[Readiness for Implementation of Prevention and Health Promotion Measures for People in Difficult Living Situations in Deprived Municipalities in Bavaria: A Qualitative Analysis]. / Bereitschaft zur Umsetzung von Präventions- und Gesundheitsförderungsmaßnahmen für Menschen in schwierigen Lebenslagen in deprivierten Kommunen in Bayern: Eine qualitative Analyse.

OBJECTIVE: The community setting is crucial to improving health equity. To enable the implementation of need-based and target-oriented measures, it is important to understand the challenges and needs of communities. This is highly relevant for deprived communities that have offered hardly any health promotion programs for socially disadvantaged people. The main research question of this study is: "How do deprived communities perceive the need for action and support in connection with the implementation of disease prevention and health promotion measures focused on socially disadvantaged people?" METHODS: A qualitative, exploratory analysis through semi-structured interviews with experts (n=10) was conducted in five deprived communities in Bavaria. The degree of deprivation was represented by the Bavarian Index of Multiple Deprivation (BIMD, 2010), which shows the extent of lack of resources at the community level. Qualitative analysis of the interviews followed the theoretical framework of qualitative content analysis according to Kuckartz. RESULTS: Themes arising from the interviews were (1) groups perceived to be in need of support, (2) disease prevention and health promotion assets, and (3) need for action regarding prevention and health promotion. Target groups in need of support were identified in the analyzed communities. Furthermore, it became apparent that in deprived communities there were scarcely resources and structures to address disease prevention and health promotion. CONCLUSION: This study shows that deprived communities need support to implement need-based and target-oriented prevention and health promotion measures for socially disadvantaged people. However, those communities have limited capacities, and thus should be supported (e. g., through networking).

Development of an ultrasound level meter for use in occupational safety and health.

The widespread use of ultrasound techniques throughout industry causes many workers to be exposed to airborne ultrasound at their workplaces. To measure and assess the exposure to airborne ultrasound at these workplaces, devices are required that allow reliable measurements of ultrasound levels and support occupational safety and health measures. However, the sound level meters available to date do not meet these requirements. Therefore, a research prototype of a sound level meter covering audible and ultrasonic frequencies was developed, paying particular attention to the suitability of the components in terms of their acoustical characteristics (such as directional patterns) in the ultrasonic frequency range. The prototype was tested based on the international standard for sound level meters IEC 61672-1, with extensions regarding the signal frequencies used. The results revealed that the sound level meter developed is suitable for application at most workplaces exposed to ultrasound, as reflected by, e.g., its frequency range (at least up to 47 kHz), upper level limits (up to 160 dB SPL), and measurement uncertainty (k = 2, GUM) of 1.15 dB. The prototype developed allows measurement and assessment of exposure at workplaces for occupational safety and health purposes. Moreover, it can serve as a basis for future developments of commercial ultrasound level meters.

Capabilities for Physical Activity by Turkish- and Russian-Speaking Immigrants Aged 65 Years and Older in Germany: A Qualitative Study.

This study builds upon Sen's seminal capability approach to analyze the interplay of individual and structural factors for immigrants' physical activity (PA) in old age. The authors conducted software-assisted thematic analysis of group interviews with Turkish- and Russian-speaking immigrants aged 65 years and older in Germany (n = 19). The authors present how interviewees perceive diverse resources, environmental, social, and individual factors that shape their capabilities for PA. Age-related health literacy, family support, and access rules to sport opportunities shape both groups' capabilities for PA. Turkish interviewees' continuous bilocation and Russian interviewees' past experience with PA as workplace exercise are two major differences between those groups. Results indicate that capabilities are ambiguous-managed and shaped by individuals, which makes more static terms like barriers and options less helpful for an analysis. Systematically applying the capability approach in intervention research would allow to analyze interaction and to ultimately better reach underserved groups like immigrants 65 years and older.

In vitro studies with two human organic anion transporters: OAT2 and OAT7.

