Depression and anxiety in female refugees from East Africa and the Middle East displaced to Germany: cross-sectional results of the female refugee study, taking sociodemographic and migration-related factors into account.

At the end of 2022, 108.4 million people around the world were forcibly displaced, the highest number ever recorded. Of these, 50% were women. Despite this situation, little is known about the mental health of female refugees. The first aim of this study was to examine the prevalence of depression and anxiety symptoms among female refugees in Germany. The second aim was to examine which sociodemographic and migration-related variables have an impact on refugees' mental health, and the third aim was to assess the potential predictors of their mental health. A sample of 92 female refugees from East Africa and the Middle East living in Germany were interviewed. Symptoms of depression and anxiety were assessed using the Hopkins Symptom Checklist (HSCL-25). The experience of potentially traumatic events (PTEs) was assessed using the Posttraumatic Diagnostic Scale (PDS) and the Harvard Trauma Questionnaire (HTQ). In our sample of female refugees, 65.2% reported symptoms of depression, and 60.9% reported symptoms of anxiety. Symptoms of depression or anxiety were associated with being from the Middle East, having a higher level of education, and reporting more PTEs. The multiple regression model for anxiety was able to explain 32.4% of the variance in anxiety symptoms. The findings highlight the high burden of mental health problems that female refugees bear. The identified predictors of depressive and anxiety symptoms should sensitize medical and refugee professionals to identify vulnerable individuals and groups, refer them to appropriate psychological treatment, and, where possible, modify the identified predictors.

Near-death experiences, attacks by family members, and absence of health care in their home countries affect the quality of life of refugee women in Germany: a multi-region, cross-sectional, gender-sensitive study.

BACKGROUND: The year 2016 has marked the highest number of displaced people worldwide on record. A large number of these refugees are women, yet little is known about their specific situation and the hurdles they have to face during their journey. Herein, we investigated whether sociodemographic characteristics and traumatic experiences in the home country and during the flight affected the quality of life of refugee women arriving in Germany in 2015-2016. METHODS: Six hundred sixty-three women from six countries (Afghanistan, Syria, Iran, Iraq, Somalia, and Eritrea) living in shared reception facilities in five distinct German regions were interviewed by native speakers using a structured questionnaire. Sociodemographic data and information about reasons for fleeing, traumatic experiences, symptoms, quality of life, and expectations towards their future were elicited. All information was stored in a central database in Berlin. Descriptive analyses, correlations, and multivariate analyses were performed. RESULTS: The most frequent reasons cited for fleeing were war, terror, and threat to one's life or the life of a family member. Eighty-seven percent of women resorted to smugglers to make the journey to Europe, and this significantly correlated to residence in a war zone (odds ratio (OR) = 2.5, 95% confidence interval (CI) = 1.4-4.6, p = 0.003) and homelessness prior to fleeing (OR = 2.1, 95% CI = 1-4.3, p = 0.04). Overall the described quality of life by the women was moderate (overall mean = 3.23, range of 1-5) and slightly worse than that of European populations (overall mean = 3.68, p < 0.0001). The main reasons correlating with lower quality of life were older age, having had a near-death experience, having been attacked by a family member, and absence of health care in case of illness. CONCLUSIONS: Refugee women experience multiple traumatic experiences before and/or during their journey, some of which are gender-specific. These experiences affect the quality of life in their current country of residence and might impact their integration. We encourage the early investigation of these traumatic experiences to rapidly identify women at higher risk and to improve health care for somatic and mental illness.

[What Enhances Teachers' Health at Inclusive Primary Schools? A Mixed-Methods Approach]. / Was trägt zur Verbesserung der gesundheitlichen Situation von Lehrkräften (LK) am Arbeitsplatz Schwerpunktgrundschule (SPGS) bei? Ein Mixed-Methods-Ansatz.

AIM: Teachers' suggestions to enhance their health at inclusive primary schools ("Schwerpunktgrundschulen") were analyzed by quantitative content analysis taking personal or job-related parameters of effort and strain into consideration. METHOD: The paper and pencil cross-sectional study was conducted by Institut für Lehrergesundheit (IFL) between August 2013 and April 2015 at 14 schools in Rhineland-Palatinate. Overall response rate was 46.3% (143/309 teachers). The answers to the open-ended question "Which concrete job-related measures would enhance your wellbeing or health situation at your work place?" was categorized and quantified. An analysis of the item-non-response was undertaken. The aim was to identify by logistic regression, personal or job-related parameters of effort or strain associated with a specific category. RESULTS: Data from 143 teachers were analyzed. 79 teachers made 362 suggestions to enhance the health situation at their work place. Making a suggestion was not related to socio-demographic parameters. 33.6% of the teachers addressed physical environmental conditions of work, e. g., climatic or acoustic conditions or the availability of space for recreation. 29.4% of the teachers made suggestions concerning human resource strategy (e. g., "double teaching"). 9.1% of the teachers referred to aspects of relationships with colleagues. After regression analysis, there were relationships between suggestions of single categories and specific job-related parameters of effort. Furthermore, teachers under (high) strain - here: teachers who (very) strongly experienced their work as hazardous to health - showed significantly higher odds to make suggestions of the categories "Colleagues" (aOR 3.71; 95%CI 1.00-13.76) or "External Support" (e. g., "supervision") (aOR 3.92; 95%CI 1.15-13.41) than teachers experiencing less stress. CONCLUSIONS: Teachers of inclusive primary schools are ready to take active part in health-related organizational development. The development of problem- and group-specific measures of intervention will be facilitated by the combined analysis of qualitative and quantitative data.

