to 17-year-old adolescents and 18- to 25-year-old young adults. Logistic regression analyses were used to estimate trend patterns for the period from 2008 to 2019. This was also done as a function of education level and migration background. RESULTS Across all surveys, more young adults than adolescents, more male than female young people, and more young people without a migration background get drunk. Between 2008 and 2019, the 30-day prevalence of binge drinking decreased overall among adolescents (male: from 23.0 to 16.4%; female: from 17.7 to 10.7%) and young men (from 53.0 to 43.9%), and it did not change statistically significantly among young women (2008: 28.1%; 2019: 24.5%). The trend analyses depending on the level of education and migration background show that at least among young women without a (technical) higher education entrance qualification there is a decrease in binge drinking. DISCUSSION The decline in binge drinking may differ depending on social characteristics. Such differences should be taken into account in the prevention of binge drinking. In particular, young women with a higher level of education must be reached with prevention offers.
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Affiliation(s)
- Boris Orth
- Referat 2-25 Forschung, Qualitätssicherung, Bundeszentrale für gesundheitliche Aufklärung (BZgA), Maarweg 149-161, 50825, Köln, Deutschland.
| | - Christina Merkel
- Referat 2-25 Forschung, Qualitätssicherung, Bundeszentrale für gesundheitliche Aufklärung (BZgA), Maarweg 149-161, 50825, Köln, Deutschland
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Rüdiger R, Geiser F, Ritter M, Brossart P, Keyver-Paik MD, Faridi A, Vatter H, Bootz F, Landsberg J, Kalff JC, Herrlinger U, Kristiansen G, Pietsch T, Aretz S, Thomas D, Radbruch L, Kramer FJ, Strassburg CP, Gonzalez-Carmona M, Skowasch D, Essler M, Schmid M, Nadal J, Ernstmann N, Sharma A, Funke B, Schmidt-Wolf IGH. No evidence to support the impact of migration background on treatment response rates and cancer survival: a retrospective matched-pair analysis in Germany. BMC Cancer 2021; 21:526. [PMID: 33971845 PMCID: PMC8108356 DOI: 10.1186/s12885-021-08141-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 04/02/2021] [Indexed: 11/27/2022] Open
Abstract
Background Immigration has taken the central stage in world politics, especially in the developed countries like Germany, where the continuous flow of immigrants has been well documented since 1960s. Strikingly, emerging data suggest that migrant patients have a poorer response to the treatment and lower survival rates in their new host country, raising concerns about health disparities. Herein, we present our investigation on the treatment response rate and cancer survival in German patients with and without an immigrant background that were treated at our comprehensive cancer center in Germany. Methods Initially, we considered 8162 cancer patients treated at the Center for Integrated Oncology (CIO), University Hospital Bonn, Germany (April 2002–December 2015) for matched-pair analysis. Subsequently, the German patients with a migration background and those from the native German population were manually identified and catalogued using a highly specific name-based algorithm. The clinical parameters such as demographic characteristics, tumor characteristics, defined staging criteria, and primary therapy were further adjusted. Using these stringent criteria, a total of 422 patients (n = 211, Germans with migration background; n = 211, native German population) were screened to compare for the treatment response and survival rates (i.e., 5-year overall survival, progression-free survival, and time to progression). Results Compared to the cohort with migration background, the cohort without migration background was slightly older (54.9 vs. 57.9 years) while having the same sex distribution (54.5% vs. 55.0% female) and longer follow-up time (36.9 vs. 42.6 months). We did not find significant differences in cancer survival (5-year overall survival, P = 0.771) and the response rates (Overall Remission Rate; McNemar’s test, P = 0.346) between both collectives. Conclusion Contrary to prior reports, we found no significant differences in cancer survival between German patients with immigrant background and native German patients. Nevertheless, the advanced treatment protocols implemented at our comprehensive cancer center may possibly account for the low variance in outcome. To conduct similar studies with a broader perspective, we propose that certain risk factors (country-of-origin-specific infections, dietary habits, epigenetics for chronic diseases etc.) should be considered, specially in the future studies that will recruit new arrivals from the 2015 German refugee crisis.
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Affiliation(s)
- Roman Rüdiger
- Department of Integrated Oncology, CIO Bonn, Center for Integrated Oncology ABCD, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Franziska Geiser
- Institute of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Manuel Ritter
- Department of Urology, University Hospital Bonn, Bonn, Germany
| | - Peter Brossart
- Department of Internal Medicine III, University Hospital Bonn, Bonn, Germany
| | | | - Andree Faridi
- Department of Senology and certified Breast Center, University Hospital Bonn, Bonn, Germany
| | - Hartmut Vatter
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | - Friedrich Bootz
- Department of Otorhinolaryngology, University Hospital Bonn, Bonn, Germany
| | - Jennifer Landsberg
- Department of Dermatology and Allergy, University Hospital Bonn, Bonn, Germany
| | - Jörg C Kalff
- Department of Surgery, University Hospital Bonn, Bonn, Germany
| | | | | | - Torsten Pietsch
- Department of Neuropathology, University Hospital Bonn, Bonn, Germany
| | - Stefan Aretz
- Institute of Human Genetics, University Hospital Bonn, Bonn, Germany
| | - Daniel Thomas
- Department of Radiology, University Hospital Bonn, Bonn, Germany
| | - Lukas Radbruch
- Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany
| | - Franz-Josef Kramer
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital Bonn, Bonn, Germany
| | | | | | - Dirk Skowasch
- Department of Internal Medicine II, University Hospital Bonn, Bonn, Germany
| | - Markus Essler
- Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany
| | - Matthias Schmid
- Institute for Medical Biometry, Computer Science and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - Jennifer Nadal
- Institute for Medical Biometry, Computer Science and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - Nicole Ernstmann
- Center for Health Communication and Health Services Research, Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Amit Sharma
- Department of Integrated Oncology, CIO Bonn, Center for Integrated Oncology ABCD, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Benjamin Funke
- Department of Integrated Oncology, CIO Bonn, Center for Integrated Oncology ABCD, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Ingo G H Schmidt-Wolf
- Department of Integrated Oncology, CIO Bonn, Center for Integrated Oncology ABCD, University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
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David M, Richter R, Naghavi B, Borde T, Razum O, Somasundaram R, Stein H, Sehouli J. [Use of emergency rooms by so-called multiple users: results of a prospective study with special consideration of the migration status]. Notf Rett Med 2021; 25:252-259. [PMID: 33649703 PMCID: PMC7904028 DOI: 10.1007/s10049-021-00851-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2021] [Indexed: 11/24/2022]
Abstract
Fragestellung Welche prädiktiven Faktoren lassen sich für die Gruppe der sog. Mehrfachnutzer (MFN; 4 und mehr Inanspruchnahmen einer Notaufnahme [NA] in den letzten 12 Monaten) finden? Sind Personen mit Migrationshintergrund häufiger in die Gruppe der MFN einzuordnen? Methodik Konsekutive Patienten, die von Juli 2017 bis Juli 2018 drei Klinik-NA in Berlin aufsuchten. Mittels Fragebogen Erfassung von Erkrankungen, Gründen für den NA-Besuch und sozioökonomischen Faktoren. Die Unterschiede zwischen Migranten (1. Generation), ihren Nachkommen (2. Generation) und Nichtmigranten wurden mithilfe der logistischen Regression bewertet. Ergebnisse 2339 Patienten konnten in die Auswertung einbezogen werden (Rücklaufrate 56 %), davon hatten 901 einen Migrationshintergrund. Bei jungen Frauen (<30 Jahre), chronisch Kranken, Schwangeren, Patientinnen und Patienten mit starken Beschwerden und Personen mit (selbsteingeschätzter) mittlerer und schlechter „Gesundheitsqualität“ sowie solchen ohne ärztliche Zuweisung war die Chance für eine Mehrfachnutzung der NA größer. Schlussfolgerung MFN belasten das ohnehin zunehmende Patientenvolumen von NA. Sie stellen jedoch eine heterogene Patientengruppe dar, unter der Menschen mit Migrationshintergrund nicht häufiger vertreten sind. Weitere Untersuchungen sind erforderlich, um die Faktoren, die zu einer häufigen Inanspruchnahme führen, besser zu verstehen und wirksame Strategien zu entwickeln, um den komplexen Gesundheitsbedürfnissen von MFN gerecht zu werden.
