Threatened or Threatening? How Ideology Shapes Asylum Seekers’ Immigration Policy Attitudes in Israel and Australia

PubMed Central

Canetti, Daphna; Snider, Keren L. G.; Pedersen, Anne

2016-01-01

Can different political ideologies explain policy preferences regarding asylum seekers? We focus on attitudes regarding governmental policy towards out-group members and suggest that perceptions of threat help to shape these policy attitudes. Study 1 compared public opinion regarding asylum policy in Israel (N = 137) and Australia (N = 138), two countries with restrictive asylum policies and who host a large number of asylum seekers; Study 2, a longitudinal study, was conducted during two different time periods in Israel—before and during the Gaza conflict. Results of both studies showed that threat perceptions of out-group members drive the relationship between conservative political ideologies and support for exclusionary asylum policies among citizens. Perceptions of threat held by members of the host country (the in-group) towards asylum seekers (the out-group) may influence policy formation. The effect of these out-groups threats needs to be critically weighed when considering Israeli and Australian policies towards asylum seekers. PMID:28190933

Seeking asylum-trauma, mental health, and human rights: an Australian perspective.

PubMed

Newman, Louise

2013-01-01

Asylum seekers represent a highly traumatized group with experiences of systematic oppression, loss, displacement, and exposure to violence. Around the world many are viewed with distrust and anxiety. The Australian response to asylum seekers is one that has used prolonged detention with significant negative impact on mental health. This has prompted much social debate and the involvement of clinicians and researchers in advocating for the human rights of asylum seekers. This article reviews the impact of mandatory prolonged detention on the mental health of asylum seekers and the significance of this for recovery and adaption. It concludes that the mandatory detention of high-risk and oppressed groups compounds trauma, with a potential long-term negative impact on mental health.

[Infectious disease outbreaks in centralized homes for asylum seekers in Germany from 2004-2014].

PubMed

Kühne, Anna; Gilsdorf, Andreas

2016-05-01

Migration and imported infections are changing the distribution of infectious diseases in Europe. However little is known about the extent of transmission of imported diseases within Europe. Asylum seekers are of increasing importance for infectious disease epidemiology and can be particularly vulnerable for infections and disease progression due to stressful conditions of migration and incomplete vaccination status. The aim is to analyse transmission of infectious diseases in centralized homes for asylum seekers in national infectious disease surveillance data to identify relevant infectious diseases and possible public health measures to reduce transmission. German national notification data was systematically analysed from 2004 to 2014 for outbreaks reported to have occurred within centralized homes for asylum seekers followed by descriptive analysis of outbreak- and case-characteristics. From 2004 to 2014 the number of outbreaks in centralized homes for asylum seekers per year increased, a total of 119 outbreaks with 615 cases were reported. Cases in these outbreaks were caused by chicken pox (30 %), measles (20 %), scabies (19 %), rota-virus-gastroenteritis (8 %) and others (each <5 %). Of 119 outbreaks, two outbreaks of measles in centralized homes were connected to outbreaks outside the centralized homes. For 210 of 311 cases in 2014 the place of infection was reported, 87 % of those with known place of infection were infected in Germany. Infectious disease outbreaks in centralized homes for asylum seekers are reported increasingly often in Germany. Chicken pox, measles and scabies were the most frequent outbreak causing diseases. Spread of such outbreaks outside centralized homes for asylum seekers was rare and infectious diseases are mainly acquired in Germany. The majority of outbreaks in centralized homes for asylum seekers would be preventable with vaccinations at arrival and appropriate hygiene measures.

[Tuberculosis Among Refugees and Asylum Seekers: Tuberculosis Screening on Arrival and Case Management].

PubMed

Priwitzer, Martin

2018-04-01

The statement of the Federal Association of Physicians of Public Health Services provides recommendations concerning tuberculosis screening of refugees and asylum seekers on arrival specific to different groups of persons (adults, children, pregnant women, unaccompanied minors), taking into account the legal background and the current recommendations of the Robert Koch Institute as well as of the German Society for Pediatric Infectiology. In addition, recommendations are given to ensure treatment success in refugees and asylum seekers with tuberculosis, to carry out contact investigations and for preventive treatment of latent tuberculosis infection among refugees and asylum seekers. © Georg Thieme Verlag KG Stuttgart · New York.

