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Examination of the attendance for using internet-based measures after inpatient treatment.Cross-sectional-survey in former inpatients (N = 247).44.9 % are willing to use measures via videoconference, 34.7 % via Chat, 50.0 % via E-Mail and 38.0 % as onlinetherapy. Attendance is lower in older age groups. Benefits regarding the introduced measures are seen mainly in the flexibility and disadvantages in the impersonal character.A relevant share of especially younger patients is willing to use internet-based measures.Untersuchung der Bereitschaft zur Inanspruchnahme internetbasierter Maßnahmen nach stationärer Behandlung.Querschnittbefragung an ehemals stationären Patienten (N = 247).44,9 % sind bereit, ein Angebot über Videokonferenz zu nutzen, 34,7 % über Chat, 50,0 % über Mail und 38,0 % als Onlinetherapie. In älteren Altersgruppen ist die Bereitschaft geringer. Vorteile werden in der Flexibilität und Nachteile im unpersönlichen Charakter gesehen.Ein relevanter Anteil vor allem jüngerer Patienten ist bereit, internetbasierte Maßnahmen in Anspruch zu nehmen.

This study was part of a double-blind randomised controlled trial aimed to evaluate the effects of culture-sensitive patient information materials (PIM) compared with standard translated material. The study aimed to obtain the data for the development of culture sensitive PIM about unipolar depression for the 4 largest migrant groups in Germany (Turkish, Polish, Russian and Italian migration background).A qualitative study using 4 manual-based focus groups (FG), one for each migrant group, with 29 participants (9 with a Turkish (TüG), 8 with a Polish (PoG), 5 with a Russian (RuG) and 7 with an Italian (ItG) migration background) was conducted. The discussions were recorded, transcribed and analyzed using qualitative content analysis.7 categories were identified. For the (1.) development of a good culture-sensitive PIM an easy language, a clear structure, an assessable extent of information and the avoidance of stereotypes were highlighted cross-culturally in all four FG. RuG and PoG had the largest (2.) lack of information about the German health care system. Concerning the (3.) illness perception RuG named problems with recognizing and understanding depression. PoG, RuG and TüG thematized (4.) feared consequences of the illness and of professional helpseeking. ItG, PoG, RuG had fears concerning (5.) psychotropic drugs as a result from insufficient knowledge about medication. For (6.) doctor-patient relationship cultural specifics were identified in RuG and TüG and for (7.) migration or culture specific reasons for depression in RuG, ItG and TüG.Although the identified categories were relevant for all or for the majority of migrant groups, for most categories specific cultural aspects were discovered. These findings show the importance of a culture sensitive adaptation of PIM.Die Studie war ein Teil einer größeren, randomisiert-kontrollierten Studie, in der die Effekte kultursensitiver Patienteninformationsmaterialien (PIM) im Vergleich mit übersetzten PIM evaluiert wurden. Die vorliegende Studie hatte zum Ziel, Daten zur Entwicklung von PIM zu unipolarer Depression für die 4 größten Gruppen von Menschen mit Migrationshintergrund (türkischer, polnischer, russischer und italienischer Migrationshintergrund) in Deutschland zu gewinnen.Im Rahmen einer qualitativen Studie wurde pro Migrantengruppe jeweils eine leitfadenbasierte Fokusgruppe (FG) mit insgesamt n=29 Teilnehmenden (n=9 mit türkischem (TüG), n=8 polnischem (PoG), n=5 russischem (RuG), n=7 italienischem (ItG) Migrationshintergrund) durchgeführt, aufgezeichnet, transkribiert und mittels eines qualitativ-inhaltsanalytischen Analysemodells ausgewertet.Es konnten 7 Kategorien identifiziert werden. Über alle 4 FG wurde kulturübergreifend als wichtig die (1.) Gestaltung einer guten kultursensitiven PIM durch eine einfache Sprache, eine klare Struktur, einen überschaubareren Informationsumfang sowie die Vermeidung von Stereotypien erachtet. (2.) Informationsdefizite über das Gesundheitssystem zeigten sich v. a. bei der RuG und der PoG. Bezogen auf das (3.) Krankheitsbild der Depression wurden von der RuG Schwierigkeiten bzgl. des Erkennens und des Verstehens einer Depression beschrieben. In der PoG, der RuG und der TüG wurde die (4.) befürchteten Folgen der Erkrankung sowie der Inanspruchnahme professioneller Hilfe thematisiert. In den ItG, PoG und RuG wurden Angstgefühle aufgrund von Wissenslücken im Zusammenhang mit (5.) Psychopharmaka beschrieben. In der Kategorie (6.) Arzt-Patienten-Beziehung konnten kulturspezifische Besonderheiten für die RuG und die TüG und in der Kategorie (7.) migrations- und kulturspezifische Depressionsursachen für die RuG, die ItG und die TüG identifiziert werden.Obwohl einige Kategorien kulturübergreifend für alle bzw. für die Mehrheit untersuchter Migrantengruppen eine Relevanz zeigten, waren bei einer Vielzahl von Kategorien kulturelle Spezifika erkennbar. Dies spricht für die Wichtigkeit einer kultursensitiven Anpassung von PIM.

