Ethnic minority groups show elevated suicide attempt rates across Europe. Evidence suggests a similar trend for women of Turkish origin in Germany, yet data on suicidal behaviour in minorities in Germany is scarce. The objective was to examine rates of suicidal behaviour, underlying motives, and to explore the effectiveness of an intervention program.

From 05/2009–09/2011, data on all suicide attempts among women of Turkish origin who presented at a hospital-based emergency unit in Berlin, Germany, were collected. A multi-modal intervention was conducted in 2010 and the effects of age, generation and the intervention on suicide attempt rates were examined.

At the start, the highest rate was found in women aged 18–24 years with 225.4 (95% CI = 208.8–242.0)/100,000. Adjustment disorder was the most prevalent diagnosis with 49.7% (n = 79), being more common in second-generation women (P = .004). Further analyses suggested an effect of the intervention in the youngest age group (trend change of ß = –1.25; P = .017).

Our findings suggest a particularly high rate of suicide attempts by 18–24-year-old, second-generation women of Turkish origin in Berlin. Furthermore, our results suggest a trend change in suicide attempts in women aged 18–24 years related to a population-based intervention program.

A core component of stigma is being set apart as a distinct, dichotomously different kind of person. We examine whether information on a continuum from mental health to mental illness reduces stigma.

Online survey experiment in a quota sample matching the German population for age, gender and region (n = 1679). Participants randomly received information on either (1) a continuum, (2) a strict dichotomy of mental health and mental illness, or (3) no information. We elicited continuity beliefs and stigma toward a person with schizophrenia or depression.

The continuum intervention decreased perceived difference by 0.19 standard deviations (SD, P < 0.001) and increased social acceptance by 0.18 SD (P = 0.003) compared to the no-text condition. These effects were partially mediated by continuity beliefs (proportion mediated, 25% and 26%), which increased by 0.19 SD (P < 0.001). The dichotomy intervention, in turn, decreased continuity beliefs and increased notions of difference, but did not affect social acceptance.

Attitudes towards a person with mental illness can be improved by providing information on a mental health-mental illness continuum.

The present study aimed to examine the effectiveness of two different implementation forms of the EU School Fruit and Vegetable Scheme (SFVS).

A quasi-experimental design was applied including a thrice as well as a twice weekly intervention group. Repeated 24 h dietary recalls were used to measure children’s fruit and vegetable (F&V) intake. Effects were analysed on days with and without F&V deliveries using hierarchical linear regression models.

Twelve primary schools in North Rhine-Westphalia, Germany.

Third and fourth graders (n 664).

Average daily F&V intake at pre-intervention was 0·84 frequencies in the thrice weekly intervention group, 0·90 frequencies in the twice weekly intervention group and 1·25 frequencies in the control group. Providing children thrice weekly with F&V increased children’s F&V intake on average by 0·96 (P<0·001) frequencies/d. The effects were higher on days with (1·07; P<0·001) than on days without (0·75; P<0·001) F&V deliveries. Distributing F&V twice weekly resulted in an increase of 0·75 (P<0·001) frequencies/d on average, again with higher effects on days with (1·30; P<0·001) than without (0·48; P<0·003) F&V deliveries. Subgroup analysis revealed some indications for differential effectiveness only in the twice weekly intervention group.

The SFVS with thrice or twice weekly deliveries of F&V led to a significant increase in children’s F&V intake on days with and without deliveries. The latter might provide an indication of positive long-term effects of the scheme. The scheme shows equal efficiency for almost all subgroups.

To assess the impact of the European School Fruit Scheme (SFS) in North Rhine-Westphalia, Germany, on children’s fruit and vegetable (F&V) consumption, in particular frequency.

The study consisted of a pre-test/post-test design with an intervention (eight primary schools) and a control group (two primary schools). Children’s F&V consumption frequency was measured prior to the introduction of the SFS in 2010 and after one year’s delivery of F&V (2011).

Ten primary schools in North Rhine-Westphalia, Germany.

In total, 499 primary-school children aged 6–11 years, 390 in the intervention and 109 in the control schools.

Children highly appreciated the SFS. More than 90 % evaluated the programme positively. Children in the intervention group showed a significant increase in F&V intake frequency from baseline to follow-up, from on average 1·26 (sd 1·37) to 2·02 (sd 1·33) times/d (P=0·000). The intervention variable had a highly significant impact on children’s F&V consumption frequency, even after controlling for gender, age and stay at school for lunch (β=0·773; 95 % CI 0·59, 0·96). The SFS did not induce a reduction of F&V consumption at home. In the control group a non-significant decline in F&V consumption frequency from 1·31 (sd 1·26) to 1·18 (sd 1·34) times/d (P=0·325) was observed.

