| 1. |
- Faatz, B., et al.
(author)
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Simultaneous operation of two soft x-ray free-electron lasers driven by one linear accelerator
- 2016
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In: New Journal of Physics. - : IOP Publishing. - 1367-2630. ; 18
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Journal article (peer-reviewed)abstract
- Extreme-ultraviolet to x-ray free-electron lasers (FELs) in operation for scientific applications are up to now single-user facilities. While most FELs generate around 100 photon pulses per second, FLASH at DESY can deliver almost two orders of magnitude more pulses in this time span due to its superconducting accelerator technology. This makes the facility a prime candidate to realize the next step in FELs-dividing the electron pulse trains into several FEL lines and delivering photon pulses to several users at the same time. Hence, FLASH has been extended with a second undulator line and self-amplified spontaneous emission (SASE) is demonstrated in both FELs simultaneously. FLASH can now deliver MHz pulse trains to two user experiments in parallel with individually selected photon beam characteristics. First results of the capabilities of this extension are shown with emphasis on independent variation of wavelength, repetition rate, and photon pulse length.
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| 2. |
- Fiorillo, A., et al.
(author)
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How to improve clinical practice on involuntary hospital admissions of psychiatric patients : suggestions from the EUNOMIA study
- 2011
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In: European psychiatry. - : Elsevier. - 0924-9338 .- 1778-3585. ; 26:4, s. 201-207
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Journal article (peer-reviewed)abstract
- Number and procedures of involuntary hospital admissions vary in Europe according to the different socio-cultural contexts. The European Commission has funded the EUNOMIA study in 12 European countries in order to develop European recommendations for good clinical practice in involuntary hospital admissions. The recommendations have been developed with the direct and active involvement of national leaders and key professionals, who worked out national recommendations, subsequently summarized into a European document, through the use of specific categories. The need for standardizing the involuntary hospital admission has been highlighted by all centers. In the final recommendations, it has been stressed the need to: providing information to patients about the reasons for hospitalization and its presumable duration; protecting patients’ rights during hospitalization; encouraging the involvement of family members; improving the communication between community and hospital teams; organizing meetings, seminars and focus-groups with users; developing training courses for involved professionals on the management of aggressive behaviors, clinical aspects of major mental disorders, the legal and administrative aspects of involuntary hospital admissions, on communication skills. The results showed the huge variation of involuntary hospital admissions in Europe and the importance of developing guidelines on this procedure.
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| 3. |
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| 4. |
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| 5. |
- Costa, D, et al.
(author)
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Factors associated with quality of services for marginalized groups with mental health problems in 14 European countries
- 2014
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In: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; , s. Art. no. 49-
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Journal article (peer-reviewed)abstract
- Background:Different service characteristics are known to influence mental health care delivery. Much less isknown about the impact of contextual factors, such as the socioeconomic circumstances, on the provision of careto socially marginalized groups.The objectives of this work were to assess the organisational characteristics of services providing mental health carefor marginalized groups in 14 European capital cities and to explore the associations between organisationalquality, service features and country-level characteristics.Methods:617 services were assessed in two highly deprived areas in 14 European capital cities. A Quality Index ofService Organisation (QISO) was developed and applied across all sites. Service characteristics and country levelsocioeconomic indicators were tested and related with the Index using linear regressions and random interceptlinear models.Results:The mean (standard deviation) of the QISO score (minimum = 0; maximum = 15) varied from 8.63 (2.23) inIreland to 12.40 (2.07) in Hungary. The number of different programmes provided was the only service characteristicsignificantly correlated with the QISO (p < 0.05). The national Gross Domestic Product (GDP) was inverselyassociated with the QISO. Nearly 15% of the variance of the QISO was attributed to country-level variables, withGDP explaining 12% of this variance.Conclusions:Socioeconomic contextual factors, in particular the national GDP are likely to influence theorganisational quality of services providing mental health care for marginalized groups. Such factors should beconsidered in international comparative studies. Their significance for different types of services should be exploredin further research.Keywords:Mental health services, Quality index of service organization, Socially marginalized groups,Multi-level analysis
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| 6. |
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| 7. |
- Fiorillo, A., et al.
