Sedentary behaviour (SB) has emerged as a potential risk factor for metabolic health in youth. Knowledge on the determinants of SB in youth is necessary to inform future intervention development to reduce SB. A systematic review was conducted to identify predictors and determinants of SB in youth. Pubmed, Embase, CINAHL, PsycINFO and Web of Science were searched, limiting to articles in English, published between January 2000 and May 2014. The search strategy was based on four key elements and their synonyms: (a) sedentary behaviour, (b) determinants, (c) types of sedentary behaviours, (d) types of determinants. The full protocol is available from PROSPERO (PROSPERO 2014:CRD42014009823). Cross-sectional studies were excluded. The analysis was guided by the socio-ecological model. 37 studies were selected out of 2654 identified papers from the systematic literature search. Most studies were conducted in Europe (n = 13), USA (n = 11), and Australia (n = 10). The study quality, using the Qualsyst tool, was high with a median of 82 % (IQR: 74–91 %). Multiple potential determinants were studied in only one or two studies. Determinants were found at the individual, interpersonal, environmental and policy level but few studies examined a comprehensive set of factors at different levels of influences. Evidence was found for age being positively associated with total SB, and weight status and baseline assessment of screen time being positively associated with screen time (at follow-up). A higher playground density and a higher availability of play and sports equipment at school were consistently related to an increased total SB, although these consistent findings come from single studies. Evidence was also reported for the presence of safe places to cross roads and lengthening morning and lunch breaks being associated with less total SB. Future interventions to decrease SB levels should especially target children with overweight or obesity and should start at a young age. However, since the relationship of many determinants with SB remains inconsistent, there is still a need for more longitudinal research on determinants of SB in youth.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-015-0291-4) contains supplementary material, which is available to authorized users.

BackgroundSince 2009 some German health insurance companies have implemented integrated mental health care services along the principles of assertive community treatment in collaboration with local mental health service providers across Germany. Focus of this study is the analysis of effectiveness and cost-effectiveness of this integrated care programme compared to care as usual in routine care surroundings in five regions in Germany.MethodsIn this 18-month multi-centre observational trial 250 patients enrolled in an integrated mental health care programme and 250 patients who receive treatment as usual from five catchment areas will be included. In addition, in each group about 125 relatives of the participating patients will be included. The primary outcome criterion is the improvement of empowerment; secondary outcomes are subjective quality of life, functional impairment and costs of illness. Data will be collected at baseline and three follow-ups after 6, 12 and 18 months. Data will be analysed by means of mixed effects regression models. Propensity score methods are used for selection bias control.DiscussionStudy results are expected to provide information about how integrated care programmes in their present form contribute to the improvement of mental health care. In addition, the study will provide hints to weaknesses of the current integrated care programme and options to overcome them. The major strengths of this study are the real-world character of the study intervention with a simultaneous high level of academic rigour. However, the fact that patients are not randomised to study groups and that there is no blinding might limit the study.Trial registrationGerman Clinical Trial Register DRKS00005111.

The results argue for the validity of the BPS in identifying subsyndromes of schizophrenia spectrum disorders according to a dimensional approach. Future research should address the longitudinal assessment of dimensional psychopathological symptoms and elucidate the underlying neurobiological processes.

Evaluating innovative mental health care in GermanyThomas Becker, Annabel Stierlin, Reinhold Kilian, Ulm/Günzburg, GermanyThere is an interest in innovative mental health service models in Germany. This comprises, among others, crisis intervention and home treatment service models and assertive community treatment teams. Innovative funding models are being put to test. There are several catchment areas in the country where care is provided according to a capitation funding model that gives a high degree of freedom to health care providers in what services they use to provide care for patients (Regionale Psychiatriebudgets). Models of this type are also used in so-called model projects on the basis of federal law (Modellvorhaben §64b SGBV). In Hamburg, a comprehensive community- and hospital-based service for people with severe mental illness has been implemented (IV Vertrag) and put to test in the ACCESS trial. The focus of this talk is on an observational controlled trial (IVPower) studying the effectiveness and cost-effectiveness of an integrated community-base care programme (NWpG) implemented in several regions of Germany (in five federal states, Schleswig-Holstein, Northrhine-Westfalia, Berlin, Saxony and Bavaria. The 18-month multi-centre observational trial enrolls 250 patients in the NWpG programme and 250 patients who receive treatment as usual from routine mental health services in five catchment areas. Data are collected at baseline and three follow-ups after 6, 12 and 18 months Preliminary study results will be presented and discussed.