TY - CHAP A1 - Brause, Michaela A1 - Brzoska, Patrick A1 - Razum, Oliver A1 - Reutin, Barbara A1 - Schott, Thomas A1 - Spallek, Jacob A1 - Voigtländer, Sven A1 - Yilmaz-Aslan, Yüce ED - Schott, Thomas ED - Razum, Oliver T1 - Abschließende Handlungsempfehlungen und Schlussfolgerungen für die Praxis T2 - Migration und medizinische Rehabilitation KW - Handlungsempfehlungen KW - Schlussfolgerungen Y1 - 2013 SN - 978-3-7799-1987-2 SP - 211 EP - 216 PB - Beltz Juventa CY - Weinheim ; Basel ER - TY - CHAP A1 - Spallek, Jacob A1 - Yilmaz-Aslan, Yüce A1 - Spallek, Lena A1 - Gök, Yesim A1 - Razum, Oliver ED - Mehnert, Anja ED - Koch, Uwe T1 - Interkulturelle Aspekte und Migration T2 - Handbuch Psychoonkologie KW - interkulturell KW - Aspekte KW - Migration Y1 - 2016 SN - 978-3-8017-2474-0 SP - 444 EP - 453 PB - Hogrefe CY - Göttingen ER - TY - GEN A1 - Tallarek, Marie A1 - Spallek, Jacob T1 - Factors promoting or limiting self-determined childbirth: midwives’ perspectives in Germany T2 - European Journal of Public Health N2 - Background Claims for self-determined childbirth (SDC) have gained increasing scientific, political and societal attention. However, research on SDC is limited. This study analyzes and compares midwives’ experiences and perspectives on factors that promote or limit SDC in hospitals, birthing centers and during home births in Germany. We argue that these insights are essential in order to foster self-determination and to avoid its violation. Methods A qualitative case study was conducted based on semi-structured face-to-face interviews with midwives working in hospitals, birthing centers, and offering home births in Germany. In total, nine interviews were conducted in 2021 and have been audiotaped, transcribed, anonymized and analyzed by use of Thematic Analysis. Results The results indicate eight inter-related categories, each of which imply promoting and limiting factors: 1) Structural/ legal conditions; 2) Perception of birth (e. g. as natural or medical process; required competence and control); 3) Trust and atmosphere; 4) Getting acquainted/relationship building; 5) Birthing person’s socioeconomic position; 6) Birthing person’s preparation/ education; 7) Birthing person’s capability of decision making and expression; and 8) Behavior of accompanying persons. Moreover, we identified midwives’ strategies to extend possibilities of choice. Several factors clearly differ depending on the birth setting. Conclusions The opportunities for SDC seem to differ according to the setting (e.g. institutional routines), inter-personal relations (e.g. getting acquainted, trust), and individual factors (e.g. socioeconomic position, capabilities). Hence, political, institutional and individual strategies may support SDC in consideration of the above factors. Measures may, among others, include the improvement of information processes, the reduction of economic barriers, relationship building before and during birth as well as respective structural adjustments. KW - self-determined childbirth KW - interview study KW - obstetric care KW - hospitals KW - birthing centers KW - home birth Y1 - 2022 UR - https://academic.oup.com/eurpub/article/32/Supplement_3/ckac131.423/6765637?searchresult=1 U6 - https://doi.org/10.1093/eurpub/ckac131.423 SN - 1101-1262 SN - 1464-360X VL - 32 IS - Supplement_3 ER - TY - GEN A1 - Hoffmann, Stephanie A1 - Tschorn, Mira A1 - Michalski, Niels A1 - Hoebel, Jens A1 - Förstner, Bernd R. A1 - Rapp, Michael A. A1 - Spallek, Jacob T1 - Do regional characteristics predict developmental delay? Analyses of German school entry examination T2 - European Journal of Public Health N2 - Background Children's health and development are strongly linked to their living situation, including their family's socioeconomic position (SEP) and living region. However, research on the impact of the living region on children's development beyond family SEP is scarce. This study evaluated whether rurality and regional socioeconomic deprivation (DEP) are associated