Hopfion rings in a cubic chiral magnet.

Magnetic skyrmions and hopfions are topological solitons1-well-localized field configurations that have gained considerable attention over the past decade owing to their unique particle-like properties, which make them promising objects for spintronic applications. Skyrmions2,3 are two-dimensional solitons resembling vortex-like string structures that can penetrate an entire sample. Hopfions4-9 are three-dimensional solitons confined within a magnetic sample volume and can be considered as closed twisted skyrmion strings that take the shape of a ring in the simplest case. Despite extensive research on magnetic skyrmions, the direct observation of magnetic hopfions is challenging10 and has only been reported in a synthetic material11. Here we present direct observations of hopfions in crystals. In our experiment, we use transmission electron microscopy to observe hopfions forming coupled states with skyrmion strings in B20-type FeGe plates. We provide a protocol for nucleating such hopfion rings, which we verify using Lorentz imaging and electron holography. Our results are highly reproducible and in full agreement with micromagnetic simulations. We provide a unified skyrmion-hopfion homotopy classification and offer insight into the diversity of topological solitons in three-dimensional chiral magnets.

The effect of a low-level psychological intervention (PM+) on post-migration living difficulties - Results from two studies in Switzerland and in the Netherlands.

AIMS OF THE STUDY: After arriving in host countries, most refugees are confronted with numerous post-migration stressors (e.g., separation from family, discrimination, and employment difficulties). Post-migration living difficulties (PMLDs) significantly contribute to the development and persistence of mental disorders. Effective treatment approaches focusing on reducing post-migration stress are urgently needed. The aim of the present study was to examine the effect of a brief psychological intervention, Problem Management Plus (PM+), on PMLDs among Syrian refugees in two European countries. METHODS: We merged data from two single-blind feasibility trials with Syrian refugees experiencing elevated levels of psychological distress and impaired functioning in Switzerland (N = 59) and the Netherlands (N = 60). Participants were randomised to receive either five sessions of PM+ or an enhanced care-as-usual control condition. PMLDs were assessed at baseline and 3 months after the intervention. To estimate treatment effect on PMLD, linear mixed model analysis was performed. RESULTS: Three months after the intervention, participants in the PM+ condition reported significantly fewer PMLDs compared to the control condition. Further analyses at item-level showed that interpersonal and family related PMLDs, such as "worries about family back home" significantly improved over time in the PM+ condition. CONCLUSIONS: This exploratory study suggests that brief psychological interventions have the potential to reduce PMLDs in refugees and asylum seekers. The reduction of post-migration stress in turn may subsequently lead to an overall reduction in psychological distress. CLINICAL TRIAL NUMBERS: BASEC Nr. 2017-0117 (Swiss trial) and NL61361.029.17, 7 September 2017 (Dutch trial).

Problems after flight: understanding and comparing Syrians' perspectives in the Middle East and Europe.

BACKGROUND: Syrian refugees and asylum seekers (SRAs) face multiple stressors after flight, which may vary due to different geographic, economic, cultural and socio-political contexts in the host countries. Past research has recognised the importance of participants' own perspectives. The aims of this multi-country study were to identify and compare self-reported problems of SRAs between various settings. METHODS: A semi-structured client-generated outcome measurement was used to collect data among adult SRAs in Jordan (N = 61), Turkey (N = 46) and Switzerland (N = 57) between September 2018 and November 2019. Answers were analysed following thematic analysis. RESULTS: Over half of the participants reported practical problems with an emphasis on camp-related problems (Jordan), finances (Turkey), employment (Jordan and Switzerland) and government regulations (Switzerland), followed by psychological, and social issues. CONCLUSION: This study highlights the impact of local contextual factors on wellbeing. The findings emphasise that planning preventative procedures and mental health care services for SRAs need to consider local challenges affecting the population in specific countries.

Barriers to access to outpatient mental health care for refugees and asylum seekers in Switzerland: the therapist's view.

