Improving primary healthcare access for asylum seekers and refugees: a qualitative study from a swiss family physician perspective

Since 2015 the need for evidence-based guidance in primary health care management of refugees, asylum seekers, and immigrants has dramatically increased. The aims of this study were to identify the challenges met by primary care physicians in Switzerland, by performing semi-structured interviews and to identify possible approaches and interventions. Between January 2019 and January 2020, 20 GPs in 3 Swiss cantons were interviewed. The interviews were transcribed, coded with MAXQDA 18, and analyzed using the framework methodology. Following relevant findings were highlighted; (i) problems relating to health insurance companies among (health-insured) asylum seekers and refugees were negligible; (ii) there is a high acceptance for vaccination by refugees, asylum seekers, and immigrants; (iii) limitations in time for consultations and adequate reimbursement for practitioners pose a serious challenge; (iv) the majority of consultations are complaint-oriented, preventive consultations are rare; and (v) the language barrier is a major challenge for psychosocial consultations, whereas this appears less relevant for somatic complaints. The following issues were identified as high priority needs by the study participants; (i) increased networking between GPs, that is, establishing bridging services with asylum centers, (ii) improved training opportunities for GPs in Migration Medicine with regular updates of current guidelines, and (iii) a standardisation of health documentation facilitating exchange of medical data, that is, digital/paper-based "health booklet" or "health pass.

Networking to death: On the dark side of start-ups’ external networking

Purpose – Many start-ups do not survive the first few years of business. Previous studies suggest that networks play a role in start-ups’ success, but this positive effect has limits. The purpose of this paper is to answer the call for a better understanding of the dark side of networks and the variables that condition variables’ effect on the likelihood of start-ups’ survival. Design/methodology/approach –Alongitudinal research design includes 139 start-ups (102 from Germany and 37 from Portugal) and a total of 252 participants. A generalized linear mixed model (GLMM)was applied to estimate all the coefficients, to test the mediation (H1), the moderation (H2) and the moderated mediation (H3) while considering the economic situation of the start-up (sales growth), start-ups’ networking behavior, creativity orientation and ultimately the likelihood of survival. Findings – Based on an empirical study from two different countries, the results show that effective networking is contingent on the start-up’s economic situation and creative potential. Specifically, the results point to situations in which early sales growth may lead to external networking, which, in contexts of low creativity-oriented start-ups, can compromise the start-ups’ success. Originality/value – Based on the findings, the authors compare scenarios in which networking increases the chances for start-up survival with situations where networking can have adverse effects. This study highlights the importance of considering specific start-up parameters, such as start-ups’ economic situation and level of creativity orientation, in the business venturing literature.info:eu-repo/semantics/publishedVersio

Stochastic analysis of surface roughness

For the characterization of surface height profiles we present a new stochastic approach which is based on the theory of Markov processes. With this analysis we achieve a characterization of the complexity of the surface roughness by means of a Fokker-Planck or Langevin equation, providing the complete stochastic information of multiscale joint probabilities. The method was applied to different road surface profiles which were measured with high resolution. Evidence of Markov properties is shown. Estimations for the parameters of the Fokker-Planck equation are based on pure, parameter free data analysis

Mental health and resilience among Eritrean refugees at arrival and one-year post-registration in Switzerland: a cohort study

OBJECTIVE: Eritrea is the most frequent country of origin among asylum seekers in Switzerland. On their journey through the desert and across the Mediterranean Sea, Eritrea refugees are often exposed to traumatizing experiences. The aim of this study is to assess the mental health status and resilience of Eritrean migrants in Switzerland upon arrival and one-year post-arrival, using standardized mental health screening and resilience assessment tools. RESULTS: At baseline, 107 refugees (11.2% female, median age 25) were interviewed: 52 (48.6%) screened positive for Post-Traumatic Stress Disorder (score ≥ 30), 10.3% for anxiety (≥ 10) and 15.0% for depression (≥ 10); 17.8% scored as risk/hazardous drinkers (≥ 8). The majority (94.4%) had a high resilience score (≥ 65). For one-year follow-up, 48 asylum seekers could be reached. In interviews 18 (38%) of these reported imprisonment in a transit country and 28 (58%) that they had witnessed the death of a close person along the migration route. At the one year assessment, rates of risky/hazardous alcohol use remained unchanged, rates of positive PTSD screening tended to be lower (50.0% (24/48) at baseline vs 25.0% (12/48) at follow-up), as were rates of positive screening for anxiety (8.3% vs 4.2%) and depression (14.6 vs 6.3%)

Nucleon-deuteron elastic scattering as a tool to probe properties of three-nucleon forces

Faddeev equations for elastic Nd scattering have been solved using modern NN forces combined with the Tucson-Melbourne two-pion exchange three-nucleon force, with a modification thereof closer to chiral symmetry and the Urbana IX three-nucleon force. Theoretical predictions for the differential cross section and several spin observables using NN forces only and NN forces combined with three-nucleon force models are compared to each other and to the existing data. A wide range of energies from 3 to 200 MeV is covered. Especially at the higher energies striking three-nucleon force effects are found, some of which are supported by the still rare set of data, some are in conflict with data and thus very likely point to defects in those three-nucleon force models.Comment: 30 pages, 14 Postscript figures; now minor changes in figures and reference

Three-Nucleon Force Effects in Nucleon Induced Deuteron Breakup: Predictions of Current Models (I)

An extensive study of three-nucleon force effects in the entire phase space of the nucleon-deuteron breakup process, for energies from above the deuteron breakup threshold up to 200 MeV, has been performed. 3N Faddeev equations have been solved rigorously using the modern high precision nucleon-nucleon potentials AV18, CD Bonn, Nijm I, II and Nijm 93, and also adding 3N forces. We compare predictions for cross sections and various polarization observables when NN forces are used alone or when the two pion-exchange Tucson-Melbourne 3NF was combined with each of them. In addition AV18 was combined with the Urbana IX 3NF and CD Bonn with the TM' 3NF, which is a modified version of the TM 3NF, more consistent with chiral symmetry. Large but generally model dependent 3NF effects have been found in certain breakup configurations, especially at the higher energies, both for cross sections and spin observables. These results demonstrate the usefulness of the kinematically complete breakup reaction in testing the proper structure of 3N forces.Comment: 42 pages, 20 ps figures, 2 gif figure

Visualizing brain inflammation with a shingled-leg radio-frequency head probe for (19)F/(1)H MRI

Magnetic resonance imaging (MRI) provides the opportunity of tracking cells in vivo. Major challenges in dissecting cells from the recipient tissue and signal sensitivity constraints albeit exist. In this study, we aimed to tackle these limitations in order to study inflammation in autoimmune encephalomyelitis. We constructed a very small dual-tunable radio frequency (RF) birdcage probe tailored for (19)F (fluorine) and (1)H (proton) MR mouse neuroimaging. The novel design eliminated the need for extra electrical components on the probe structure and afforded a uniform -field as well as good SNR. We employed fluorescently-tagged (19)F nanoparticles and could study the dynamics of inflammatory cells between CNS and lymphatic system during development of encephalomyelitis, even within regions of the brain that are otherwise not easily visualized by conventional probes. (19)F/(1)H MR Neuroimaging will allow us to study the nature of immune cell infiltration during brain inflammation over an extensive period of time