The relation between emotion regulation and migraine: A cross-cultural study on the moderating effect of culture.

BACKGROUND: Effects of emotion suppression on physical health might be contingent on culture. Existing research on emotion regulation has mainly included western participants. Herewith the question arises, whether this gained expertise is transferable to an Asian culture. OBJECTIVES: This cross-sectional study evaluated to what extent the regulation of emotions is related to migraine and if the relation between emotion regulation and migraine complaints differs between a Western and an Asian population. Therefore, the main characteristics and symptoms of patients with migraine from both Germany and Japan are compared. METHODS: 261 Japanese and 347 German headache patients participated in this online study and completed self-report measures of emotion regulation (suppression and reappraisal) and headache complaints. RESULTS: Cultural groups did not differ regarding their demographic data, intake of medication and number of days with headache. German participants showed significantly higher levels of anxiety and lower levels of emotion suppression compared to Japanese patients. Emotion regulation is not correlated with headache complaints either in the Japanese or in the German patient group. CONCLUSION: Although group differences were found with respect to anxiety and emotion suppression, subsequent regression analysis revealed these differences were unrelated to headache complaints. As our baseline analysis focused on group means, approaches that examine individual reaction patterns to stress and accompanying sensory stimulus processing may prove to be more fruitful and illuminating.

Differential Influence of Same- and Cross-Ethnic Friends on Ethnic-Racial Identity Development in Early Adolescence.

Recent research has shown that peers influence ethnic-racial identity (ERI) development during early adolescence. Arguments based on social identity theory, however, suggest that only same-ethnic but not cross-ethnic friends are important for ERI development. Using longitudinal social network analysis, we examined peer influence of both same- and cross-ethnic friends on ERI attachment and private regard. Data were drawn from six ethnically diverse schools in Western Germany (N = 1,349; Mage  = 13.3). Our results provide empirical evidence for early adolescents' ERI being influenced by same- but less by cross-ethnic friends. Considering peers' ethnicity therefore is crucial for understanding peer influence on ERI development.

Cross-cultural variation in how much, but not whether, children overimitate.

Children from Western industrialized populations tend to copy actions modeled by an adult with high fidelity even if these actions are functionally irrelevant. This so-called overimitation has been argued to be an important driver of cumulative cultural learning. However, cross-cultural and developmental evidence on overimitation is controversial, likely due to diverging task demands regarding children's attention and memory capabilities. Here, children from a recent hunter-gatherer population (Hai||om in Namibia) were compared with urban Western children (Germany) using an overimitation procedure with minimal cognitive task demands. Although the proportion of children engaging in any overimitation was similar across the two populations, German overimitators copied irrelevant actions more persistently across tasks. These results suggest that the influence of culture on children's overimitation may be one of degree, not kind.

Cultural determinants of food attitudes in anosmic patients.

The decrease in food enjoyment is a major factor why patients suffer from depression when having anosmia, or total loss of smell. While we have some knowledge about how food preferences and attitudes change with dysosmia, these findings are limited because other factors such as culture are not factored in. It is likely that the culture in which an anosmic patient identifies with will influence how their smell loss impacts their relationship with food. This study examined the current attitudes within the United States and Germany towards foods, focusing on the comparison between anosmic patients (N = 53) and those with a healthy sense of smell (N = 121). A survey was used to collect free responses for liking on a variety of foods (N = 15) that were also rated for their overall liking. Additionally, individuals rated and ranked their liking for sensory attributes in relation to their enjoyment of food. Free responses were classified into categories and subcategories, the frequency of those responses were then compared across groups. The patient population of each culture gave lower importance to aroma and flavor; however, the U.S.A. patient population showed a larger decrease from their healthy counterparts. Furthermore, anosmic patients from the U.S.A. showed less overall liking towards the food stimuli compared to their healthy counterparts, while no such effect observed among the German population. Reasons to enjoy a food were largely explained by the culture, and patients within a culture took on different compensation strategies which we use to explain their effectiveness.

Effect of Covid-19 pandemic on mental health among Albanian people residing in the country and abroad - Implications for mental care.