with children's development independently of family SEP. Methods The study used population-based data of 5-6.5 years old children (n = 22,801) from mandatory school entry examinations (SEE) in the German federal state of Brandenburg, which were examined in 2018/2019. The SEE data have been linked with data on i. rurality that was defined by an inverted population density and ii. regional DEP that were provided by the German Index of Socioeconomic Deprivation. By binary multilevel models, the predictive values of rurality and regional DEP for global developmental delay (GDD) were evaluated, while adjusting for family SEP. Results Children with high family SEP showed reduced odds for GDD compared to medium family SEP (female: OR = 4.26, CI95=3.14-5.79, male: OR = 3.46, CI95=2.83-4.22) and low family SEP (female: OR = 16.58, CI95=11.90-23.09, male: OR = 12.79, CI95=10.13-16.16). Regional DEP additionally predicted GDD, with higher odds for children from more deprived regions (female: OR = 1.35, CI95=1.13-1.62, male: OR = 1.20, CI95=1.05-1.39). Rurality did not predict GDD beyond family SEP and regional DEP. Conclusions In addition to family SEP, the regional DEP has an effect on children's developmental delay. Hence, Public Health should take into account regional socioeconomic conditions as determinant of health over the life course in addition to family SEP. KW - regional characteristics KW - developmental delay KW - school entry examination KW - Germany Y1 - 2022 UR - https://academic.oup.com/eurpub/article/32/Supplement_3/ckac129.342/6766047?searchresult=1 U6 - https://doi.org/10.1093/eurpub/ckac129.342 SN - 1101-1262 SN - 1464-360X VL - 32 IS - Supplement_3 ER - TY - GEN A1 - Scholaske, Laura A1 - Entringer, Sonja A1 - Razum, Oliver A1 - Spallek, Jacob T1 - Elevated stress during pregnancy in women of Turkish origin: Results from a prospective cohort study T2 - European Journal of Public Health N2 - Background Ethnic health disparities exist in the context of pregnancy and childbirth, suggesting that women of Turkish origin (i.e., they or their parents born in Turkey) in Germany have higher risks for some adverse maternal health and child developmental outcomes. Stress is believed to be a relevant pathway by which migration may be associated with these risks. In this study, we tested associations of Turkish origin with stress biology and psychological stress experiences during pregnancy. Methods 140 pregnant women (33 of Turkish/26 of other origin) participated in a prospective cohort study that was carried out in Bielefeld and Berlin (Spallek et al., 2020). Inflammatory markers CRP and IL-6 from venous blood samples and diurnal cortisol profiles from salivary cortisol samples were derived and participants completed the Perceived Stress Scale (PSS) and Center for Epidemiologic Studies Depression Scale (CESD) at two study visits during pregnancy (T1: 20-25 weeks of gestation, T2: 30-35 weeks of gestation). Multilevel models were conducted to account for the nested data structure due to repeated measurements. Results Compared to non-migrant women, women of Turkish origin had significantly higher inflammatory levels (b = 0.28, SE = 0.14, p=.052) (Spallek et al., 2021), a blunted cortisol awakening response (b=-0.21, CI=-0.38–0.03, p<.05), a flatter diurnal cortisol slope (b = 0.02, CI = 0.00-0.04, p<.05), and higher PSS (b = 0.46, SE = 0.13, p< .001) and CESD scores (b = 0.29, SE = 0.08, p<.001) during pregnancy after adjusting for socioeconomic factors. Conclusions The results of our study suggest higher stress at the biological and psychological level in pregnant women of Turkish origin. Stress is a risk factor for pregnancy complications and poor birth and child developmental outcomes. To reduce such unequally distributed risks, interventions for stress reduction are needed that are tailored to women of Turkish origin. KW - stress KW - pregnancy KW - Turkish origin KW - prospective cohort study Y1 - 2022 UR - https://academic.oup.com/eurpub/article/32/Supplement_3/ckac129.608/6765682?searchresult=1 