BACKGROUND: More than 120,000 refugees and asylum seekers are currently living in Switzerland. The prevalence of mental disorders among this population is significantly higher than that in the general population. While effective treatment options and cross-cultural, specialized treatment centers exist, they tend to be overloaded by their target populations. General outpatient primary health care providers might be able to compensate for the lack of specialized treatment slots. To date, however, it is unknown how often and under what conditions (e.g., length of waiting lists) refugees and asylum seekers are treated outside of specialized centers and whether there are barriers that prevent providers in outpatient settings from treating more patients in this subgroup. The present study aimed to assess the challenges and barriers faced by psychiatrists and psychotherapists working in outpatient settings in Switzerland in treating refugees and asylum seekers to determine the potential capacity of this group to provide mental health care. METHODS: An online survey was conducted during the winter of 2017/2018. The survey was constructed in three official languages and took 10-15 min to complete. Spearman's correlations, Mann-Whitney U-Tests, and Chi-squared tests were conducted to analyze the data. RESULTS: Eight hundred and sixty-seven (N = 867) psychotherapists and psychiatrists working in outpatient settings completed the survey: 43% of them reported having treated between 1 and 9 refugees or asylum seekers in the past 12 months, and a further 13% reported treating 10 or more. Interpreters were used for almost every other patient with a refugee or asylum-seeker background. At the same time, the funding of interpreters, as well as the funding of treatment in general, were reported to be the biggest hurdles to treating more refugees and asylum seekers. CONCLUSIONS: Given the low number of patients rejected for capacity reasons (between 2 and 5%) and the median waiting times for the admission of new patients ranging between 2 and 3 weeks, outpatient primary mental health care providers might treat more refugees and asylum seekers and relieve specialized treatment centers. However, barriers such as lack of funding of interpreters seem to hinder them. Appropriate steps by the authorities are needed to improve the current situation.

Duplication, Collapse, and Escape of Magnetic Skyrmions Revealed Using a Systematic Saddle Point Search Method.

Various transitions that a magnetic Skyrmion can undergo are found in calculations using a method for climbing up the energy surface and converging onto first order saddle points. In addition to collapse and escape through a boundary, the method identifies a transition where the Skyrmion divides and forms two Skyrmions. The activation energy for this duplication process can be similar to that of collapse and escape. A tilting of the external magnetic field for a certain time interval is found to induce the duplication process in a dynamical simulation. Such a process could turn out to be an important avenue for the creation of Skyrmions in future magnetic devices.

Interaction of Individual Skyrmions in a Nanostructured Cubic Chiral Magnet.

We report direct evidence of the field-dependent character of the interaction between individual magnetic skyrmions as well as between skyrmions and edges in B20-type FeGe nanostripes observed by means of high-resolution Lorentz transmission electron microscopy. It is shown that above certain critical values of an external magnetic field the character of such long-range skyrmion interactions changes from attraction to repulsion. Experimentally measured equilibrium inter-skyrmion and skyrmion-edge distances as a function of the applied magnetic field shows quantitative agreement with the results of micromagnetic simulations. The important role of demagnetizing fields and the internal symmetry of three-dimensional magnetic skyrmions are discussed in detail.

Bioselection of coxsackievirus B6 strain variants with altered tropism to human cancer cell lines.

Cancer cells develop increased sensitivity to members of many virus families and, in particular, can be efficiently infected and lysed by many low-pathogenic human enteroviruses. However, because of their great genetic heterogeneity, cancer cells display different levels of sensitivity to particular enterovirus strains, which may substantially limit the chances of a positive clinical response. We show that a non-pathogenic strain of coxsackievirus B6 (LEV15) can efficiently replicate to high titers in the malignant human cell lines C33A, DU145, AsPC-1 and SK-Mel28, although it displays much lower replication efficiency in A431 and A549 cells and very limited replication ability in RD and MCF7 cells, as well as in the normal lung fibroblast cell line MRC-5 and the immortalized mammary epithelial cell line MCF10A. By serial passaging in RD, MCF7 and A431 cells, we obtained LEV15 strain variants that had acquired high replication capacity in the appropriate carcinoma cell lines without losing their high replication capability in the original set of cancer cell lines and had limited replication capability in untransformed cells. The strains demonstrated improved oncolytic properties in nude-mouse xenografts. We identified nucleotide changes responsible for the phenotypes and suggest a bioselection approach for a generation of oncolytic virus strains with a wider spectrum of affected tumors.

Interlayer Exchange Coupling: A General Scheme Turning Chiral Magnets into Magnetic Multilayers Carrying Atomic-Scale Skyrmions.