Child Poverty as Public Policy: Direct Provision and Asylum Seeker Children in the Republic of Ireland

ERIC Educational Resources Information Center

Fanning, Bryan; Veale, Angela

2004-01-01

This paper evaluates responses to asylum seeker children in Ireland from a child poverty perspective and from that of the United Nations Convention on the Rights of the Child. It draws upon research undertaken in early 2001 on behalf of the Irish Refugee Council among asylum seeker families with children in Cork, Limerick and Ennis on their…

Mental health interventions for traumatized asylum seekers and refugees: What do we know about their efficacy?

PubMed

Slobodin, Ortal; de Jong, Joop T V M

2015-02-01

The prevalence of trauma-related problems among refugees and asylum seekers is extremely high due to adverse experiences associated with forced migration. Although the literature presents a considerable number of guidelines and theoretical frameworks for working with traumatized refugees and asylum seekers, the efficacy, feasibility and applicability of these interventions have little empirical evidence. The purpose of this article is to critically review the literature to provide a rationale for developing culturally sensitive, evidence-based interventions for refugees and asylum seekers. A literature review integrating research findings on interventions designed especially for traumatized asylum seekers and refugees was conducted. Retained studies had to use some quantitative measurements of post-traumatic stress and to have pre- and post-measurements to evaluate the efficacy of the intervention. Studies included in this review cover a wide variety of interventions, including trauma-focused interventions, group therapy, multidisciplinary interventions and pharmacological treatments. The majority of studies with traumatized refugees and asylum seekers reported positive outcomes of the intervention in reducing trauma-related symptoms. There is evidence to support the suitability of cognitive-behavioral therapy (CBT) and narrative exposure therapy (NET) in certain populations of refugees. Other intervention studies are limited by methodological considerations, such as lack of randomization, absence of control group and small samples. This review has again highlighted the shortage of guiding frameworks available to investigators and clinicians who are interested in tailoring interventions to work with refugees and asylum seekers. Theoretical, ethical and methodological considerations for future research are discussed. © The Author(s) 2014.

Find and treat or find and lose? Tuberculosis treatment outcomes among screened newly arrived asylum seekers in Germany 2002 to 2014.

PubMed

Kuehne, Anna; Hauer, Barbara; Brodhun, Bonita; Haas, Walter; Fiebig, Lena

2018-03-01

BackgroundGermany has a low tuberculosis (TB) incidence. A relevant and increasing proportion of TB cases is diagnosed among asylum seekers upon screening. Aim: We aimed to assess whether cases identified by screening asylum seekers had equally successful and completely reported treatment outcomes as cases diagnosed by passive case finding and contact tracing in the general population. Methods: We analysed characteristics and treatment outcomes of pulmonary TB cases notified in Germany between 2002 and 2014, stratified by mode of case finding. We performed three multivariable analyses with different dependent variables: Model A: successful vs all other outcomes, Model B: successful vs documented non-successful clinical outcome and Model C: known outcome vs lost to follow-up. Results: TB treatment success was highest among cases identified by contact tracing (87%; 3,139/3,591), followed by passive case finding (74%; 28,804/39,019) and by screening asylum seekers (60%; 884/1,474). Cases identified by screening asylum seekers had 2.4 times higher odds of not having a successful treatment outcome as opposed to all other outcomes (A), 1.4 times higher odds of not having a successful treatment outcome as opposed to known non-successful outcomes (B) and 2.3 times higher odds of loss to follow-up (C) than cases identified by passive case finding. Conclusion: Screened asylum seekers had poorer treatment outcomes and were more often lost to follow-up. Linking patients to treatment facilities and investigating potential barriers to treatment completion are needed to secure screening benefits for asylum seekers and communities.

Screening for infectious diseases of asylum seekers upon arrival: the necessity of the moral principle of reciprocity.