(author)
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Patient characteristics and symptoms associated with perceived coercion during hospital treatment
- 2012
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In: Acta Psychiatrica Scandinavica. - Malden, USA : Wiley-Blackwell. - 0001-690X .- 1600-0447. ; 125:6, s. 460-467
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Journal article (peer-reviewed)abstract
- Objective: Large numbers of psychiatric patients either are involuntarily admitted to hospital treatment or feel coerced despite a legally voluntary admission. For ethical and clinical reasons, their perceived coercion should be reduced as far as possible. There is however limited evidence on patient characteristics associated with perceived coercion during hospital treatment. This study aimed to identify i) sociodemographic and clinical characteristics associated with perceived coercion at admission and ii) changes in symptoms and global functioning associated with changes in perceived coercion over time.Method: Three thousand and ninety three in-patients who were involuntarily admitted or felt coerced to hospital treatment despite a legally voluntary admission were recruited in the European evaluation of coercion in psychiatry and harmonization of best clinical practice EUNOMIA project in 11 European countries. Perceived coercion, global functioning and symptoms were assessed after admission and at a 3-month follow-up.Results: Involuntary admission, female gender, poorer global functioning and more positive symptoms were associated with higher levels of perceived coercion at admission. Perceived coercion significantly decreased over time, and the improvements in global functioning and positive symptoms were associated with reduction in perceived coercion.Conclusion: Female patients perceive more coercion in psychiatric hospital treatment. Effective treatment for positive symptoms and improving patients global functioning may lead to a reduction in perceived coercion.
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| 8. |
- He, T., et al.
(author)
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The role of colonic metabolism in lactose intolerance
- 2008
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In: European Journal of Clinical Investigation. - : Wiley. - 0014-2972 .- 1365-2362. ; 38:8, s. 541-547
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Research review (peer-reviewed)abstract
- Lactose maldigestion and intolerance affect a large part of the world population. The underlying factors of lactose intolerance are not fully understood. In this review, the role of colonic metabolism is discussed, i.e. fermentation of lactose by the colonic microbiota, colonic processing of the fermentation metabolites and how these processes would play a role in the pathophysiology of lactose intolerance. We suggest that the balance between the removal and production rate of osmotic-active components (lactose, and intermediate metabolites, e.g. lactate, succinate, etc.) in the colon is a key factor in the development of symptoms. The involvement of the colon may provide the basis for designing new targeted strategies for dietary and clinical management of lactose intolerance.
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| 9. |
- Kluge, U, et al.
(author)
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Health services and the treatment of immigrants : data on service use, interpreting services and immigrant staff members in services across Europe
- 2012
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In: European psychiatry. - 0924-9338 .- 1778-3585. ; 27:Suppl 2, s. 56-62
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Journal article (peer-reviewed)abstract
- BACKGROUND:The number of immigrants using health services has increased across Europe. For assessing and improving the quality of care provided for immigrants, information is required on how many immigrants use services, what interpreting services are provided and whether staff members are from immigrant groups.METHODS:Structured interviews were conducted with 15 health services (9 primary care, 3 emergency departments, 3 mental health) located in areas with high immigrant populations in each of 16 European countries (n=240). Responses were collected on the availability of data on service use by immigrant patients, the provision of interpreting services and immigrant staff members.RESULTS:Data on service use by immigrants were recorded by only 15% of services. More than 40% of services did not provide any form of interpreting service and 54% of the services reported having no immigrant staff. Mental health services were more likely to use direct interpreting services, and both mental health and emergency services were more likely to have immigrant staff members.DISCUSSION:For assessing and improving the quality of care provided for immigrants, there is a need to improve the availability of data on service use by immigrants in health services throughout Europe and to provide more consistent access to interpreting services.
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| 10. |
- Müller-Engelmann, M., et al.
(author)
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Psychometric Properties and Factor Structure of the German Version of the Clinician-Administered PTSD Scale for DSM-5
- 2020
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In: Assessment (Odessa, Fla.). - : SAGE Publications Inc.. - 1073-1911 .- 1552-3489. ; 27:6, s. 1128-1138
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Journal article (peer-reviewed)abstract
- The Clinician-Administered PTSD Scale (CAPS) is a widely used diagnostic interview for posttraumatic stress disorder (PTSD). Following fundamental modifications in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the CAPS had to be revised. This study examined the psychometric properties (internal consistency, interrater reliability, convergent and discriminant validity, and structural validity) of the German version of the CAPS-5 in a trauma-exposed sample (n = 223 with PTSD; n =51 without PTSD). The results demonstrated high internal consistency (αs =.65-.93) and high interrater reliability (ICCs =.81-.89). With regard to convergent and discriminant validity, we found high correlations between the CAPS severity score and both the Posttraumatic Diagnostic Scale sum score (r =.87) and the Beck Depression Inventory total score (r =.72). Regarding the underlying factor structure, the hybrid model demonstrated the best fit, followed by the anhedonia model. However, we encountered some nonpositive estimates for the correlations of the latent variables (factors) for both models. The model with the best fit without methodological problems was the externalizing behaviors model, but the results also supported the DSM-5 model. Overall, the results demonstrate that the German version of the CAPS-5 is a psychometrically sound measure.
