A Regional Socio-Economic Life Cycle Assessment of a Bioeconomy Value Chain

A bioeconomy tackles sustainable development at both the global and regional levels, as it relies on the optimized use of renewable bio-based resources for the provisioning of food, materials, and energy to meet societal demands. The effects of the bioeconomy can be best observed at a regional level, as it supports regional development and affects the social dimension of sustainability. In order to assess the social impacts of wood-based production chains with regional differentiation, the social life cycle assessment framework “RESPONSA” was established in 2018. We present an initial study, in which this method is applied to an exemplary production chain in a case study of laminated veneer lumber produced in central Germany. The results show a relatively better social performance compared to the reference economic sector, reflecting a relatively low rate of female employees as a major social hotspot. Several social opportunities are identified, in terms of health and safety, equal opportunities, and adequate remuneration, for the organization taking part in the value chain. Finally, considering the UN’s Sustainable Development Goals (SDGs) as a global normative framework, a number of additional indicators for RESPONSA, as well as further developments and recommendations regarding its application in other regions and the upcoming social life cycle assessment (S-LCA) guidelines, are identified

CortiLove: A pilot study on hair steroids in the context of being in love and separation

While romantic infatuation and separation influence psychological and physiological functioning, the hypothalamic-pituitary-adrenal axis with its biomarkers cortisol, dehydroepiandrosterone (DHEA), and progesterone central for coping and distress has been scarcely researched in this context. In particular, endocrine hair analyses assumed to be more valid than saliva or blood assessments for studying long-term processes have not yet been conducted in the context of romantic love. Thus, 101 female subjects in phases of infatuation (n = 16), separation (n = 14), long-term relationships (n = 40), and singlehood (n = 31) reported psychological distress and provided 1 cm hair samples for the assessment of long-term integrated cortisol, DHEA, and progesterone over the last month. Separated, infatuated, and single women exhibited higher cortisol levels than those in a long-term relationship (all ps ≤ .031), while self-reported distress was only evident in separated individuals. Further, no group differences for progesterone (p = .602), but higher DHEA levels in the separation (p = .009) and single group (p = .016) compared to the long-term relationship group were detected. This is the first study showing that compared to women in long-term relationships, infatuation, separation, and single groups exhibit higher levels of physiological, but not necessarily self-reported indicators of distress. These findings, albeit on a very small and preliminary sample, are discussed in the context of the stress-buffering effect of relationships, and provide important starting points for bigger, more balanced studies combining multimodal self-report and biological markers in psychological research of romantic love

Living Conditions and the Mental Health and Well-being of Refugees: Evidence from a Large-Scale German Survey

Refugees are at an increased risk of mental health problems and low subjective well-being. Living circumstances in the host country are thought to play a vital role in shaping these health outcomes, which, in turn, are prerequisites for successful integration. Using data from a representative survey of 4325 adult refugees who arrived in Germany between 2013 and 2016, we investigated how different living conditions, especially those subject to integration policies, are associated with psychological distress and life satisfaction using linear regression models. Our findings show that an uncertain legal status, separation from family, and living in refugee housing facilities are related to higher levels of distress and decreased life satisfaction. Being employed, contact to members of the host society, and better host country language skills, by contrast, are related to reduced distress and higher levels of life satisfaction. These associations should inform decision making in a highly contested policy area

Faith-Based Coping Among Arabic-Speaking Refugees Seeking Mental Health Services in Berlin, Germany: An Exploratory Qualitative Study

Background: The benefits of faith-based coping or using religious and spiritual beliefs as a stabilizing force for interpreting stressful or distressing events are largely unexplored among the exodus of Arabic-speaking refugee populations from Muslim-majority countries, particularly those resettled in Europe. The present study aimed to explore the manifestation of faith-based coping strategies among Arabic-speaking refugee adults seeking mental healthcare services in Berlin, Germany and explore how favorable faith-based coping strategies can be optimized from a mental health service-delivery and broader integration perspective. Methods: A total of 17 qualitative interviews were conducted with Arabic-speaking refugee adults (six females, 11 males) seeking mental health services at the Charite Universitaetsmedizin in Berlin. Research questions aimed to solicit comprehensive perspectives from refugee adults on their mental health, with an emphasis on faith-based coping, and how this facilitated or impeded their integration into German society. Interview transcripts were translated to English from Arabic and analyzed using MAXQDA (2018) to highlight thematic patterns using a grounded theory approach. Results: Findings were structured into four themes, including: (I) faith-based coping methods during flight, (II) changes in faith practices upon arrival, (III) faith-based coping methods to address distress during integration, and (IV) advice for German mental healthcare providers. Participants who demonstrated a stronger commitment to faith were more likely to utilize faith-based coping strategies when seeking mental health services and facing the challenges of displacement and integration. Examples of faith-based coping included prayer, supplication, reciting scripture, and seeking help from a local religious leader. Conclusion: The findings suggest how faith and faith practices play a significant role in the mental health and integration of refugee populations in Germany and provide insight on how mental healthcare can be delivered in a culturally-sensitive manner, providing alternatives to the social, cultural, and linguistic barriers posed by the German health system. These findings are particularly relevant for mental health professionals, non-governmental organizations, and humanitarian aid agencies providing mental healthcare to Arabic-speaking populations recently resettled in Western contexts

