On Modeling Missing Data in Structural Investigations Based on Tetrachoric Correlations With Free and Fixed Factor Loadings.

In modeling missing data, the missing data latent variable of the confirmatory factor model accounts for systematic variation associated with missing data so that replacement of what is missing is not required. This study aimed at extending the modeling missing data approach to tetrachoric correlations as input and at exploring the consequences of switching between models with free and fixed factor loadings. In a simulation study, confirmatory factor analysis (CFA) models with and without a missing data latent variable were used for investigating the structure of data with and without missing data. In addition, the numbers of columns of data sets with missing data and the amount of missing data were varied. The root mean square error of approximation (RMSEA) results revealed that an additional missing data latent variable recovered the degree-of-model fit characterizing complete data when tetrachoric correlations served as input while comparative fit index (CFI) results showed overestimation of this degree-of-model fit. Whereas the results for fixed factor loadings were in line with the assumptions of modeling missing data, the other results showed only partial agreement. Therefore, modeling missing data with fixed factor loadings is recommended.

[Early crisis response to the COVID-19 pandemic in collective accommodation facilities for refugees : Analysis of cross-actor working arrangements from the perspective of the reception authorities in Germany]. / Krisenreaktion zu Beginn der COVID-19-Pandemie in Sammelunterkünften für Geflüchtete : Analyse der akteursübergreifenden Zusammenarbeit aus Perspektive der Aufnahmebehörden in Deutschland.

BACKGROUND: Refugees in collective accommodation facilities are at increased risk of COVID-19-infections due to high occupancy density and shared spaces. It is unclear which (organisational) actors the reception authorities were working with in their crisis response and how. The aim of this paper is to examine the working arrangements between reception authorities and other actors involved in accommodation and (health) care during the first wave of the COVID-19 pandemic and to derive recommendations for future crisis responses. METHODS: The analysis was based on qualitative interviews with representatives responsible for the reception and accommodation of refugees (N = 46) conducted from May to July 2020. Cross-actor networks were visualised, and a qualitative analysis of the data material was carried out using the framework method. RESULTS: The reception authorities worked with a multitude of other (organisational) actors. Health authorities, social workers and security personnel were mentioned most frequently. The crisis response was found to be highly heterogeneous due to its dependence on the commitment, knowledge and attitude of the individuals and organisations involved. In the absence of a coordinating actor, there may also be delays due to a "wait-and-see" attitude of the actors involved. CONCLUSION: Crisis response in collective accommodation facilities for refugees would benefit from a clear allocation of the coordinating role to an appropriate actor. Instead of improvised ad hoc solutions, sustainable improvements in terms of transformative resilience are needed to reduce structural vulnerabilities.

From Research into Practice: Converting Epidemiological Data into Relevant Information for Planning of Regional Health Services for Refugees in Germany.

Health data of refugees and asylum seekers (ASR) is not routinely collected in Germany. Based on health data of ASR collected in 2018 in regional accommodation centres, we developed a dashboard to estimate regional burden of disease in Baden-Wuerttemberg, Germany. We aimed to find out how scientific data can support actors involved in healthcare planning for ASR in Germany and, within this scope, to explore how healthcare planning is conducted in this context. We conducted 12 qualitative semi-structured interviews including a usability test for a health data dashboard with regional decision-makers. Results showed that healthcare planning processes for ASR in Germany involve a complex set of actors in both long- and short-term decision-making. Data gained from representative surveys can support long-term decision-making and thus support the resilience of the health system, but it must balance the need for simple data presentation with transparent communication of potentially complex methods.

Covid-19 pandemic policy monitor (COV-PPM) - European level tracking data of non-pharmaceutical interventions.