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Affiliation(s)
- Matthias David
- Campus Virchow-Klinikum, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Deutschland
| | - Rolf Richter
- Campus Virchow-Klinikum, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Deutschland
| | - Baharan Naghavi
- Charité Comprehensive Cancer Center, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Theda Borde
- Alice Salomon-Hochschule Berlin, Berlin, Deutschland
| | - Oliver Razum
- Fakultät für Gesundheitswissenschaften, AG 3: Epidemiologie und International Public Health, Universität Bielefeld, Bielefeld, Deutschland
| | - Rajan Somasundaram
- Zentrale Notaufnahme, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Hendrike Stein
- Rettungsstelle, Vivantes Klinikum Berlin-Neukölln, Berlin, Deutschland
| | - Jalid Sehouli
- Campus Virchow-Klinikum, Klinik für Gynäkologie mit Zentrum für onkologische Chirurgie, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Deutschland
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14
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Ludwig A, Miani C, Breckenkamp J, Sauzet O, Borde T, Doyle IM, Brenne S, Höller-Holtrichter C, David M, Spallek J, Razum O. Are Social Status and Migration Background Associated with Utilization of Non-medical Antenatal Care? Analyses from Two German Studies. Matern Child Health J 2021; 24:943-952. [PMID: 32388767 PMCID: PMC7261266 DOI: 10.1007/s10995-020-02937-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Non-medical antenatal care (ANC) refers to a range of non-medical services available to women during pregnancy aiming at supporting women and prepare them for the birth and the postpartum period. In Germany, they include antenatal classes, breastfeeding classes and pregnancy-specific yoga or gymnastics courses. Studies suggest that various types of non-medical ANC carry benefits for both the women and their babies. Little is known about the uptake of non-medical ANC among different socioeconomic population subgroups, but one may expect lower utilization among socio-economically disadvantaged women. We analyzed factors contributing to the utilization of non-medical ANC in general and antenatal classes in particular. METHODS Baseline data of the Bielefeld BaBi birth cohort (2013-2016) and the Berlin perinatal study (2011-2012) were analyzed. Comparing the two cohorts allowed to increase the socio-economic and migration background variance of the study population and to capture the effect of the local context on uptake of services. Multivariate logistic regression analyses were performed to study associations between the uptake of non-medical ANC and socio-economic and migration status. RESULTS In Berlin and Bielefeld, being a first generation migrant and having lower levels of education were associated with lower non-medical ANC uptake. In Berlin, being a 2nd generation woman or having a low income was also associated with lower uptake. CONCLUSIONS FOR PRACTICE Our study suggests that non-medical ANC remains in some part the prerogative of non-migrant, well-educated and economically privileged women. Since differences in non-medical ANC have the potential to create inequalities in terms of birth outcomes and maternal health during pregnancy and post-partum, more efforts are needed to promote the use of non-medical ANC by all population groups.
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Affiliation(s)
- Angelique Ludwig
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany. .,Center for Innovation in Health Economics (ZIG OWL), Bielefeld, Germany.
| | - Céline Miani
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Jürgen Breckenkamp
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Odile Sauzet
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany.,Centre for Statistics, Bielefeld University, Bielefeld, Germany
| | - Theda Borde
- Alice Salomon Hochschule Berlin, University of Applied Sciences, Berlin, Germany
| | - Ina-Merle Doyle
- Institute for General Practice, Hannover Medical School, Hannover, Germany
| | - Silke Brenne
- Institute of General Practice, Medical Faculty, Otto-Von-Guericke-University, Magdeburg, Germany
| | - Chantal Höller-Holtrichter
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Matthias David
- Clinic for Gynaecology, Charité University Medicine Berlin, Campus Virchow-Klinikum, Berlin, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology, Senftenberg, Germany
| | - Oliver Razum
- Department of Epidemiology & International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
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15
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Mönkemöller K, Kamrath C, Hammersen J, Biester T, Warncke K, Pappa A, Fink K, Raile K, Rohrer TR, Holl RW; DPV Initiative. [Is it possible to prevent diabetic ketoacidosis at diagnosis of pediatric type 1 diabetes? Lessons from the COVID-19 pandemic]. Monatsschr Kinderheilkd 2021;:1-8. [PMID: 33437098 DOI: 10.1007/s00112-020-01108-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 12/08/2020] [Indexed: 11/11/2022]
Abstract
Hintergrund Die diabetische Ketoacidose (DKA) ist ein lebensbedrohlicher Notfall bei Manifestation eines Diabetes mellitus Typ 1 (DM1) bei Kindern und Jugendlichen, häufig bei verspäteter Diagnosestellung oder vorheriger Fehldiagnose. Während der Zeit des „Coronavirus-disease-2019(COVID-19)-Lockdowns“ in Deutschland stellten sich weniger Patienten in Notfallambulanzen und Arztpraxen vor. Fragestellung Hat sich der Anteil der DKA bei Manifestation eines DM1 in der pädiatrischen Population in diesem Zeitraum verändert, und welche Gruppen sind besonders gefährdet, eine DKA zu erleiden? Material und Methoden Die DKA-Häufigkeit in der Zeit vom 13.03.2020 bis 13.05.2020 wurde bei Patienten <18 Jahren mit DM1-Manifestation in pädiatrischen Diabeteszentren untersucht. Die Diabeteszentren dokumentierten ihre Einschätzung, ob durch COVID-19 die Vorstellung verzögert war. Um den Einfluss von Risikofaktoren auf die DKA-Häufigkeit zu analysieren, erfolgte ein Vergleich der Daten aus dem Jahr 2020 mit denselben Zeiträumen der Jahre 2018 und 2019 mit linearen und logistischen Regressionsmodellen. Ergebnisse Die Daten von 532 Patienten aus 216 Diabeteszentren zeigten, dass das Risiko für eine DKA im Vergleich zu den Jahren 2018/2019 um 84,7 % und für eine schwere DKA um 45,3 % erhöht war. Kinder <6 Jahren waren mit einer Steigerung einer DKA um 141,6 % bzw. einer schweren DKA um 97,0 % besonders betroffen. Migrationshintergrund war ein COVID-19-unabhängiger Risikofaktor. Insgesamt wurden 31 % der Patienten verspätet vorgestellt, oder ihre Diagnose wurde zuvor verkannt. Diskussion In der Zeit des „COVID-19-Lockdowns“ war die Häufigkeit der DKA bei DM1-Manifestation für Kinder und Jugendliche signifikant erhöht. Alter <6 Jahre, Migrationshintergrund und verzögerte Vorstellung waren die Hauptrisikofaktoren.