U6 - https://doi.org/10.1093/eurpub/ckac129.608 SN - 1101-1262 SN - 1464-360X VL - 32 IS - Supplement_3 ER - TY - GEN A1 - Rattay, Petra A1 - Blume, Miriam A1 - Spallek, Jacob A1 - Hoffmann, Stephanie A1 - Sander, Lydia A1 - Herr, Raphael A1 - Herke, Max A1 - Reuter, Marvin A1 - Novelli, Anna A1 - Hövener, Claudia T1 - Socioeconomic position and self-rated health among adolescents: the mediating role of the family T2 - European Journal of Public Health N2 - Background Although health inequalities in adolescence are well documented, the underlying mechanisms remain unclear. Few studies have examined the role of the family in explaining adolescents’ health inequalities. The study aimed to explore whether the association between socioeconomic position and self-rated health (SRH) was mediated by familial determinants. Methods Using data from wave 2 of the KiGGS study (1,838 female and 1,718 male 11- to 17-year-olds), linear regression analyses were conducted to decompose the total effects of parents’ education, occupation, income, socioeconomic position index, and adolescents’ subjective social status on SRH into direct effects and indirect effects through familial determinants (family cohesion, parenting styles, parental well-being, stress, obesity, smoking and sporting activity). Results A significant total effect of all socioeconomic position indicators on SRH was found, except for income in male adolescents. In female adolescents, more than 70% of the total effects of each socioeconomic position indicator were explained by familial mediators, whereas no significant direct effects remained. The most important mediator was parental well-being, followed by family cohesion, parental smoking and sporting activity. In male adolescents, the associations of parental education, the socioeconomic position index and subjective social status with SRH were also mediated by familial determinants (family cohesion, parental smoking and obesity). However, a significant direct effect of subjective social status remained. Conclusions The family appears to play an important role in explaining health inequalities, particularly in female adolescents. Reducing health inequalities in adolescence requires policy interventions, community-based strategies, as well as programs to improve parenting and family functioning. KW - Socioeconomic position KW - self-rated health KW - adolescents KW - family Y1 - 2022 UR - https://academic.oup.com/eurpub/article/32/Supplement_3/ckac129.580/6765541?searchresult=1 U6 - https://doi.org/10.1093/eurpub/ckac129.580 SN - 1101-1262 SN - 1464-360X VL - 32 IS - Supplement_3 ER - TY - GEN A1 - Ulrich, Hanna-Sophie A1 - Kohler, Emma A1 - Spallek, Jacob A1 - Richter, Matthias A1 - Clauß, Daniel A1 - Mlinarić, Martin T1 - Explaining psychosocial care among unaccompanied minor refugees: a realist review T2 - European child & adolescent psychiatry N2 - Research on the psychosocial care (PSC) of unaccompanied minor refugees (UMRs) has mainly taken a socioepidemiological approach and has focused on the perspectives of experts in the field. In contrast, the knowledge concerning the differing context factors and the underlying mechanisms of current PSC which could inform policy recommendations is scant. The study aims at unravelling the contexts, mechanisms and outcomes of PSC for UMRs. For a realist review (RR), scientific evidence and gray literature were synthesised consistent with the RAMESES publication standards for realist synthesis. Based on an iterative keyword search in electronic databases (e.g., PubMed) and screening, 34 works from 2005 to 2019 were included in a realist synthesis. Theory-informed context-mechanism-outcome configurations (CMOs) were extracted, to explain underlying processes and mechanisms. Characterised by their interrelatedness, the dominant CMOs included the UMRs' intersections of transitions (e.g., adolescence and migration), their needs for culture-, and gender-sensitive PSC, and the undersupply