The Covid-19 Pandemic Policy Monitor (COV-PPM) dataset prospectively documents non-pharmaceutical interventions (NPIs) taken to contain SARS-Cov-2 transmission across countries in EU27, EEA and UK. In Germany, measures have also been recorded at the federal state and, partially, at the district levels. NPIs implemented since January 2020 have been retrieved and updated weekly from March 2020, from official governments webpages, Ministries of Health, National (Public) Health Institutes or Administrations. NPI categories collected refer to restrictions, closures or changes in functioning implemented in 13 domains: public events (gatherings in indoor or outdoor spaces); public institutions (kindergartens, schools, universities); public spaces (shops, bars, restaurants); public transport (trains, buses, trams, metro); citizens movement/mobility (e.g. pedestrians, cars, ships); border closures (air, land or sea, all incoming travels, from high-risk regions, only non-nationals); measures to improve the healthcare system (e.g. human resources or technical reinforcement, redistribution, material or infrastructural); measures for risk/vulnerable groups (e.g. elderly, chronically ill, pregnant); economic measures (e.g. lay-off rules establishment, actions to avoid job-loss, tax relaxation); testing policies (e.g. testing criteria changes); nose and mouth protection rules, vaccination and others/miscellaneous measures.

[COVID-19 in collective accommodation centres for refugees: assessment of pandemic control measures and priorities from the perspective of authorities]. / COVID-19 in Sammelunterkünften für Geflüchtete: Analyse von Pandemiemaßnahmen und prioritäre Bedarfe aus behördlicher Sicht.

BACKGROUND: The containment of the COVID-19 pandemic in collective accommodation centres is crucial to maintain the physical and mental health of refugees. It is unclear what measures have been taken by authorities in this setting to reduce the risk of infection, minimise stressors for refugees during the pandemic and communicate containment measures. OBJECTIVES: Assessment of measures that have been taken to prevent and contain SARS-CoV­2 in collective accommodation for refugees and identification of support required by authorities. METHODS: Qualitative interview study with 48 representatives responsible for the reception and accommodation of refugees. Individual interviews were transcribed verbatim and evaluated using framework analysis. RESULTS: We found substantial heterogeneity of measures taken to prevent infection, inform refugees, maintain social and health services, test for SARS-CoV­2 and quarantine positive cases. Effective intersectoral cooperation proved to be particularly important for coordination and implementation of measures. Need for support was expressed with regard to the improvement of infrastructure, opportunities to work with language interpreters and stronger involvement of local health experts. CONCLUSION: Amidst multiple actors and the complexity of structures and processes, the admission authorities have been taking on essential responsibilities related to infection control on an ad hoc basis, without being sufficiently positioned to do so. In order to further contain the pandemic, a strengthening of centralised, setting-specific recommendations and information as well as their translation through the pro-active involvement of the public health authorities at the local level are essential.

On Modeling Missing Data of an Incomplete Design in the CFA Framework.

The paper reports an investigation on whether valid results can be achieved in analyzing the structure of datasets although a large percentage of data is missing without replacement. Two types of confirmatory factor analysis (CFA) models were employed for this purpose: the missing data CFA model with an additional latent variable for representing the missing data and the semi-hierarchical CFA model that also includes the additional latent variable and reflects the hierarchical structure assumed to underlie the data. Whereas, the missing data CFA model assumes that the model is equally valid for all participants, the semi-hierarchical CFA model is implicitly specified differently for subgroups of participants with and without omissions. The comparison of these models with the regular one-factor model in investigating simulated binary data revealed that the modeling of missing data prevented negative effects of missing data on model fit. The investigation of the accuracy in estimating the factor loadings yielded the best results for the semi-hierarchical CFA model. The average estimated factor loadings for items with and without omissions showed the expected equal sizes. But even this model tended to underestimate the expected values.

Self-regulation strategies support children with ADHD to overcome symptom-related behavior in the classroom.

Children with attention deficit hyperactivity disorder (ADHD) suffer from self-regulation deficits that cause inattention, impulsivity, and hyperactivity. Self-regulation interventions may address these deficits, but to date, only few empirical studies have examined their benefits for children with ADHD in everyday life. The present study investigated three classroom interventions to promote self-regulation and tested their benefit on self-regulatory competencies (assessed with an ADHD questionnaire) in children with ADHD. Students of a special education school for children with ADHD participated in the intervention study that included three sessions (Session 1: Goal Intention or Goal Intention + If-Then Plan; Session 2: Goal Intention + If-Then Plan; Session 3: Goal Intention + If-Then Plan + Self-Monitoring). Teacher-rated self-regulatory competencies were assessed both before and after the intervention sessions. Children with ADHD had better self-regulatory competencies after their first Goal Intention + If-Then Plan Session, but lasting intervention effects were found only when children started with a mere goal intention session.

