From formative research to cultural adaptation of a face-to-face and internet-based cognitive-behavioural intervention for Arabic-speaking refugees in Germany

<sec xmlns="http://www.ncbi.nlm.nih.gov/JATS1"> <title>Background</title> <p>This study aims to provide a transparent and replicable documentation approach for the cultural adaptation of a cognitive-behavioural transdiagnostic intervention (Common Elements Treatment Approach, CETA) for Arabic-speaking refugees with common mental disorders in Germany.</p> </sec> <sec xmlns="http://www.ncbi.nlm.nih.gov/JATS1"> <title>Method</title> <p>A mixed-methods approach was used, including literature review, interviews, expert decisions and questionnaires, in order to adapt the original CETA as well as an internet-based guided version (eCETA). The process of cultural adaptation was based on a conceptual framework and was facilitated by an adaptation monitoring form as well as guidelines which facilitate the reporting of cultural adaptation in psychological trials (RECAPT).</p> </sec> <sec xmlns="http://www.ncbi.nlm.nih.gov/JATS1"> <title>Results</title> <p>Consistent with this form and the guidelines, the decision-making process of adaptation proved to be coherent and stringent. All specific CETA treatment components seem to be suitable for the treatment of Arabic-speaking refugees in Germany. Adaptations were made to three different elements: 1) Cultural concepts of distress: a culturally appropriate explanatory model of symptoms was added; socially accepted terms for expressing symptoms (for eCETA only) and assessing suicidal ideation were adapted; 2) Treatment components: no adaptations for theoretically/empirically based components of the intervention, two adaptations for elements used by the therapist to engage the patient or implement the intervention (nonspecific elements), seven adaptations for skills implemented during sessions (therapeutic techniques; two for eCETA only) and 3) Treatment delivery: 21 surface adaptations (10 for eCETA only), two eCETA-only adaptations regarding the format.</p> </sec> <sec xmlns="http://www.ncbi.nlm.nih.gov/JATS1"> <title>Conclusion</title> <p>The conceptual framework and the RECAPT guidelines simplify, standardise and clarify the cultural adaptation process.</p> </sec&gt

Precise somatotopic thalamocortical axon guidance depends on LPA-mediated PRG-2/radixin signaling

Precise connection of thalamic barreloids with their corresponding cortical barrels is critical for processing of vibrissal sensory information. Here, we show that PRG-2, a phospholipid-interacting molecule, is important for thalamocortical axon guidance. Developing thalamocortical fibers both in PRG-2 full knockout (KO) and in thalamus-specific KO mice prematurely entered the cortical plate, eventually innervating non-corresponding barrels. This misrouting relied on lost axonal sensitivity toward lysophosphatidic acid (LPA), which failed to repel PRG-2-deficient thalamocortical fibers. PRG-2 electroporation in the PRG-2(-/-) thalamus restored the aberrant cortical innervation. We identified radixin as a PRG-2 interaction partner and showed that radixin accumulation in growth cones and its LPA-dependent phosphorylation depend on its binding to specific regions within the C-terminal region of PRG-2. In vivo recordings and whisker-specific behavioral tests demonstrated sensory discrimination deficits in PRG-2(-/-) animals. Our data show that bioactive phospholipids and PRG-2 are critical for guiding thalamic axons to their proper cortical targets

Health systems responsiveness to the mental health needs of forcibly displaced persons

In this chapter, we discuss health system responsiveness to the mental health needs of forcibly displaced persons. First, we discuss health system responsiveness as key health system characteristic, and introduce a conceptual framework guiding its assessment. We then present the use of a rapid appraisal methodology upon which the conceptual framework is based. Finally, we present findings of a case-study on mental health care among Syrian refugees residing in the Netherlands employing this methodology