Migration Background In Germany Research Articles

Barriers in general practitioners\u2019 dementia diagnostics among people with a migration background in Germany (BaDeMi) - study protocol for a cross-sectional survey

BackgroundConsidering 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.MethodsA 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.DiscussionThis 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 registrationGerman 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.

Variations in cardiovascular risk factors in people with and without migration background in Germany – Results from the STAAB cohort study

BackgroundAbout 20% of the German population have a migration background which might influence prevalence of preventable cardiovascular risk factors (CVRF). MethodsWe 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. ResultsOf 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). ConclusionIndividuals 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.

Prävalenz von Demenz bei Menschen mit Migrationshintergrund in Deutschland

In Germany the number of people with a migration background was 16.5million people in 2013 with 9% being older than 65years. In this population utilization of health services is low, especially in older people, although they often display worse health outcomes. Little is known about the number of people with dementia and migration background in Germany and their distribution on the state level, resulting in achallenge that is barely assessable for the healthcare system. The depiction of the prevalence of dementia in people with amigration background for Germany and the individual federal states. The number of people with amigration background and dementia living in Germany and the individual federal states was estimated for different ethnic groups using country and state-specific data on the population, dementia frequency and age-specific prevalence. Out of 1.86million people with amigration background who are 65years or older, approximately 96,500 persons (5.2%) have dementia. The majority are of European (84,490), more specifically Polish (13,960), Italian (8920) and Turkish (8840) heritage. North Rhine-Westphalia (26,000), Baden-Wuerttemberg (18,080) and Bavaria (16,710) are presumed to show the highest rates of people affected. In Germany people with a migration background and dementia represent alarge target group for health care; however, the numbers and ethnic populations affected differ considerably between states. These analyses can be used for state-specific healthcare planning of culture-specific and culture-sensitive services and care so that specific healthcare improvements can be achieved.

Depressive and somatoform disorders in persons with aTurkish migration background in Germany

Migration is arisk factor for the onset of mental disorders. Epidemiologic studies indicate that there is an increased prevalence of depressive and somatoform disorders in individuals with aTurkish migration background in Germany. The aim of this review article is to determine the impact of sociocultural factors on depressive and somatoform disorders in individuals with aTurkish migration background in Germany. The systematic review is based on 23studies identified in PubMed and PsycINFO. Acculturation, perceived discrimination and the socioeconomic status affect the severity of mental disorders, and impair the access to the health care system as well as to psychotherapy. Women with aTurkish migration background represent aparticularly vulnerable group in this context. Multiple factors influence the increased prevalence of depressive and somatoform disorders in individuals with aTurkish migration background in Germany. Most of the identified studies suffer from significant methodological restrictions and as such do not allow generalization to the whole population of individuals with aTurkish migration background in Germany. There is alack of national surveys and aneed for longitudinal studies in representative population samples.

Oral health-related quality of life of children and adolescents with and without migration background in Germany.

To compare oral health-related quality of life (OHRQoL) in children and adolescents with and without migration background, and to assess whether potential differences in OHRQoL can be sufficiently explained by oral health characteristics. A consecutive sample of 112 children and adolescents was recruited in a German university-based orthodontic clinic, and a convenience sample of 313 children and adolescents of German public schools was enrolled in the study (total N = 425, age range 7-17years). However, 29 participants were excluded due to insufficient information regarding migration background. Accordingly, the non-migrant group consisted of 262 participants (61.6%). For children with migration background, two groups were classified: (i) one parent born in a foreign country (N = 41, 9.6%, single-sided migration background), and (ii) both parents and/or child born in a foreign country ( N= 93, 21.9%, double-sided migration background). OHRQoL was assessed using the German 19-item version of the Child Oral Health Impact Profile (COHIP-G19). Additionally, physical oral health of 269 children with classified migration background was determined in a dental examination. Overall, OHRQoL was significantly lower in the group with double-sided migration background indicated by lower COHIP-G19 summary scores (mean: 58.6 points) than in the group with single-sided migration background (mean: 63.3 points) or the non-migrant group (mean: 63.2 points). Likewise, the summary scores of the subscale "oral health well-being" and the subscale "social/emotional, school, and self-image" were also lower in the double-sided migrant group than in the other two groups. Linear regression analysis showed an association between double-sided migration background and impaired OHRQoL, even after statistically controlling for demographic, socioeconomic, and oral health characteristics. Children and adolescents with double-sided migration background have poorer OHRQoL than comparably aged migrants with single-sided migration background or non-migrations. Between-group differences in OHRQoL could not be sufficiently explained by effects of socioeconomic status or physical oral health characteristics. Thus, other methodological, cultural, or immigration-related factors might also play an important role for the observed effects.

