Narrative exposure therapy to treat traumatic stress in middle eastern refugees: a clinical trial

There are millions of refugees and displaced persons around the world. Refugees often experience multiple stressors and traumas across the various stages of their journey such as witnessing political upheaval, loss of property and loved ones, a perilous journey, and difficulty in countries of resettlement. The multiple stressors that refugees experience place them at significant risk for various mental health problems, especially depression and post traumatic stress disorder, as well as physical health problems. Yet, despite the growing number of refugees and their vulnerability to various mental and physical health problems, knowledge about appropriate treatments for PTSD and other conditions among refugees is still growing and at times suffers from methodological problems. One promising treatment developed specifically for survivors of organized violence, such as refugees, is Narrative Exposure Therapy (NET), which combines elements of traditional exposure therapy as well as the construction of detailed life narratives found in testimony therapy. There is growing evidence from various trials that NET is effective in reducing PTSD symptoms to remission, as well as effectively reducing other 126 symptoms such as depression and physical complaints. NET has also demonstrated effectiveness across a variety of cultural groups, resettlement countries and contexts, and severity/chronicity of PTSD symptoms. The goal of this study was to evaluate NET in a sample of Arabic speaking, mostly Iraqi, refugees, who have come to the Metro Detroit area. Fifty three Iraqi refugees who experienced a traumatic incident and reported related distress due to the incident were recruited and randomized into an experimental group that received three sessions of NET or into a wait-list control group. Both groups completed baseline assessments of their trauma symptoms, depression, sleep quality, physical health problems, overall wellbeing, daily functioning, and post traumatic growth. They were re-assessed at 2-month and at 4-month follow-up to report their symptom levels. Results indicate that the group that received NET reported significantly higher levels of post traumatic growth at the 4-month follow-up compared to the control group. The group that received NET also reported small but meaningful trends towards lower depression and PTSD scores and higher levels of psychological wellbeing and frequency of spending time with family and friends at the 2-month follow-up compared to the control group. This study shows that a trauma focused intervention, such as NET, can increase levels of post traumatic growth among trauma survivors. Moreover, the study suggests some promise of NET in treating psychological symptoms in Middle Eastern samples

La Inversión europea en el Consejo de Cooperación del Golfo (CCG)

De hecho, nadie puede negar que la inversión europea en el Consejo de Cooperación del Golfo es una de las cuestiones más importantes. En realidad, vale la pena debatir este tema. Me despierta tanto interés que considero un gran placer escribir sobre él. Este trabajo tiene como objetivo evaluar la evolución de los países del CCG en el aspecto económico como base para alcanzar la plena unión económica. Se pretende analizar, además, el acceso y el fortalecimiento de las relaciones de estos países con la Unión Europea. De la necesidad de examinar los logros alcanzados, los obstáculos, oportunidades y amenazas (DAFO) se plantea un modelo tentativo de relación que incremente las relaciones económicas de todos los países estudiados. Resultados previstos - Contribuir al fortalecimiento de la estabilidad en una región de importancia estratégica y facilitar las relaciones políticas, económicas y comerciales. - Ampliar la cooperación económica y técnica, así como la cooperación en los ámbitos de la energía, el comercio, los servicios, la agricultura, la industria pesquera, la inversión, la ciencia, la tecnología y el medio ambiente

Balancing Supercapacitor Voltages in Modular Bidirectional DC–DC Converter Circuits

At present, passive balancing methods dominate energy storage applications, however, they suffer from a long balancing duration. In this article, we took advantage of a modular architecture, where several modular power converters replace a central dc–dc converter for fast charging and balancing of a supercapacitor stack. A strategy has been proposed to control how power is shared among the converters during the charging period in order to balance the supercapacitors. However, some converters enter control saturation due to voltage differences between supercapacitors caused by their nonuniform conditions and characteristics. The originality of this article lies in taking into account the saturation by modifying an energy-based strategy to correct the power shares and make balancing the supercapacitors possible. Simulation and experimental case studies were used to demonstrate the strategy\u27s performance and limitations

Effects of Anger Awareness and Expression Training versus Relaxation Training on Headaches: A Randomized Trial

Background and purpose: Stress contributes to headaches, and effective interventions for headaches routinely include relaxation training (RT) to directly reduce negative emotions and arousal. Yet, suppressing negative emotions, particularly anger, appears to augment pain, and experimental studies suggest that expressing anger may reduce pain. Therefore, we developed and tested anger awareness and expression training (AAET) on people with headaches. Methods: Young adults with headaches (N = 147) were randomized to AAET, RT, or a wait-list control. We assessed affect during sessions, and process and outcome variables at baseline and 4 weeks after treatment. Results: On process measures, both interventions increased self-efficacy to manage headaches, but only AAET reduced alexithymia and increased emotional processing and assertiveness. Yet, both interventions were equally effective at improving headache outcomes relative to controls. Conclusions: Enhancing anger awareness and expression may improve chronic headaches, although not more than RT. Researchers should study which patients are most likely to benefit from an emotional expression or emotional reduction approach to chronic pain

