Diurnal coupling between testosterone and cortisol from adolescence to older adulthood
The hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-gonadal (HPG) axes are typically conceptualized as mutually inhibitory systems; however, previous studies have found evidence for positive within-person associations (i.e., coupling) between cortisol and testosterone. One developmental hypothesis is that positive testosterone-cortisol coupling is unique to the adolescent period and that coupling becomes attenuated, or even switches direction, in adulthood. This study used a lifespan sample (N = 292, ages 11 to 88) to test for age-related differences in coupling between cortisol and testosterone in daily life. Participants provided salivary hormone samples at waking, 30 minu…
Improve hip fracture outcome in the elderly patient (iHOPE) : A study protocol for a pragmatic, multicentre randomised controlled trial to test the efficacy of spinal versus general anaesthesia
IntroductionHip fracture surgery is associated with high in-hospital and 30-day mortality rates and serious adverse patient outcomes. Evidence from randomised controlled trials regarding effectiveness of spinal versus general anaesthesia on patient-centred outcomes after hip fracture surgery is sparse.Methods and analysisThe iHOPE study is a pragmatic national, multicentre, randomised controlled, open-label clinical trial with a two-arm parallel group design. In total, 1032 patients with hip fracture (>65 years) will be randomised in an intended 1:1 allocation ratio to receive spinal anaesthesia (n=516) or general anaesthesia (n=516). Outcome assessment will occur in a blinded manner aft…
Psychological distress among refugees in Germany: a cross-sectional analysis of individual and contextual risk factors and potential consequences for integration using a nationally representative survey
Objectives Responding to the mental health needs of refugees remains a pressing challenge worldwide. We estimated the prevalence of psychological distress in a large refugee population in Germany and assessed its association with host country factors amenable to policy intervention and integration indicators.Design A cross-sectional and population-based secondary analysis of the 2017 wave of the IAB-BAMF-SOEP refugee survey.Setting Germany.Participants 2639 adult refugees who arrived in Germany between 2013 and 2016.Main outcome measures Psychological distress involving symptoms of depression, anxiety and post-traumatic stress disorder was measured using the Refugee Health Screener-13.Resul…