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AbstractBackgroundSyrians have been the largest group of refugees in Germany since 2014. Little is known about Syrian refugees` perspectives on substance use. The aim of this study is to investigate the perspective of male refugees from Syria and to foster specific knowledge and understanding of substance use.MethodsWe applied a qualitative study design. Five semi-structured focus group discussions with a total of 19 refugees were conducted in 2019 among the difficult to reach population of Syrian refugees. Audio recordings were translated and transcribed. We used a hybrid approach by integrating inductive and deductive thematic frameworks.ResultsWe identified common themes. Firstly, refugees perceived that substances are widely available and accepted in Germany. Secondly, refugees perceived that rules and norms in Germany differ from rules and norms in the home country and favor availability of substances. Thirdly, substance use is related to the intention to escape the past. Fourthly, substance use is related to living in the present through connecting with others and being part of the community. Finally, mental health professional treatment for substance use is associated with shame.ConclusionsFindings support Syrian refugees` perspectives of substance use as a way of both escaping the past and coping with psychosocial difficulties in the present in a socio-ecological understanding. Understanding the explanatory model of Syrian refugees can inform future interventions to prevent substance abuse and design tailored interventions. Further studies with Syrian refugees in more countries are needed to better understand resettled refugees` perspectives on substance use.

While the COVID-19 pandemic forced millions of people to stay home and minimize their social contacts, newspaper reports worldwide raised concerns as they reported an increasing rate of intimate partner violence (IPV). One link of the measures enforced to control the pandemic to IPV might be a possible side effect of those measures, namely social and geographical isolation. As there was no scientific data investigating the association of IPV and social and geographical isolation in the context of epidemics or pandemics at the time of conducting this rapid review, we aimed at investigating a broader range of contexts of social as well as geographical isolation and its association with IPV to draw conclusions regarding the COVID-19 pandemic. We searched Embase, PubMed, PsycINFO, and Web of Science (core collection). A research strategy was developed and observational studies were included if they considered men and/or women, estimates of social and geographical isolation, and IPV as a primary outcome. Of the 526 identified studies, 11 were included in this review. The included studies involved 15,695 women and were conducted in the USA, Sweden, Ethiopia, Egypt, Spain, and Turkey. Indicators of social isolation such as lack of social, emotional, or informational support or the frequency and quality of social contacts were narratively assessed. Geographical isolation was primarily assessed by physical distance to the next town or support service. Both social and geographic isolation were found to be associated with an increased risk of IPV. Recommendations made by the individual studies include the following: (a) improving access to social networks outside the victims' own group, (b) improving their economic circumstances, (c) asserting the responsibility for those in contact with the victims, and (d) increasing the focus on access to preventive services and programs need to be taken into account. Therefore, considering the particular infrastructure and legislation of the countries affected by the pandemic, policies ...

Zusammenfassung: Zielsetzung: Personen mit Fluchthintergrund weisen besondere Risiken für substanzbezogene Störungen auf. Zugleich werden sie seltener von Suchthilfeeinrichtungen erreicht. Strategien zur Prävention und Behandlung von Substanzstörungen bei Geflüchteten sind deshalb dringend erforderlich. Methodik: In vier eng miteinander verbundenen Projekten nutzt der PREPARE-Verbund ein Spektrum von methodischen Ansätzen, darunter systematische "Rapid Assessments", die multiple Indikatoren und Informationsquellen kombinieren, qualitative Erhebungen und Interventionsstudien zur Prävention und Behandlung. Ergebnisse: PREPARE wird systematisch Erkenntnisse zu Substanzproblemen bei Geflüchteten in Deutschland bereitstellen, Strategien zu guter Praxis für Suchtprävention und -behandlung identifizieren, einen Beitrag zu einer verbesserten Diagnostik von Substanzproblemen bei Geflüchteten leisten und innovative Interventionen zur indizierten Prävention von substanzbezogenen Störungen und zur integrativen Behandlung von Betroffenen mit Traumatisierungen und substanzbezogenen Störungen entwickeln. Weiter wird ein nationales webbasiertes Ressourcenzentrum in Zusammenarbeit mit der Deutschen Hauptstelle für Suchtfragen (DHS) aufgebaut. Schlussfolgerungen: Geflüchtete mit substanzbezogenen Störungen weisen besondere Bedarfe in Bezug auf den Zugang zu Angeboten der Suchthilfe und die Art der Hilfen auf. Der PREPARE-Verbund soll dazu beitragen, diese besonders vulnerable Gruppe besser zu versorgen.