We report on a general principle using interlayer exchange coupling to extend the regime of chiral magnetic films in which stable or metastable magnetic Skyrmions can appear at a zero magnetic field. We verify this concept on the basis of a first-principles model for a Mn monolayer on a W(001) substrate, a prototype chiral magnet for which the atomic-scale magnetic texture is determined by the frustration of exchange interactions, impossible to unwind by laboratory magnetic fields. By means of ab initio calculations for the Mn/W_{m}/Co_{n}/Pt/W(001) multilayer system we show that for certain thicknesses m of the W spacer and n of the Co reference layer, the effective field of the reference layer fully substitutes the required magnetic field for Skyrmion formation.

New type of stable particlelike states in chiral magnets.

We present a new type of thermodynamically stable magnetic state at interfaces and surfaces of chiral magnets. The state is a soliton solution of micromagnetic equations localized in all three dimensions near a boundary, and it contains a singularity but nevertheless has finite energy. Both features combine to form a quasiparticle state for which we expect unusual transport and dynamical properties. It exhibits high thermal stability and thereby can be considered as a promising object for fundamental research and practical applications in spintronic devices. We identified the range of existence of such particlelike states in the thickness dependent magnetic phase diagram for helimagnet films and analyzed its stability in comparison with the isolated skyrmion within the conical phase. We provide arguments that such a state can be found in different B20-type alloys, e.g., Mn_{1-x}Fe_{x}Ge, Mn_{1-x}Fe_{x}Si, Fe_{1-x}Co_{x}Si.

Geometric phase analysis of magnetic skyrmion lattices in Lorentz transmission electron microscopy images.

Magnetic skyrmions are quasi-particles with a swirling spin texture that form two-dimensional lattices. Skyrmion lattices can exhibit defects in response to geometric constraints, variations of temperature or applied magnetic fields. Measuring deformations in skyrmion lattices is important to understand the interplay between the lattice structure and external influences. Geometric phase analysis (GPA) is a Fourier-based image processing method that is used to measure deformation fields in high resolution transmission electron microscopy (TEM) images of crystalline materials. Here, we show that GPA can be applied quantitatively to Lorentz TEM images of two-dimensional skyrmion lattices obtained from a chiral magnet of FeGe. First, GPA is used to map deformation fields around a 5-7 dislocation and the results are compared with the linear theory of elasticity. Second, rotation angles between skyrmion crystal grains are measured and compared with angles calculated from the density of dislocations. Third, an orientational order parameter and the corresponding correlation function are calculated to describe the evolution of the disorder as a function of applied magnetic field. The influence of sources of artifacts such as geometric distortions and large defoci are also discussed.

Dipolar skyrmions and antiskyrmions of arbitrary topological charge at room temperature.

Magnetic skyrmions are localized, stable topological magnetic textures that can move and interact with each other like ordinary particles when an external stimulus is applied. The efficient control of the motion of spin textures using spin-polarized currents opened an opportunity for skyrmionic devices such as racetrack memory and neuromorphic or reservoir computing. The coexistence of skyrmions with high topological charge in the same system promises further possibilities for efficient technological applications. In this work, we directly observe dipolar skyrmions and antiskyrmions with arbitrary topological charge in Co/Ni multilayers at room temperature. We explore the dipolar-stabilized spin objects with topological charges of up to 10 and characterize their nucleation process, their energy dependence on the topological charge and the effect of the material parameters on their stability. Furthermore, our micromagnetic simulations demonstrate spin-transfer-induced motion of these spin objects, which is important for their potential device application.

Magnetic hardening induced by nonmagnetic organic molecules.

We reveal for the first time through a theoretical first-principles study that the adsorption of a nonmagnetic π-conjugated organic molecule on a ferromagnetic surface locally increases the strength of the magnetic exchange interaction between the magnetic atoms binding directly to the molecule. This magnetic hardening effect leads to the creation of a local molecular mediated magnetic unit with a stable magnetization direction and an enhanced barrier for the magnetization switching as compared to the clean surface. Remarkably, such a hybrid organic-ferromagnetic system exhibits also a spin-filter functionality with sharp spin-split molecularlike electronic features at the molecular site.

Predictors of Youth Accessibility for a Mobile Phone-Based Life Skills Training Program for Addiction Prevention.