The relationship between migration background and knowledge and understanding of personal finance of young adults in Germany

Financial knowledge and understanding is needed to function well in society; however, young people with a migration background in Germany have been found to perform worse on tests of financial knowledge than those without. Very little investigation has been made into the relationship between financial knowledge and language ability, and ostensibly no in-depth investigation has been made into the connection between frequency of use of the local language and how it correlates to performance on such tests. In this paper we examine the relationship between migration background and knowledge and understanding of personal finance of young adults in Germany. We administered a validated German version of the Council for Economic Education’s Test of Financial Literacy to 1037 individuals between the ages of 17 and 25 and controlled not only for migration background but also for frequency of German language use. In line with results of previous studies, we found participants with a migration background generally had less financial knowledge than those with no migration background. More specifically, migrants who spoke predominantly a language other than German at home demonstrated less financial knowledge than those who spoke German at home with their families. Thus, it is not migration background per se, but rather more obscure variables related to migration background that may influence performance on such tests of financial knowledge.

6.4-O6Astonishing new insight into the relationship between health literacy and health practices of adolescents with Turkish migration background in Germany

6.4-O6Astonishing new insight into the relationship between health literacy and health practices of adolescents with Turkish migration background in Germany

6.10-P11Barriers in general practitioners’ dementia diagnostics among patients with a migration background in Germany (BaDeMi)

6.10-P11Barriers in general practitioners’ dementia diagnostics among patients with a migration background in Germany (BaDeMi)

1.11-P27Food consumption and nutrient intake of children and adolescents with a Chinese migrant background in Germany

1.11-P27Food consumption and nutrient intake of children and adolescents with a Chinese migrant background in Germany

Migration Background Influences Consumption Patterns Based on Dietary Recommendations of Food Bank Users in Germany.

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.

Caesarean birth frequency among women with and without migration background in Germany

Caesarean birth frequency among women with and without migration background in Germany

Acculturation and health-related quality of life: results from the German National Cohort migrant feasibility study

We assessed the association between acculturation and health-related quality of life (HRQoL) among persons with a Turkish migrant background in Germany. 1226 adults of Turkish origin were recruited in four German cities. Acculturation was assessed using the Frankfurt Acculturation Scale resulting in four groups (integration, assimilation, separation and marginalization). Short Form-8 physical and mental components were used to assess the HRQoL. Associations were analysed with linear regression models. Of the respondents, 20% were classified as integrated, 29% assimilated, 29% separated and 19% as marginalized. Separation was associated with poorer physical and mental health (linear regression coefficient (RC) = -2.3, 95% CI -3.9 to -0.8 and RC = -2.4, 95% CI -4.4 to -0.5, respectively; reference: integration). Marginalization was associated with poorer mental health in descendants of migrants (RC = -6.4, 95% CI -12.0 to -0.8; reference: integration). Separation and marginalization are associated with a poorer HRQoL. Policies should support the integration of migrants, and health promotion interventions should target separated and marginalized migrants to improve their HRQoL.

Transitions of young migrants to initial vocational education and training in Germany: the significance of social origin and gender

The topic of the present paper is how successful young people from a migration background in Germany are in making the transition to initial vocational education and training (VET). Particular emphasis is placed on interactions with social origin and gender. The analyses are based on the 2011 BIBB Transitional Study, a representative survey of over 5000 young people living in Germany from the birth cohorts between 1987 and 1993. It is revealed that a migration background exerts a negative effect on the chances of progressing to company-based or fully qualifying training. For a successful transition to VET the school-leaving qualification achieved is very important and migrants often achieve only lower school-leaving qualifications. Interaction effects occur between migration background, social origin and gender. The transition chances of young migrants are, however, also worse when a multitude of relevant factors are controlled for. The results indicate that migrants in German society still have to contend with reservations.