1. Penciclovir, ganciclovir, creatinine, para-aminohippuric acid (PAH), ketoprofen, estrone 3-O-sulfate (E3S), dehydroepiandrosterone 3-O-sulfate (DHEAS) and cyclic guanosine monophosphate (cGMP) were screened as substrates of human liver organic anion transporters OAT2 and OAT7. 2. For OAT7, high uptake ratios (versus mock transfected HEK293 cells) of 29.6 and 15.3 were obtained with E3S and DHEAS. Less robust uptake ratios (≤3.6) were evident with the other substrates. OAT2 (transcript variant 1, OAT2-tv1) presented high uptake ratios of 30, 13, ∼35, ∼25, 8.5 and 9 with cGMP, PAH, penciclovir, ganciclovir, creatinine and E3S, respectively. No uptake was observed with DHEAS. 3. Although not a substrate of either transporter, ketoprofen did inhibit transfected OAT2-tv1 (IC50 of 17, 22, 23, 24, 35 and 586 µM; creatinine, ganciclovir, penciclovir, cGMP, E3S and prostaglandin F2α, respectively) and penciclovir uptake (IC50 = 27 µM; >90% inhibition) by plated human hepatocytes (PHH). 4. It is concluded that penciclovir and ketoprofen may serve as useful tools for the assessment of OAT2 activity in PHH. However, measurement of OAT7 activity therein will prove more challenging, as high uptake rates are evident with E3S and DHEAS only and both sulfoconjugates are known to be substrates of organic anion transporting polypeptides.

Citizen science applied to building healthier community environments: advancing the field through shared construct and measurement development.

BACKGROUND: Physical inactivity across the lifespan remains a public health issue for many developed countries. Inactivity has contributed considerably to the pervasiveness of lifestyle diseases. Government, national and local agencies and organizations have been unable to systematically, and in a coordinated way, translate behavioral research into practice that makes a difference at a population level. One approach for mobilizing multi-level efforts to improve the environment for physical activity is to engage in a process of citizen science. Citizen Science here is defined as a participatory research approach involving members of the public working closely with research investigators to initiate and advance scientific research projects. However, there are no common measures or protocols to guide citizen science research at the local community setting. OBJECTIVES: We describe overarching categories of constructs that can be considered when designing citizen science projects expected to yield multi-level interventions, and provide an example of the citizen science approach to promoting PA. We also recommend potential measures across different levels of impact. DISCUSSION: Encouraging some consistency in measurement across studies will potentially accelerate the efficiency with which citizen science participatory research provides new insights into and solutions to the behaviorally-based public health issues that drive most of morbidity and mortality. The measures described in this paper abide by four fundamental principles specifically selected for inclusion in citizen science projects: feasibility, accuracy, propriety, and utility. The choice of measures will take into account the potential resources available for outcome and process evaluation. Our intent is to emphasize the importance for all citizen science participatory projects to follow an evidence-based approach and ensure that they incorporate an appropriate assessment protocol. CONCLUSIONS: We provided the rationale for and a list of contextual factors along with specific examples of measures to encourage consistency among studies that plan to use a citizen science participatory approach. The potential of this approach to promote health and wellbeing in communities is high and we hope that we have provided the tools needed to optimally promote synergistic gains in knowledge across a range of Citizen Science participatory projects.

Health promotion networks in two districts in Bavaria, Germany: an exploratory case study mapping networks with respect to thematic agenda and location.

Introduction: Building networks is an essential part of health promotion. However, network analysis remains relatively unexplored in this field. This study introduces a new technique that maps thematic agendas and geographical locations of health promotion actors. Methods: This case study used elements of quantitative and qualitative methods to analyse network data. We used empirical data from two networks in Bavaria, a federal state of Germany. Results: We identified a total of 55 actors in the first network and 64 actors in the second. We categorized the thematic agenda of actors according to their main field of work: "healthy childhood development," "healthy middle age phase," "healthy ageing," "health equity in all phases of life." One network showed a significant surplus of actors that focus on "healthy ageing." We combined and analysed data from both networks collectively. Two districts with no health promotion actors within their geographical borders were identified. To put geographical gaps into context, data about deprivation and age was included. Discussion: Results identified geographical areas with high need for support from health promotion actors. Through comparison of our results with existing literature, we derived potential network strategies for further successful networking. This study adds a new perspective to characterize health promotion networks by mapping them thematically and geographically. The concept can be used to give health promotion organisations relevant insight into network structures. This can improve decision-making processes concerning partnership strategy and finally lead to a positive health impact. Hence, our findings encourage further development of this technique and other networking methods in the field of health equity and health promotion.

Development of a Personal Ultrasound Exposimeter for Occupational Health Monitoring.

