[Health care of refugees in 2015 - Evaluation of an ambulance for refugees in a Cologne emergency accommodation (Cologne Model)]. / Gesundheitliche Versorgung von Geflüchteten in 2015 ­ Evaluation einer Ambulanz für Geflüchtete in einer Kölner Notunterkunft (Kölner Modell).

Access to medical care is a core element in the care of refugees and asylum seekers, and should therefore be guaranteed in a barrier-free way. In practice, there are usually numerous access barriers and the first contact with the German Health Care System takes place in form of a statutory examination to exclude infectious diseases. In addition to the introduction of health insurance cards for refugees, an offer of medical consultation for several hours a week in the municipal emergency accommodations provides an opportunity for low threshold access to primary care and a bridging function to the integration into the regular health care system. This offer is independent of the obligatory initial examination according to § 62 Asylum Law (AsylG) 1. The evaluation of the first year of such a health care center is presented.

[Medical Care for Refugees by the Public Health Services: Always Ready--But for How Much Longer?]. / Medizinische Versorgung von Flüchtlingen durch den Öffentlichen Gesundheitsdienst: Allzeit bereit--nur wie lange noch?

Refugees continue seeking sanctuary in Germany and it can reasonably be expected that their health will be affected by the conditions they lived in before and during flight. Ensuring nationwide care for refugees should be demand oriented, effective and efficient, which requires tackling mostly similar challenges a community level in a consistent manner. The aim must be providing adequate medical care based on the principle of respect for human dignity and ensuring public health standards. Within the currently situation, this basic expectations are often not sufficiently met. Generally accepted national standards, longer-term strategies and sustainable care are not yet achieved noticeably by public health services in Germany.To warrant permanent and sustainable high-quality medical care for refugees, local networks of involved institutions should be established with a longer-term perspective. Moreover, the financially eroded and personnel thinned public health service will only be able to fulfil statutory requirements and expectations of the local, state and federal policy makers for a limited amount of time only. Safeguarding that services are coping with the size of challenges over longer periods of time and anchoring the acquired expertise of medical care for refugees within the public health services, requires immediately better financial and personnel resources. Then the public health services will be a reliable partner supporting all people in Germany, particularly those that require subsidiary and socially-compensatory supply.

[Cologne Statement for Medical Care of Refugees]. / Kölner Statement zur medizinischen Versorgung von Flüchtlingen.

The Cologne statement resulted from both regional and nationwide controversial discussions about meaning and purpose of an initial examination for infectious diseases of refugees with respect to limited time, personnel and financial resources. Refugees per se are no increased infection risk factors for the general population as well as aiders, when the aiders comply with general hygiene rules and are vaccinated according to the recommendations of the German Standing Committee on Vaccination (STIKO). This is supported by our own data. Based on individual medical history, refugees need medical care, which is offered purposeful, economic, humanitarian and ethical. In addition to medical confidentiality, the reporting obligation according § 34 Infection Protection Act (IPA) and the examination concerning infectious pulmonary tuberculosis according to § 36 (4) IPA must be considered.

[The use and benefit of the 'children with special health care needs screener' in the paediatric school entrance examinations 2004/2005 in Cologne]. / Einsatz und Nutzen des "Children with Special Health Care Needs-Screener" im Rahmen der Schuleingangsuntersuchung 2004/2005 in Köln.

The aim of this study was to provide an assessment of the usefulness of the questionnaire "Children with Special Health Care Needs Screener" (CSHCN Screener) as a screening instrument to identify children with special needs in the context of paediatric school entrance examinations (SEE).In a retrospective cross-sectional study of the years 2004 and 2005 in Cologne, Germany, the sum variables were derived from the results of the SEE in accordance to the 7 questions of the CSHCN Screener. The correlations of the SEE sum variables and the CSHCN Screener results were analysed and tested for correlations with sociodemographic factors.Of the 18 402 children of the cohorts 2004/2005, corresponding SEE findings and results of the CSHCN Screener were available for 13 076 children. The prevalence of children with special needs was only 6% according to the results of the CSHCN Screener. According to the SEE, however, 26% of the children showed diseases or developmental problems. Out of this group, only one in 8 children was identified by the CSHCN Screener (sensitivity 13%). The sensitivity of the screener was also 13% for children who had been diagnosed to be in need of special support by school physicians. In the case of girls and of children with migration family backgrounds, the sensitivity of the screener was even lower. The CSHCN Screener also could not detect the higher rate of special needs determined by school physicians in children from areas with high quotas of state family support payments.The results of the CSHCN Screener are not convincing, due to his low sensitivity. This is true with regard to its use as a diagnostic tool for the individual child at the beginning of school age as well for its use as an instrument to assess an increased need for support in cohorts of school entry students.