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16
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Filbert AL, Jäger SC, Weltermann B. Acceptance and self-reported use of a dementia care toolbox by general practice personal: results from an intervention study in German practices. BMC Fam Pract 2020; 21:264. [PMID: 33297967 PMCID: PMC7726861 DOI: 10.1186/s12875-020-01345-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 12/02/2020] [Indexed: 11/10/2022]
Abstract
Background Dementia is an age-related syndrome that is estimated to affect 46.8 million people worldwide (2015). In ageing populations, the prevalence of dementia is expected to increase. General practitioners (GPs) are often the first to be contacted when signs of dementia appear. This cluster-randomised trial (CRT) investigates the effects of a dementia care toolbox mailed to GP practices to facilitate dementia care. It contained patient brochures and posters for the waiting room in three languages, information cards for professionals and practical tools in three languages. The GPs’ and practice assistants’ (PrAs) use of and opinion about the toolbox is reported here. Methods Three months after receiving the toolbox, participating GPs and PrAs were sent a standardised, self-administered questionnaire asking about the use and helpfulness of the various toolbox items by mail. Results A total of 50 GPs and PrAs (14 GPs and 36 PrAs) from 15 practices completed the questionnaire. Of the participants, 82.0% reported using at least one of the tools, while 18.0% had used none. In descending order, the patient brochures (70.0%), the information card (58.0%) and the poster (40.0%) were used. In general, the brochures (52.1%), the information card (44.9%) as well as the poster (28.6%) were perceived as helpful. Conclusion Overall, the dementia toolbox was widely accepted by both professional groups. Future research should investigate long-term effects of information strategies for GP practice settings. Trial registration German Clinical Trials Register, DRKS00014632. Registered 02 August 2018. Clinical register of the study coordination office of the University hospital of Bonn. Registered 05 September 2017.
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Affiliation(s)
- Anna-Liesa Filbert
- Institute of General Practice and Family Medicine, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
| | - Sabine Christine Jäger
- Institute of General Practice and Family Medicine, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Birgitta Weltermann
- Institute of General Practice and Family Medicine, University of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
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Sánchez Guerrero L, Schober PS. Socialisation Influences on Gender Ideologies of Immigrant and Native Youth in Germany, England, Sweden and the Netherlands. Sex Roles 2020; 85:113-127. [PMID: 33311836 PMCID: PMC7719056 DOI: 10.1007/s11199-020-01208-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2020] [Indexed: 11/29/2022]
Abstract
Adolescence is a crucial life course phase for identity formation, and youths’ gender ideologies significantly predict gendered behaviours and longer-term transitions. With Western post-industrial societies becoming more culturally diverse, the present study provides novel cross-nationally comparative evidence on gender socialisation processes among native and immigrant youth in Sweden, Germany, England, and the Netherlands, which vary in gender and migration policies and cultures. In addition to parents’ gender ideologies, the study also considers classmates’ gender ideologies as factors shaping 14-year-old adolescents’ gender ideologies. The analysis draws on 5917 adolescent-parent dyads from the Children of Immigrants Longitudinal Study which we link with country-level gender empowerment measures from the United Nations. Remarkably, with the exception of native female adolescents in England and Germany, parents tend to report slightly more egalitarian beliefs than adolescents across the four countries. OLS regressions show that parents’ and classmates’ gender ideologies correlate significantly with adolescents’ ideologies, with little variation across gender and immigrant groups in all four countries. From a policy and practical point of view, the great similarity in the intergenerational transmission of gender beliefs across diverse family backgrounds as well as cultural and policy contexts seem remarkable.
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Affiliation(s)
| | - Pia S Schober
- Department of Sociology, University of Tübingen, Tübingen, Germany.,German Institute for Economic Research (DIW Berlin), Berlin, Germany
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18
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Mews C, Eisele M, Boczor S, Scherer M. [Diabetes education of Turkish people with low literacy skills: Results of an online survey of training practices]. Z Evid Fortbild Qual Gesundhwes 2020; 155:40-47. [PMID: 32807719 DOI: 10.1016/j.zefq.2020.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/18/2020] [Accepted: 06/02/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION For patients with diabetes mellitus, training is an essential part of therapy. There is a lack of empirical data regarding training experiences for people with a (Turkish) migration background and low literacy skills concerning the established training programmes. The objective of this research was to collect data from general practices based on their experiences in training these particular groups of patients. METHODS In a quantitative cross-sectional study design, 795 general practices throughout Germany with the additional designation of diabetology were invited via e-mail to participate in a fully structured, standardised online survey. An exploratory data analysis was performed using the statistics software IBM SPSS. RESULTS Out of 146 participating practices (response rate 18%), 66 (45%) estimated the proportion of patients with migration background in their practice to be more than 20%. Approximately 76% of the practices providing diabetes training (n=119) trained patients of Turkish origin. Forty six percent of these practices estimated the ratio of patients of Turkish origin with low literacy skills to be 10 to 50%. Less than 36% of the practices were aware of suitable training programmes for this target group. Existing programmes were modified to special needs and new materials creatively developed. Additional culturally sensitive and visually enriched materials are needed. Forty two percent of the interviewed practices reported billing difficulties concerning frequently needed individual trainings. DISCUSSION Training was carried out in different ways due to individual addition or deletion of content elements. There is a lack of evaluated materials that are adapted to the users' cultural background and level of education. In the face of a significantly changed immigration structure, information and materials as well as interpreters for additional languages are increasingly required. CONCLUSION Further development of evidence-based, multi-lingual, image-based, culturally sensitive and educationally diverse materials and training units and their scientific evaluation is needed. Learning contents adapted to the level of education and promoting cultural sensitivity in the provision of healthcare should be implemented increasingly in the training and continuous professional development of health professionals.