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Modélisation électrothermique, commande et dimensionnement d’un système de stockage d’énergie par supercondensateurs avec prise en compte de son vieillissement : application à la récupération de l’énergie de freinage d’un trolleybus

The studies presented in this thesis concern the thermal modeling, sizing and control of a stack composed of supercapacitors and DC/DC converter that feeds the auxiliaries or traction motors of the trolleybus in the case of electrical microcuts. In the first part, we were interested in the sizing of the storage system for an application concerning the recovering braking energy of a trolleybus. Direct and inverse models of the kinematic chain were studied in order to define a design strategy based on the Ragon. The second part concerns the reliability of the storage system. The aim is to evaluate the stresses on supercapacitors during cycling and to predict the aging of the components. Toachieve this goal, we have developed and validated an electrothermal model of the stack. This model was then coupled to aging laws allowing taking into account the major parametric variation of the system. The results show the impact of the dispersion of temperatures inside the stack on the life time of each supercapacitors in the storage system. Finally, the control of the static converter (Buck/Boost converter) combined with supercapacitors is analyzed. A theoretical study was conducted to synthesize PI and sliding mode controller applied to a boost converter. This control laws has been validated on a test bench consisting of a reversible converter, a DC power supply, a resistive load and eight supercapacitors. The experimental results show the advantage of sliding mode control in terms of robustness and reactivity compared to a classical PI control.Les travaux présentés dans cette thèse concernent la modélisation, le dimensionnement et la commande d'un coffre composé de supercondensateurs et d'un convertisseur DC/DC permettant d’alimenter les auxiliaires d’un trolleybus ou les moteurs de traction lors des coupures de la ligne aérienne. Dans la première partie, nous nous sommes intéressés au dimensionnement du système destockage pour une application du type récupération de l'énergie au freinage d'un trolleybus. Les modèles directes et inverses de la chaine cinématique ont été étudiés afin de définir une stratégie de dimensionnement du coffre s'appuyant sur le plan de Ragon. La seconde partie aborde la problématique de la fiabilité de l'élément de stockage. Le but est d'évaluer les contraintes que subissent les supercondensateurs en cours de fonctionnement et de prédire le vieillissement de ces derniers. Pour ce faire, nous avons développé et validé un modèle électrothermique du coffre de supercondensateurs. Ce modèle électrothermique a également été couplé à des lois de vieillissement permettant ainsi de prendre en compte les variations paramétriques majeures de ce système. Les résultats de ce couplage montrent l'impact de la dispersion des températures à l'intérieur du coffre sur la durée de vie de chaquesupercondensateur et du système de stockage. Finalement, le contrôle du convertisseur statique (hacheur Buck/Boost) associé auxsupercondensateurs est abordé. Une étude théorique a été menée pour synthétiser des lois de commande par mode de glissement et par PI appliqués au mode élévateur du hacheur (Boost). Ces lois de commande ont été validées sur un banc de test constitué d'un hacheur réversible, d'une alimentation DC, d'une charge résistive et de huit supercondensateurs. La comparaisondes résultats expérimentaux mettre en évidence l'intérêt de la commande par mode glissant enraison de sa robustesse et de sa réactivité par rapport à une commande classique (PI)

Electrothermal modeling, control and sizing of supercacitor’s energy storage system taking into account the ageing : application to the recovery of braking energy of electrical bus