Collaborative Care programs like the Improving Mood Promoting Access to Collaborative Care Program (IMPACT) present an opportunity to support primary care for elderly depressed patients. The GermanIMPACT study evaluates whether this low-threshold model using short behavioral interventions that are conducted by care managers and supervised by a psychotherapist/psychiatrist, is as effective as in other countries. Besides effectiveness, the feasibility of the intervention is also essential for the implementation of the program.Care managers and supervisors were interviewed using a qualitative interview guide with questions concerning feasibility and effectiveness of the GermanIMPACT intervention, and the interviews were then evaluated using qualitative content analysis.The interviewees provided important information on how to optimize the realization of the intervention by selecting patients more carefully and by providing case managers with more training. Moreover, the intervention was described as being supportive of patients and as providing relief for general practitioners. Whereas interviewees wanted the intervention to be expanded to other disorders, they simultaneously highlighted the limits of the intervention.The present study provides practical information for implementing the GermanIMPACT model. Thus, specific recommendations for implementation into standard care can be derived.

Background Adults with autism spectrum disorders (ASD) experience challenges in participating in the labour market and struggle to achieve and maintain appropriate professional positions, possibly due to impairments of communication and social interaction. Studies have shown high rates of unemployment as well as evidence of inadequate employment. As knowledge on the participation in the German labour market is scarce, the aim of our study was to examine employment status, type of occupation and inadequate employment in a sample of clinically mostly late-diagnosed and most likely not intellectually disabled adults with ASD in Germany. Methods We conducted a cross-sectional-survey in clinically mostly late-diagnosed adults with ASD. Employment status, type of occupation, and the level of formal education and training were examined through a postal questionnaire. Inadequate employment regarding participants’ current and longest practised occupation was assessed by transforming participants’ information into skill levels of the “Classification of Occupations 2010” of the German Federal Employment Agency, and comparing these with participants’ level of formal education and training. Results The response rate was 43.2% (N = 185 of N = 428 potential participants). 94.6% were first-time diagnosed when being 18 years of age or older. 56.8% held a general university entrance-level qualification and 24.9% had obtained a Masters’ or diploma degree as their highest vocational qualification. 94.1% had been employed at some time. Of these, 68.4% reported being currently employed, 13.5% being currently unemployed and 17.0% being retired for health reasons. Regarding the longest-practised and the current occupation, the highest proportion of participants was found in the occupational area “health and social sector, teaching and education” (22.4% and 23.3%, respectively). With respect to inadequate employment, 22.1% were found to be overeducated in relation to their longest-practised occupation and 31.3% in relation to their current occupation. This is significantly higher than the percentage of overeducation in the general population. Conclusions Despite largely high formal qualifications, the clinically mostly late-diagnosed adults with ASD represented in our sample are disadvantaged regarding their participation in the German labour market, especially with respect to rates of unemployment, early retirement and overeducation. Employment support programs should be developed to improve employment outcomes. Electronic supplementary material The online version of this article (10.1186/s12888-018-1645-7) contains supplementary material, which is available to authorized users.