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Affiliation(s)
- Claudia Mews
- Universitätsklinikum Hamburg-Eppendorf. Institut und Poliklinik für Allgemeinmedizin, Hamburg, Deutschland.
| | - Marion Eisele
- Universitätsklinikum Hamburg-Eppendorf. Institut und Poliklinik für Allgemeinmedizin, Hamburg, Deutschland
| | - Sigrid Boczor
- Universitätsklinikum Hamburg-Eppendorf. Institut und Poliklinik für Allgemeinmedizin, Hamburg, Deutschland
| | - Martin Scherer
- Universitätsklinikum Hamburg-Eppendorf. Institut und Poliklinik für Allgemeinmedizin, Hamburg, Deutschland
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Brauchmann J, Hruschka L, Baer NR, Jödicke B, Urlen M, Wiegand S, Schenk L. [Health promotion and overweight prevention-a systematic evaluation of available information materials with a focus on risk groups]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 62:1522-1530. [PMID: 31605165 DOI: 10.1007/s00103-019-03031-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Children and adolescents from families with a migration background and/or low social status belong to risk groups for the development of overweight. At the same time, they are considered difficult to approach for health promotion. This paper aims to provide an overview of freely available print and web-based materials on health promotion and to evaluate these in terms of formal, content-related, and target-group-specific criteria. METHOD From August to September 2017, print media and websites were screened using systematic keyword searches in a large search engine. Search results were evaluated by an evidence-based catalogue of criteria and rated by comparative analysis. Health apps freely available from an app store were investigated, tested, and evaluated descriptively. RESULTS Eighty-nine print media, 58 websites and 32 apps were found. Of the print media items, 11.2% are available in different languages; in 29% culturally sensitive aspects are considered and in 12.4% the material makes use of clear, nontechnical language. In 40.6% of the websites, either another language can be chosen or foreign language downloads are available. Most common are translations into English (37.5%), Turkish (31.3%), Arabic (28.1%), and Russian (25%). In 37.5% of the websites, the material addresses culturally sensitive aspects. From the tested apps (n = 25), only a few qualitatively high-ranked ones are aimed at parents and pregnant women and these are often text-based and exclusively available in German. DISCUSSION Only few informational materials are directly oriented to the everyday world of risk groups. For this target group, material drawn up in clear language with multiple translations as well as with culturally adapted designs is recommended.
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Affiliation(s)
- Jana Brauchmann
- Sozialpädiatrisches Zentrum für chronisch kranke Kinder und Jugendliche, Abteilung: Interdisziplinär/Bereich: Adipositas, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
| | - Laura Hruschka
- Sozialpädiatrisches Zentrum für chronisch kranke Kinder und Jugendliche, Abteilung: Interdisziplinär/Bereich: Adipositas, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - Nadja-Raphaela Baer
- Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Abteilung Medizinische und pflegerische Versorgung, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - Birgit Jödicke
- Sozialpädiatrisches Zentrum für chronisch kranke Kinder und Jugendliche, Abteilung: Interdisziplinär/Bereich: Adipositas, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - Marc Urlen
- Abteilung Kinder und Kinderbetreuung, Deutsches Jugendinstitut, München, Deutschland
| | - Susanna Wiegand
- Sozialpädiatrisches Zentrum für chronisch kranke Kinder und Jugendliche, Abteilung: Interdisziplinär/Bereich: Adipositas, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland
| | - Liane Schenk
- Institut für Medizinische Soziologie und Rehabilitationswissenschaft, Abteilung Medizinische und pflegerische Versorgung, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
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20
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Gutmann MT, Aysel M, Özlü-Erkilic Z, Popow C, Akkaya-Kalayci T. Mental health problems of children and adolescents, with and without migration background, living in Vienna, Austria. Child Adolesc Psychiatry Ment Health 2019; 13:35. [PMID: 31528201 PMCID: PMC6737609 DOI: 10.1186/s13034-019-0295-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 08/31/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Compared to their indigenous peers, migrant children and adolescents are at increased risk for mental health problems. The aim of our study was to compare psychological disorders of children and adolescents with Turkish migration background and their native Austrian peers. METHODS We analysed 302 children and adolescents aged between 7 and 18 years. The sample consisted of 100 Austrian and 100 Turkish outpatients with mental health problems, and 102 healthy controls, 52 with Austrian and 50 with Turkish background, recruited from various Viennese local child and youth centres. RESULTS Native patients had more frequently externalizing problems (42.1%) compared to the Turkish-speaking sample (28%). However, in the control group, Turkish-speaking children and adolescents had higher levels of internalizing, depressive and anxiety symptoms compared to their native peers. CONCLUSIONS We found noticeable differences in psychological problems among children and adolescents with and without migration background. We assume that migration-related stress factors are responsible for these differences. Also, children and adolescents with migration background seek for psychological help less frequently than their indigenous peers.
