[Development of an Integrated Community-Based Prevention Strategy in Freiham (Munich) from the Perspective of the Steering Group: A Qualitative Interview Study with Social Network Analysis]. / Aufbau der Präventionskette Freiham aus Sicht des Steuerungsgremiums: Eine qualitative Interviewstudie mit Sozialer Netzwerkanalyse.

BACKGROUND: The City of Munich is planning and implementing a "Prevention Chain" as an integrated community-based prevention strategy in the new district of "Freiham" in Munich. This is taking place while the district is being built. The "Prevention Chain Freiham" aims to create an environment that enables a healthy upbringing of all children and adolescents right from the start. In order to guide this project, an interdepartmental working group was formed within the City of Munich's administration. This study analyses the working group's structures, processes and its collaboration with a variety of stakeholders. METHODS: We conducted a multimethod study comprising qualitative interviews and social network analysis. Between March and April 2018, we conducted semi-structured interviews with members of the working group. The study participants also generated ego-centred social network maps. The transcripts were analysed using qualitative content analysis as described by Schreier. The network maps were also analysed using qualitative content analysis and the results were visualized. Our preliminary findings were interpreted, discussed and validated in a workshop in June 2018 with study participants. RESULTS: Ten members of the working group participated in the study. The interdepartmental, multiprofessional collaboration in the working group was perceived as beneficial for the process of developing and implementing the Prevention Chain. The external coordination by MAGs and the scientific expertise provided by the LMU Munich were considered highly supportive. Barriers to the planning and implementation of the Prevention Chain were mainly located at administration level. Most facilitators were attributed to the collaborative processes within the working group. After having mapped all stakeholders currently involved in the Prevention Chain (mainly actors within the City of Munich's administration), additional relevant stakeholders were identified by the members of the working group. CONCLUSION: The organizational form of the working group as a formalized association of representatives of various departments that are jointly responsible for the Prevention Chain is considered beneficial for the success of the Prevention Chain. This is further supported by the external coordination and academic support. Advancing the development and implementation of the Prevention Chain will require support from all relevant departments across sectors and hierarchies.

Inhibitory effects of progestogens on the estrogen stimulation of melanocytes in vitro.

BACKGROUND: The use of oral estrogen-progestogen contraceptives may cause melasma, an epidermal hyperpigmentation in sun-exposed areas of the face. It is assumed that elevated estrogen levels lead to the activation of melanocytes, while the role of the gestagen component of contraceptives in pigmentation remains unclear and may vary between the different progestogens. In this study, we analyzed the distinct effects of progesterone and chlormadinone acetate (CMA) on melanocytes in comparison with estrogen. STUDY DESIGN: Human melanocytes were exposed to different concentrations of 17beta-estradiol and progestogens and analyzed for proliferation by a fluorometric cell viability assay and for pigmentation by a (3)H-labeled tyrosine assay. Subgroups of cells were additionally irradiated with UVA or UVB. RESULTS: Proliferation of melanocytes was induced by 17beta-estradiol (0.1 and 1 nM) in approximately half of the experiments, while progesterone (100 nM) and CMA (100 nM) reduced the proliferation rate by 38% and 27%, respectively. The pigmentation activity was slightly stimulated by 17beta-estradiol, whereas progestogens had no effect on the tyrosinase activity. CONCLUSIONS: Our data suggest that progesterone and CMA can inhibit proliferation of human melanocytes, which counteracts the stimulatory effects of estrogen. This may be of relevance for the choice of progestogen in oral contraceptives to prevent the development of melasma.