A qualitative study on resilience in adult refugees in Germany

Background: Because refugees face significant adversities before, during, and after resettlement, resilience is of central importance to this population. However, strengths-based research on post-migration refugee experiences is sparse. Methods: We conducted semi-structured interviews with 54 adult refugee participants who arrived in Germany between 2013 and 2018 in their preferred language. We analyzed different aspects of resilience in these interviews using thematic analysis. Results: Nine themes were identified. Four themes manifest resilience in different ways and encompass cognitive as well as behavioral strategies for facing adversity, self-ascriptions of resilience as a personal trait or lasting characteristic, and the role of volunteering, work, and activism for refugee causes. Five themes capture factors that facilitate resilience: social support, experiencing migration as an opportunity generally and for women in particular, being a parent, and being young. Conclusions: This study adds to a growing body of knowledge about resilience among adult refugees. It may support clinicians working with refugees by making them aware of specific manifestations of resilience and factors promoting positive adaptation specific to this client group. It also contributes to a more strengths-based view on refugee mental health and processes of integration

Hochfrequente Mental Health Surveillance

Im Rahmen der Mental Health Surveillance (MHS) am Robert Koch-Institut (RKI) werden für eine Auswahl an Indikatoren der psychischen Gesundheit von Erwachsenen basierend auf Surveydaten Zeitreihen bestehend aus gleitenden Drei-Monats-Schätzern und Glättungskurven berechnet. Dadurch sollen Entwicklungen in der psychischen Gesundheit der erwachsenen Bevölkerung in Deutschland mit möglichst geringem Zeitverzug beobachtet und insbesondere negative Entwicklungen frühzeitig erkannt werden. Diese hochfrequente Surveillance wurde ursprünglich vor dem Hintergrund neuer Informationsbedarfe zur Entwicklung der psychischen Gesundheit der Bevölkerung in der COVID-19-Pandemie entwickelt

Development of a prototype for high-frequency mental health surveillance in Germany: data infrastructure and statistical methods

In the course of the COVID-19 pandemic and the implementation of associated non-pharmaceutical containment measures, the need for continuous monitoring of the mental health of populations became apparent. When the pandemic hit Germany, a nationwide Mental Health Surveillance (MHS) was in conceptual development at Germany’s governmental public health institute, the Robert Koch Institute. To meet the need for high-frequency reporting on population mental health we developed a prototype that provides monthly estimates of several mental health indicators with smoothing splines. We used data from the telephone surveys German Health Update (GEDA) and COVID-19 vaccination rate monitoring in Germany (COVIMO). This paper provides a description of the highly automated data pipeline that produces time series data for graphical representations, including details on data collection, data preparation, calculation of estimates, and output creation. Furthermore, statistical methods used in the weighting algorithm, model estimations for moving three-month predictions as well as smoothing techniques are described and discussed. Generalized additive modelling with smoothing splines best meets the desired criteria with regard to identifying general time trends. We show that the prototype is suitable for a population-based high-frequency mental health surveillance that is fast, flexible, and able to identify variation in the data over time. The automated and standardized data pipeline can also easily be applied to other health topics or other surveys and survey types. It is highly suitable as a data processing tool for the efficient continuous health surveillance required in fast-moving times of crisis such as the Covid-19 pandemic

How to deal with non-detectable and outlying values in biomarker research: Best practices and recommendations for univariate imputation approaches