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Affiliation(s)
- Maria Teresa Gutmann
- 0000 0004 0520 9719grid.411904.9Department of Child and Adolescent Psychiatry and Psychotherapy, General Hospital Baden-Mödling, Fürstenweg 8, 2371 Hinterbrühl, Austria
| | - Metin Aysel
- 0000 0004 1937 0650grid.7400.3Department of Child and Adolescent Psychiatry and Psychotherapy, University of Zürich, Rämistrasse 71, 8006 Zurich, Switzerland
| | - Zeliha Özlü-Erkilic
- 0000 0000 9259 8492grid.22937.3dOutpatient Clinic of Transcultural Psychiatry and Migration-Induced Disorders in Childhood and Adolescence, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Christian Popow
- 0000 0000 9259 8492grid.22937.3dDepartment of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
| | - Türkan Akkaya-Kalayci
- 0000 0000 9259 8492grid.22937.3dOutpatient Clinic of Transcultural Psychiatry and Migration-Induced Disorders in Childhood and Adolescence, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
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Marksteiner T, Janke S, Dickhäuser O. Effects of a brief psychological intervention on students' sense of belonging and educational outcomes: The role of students' migration and educational background. J Sch Psychol 2019; 75:41-57. [PMID: 31474280 DOI: 10.1016/j.jsp.2019.06.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 01/28/2019] [Accepted: 06/27/2019] [Indexed: 10/26/2022]
Abstract
Disadvantaged students who or whose parents immigrated (i.e., migration background) and first-generation students (i.e., non-academic background) have a higher risk of dropping out of school or university, earning poor grades, and facing mental health problems. This is likely in part a result of their impaired sense of belonging (e.g., feeling accepted and valued by peers and others) at educational institutions. In the current study, we tested the effectiveness of a belonging intervention that aims to reduce social disparities in sense of belonging-for the first time outside North America. Past research has demonstrated that the intervention supports disadvantaged students during the transition to middle school as well as to university. The intervention, at its core, is a brief reading-writing-exercise, which teaches that worries about belonging are common among freshmen and diminish over time. We conducted a pre-post-follow-up randomized control study with 86 freshmen (34.9% academic background, 44.2% non-academic background, 20.9% migration background). The intervention had differential effects on sense of belonging and self-reported grades after the first semester: For students without a migration background, the intervention had lasting positive effects on belonging; for students with a migration background, the positive effect diminished over time. Further, compared to students without a migration background, students with a migration background reported worse grades in the control condition and similar grades in the intervention condition. In addition, the intervention had positive-but no differential-effects on depression symptoms: students in the intervention group experienced less fluctuation and lower levels of depression symptoms than in the control group. The intervention had no significant effects on intentions to persist and emotional burden after six months. In sum, we found that the presented brief psychological intervention, adapted for the students with migration background, is effective but needs further customization to achieve positive and lasting outcomes.
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Affiliation(s)
| | - Stefan Janke
- University of Mannheim, Department of Educational Psychology, Germany
| | - Oliver Dickhäuser
- University of Mannheim, Department of Educational Psychology, Germany
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22
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Tillmann J, Schnakenberg R, Puth MT, Weckbecker K, Just J, Münster E. Barriers in general practitioners' dementia diagnostics among people with a migration background in Germany (BaDeMi) - study protocol for a cross-sectional survey. BMC Med Res Methodol 2018; 18:124. [PMID: 30400773 PMCID: PMC6220477 DOI: 10.1186/s12874-018-0580-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 10/18/2018] [Indexed: 11/10/2022] Open
Abstract
Background Considering the targeted general practitioner-centred healthcare in Germany, general practitioners (GPs) are in the best possible position to increase awareness of all sorts of dementia, an age-related syndrome with rising relevance in the future. In Germany, a doubling of the number of cases from 1.55 million up to 3 million in 2050 is predicted. Diagnostics can be challenging, especially among patients with a migration background. Complicating factors include: Language-based diagnostic tools, cultural differences in handling the syndrome and its underlying diseases as well as a differing use of the healthcare system. Because of missing research in this field in Germany, the type, frequency and intensity of barriers as well as the way GPs cope with them is unknown. That is why it’s crucial to focus research on diagnostics in total and especially among this population group. Methods A cross-sectional study among a random sample of 1000 general practitioners in Germany is conducted in October 2017. A self-administered standardized questionnaire was developed, evaluated and send to the GP practices. A response rate of 30% is expected with one reminder letter. Descriptive statistics as well as, depending on the results, multivariable analyses will be executed. Based on these results and the stated needs, a cluster-randomized intervention study will be constructed to improve healthcare. Discussion This study is the first in Germany focusing on how dementia diagnostics in general practice is performed, what problems occur, especially because of a migration background of patients, and how GPs cope with them. Depending on the results, it should emphasize the necessity of dementia diagnostics to be adjusted to the needs of the rising amount of people with a migration background (22.5% in Germany, 2016) like concluded from international studies. Trial registration German Clinical Trials Register: DRKS00012503, date of registration: 05.09.2017. Clinical register of the study coordination office of the University hospital of Bonn: ID530, date of registration: 05.09.2017.
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Affiliation(s)
- Judith Tillmann
- Institute of General Practice and Family Medicine, Medical Faculty of the University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.
| | - Rieke Schnakenberg
- Institute of General Practice and Family Medicine, Medical Faculty of the University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
| | - Marie-Therese Puth
- Institute of General Practice and Family Medicine, Medical Faculty of the University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.,Department of Medical Biometry, Informatics and Epidemiology (IMBIE), University Hospital of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
| | - Klaus Weckbecker
- Institute of General Practice and Family Medicine, Medical Faculty of the University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
| | - Johannes Just
- Institute of General Practice and Family Medicine, Medical Faculty of the University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
| | - Eva Münster
- Institute of General Practice and Family Medicine, Medical Faculty of the University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
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Morbach C, Gelbrich G, Tiffe T, Eichner F, Wagner M, Heuschmann PU, Störk S, Frantz S, Maack C, Ertl G, Fassnacht M, Wanner C, Leyh R, Volkmann J, Deckert J, Faller H, Jahns R. Variations in cardiovascular risk factors in people with and without migration background in Germany - Results from the STAAB cohort study. Int J Cardiol 2018; 286:186-189. [PMID: 30420145 DOI: 10.1016/j.ijcard.2018.10.098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 10/02/2018] [Accepted: 10/29/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND About 20% of the German population have a migration background which might influence prevalence of preventable cardiovascular risk factors (CVRF). METHODS We report data of the prospective Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression (STAAB) cohort study investigating a representative sample of inhabitants of the City of Würzburg, Germany, aged 30 to 79 years. Individuals without migration background were defined as follows: German as native language, no other native language, and/or born in Germany. All other participants were defined as individuals with migration background. RESULTS Of 2473 subjects (51% female, mean age 54 ± 12 years), 291 (12%) reported a migration background: n = 107 (37%) from a country within the EU, n = 117 (40%) from Russia, and n = 67 (23%) from other countries. Prevalence of hypertension, atherosclerotic disease, and diabetes mellitus was similar in individuals with and without migration background. By contrast, prevalence of obesity and metabolic syndrome was significantly higher in individuals with migration background, with the least favourable profile apparent in individuals from Russia (individuals without vs. with migration background: obesity 19 vs. 24%, p < 0.05; odds ratio: EU: 1.6, Russia: 2.2*, other countries: 0.6; metabolic syndrome 18 vs. 21%, p < 0.05; odds ratio: EU: 1.2, Russia: 1.7*, other countries: 1.5; *p < 0.05). CONCLUSION Individuals with migration background in Germany might exhibit a higher CVRF burden due to a higher prevalence of obesity and metabolic syndrome. Strategies for primary prevention of heart failure may benefit from deliberately considering the migration background.