QFT-Plus: a plus in variability? \u2013 Evaluation of new generation IGRA in serial testing of students with a migration background in Germany

BackgroundCurrently available Interferon-gamma release assays (IGRAs) show a considerable variability in serial testing for latent tuberculosis infection (LTBI).This study offers first results for the new generation IGRA QuantiFERON-TB Gold Plus (QFT-Plus) introduced in 2015 in comparison with its predecessor QuantiFERON-TB Gold In-Tube (QFT-GIT) from serial testing of students with a migration background at German universities.MethodsForty-one students were selected from a previous study. All students with a positive IGRA were asked and 11 agreed to participate in this cohort study. Additionally 30 students with negative IGRA results were selected by chance. Weekly testing with QFT-Plus and QFT-GIT was performed in all individuals over a 4-week period. IGRA variability was evaluated by calculating conversion and reversion rates.ResultsFrom 41 participants a total number of 163 serial measurements were analyzed for each IGRA, leading to 122 possible IGRA changes each. QFT-Plus had four conversions and two reversions leading to a conversion rate of 4.3% (4 of 93 possible conversions, 95% CI 1.4–11.3%) and reversion rate of 6.9% (2 of 29 possible reversions, 95% CI 1.2–24.2%). QFT-GIT had 2 conversions and 1 reversion causing slightly lower rates with 2.2% conversions (2 of 91, 95% CI 0.4–8.5%) and 3.2% reversions (1 of 31, 95% CI 0.2–18.5%). Inconsistent IGRA results occurred in 4 subjects for QFT-Plus (8 stable positives, 29 stable negatives) and in 2 subjects for QFT-GIT (9 stable positives, 30 stable negatives). Agreement between the two IGRAs was 95.1% (κ = 0.89). Variance attributed to the individuals was low (QFT-Plus: ICC = 0.88).ConclusionThis study confirms occurrence of conversions and reversions for the new QFT-Plus in serial testing of a high-risk cohort in a low-incidence setting with improbable new TB contact during the study. QFT-Plus conversion and reversion rates were slightly higher than for the QFT-GIT but overall they were lower for both IGRAs than in other studies that investigated IGRA variability.

From Free Speech to IS – Pathological Regression of Some Traumatized Adolescents from a Migrant Background in Germany

AbstractIslamic fundamentalism is a contemporary dangerous form of extreme restriction of “free speech”. In Germany, 700 Islamists from Germany are fighting in Syria and Iraq, including a number of women. Most of the German Islamists' personal histories highlight the importance of their radicalization in the course of their adolescent search for identity. Many youth who turn to Islam are socially isolated, and do not succeed in forming relationships to friends and love‐objects. Many experience a severe adolescent crisis. They are won over by the Islamic State's powerful message of a return to the “Golden Age” of Islam. Why is this Islamic ideology so fascinating for them? What imaginary worlds and emotions are activated by it? Why is the rigid restriction of “free speech” so attractive for some of them? These are questions psychoanalysis can address. Here I explore some unconscious sources of Fundamentalism and the process of radicalization in adolescence. We analysts must explain what we understand of their radicalization so that teachers, social pedagogues and social workers can better recognize and reflect upon the problems some adolescents in their charge may encounter in the process of restructuring their age‐appropriate identity. Supervision by well‐trained child development mental health professionals can help pedagogues to better understand unconscious determinants of what derails their students' adolescent development.

Perceived Discrimination in Patients With Psychiatric Disorder and Turkish Migration Background in Germany.

Perceived discrimination (PD) has a negative impact on the course of psychiatric disorders. We have investigated PD in inpatients with affective or anxiety disorder and Turkish migration background (TP) or native Germans (GP). Migration-related, clinical, and sociodemographic data of n = 62 TP and n = 62 GP, matched for age, sex, and psychiatric diagnoses, were retrospectively analyzed. PD was assessed as one of 10 questions related to migration and acculturation (yes/no, severity 0-10). PD prevalence rates were compared between TP and GP; relationships of PD with other variables were analyzed using bivariate correlations and multiple regression analyses. A PD prevalence of 26% in TP and 1% in GP was found (odds ratio, 21.2 [2.7-165.8]). Migration background was the strongest predictor of PD in the total group. Within the TP sample, asylum-seeking status and migration-related distress were significantly predictive of PD. In patients with psychiatric disorder in Germany, PD seems to be strongly related to migration-related distress.