BACKGROUND: Coronavirus disease caused by the novel coronavirus Covid-19 is a current worldwide outbreak. The use of quarantine and isolation proved effective in containing the spread of infection. OBJECTIVES: The purpose of this cross-sectional study was to assess the mental health of Albanian people residing in the country and abroad during the quarantine period for the Covid-19 pandemic. DESIGN: This study was carried out from 25th March - 20th April 2020 through a web survey shared on social networks. The goal was to reach at least the minimum sample size for cross-sectional studies. The Patient Health Questionnaire (PHQ-9) was used to assess mental health. Chi-square (χ2) and Fisher -Exact test were used to assess the statistical significance among variables. P values ≤0.05 were considered statistically significant. RESULTS: 715 participants were included in the final analyses (78.41% females and 21.53% males). Most were residents in Albania (80.41%) and the others resided mainly in Italy (6.89%), Greece (3.51%), Germany (2.43%), Kosovo (1.62%) and the UK (1.69%). Statistical association was found between gender, country of residency and measures taken. Summary score of PHQ-9 items was 6.4662. The total score of depression classification shows that 31.82% and 12.90% of participants have respectively mild and moderate depression. Female participants showed the highest score for some items of PHQ-9, p≤0.05. CONCLUSIONS: Findings suggest that health care professionals should recognize and address mental health problems associated with Covid-19 especially in vulnerable groups. Acting in a timely and proper manner is essential in preventing these problems from becoming chronic.

A matched-pair analysis on survival and response rates between German and non-German cancer patients treated at a Comprehensive Cancer Center.

BACKGROUND: Research shows disparities in cancer outcomes by ethnicity or socio-economic status. Therefore, it is the aim of our study to perform a matched-pair analysis which compares the outcome of German and non-German (in the following described as 'foreign') cancer patients being treated at the Center for Integrated Oncology (CIO) Köln Bonn at the University Hospital of Bonn between January 2010 and June 2016. METHODS: During this time, 6314 well-documented patients received a diagnosis of cancer. Out of these patients, 219 patients with foreign nationality could be matched to German patients based on diagnostic and demographic criteria and were included in the study. All of these 438 patients were well characterized concerning survival data (Overall survival, Progression-free survival and Time to progression) and response to treatment. RESULTS: No significant differences regarding the patients' survival and response rates were seen when all German and foreign patients were compared. A subgroup analysis of German and foreign patients with head and neck cancer revealed a significantly longer progression-free survival for the German patients. Differences in response to treatment could not be found in this subgroup analysis. CONCLUSIONS: In summary, no major differences in survival and response rates of German and foreign cancer patients were revealed in this study. Nevertheless, the differences in progression-free survival, which could be found in the subgroup analysis of patients with head and neck cancer, should lead to further research, especially evaluating the role of infectious diseases like human papillomavirus (HPV) and Epstein-Barr virus (EBV) on carcinogenesis and disease progression.

Vitamin D status and its determinants in healthy pregnant women living in Switzerland in the first trimester of pregnancy.

OBJECTIVES: Our study aimed at assessing the prevalence and determinants of vitamin D deficiency (25-hydroxy-vitamin D [25(OH)D] < 20 ng/mL) in pregnant women in the first trimester living in Switzerland. METHODS: From September 2014 through December 2015, 204 pregnant women were conveniently recruited during their first clinical appointment at the Clinic of Obstetrics of the University Hospital Zurich (between week 6 and 12 of pregnancy). Blood samples were collected and a questionnaire focusing on lifestyle and skin colour was completed face-to-face with the responsible physician. Logistic regression analyses were performed with vitamin D status as dependent variable. RESULTS: 63.2% of the participating women were vitamin D deficient, and the median vitamin D concentration in the overall sample was 17.1 ng/mL [Q1, Q3: 9.78, 22.3]. The highest proportions of vitamin D deficiency were detected in women originating from Africa and Middle East (91.4% deficient, median vitamin D concentration of 10.7 ng/mL [Q1, Q3: 6.55, 14.45]) and from South-East Asia/Pacific (88.5% deficient, median vitamin D concentration of 8.4 ng/mL [Q1, Q3: 6.10, 14.88]). Multivariable logistic regression showed that significant risk factors of vitamin D deficiency were country of origin (women born in Switzerland and Germany had a lower risk than women born in other countries), smoking status (lower risk for former smokers) and intake of vitamin D supplements. CONCLUSIONS: Our results confirm a high prevalence of vitamin D deficiency in this Swiss cohort, in particular in women coming from Asian and African countries, and underline the importance of appropriate counseling and vitamin D supplementation in early pregnancy.

Alone, but protected? Effects of social support on mental health of unaccompanied refugee minors.