Les travaux présentés dans cette thèse concernent la modélisation, le dimensionnement et la commande d'un coffre composé de supercondensateurs et d'un convertisseur DC/DC permettant d’alimenter les auxiliaires d’un trolleybus ou les moteurs de traction lors des coupures de la ligne aérienne. Dans la première partie, nous nous sommes intéressés au dimensionnement du système destockage pour une application du type récupération de l'énergie au freinage d'un trolleybus. Les modèles directes et inverses de la chaine cinématique ont été étudiés afin de définir une stratégie de dimensionnement du coffre s'appuyant sur le plan de Ragon. La seconde partie aborde la problématique de la fiabilité de l'élément de stockage. Le but est d'évaluer les contraintes que subissent les supercondensateurs en cours de fonctionnement et de prédire le vieillissement de ces derniers. Pour ce faire, nous avons développé et validé un modèle électrothermique du coffre de supercondensateurs. Ce modèle électrothermique a également été couplé à des lois de vieillissement permettant ainsi de prendre en compte les variations paramétriques majeures de ce système. Les résultats de ce couplage montrent l'impact de la dispersion des températures à l'intérieur du coffre sur la durée de vie de chaquesupercondensateur et du système de stockage. Finalement, le contrôle du convertisseur statique (hacheur Buck/Boost) associé auxsupercondensateurs est abordé. Une étude théorique a été menée pour synthétiser des lois de commande par mode de glissement et par PI appliqués au mode élévateur du hacheur (Boost). Ces lois de commande ont été validées sur un banc de test constitué d'un hacheur réversible, d'une alimentation DC, d'une charge résistive et de huit supercondensateurs. La comparaisondes résultats expérimentaux mettre en évidence l'intérêt de la commande par mode glissant enraison de sa robustesse et de sa réactivité par rapport à une commande classique (PI).The studies presented in this thesis concern the thermal modeling, sizing and control of a stack composed of supercapacitors and DC/DC converter that feeds the auxiliaries or traction motors of the trolleybus in the case of electrical microcuts. In the first part, we were interested in the sizing of the storage system for an application concerning the recovering braking energy of a trolleybus. Direct and inverse models of the kinematic chain were studied in order to define a design strategy based on the Ragon. The second part concerns the reliability of the storage system. The aim is to evaluate the stresses on supercapacitors during cycling and to predict the aging of the components. Toachieve this goal, we have developed and validated an electrothermal model of the stack. This model was then coupled to aging laws allowing taking into account the major parametric variation of the system. The results show the impact of the dispersion of temperatures inside the stack on the life time of each supercapacitors in the storage system. Finally, the control of the static converter (Buck/Boost converter) combined with supercapacitors is analyzed. A theoretical study was conducted to synthesize PI and sliding mode controller applied to a boost converter. This control laws has been validated on a test bench consisting of a reversible converter, a DC power supply, a resistive load and eight supercapacitors. The experimental results show the advantage of sliding mode control in terms of robustness and reactivity compared to a classical PI control

Etude de la commande d'un dispositif de stockage d'énergie par supercondensateurs

Texte complet : http://www.jcge2008.ec-lyon.fr/web_JCGE08/papiers/JCGE08_Alaa_HIJAZI.pdfNational audienceLa régulation par mode glissants est surtout reconnue pour ces qualités de robustesse et de réponse dynamique. Cet article rappellera brièvement les principes de la régulation par mode glissants ainsi que l'extension de ceux-ci au réglage d'un banc de supercondensateur en phase de décharge. En se basant sur le choix de la surface de glissement, différentes modes de contrôle sont étudiés. Dans cette optique, on proposera alors un surface de glissement faisant intervenir tous les variables d'état améliorant ainsi les performances du système en terme de robustesse et de réponse dynamique. L'influence des paramètres du contrôleur sur les performances du système est analysé. Un nouveau surface de glissement permettant la limitation du courant dans l'inductance, tout en garantissant les propriétés du modes glissants, est aussi étudié

La Inversión europea en el Consejo de Cooperación del Golfo (CCG)

De hecho, nadie puede negar que la inversión europea en el Consejo de Cooperación del Golfo es una de las cuestiones más importantes. En realidad, vale la pena debatir este tema. Me despierta tanto interés que considero un gran placer escribir sobre él. Este trabajo tiene como objetivo evaluar la evolución de los países del CCG en el aspecto económico como base para alcanzar la plena unión económica. Se pretende analizar, además, el acceso y el fortalecimiento de las relaciones de estos países con la Unión Europea. De la necesidad de examinar los logros alcanzados, los obstáculos, oportunidades y amenazas (DAFO) se plantea un modelo tentativo de relación que incremente las relaciones económicas de todos los países estudiados. Resultados previstos - Contribuir al fortalecimiento de la estabilidad en una región de importancia estratégica y facilitar las relaciones políticas, económicas y comerciales. - Ampliar la cooperación económica y técnica, así como la cooperación en los ámbitos de la energía, el comercio, los servicios, la agricultura, la industria pesquera, la inversión, la ciencia, la tecnología y el medio ambiente

La Inversión europea en el Consejo de Cooperación del Golfo (CCG)

De hecho, nadie puede negar que la inversión europea en el Consejo de Cooperación del Golfo es una de las cuestiones más importantes. En realidad, vale la pena debatir este tema. Me despierta tanto interés que considero un gran placer escribir sobre él. Este trabajo tiene como objetivo evaluar la evolución de los países del CCG en el aspecto económico como base para alcanzar la plena unión económica. Se pretende analizar, además, el acceso y el fortalecimiento de las relaciones de estos países con la Unión Europea. De la necesidad de examinar los logros alcanzados, los obstáculos, oportunidades y amenazas (DAFO) se plantea un modelo tentativo de relación que incremente las relaciones económicas de todos los países estudiados. Resultados previstos - Contribuir al fortalecimiento de la estabilidad en una región de importancia estratégica y facilitar las relaciones políticas, económicas y comerciales. - Ampliar la cooperación económica y técnica, así como la cooperación en los ámbitos de la energía, el comercio, los servicios, la agricultura, la industria pesquera, la inversión, la ciencia, la tecnología y el medio ambiente