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Affiliation(s)
- Caroline Morbach
- Comprehensive Heart Failure Center and Dept. of Medicine I, University Hospital and University of Würzburg, Germany
| | - Götz Gelbrich
- Institute of Clinical Epidemiology and Biometry and Comprehensive Heart Failure Center, University of Würzburg, Germany
| | - Theresa Tiffe
- Institute of Clinical Epidemiology and Biometry and Comprehensive Heart Failure Center, University of Würzburg, Germany
| | - Felizitas Eichner
- Institute of Clinical Epidemiology and Biometry and Comprehensive Heart Failure Center, University of Würzburg, Germany
| | - Martin Wagner
- Institute of Clinical Epidemiology and Biometry and Comprehensive Heart Failure Center, University of Würzburg, Germany
| | - Peter U Heuschmann
- Institute of Clinical Epidemiology and Biometry, Comprehensive Heart Failure Center, and Clinical Trial Center, University of Würzburg, Germany
| | - Stefan Störk
- Comprehensive Heart Failure Center and Dept. of Medicine I, University Hospital and University of Würzburg, Germany.
| | | | - S Frantz
- Dept. of Medicine I, Div. of Cardiology, University Hospital Würzburg, Germany
| | - C Maack
- Comprehensive Heart Failure Center, University Hospital and University of Würzburg, Germany
| | - G Ertl
- University Hospital Würzburg, Germany
| | - M Fassnacht
- Dept. of Medicine I, Div. of Endocrinology, University Hospital Würzburg, Germany
| | - C Wanner
- Dept. of Medicine I, University Hospital Würzburg, Germany
| | - R Leyh
- Dept. of Cardiovascular Surgery, University Hospital Würzburg, Germany
| | - J Volkmann
- Dept. of Neurology, University Hospital Würzburg, Germany
| | - J Deckert
- Dept. of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Germany
| | - H Faller
- Dept. of Medical Psychology, University of Würzburg, Germany
| | - R Jahns
- Interdisciplinary Bank of Biomaterials and Data Würzburg, University Hospital Würzburg, Germany
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24
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Zhou Y, von Lengerke T, Walter U, Dreier M. Migration background and childhood overweight in the Hannover Region in 2010-2014: a population-based secondary data analysis of school entry examinations. Eur J Pediatr 2018; 177:753-763. [PMID: 29470636 DOI: 10.1007/s00431-018-3118-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 12/20/2017] [Accepted: 02/12/2018] [Indexed: 11/28/2022]
Abstract
UNLABELLED Overweight and obesity constitute a global epidemic with rates that are increasing rapidly in children. The aim of the present study was to examine ethnic differences in the prevalence of overweight in pre-school children in a multicultural context. Data were collected from a compulsory school entry examination in the Hannover Region, Germany (n = 50,716) from 2010 to 2014. The prevalence of overweight (including pre-obesity and obesity status) and obesity was estimated using a German national reference. The migration status of the children was based on the parent's migration history. Multivariable logistic and hierarchical multinomial regression analyses were performed to identify factors associated with the overweight, pre-obesity, and obesity status. The prevalence of overweight was significantly higher among migrant children (12.7%) than among the non-migrant children (6.9%). After adjusting for socioeconomic and child development variables, migration background was strongly associated with weight status. The Turkish migrant children showed the highest odds of being pre-obesity (OR 2.05, 95%CI 1.7-2.56) and obesity (OR 2.09, 95%CI 1.67-2.77) compared to non-migrant children. CONCLUSION Ethnic and social inequalities exist in childhood overweight among pre-school children in the Hannover Region. Thus, appropriate interventions targeting high-risk migrant groups are needed. What is Known: • The current trend of prevalence rates in Germany for overweight and obesity of pre-school children is becoming stable. • Prevalence of overweight and obesity is clearly higher among migrant children than among non-migrant children. What is New: • This article reveals ethnic variance among different migrant groups. • Turkish migrant children have a higher rate of prevalence even compared to other migrant groups. • Length of child day care attendance fails to exert a strong influence on overweight after adjusting for socio-economic and child development variables.
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Affiliation(s)
- Yusheng Zhou
- Institute of Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| | - Thomas von Lengerke
- Medical Psychology Unit, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Ulla Walter
- Institute of Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Maren Dreier
- Institute of Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
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25
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Stroebele-Benschop N, Depa J, Gyngell F, Müller A, Eleraky L, Hilzendegen C. Migration Background Influences Consumption Patterns Based on Dietary Recommendations of Food Bank Users in Germany. J Immigr Minor Health 2018; 20:1387-1395. [PMID: 29600471 DOI: 10.1007/s10903-018-0734-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
People with low income tend to eat less balanced than people with higher income. This seems to be particularly the case for people with migration background. This cross-sectional study examined the relation of consumption patterns of 597 food bank users with different migration background in Germany. Questionnaires were distributed assessing sociodemographic information and consumption patterns. Analyses were conducted using binary logistic regressions. Models were controlled for age, gender, type of household and education. The group of German food bank users consumed fewer fruits and vegetables and less fish compared to all other groups with migration background (former USSR, Balkan region, Middle East). A significant predictor for fruit and vegetable consumption was migration status. Participants from the former USSR consumed less often SSBs compared to the other groups. Dietary recommendations for low income populations should take into consideration other aspects besides income such as migration status.
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Affiliation(s)
- Nanette Stroebele-Benschop
- Department of Nutritional Psychology, Institute of Nutritional Medicine, University of Hohenheim, Fruwirthstr. 12, 70593, Stuttgart, Germany.
| | - Julia Depa
- Department of Nutritional Psychology, Institute of Nutritional Medicine, University of Hohenheim, Fruwirthstr. 12, 70593, Stuttgart, Germany
| | - Fiona Gyngell
- Department of Nutritional Psychology, Institute of Nutritional Medicine, University of Hohenheim, Fruwirthstr. 12, 70593, Stuttgart, Germany
| | - Annalena Müller
- Department of Nutritional Psychology, Institute of Nutritional Medicine, University of Hohenheim, Fruwirthstr. 12, 70593, Stuttgart, Germany
| | - Laila Eleraky
- Department of Nutritional Psychology, Institute of Nutritional Medicine, University of Hohenheim, Fruwirthstr. 12, 70593, Stuttgart, Germany
| | - Carolin Hilzendegen
- Department of Nutritional Psychology, Institute of Nutritional Medicine, University of Hohenheim, Fruwirthstr. 12, 70593, Stuttgart, Germany
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Müller MJ, Koch E. Gender Differences in Stressors Related to Migration and Acculturation in Patients with Psychiatric Disorders and Turkish Migration Background. J Immigr Minor Health 2018; 19:623-630. [PMID: 27026345 DOI: 10.1007/s10903-016-0408-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Migration, acculturation, and psychiatric disorders may cause stress and adaptation processes differently in men and women, but empirical research is scarce. In a retrospective study n = 62 Turkish migrants and n = 62 native German inpatients with depressive or anxiety disorders, matched for age, gender, and diagnoses, were compared using a 10-item instrument for the assessment of migration- and acculturation related stressors (MIGSTR10). Gender differences in the prevalence of stressors and in the total sum of stressors were calculated and compared between migrants and indigenous patients. Results showed a higher global stress level in migrants and in women than in men with migration background. Regarding single stressors, the perceived loss of status was significantly more prevalent and more pronounced in men than in women (P < 0.05) whereas guilt feelings were more severe in women with Turkish migration background compared to men (P < 0.05). Gender differences of perceived stress should be taken into account in migration and acculturation research.