One year after the programme’s implementation, the SFS led to a significant short-term increase in children’s F&V consumption.

Interventions based on the experience sampling method (ESM) are ideally suited to provide insight into personal, contextualized affective patterns in the flow of daily life. Recently, we showed that an ESM-intervention focusing on positive affect was associated with a decrease in symptoms in patients with depression. The aim of the present study was to examine whether ESM-intervention increased patient empowerment.

Depressed out-patients (n = 102) receiving psychopharmacological treatment who had participated in a randomized controlled trial with three arms: (i) an experimental group receiving six weeks of ESM self-monitoring combined with weekly feedback sessions, (ii) a pseudo-experimental group participating in six weeks of ESM self-monitoring without feedback, and (iii) a control group (treatment as usual only). Patients were recruited in the Netherlands between January 2010 and February 2012. Self-report empowerment scores were obtained pre- and post-intervention.

There was an effect of group × assessment period, indicating that the experimental (B = 7.26, P = 0.061, d = 0.44, statistically imprecise) and pseudo-experimental group (B = 11.19, P = 0.003, d = 0.76) increased more in reported empowerment compared to the control group. In the pseudo-experimental group, 29% of the participants showed a statistically reliable increase in empowerment score and 0% reliable decrease compared to 17% reliable increase and 21% reliable decrease in the control group. The experimental group showed 19% reliable increase and 4% reliable decrease.

These findings tentatively suggest that self-monitoring to complement standard antidepressant treatment may increase patients’ feelings of empowerment. Further research is necessary to investigate long-term empowering effects of self-monitoring in combination with person-tailored feedback.

Apathy is common in nursing home (NH) residents and it overlaps with depression. This study examines the effects of a multidisciplinary depression program on apathy and depressive motivational and mood symptoms.

Secondary analyses of a stepped-wedge cluster-randomized controlled trial were conducted with six measurements. Sixteen dementia NH units and 17 somatic units were enrolled. In the intervention condition, a program containing depression assessment procedures and multidisciplinary treatment (activating strategies, psychotherapy, and medication) was introduced. Usual care was provided in the control condition. Outcomes were assessed using the 10-item Apathy Evaluation Scale and the Cornell Scale for Depression in Dementia.

Intention-to-treat analyses showed that the whole depression management program reduced apathy in dementia units (p < 0.001; Cohen's d, −0.35), and depressive motivational symptoms in somatic units (p = 0.008; Cohen's d, −0.40). Depressive mood symptoms were not affected in both unit types. The effect on apathy in dementia units was mainly attributed to activating strategies (p < 0.001; Cohen's d, −0.73). The effect on motivational symptoms in somatic units was mainly attributed to psychotherapy (p = 0.002; Cohen's d, −0.80). Apathy worsening was associated with pharmacological depression treatment in both unit types (p = 0.009; Cohen's d, 0.35).

Depression management may affect apathy and depressive symptoms differently, which underpins the position of apathy as a distinct syndrome. NH professionals can effectively use activating strategies in dementia units, and psychotherapy in somatic units. More research is needed on treating depressive mood symptoms, and on effects of antidepressants in NHs.

To decrease the intake of sucrose, increase the intake of fibre and the consumption of fruit and vegetables among secondary-school pupils.

Intervention study among eighth grade pupils during one school year. Data were collected by questionnaires and from a subgroup of pupils by 48 h dietary recall at baseline in spring 2007 and after the intervention in 2008.

Twelve secondary schools were randomly allocated to intervention (IS) and control schools (CS) within three cities. Intervention included nutrition education and improvement of the food environment focusing particularly on the quality of snacks at school.

A total of 659 pupils completed the questionnaires and the dietary recall was obtained from 287 pupils both at baseline and follow-up.

The frequency of consumption of rye bread increased (P = 0·03) and that of sweets decreased (P = 0·006) among girls in the IS. The intake of sucrose fell among IS pupils, from 12·8 % to 10·5 % of the total energy intake (P = 0·01). Intake of fruit (g/MJ) remained the same in IS, whereas it decreased in CS (P = 0·04).