[Observing migration and deficiencies in health care - STD center at the Cologne Municipal Health Department]. / Seismograf für Migration und Versorgungsdefizite - STD-Sprechstunde im Gesundheitsamt Köln.

BACKGROUND: In spite of the compulsory health insurance in Germany, many people only have limited access to medical services. This has serious consequences, especially in the field of sexual health. The affected people are not only undocumented migrants, but also many people from the new European Union countries who are temporarily living in Germany. Many of these people, especially in larger cities, frequent STD counselling centers. METHOD: Since 2002, in addition to basic socio-demographic data, other anonymous data have been recorded for all consultations in the STD offices of the Cologne Health Department. These data include the patients' country of origin, rea-son for consultation, whether the patients are medically insured, as well as the medical services provided and the diagnoses. The data is evaluated with the help of EpiInfo. RESULTS: During the study period, between 608 and 883 people visited the STD Counselling Centre per year. During this period, 4 235 people received in total medical help. The proportion of patients with a migration history rose from 65% in 2002 to 83% in 2010. The proportion of patients without health insurance rose from 45% (2002) to 67% (2010).About half of the counselled migrants were, at least for a short time, involved in professional sexwork. The number of counselled patients from the sub-Saharan region decreased from 123 (2002) to 72 (2010). The number of patients from Central Europe increased from 112 to 364 in this period.Migrants were over-represented in the group of patients who were diagnosed with gonorrhea and trichomoniasis, as well as among women with a conspicuous cytological swab. Chlamydia infections were, in contrast, more frequent among German clients.Gender, sexual orientation, age and the proportion of people involved in sexwork are, however, more important predictive factors than having an immigration status. CONCLUSION: The client spectrum has changed considerably during the study period.These changes are related to economic and political developments, as well as to the consequences of immigration laws. For the majority of patients with a migration history, the STD centre is the primary means of access to medical care in Germany. The rapid change in the client spectrum, the patients' limited access to information and to medical care and the resulting changes in epidemiology represent a major challenge for the public health services.

Biogenic amines in fermented foods.

Food-fermenting lactic acid bacteria (LAB) are generally considered to be non-toxic and non-pathogenic. Some species of LAB, however, can produce biogenic amines (BAs). BAs are organic, basic, nitrogenous compounds, mainly formed through decarboxylation of amino acids. BAs are present in a wide range of foods, including dairy products, and can occasionally accumulate in high concentrations. The consumption of food containing large amounts of these amines can have toxicological consequences. Although there is no specific legislation regarding BA content in many fermented products, it is generally assumed that they should not be allowed to accumulate. The ability of microorganisms to decarboxylate amino acids is highly variable, often being strain specific, and therefore the detection of bacteria possessing amino acid decarboxylase activity is important to estimate the likelihood that foods contain BA and to prevent their accumulation in food products. Moreover, improved knowledge of the factors involved in the synthesis and accumulation of BA should lead to a reduction in their incidence in foods.

Proliferation-dependent changes of proteoglycan metabolism in arterial smooth muscle cells.

Cultured arterial smooth muscle cells synthesize and secrete two types of sulfated proteoglycans designated as proteoglycan A and proteoglycan B. Proteoglycan A has been characterized as chondroitin sulfate-rich, whereas proteoglycan B was found to be dermatan sulfate-rich [Schmidt, A. & Buddecke, E. (1985) Eur. J. Biochem. 153, 260-273]. During the logarithmic growth phase, arterial smooth muscle cells incorporated about 3 times more [35S]sulfate into the total proteoglycans secreted into the culture medium than did non-dividing cells. When arterial smooth muscle cells stopped proliferating the ratio of [35S]proteoglycan A/B increased. No differences were detected in the respective molecular and chemical characteristics of purified proteoglycans A and B isolated from both proliferating and non-dividing cells. Regardless of the growth phase proteoglycan A had a molecular mass of about 280 kDa and contained 8-9 chondroitin sulfate-rich side chains. Proteoglycan B had a molecular mass of about 180 kDa and contained 6-7 dermatan sulfate-rich side chains. The [35S]methionine-labelled protein cores of proteoglycan A and B had a molecular mass of about 48 kDa, but were distinguishable by their specific reactions to monospecific antibodies. Proliferating cells endocytosed proteoglycan B at a rate up to 100% higher than that of non-dividing cells. In all growth phases proteoglycan A was endocytosed at a 10-fold lower rate than proteoglycan B.