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Dropout from healthcare interventions can negatively affect patients and healthcare providers through impaired trust in the healthcare system and ineffective use of resources. Research on this topic is still largely missing on refugees and asylum seekers. The current study aimed to characterize predictors for dropout in the Mental Health in Refugees and Asylum Seekers (MEHIRA) study, one of the largest multicentered controlled trials investigating the effectiveness and cost-effectiveness of a nationwide stepped and collaborative care model.
Predictors were multiply imputed and selected for descriptive modelling using backward elimination. The final variable set was entered into logistic regression.
The overall dropout rate was 41,7%. Dropout was higher in participants in group therapy (p = 0.001; OR = 10.7), with larger satisfaction with social relationships (p = 0.017; OR = 1.87), with difficulties in maintaining personal relationships (p = 0.005; OR = 4.27), and with higher depressive symptoms (p = 0.029; OR = 1.05). Participants living in refugee accommodation (p = 0.040; OR = 0.45), with a change in social status (p = 0.008; OR = 0.67) and with conduct (p = 0.020; OR = 0.24) and emotional problems (p = 0.013; OR = 0.31) were significantly less likely to drop out of treatment.
Overall, the outcomes of this study suggest that predictors assessing social relationships, social status, and living conditions should be considered as topics of psychological treatment to increase adherence and as predictors for future research studies (including treatment type).
This paper presents an assessment of the surplus grass production in the Region of Southern Denmark, and the perspectives of utilizing it in local biogas production. Grass production represents a significant role in the Danish agricultural sector. However, statistical data show an excess production of averagely 12% in the period 2006–2012. Based on spatial analyses and statistical data, the geographical distribution of grass production and consumption was estimated and mapped for the Region of Southern Denmark. An excess production of grass was estimated for several of the municipalities in the Region of Southern Denmark, but the excess production was found to be quite sensitive to the management practice of the grass fields and the productivity of the grass. The yields of excess grass estimated in the sensitive and conservative scenario were found to be sufficient to serve a sole co-substrate in 2–8 biogas plants using animal manure as primary feedstock. The yields in the intensive scenario were assessed to be sufficient to serve a sole co-substrate in 8–16 biogas plants. Alternatively, at least 31% of the regionally produced maize which is exported to the biogas sector could annually be substituted by methane produced from the production of excess grass. The intensive scenario was estimated to have significantly higher grass yields than the sensitive and conservative scenario. The environmental impacts of intensified agricultural management should, however, be assessed carefully in order to ensure that the ecosystems are not increasingly being burdened. The potential of utilizing residual grass for energy production in the region or as an alternative to the maize exported to Northern Germany, was concluded to seem as a promising possibility for a sustainable development of the regional biogas sector. Furthermore, it could provide incentives for establishing new biogas plants in the region and thereby increase the share of manure being digested anaerobically, which could help extrapolate the environmental and climate related benefits documented for the use of digested animal manure as fertilizer on agricultural land.
LiFe1/3Mn1/3Co1/3PO4 (LFMC) has been synthesized by a microwave-assisted hydrothermal technique. During the crystal growth, two evolutionary routes coexist and compete with each other after the nuclei have been stably formed. One of them is the continuous growth of single particles and the other one is agglomeration. The size and morphology of the products are determined by the interplay of the two competing routes. The growth morphology is quantitatively analyzed from first principle calculations. A phase diagram is constructed, which guides to control the morphology by adjusting CM and pH. Static magnetic properties imply long range antiferromagnetic order below TN = 39 K and a paramagnetic Curie–Weiss-like behavior with θ = 75 K and peff = 5.51 μB at high temperatures. Cyclic voltammetry shows two distinct peaks corresponding to the Fe2+/Fe3+ and Co2+/Co3+ redox couples, respectively, whereas the Mn2+/Mn3+ redox couple is not observed due to its sluggish kinetics induced by the Jahn–Teller effect of Mn3+.
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