Liquid release as a source of potential drug exposure during the handling of intravenous infusions in nursing.

PURPOSE: This study aims at experimentally determining the incidence and extent of liquid releases onto the operator's hands and into the work environment during common nursing operations involving infusions. METHODS: A sequence of operations related to the preparation and administration of infusions was conducted by three subjects for 15 times each using fluorescein marked infusion solutions and two different infusion sets (standard set vs. safety-optimized set). Unintended release of liquid was quantified by glove and surface wipe sampling and HPLC/FD analysis of the samples. Operations concerning the disposal of infusions were also part of the study. RESULTS: In over 90% of the simulations, a release of infusion solution was observed in a standard workflow, comprising priming and decapping the infusion set, connecting it to a peripheral intravenous (IV) cannula, and detaching it again. Based on median values (229 vs. 26 µl), the release of infusion solution was about ninefold higher when using the non-optimized standard infusion set. During decapping, a hand contamination was found in a majority of cases. CONCLUSIONS: The handling of infusions may involve a risk of nurses' exposure to active agents by release of infusion solution into the work environment. According to our results with different infusion sets, exposure risks can be reduced technically and by appropriate handling. Nevertheless, hand contaminations found for both sets emphasize the necessity for additional measures such as more consistent use of protective gloves.

Seroepidemiology of hepatitis A and B and vaccination status in staff at German schools for the handicapped.

This study aims to assess serostatus and vaccination status of hepatitis A and B among staff at schools for the handicapped. We also wanted to investigate factors associated with serostatus, number of infections with hepatitis A/hepatitis B at work, and factors influencing being vaccinated or not. The cross-sectional study was carried out between August 2010 and August 2012 at 13 German schools for severely handicapped. Data were analyzed using blood samples, vaccination documents, and questionnaires. A total of 395 persons participated in our study (response: 59.7%), information on 367 could be used for analysis. Two respondents have been infected with HAV at work, 53.4% were anti-HAV seropositive. Vaccination against hepatitis A was influenced by information about infectious diseases before starting to work, level of education, and marital status. One person got infected with hepatitis B during work, 53.2% were anti-HBs-seropositive. Vaccination against hepatitis B depended on perceived burden by nursing activities, and vaccination costs being paid by employer. Immunity to hepatitis A and B in our sample is insufficient and does not correspond to the infectious risks. Two persons got infected with hepatitis A and one person with hepatitis B during work at school, indicating an urgent need for preventive actions. J. Med. Virol. 89:825-833, 2017. © 2016 Wiley Periodicals, Inc.

How can the health situation and well-being of staff at German schools for the severely handicapped be improved?

PURPOSE: The aim of the study was to describe measures suggested by staff at German schools for the severely handicapped regarding possibilities to improve their health situation and well-being at work. We further wanted to analyze whether sociodemographic, occupation-related, and health-related characteristics influence the type of measures proposed. METHODS: The cross-sectional study was carried out between August 2010 and August 2012 at 13 schools for the handicapped focusing on motoric and/or holistic development of severely handicapped pupils. Data of teachers and educational staff were surveyed using written questionnaires. The analysis is based on free-text answers regarding the question: "What specific occupation-related measures would lead to an improvement of your well-being or health situation at the workplace?" RESULTS: A total of 395 persons (response proportion: 59.7 %) with a mean age of 45 years and predominantly female (86.8 %) participated in our survey. A total of 205 persons answered the study question providing 456 improvement suggestions, which were classified into 6 main and 13 subcategories. The main categories were professional education and supervision, organization of working tasks and time, work safety and work equipment, social aspects of work, human resources and contractual framework, and other. Measures proposed were influenced by gender, burden by nursing activities, teaching, and administrative tasks, and frequency of deterioration in working atmosphere. DISCUSSION: Proposed measures raise awareness for job-related health stressors and are a starting point to improve working conditions at these schools. Since suggestions vary widely by school and composition of staff, individual priorities have to be set and discussed with the school management.

