Health Care Services Utilization and Health-Related Quality of Life of Syrian Refugees with Post-Traumatic Stress Symptoms in Germany (the Sanadak Trial)

Refugees who have fled from the ongoing civil war in Syria that arrived in Germany often develop post-traumatic stress symptoms (PTSS). The aim of this study was to determine health care services utilization (HCSU), health care costs and health-related quality of life (HrQoL) of Syrian refugees with mild to moderate PTSS without current treatment in Germany. The study was based on the baseline sample of a randomized controlled trial of a self-help app for Syrian refugees with PTSS (n = 133). HCSU and HrQoL based on the EQ-5D-5L and its visual analogue scale (EQ-VAS) were assessed with standardized interviews. Annual health care costs were calculated using extrapolated four-month HCSU and standardized unit costs. Associations between health care costs, HrQoL and PTSS severity were examined using generalized linear models. Overall, 85.0% of the sample utilized health care services within four months. The mean total annual health care costs were EUR 1920 per person. PTSS severity was not associated with health care costs. The EQ-5D-5L index score and the EQ-VAS score was 0.82 and 73.6, respectively. For Syrian refugees with higher PTSS severity, the EQ-5D-5L index score was lower (−0.17; p < 0.001). The HCSU and the resulting health care costs of Syrian refugees with mild to moderate PTSS without current treatment are low and those with a higher PTSS severity had a lower HrQoL

Recruitment and Baseline Characteristics of Participants in the “Sanadak” Trial: A Self-Help App for Syrian Refugees with Post-traumatic Stress

Many Syrian refugees residing in Germany have been exposed to traumatizing events, while treatment options are scarce. Therefore, the self-help app “Sanadak” was developed to target post-traumatic stress in Syrian refugees. We aimed to inspect the recruitment and baseline characteristics of the participants in the trial, which is conducted to evaluate the app. Analyses were based on the recruitment sample (n = 170) and the trial sample (n = 133). Data were collected during structured face-to-face interviews in the Arabic language. Targeted outcomes included post-traumatic stress (primary; Post-traumatic Diagnostic Scale for DSM-5/PDS-5) and depressive symptoms, anxiety, resilience, among others (secondary). Recruited individuals were M = 32.8 (SD = 11.2, range = 18–65) years old; 38.8% were women. The average PDS-5 score was 23.6 (SD = 13.2) regarding trauma exposure, which was most frequently related to experiencing military- or combat-related events (32.9%). Moreover, 46.5% had major depression and 51.8% showed low resilience. Anxiety was present in 40.6% of the trial participants. Psychological distress was high in Syrian refugees residing in Germany, enrolled in a trial targeting post-traumatic stress. This underlines the need for intervention. Our results provide important figures on the mental health of a not well-studied population group in Germany

Alterations in rhythmic and non-rhythmic resting-state EEG activity and their link to cognition in older age

While many structural and biochemical changes in the brain have been previously associated with aging, the findings concerning electrophysiological signatures, reflecting functional properties of neuronal networks, remain rather controversial. To try resolve this issue, we took advantage of a large population study (N=1703) and comprehensively investigated the association of multiple EEG biomarkers (power of alpha and theta oscillations, individual alpha peak frequency (IAF), the slope of 1/f power spectral decay), aging, and aging and cognitive performance. Cognitive performance was captured with three factors representing processing speed, episodic memory, and interference resolution. Our results show that not only did IAF decline with age but it was also associated with interference resolution over multiple cortical areas. To a weaker extent, 1/f slope of the PSD showed age-related reductions, mostly in frontal brain regions. Finally, alpha power was negatively associated with the speed of processing in the right frontal lobe, despite the absence of age-related alterations. Our results thus demonstrate that multiple electrophysiological features, as well as their interplay, should be considered when investigating the association between age, neuronal activity, and cognitive performance

The (In)Visibility of Gender in Scandinavian Climate Policy-Making

© 2014 Taylor &amp; Francis. This article explores the link between gender representation and climate policy-making in Scandinavia. We ask to what extent equal descriptive representation (critical mass) results in substantive representation (critical acts). Our study shows that women and men are equally represented in administrative and political units involved in climate policy-making, and in some units women are in the majority. However, a text analysis of the outcomes, that is, the Scandinavian climate strategies, reveals a silence regarding gender, further confirmed through interviews. Accordingly, a critical mass of women does not automatically result in gender-sensitive climate policy-making, recognizing established gender differences in material conditions and in attitudes toward climate issues. In interviews, we also note that policy-makers are largely unaware of gender differences on climate issues in the Scandinavian context. We discuss why a critical mass of women in climate policy-making has not led to critical acts and offer alternative explanations informed by feminist IR theory. For example, poststructural feminism claims that masculine norms are deeply institutionalized in climate institutions; hence, policy-makers adapt their actions to the masculinized institutional environment. Thus, substantive representation should be understood in relation to gendered institutional processes

Zur Analyse hydroakustisch erregter Strukturschwingungen auf FE-BE-Basis

The prediction of excitation, reflection and radiation behaviour of complex structures immersed in incompressible/compressible, non-viscous fluid represents a theoretical and numerical demanding task due to fluid-structure interaction. The paper presented is addressed to a method based on the mathematical model of a boundary value problem of the Laplace/Helmholtz Equation and the added&nbsp; matrix concept. A combined FE-BE-procedure utilizing a direct boundary integral formulation of the potential fluid problem in interior/exterior domains is employed. The discretization in fluid domain is realized by boundary element collocation method using conventional as well as semi-infinite boundary element formulations. The solution of this partial problem is represented by frequency depended added mass and damping matrix being added to the equations of motion of the structure. Multi-body systems are considered explicitly. The convergence and the influence of frequency and structural impedance in hydro-acoustic range are demonstrated by numerical examples dealing with practical relevant excitation problems