of PSC. These contexts and outcomes are mediated by pre-, peri- and post-migratory stressors as well as care structures and are moreover influenced by overarching discourses and concepts. They comprise adverse and beneficial mechanisms in the PSC of UMRs. The existing literature grasps the PSC of UMRs by different disciplines and approaches but does not offer a comprehensive overview on micro-macro intersections and included discourses. The inclusion of lay perspectives and an intersectional approach could inform health service research. The reflection of UMR-related categorical constructs of resilience and vulnerability, discourses of othering, as well as restrictive health policies may guide policy recommendations. KW - Migration KW - Psychosocial care KW - Realist review KW - Unaccompanied minor refugees KW - mental health Y1 - 2021 U6 - https://doi.org/10.1007/s00787-021-01762-1 SN - 1435-165X VL - 31(2022) IS - 12 SP - 1857 EP - 1870 ER - TY - GEN A1 - Schmidt, Juliana J. A1 - Schmidt, Guilherme J. A1 - Tolentino, Julio C. A1 - Simoes, Eunice N. A1 - Obongo, Angela A1 - Tolentino, Yolanda A1 - Coelho, Francisco A. A1 - Landesmann, Maria C. P. P. A1 - Fonseca, Lea M. B. A1 - Lacerda, Glenda C. B. A1 - Schmidt, Sergio L. T1 - A serial SPECT-CT study in a celiac disease patient with cerebellar ataxia and psychiatric symptoms T2 - Neurological sciences N2 - Celiac disease (CD) is an immune-mediated systemic disorder triggered by gluten and related prolamins in genetically predisposed individuals. Here, we described a case of a 31-year-old Caucasian woman who exhibited cerebellar and psychiatric dysfunctions. The patient underwent single-photon emission computed tomography (SPECT-CT) before and after a gluten-free diet (GFD). There was an improvement in cerebellar perfusion accompanied by a remission of cerebellar manifestations. The maintenance of the psychiatric manifestations was related to the persistence of the hypoperfusion in the frontal lobes. The patient's psychiatric symptoms did not change after 4 months under a GFD in the hospital. To our knowledge, this is the first case that shows the relationship between improvement in cerebellar perfusion and remission of cerebellar clinical manifestations in a CD patient under a GFD. KW - Celiac disease KW - Cerebellar perfusion KW - Cerebellum KW - SPECT-CT Y1 - 2021 UR - https://pubmed.ncbi.nlm.nih.gov/33230758/ U6 - https://doi.org/10.1007/s10072-020-04908-2 SN - 1590-3478 VL - 42 SP - 1545 EP - 1548 ER - TY - GEN A1 - Tallarek, Marie A1 - Bozorgmehr, Kayvan A1 - Spallek, Jacob T1 - Towards inclusionary and diversity-sensitive public health: the consequences of exclusionary othering in public health using the example of COVID-19 management in German reception centres and asylum camps T2 - BMJ Global Health N2 - The German government’s response to the COVID-19 pandemic has been predominantly considered wellfounded. Still, the practice of mass quarantine in reception centres and asylum camps has been criticised for its discrimination of refugees and asylum seekers. Building on the concept of othering, this article argues that processes of othering are structurally anchored in German asylum regulations and they have further pervaded public health measures against COVID-19. The practice of mass quarantine made the negative consequences of exclusionary othering for public health particularly noticeable. In the light of recent data indicating this measure to be epidemiologically, legally and ethically insufficient, we apply the concept of othering to public health and discuss (1) exclusionary, (2) inclusionary and (3) diversity-sensitive approaches to public health. We finally conclude that a shift of perspective from exclusion to inclusion, from subordination to empowerment and from silencing to participation is urgently required. KW - inclusionary public health KW - exclusionary public health KW - diversity-sensitive public health KW - othering KW - COVID-19 KW - refugees KW - asylum seekers KW - mass quarantine