A specific instrument combination was developed to achieve a better microphysical and chemical characterization of atmospheric aerosol particles that have the potential to act as ice nucleating particles (INP). For this purpose a pumped counterflow virtual impactor system called IN-PCVI was set up and characterized to separate ice particles that had been activated on INP in the Fast Ice Nucleus Chamber (FINCH) from interstitial, non-activated particles. This coupled setup consisting of FINCH (ice particle activation and counting), IN-PCVI (INP separation and preparation), and further aerosol instrumentation (INP characterization) had been developed for the application in field experiments. The separated INP were characterized on-line with regard to their total number concentration, number size distribution and chemical composition, especially with the Aircraft-based Laser Ablation Aerosol Mass Spectrometer ALABAMA. Moreover, impactor samples for electron microscopy were taken. Due to the coupling the IN-PCVI had to be operated with different flow settings than known from literature, which required a further characterization of its cut-off-behavior. Taking the changed cut-off-behavior into account, the INP number concentration measured by the IN-PCVI system was in good agreement with the one detected by the FINCH optics for water saturation ratios up to 1.01 (ice saturation ratios between 1.21–1.34 and temperatures between −18 and −26 °C). First field results of INP properties are presented which were gained during the INUIT-JFJ/CLACE 2013 campaign at the high altitude research station Jungfraujoch in the Bernese Alps, Switzerland (3580 m a.s.l.).

Between 1 September and 4 October 2014, a combined airborne and ground-based measurement campaign was conducted to study tropical deep convective clouds over the Brazilian Amazon rain forest. The new German research aircraft, High Altitude and Long Range Research Aircraft (HALO), a modified Gulfstream G550, and extensive ground-based instrumentation were deployed in and near Manaus (State of Amazonas). The campaign was part of the German–Brazilian Aerosol, Cloud, Precipitation, and Radiation Interactions and Dynamics of Convective Cloud Systems–Cloud Processes of the Main Precipitation Systems in Brazil: A Contribution to Cloud Resolving Modeling and to the GPM (Global Precipitation Measurement) (ACRIDICON– CHUVA) venture to quantify aerosol–cloud–precipitation interactions and their thermodynamic, dynamic, and radiative effects by in situ and remote sensing measurements over Amazonia. The ACRIDICON–CHUVA field observations were carried out in cooperation with the second intensive operating period of Green Ocean Amazon 2014/15 (GoAmazon2014/5). In this paper we focus on the airborne data measured on HALO, which was equipped with about 30 in situ and remote sensing instruments for meteorological, trace gas, aerosol, cloud, precipitation, and spectral solar radiation measurements. Fourteen research flights with a total duration of 96 flight hours were performed. Five scientific topics were pursued: 1) cloud vertical evolution and life cycle (cloud profiling), 2) cloud processing of aerosol particles and trace gases (inflow and outflow), 3) satellite and radar validation (cloud products), 4) vertical transport and mixing (tracer experiment), and 5) cloud formation over forested/deforested areas. Data were collected in near-pristine atmospheric conditions and in environments polluted by biomass burning and urban emissions. The paper presents a general introduction of the ACRIDICON– CHUVA campaign (motivation and addressed research topics) and of HALO with its extensive instrument package, as well as a presentation of a few selected measurement results acquired during the flights for some selected scientific topics.

Anliegen Analyse des Inanspruchnahmeverhaltens von Migranten mit einer psychischen Storung im Vergleich zu Deutschen. Methode Reanalyse des Bundesgesundheitssurveys mit einer gematchten Stichprobe aus Migranten (n = 151) und Deutschen (n = 151). Ergebnisse Hinsichtlich der gesundheitsbezogenen Inanspruchnahme gibt es keine Unterschiede. Schlussfolgerungen Der Migrationshintergrund alleine erklart die in vielen Studien gefundenen Unterschiede nicht. Auszugehen ist von einer multifaktoriellen Entstehung, die neben migrationsbezogenen vor allem auf soziookonomischen Faktoren beruht.

Background Relapses and rehospitalisations are common after acute inpatient treatment in depressive disorders. Interventions for stabilising treatment outcomes are urgently needed. Psychoeducational group interventions for relatives were shown to be suitable for improving the course of disease in schizophrenia and bipolar disorders. A small Japanese monocentre randomised controlled trial also showed promising results for depressive disorders. However, the evidence regarding psychoeducation for relatives of patients with depressive disorders is unclear. Methods/Design The study is conducted as a two-arm multisite randomised controlled trial to evaluate the incremental effect of a brief psychoeducational group intervention for relatives as a maintenance treatment on the course of disease compared to treatment as usual. Primary outcome is the estimated number of depression-free-days in patients within one year after discharge from inpatient treatment. 180 patients diagnosed with unipolar depressive disorders as well as one key relative per patient will be included during inpatient treatment and randomly allocated to the conditions at discharge. In the intervention group, relatives will participate in a brief psychoeducational group intervention following the patient’s discharge. The intervention consists of four group sessions lasting 90 to 120 min each. Every group session contains informational parts as well as structured training in problem-solving. In both study conditions, patients will receive treatment as usual. Patients as well as relatives will be surveyed by means of questionnaires at discharge and three, six, nine and twelve months after discharge. In addition to the primary outcome, several patient-related and relative-related secondary outcomes will be considered and health economics will be investigated. Discussion Our study will provide evidence on the incremental effect of a brief psychoeducational intervention for relatives as a maintenance treatment after inpatient depression treatment. Positive results may have a major impact on health care for depression. Trial registration German Clinical Trials Register (DRKS): DRKS00006819; Trial registration date: 2014 Oktober 31; Universal Trial Number (UTN): U1111-1163-5391