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| 11. |
- Priebe, S, et al.
(author)
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Good practice in emergency care: views from practitioners :
- 2011
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In: Migration and Health in the European Union. - : Open University Press. - 9780335245673
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Book chapter (peer-reviewed)abstract
- Migrants make up a growing share of European populations. However, all too often their situation is compounded by problems with accessing health and other basic services. There is a need for tailored health policies, but robust data on the health needs of migrants and how best these needs can be met are scarce.Written by a collaboration of authors from three key international organisations (the European Observatory on Health Systems and Policies, the EUPHA Section on Migrant and Ethnic Minority Health, and the International Organization for Migration), as well as leading researchers from across Europe, the book thoroughly explores the different aspects of migration and health in the EU and how they can be addressed by health systems.Structured into five easy-to-follow sections, the volume includes:Contributions from experts from across EuropeKey topics such as: access to human rights and health care; health issues faced by migrants; and the national and European policy response so farConclusions drawn from the latest available evidenceComprehensive information on different aspects of health and migration and how they can best be addressed by health systems is still not easy to find. This book addresses this shortfall and will be of major value to researchers, students, policy-makers and practitioners concerned with migration and health in an increasingly diverse Europe.
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| 12. |
- Priebe, S, et al.
(author)
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Good practice in health care for migrants : views and experiences of care professionals in 16 European countries
- 2011
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In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 11, s. 187-
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Journal article (peer-reviewed)abstract
- BackgroundHealth services across Europe provide health care for migrant patients every day. However, little systematic research has explored the views and experiences of health care professionals in different European countries. The aim of this study was to assess the difficulties professionals experience in their service when providing such care and what they consider constitutes good practice to overcome these problems or limit their negative impact on the quality of care.MethodsStructured interviews with open questions and case vignettes were conducted with health care professionals working in areas with high proportion of migrant populations in 16 countries. In each country, professionals in nine primary care practices, three accident and emergency hospital departments, and three community mental health services (total sample = 240) were interviewed about their views and experiences in providing care for migrant patients, i.e. from first generation immigrant populations. Answers were analysed using thematic content analysis.ResultsEight types of problems and seven components of good practice were identified representing all statements in the interviews. The eight problems were: language barriers, difficulties in arranging care for migrants without health care coverage, social deprivation and traumatic experiences, lack of familiarity with the health care system, cultural differences, different understandings of illness and treatment, negative attitudes among staff and patients, and lack of access to medical history. The components of good practice to overcome these problems or limit their impact were: organisational flexibility with sufficient time and resources, good interpreting services, working with families and social services, cultural awareness of staff, educational programmes and information material for migrants, positive and stable relationships with staff, and clear guidelines on the care entitlements of different migrant groups. Problems and good care components were similar across the three types of services.ConclusionsHealth care professionals in different services experience similar difficulties when providing care to migrants. They also have relatively consistent views on what constitutes good practice. The degree to which these components already are part of routine practice varies. Implementing good practice requires sufficient resources and organisational flexibility, positive attitudes, training for staff and the provision of information.
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| 13. |
- Priebe, S, et al.
(author)
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Objective social outcomes index (SIX): a method to summarise objective indicators of social outcomes in mental health care
- 2008
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In: Acta Psychiatrica Scandinavica. - : Wiley. - 1600-0447 .- 0001-690X. ; 118:1, s. 57-63
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Journal article (peer-reviewed)abstract
- Objective: No method has yet been established to summarise different objective indicators of social outcomes into one score. The study aimed to develop and test a simple, brief and meaningful index of social outcomes that can be used across a broad range of mental health studies and is potentially obtainable from routine documentation. Method: An index capturing employment, accommodation and living situation (range from 0 to 6; SIX) was devised and tested in three longitudinal datasets of patients with severe mental illness from Germany, Sweden and the UK. Results: SIX showed an almost normal distribution cross-sectionally in all three datasets. Between 58 and 78% of patients changed scores over time. Change scores were weakly associated with change scores of symptoms, quality of life, global functioning and disability. Conclusion: A simple method to summarise different indicators of social outcomes provides meaningful results. It can be widely used in research and routine care.