Y1 - 2020 UR - https://gh.bmj.com/content/bmjgh/5/12/e003789.full.pdf U6 - https://doi.org/10.1136/bmjgh-2020-003789 SN - 2059-7908 VL - 5 IS - 12 ER - TY - GEN A1 - Mayer, Alena A1 - Herr, Raphael M. A1 - Klein, Thomas A1 - Wiedemann, Eva A1 - Diehl, Katharina A1 - Hoffmann, Stephanie A1 - Blume, Miriam A1 - Jepsen, Dennis A1 - Sundmacher, Leonie A1 - Andreas, Marike A1 - Schneider, Sven T1 - Socio-economic inequalities in body mass index among preschool children: do sports programs in early childhood education and care centers make a difference? T2 - Frontiers in Public Health N2 - Background: Overweight in childhood is considered to be one of the most serious public health challenges. Many studies have investigated individual-level determinants of children's body mass index (BMI), yet studies exploring determinants at the meso-level are sparse. The aim of our study was to examine how a sports focus at early childhood education and care (ECEC) centers moderates the effect of parental socio-economic position (SEP) on children's BMI. Methods: We used data from the German National Educational Panel Study and included 1,891 children (955 boys and 936 girls) from 224 ECEC centers in our analysis. Linear multilevel regressions were used to estimate the main effects of family SEP and the ECEC center sports focus, as well as their interaction, on children's BMI. All analyses were stratified by sex and adjusted for age, migration background, number of siblings, and employment status of parents. Results: Our analysis confirmed the wellknown health inequalities in childhood overweight with a social gradient toward a higher BMI for children from lower SEP families. An interactive effect between family SEP and ECEC center sports focus was found. Boys with low family SEP not attending a sports-focused ECEC center had the highest BMI among all boys. In contrast, boys with low family SEP attending a sports-focused ECEC center had the lowest BMI. For girls, no association regarding ECEC center focus or interactive effects emerged. Girls with a high SEP had the lowest BMI, independent of the ECEC center focus. Conclusion: We provided evidence for the gender-specific relevance of sports-focused ECEC centers for the prevention of overweight. Especially boys from low SEP families benefited from a sports focus, whereas for girls the family's SEP was more relevant. As a consequence, gender differences in determinants for BMI at different levels and their interaction should be considered in further research and preventive measures. Our research indicates that ECEC centers may decrease health inequalities by providing opportunities for physical activity. KW - BMI KW - children KW - meso-level KW - sport KW - early childhood education and care center KW - pre-school KW - health equalities Y1 - 2023 U6 - https://doi.org/10.3389/fpubh.2023.1079871 SN - 2296-2565 VL - Vol. 11 ER - TY - CHAP A1 - Schulz, Karl-Heinz A1 - Eckert, Sandra van ED - Mehnert, Anja ED - Koch, Uwe T1 - Körperliche Aktivität und Tumorerkrankungen T2 - Handbuch Psychoonkologie Y1 - 2016 SN - 978-3-8017-2474-0 SP - 554 EP - 566 PB - Hogrefe Verlag CY - Göttingen ET - 1. Auflage ER - TY - GEN A1 - Entringer, Sonja A1 - Scholaske, Laura A1 - Kurt, Medlin A1 - Duman, Elif Aysimi A1 - Adam, Emma K. A1 - Razum, Oliver A1 - Spallek, Jacob T1 - Diurnal cortisol variation during pregnancy in Turkish origin and non-migrant women in a German birth cohort study T2 - Journal of Psychosomatic Research N2 - Background Immigrants from Turkey experience health disadvantages relative to non-immigrant populations in Germany that are manifest from the earliest stages of the lifespan onwards and are perpetuated across generations. Chronic stress and perturbations of stress-responsive physiological systems, including the hypothalamus-pituitary-adrenal (HPA)-axis, are believed to in part mediate this relationship. Cortisol plays an important role in the association between maternal stress during pregnancy and many pregnancy-, birth- and