[Families with Migrant Backgrounds as Target Group of Early Interventions: Results of a Social Early Warning System in a Metropolitan Region]. / Familien mit Migrationshintergrund als Zielgruppe in den Frühen Hilfen: Ergebnisse eines Sozialen Frühwarnsystems einer Metropolregion.

OBJECTIVES: Families with migrant backgrounds (MB) are exposed to several psychosocial risk factors that increase the likelihood of impaired child development, in particular. QUESTIONS: We investigated whether families with MB differ from families without MB regarding their psychosocial stressors in the period of pregnancy and birth. METHOD: As part of a social early warning system in an obstetrics clinic in Germany n=502 families with MB were compared with n=349 families without MB with respect to the degree of stress and stress factors on the basis of an initial screening of risk factors for child maltreatment by a midwife or physician and a subsequent structured clearing interview by social education workers during the mothers' inpatient hospitalisation. RESULTS: For families without MB, a significantly higher total score was found in the risk screening (M=3,9 points vs. M=2,9 points) in comparison to families with MB. While families with MB compared to families without MB were faced more frequently by social stressors, e. g., financial problems or a difficult housing situation (81 vs. 37%), they were less frequently impacted by mental strain (27 vs. 48%), young fathers (2 vs. 10%) and maternal psychiatric diseases (3 vs. 17%), according to the risk screening. Socio-economic determinants such as social inclusion and living environment were found to be important factors influencing the psychosocial stress level of families. CONCLUSION: Explanations and implications for research and practice are discussed.

The willingness to participate in health research studies of individuals with Turkish migration backgrounds: barriers and resources.

BACKGROUND: Lower participation rates of ethnic minorities in health research studies and potential participation barriers are commonly reported. METHODS: Four semi-structured focus groups of individuals with Turkish migration backgrounds living in Germany were conducted to identify potential participation barriers. Documented statements and superscripted presentation cards by the participants were evaluated with a qualitative content analysis. RESULTS: The following eight potential reasons for the lower participation rates were identified: role of women, lack of knowledge, lack of interest, German-Turkish interactions, mistrust, anxiety, data privacy protection and benefits of the study. Additionally, the following recruitment strategies to enhance participation rates were found: public relations, especially word-of-mouth promotion and contacting Turkish key figures, (non-) tangible incentives and trust building through transparent communication of the project and its conditions. DISCUSSION: The findings provide a wide range of potential participation barriers and implications that should be considered to enhance the participation rates of minority populations. CONCLUSION: The willingness to participate in health research studies can be increased through particular efforts, which should be tailored to the recruitment of the underrepresented target population.

Cross-cultural training in mental health care--challenges and experiences from Sweden and Germany.

Globalization and cultural diversity challenge mental health care in Europe. Sensitivity to culture in mental health care benefits effective delivery of care to the individual patient and can be a contribution to the larger project of building a tolerant multicultural society. Pivotal for improving cultural sensitivity in mental health care is knowledge in cross-cultural psychiatry, psychology, nursing and related fields among professionals and accordingly training of students and mental health professionals. This paper will give an overview, and a critical examination, of current conceptualisation of cross-cultural mental health training. From German and Swedish experiences the need for crosscultural training and clinical research on evaluation will be presented.

[The care of people with a migration background in psychosomatic rehabilitation]. / Die Versorgung von Menschen mit Migrationshintergrund in der psychosomatischen Rehabilitation.

It was evaluated in an inpatient rehabilitation setting whether patients with mental or psychosomatic disorders people with a migration background are treated less frequently, profit less from the treatment, and have a higher risk for a negative outcome. On the basis of a prospective sample (n=25,066), the healthcare utilization of inpatient rehabilitation institutions, the level of mental stress, the quality of treatment, and the influence of risk factors were reviewed. Patients with a migration background show a lower level of health care utilization and a higher level of overall mental stress. Turkish patients and patients from the former Yugoslavia show the poorest treatment results. The regression analysis underlines clinical and sociodemographic factors as independent, negative predictors for good treatment results. Treatment concepts should be more strongly oriented to the needs of patients with a migration background and socioeconomically deprived patients.

[Measuring positive behaviour and experience in inpatients with mental disorders--the Hamburg Self-Care Questionnaire (HamSCQ)]. / Erfassung von positivem Verhalten und Erleben bei Patienten mit psychischen und psychosomatischen Erkrankungen in der Rehabilitation--der Hamburger Selbstfürsorgefragebogen (HSF).

OBJECTIVES: Treatments of patients with chronic mental disorders are increasingly focusing on salutogenetic aims to support human health and well-being. Up to now, standardized instruments to evaluate these treatment goals are still missing. We present results of analyses of the psychometric properties of the Hamburg Self-Care Questionnaire (HamSCQ). Besides reliability we are focusing on different aspects of validity: factor structure, concurrent validity, and sensitivity to change. METHODS: A total sample of 7 478 inpatients with mental disorders from four different psychotherapeutic clinics participated in the study. Patients completed self-rating questionnaires at admission and discharge: Besides the HamSCQ we used the Symptom Checklist SCL-14, the Short Form SF-8, the CES-D depression scale, the Inventory of Interpersonal Problems IIP-25 and the AVEM. RESULTS: The two-dimensional structure of the HamSCQ with the two subscales PACING and POSITIVE EXPERIENCE could be replicated by means of both principal component and confirmatory factor analysis. The two scales correlate with r=0.56. Both scales show a high internal consistency (alpha >or=0.90), they correlate with the selected measures of concurrent validity (except the AVEM scales) with medium (Pacing) or high (Positive Experience) effect sizes, and their mean scores differ significantly from admission to discharge with large effect sizes. CONCLUSIONS: The HamSCQ proves to be a reliable questionnaire, which is also sensitive to change. The two-dimensional factor structure could be replicated, and some aspects of concurrent validity could be demonstrated, but concerning criterion validity further research is still necessary. Thus we recommend the use of the HamSCQ for inpatients with mental disorders treated in psychotherapeutic/rehabilitative clinics.

Nucleoside diphosphate kinase, a source of GTP, is required for dynamin-dependent synaptic vesicle recycling.

Nucleoside diphosphate kinase (NDK), an enzyme encoded by the Drosophila abnormal wing discs (awd) or human nm23 tumor suppressor genes, generates nucleoside triphosphates from respective diphosphates. We demonstrate that NDK regulates synaptic vesicle internalization at the stage where function of the dynamin GTPase is required. awd mutations lower the temperature at which behavioral paralysis, synaptic failure, and blocked membrane internalization occur at dynamin-deficient, shi(ts), mutant nerve terminals. Hypomorphic awd alleles display shi(ts)-like defects. NDK is present at synapses and its enzymatic activity is essential for normal presynaptic function. We suggest a model in which dynamin activity in nerve terminals is highly dependent on NDK-mediated supply of GTP. This connection between NDK and membrane internalization further strengthens an emerging hypothesis that endocytosis, probably of activated growth factor receptors, is an important tumor suppressor activity in vivo.