Occupational injuries of teachers and educational staff at special schools with multiple and severely handicapped children in Rhineland-Palatinate (Germany): results of a cross-sectional study.

OBJECTIVES: The present study aimed to describe the prevalence, type, and influencing factors of occupational injuries of staff working at special schools with multiple and severely handicapped pupils in Southwestern Germany. METHODS: This cross-sectional study was carried out between August 2010 and August 2012 at 13 special schools with focus on motoric and/or holistic development of handicapped pupils in Rhineland-Palatinate (Germany). Participants were interviewed using a written questionnaire. RESULTS: There were 395 participants (response proportion: 59.7%) in our study, with 390 being eligible for statistical analysis. Respondents were on average 45 years old and mainly female (86.9%). The 12-month injury prevalence was 16.9%. Joint dislocations, sprains, and torn ligaments (41.6%) were the main types of injuries. Pupils (59.8%) and auxiliary equipment (12.2%) were identified as the main causes of injury by the respondents. Multivariable logistic regression analysis showed that washing pupils (using auxiliary equipment) (aOR, 3.93; 95% CI, 1.66-9.31) and daily physical strain due to unexpected conduct of pupils (aOR, 3.70; 95% CI, 1.20-11.37) were the main influencing factors for an occupational injury. CONCLUSIONS: Almost one in five persons suffered an occupational injury in the previous 12 months. Nursing activities, including close contact with pupils, were identified as the most important factors for an injury. In order to prevent injuries at special schools, a multifaceted approach is necessary. This includes sufficient supply of auxiliary devices including proper technical maintenance. Furthermore, regular participation in training for manual handling of heavy loads and schooling on the technical use of auxiliary devices should be encouraged.

Prevalence and influencing factors of chronic back pain among staff at special schools with multiple and severely handicapped children in Germany: results of a cross-sectional study.

BACKGROUND: In Germany, about 70,000 teachers and educational staff were teaching at more than 3,000 special schools during the school year 2010/2011. Nursing services like lifting pupils form a substantial part of the work content of the staff at special schools. Since nursing care often involves carrying and lifting pupils, there is a reason to assume an adverse effect on the musculoskeletal health of teachers and other professionals. With the present study we aimed to describe the prevalence and risk factors of chronic back pain among employees at this type of school. METHODS: The cross-sectional survey was carried out between August 2010 and August 2012 at 13 special schools focusing on motoric and/or holistic development of handicapped children in Rhineland-Palatinate (Germany). Teachers and educational staff were interviewed using a questionnaire. We applied multivariable logistic regression analyses to identify influencing factors of chronic back pain. RESULTS: Altogether 395 persons (response rate: 59.7%) participated in our study. Respondents were mostly female (86.8%) with a mean age of 45 years. The prevalence of chronic back pain was 38.7%. More than 40% reported frequently carrying and lifting heavy loads (>20 kg). Age [adjusted OR = 1.03 (95%-CI 1.00-1.05) for 1-year increase in age], current smoking [adjusted OR = 2.31 (95%-CI 1.27-4.23)], depression/depressive mood [adjusted OR = 1.85 (95%-CI 1.12-3.06)], frequently carrying and lifting heavy loads [adjusted OR = 2.69 (95%-CI 1.53-4.75)], and frequent exposure to environmental impacts [adjusted OR = 2.18 (95%-CI 1.26-3.76)] were influencing factors of chronic back pain in the final multivariable regression model. CONCLUSIONS: A large proportion of teachers and educational staff suffered from chronic back pain in our study, indicating a high need for treatment in this professional group. Increasing age, current smoking, a diagnosed depression/depressive mood, carrying and lifting heavy loads, and exposure to environmental impacts were associated with chronic back pain. Due to the sparse literature on the topic, further studies using a longitudinal design are necessary for a better understanding of the risk factors of chronic back pain.

The "Mainzer EMF-Wachhund": results from a watchdog project on self-reported health complaints attributed to exposure to electromagnetic fields.

The "Mainzer EMF-Wachhund," a watchdog project, offered a system of self-notification of health complaints attributed to exposures to electromagnetic fields (EMFs) to a population of a part of Germany with about 4 million inhabitants. By using a self-administered questionnaire, which was provided online and for download from the Internet, 192 persons reported such health complaints in the period from October 2003 to March 2005. Of these, 56% classified themselves as electromagnetic hypersensitive (EH). Predictors of this self classification were being affected by all kinds of EMF rather than single EMF sources and being female. On average, EH subjects reported a high degree of suffering, 77% of whom had already sought advice from physicians. An Internet-based standardized questionnaire is an economic way of offering affected persons a direct link to scientific institutions to establish contact. However, the study base obtained by such an approach is not representative to estimate a population-based prevalence. As a large number of subjects did not classify themselves as EH and reported very specific links between exposure and symptoms, they may provide a very distinct and interesting group for future research.