Sugar intake can be lowered by improving the quality of snacks, but it is more difficult to increase fibre intake and fruit and vegetable consumption unless the content of school lunches can be modified. It is the responsibility of the adults working in schools to create a healthy environment and to make healthy choices easy for pupils.

It has been substantiated that the onset of most major diseases (CVD, diabetes, obesity, cancers, etc.) is modulated by the interaction between genetic traits (susceptibility) and environmental factors, especially diet. We aim to report more specific observations relating the effects of Mediterranean-type diets on cardiovascular risk factors and the genetic background of subjects.

In the first part, general concepts about nutrigenetics are briefly presented. Human genome has, overall, only marginally changed since its origin but it is thought that minor changes (polymorphisms) of common genes that occurred during evolution are now widespread in human populations, and can alter metabolic pathways and response to diets.

In the second part, we report the data obtained during the Medi-RIVAGE intervention study performed in the South-East of France. Data obtained in 169 subjects at moderate cardiovascular risk after a 3-month dietary intervention indicate that some of the twenty-three single nucleotide polymorphisms (SNP) studied exhibit interactions with diets regarding changes of particular parameters after 3-month regimens. Detailed examples are presented, such as interactions between SNP in genes coding for microsomial transfer protein (MTTP) or intestinal fatty acid binding protein (FABP2) and triglyceride, LDL-cholesterol or Framigham score lowering in responses to Mediterranean-type diets.

The data provided add further evidence of the interaction between particular SNP and metabolic responses to diets. Finally, improvement in dietary recommendations by taking into account known genetic variability has been discussed.

There is a paucity of randomized controlled trials (RCTs) to evaluate models of palliative care. Although interventions vary, all have faced a variety of methodological challenges including adequate recruitment, missing data, and contamination of the control group. We describe the ENABLE II intervention, methods, and sample baseline characteristics to increase intervention and methodological transparency, and to describe our solutions to selected methodological issues.

Half of the participants recruited from our rural U.S. comprehensive cancer center and affiliated clinics were randomly assigned to a phone-based, nurse-led educational, care coordination palliative care intervention model. Intervention services were provided to half of the participants weekly for the first month and then monthly until death, including bereavement follow-up call to the caregiver. The other half of the participants were assigned to care as usual. Symptoms, quality of life, mood, and functional status were assessed every 3 months until death.

Baseline data of 279 participants were similar to normative samples. Solutions to methodological challenges of recruitment, missing data, and “usual care” control group contamination are described.

It is feasible to overcome many of the methodological challenges to conducting a rigorous palliative care RCT.

To compare the effect of advice to reduce both dietary fat and sugar with advice to reduce fat alone on subsequent dietary intake in Scottish men.

A parallel design intervention study was employed to measure compliance to the two types of dietary advice. Subjects were randomly assigned to Group 1 (advice to reduce fat and non-milk extrinsic (NME) sugar), Group 2 (advice to reduce fat only, ad libitum sugar) or a control Group 0 (no advice). Compliance was assessed by two 4-day food diaries over 6 months.

The study was conducted in the Strathclyde area of Scotland.

Subjects were normal to moderately overweight Scottish men. The men recruited were non-dieting and volunteered for a ‘healthy eating’ study with the aim to improve the ‘healthiness’ of their diet.

Groups 1 and 2 achieved the dietary target for fat, reducing their mean intake to below 35% energy. Group 1 achieved a statistically significant reduction in percentage energy from NME sugar in the short term (6 weeks), decreasing their mean intake from 9.9% to 7.2% energy. This initial decrease appeared to slip back towards baseline levels at 6 months (8.1% energy from NME sugar) and was no longer significantly different from baseline. At 6 months Group 1 reported a significantly lower mean energy intake than at baseline, whereas Group 2 adjusted for an initial decrease in energy intake and by 6 months energy intakes were not significantly different from baseline intakes. Group 2 appeared to compensate for the absolute reduction in dietary fat with a slight increase in total sugars and the maintenance of NME sugar intakes.

Subjects in Group 1 complied with advice to reduce both fat and sugar over 6 weeks but to a lesser extent over 6 months. The 1.8% reduction in percentage energy from NME sugars in Group 1 at 6 months may not have reached significance due to the small sample size. Alternatively it may be that free-living populations find it hard to maintain concurrent reductions in fat and sugar owing to the well-documented inverse relationship between intakes of these macronutrients when expressed as a proportion of energy.