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Affiliation(s)
- Matthias Johannes Müller
- Faculty of Medicine, University of Giessen, Giessen, Germany.
- Vitos Clinical Centre for Psychiatry and Psychotherapy Giessen-Marburg, Licher Strasse 106, 35394, Giessen, Germany.
| | - Eckhardt Koch
- Vitos Clinical Centre for Psychiatry and Psychotherapy Giessen-Marburg, Licher Strasse 106, 35394, Giessen, Germany
- Institute of European Ethnology and Cultural Studies, University of Marburg, Marburg, Germany
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Abstract
Cultural setting and sex and gender of the patient are important factors affecting the occurrence, severity, clinical course and prognosis of pain and pain-related diseases. Intercultural differences in the perception and verbal expression of symptoms and emotional function are fundamental and it is important to realize these differences in order to understand patients with a migration background. A trusting doctor-patient relationship is generally very sensitive and it is even more difficult to establish when differences in the cultural background impair mutual understanding. Regarding sex and gender there is evidence that females are more susceptible to developing chronic pain conditions, experience more severe pain and respond differently to pain therapy; however, results of recent studies indicate that females are not that different to males when comparing several modalities of experimental pain (although some differences exist). Similarly, sex and gender differences in postoperative pain seem to exist but the differences are relatively small when pain scores are compared. Other aspects, such as the response to analgesics and role of psychosocial factors should be addressed when sex and gender aspects are studied. Similarly, sex and gender differences in the prevalence of chronic pain exist but the results of some studies, e.g. those controlling for confounders, are not very clear. Research is needed to delineate the role of specific aspects affecting sex and gender differences and the underlying mechanisms (e.g. reduced inhibitory control, hormones, psychological aspects and social factors). Altogether, we need to open our minds to some intercultural and sex and gender aspects in the clinical setting. For sex and gender differences we may need a more biopsychosocial approach to understand the underlying differences and differentiate between sex and gender and sex and gender-associated aspects for acute and chronic pain.
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Affiliation(s)
- M Schiltenwolf
- Klinik für Orthopädie und Unfallchirurgie, Zentrum für Orthopädie, Unfallchirurgie und Paraplegiologie, Universitätsklinikum Heidelberg, Schlierbacher Landstr. 200a, 69118, Heidelberg, Deutschland.
| | - E M Pogatzki-Zahn
- Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin, Münster, Deutschland
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28
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Akkaya-Kalayci T, Popow C, Waldhör T, Winkler D, Özlü-Erkilic Z. Psychiatric emergencies of minors with and without migration background. Neuropsychiatr 2017; 31:1-7. [PMID: 27966096 DOI: 10.1007/s40211-016-0213-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 11/21/2016] [Indexed: 11/24/2022]
Abstract
Background The conditions of children and adolescents with migration background receiving emergency psychiatric care in Europe are not well known. Migrants usually attend regular psychiatric care less frequently than the autochthonous population. We therefore speculated that, being undertreated, they would be overrepresented among psychiatric emergency care patients. Methods We retrospectively analyzed the records of 1093 minors aged 4‑18 years treated during a period of three years at the psychiatric emergency outpatient clinic of the Department of Child and Adolescent Psychiatry at the Medical University of Vienna. Results More minors with migration background than natives consulted our emergency clinic. Most frequent reasons for referral were suicide attempts by Turkish patients, acute stress disorder in Serbian/Croatian/Bosnian and in Austrian patients. Psychiatric diagnoses like eating and personality disorders were mostly diagnosed in natives. We found gender specific differences between the groups. Conclusions The reasons for these differences possibly relate to deficits of adequate mental health-care in Austria, to intercultural and intrafamiliar conflicts related to acculturation distress in the migrant population. Prospective longitudinal studies focusing on the utilization of mental health care by the migrant children and the impact of the migration background on their mental health are needed for improving adequate culture-sensitive mental-health care for this population.
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29
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Kietzmann D, Knuth D, Schmidt S. (Non-)utilization of pre-hospital emergency care by migrants and non-migrants in Germany. Int J Public Health 2016; 62:95-102. [PMID: 27658813 DOI: 10.1007/s00038-016-0904-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 09/10/2016] [Accepted: 09/16/2016] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES This study was designed to explore the utilization and non-utilization of pre-hospital emergency care by migrants and non-migrants, and the factors that influence this behaviour. METHODS A cross-sectional representative German survey was conducted in a sample of 2.175 people, 295 of whom had a migration background. An additional sample of 50 people with Turkish migration background was conducted, partially in the Turkish language. Apart from socio-demographics, the utilization of emergency services and the reasons for non-utilization were assessed. RESULTS Migrants had a higher utilization rate of pre-hospital emergency care (RR = 1.492) than non-migrants. Furthermore, migrants who were not born in Germany had a lower utilization rate (RR = 0.793) than migrants who were born in Germany. Regarding non-utilization, the most frequently stated reasons belonged to the categories initial misjudgment of the emergency situation and acting on one's own behalf, with the latter stated more frequently by migrants than by non-migrants. CONCLUSIONS To prevent over-, under-, and lack of supply, it is necessary to transfer knowledge about the functioning of the medical emergency services, including first aid knowledge.