PubMed

Beeres, Dorien T; Cornish, Darren; Vonk, Machiel; Ravensbergen, Sofanne J; Maeckelberghe, Els L M; Boele Van Hensbroek, Pieter; Stienstra, Ymkje

2018-03-02

With a large number of forcibly displaced people seeking safety, the EU is facing a challenge in maintaining solidarity. Europe has seen millions of asylum seekers crossing European borders, the largest number of asylum seekers since the second world war. Endemic diseases and often failing health systems in their countries of origin, and arduous conditions during transit, raise questions around how to meet the health needs of this vulnerable population on arrival in terms of screening, vaccination, and access to timely and appropriate statutory health services. This paper explores the potential role of the principle of reciprocity, defined as the disposition 'to return good in proportion to the good we receive, and to make reparations for the harm we have done', as a mid-level principle in infectious disease screening policies. More than half of the European countries implemented screening programmes for newly arrived asylum seekers. Screening may serve to avoid potential infectious disease risks in the receiving countries as well as help identify health needs of asylum seekers. But screening may infringe upon basic rights of those screened, thus creating an ethical dilemma. The use of the principle of reciprocity can contribute to the identification of potential improvements for current screening programmes and emphasizes the importance of certain rights into guidelines for screening. It may create a two way moral obligation, upon asylum seekers to actively participate in the programme, and upon authorities to reciprocate the asylum seekers' participation and the benefits for the control of public health. The authors argue that the reciprocity principle leads to a stronger ethical justification of screening programmes and help achieve a balance between justifiable rights claims of the host population and the asylum seekers. The principle deserves a further and more thorough exploration of its potential use in the field of screening, migration and infectious diseases.

Increasing prevalence of infectious diseases in asylum seekers at a tertiary care hospital in Switzerland

PubMed Central

Bloch-Infanger, Constantine; Bättig, Veronika; Kremo, Jürg; Widmer, Andreas F.; Egli, Adrian; Bingisser, Roland; Battegay, Manuel; Erb, Stefan

2017-01-01

Objective The increasing number of refugees seeking asylum in Europe in recent years poses new challenges for the healthcare systems in the destination countries. The goal of the study was to describe the evolution of medical problems of asylum seekers at a tertiary care centre in Switzerland. Methods At the University Hospital Basel, we compared all asylum seekers during two 1-year time periods in 2004/05 and 2014/15 concerning demographic characteristics and reasons for referrals and hospitalizations. Results Hundred ninety five of 2’544 and 516 of 6’243 asylum seekers registered at the national asylum reception and procedure centre Basel were referred to the University Hospital Basel in 2004/05 and 2014/15, and originated mainly from Europe (62.3%, mainly Turkey) and Africa (49.1%, mainly Eritrea), respectively. Median age was similar in both study periods (26.9 and 26.2 years). Infectious diseases in asylum seekers increased from 22.6% to 36.6% (p<0.001) and were the main reasons for hospitalizations (33.3% of 45 and 55.6% of 81 hospitalized patients, p = 0.017) in 2004/05 compared to 2014/15. The leading infectious diseases in hospitalized patients were tuberculosis (n = 4) and bacterial skin infections (n = 2) in 2004/05; Malaria (n = 9), pneumonia (n = 6), Chickenpox (n = 5), other viral infections (n = 5) and bacterial skin infections (n = 5) in 2014/15. Infectious diseases like malaria, cutaneous diphtheria, louseborne-relapsing fever or scabies were only found in the second study period. Almost one third of the admitted asylum seekers required isolation precautions with median duration of 6–9.5 days in both study periods. Conclusions The changing demography of asylum seekers arriving in Switzerland in the current refugee crisis has led to a shift in disease patterns with an increase of infectious diseases and the re-emergence of migration-associated neglected infections. Physicians should be aware of these new challenges. PMID:28617860

Understanding Refugees' Health.

PubMed

Müller, Martin; Khamis, Dana; Srivastava, David; Exadaktylos, Aristomenis K; Pfortmueller, Carmen Andrea