Depressive disorders place a high burden on patients and their relatives. Psychoeducational groups for relatives may reduce relatives' burden and improve the course of disease in patients. To foster the development of psychoeducational interventions which meet relatives' needs, information demands in relatives of patients with depressive disorders were examined.A qualitative study using 3 focus groups was conducted among adult relatives of patients with depressive disorders (N=17). Discussions were audio-taped, transcribed and analyzed using qualitative content analysis.Information demands are based on information gaps, emotional burden as well as strains in everyday living and were identified with regard to illness-specific (symptoms, course and etiology), treatment-specific (treatment options and health care system) and - as central aspects - interaction-specific issues (dealing with the patient, difficulties in everyday living and relationship problems) as well as support options for relatives themselves and self-care.Information brokerage within psychoeducational groups for relatives should consider the burden of relatives as well as strains in everyday living on which information demands are based. To consider interaction-specific issues, specific skills - e. g. in problemsolving - should be trained.

In the present work, three different techniques to separate ice-nucleating particles (INPs) as well as ice particle residuals (IPRs) from non-ice-active particles are compared. The Ice Selective Inlet (ISI) and the Ice Counterflow Virtual Impactor (Ice-CVI) sample ice particles from mixed-phase clouds and allow after evaporation in the instrument for the analysis of the residuals. The Fast Ice Nucleus Chamber (FINCH) coupled with the Ice Nuclei Pumped Counterflow Virtual Impactor (IN-PCVI) provides ice-activating conditions to aerosol particles and extracts the activated particles for analysis. The instruments were run during a joint field campaign which took place in January and February 2013 at the High Alpine Research Station Jungfraujoch (Switzerland). INPs and IPRs were analyzed offline by scanning electron microscopy and energy-dispersive X-ray microanalysis to determine their size, chemical composition and mixing state. Online analysis of the size and chemical composition of INP activated in FINCH was performed by laser ablation mass spectrometry. With all three INP/IPR separation techniques high abundances (median 20–70%) of instrumental contamination artifacts were observed (ISI: Si-O spheres, probably calibration aerosol; Ice-CVI: Al-O particles; FINCH + IN-PCVI: steel particles). After removal of the instrumental contamination particles, silicates, Ca-rich particles, carbonaceous material and metal oxides were the major INP/IPR particle types obtained by all three techniques. In addition, considerable amounts (median abundance mostly a few percent) of soluble material (e.g., sea salt, sulfates) were observed. As these soluble particles are often not expected to act as INP/IPR, we consider them as potential measurement artifacts. Minor types of INP/IPR include soot and Pb-bearing particles. The Pb-bearing particles are mainly present as an internal mixture with other particle types. Most samples showed a maximum of the INP/IPR size distribution at 200–400 nm in geometric diameter. In a few cases, a second supermicron maximum was identified. Soot/carbonaceous material and metal oxides were present mainly in the sub-micrometer range. Silicates and Ca-rich particles were mainly found with diameters above 1 μm (using ISI and FINCH), in contrast to the Ice-CVI which also sampled many submicron particles of both groups. Due to changing meteorological conditions, the INP/IPR composition was highly variable if different samples were compared. Thus, the observed discrepancies between the different separation techniques may partly result from the non-parallel sampling. The differences of the particle group relative number abundance as well as the mixing state of INP/IPR clearly demonstrate the need of further studies to better understand the influence of the separation techniques on the INP/IPR chemical composition. Also, it must be concluded that the abundance of contamination artifacts in the separated INP and IPR is generally large and should be corrected for, emphasizing the need for the accompanying chemical measurements. Thus, further work is needed to allow for routine operation of the three separation techniques investigated.