Prolonged exposure to airborne ultrasound in a workplace can have a detrimental influence on a worker's well-being. Given the ever-increasing use of ultrasonic industrial equipment, it is of vital importance-and may also be regulated by law-to monitor ultrasound exposure during a normal workday as part of workplace risk assessment. However, the devices currently utilized exhibit limitations with regard to both their operational frequency and their portability (wearability). In this paper, the first prototype of a high-frequency and ultrasound personal exposimeter is presented in the light of the latest national and international standards governing high-frequency and ultrasonic noise measurement in the field of occupational health monitoring. The prototype was tested in the laboratory environment in order to assess its sound level detection capabilities in both the audible and ultrasonic frequency ranges. Several common industrial scenarios-including an ultrasonic welding machine, an ultrasonic cleaning bath, and a compressed air gun-were simulated in a laboratory environment. For each simulated set-up, a corresponding high-frequency or ultrasonic signal was fed through a specially prepared generation chain. Each experimental scenario was initially surveyed with an ultrasound level meter previously tested up to 100 kHz. This was followed by a measurement with the prototype. For this study, the simulated sound signals varied between 10 kHz and 40 kHz on the frequency scale and between 60 dB and 90 dB in amplitude. The portability of the prototype, which may be required to be worn throughout an entire workday (e.g., 8 h), was also considered. All the experiments were performed on a customized ultrasound measurement set-up within a free-field environment located at the Physikalisch-Technische Bundesanstalt (PTB) in Braunschweig, Germany. Results obtained suggest a good agreement between the measurements performed with both devices in the louder areas of the sound fields produced. Because the overall measurement uncertainty is highly dependent on the specificity of the individual measurement set-up and measurement procedure, an uncertainty budget estimated for the prototype considers electro-acoustical contributions only.

Robustness and epistasis in mutation-selection models.

We investigate the fitness advantage associated with the robustness of a phenotype against deleterious mutations using deterministic mutation-selection models of a quasispecies type equipped with a mesa-shaped fitness landscape. We obtain analytic results for the robustness effect which become exact in the limit of infinite sequence length. Thereby, we are able to clarify a seeming contradiction between recent rigorous work and an earlier heuristic treatment based on mapping to a Schrödinger equation. We exploit the quantum mechanical analogy to calculate a correction term for finite sequence lengths and verify our analytic results by numerical studies. In addition, we investigate the occurrence of an error threshold for a general class of epistatic landscapes and show that diminishing epistasis is a necessary but not sufficient condition for error threshold behaviour.

Movement as Investment for Health: integrated evaluation in participatory physical activity promotion among women in difficult life situations.

Movement as Investment for Health (Bewegung als Investition in Gesundheit or BIG) was a multidimensional research study in participatory physical activity promotion among socially disadvantaged women in a deprived neighbourhood in Erlangen, Germany. It aimed at making full use of health-promoting effects of movement and developing integrated evaluation through approaches from different disciplines. We defined the target population through national health survey data, and determined important intervention and evaluation dimensions through meta-analyses. A co-operative planning group of women, researchers, policy-makers, and local experts made decisions on the most appropriate procedures. Integrated evaluation in participatory approaches is promising. It calls for context-specific evaluation, requires adaptation of existing approaches or even development of its own evidence base.

Diffusion-limited reactions on a two-dimensional lattice with binary disorder.

Reaction-diffusion systems where transition rates exhibit quenched disorder are common in physical and chemical systems. We study pair reactions on a periodic two-dimensional lattice, including continuous deposition and spontaneous desorption of particles. Hopping and desorption are taken to be thermally activated processes. The activation energies are drawn from a binary distribution of well depths, corresponding to "shallow" and "deep" sites. This is the simplest nontrivial distribution, which we use to examine and explain fundamental features of the system. We simulate the system using kinetic Monte Carlo methods and provide a thorough understanding of our findings. We show that the combination of shallow and deep sites broadens the temperature window in which the reaction is efficient, compared to either homogeneous system. We also examine the role of spatial correlations, including systems where one type of site is arranged in a cluster or a sublattice. Finally, we show that a simple rate equation model reproduces simulation results with very good accuracy.

Pseudo-Meigs syndrome secondary to ovarian germ cell tumor.

An 11-year-old white girl presenting with fever, dyspnea, and cough demonstrated a left pleural effusion, ascites, and a suprapubic mass on physical and radiologic examinations. Surgical resection of the mass found a stage Ic malignant mixed germ cell tumor of the ovary. The pleural effusion and ascites were benign and resolved spontaneously after complete resection of the tumor, which is characteristic of a pseudo-Meigs syndrome.