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Affiliation(s)
- Diana Kietzmann
- Department Health and Prevention, Institute of Psychology, Ernst-Moritz-Arndt-University Greifswald, Robert-Blum-Str. 13, 17487, Greifswald, Germany.
| | - Daniela Knuth
- Department Health and Prevention, Institute of Psychology, Ernst-Moritz-Arndt-University Greifswald, Robert-Blum-Str. 13, 17487, Greifswald, Germany
| | - Silke Schmidt
- Department Health and Prevention, Institute of Psychology, Ernst-Moritz-Arndt-University Greifswald, Robert-Blum-Str. 13, 17487, Greifswald, Germany
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Ruedl G, Greier K, Kirschner W, Kopp M. Factors associated with motor performance among overweight and nonoverweight Tyrolean primary school children. Wien Klin Wochenschr 2015; 128:14-9. [PMID: 26546350 DOI: 10.1007/s00508-015-0887-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 10/12/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND The increasing prevalence of overweight and obesity among children is often associated with motor deficits. Motor performance among children partly depends on modifiable factors, for example, weight status, electronic media use, sports club participation, and on nonmodifiable factors, for example, sex, age, migration background, or socio-economic status. AIM To evaluate factors associated with motor performance among overweight and nonoverweight Tyrolean primary school children. METHODS Height, weight, and sport motor performance of primary school children were measured using the German motor performance test DMT 6-18. In addition, children were asked about migration background, sports club participation, and electronic media use in their room. RESULTS A total of 304 children (48.7% girls) with a mean age of 8.0 ± 1.2 years were tested. In total, 61 (20.1%) children were overweight or obese. Regarding motor performance, nonoverweight children showed significantly higher total z-scores (106.8 ± 5.7 vs. 102.4 ± 6.8). For the total cohort, results of the multiple linear regression analysis (R (2) = 0.20) revealed that factors male sex (β = 0.12), nonoverweight children (β = 0.28), higher school grade (β = 0.23), sports club participation (β = 0.18),and > 2 weekly lessons of physical education (β = 0.26) were associated with an increased motor performance. For nonoverweight children results of the multiple linear regression analysis (R (2) = 0.09) found that a higher school grade (β = 0.17), sports club participation (β = 0.16),and more than 2 weekly lessons of physical education (β = 0.22) were associated with an increased motor performance. For the overweight children, results of the multiple linear regression analysis (R (2) = 0 .43) showed that no migration background (β = 0.23), a higher school grade (β = 0.55), sports club participation (β = 0.33) and more than 2 weekly lessons of physical education (β = 0.48) were associated with an increased motor performance. CONCLUSION Regarding modifiable factors, motor performance among overweight and nonoverweight children is strongly associated with a higher number of weekly lessons in physical education. Therefore, daily lessons in physical education are strongly recommended to improve motor performance especially among overweight primary school children.
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Affiliation(s)
- Gerhard Ruedl
- Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020, Innsbruck, Austria.
| | - Klaus Greier
- University College of Education (KPH) Stams, Stams, Austria
| | - Werner Kirschner
- Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020, Innsbruck, Austria
| | - Martin Kopp
- Department of Sport Science, University of Innsbruck, Fürstenweg 185, 6020, Innsbruck, Austria
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31
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Quindemil K, Nagl-Cupal M, Anderson KH, Mayer H. Migrant and minority family members in the intensive care unit. A review of the literature. ACTA ACUST UNITED AC 2013; 4:128-135. [PMID: 24860716 DOI: 10.1007/s16024-013-0171-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Statistics show that people with migrant and minority background as patients are significant in numbers in the intensive care unit. This also puts family members in the perspective of nursing because family members are an inherent part of the intensive care unit. Family-centered care is perhaps most applicable to vulnerable populations like migrant family in the intensive care unit to meet family member's needs. But very little is known about the situation of migrant and minority family members in the intensive care unit. The aim of the study was to explore the state of the science regarding family-centered care in the intensive care unit of patients with migration background in general and with a possible focus on major migrant populations in Austria-Former Yugoslavian und Turkish origin. A literature review investigated research articles that contained information on migrant and minority family members in the intensive care unit. Key points in the relevant articles were identified and categorized into themes with an explanation of findings at the end. Seventeen articles fulfilled the inclusion criteria. No article was found regarding groups of major migrant population groups in Austria. The included articles uncovered five predominant themes: importance of cultural norms, communication, family dynamics, universal caring, and nursing/provider deficit in culturally competent care. In order to provide adequate nursing care a more cohesive body of information on more specific geographic and cultural populations is recommended. Because of the complete lack of research regarding migrant families of Former Yugoslavian and Turkish origin into Austria, an exploration of this population is recommended.
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Affiliation(s)
| | - Martin Nagl-Cupal
- Department of Nursing Science, University of Vienna, Vienna, Austria
| | | | - Hanna Mayer
- Department of Nursing Science, University of Vienna, Vienna, Austria
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Mösko MO, Gil-Martinez F, Schulz H. Cross-cultural opening in German outpatient mental healthcare service: an exploratory study of structural and procedural aspects. Clin Psychol Psychother 2012; 20:434-46. [PMID: 22371333 DOI: 10.1002/cpp.1785] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
UNLABELLED Mental healthcare services need to be sensitive towards the cultural needs of patients. Cross-cultural opening is an organizational process to fulfil these needs. This study aims to provide representative structural and procedural data regarding the use of German outpatient mental healthcare services by allochthonous patients, the diversity of psychotherapists in outpatient mental healthcare service, the cross-cultural encounters of therapists and the cross-cultural sensitivity of psychotherapists working in this healthcare area. Of all public outpatient psychotherapists in Hamburg, 81% (n = 485) participated in this survey. Regarding the distribution of the population in this metropolis, allochthonous therapists were underrepresented. Unlike the overall distribution of foreign inhabitants, the largest groups of immigrant therapists came from England, German-speaking countries and other countries within the European Union. The proportion of allochthonous patients in outpatient mental healthcare service was almost half of the proportion of the allochthonous in the general population. Psychotherapists with a migration background regarded themselves as having a higher level of cross-cultural sensitivity than their native colleagues, especially those who have had fewer cross-cultural encounters. Overall, psychotherapists named different challenges in providing cross-cultural treatment. For the German outpatient mental healthcare service to be more accessible to immigrants and their descendants, a greater number of bilingual psychotherapists must gain access to the mental healthcare service, and more advanced cross-cultural sensitivity training and supervision should be provided. KEY PRACTITIONER MESSAGE German outpatient psychotherapists are culturally and linguistically diverse. Nevertheless, psychotherapists with a migration background are underrepresented in outpatient mental healthcare services. Patients with a migration background are also underrepresented in the German outpatient mental healthcare system. Because mental healthcare services must be sensitive and respectful towards patients' cultural and linguistic needs, the mental healthcare outpatient service must be more accessible to therapists who speak languages other than German and English. Psychotherapeutic treatment of patients with a migration background can be tremendously challenging because of other cultures' differing value systems. Prospective, advanced training in cross-cultural sensitivity and cross-cultural supervision should be provided.
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Affiliation(s)
- Mike-Oliver Mösko
- Department of Medical Psychology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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