Unaccompanied refugee minors (URM) are the most vulnerable group of refugees suffering from higher levels of mental health problems. Yet, there is also a group of URM with little or no symptoms or disorders. A major predictor for positive mental health outcomes is the social support network in the post-flight period which has rarely been investigated for the group of URM. The present study analyzes differences between perceived social support from family, peers, and adult mentors in URM, with subgroup analyses of peer and mentor support in URM with and without family contact. Furthermore, we investigate whether social support from each of the three sectors moderates the relationship between stressful life events (SLE) and mental health of URM with family contact. Questionnaire data were collected from 105 male URM from Syria and Afghanistan aged 14-19 years who were living in group homes of the Child Protection Services in Leipzig, Germany, in summer 2017. URM receive most social support from their families, followed by peers and adult mentors. URM without family contact received less peer and mentor support compared to URM with family contact. Lower social support from mentors increased the risk for PTSD, depression and anxiety symptoms after SLE, whereas lower social support from peers increased the association between SLE and anxiety symptoms. Mentor and peer support in the host country is relevant for the processing of SLE. URM without family contact represent a "double burden" group, as they might feel less supported by other social networks.

Is assessment of depression equivalent for migrants of different cultural backgrounds? Results from the German population-based Gutenberg Health Study (GHS).

BACKGROUND: Bearing in mind the multicultural background of a national population, little is known about the measurement invariance across different cultures or ethnicities of frequently used screeners for depression. For this reason, the main objective of the current study is to assess the measurement invariance of the Patient Health Questionnaire (PHQ-9) across groups with different migration backgrounds. METHODS: We provided psychometric analyses (descriptive statistics at item and scale level, reliability analysis, exploratory [EFA] and confirmatory factor analyses [CFA]) comparing a native population with first- and second-generation migrants of the German population-based Gutenberg Health Study with N = 13,973 participants completing the PHQ-9. Furthermore, we conducted measurement invariance analyses among different groups of first-generation migrants. RESULTS: Comparing the native population with first- and second-generation migrants, a higher prevalence for mental distress was found for first generation. Although mean score patterns were similar for all groups, analyses of item loadings among first-generation migrants yielded some variance in patterns pointing out that certain items have a distinct impact on depression for specific groups. With regard to the factorial validity for all groups, EFA and CFA provided evidence for the proposed one latent factor structure of the PHQ-9. Depression assessed by the PHQ-9 turned out to be equivalent from a psychometric perspective across different groups stratified by their migration background. CONCLUSIONS: Overall, results of thorough scale and item analyses, especially multigroup confirmatory analyses, provided support that depression, assessed by the PHQ-9, can be considered as psychometrically equivalent across all analyzed groups.

Waiting for the Second Treat: Developing Culture-Specific Modes of Self-Regulation.

The development of self-regulation has been studied primarily in Western middle-class contexts and has, therefore, neglected what is known about culturally varying self-concepts and socialization strategies. The research reported here compared the self-regulatory competencies of German middle-class (N = 125) and rural Cameroonian Nso preschoolers (N = 76) using the Marshmallow test (Mischel, 2014). Study 1 revealed that 4-year-old Nso children showed better delay-of-gratification performance than their German peers. Study 2 revealed that culture-specific maternal socialization goals and interaction behaviors were related to delay-of-gratification performance. Nso mothers' focus on hierarchical relational socialization goals and responsive control seems to support children's delay-of-gratification performance more than German middle-class mothers' emphasis on psychological autonomous socialization goals and sensitive, child-centered parenting.

The Effects of Ethnic Minority Adolescents' Ethnic Self-Identification on Friendship Selection.

This study investigated the effects of ethnic minority adolescents' ethnic self-identification (host country, dual, or heritage country) on friendship choices among ethnic majority and minority peers. Hypotheses were derived from similarity-attraction and social identity theory and tested using longitudinal social network data from 1,004 middle school students (five schools) in Germany. Results showed that ethnic minority adolescents' ethnic self-identification affected friendship selection beyond ethnic homophily. While host country and dual identification was beneficial with respect to friendships with both ethnic majority and minority peers, heritage country identification was detrimental to relations with both of them.

Three-dimensional printable ultrasound transducer stabilization system.

When using ultrasound imaging of the tongue for speech recording/research, submental transducer stabilization is required to prevent the ultrasound transducer from translating or rotating in relation to the tongue. An iterative prototype of a lightweight three-dimensional-printable wearable ultrasound transducer stabilization system that allows flexible jaw motion and free head movement is presented. The system is completely non-metallic, eliminating interference with co-recorded signals, thus permitting co-collection and co-registration with articulometry systems. A motion study of the final version demonstrates that transducer rotation is limited to 1.25° and translation to 2.5 mm-well within accepted tolerances.

