The dynamic nature of refugee children's resilience: a cohort study of Syrian refugees in Lebanon.

AIMS: Children's responses to war and displacement are varied; many struggle, while others appear resilient. However, research into these outcomes disproportionately focuses on cross-sectional data in high-income countries. We aimed to (1) investigate change in resilience across two timepoints in a highly vulnerable sample of Syrian refugee children in Lebanon, and (2) explore predictors of their mental health problems across time. METHODS: In total, 982 Syrian child-caregiver dyads living in refugee settlements in Lebanon completed questionnaires via interview at baseline and follow-up one year later. We categorised children into groups based on their risk for mental health problems across both timepoints (stable high risk/SHR, deteriorating, improving, stable low risk) according to locally validated cut-offs on measures of post-traumatic stress disorder (PTSD), depression and behavioural problems. Analyses of covariance identified how the groups differed on a range of individual and socio-environmental predictors, followed up by cross-lagged panel models (CLPMs) to investigate the directionality of the relationships between significantly related predictors and symptoms. RESULTS: The sample showed a meaningful amount of change in mental health symptoms from baseline to follow-up. Over half (56.3%) of children met SHR criteria and 10.3% deteriorated over time, but almost one-quarter (24.2%) showed meaningful improvement, and 9.2% were consistently at low risk for mental health problems at both timepoints. Several predictors differentiated the groups, particularly social measures. According to CLPMs, maternal acceptance (β = -0.07) predicted child mental health symptoms over time. Self-esteem (β = -0.08), maternal psychological control (β = 0.10), child maltreatment (β = 0.09) and caregiver depression (β = 0.08) predicted child symptoms and vice versa (βse = -0.11, βb = 0.07, βmpc = 0.08, βcm = 0.1, βcd = 0.11). Finally, child symptoms predicted loneliness (β = 0.12), bullying (β = 0.07), perceived social support (β = -0.12), parent-child conflict (β = 0.13), caregiver PTSD (β = 0.07), caregiver anxiety (β = 0.08) and the perceived refugee environment (β = -0.09). CONCLUSIONS: Our results show risk and resilience are dynamic, and the family environment plays a key role in children's response to war and displacement. Conversely, children also have a significant impact on the family environment and caregiver's own mental health. Interventions to promote resilience in refugee children should therefore consider family-wide mechanisms

Associations of Successful Aging With Socioeconomic Position Across the Life-Course: The West of Scotland Twenty-07 Prospective Cohort Study

Objective: The aim of this study is to investigate how socioeconomic position (SEP) is associated with multidimensional measures of successful aging (SA), and how this varies and accumulates across the life-course. Method: Using data from 1,733 Scottish men and women from two cohorts aged around 57 and 76, respectively, we explored associations of SA, based on the Rowe?Kahn model, with 10 measures of SEP measured in childhood and, distally and proximally, in adulthood. Results: Individual SEP associations with SA score were generally consistent across different indicators and life stages: Respondents with the most versus least favorable SEP had two additional positive SA dimensions. There was also a strong association between SA and cumulative SEP based on all 10 measures combined; respondents with the most versus least favorable lifelong SEP had four additional positive SA dimensions. Conclusion: SEP advantages/disadvantages act and accumulate across the life-course, resulting in widening socioeconomic inequalities in SA in later life

The X-ray eclipse of the dwarf nova HT CAS observed by the XMM-Newton satellite: spectral and timing analysis