To what extent are task-switching deficits in children with attention-deficit/hyperactivity disorder independent of impaired inhibition?

Executive functions, higher-order cognitive functions needed for goal-directed behavior, have been studied extensively in the search for endophenotypes for ADHD, yet results have been inconclusive. We examine the performance of children with ADHD in task switching as an as yet understudied potential endophenotype. A group of 20 children with ADHD and a group of 23 children without ADHD (ages 7-12) performed a task-switching paradigm and a Go/No-Go Task. Children with ADHD displayed significantly greater specific switch costs, that is, compared to control children they were especially impaired directly after task switches. There were no group differences with respect to the general switch costs, which are estimated by comparing performance on single task blocks to the block where both tasks are intermixed. Specific switch costs and Go/No-Go error rate were significantly correlated; yet, group differences in the task-switching paradigm remained significant even when inhibition was controlled for. This pattern of results suggests that children with ADHD are neither generally impaired in executive function nor only impaired with respect to inhibition. Instead, they display a highly specific deficit with regard to the flexible suppression and amplification of different task rules according to the context. Our conclusion that task switching has the potential to be added to the list of ADHD endophenotypes is strengthened by the independence of task-switching deficits and inhibition.

[Deficient adaptive regulation of emotion in children with ADHD]. / Defizitäre adaptive emotions- regulation bei kindern mit ADHS.

OBJECTIVES: The current study investigates whether children with and without ADHD differ in their implementation of emotion-regulation strategies. In addition, it explores whether the regulation patterns of ADHD children are related to co-occurring behavioral and emotional problems. METHODS: A group of 21 children with ADHD and a group of 20 children without ADHD (ages 10-13) completed the Questionnaire on Emotion Regulation in Children and Adolescents (FEEL-KJ, Grob & Smolenski, 2005). Furthermore, we employed the parent-rated Strengths and Difficulties Questionnaire (Woerner, Becker & Rothenberger, 2004) to assess the socioemotional problems of ADHD children. RESULTS: Self-reports revealed group differences in terms of adaptive emotion regulation, though no group differences were found in terms of maladaptive emotion regulation. Specifically, children with ADHD reported less frequently applying the strategies "Cognitive Problem Solving," "Problem-Oriented Acting," "Mood Enhancement," "Reevaluation," and "Distraction." Children with ADHD also reported seeking social support less frequently than the controls. Moreover, significant negative correlations were found between adaptive coping and co-occurring behavioral and emotional problems. CONCLUSIONS: Children with and without ADHD specifically differ in their application of problem-oriented emotion-regulation strategies, especially those ADHD children suffer from co-occurring problems who particularly infrequently apply adaptive emotion regulation strategies.

Prediction of fracture callus mechanical properties using micro-CT images and voxel-based finite element analysis.

Assessment of fracture healing is a common problem in orthopaedic practice and research. To determine the effectiveness of certain treatments, drugs, mechanical loads, or rehabilitation regimes, the strength of the fracture callus must be determined. Both clinically and experimentally, there is a need to noninvasively and quantitatively evaluate fracture callus quality during healing. The objective of this study was to develop a method to assess fracture stiffness using micro-computed tomography (micro-CT) and finite element analysis. The method was developed and validated with plastic phantoms of various cross sections and known material properties, tested experimentally in four-point bending and torsion. The method was then applied to fractured rat femurs after 3 and 4 weeks of healing tested experimentally in torsion (50 femurs total). Micro-CT scans were made of the fracture calluses to determine three-dimensional geometry and material properties for the finite element models. Experimentally measured torsional rigidities were compared to finite element solutions. Finite element model predictions of callus rigidity correlated significantly better with experimental torsional rigidity than other common measures of healing progress such as callus area, bone mineral density, or area moment of inertia. Using FEA to predict mechanical properties of the callus could prove to be a useful tool in fracture-healing studies.