BACKGROUND: Digital interventions are an emerging and promising avenue for addiction prevention and mental health promotion, but their reach and use are often limited, and little is known about the factors associated with youth accessibility. SmartCoach is a life skills training program for addiction prevention where adolescents are proactively invited for program participation in secondary school classes. The mobile phone-based program provides individualized coaching for a period of 4 months and addresses self-management skills, social skills, and substance use resistance skills. This study examined sociodemographic and other predictors of program participation and program use. METHODS: A total of 476 adolescents in 28 secondary and upper secondary school classes in the German-speaking part of Switzerland were proactively invited for participation in the SmartCoach program. Using generalized linear mixed models (GLMMs), we examined predictors of both program participation and program use at the individual and school class levels. RESULTS: In total, 315 (66.2%) of the present 476 adolescents gave their active consent and provided the necessary information to be included in the program. None of the individual sociodemographic characteristics significantly predicted program participation, however, the participation rate was significantly higher in upper secondary school classes (84%) than secondary school classes (59%). The mean number of interactions with the program was 15.9, i.e., participants took part in almost half of the 34 possible interactions with the SmartCoach program. None of the baseline characteristics on the level of the school class significantly predicted program use. On the level of the individual, the univariate models showed that, compared to the reference category of 14-year-old students, program use was significantly lower for students who were 16 or older. Furthermore, participants with a migration background or an origin from a non-German-speaking country showed significantly lower program use. Finally, students with a medium level of perceived stress showed higher program use compared to those with a low level of stress. Within the final multivariate model for program use, only the variable "origin from a non-German-speaking country" remained significant. CONCLUSIONS: SmartCoach is an attractive offer for young people, in which two out of three young people who are invited in the classroom to participate do so. Among the program participants, the use of the program is acceptable, with an average of almost half of the content being worked on. There is potential for improvement in terms of recruitment, especially in school classes with a lower level of education. The most important starting point for improving program use lies in taking greater account of needs and wishes of students with non-German-speaking countries of origin.

Perspectives of Swiss Paediatric Health Care Professionals on Factors Influencing Physical Activity Participation in Children with Disabilities.

AIM: Investigation of the perspectives of paediatric health care professionals (PHCPs) in Switzerland regarding factors that influence participation in physical activity programs for children and adolescents with disabilities or chronic conditions (CADCCs). Evaluation of self-reported exercise counselling behavior of those professionals. METHOD: A cross-sectional survey was used to collect the opinions of 171 PHCPs working with CADCCs using a structured questionnaire. The information obtained was evaluated by performing a combined quantitative and qualitative statistical analysis. RESULTS: PHCPs in Switzerland think that CADCC do not get enough physical activity and see the underlying reasons in lacking information/knowledge and organizational factors. We found that the level of knowledge about disability sports opportunities among PHCPs has a positive influence on their exercise counselling behaviour. CONCLUSIONS: We propose three approaches to increase the level of physical activity in CADCC: Establishing personalized exercise counseling, intensifying information about disability sports programmes towards PHCPs, and improving inclusion and integration in PE lessons or regular sports clubs.

Recommending Physical Activity for People with Intellectual Disabilities: The Relevance of Public Health Guidelines, Physical Activity Behaviour and Type of Contact.

People with an intellectual disability (ID) often exhibit more sedentary behaviour and are less physically active than the general population. While previous public health guidelines on physical activity (PA) did not specifically address the needs of people with an ID, the recent updates now include this population, with recommendations similar to those for the general population. However, it is unclear whether the information about these guidelines has reached the broader public and what factors may influence their implementation. To investigate these issues, an online survey was conducted in Austria, Germany and Switzerland, which examined the (a) PA recommendation for people with an ID, (b) awareness of current guidelines, (c) participants' own PA behaviour (IPAQ-SF) and (d) specific contact with people with an ID. Participants (n = 585) recommended similar levels of PA for people with an ID as for the general population, but knowledge of the guidelines did not affect their recommendation. However, participants' own PA behaviour and context-specific contact (e.g., in family or at work) were associated with the recommended PA levels. Therefore, promoting the relevance of PA and fostering contact with people with an ID might be suitable ways to increase PA in people with an ID.

Voluntary sports programs for individuals with mental health disorders: The trainer's view.