A cataclysmic variable is a binary system consisting of a white dwarf that accretes material from a secondary object via the Roche-lobe mechanism. In the case of long enough observation, a detailed temporal analysis can be performed, allowing the physical properties of the binary system to be determined. We present an XMM-Newton observation of the dwarf nova HT Cas acquired to resolve the binary system eclipses and constrain the origin of the X-rays observed. We also compare our results with previous ROSAT and ASCA data. After the spectral analysis of the three EPIC camera signals, the observed X-ray light curve was studied with well known techniques and the eclipse contact points obtained. The X-ray spectrum can be described by thermal bremsstrahlung of temperature $kT_1=6.89 \pm 0.23$ keV plus a black-body component (upper limit) with temperature $kT_2=30_{-6}^{+8}$ eV. Neglecting the black-body, the bolometric absorption corrected flux is $F^{\rm{Bol}}=(6.5\pm 0.1)\times10^{-12}$ erg s$^{-1}$ cm$^{-2}$, which, for a distance of HT Cas of 131 pc, corresponds to a bolometric luminosity of $(1.33\pm 0.02)\times10^{31}$ erg s$^{-1}$. The study of the eclipse in the EPIC light curve permits us to constrain the size and location of the X-ray emitting region, which turns out to be close to the white dwarf radius. We measure an X-ray eclipse somewhat smaller (but only at a level of $\simeq 1.5 \sigma$) than the corresponding optical one. If this is the case, we have possibly identified the signature of either high latitude emission or a layer of X-ray emitting material partially obscured by an accretion disk.Comment: Accepted for publication on Astronomy and Astrophysics, 200

Hyper-Accreting Black Holes and Gamma-Ray Bursts

A variety of current models for gamma-ray bursts (GRBs) suggest a common engine - a black hole of several solar masses accreting matter from a disk at a rate 0.01 to 10 solar masses per second. Using a numerical model for relativistic disk accretion, we have studied steady-state accretion at these high rates. Inside a radius ~ 10**8 cm, for accretion rates greater than about 0.01 solar masses per second, a global state of balanced power comes to exist between neutrino losses, chiefly pair capture on nucleons, and dissipation. Energy emitted in neutrinos is less, and in the case of low accretion rates, very much less, than the maximum efficiency factor for black hole accretion (0.057 for no rotation; 0.42 for extreme Kerr rotation) times Mdot c**2. The efficiency for producing a pair fireball along the rotational axis by neutrino annihilation is calculated and found to be highly variable and very sensitive to the accretion rate. For some of the higher accretion rates studied, it can be several per cent or more; for accretion rates less than 0.05 solar masses per second, it is essentially zero. The efficiency of the Blandford-Znajek mechanism in extracting rotational energy from the black hole is also estimated. In light of these results, the viability of various gamma-ray burst models is discussed and the sensitivity of the results to disk viscosity, black hole rotation rate, and black hole mass explored. A diverse range of GRB energies seems unavoidable and neutrino annihilation in hyper-accreting black hole systems can explain bursts up to 10**52 erg. Larger energies may be inferred for beaming systems.Comment: 46 pages, includes 9 figures, LaTeX (uses aaspp4.sty), accepted by The Astrophysical Journal. Additional solutions in Tables and Figs. 4 and 5, minor revisions to text, references adde

Gravitational radiation from precessing accretion disks in gamma-ray bursts

We study the precession of accretion disks in the context of gamma-ray burst inner engines. Our aim is to quantitatively estimate the characteristics of gravitational waves produced by the precession of the transient accretion disk in gamma-ray bursts. We evaluate the possible periods of disk precession caused by the Lense-Thirring effect using an accretion disk model that allows for neutrino cooling. Assuming jet ejection perpendicular to the disk plane and a typical intrinsic time-dependence for the burst, we find gamma-ray light curves that have a temporal microstructure similar to that observed in some reported events. The parameters obtained for the precession are then used to evaluate the production of gravitational waves. We find that the precession of accretion disks of outer radius smaller than $10^8$ cm and accretion rates above 1 solar mass per second could be detected by Advanced LIGO if they occur at distances of less than 100 Mpc. We conclude that the precession of a neutrino-cooled accretion disk in long gamma-ray bursts can be probed by gravitational wave astronomy. Precession of the disks in short gamma-ray events is undetectable with the current technology.Comment: 5 pages, 5 figures, accepted for publication in A&

Efficiency of Electron-Positron Pair Productionby Neutrino Flux from Accretion Disk of a Kerr Black Hole

Dominant processes of neutrino production and neutrino-induced \ep-pair production are examined in the model of a disk hyper-accreting onto a Kerr black hole. The efficiency of plasma production by a neutrino flux from the disk, obtained for the both cases of presence and absence of a magnetic field, is found to be no more than several tenths of percent and, therefore, not enough for the origin of cosmological gamma-ray bursts.Comment: 8 pages, 1 figur

Cohort profile: biological pathways of risk and resilience in Syrian refugee children (BIOPATH)