In this work we present IN measurements at Mt. Zugspitze, Germany, 2650 m.a.s.l., Mt. Puy de Dome, France, 1464 m.a.s.l. and Jungfraujoch, Switzerland, 3580 m a.s.l during fall and winter 2012 with the instrument FINCH HALO (Fast Ice Nucleus Chamber for the High Altitude and LOng range research aircraft HALO). In this device the temperature and super saturation for activation of Ice Nuclei (IN) and the growth to ice crystals is obtained by mixing three gas flows of different temperatures and moisture. After the growth of IN and Cloud Condensation Nuclei (CCN) to macroscopic ice crystals and super-cooled water droplets in the development chamber, they are counted using an optical detector. The discrimination between ice and water is made by measuring the circular depolarization ratio of the backscattered laser light of each individual particle. IN are classified as biological particles by measuring their individual intrinsic-fluorescence during the winter campaigns in average 30-40 % of the IN show an intr...

Analysis of the health care utilisation of migrants with mental disorders compared to Germans with mental disorders under consideration of migration-related and socio-economic factors.Reanalysis of the supplement survey "Mental Disorders" of the "German Health Survey" 1998 with a matched sample of migrants (n = 151) and Germans (n = 151) with a positive 12-month prevalence of mental disorders.Regarding the prevalence rates for mental disorders and health care utilisation no differences in the sample between Germans and migrants could be found.The migration background alone does not explain the differences in health care utilisation which are found in many studies. It is assumed, that differences arise multifactorial, and can be explained through migration-related factors but especially through socio-economic factors. To provide a better understanding of health care utilisation of migrants it might be necessary to set the focus on socio-economic factors. In addition a differentiated measurement of cultural and migration-related factors is needed in future studies.

Im Rahmen des sechsten Kapitels werden die zentralen Ergebnisse der vorliegenden Studie vorgestellt und unter Ruckbezug auf die dargelegten theoretischen Grundlagen vor allem im Hinblick auf netzwerkrelevante Aspekte sowie Aspekte der sozialen Unterstutzung betrachtet. Hierzu werden zunachst die Soziodemographie der Befragten (Kapitel 6.1.) sowie anschliesend deren Aussiedlungskontext (Kapitel 6.2.) beschrieben. Daraufhin werden Selbsthilfemotivation und Hilfeuberzeugung beleuchtet (Kapitel 6.3.), um anschliesend die personlichen sozialen Netzwerke sowie die hierin enthaltenen Potentiale sozialer Unterstutzung entlang der verschiedenen Netzwerkbereiche darzustellen (Kapitel 6.4.).

Einleitung Alkohol wird bei Migranten insbesondere ab dem 50. Lebensjahr zu einem häufigen Problem. Diese Gruppe wird aber durch alkoholbezogene Präventionsmaßnahmen nur unzulänglich erreicht. Vor diesem Hintergrund wurde am Universitätsklinikum Freiburg ein auf ältere Migranten gerichtetes transkulturelles Präventionskonzept für alkoholbezogene Störungen in einer cluster-randomisierten Studie mit n = 268 Migranten evaluiert. Akzeptanz, Bewertung und selbstangegebene Reduktion im Alkoholkonsum in der Interventionsgruppe signifikant höher. Die Berücksichtigung der Diversität bezüglich kultureller, migrationsbezogener war, soziodemographischer und sprachlicher Faktoren erhöht die Effektivität von Präventionsmaßnahmen.

Background In migrants, alcohol becomes a frequent problem in particular from the age of 50 onwards. Preventive behaviour is influenced by cultural differences in terms of how alcohol consumption is evaluated and dealt with. But migrants are not sufficiently reached by offers of help in combating addiction. Aim of the study was to improve the sensitisation regarding alcohol consumption. Method Cluster-randomized controlled multicenter study with immigrants (n = 268) comparing a transcultural prevention measurement (one event and migration sensitive transcultural brochures; TPC) against an usual prevention measurement (event and information brochure; TAU). Main outcomes were attitudes towards alcohol and alcohol consumption after 6 months. Results Overall the immigrants accept the transcultural prevention concept better (TPC > TAU; p = .023). Attitudes towards alcohol are more difficult to change. Only regarding talking openly about alcohol problems (TPC > TAU; p = .021) and willingness to seek for help (TPC > TAU; p = .001) we found an effect of the TPC. 6 months after the participants in TPC reduced their alcohol consumption markedly (I drink less/I don't drink at all: TPC 45,9% vs. TAU 16,7%; p = .004). Conclusions The consideration of cultural, migration-related and linguistic factors in health care is important to change health related behaviour. Therefore the sensitization of health care providers for transcultural perspectives and diversity is necessary.