Psychometric Properties of the Syrian Arabic Version of the Impact of Event Scale-Revised in the Context of the Syrian Refugee Crisis.

The Impact of Event Scale-Revised (IES-R) is a widely used self-report questionnaire used to assess symptoms of posttraumatic stress disorder (PTSD). Although the IES-R has been translated and validated in multiple languages, no previous version has employed the Arabic dialect commonly spoken in Syria. The present work aimed to assess the psychometric properties of a Syrian Arabic version of the IES-R. Syrian citizens (N = 288) living in refugee camps in Turkey were administered the Syrian Arabic IES-R as part of a humanitarian aid project focused on providing psychological assistance. The data were analyzed with respect to 10 previously published factor solutions. We found that the best-fitting model was a four-factor structure that included factors involving Avoidance-Numbing, Intrusion, Hyperarousal, and Sleep Disturbance. The model showed strong measurement invariance between male and female subsamples, allowing for meaningful comparisons of the factor means. Overall, the present findings support the validity of a new version of the IES-R, which can be used by both researchers and clinicians responding to the urgent need for psychological care for Syrian refugees fleeing war-related violence.

Exploring EFs and Math Abilities in Highly Deprived Contexts.

Executive functions (EFs)' development is critically affected by childhood adversity exposure. Although recent studies underlined the deleterious effects of early life stresses on working memory (WM) and inhibitory control, they were scarcely investigated in war context especially in relation with learning abilities. In order to fill this gap, we designed a research with the aim to evaluate EFs together with early math skills. In particular, we conducted a study involving 150 children divided into three groups: 48 Yazidis (M age = 71 months, SD = 6.59), 47 Syrian refugees (M age = 68.77 months, SD = 7, age), and 55 Italians (M age = 68.65 months, SD = 2.88) attending the third year of kindergarten in Italy or inserted in Psyco-Social-Support activities in Iraq. The children were evaluated with a variety of tasks assessing WM, inhibitory control, counting, digit-quantity mapping, and digit naming skills. The results indicated substantial differences both in EFs and early numerical abilities between the deprived groups and the Italian children. Data are discussed in terms of implications for children both exposed to mainstream school environments and living in socio-economically disadvantaged and deprived contexts.

Evaluation and training of Executive Functions in genocide survivors. The case of Yazidi children.

Executive Functions (EFs) development is critically affected by stress and trauma, as well as the socioeconomic context in which children grow up (Welsh, Nix, Blair, Bierman, & Nelson, 2010, Journal of Educational Psychology, 102, 43-53). Research in this field is surprisingly lacking in relation to war contexts. This study represents a first attempt at addressing this topic by evaluating EFs in Yazidi children. The Yazidi community is an ethnic and religious minority living in Iraq. From August 2014 onwards, the Yazidi community has been the target of several atrocities perpetrated by ISIS and described as genocide by the international community at large. The University of Trieste, thanks to a program financed by the Friuli Venezia Giulia Region, developed a study aimed at (a) evaluating hot and cool EFs in children living in a war context and (b) developing a specific training method to enhance hot and cool EFs in Yazidi children of preschool age (N = 53). Data related to this group of children were compared with a sample of typically developing Italian children randomly assigned to either an EFs training group (N = 55) or a passive control group (N = 51). Results indicate different baselines in EFs in Yazidi and Italian samples and a significant effect of the program on both trained groups, especially in tasks measuring hot EFs. Data are discussed in terms of hot and cool EFs in children growing in adverse environments, as well as the evaluation of educational and developmental opportunities to prevent children who survived genocide from becoming a 'lost generation'. A video abstract of this article can be viewed at https://youtu.be/7t_08TbxR_8.

Economic Evaluation of an Integrated Health and Social Care Program for Heart Failure Through 2 Different Modeling Techniques.

INTRODUCTION: An integrated health and social care program for patients with heart failure (HF) was implemented at the Friuli-Venezia Giulia deployment site as part of the SmartCare European project. The objective of this study was to validate 2 different decision modeling techniques used to perform the economic evaluation. METHODS: Data were collected during the SmartCare project which enrolled 108 patients with HF and followed for more than 6 months. The techniques used were Markov and discrete event simulation models. In both cases, a cost-effectiveness analysis and a budget impact analysis were carried out. The former was used to assign priority to the intervention and the latter to assess its sustainability. Analyses were conducted from the perspective of the Regional Health Authority. RESULTS: Results were similar with both types of model. Cost-effectiveness analysis found no significant differences in quality of life, but the intervention generated significant cost savings, becoming the dominant option. Data extrapolation showed no benefits in terms of mortality or hospital admissions, but budget impact analysis also predicted annual savings, as a significant number of in-hospital days were avoided. In budget analysis, both models predicted early, increasing and cumulative annual savings. DISCUSSION: The integrated program was dominant as it provided better outcomes and lower total costs, and thus, decision-makers should prioritize it. Besides, the work demonstrates the capacity of decision modeling to become a complementary tool in managing integrated health and social care models.