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Research on the psychosocial care (PSC) of unaccompanied minor refugees (UMRs) has mainly taken a socioepidemiological approach and has focused on the perspectives of experts in the field. In contrast, the knowledge concerning the differing context factors and the underlying mechanisms of current PSC which could inform policy recommendations is scant. The study aims at unravelling the contexts, mechanisms and outcomes of PSC for UMRs. For a realist review (RR), scientific evidence and gray literature were synthesised consistent with the RAMESES publication standards for realist synthesis. Based on an iterative keyword search in electronic databases (e.g., PubMed) and screening, 34 works from 2005 to 2019 were included in a realist synthesis. Theory-informed context-mechanism-outcome configurations (CMOs) were extracted, to explain underlying processes and mechanisms. Characterised by their interrelatedness, the dominant CMOs included the UMRs' intersections of transitions (e.g., adolescence and migration), their needs for culture-, and gender-sensitive PSC, and the undersupply of PSC. These contexts and outcomes are mediated by pre-, peri- and post-migratory stressors as well as care structures and are moreover influenced by overarching discourses and concepts. They comprise adverse and beneficial mechanisms in the PSC of UMRs. The existing literature grasps the PSC of UMRs by different disciplines and approaches but does not offer a comprehensive overview on micro-macro intersections and included discourses. The inclusion of lay perspectives and an intersectional approach could inform health service research. The reflection of UMR-related categorical constructs of resilience and vulnerability, discourses of othering, as well as restrictive health policies may guide policy recommendations.
Socioeconomic inequalities in primary-care and specialist physician visits: a systematic review
(2021)
Background
Utilization of primary-care and specialist physicians seems to be associated differently with socioeconomic status (SES). This review aims to summarize and compare the evidence on socioeconomic inequalities in consulting primary-care or specialist physicians in the general adult population in high-income countries.
Methods
We carried out a systematic search across the most relevant databases (Web of Science, Medline) and included all studies, published since 2004, reporting associations between SES and utilization of primary-care and/or specialist physicians. In total, 57 studies fulfilled the eligibility criteria.
Results
Many studies found socioeconomic inequalities in physician utilization, but inequalities were more pronounced in visiting specialists than primary-care physicians. The results of the studies varied strongly according to the operationalization of utilization, namely whether a physician was visited (probability) or how often a physician was visited (frequency). For probabilities of visiting primary-care physicians predominantly no association with SES was found, but frequencies of visits were higher in the most disadvantaged. The most disadvantaged often had lower probabilities of visiting specialists, but in many studies no link was found between the number of visits and SES.
Conclusion
This systematic review emphasizes that inequalities to the detriment of the most deprived is primarily a problem in the probability of visiting specialist physicians. Healthcare policy should focus first off on effective access to specialist physicians in order to tackle inequalities in healthcare.
The Health Behaviour in School-aged Children (HBSC) study is an international research project in collaboration with the World Health Organization (WHO) for over 35 years. HBSC is the largest study on child and adolescent health and one of the most important sources of data for the WHO’s international comparative health monitoring. Every four years, data on the health and health behaviour of students aged 11, 13 and 15, as well as the social contexts and conditions for growing up healthy, are collected. A total of 50 countries belong to the HBSC network, with 45 countries taking part in the 2017/18 survey. Germany has contributed to the HBSC surveys since 1993/94. For the most recent 2017/18 cycle, students at 146 schools in Germany were interviewed (response rate of schools: 15.6%). A net sample of n = 4,347 girls and boys was achieved for Germany (response rate: 52.7%). Participation was voluntary and the survey was conducted in German school years five, seven and nine (corresponding to ages 11, 13 and 15). A weighting procedure was applied to allow for representative findings on the health of children and adolescents in Germany. HBSC offers a valuable contribution to health monitoring and provides numerous starting points to identify needs, risk groups and fields of action to initiate targeted and actual needs-based measures of prevention and health promotion in the school setting.
Introduction: Several studies have identified that unaccompanied minor refugees (UMRs) are allegedly ‘vulnerable’ and belong to a high-risk group in terms of psychological distress and post-traumatic stress disorder due to their preflight, periflight and postflight experiences. Psychosocial care (PSC) is of high importance for UMRs, but little is known about barriers to access and utilisation of PSC across place and gender. The aims of this gender-sensitive qualitative study will be to build on the existing body of literature and to provide qualitative evidence on the contexts and mechanisms of PSC for male and female UMRs in Germany by comparing two German regions.
Methods and analysis: Following the study preparing realist review, a qualitative study will be undertaken in Berlin and Central German cities. Approximately 24 experts from the field of PSC and 12 lay UMRs will participate in face-to-face, semistructured interviews. Data will be transcribed and analysed based on the grounded theory research paradigm.
Ethics and dissemination: Only participants who have been informed in both German and their native tongue and who have signed a declaration of consent will be included in the study. The study will comply rigorously with German data protection standards. Approval from the Ethical Review Committee at Martin Luther University Halle-Wittenberg, Germany has been obtained and granted. The results of the study will be presented at several conferences and will be published in high-quality, peer-reviewed international journals. The results will display a differentiated picture of the PSC of UMRs in Germany. Such knowledge is a precondition for a ‘science of change’ that translates explanations into practical recommendations on how to improve healthcare policies.
We report on spectroscopic investigations on In2O3 single crystals. We focus on the detailed analysis of the O1s resonance profile by resonant photoelectron spectroscopy (resPES). From these we analyze the electronic structure and assign the O2p- and In5sp state to build the valence band and the conduction band in different contributions, respectively. This is deduced from constant final state spectra on the O-KLL-Auger along the O K-edge and In M4,5-edge and a comparison to the corresponding X-ray absorption spectroscopy data. We also identify several types of defects. A broad band of oxygen derived defects is identified in the valence band and extends throughout the gap. Small polarons are attributed to cause an anti-resonance in the constant initial states around the O1s threshold. In addition, an Auger decay separated by the O-KLL is present at O-K resonance and indicates the existence of localized charge transfer states which involves In5sp states. Finally, we are able to distinguish two different oxygen species from the resPES data. One corresponds to theintrinsic In2O3 structure and the other is a non-corresponding species.
Characterization and Simulation of Shear-Induced Damage in Selective-Laser-Sintered Polyamide 12
(2024)
This paper presents the characterisation of selective-laser-sintered (SLS) samples of polyamide 12 (PA12) under shear loading. PA12 is a semi-crystalline thermoplastic and is used in various industries. Its behaviour under shear stress, which is particularly important for product reliability, has not yet been sufficiently investigated. This research focuses on understanding the material and damage behaviour of PA12 under shear-induced stress conditions. The study included quasi-static experiments and numerical simulations. Samples were prepared via SLS and tested according to ASTM standards. Digital image correlation (DIC) was used for precise deformation measurements. The Chaboche material model was used for the viscoplastic behaviour in the numerical simulations. Due to existing material discontinuities in the form of voids, the material model was coupled with the Gurson–Tvergaard–Needleman (GTN) damage model. A modified approach of the GTN model was used to account for low stress triaxiality under shear loading. These models were implemented in MATLAB and integrated into Abaqus via a User Material (UMAT) subroutine. The results of the experiments and simulations showed a high degree of accuracy. An important finding was the significant influence of the shear factor kw on the damage behaviour, especially during failure. This factor proved to be essential for the accurate prediction of material behaviour under shear-induced stress conditions. The integration of the modified GTN model with the Chaboche material model in UMAT enables an accurate prediction of the material and damage behaviour and thus makes an important contribution to the understanding of the mechanical material behaviour of SLS PA12 specimens.