Breast cancer presentation and therapy in migrant versus native German patients: contrasting and convergent data of a retrospective monocentric study

The aim of this study was to identify differences between breast cancer patients with and without migrant background in Germany, especially differences concerning patient characteristics, tumor biology, diagnostics, therapy, and oncological outcome. In 99 breast cancer patients (composed of 50 native, randomly selected Germans and 49 consecutively selected immigrants of Anatolian origin) who were operated due to breast cancer at the Heidelberg University Hospital between the years 2009-2012, relevant information was retrospectively reviewed. Patients with migrant background were significantly younger at the time of receiving the diagnosis of breast cancer than native German patients with an average age difference of nine years (p<0.001). Moreover, immigrants needed a second operation for re-excision more frequently than native Germans (45 vs. 20%, p=0.01). The medication used for hormone therapy was significantly different between the two cohorts (p=0.049). Although statistically not significant, a tendency towards difference was observed in six characteristics examined: Premenopausal status, estrogen receptor-positive tumors, multifocal or bilateral tumors, BRCA-1 mutations, and an accompanying carcinoma in situ were more common in patients with migrant background. On the other hand, correspondence was found between both patient groups relating to tumor staging, grading and metastasis as well as surgical, drug, and radiologic therapies employed. Oncologic outcome data were not different either. A difference in age between breast cancer patients of diverse ethnic groups has already been described previously. The difference in the frequency of surgical re-excision might be explained by several factors like a young age at first diagnosis, premenopausal status, multifocal tumors and an accompanying carcinoma in situ which were more common in the migrant patients of this study and are known to increase the risk of re-excision. The medication used for hormonal therapy was also different between migrants and native Germans, which might be interpreted by the difference in patients' age and menopausal status. Of note, however, in the present study, the overall breast cancer outcome did not show any substantial disparity between the different ethnic patient groups investigated.

Postal Survey Among Women With Turkish Migration Background in Germany - Identification, Sample Revision and Response in the InEMa Study

Migrants are an important target group for mailed surveys but also difficult to reach. For planning these surveys and invitational health measures, we assessed response figures for women with and without Turkish migration background. Women aged 50 years living in Westphalia-Lippe were invited to a postal survey at 2 time points about mammography screening. Turkish migrant women were identified in the contact database by a name-based algorithm. Possible differences in sample revision and response among women with and without Turkish migration background were assessed. Women with Turkish migration background had unknown addresses significantly more often (4.6 vs. 1.7%) and responded to the questionnaires less often (first questionnaire: 14.3 vs. 35.9%; second questionnaire: 70.7 vs. 85.6%). For postal invitation to participate in healthcare measures, or recruitment of Turkish migrants for studies, differences in current address and readiness to respond must be taken into consideration.

Assessment of country-of-origin-related and -neutral elements of mobile communication service offers: An empirical study of consumers with a Turkish migration background in Germany

Article history: Received January 28, 2015 Received in revised format 6 February 2015 Accepted 7 February 2015 Available online February 1

Illness Perception and Clinical Treatment Experiences in Patients with M. Maroteaux-Lamy (Mucopolysaccharidosis Type VI) and a Turkish Migration Background in Germany

IntroductionMucopolysaccharidosis VI (MPS VI) is an inherited lysosomal storage disease caused by a mutation of the gene for arylsulfatase B (ASB). Of the thirty-one patients registered in Germany, almost fifty percent have a Turkish migration background. MPS VI is treated by enzyme replacement therapy (ERT), which is time-consuming and expensive.MethodsThis interdisciplinary study explored the illness perceptions and clinical treatment experiences among ten MPS VI patients with a Turkish migration background in two centers for metabolic diseases (Berlin and Mainz, Germany). The clinical treatment situation was observed and semi-structured interviews were conducted with patients and health care personnel, in addition to participatory observation in four patients' everyday environments in Berlin. The data from the interviews, patient records, and personal field notes were encoded, cross-related, and analyzed.ResultsPatients' acknowledgement of the disease and coping strategies are influenced predominantly by the perception of their individual health status and the handling of the disease within their family. Patients' willingness to cooperate with treatment strategies is further modified by their knowledge of the disease and the relationships with their health care providers. In this analysis, cultural factors turned out to be marginally relevant.ConclusionAs with other chronic and debilitating diseases, effective treatment strategies have to reach beyond delivering medication. Health care providers need to strengthen the support for patients with a migration background. In this regard, they should respect the patients' cultural and social background and their personal perception of the disease and the therapy. Yet structural and social aspects (clinical setting, family and educational background) may be more crucial here than “cultural barriers.”