The impact of the Baltic Germans' emigration on the pharmaceutical sector in Latvia (1939-1940).

For several hundred years, the Baltic German families of pharmacists have been the decisive creator of traditions in Latvian pharmacy. A large amount of the oldest pharmacies in Latvia, especially in Riga, were owned by pharmacists of Baltic German origin. Many of these ancient pharmacies ceased to exist in 1939, as a result of the emigration of the Baltic Germans. The agreement on the outward migration of German nationality citizens between Latvia and Germany was signed October 30, 1939. According to the information of the Pharmacy Board of Latvia, the number of employees in the pharmaceutical sector, registered in 1939, was 2068 persons. During the first wave of emigration, at the end of the year 1939, 306 persons, related to pharmacy, renounced the Latvian citizenship and emigrated. During the second wave of emigration, in spring of 1941, when Latvia had already lost its political independence, another 49 pharmaceutic employees left Latvia. In total 355 employees emigrated to Germany. As a result of the Baltic German emigration there was a decreased number of pharmacies in Latvia and the lack of pharmacists became a local issue. In rural areas quite often the only one pharmacy, which had been owned by a German origin pharmacist was liquidated or stayed closed for several months.

Differential effects of school experiences on active citizenship among German and Turkish-origin students.

While research suggests that schools can foster active citizenship among youth, studies have not tested whether ethnic minority youth may benefit differently from school experiences than ethnic majority youth. In this study of 219 students (138 German majority and 81 Turkish-origin minority; Mage = 18.26; 55% females), we examined the association between different experiences at school and 4 indicators of youth active citizenship, controlling for various socio-demographic characteristics. Although value of social studies was associated with three out of four active citizenship indicators among both ethnic groups, the effects of the other school-related variables on active citizenship were moderated by ethnicity. Specifically, indicators of classroom climate, such as open classroom climate and classroom community, were only associated with greater active citizenship among Turkish-minority youth, while participatory factors, such as engagement in school decisions, were only associated with active citizenship among native German youth.

"Ausländer" (Foreigners), Migrants, or New Germans? Identity-Building Processes and School Socialization Among Adolescents From Immigrant Backgrounds in Germany.

In public discourse in Germany, identity is widely constructed along the juxtaposition of two categories: "German"-defined primordially in ethnic terms-and "migrant" or "of migration background." But most urban schools today consist of a majority of children with such "non-German" backgrounds, while "ethnic German" children have become one minority among many others. Drawing from research on German identity, social mobility careers from among second-generation Turkey-originating families-including retrospective accounts of their school experiences in the 1960s to 2000s-and a very recent project on urban diversity, this article compares experiences of native-born adolescents and adults from immigrant families in relation to representations of Germanness. With immigrant children attending German schools over almost 50 years, it considers how demographic changes are shaping different experiences in the second and third generations and how this challenges German national self-definitions. The discussion examines meanings and effects on identity building and future orientations of youth from immigrant families and implications for future research in "majority-minority" societies.

Ancient DNA Investigation of a Medieval German Cemetery Confirms Long-Term Stability of CCR5-Δ32 Allele Frequencies in Central Europe.

The CCR5-Δ32 mutation present in European populations is among the most prominently debated cases of recent positive selection in humans. This allele, a 32-bp deletion that renders the T-cell CCR5 receptor nonfunctional, has important epidemiological and public health significance, as homozygous carriers are resistant to several HIV strains. However, although the function of this allele in preventing HIV infection is now well described, its human evolutionary origin is poorly understood. Initial attempts to determine the emergence of the CCR5-Δ32 allele pointed to selection during the 14th-century Black Death pandemic; however, subsequent analyses suggest that the allele rose in frequency more than 5,000 years ago, possibly through drift. Recently, three studies have identified populations predating the 14th century CE that are positive for the CCR5-Δ32 allele, supporting the claim for a more ancient origin. However, these studies also suggest poorly understood regional differences in the recent evolutionary history of the CCR5-Δ32 allele. Here a new hydrolysis-probe-based real-time PCR assay was designed to ascertain CCR5 allele frequency in 53 individuals from a 10th- to 12th-century CE church and convent complex in central Germany that predates outbreaks of the Black Death pandemic. High-confidence genotypes were obtained for 32 individuals, and results show that CCR5-Δ32 allele frequency has remained unchanged in this region of Central Europe over the last millennium, suggesting that there has been no strong positive selective pressure over this time period and confirming a more ancient origin for the allele.