Purpose– The purpose of this paper is to examine differences in the experience of somatic symptoms by domain (exhaustion, musculoskeletal, gastrointestinal, heart distress) between psychologically abused and non-abused older persons, and to scrutinize associations between abuse and somatic symptoms while considering other factors (e.g. social support).Design/methodology/approach– The design was cross-sectional. The participants were 4,467 women/men aged 60-84 years living in seven European cities. The data were analysed using bivariate/multivariate methods.Findings– Psychologically abused participants scored higher on all somatic symptom domains than non-abused, and thus were more affected by the symptoms. The regressions confirmed a positive association between psychological abuse and most somatic symptom domains, but other factors (e.g. depression, anxiety) were more salient. Demographics/socio-economics were positively (e.g. marriage/cohabitation) or negatively (e.g. education) associated with somatic symptoms depending on the domain. Social support and family structure "protected" the experience of somatic symptoms.Research limitations/implications– The research focused on psychological abuse. It did not incorporate other abuse types calling for further research on the effects of other abuse types on somatic symptoms. Nevertheless, the findings indicate that psychological abuse is linked to somatic symptoms, but the role of other factors (e.g. depression, anxiety, social support) is also important.Practical implications– Improvements in the older person's situation regarding somatic symptoms need to consider psychological abuse, co-morbidities, social support and living conditions.Originality/value– The paper reports data from the ABUEL Survey, which collected population-based data on elder abuse.

Abstract
Social support may encourage victims to disclose their experiences of intimate partner violence (IPV), but also to seek the appropriate help and care in the social and health services. Using data from a multicenter European project, DOVE (Domestic Violence Against women/men in Europe—prevalence, determinants, effects, and policies/practices), the present study aimed at measuring the frequency of primary care and emergency use according to IPV types of victimization, and to investigate whether victims receiving different levels of informal social support are using health care differently. Results suggested a significant association between IPV types and use of emergency services, and no association was found regarding primary care services. Victims of physical abuse and sexual coercion went to the emergency department (ED) more frequently (more than once a year). Also, victims of physical abuse receiving low social support visited an ED more frequently than those with high social support, whereas victims of sexual coercion with high informal social support went more often to the ED compared with victims of sexual coercion with low social support, even after controlling for other covariates. These results seem to suggest that social support has a significant role in the decision to use health care among victims of IPV.