The BIOPATH cohort was established to explore the interplay of psychosocial and biological factors in the development of resilience and mental health problems in Syrian refugee children. Based in Lebanon, a middle-income country significantly impacted by the refugee crisis, it is the first such cohort of refugees in the Middle East. Families were recruited from informal tented settlements in the Beqaa region using purposive cluster sampling. At baseline (October 2017–January 2018), N = 3188 individuals participated [n = 1594 child–caregiver dyads; child gender, 52.6% female; mean (SD) age = 11.44 (2.44) years, range = 6–19]. Re-participation rate at 1-year follow-up was 62.8%. Individual interviews were conducted with children and primary caregivers and biological samples collected from children. Measures include: (1) children’s well-being and mental health problems (using tools validated against clinical interviews in a subsample of the cohort); (2) psychosocial risk and protective factors at the level of the individual (e.g. coping strategies), family (e.g. parent–child relationship), community (e.g. collective efficacy), and wider context (e.g. services); (3) saliva samples for genetic and epigenetic (methylation) analyses; (4) hair samples to measure cortisol, dehydroepiandrosterone (DHEA) and testosterone. This cohort profile provides details about sampling and recruitment, data collection and measures, demographic data, attrition and potential bias, key findings on resilience and mental health problems in children and strengths and limitations of the cohort. Researchers interested in accessing data should contact Professor Michael Pluess at Queen Mary University of London, UK (e-mail: [email protected]). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00127-022-02228-8

Advection-Dominated Accretion Model of Sagittarius A*: Evidence for a Black Hole at the Galactic Center

Sgr A* at the Galactic Center is a puzzling source. It has a mass M=(2.5+/-0.4) x 10^6 solar masses which makes it an excellent black hole candidate. Observations of stellar winds and other gas flows in its vicinity suggest a mass accretion rate approximately few x 10^{-6} solar masses per year. However, such an accretion rate would imply a luminosity > 10^{40} erg/s if the radiative efficiency is the usual 10 percent, whereas observations indicate a bolometric luminosity <10^{37} erg/s. The spectrum of Sgr A* is unusual, with emission extending over many decades of wavelength. We present a model of Sgr A* which is based on a two-temperature optically-thin advection-dominated accretion flow. The model is consistent with the estimated mass and accretion rate, and fits the observed fluxes in the cm/mm and X-ray bands as well as upper limits in the sub-mm and infrared bands; the fit is less good in the radio below 86 GHz and in gamma-rays above 100 MeV. The very low luminosity of Sgr A* is explained naturally in the model by means of advection. Most of the viscously dissipated energy is advected into the central mass by the accreting gas, and therefore the radiative efficiency is extremely low, approximately 5 x 10^{-6}. A critical element of the model is the presence of an event horizon at the center which swallows the advected energy. The success of the model could thus be viewed as confirmation that Sgr A* is a black hole.Comment: 41 pages (Latex) including 6 Figures and 2 Tables. Final Revised Version changes to text, tables and figures. ApJ, 492, in pres

Using item response theory to explore the psychometric properties of extended matching questions examination in undergraduate medical education

BACKGROUND: As assessment has been shown to direct learning, it is critical that the examinations developed to test clinical competence in medical undergraduates are valid and reliable. The use of extended matching questions (EMQ) has been advocated to overcome some of the criticisms of using multiple-choice questions to test factual and applied knowledge. METHODS: We analysed the results from the Extended Matching Questions Examination taken by 4th year undergraduate medical students in the academic year 2001 to 2002. Rasch analysis was used to examine whether the set of questions used in the examination mapped on to a unidimensional scale, the degree of difficulty of questions within and between the various medical and surgical specialties and the pattern of responses within individual questions to assess the impact of the distractor options. RESULTS: Analysis of a subset of items and of the full examination demonstrated internal construct validity and the absence of bias on the majority of questions. Three main patterns of response selection were identified. CONCLUSION: Modern psychometric methods based upon the work of Rasch provide a useful approach to the calibration and analysis of EMQ undergraduate medical assessments. The approach allows for a formal test of the unidimensionality of the questions and thus the validity of the summed score. Given the metric calibration which follows fit to the model, it also allows for the establishment of items banks to facilitate continuity and equity in exam standards