An ethnographic study of the effects of cognitive symptoms in patients with major depressive disorder: the IMPACT study.

BACKGROUND: The manifestation of major depressive disorder (MDD) may include cognitive symptoms that can precede the onset of MDD and persist beyond the resolution of acute depressive episodes. However, little is known about how cognitive symptoms are experienced by MDD patients and the people around them. METHODS: In this international (Brazil, Canada, China, France, and Germany) ethnographic study, we conducted semi-structured interviews and observations of remitted as well as symptomatic MDD patients (all patients self-reported being diagnosed by an HCP and self-reported being on an antidepressant) aged 18-60 years with self-reported cognitive symptoms (N = 34). In addition, participating depressed patients' close family or friends (N = 31) were interviewed. Separately recruited from depressed participants, work colleagues (N = 21) and healthcare providers (HCPs; N = 13) of depressed individuals were interviewed. RESULTS: Key insights were that: (1) patients were generally unaware that their cognitive symptoms were linked to their depression and, instead, attributed these symptoms to negative aspects of their person (e.g., age, separate disease, laziness, exhaustion); (2) cognitive symptoms in MDD appeared to negatively impact patients' social relationships and patients' ability to handle daily tasks at work and at home; (3) patients' cognitive symptoms also impacted relationships with family members and coworkers; (4) patients' cognitive symptoms increased stress and feelings of failure, which in turn seemed to worsen the cognitive symptoms, thereby creating a destructive cycle; and (5) although HCPs recommended that patients re-engage in everyday activities to help overcome their depression, cognitive symptoms seemed to impede such functional recovery. CONCLUSIONS: Taken together, these findings highlight a negative impact of patients' cognitive symptoms on their social functioning, work performance, and quality of life on the people close to them, and consequently on the degree of functional recovery after depression.

Bilingual toddlers have advanced abilities to repair communication failure.

Recent research has demonstrated enhanced communicative abilities in bilingual children compared with monolingual children throughout childhood and in a variety of domains. The processes underlying these advantages are, however, not well understood. It has been suggested that one aspect that particularly stimulates bilinguals' communication skills is their daily experience with challenging communication. In the current study, we investigated whether children's assumed experience with communication failures would increase their skills when it came to repairing communication failure. Non-German bilingual, German bilingual, and monolingual 2.5-year-old toddlers participated in a communication task in which a misunderstanding occurred. We hypothesized that monolingual and German bilingual children would have fewer daily communication failures-and, therefore, less well-trained repair skills-compared with non-German bilinguals. The results showed that non-German bilinguals were more likely to repair the misunderstanding compared with both monolingual children and German bilingual children. The current findings support the view that the communicative advantages of bilingual individuals develop based on their unique experience with interpersonal communication and its difficulties.

[Differences between German and Turkish-speaking participants in a chronic heart failure management program]. / Unterschiede zwischen deutsch- und türkischsprachigen Teilnehmenden an einem strukturierten Herzinsuffizienz-Versorgungsmodell.

BACKGROUND: German and Turkish-speaking patients were recruited for a chronic heart failure management program. So far little is known about the special needs and characteristics of Turkish-speaking patients with chronic heart failure; therefore, the aim of this study was to examine sociodemographic and illness-related differences between German and Turkish-speaking patients with chronic heart failure. METHODS: German and Turkish-speaking patients suffering from chronic heart failure and insured with the AOK Rheinland/Hamburg or the BARMER GEK health insurance companies and living in Cologne, Germany, were enrolled. Recruitment took place in hospitals, private practices and at information events. Components of the program were coordination of a guideline-oriented medical care, telemonitoring (e.g., blood pressure, electrocardiogram, and weight), a 24-h information hotline, attendance by German and Turkish-speaking nurses and a patient education program. Data were collected by standardized interviews in German or Turkish language. Data were analyzed with descriptive measures and tested for significance differences using Pearson's χ2-test and the t­test. RESULTS: A total of 465 patients (average age 71 years, 55 % male and 33 % Turkish-speaking) were enrolled in the care program during the study period. Significant differences between German and Turkish-speaking patients were found for age, education, employment status, comorbidities, risk perception, knowledge on heart failure and fear of loss of independence. DISCUSSION: The response rate could be achieved with the help of specific measures for patient enrollment by Turkish-speaking integration nurses. The differences between German and Turkish-speaking patients should in future be taken into account in the care of people with chronic heart failure.