A year has passed, and the COVID-19 pandemic continues to spread around the world. Apart from its direct devastating health consequences, voices have been raised about decreasing mental health. The introduction of social distancing measures and lockdown to prevent the spread of COVID-19 led to a sudden change of routine, a drastic change of the physical and social environment (e.g., reduced social contacts and connection), a change of working conditions and economic losses, all are known to be important drivers for mental health and mental disorders. Evidence from previous studies that have examined the psychological impact of disaster and outbreaks, shows that such health emergencies have its toll on mental health. In Hong-Kong, for example, suicide rates rose sharply during the 2003 SARS epidemic. Given that measures taken during the SARS epidemic interfered much less with normal life and for a shorter period, it is not far-fetched to assume that the COVID-19 pandemic, in one way or another, will affect mental health. In fact, surveys conducted so far, using contemporary data from national surveys, show that since the start of the pandemic, mental health has deteriorated. Current research suggests that poorer mental health is associated with increased fear of illness, social distancing policies and social adversities (e.g. loss of employment), housing conditions as well as loss of support from health and other services. As a consequence of the lockdown and social distancing measures, psychosocial services as well as in- and out-patient mental health care facilities greatly interrupted, reduced and changed their services. Many services switched from face-to-face to digital services and check-in phone calls. However, due to lack of access or ability to use technology and a lack of privacy, remote care is not always considered sufficient. Additionally, people at risk, might feel stigmatized due to the perceptions of being a burden to society. The epidemic may shatter personal goals and way of living and undermine a sense of meaning in life and trust in others. Meaning making, however, is a predictor of resilience and mental health. Resilience is a multidimensional concept which can be defined as being able to adapt to stressful (e.g., family and relationship problems, workplace and financial stressors) and extraordinary threatening events, such as a pandemic. The factors, which contribute to resilience, are manifold, including individual, interpersonal and community factors. At the individual level, very recent research suggests that healthcare personnel, youth and older individuals, and those with a current or past medical history, especially a history of mental illness, are at risk. Additionally, we learnt from other disasters that at the interpersonal level, social isolation, and lack of trusting relationships and at the society level lack of trust in the government might put people at risk. While evidence about the effects of COVID-19 on resilience and mental health is emerging, at this point, no accurate assumptions about the extent of the pandemic on mental health can be made. Furthermore, the mental health responses to the pandemic and the trajectories of mental health and resilience remain unknown. Approaches to mental health and psychiatric care in such outbreaks remain poorly understood, outlined or covered by existing research and there is virtually no substantial knowledge of the mental health impact of rapidly spreading outbreaks of infectious diseases. International cooperation is essential for building appropriate mental health prevention and promotion strategies. Identifying factors that may contribute to better mental health and greater psychological resilience at an international level and sharing experiences and information is of utmost importance. Therefore, a comprehensive assessment of the prevalence, risk and protective factors, of mental health is necessary. For that reasons the international Public Mental Health Section of the European Public Health Association (EUPHA) initiated this study and worked together with the consortium members to set up the Coping with COVID-19 with Resilience (COPERS) study. The consortium includes members of 10 countries all over Europe. COPERS aims to grasp longitudinally the extent of mental health and resilience across Europe, to identify mental health, and resilience trajectories of adults aged 18 years and older and to detect factors that potentially influence mental health and resilience in the different countries. The researchers also aim to conduct a living mapping review to identify, analyze, and present mental health policy responses to the COVID-19 pandemic and contribute to better knowledge on how to support personal and community resilience in times of a pandemic.

Background Preliminary country-specific reports suggest that the COVID-19 pandemic has a negative impact on the mental health of the healthcare workforce. In this paper, we summarize the protocol of the COVID-19 HEalth caRe wOrkErS (HEROES) study, an ongoing, global initiative, aimed to describe and track longitudinal trajectories of mental health symptoms and disorders among health care workers at different phases of the pandemic across a wide range of countries in Latin America, Europe, Africa, Middle-East, and Asia. Methods Participants from various settings, including primary care clinics, hospitals, nursing homes, and mental health facilities, are being enrolled. In 26 countries, we are using a similar study design with harmonized measures to capture data on COVID-19 related exposures and variables of interest during two years of follow-up. Exposures include potential stressors related to working in healthcare during the COVID-19 pandemic, as well as sociodemographic and clinical factors. Primary outcomes of interest include mental health variables such as psychological distress, depressive symptoms, and posttraumatic stress disorders. Other domains of interest include potentially mediating or moderating influences such as workplace conditions, trust in the government, and the country's income level. Results As of August 2021, similar to 34,000 health workers have been recruited. A general characterization of the recruited samples by sociodemographic and workplace variables is presented. Most participating countries have identified several health facilities where they can identify denominators and attain acceptable response rates. Of the 26 countries, 22 are collecting data and 2 plan to start shortly. Conclusions This is one of the most extensive global studies on the mental health of healthcare workers during the COVID-19 pandemic, including a variety of countries with diverse economic realities and different levels of severity of pandemic and management. Moreover, unlike most previous studies, we ...

A new introduction to a timeless dynamic: how the movement of humans affects health everywhere. International migrants compose more than three percent of the world's population, and internal migrants—those migrating within countries—are more than triple that number. Population migration has long been, and remains today, one of the central demographic shifts shaping the world around us. The world's history—and its health—is shaped and colored by stories of migration patterns, the policies and political events that drive these movements, and narratives of individual migrants. Migration and Health offers the most expansive framework to date for understanding and reckoning with human migration's implications for public health and its determinants. It interrogates this complex relationship by considering not only the welfare of migrants, but also that of the source, destination, and ensuing-generation populations. The result is an elevated, interdisciplinary resource for understanding what is known—and the considerable territory of what is not known—at an intersection that promises to grow in importance and influence as the century unfolds