offspring-related outcomes. We therefore examined whether maternal migrant background is associated with diurnal cortisol variation during pregnancy. Methods 109 pregnant women (incl. n = 32 Turkish origin women) that participated in a multi-site prospective cohort study in Germany collected saliva samples across the day on two consecutive days around 24 and 32 weeks gestation. Hierarchical linear models were applied to quantify associations between migrant background and diurnal cortisol variation across pregnancy. Results Women of Turkish origin exhibited a significantly lower cortisol awakening response (CAR) and a flatter diurnal cortisol slope (DCS) compared to non-migrant women after adjusting for household income. These relationships between migrant status and diurnal cortisol variation were mainly driven by 2nd generation migrants. Discussion A potential HPA axis dysregulation of Turkish-origin pregnant women may contribute to the intergenerational transmission of health disadvantages in this group. KW - cortisol variation KW - pregnancy KW - Turkish origin KW - birth cohort study KW - Germany Y1 - 2022 UR - https://www.sciencedirect.com/science/article/abs/pii/S0022399922003051 U6 - https://doi.org/10.1016/j.jpsychores.2022.111020 SN - 0022-3999 VL - 162 SP - 1 EP - 10 ER - TY - GEN A1 - Lampert, Thomas A1 - Richter, Matthias A1 - Schreiber, Sven A1 - Spallek, Jacob A1 - Dragano, Nico T1 - Soziale Ungleichheit und Gesundheit. Stand und Perspektiven der sozialepidemiologischen Forschung in Deutschland T2 - Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Y1 - 2016 U6 - https://doi.org/10.1007/s00103-015-2275-6 SN - 1436-9990 SN - 1437-1588 VL - 59 IS - 2 SP - 153 EP - 165 ER - TY - GEN A1 - Razum, Oliver A1 - Karrasch, Laura A1 - Spallek, Jacob T1 - Migration : Eine vernachlässigte Dimension gesundheitlicher Ungleichheit? T2 - Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Y1 - 2016 U6 - https://doi.org/10.1007/s00103-015-2286-3 SN - 1436-9990 SN - 1437-1588 VL - 59 IS - 2 SP - 259 EP - 265 ER - TY - GEN A1 - Brzoska, Patrick A1 - Voigtländer, Sven A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Die Nutzung von Routinedaten in der rehabilitationswissenschaftlichen Versorgungsforschung bei Menschen mit Migrationshintergrund: Möglichkeiten und Grenzen T2 - Gesundheitswesen Y1 - 2012 U6 - https://doi.org/10.1055/s-0031-1280759 SN - 1439-442 SN - 0941-3790 VL - 74 IS - 6 SP - 371 EP - 378 ER - TY - GEN A1 - Reeske, Anna A1 - Spallek, Jacob T1 - Sozioökonomische Aspekte der Primärprävention von Adipositas bei Kindern und Jugendlichen - Ansatzpunkte vor dem Hintergrund eines lebenslaufbasierten Ansatzes der Adipositasentstehung T2 - Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz Y1 - 2011 U6 - https://doi.org/10.1007/s00103-010-1221-x SN - 1436-9990 SN - 1437-1588 VL - 54 IS - 3 SP - 272 EP - 280 ER - TY - GEN A1 - Zeeb, Hajo A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Epidemiologische Perspektiven der Migrationsforschung am Beispiel von Krebserkrankungen T2 - Psychotherapie, Psychosomatik, Medizinische Psychologie Y1 - 2008 U6 - https://doi.org/10.1055/s-2008-1067347 SN - 1439-1058 SN - 0937-2032 VL - 58 IS - 3 SP - 130 EP - 135 ER - TY - GEN A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Gesundheit von Migranten: Defizite im Bereich der Prävention T2 - Medzinische Klinik Y1 - 2007 U6 - https://doi.org/10.1007/s00063-007-1058-8 SN - 2193-6218 SN - 2193-6226 VL - 102 IS - 6 SP - 451 EP - 456 ER - TY - GEN A1 - Reiss, Katharina A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Die Entwicklung des Rauchverhaltens im Kontext der Migration nach Deutschland T2 - Public Health Forum Y1 - 2015 U6 - https://doi.org/10.1515/pubhef-2015-0031 SN - 1876-4851 SN - 0944-5587 VL - 23 IS - 2 SP - 85 EP - 87 ER - TY - GEN A1 - Spallek, Jacob A1 - Razum, Oliver T1 - Migration und Geschlecht T2 - Public Heatlth Forum Y1 - 2015 U6 - https://doi.org/10.1515/pubhef-2015-0027 SN - 1876-4851 SN - 0944-5587 VL - 23 IS - 2 SP - 73 EP - 75 ER -