Non-detectable (ND) and outlying concentration values (OV) are a common challenge of biomarker investigations. However, best practices on how to aptly deal with the affected cases are still missing. The high methodological heterogeneity in biomarker-oriented research, as for example, in the field of psychoneuroendocrinology, and the statistical bias in some of the applied methods may compromise the robustness, comparability, and generalizability of research findings. In this paper, we describe the occurrence of ND and OV in terms of a model that considers them as censored data, for instance due to measurement error cutoffs. We then present common univariate approaches in handling ND and OV by highlighting their respective strengths and drawbacks. In a simulation study with lognormal distributed data, we compare the performance of six selected methods, ranging from simple and commonly used to more sophisticated imputation procedures, in four scenarios with varying patterns of censored values as well as for a broad range of cutoffs. Especially deletion, but also fixed-value imputations bear a high risk of biased and pseudo-precise parameter estimates. We also introduce censored regressions as a more sophisticated option for a direct modeling of the censored data. Our analyses demonstrate the impact of ND and OV handling methods on the results of biomarker-oriented research, supporting the need for transparent reporting and the implementation of best practices. In our simulations, the use of imputed data from the censored intervals of a fitted lognormal distribution shows preferable properties regarding our established criteria. We provide the algorithm for this favored routine for a direct application in R on the Open Science Framework (https://osf.io/spgtv). Further research is needed to evaluate the performance of the algorithm in various contexts, for example when the underlying assumptions do not hold. We conclude with recommendations and potential further improvements for the field

Mental Health and Integration: A Qualitative Study on the Struggles of Recently Arrived Refugees in Germany

Introduction: Forcibly displaced people are at particular risk of mental health problems and also face specific integration challenges upon resettlement. Existing literature suggests that there may be a bidirectional relationship between mental health and integration. The present study seeks to understand the relationship between integration processes and mental health problems or significant negative emotional experiences among adult refugees in Germany. Method: Applying a qualitative approach, we conducted 54 semi-structured interviews with refugees and asylum seekers who arrived in Germany between 2013 and 2018 currently residing in Berlin, Leipzig, or the Duisburg area in North Rhine-Westphalia. Data was collected between December 2018 and September 2019. We analyzed transcripts inductively using thematic analysis. Results: Five themes covering the various links between integration and mental health problems or significant negative emotional experiences were identified. First, we found that the mental health consequences of past adverse experiences, as well as ongoing worries about those left behind in the homeland, can seriously impede refugees' ability to pursue activities key to integration. Second, the process of applying for and securing asylum can result in uncertainty and fear, which, in turn, burden the individual and may impact motivation for integration. Third, many of our participants described mental health ramifications related to feeling stuck and thwarted in the pursuit of building a life, especially in securing employment. Fourth, some participants described feeling so overwhelmed by fundamental tasks throughout the integration process, namely, language learning and bureaucratic processes, that these take a psychological toll. Fifth, we identified several forms of social disconnection between refugees and members of the host community due to xenophobia, social and cultural differences, physical and emotional isolation in refugee camps, as well as with co-nationals and fellow refugees. Negative emotions, mistrust, and socio-cultural differences that emerge throughout the integration processes seem to erode social cohesion among refugee communities, potentially further threatening mental health. Conclusion: Mental health problems and integration processes appear to be closely related across different areas of integration. Innovative solutions to challenges identified by members of the refugee community in Germany stand to benefit mental health and integration outcomes simultaneously

The role of an advanced practice midwife in perinatal mental health: Outlining the process of role development and implementation

INTRODUCTION Perinatal mental health disorders (PMDs) are a global health concern. In industrialized countries, the prevalence of PMDs is estimated to be 20%, and they are associated with serious negative effects for women, their children and their families, along with high societal costs related to long-term impacts. In Switzerland, the PMD detection rate during obstetrical healthcare provision is very low (1–3%), and specialized healthcare services are limited. This study aimed to develop and implement an advanced practice midwife (APM) role at a Swiss obstetrics and gynecology hospital using the PEPPA framework to provide adequate screening and first-consultation services. METHODS The study uses a qualitative approach and follows the research stages using the 8-step from the participatory, evidence-based, patient-focused process for advanced practice nursing role development, implementation and evaluation (PEPPA) framework to develop and implement the APM role. RESULTS Utilizing the PEPPA framework, we were able to develop, implement, and evaluate the APM role in the field of perinatal mental health. Through appropriate screening and first-consultation services, we were able to identify affected women early and facilitate treatment. CONCLUSIONS In addition to stakeholder engagement and interprofessional collaboration, PEPPA serves as a beneficial framework for the process of role development, implementation, and evaluation in the midwifery profession. This study aims to assist midwives with Master's degrees in establishing corresponding roles within their practice areas, thereby enhancing care delivery. Furthermore, the current APM approach is intended to be continuously evaluated to gain new insights into its effectiveness