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| 14. |
- Priebe, S, et al.
(author)
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Reinstitutionalisation in mental-health care: comparison of data on service provision from six European countries
- 2005
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In: BMJ: British Medical Journal. - 1756-1833. ; 330:7483, s. 123-126
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Journal article (peer-reviewed)abstract
- Objective To establish whether reinstitutionalisation is occurring in mental health care mid, if so, with What variations between Western European countries. Design Comparison of data on changes in service provision. Setting Six European countries with different traditions of mental health care that have all experienced deinstitutionalisation since the 1970s - England, Germany, Italy, the Netherlands, Spain, mid Sweden. Outcome measures Changes in die number of forensic hospital beds, involuntary hospital admissions, places in supported housing, general psychiatric hospital beds, and general prison population between 1990-1 mid 2002-3. Results Forensic beds and places in supported housing have increased in all countries, whereas changes in it involuntary hospital admissions have been inconsistent. The number of psychiatric hospital beds h is been reduced in five countries, but only in two countries does this reduction outweigh the number of additional places in forensic institutions and supported housing The general prison population has substantially increased in all countries. Conclusions Reinstitutionalisation is taking place in European countries with different, traditions of health care, although with significant variation between the six countries studied. The precise reasons for the phenomenon remain unclear. General attitudes to risk containment in a society, as indicated by the size of the prison population, may be more Important than changing morbidity and new methods of mental healthcare delivery.
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| 15. |
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| 16. |
- Strassmayr, C, et al.
(author)
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Mental health care for irregular migrants in Europe : Barriers and how they are overcome
- 2012
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In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 12:367, s. Art. no. 367-
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Journal article (peer-reviewed)abstract
- BackgroundIrregular migrants (IMs) are exposed to a wide range of risk factors for developing mental health problems. However, little is known about whether and how they receive mental health care across European countries. The aims of this study were (1) to identify barriers to mental health care for IMs, and (2) to explore ways by which these barriers are overcome in practice.MethodsData from semi-structured interviews with 25 experts in the field of mental health care for IMs in the capital cities of 14 European countries were analysed using thematic analysis.ResultsExperts reported a range of barriers to mental health care for IMs. These include the absence of legal entitlements to health care in some countries or a lack of awareness of such entitlements, administrative obstacles, a shortage of culturally sensitive care, the complexity of the social needs of IMs, and their fear of being reported and deported. These barriers can be partly overcome by networks of committed professionals and supportive services. NGOs have become important initial points of contact for IMs, providing mental health care themselves or referring IMs to other suitable services. However, these services are often confronted with the ethical dilemma of either acting according to the legislation and institutional rules or providing care for humanitarian reasons, which involves the risk of acting illegally and providing care without authorisation.ConclusionsEven in countries where access to health care is legally possible for IMs, various other barriers remain. Some of these are common to all migrants, whilst others are specific for IMs. Attempts at improving mental health care for IMs should consider barriers beyond legal entitlement, including communicating information about entitlement to mental health care professionals and patients, providing culturally sensitive care and ensuring sufficient resources.
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| 17. |
- Welbel, M, et al.
(author)
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Addiction treatment in deprived urban areas in EU countries: Accessibility of care for people from socially marginalized groups
- 2013
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In: Drugs. - : Informa UK Limited. - 0968-7637 .- 1465-3370. ; 20:1, s. 74-83
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Journal article (peer-reviewed)abstract
- Aim: This study examines the accessibility of addiction treatment within services providing mental health care and support for people from socially marginalized groups in deprived urban areas across EU countries.Methods: Services providing mental health care and support in deprived areas of 14 EU capital cities were assessed with a questionnaire. We analysed the availability and accessibility of those services providing addiction treatment for people from six groups: the long-term unemployed, the homeless, street sex workers, asylum seekers and refugees, irregular migrants and people from travelling communities.Results: While 30% of all the assessed services provided addiction treatment, in 20% of services, addiction was a criterion for exclusion. Among services providing addiction treatment, 77% accepted self-referrals, 63% were open on weekends or in the evening, 60% did not charge any out-of-pocket fees, 35% provided access to interpreters, and 28% ran outreach activities. These results varied substantially among EU capitals.Conclusion: Access to addiction treatment for socially marginalized groups varies across Europe. Some of the models identified may constitute barriers to treatment. Developing care delivery models that facilitate access for vulnerable populations should be a priority for national and European policies.
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