There is strong evidence that physical activities (PAs) are an important factor in increasing and maintaining mental health as well as in preventing relapse after mental health disorders. Physical activity is an important part of the treatment program in psychiatric hospitals. However, when individuals with mental health disorders (IMHD) leave the hospitals in Switzerland (CH), there are few possibilities to do physical activity in a given setting. One of them are voluntary sports groups for individuals with mental health disorders (SGPSY), which have been growing continuously in CH since 2016. Yet, little is known about these groups and their training settings. Therefore, the present study explores challenges, barriers, and enablers for participation in SGPSY from the point of view of the trainers of these groups. Additionally, as the sustainable implementation of SGPSY relies on the trainer, the study aims to identify reasons/motivations as well as the personality characteristics of the SGPSY trainers. Semi-structured interviews were conducted with 15 trainers of SGPSY in CH during spring 2022. Interviews were audiotaped, transcribed, and analyzed using thematic analysis in nVivo. Participants identified several intrapersonal (lack of motivation and fitness, mood problems, etc.), interpersonal (conflicts between participants), and structural barriers (time/location) that hinder IMHD from participating in SGPSY. The participating trainer reported that trainer might be helpful in overcoming the barriers by supporting IMHD as enablers. They rate social skills to be essential for the successful management and organization of SGPSY, as well as the ability to set boundaries to protect one's private life and sports skills expertise. The reasons for their engagement as trainers of SGPSY were the satisfaction of doing sports with IMHD and to improve the physical activities habits of IMHD. The findings of the study highlight the need to upskill the trainers of SGPSY in order to improve recruitment of the future trainers of SGPSY by focusing on the assessment of appropriate personality characteristics of trainers and their motives. Additionally, these findings should be integrated in the educational materials of Swiss disabled sports systems. Further research should validate the results from SGPSY participants' point of view.

Proteomics-Based Serum Alterations of the Human Protein Expression after Out-of-Hospital Cardiac Arrest: Pilot Study for Prognostication of Survivors vs. Non-Survivors at Day 1 after Return of Spontaneous Circulation (ROSC).

BACKGROUND: Targeted temperature management (TTM) is considered standard therapy for patients after out-of-hospital cardiac arrest (OHCA), cardiopulmonary resuscitation (CPR), and return of spontaneous circulation (ROSC). To date, valid protein markers do not exist to prognosticate survivors and non-survivors before the end of TTM. The aim of this study is to identify specific protein patterns/arrays, which are useful for prediction in the very early phase after ROSC. MATERIAL AND METHODS: A total of 20 adult patients with ROSC (19 male, 1 female; 69.9 ± 9.5 years) were included and dichotomized in two groups (survivors and non-survivors at day 30). Serum samples were drawn at day 1 after ROSC (during TTM). Three panels (organ failure, metabolic, neurology, inflammation; OLINK, Uppsala, Sweden) were utilised. A total of four proteins were found to be differentially regulated (>2- or <-0.5-fold decrease; t-test). Bioinformatic platforms were utilised to analyse pathways and identify signalling cascades and to screen for potential biomarkers. RESULTS: A total of 276 proteins were analysed and revealed only 11 statistically significant protein alterations (Siglec-9, LAYN, SKR3, JAM-B, N2DL-2, TNF-B, BAMBI, NUCB2, STX8, PTK7, and PVLAB). Following the Bonferroni correction, no proteins were found to be regulated as statistically significant. Concerning the protein fold change for clinical significance, four proteins (IL-1 alpha, N-CDase, IL5, CRH) were found to be regulated in a clinically relevant context. CONCLUSIONS: Early analysis at 1 day after ROSC was not sufficiently possible during TTM to prognosticate survival or non-survival after OHCA. Future studies should evaluate protein expression later in the course after ROSC to identify promising protein candidates.

Feasibility and acceptability of Problem Management Plus (PM+) among Syrian refugees and asylum seekers in Switzerland: a mixed-method pilot randomized controlled trial.

Background: Syrian refugees in Switzerland face several barriers in accessing mental health care. Cost-effective psychological interventions are urgently needed to meet the mental health needs of refugees. Problem Management Plus (PM+) is an evidence-based, psychological intervention delivered by trained non-specialist 'helpers'. Objective: To assess the feasibility and acceptability of PM+ among Syrian refugees in Switzerland. Methods: We conducted a single-blind pilot randomized controlled trial (RCT) with Syrian refugees impaired by psychological distress (K10 > 15 and WHODAS 2.0 > 16). Participants were randomized to PM+ or Enhanced Treatment As Usual (ETAU). Participants were assessed at baseline, and 1 week and 3 months after the intervention, and completed measures indexing mental health problems and health care usage. Semi-structured interviews were conducted with different stakeholders. Results: N = 59 individuals were randomized into PM+ (n = 31) or ETAU (n = 28). N = 18 stakeholders were interviewed about facilitators and barriers for the implementation of PM+. Retention rates in the trial (67.8%) and mean intervention attendance (M = 3.94 sessions, SD = 1.97) were high. No severe events related to the study were reported. These findings indicate that the trial procedures and PM+ were feasible, acceptable and safe. Conclusions: The findings support the conduct of a definitive RCT and show that PM+ might have the potential to be scaled-up in Switzerland. The importance, as well as the challenges, of implementing and scaling-up PM+ in high-income countries, such as Switzerland, are discussed.

