Suchergebnisse

Der Beitrag geht der aktuellen Frage nach, ob die Gleichwertigkeit der Lebensverhältnisse im Bundesgebiet nur ein selbstgestecktes politisches Ziel oder der Bund bereits von Verfassungs wegen zur Gewährleistung jener Gleichwertigkeit der Lebensverhältnisse verpflichtet ist. Hierzu sind zunächst die Aussagen des Grundgesetzes mit Blick auf die Lebensverhältnisse im Bundesgebiet Untersuchungsgegenstand. Sodann unternimmt die Abhandlung den Versuch, jenes Verfassungsgebot aus dem Bundesstaatsprinzip unter Berücksichtigung bundesstaatstheoretischer und rechtsvergleichender Überlegungen abzuleiten. Der Bundesstaat ist eine Symbiose aus Einheit und Vielfalt. Daher können einheitliche Lebensverhältnisse im ganzen Bundesgebiet kein Verfassungsziel sein. Andererseits dürfte aus gesamtstaatlicher Sicht ein Auseinanderfallen der Lebensverhältnisse in den verschiedenen Ländern nur bis zu einem gewissen Grad verkraftbar sein. Der Beitrag kommt daher zu dem Schluss, dass die genannten Gegensätze der Bundesstaatlichkeit in Bezug auf die Lebensverhältnisse im Bundesgebiet mit der Forderung nach ihrer Gleichwertigkeit zum Ausgleich gebracht werden können. In Fortführung dessen wird abschließend unter Verallgemeinerung finanzverfassungsrechtlicher Überlegungen die Reichweite des Verfassungsgebots und somit die verfassungsrechtliche Pflicht des Bundes zur Gewährleistung gleichwertiger Lebensverhältnisse näher entfaltet.

The Domestic Violence Questionnaire (DVQ) is a measure that captures physical, sexual, economic, and psychological violence perpetrated against women. A team of local academicians and intervention experts evaluated several tools for domestic and gender-based violence, concluding that the DVQ fitted best in the context of evaluating the Living Peace intervention in conflict-affected eastern DRC. The purpose of this validation study was to: (1) validate the factor structure of the Swahili version of the DVQ, (2) to evaluate its convergent and divergent validity, and (3) to examine its internal consistency reliability. The factor structure was evaluated using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) while concurrent validity and internal consistency reliability were evaluated using Pearson correlation and Cronbach's alpha coefficients, respectively. The study participants were women, partners of men that participated in the Living Peace program, a community-based intervention program that works on promoting positive masculinity among men that are perceived to be violent by their community. Data were obtained from two independent purposive samples of 704 participants for EFA and 878 participants for CFA, selected from 60 villages in North and South Kivu, DRC. The results indicated that five and three-factor structures could be meaningfully interpreted in EFA, each with 66% explained variance. For comparative purposes, CFA was conducted on the two newly created factor models and the original factor model. All models reach good fit indexes, with the three-factor model demonstrating the best fit. Its standardized factor loadings ranged from 0.57 to 0.91. The internal consistency was α = .90 for the total scale and ranged from α = .75 to .926 per dimension. Finally, scores of DVQ were negatively correlated with mental well-being ( r = −0.23, p < .001), and positively with depression ( r = .435, p < .001), as hypothesized. The Swahili version of DVQ has excellent psychometric properties and can be applied to evaluate the physical, sexual, economic and psychological violence in victims of domestic violence in humanitarian crisis settings.

Abstract
Background
Forcibly displaced people are at elevated risk of experiencing circumstances that can adversely impact on mental health. Culturally and contextually relevant tools to assess their mental health and psychosocial needs are essential to inform the development of appropriate interventions and investigate the effectiveness of such interventions.

Methods
We conducted two related studies: (1) to translate and contextually adapt the Patient Health Questionnaire (PHQ-9), a measure of depressive symptomatology, along with assessment instruments measuring levels of daily stress (Checklist for Daily & Environmental Stressors; CDES), social capital (Shortened and Adapted Social Capital Assessment Tool; SASCAT) and perceived social support (Multidimensional Scale of Perceived Social Support; MSPSS) for use with Congolese refugees; (2) to conduct pilot testing of the assessment instruments (including cognitive interviewing about participants' views of completing them) and a validation of the adapted PHQ-9 using a 'known group' approach by recruiting Congolese refugees from refugee settings in Rwanda (n = 100) and Uganda (n = 100).

Results
Study 1 resulted in the translation and adaptation of the assessment instruments. No substantive adaptations were made to the SASCAT or MSPSS, while notable linguistic and contextual adaptations were made in both sites to the CDES and the PHQ-9. The cognitive interviewing conducted in Study 2 indicated that the adapted assessment instruments were generally well received by members of the refugee communities. Participants recruited on the basis that local informants adjudged them to have high levels of depressive symptoms had significantly higher PHQ-9 scores (M = 11.02; SD = 5.84) compared to those in the group adjudged to have low levels of depressive symptoms (M = 5.66; SD = 5.04). In both sites, the adapted versions of the PHQ-9 demonstrated concurrent validity via significant positive correlations with levels of daily stressors. Each of the four adapted assessment instruments demonstrated at least adequate levels of internal consistency in both sites.

Conclusions
The adapted versions of the PHQ-9, CDES, SASCAT and MSPSS are appropriate for use amongst Congolese refugees in Rwanda and Uganda. We recommend further application of the approaches used in the current studies for contextually adapting other assessment instruments in humanitarian settings.