Antecedentes: Los refugiados Sirios en Suiza enfrentan varias barreras para acceder a la atención en salud mental. Se necesitan con urgencia intervenciones psicológicas costo-efectivas, para satisfacer las necesidades de salud mental de los refugiados. Enfrentar Problemas Plus (PM + por sus siglas en inglés) es una intervención psicológica basada en la evidencia proporcionada por 'ayudantes' capacitados no especializados.Objetivo: Evaluar la viabilidad y aceptabilidad de PM + entre los refugiados sirios en Suiza.Métodos: Realizamos un ensayo controlado aleatorizado (ECA) piloto simple y ciego con refugiados sirios afectados por angustia psicológica (K10 > 15 y WHODAS 2.0 > 16). Los participantes fueron asignados al azar a PM + o Tratamiento usual mejorado (TUM). Los participantes fueron evaluados al inicio del estudio, 1 semana, y 3 meses después de la intervención, y completaron instrumentos que referencian problemas de salud mental y el uso de la atención médica. Se realizaron entrevistas semiestructuradas con diferentes partes relevantes.Resultados:N = 59 individuos fueron asignados al azar a PM + (n = 31) o TUM (n = 28). N = 18 partes relevantes fueron entrevistados sobre facilitadores y barreras para la implementación de PM +. Las tasas de retención en el ensayo (67,8%) y la asistencia media a la intervención (M = 3,94 sesiones, DE = 1,97) fueron altas. No se informaron eventos graves relacionados con el estudio. Estos hallazgos indican que los procedimientos del ensayo y PM + fueron factibles, aceptables y seguros.Conclusiones: Los hallazgos apoyan la realización de un ECA definitivo y muestran que PM + podría tener el potencial de ampliarse en Suiza. Se discute la importancia, así como los desafíos, de implementar y ampliar PM + en países de altos ingresos, como Suiza.

Scalable psychological interventions for Syrian refugees in Europe and the Middle East: STRENGTHS study protocol for a prospective individual participant data meta-analysis.

INTRODUCTION: The World Health Organization's (WHO) scalable psychological interventions, such as Problem Management Plus (PM+) and Step-by-Step (SbS) are designed to be cost-effective non-specialist delivered interventions to reduce symptoms of common mental disorders, such as anxiety, depression and post-traumatic stress disorder (PTSD). The STRENGTHS consortium aims to evaluate the effectiveness, cost-effectiveness and implementation of the individual format of PM+ and its group version (gPM+), as well as of the digital SbS intervention among Syrian refugees in seven countries in Europe and the Middle East. This is a study protocol for a prospective individual participant data (IPD) meta-analysis to evaluate (1) overall effectiveness and cost-effectiveness and (2) treatment moderators of PM+, gPM+ and SbS with Syrian refugees. METHODS AND ANALYSIS: Five pilot randomised controlled trials (RCTs) and seven fully powered RCTs conducted within STRENGTHS will be combined into one IPD meta-analytic dataset. The RCTs include Syrian refugees of 18 years and above with elevated psychological distress (Kessler Psychological Distress Scale (K10>15)) and impaired daily functioning (WHO Disability Assessment Schedule 2.0 (WHODAS 2.0>16)). Participants are randomised into the intervention or care as usual control group, and complete follow-up assessments at 1-week, 3-month and 12-month follow-up. Primary outcomes are symptoms of depression and anxiety (25-item Hopkins Symptom Checklist). Secondary outcomes include daily functioning (WHODAS 2.0), PTSD symptoms (PTSD Checklist for DSM-5) and self-identified problems (PSYCHLOPS). We will conduct a one-stage IPD meta-analysis using linear mixed models. Quality of evidence will be assessed using the GRADE approach, and the economic evaluation approach will be assessed using the CHEC-list. ETHICS AND DISSEMINATION: Local ethical approval has been obtained for each RCT. This IPD meta-analysis does not require ethical approval. The results of this study will be published in international peer-reviewed journals.