AbstractBackgroundRefugees fleeing conflict often experience poor mental health due to experiences in their country of origin, during displacement, and in new host environments. Conditions in refugee camps and settlements, and the wider socio-political and economic context of refugees' lives, create structural conditions that compound the effects of previous adversity. Mental health and psychosocial support services must address the daily stressors and adversities refugees face by being grounded in the lived reality of refugee's lives and addressing issues relevant to them.MethodsWe undertook a rapid qualitative study between March and May 2019 to understand the local prioritisation of problems facing Congolese refugees living in two refugee settings in Uganda and Rwanda. Thirty free list interviews were conducted in each setting, followed by 11 key informant interviews in Uganda and 12 in Rwanda.ResultsResults from all interviews were thematically analysed following a deductive process by the in-country research teams. Free list interview findings highlight priority problems of basic needs such as food, shelter, and healthcare access; alongside contextual social problems including discrimination/inequity and a lack of gender equality. Priority problems relating to mental and psychosocial health explored in key informant interviews include discrimination and inequity; alcohol and substance abuse; and violence and gender-based violence.ConclusionsOur findings strongly resonate with models of mental health and psychosocial wellbeing that emphasise their socially determined and contextually embedded nature. Specifically, findings foreground the structural conditions of refugees' lives such as the physical organisation of camp spaces or refugee policies that are stigmatising through restricting the right to work or pursue education. This structural environment can lead to disruptions in social relationships at the familial and community levels, giving rise to discrimination/inequity and gender-based violence. Therefore, our findings foreground that one consequence of living in situations of pervasive adversity caused by experiences of discrimination, inequity, and violence is poor mental health and psychosocial wellbeing. This understanding reinforces the relevance of feasible and acceptable intervention approaches that aim to strengthening familial and community-level social relationships, building upon existing community resources to promote positive mental health and psychosocial wellbeing among Congolese refugees in these settings.

The 11th Congress of the African Society of Human Genetics (AfSHG) was held from September 16, 2018 to September 21, 2018, in conjunction with the 12th Human Heredity and Health in Africa (H3Africa) Consortium meeting in Kigali, Rwanda. The event was organized by the AfSHG in partnership with the Rwanda Society of Human Genetics and the University of Rwanda. A 2-day workshop on the application of next-generation sequencing technologies for analyzing monogenic disease in African populations was organized as part of the conference (September 22, 2018-September 23, 2018, Kigali, Rwanda). The theme of the conference was "Building skills and resources for genomics, epigenetics and bioinformatics research for Africa."The conference served as a platform to bring together members from country-specific Societies of Human Genetics, including Rwanda, Cameroon, Democratic Republic of Congo, Egypt, Mali, Senegal, and South Africa, and included 435 delegates from 38 countries, including 29 African countries that attended the conference. A major topic of discussion was how to bridge the gap between the emerging knowledge on genomics and Omics in African populations. The importance of understanding the role of genetic variation in disease causation and susceptibility among Africans was a constant theme during the meeting, as was the need to develop research infrastructure and resources to enhance healthcare systems, so that they are not left behind in the genomic revolution. It was concluded that there is a need to inspire more African scientists to train and work as investigators, clinicians, and genetic counselors in the field of human genetics in Africa. Local investments, and South-South and South-North collaboration were identified as the key drivers for the successful implementation of research and development on the continent. ; SCOPUS: ar.j ; info:eu-repo/semantics/published

AbstractMajor knowledge gaps remain concerning the most effective ways to address mental health and psychosocial needs of populations affected by humanitarian crises. The Research for Health in Humanitarian Crisis (R2HC) program aims to strengthen humanitarian health practice and policy through research. As a significant portion of R2HC's research has focused on mental health and psychosocial support interventions, the program has been interested in strengthening a community of practice in this field. Following a meeting between grantees, we set out to provide an overview of the R2HC portfolio, and draw lessons learned. In this paper, we discuss the mental health and psychosocial support-focused research projects funded by R2HC; review the implications of initial findings from this research portfolio; and highlight four remaining knowledge gaps in this field. Between 2014 and 2019, R2HC funded 18 academic-practitioner partnerships focused on mental health and psychosocial support, comprising 38% of the overall portfolio (18 of 48 projects) at a value of approximately 7.2 million GBP. All projects have focused on evaluating the impact of interventions. In line with consensus-based recommendations to consider a wide range of mental health and psychosocial needs in humanitarian settings, research projects have evaluated diverse interventions. Findings so far have both challenged and confirmed widely-held assumptions about the effectiveness of mental health and psychosocial interventions in humanitarian settings. They point to the importance of building effective, sustained, and diverse partnerships between scholars, humanitarian practitioners, and funders, to ensure long-term program improvements and appropriate evidence-informed decision making. Further research needs to fill knowledge gaps regarding how to: scale-up interventions that have been found to be effective (e.g., questions related to integration across sectors, adaptation of interventions across different contexts, and optimal care systems); address neglected mental health conditions and populations (e.g., elderly, people with disabilities, sexual minorities, people with severe, pre-existing mental disorders); build on available local resources and supports (e.g., how to build on traditional, religious healing and community-wide social support practices); and ensure equity, quality, fidelity, and sustainability for interventions in real-world contexts (e.g., answering questions about how interventions from controlled studies can be transferred to more representative humanitarian contexts).