2018-04-01

According to the United Nations Refugee Agency (UNHCR), 65.6 million people have been forcibly displaced worldwide. Several factors have a major influence on asylum seekers' health; so, their health profile is markedly different from that of the population in the country of asylum. The aim of this study is to review the major issues physicians need to be aware of when treating asylum seekers, with a special focus on the neurological problems of asylum seekers and refugees. The major impact factors on refugees' health are linked to experiences and exposure (1) in the country of origin, (2) in refugee camps and en route to Europe, and (3) in the process of immigration into the host country and living in European asylum centers. Refugees' health is also affected by psychological problems and by infectious diseases. Additionally, chronic diseases resulting in polymorbidity, cancer, and neurological diseases are easy to overlook and demand special attention. Neurological injuries/diseases may be traumatic (e.g., spinal cord injuries), posttraumatic (e.g., chronic pain syndromes), the result of cerebral infections, or the consequences of starvation (e.g., epilepsy, ataxia, and paraesthesia). The main challenges for physicians are lack of awareness of the asylum seekers' specific health care problems, language and intercultural communication problems, as well as access and integration of asylum seekers into the health care system. The health issues of asylum seekers are manifold and challenging to physicians. Awareness of these conditions is mandatory to ensure good clinical practice for this patient population, which has a huge burden in chronic, infectious, mental, and neurological diseases. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

[Taking Care of Asylum Seekers: Occupational Health Aspects with a Special Focus on Vaccination].

PubMed

Kolb, S; Hörmansdorfer, S; Ackermann, N; Höller, C; Brenner, B; Herr, C

2016-04-01

Employees and volunteers often feel insecure about the potential transmission of infectious diseases when taking care of asylum seekers. It could be shown that overall only a minor risk of infection emanates from asylum seekers. However, aspects of occupational health and vaccination should be kept in mind.Besides the standard vaccination the Standing Committee on Vaccination (STIKO) recommends for occupational indication, which is given for employees and volunteers in asylum facilities, vaccination against hepatitis A, hepatitis B, polio (if the last vaccination was more than 10 years before) as well as influenza (seasonal).According to the German Occupational Safety and Health Act taking care of the employer has to determine which exposures might occur at the workplace (risk assessment) and define necessary protection measures. Depending on task and exposure when taking care of asylum seekers different acts (e. g. biological agents regulation) and technical guidelines for the handling biological agents (e. g. TRBA 250 or TRBA 500) have to be applied.The Bavarian Health and Food Safety Authority (LGL) has published several information sheets regarding "asylum seekers and health management" for employees and volunteers from the non-medical as well as the medical area (www.lgl.bayern.de search term "Asylbewerber"). With theses publications insecurities in taking care of asylum seekers should be prevented. Furthermore the employer gets support in the implementation of legal obligations to ensure occupational safety for the employees. © Georg Thieme Verlag KG Stuttgart · New York.

Perinatal health outcomes and care among asylum seekers and refugees: a systematic review of systematic reviews.

PubMed

Heslehurst, Nicola; Brown, Heather; Pemu, Augustina; Coleman, Hayley; Rankin, Judith

2018-06-12

Global migration is at an all-time high with implications for perinatal health. Migrant women, especially asylum seekers and refugees, represent a particularly vulnerable group. Understanding the impact on the perinatal health of women and offspring is an important prerequisite to improving care and outcomes. The aim of this systematic review was to summarise the current evidence base on perinatal health outcomes and care among women with asylum seeker or refugee status. Twelve electronic database, reference list and citation searches (1 January 2007-July 2017) were carried out between June and July 2017. Quantitative and qualitative systematic reviews, published in the English language, were included if they reported perinatal health outcomes or care and clearly stated that they included asylum seekers or refugees. Screening for eligibility, data extraction, quality appraisal and evidence synthesis were carried out in duplicate. The results were summarised narratively. Among 3415 records screened, 29 systematic reviews met the inclusion criteria. Only one exclusively focussed on asylum seekers; the remaining reviews grouped asylum seekers and refugees with wider migrant populations. Perinatal outcomes were predominantly worse among migrant women, particularly mental health, maternal mortality, preterm birth and congenital anomalies. Access and use of care was obstructed by structural, organisational, social, personal and cultural barriers. Migrant women's experiences of care included negative communication, discrimination, poor relationships with health professionals, cultural clashes and negative experiences of clinical intervention. Additional data for asylum seekers and refugees demonstrated complex obstetric issues, sexual assault, offspring mortality, unwanted pregnancy, poverty, social isolation and experiences of racism, prejudice and stereotyping within perinatal healthcare. This review identified adverse pregnancy outcomes among asylum seeker and refugee women, representing a double burden of inequality for one of the most globally vulnerable groups of women. Improvements in the provision of perinatal healthcare could reduce inequalities in adverse outcomes and improve women's experiences of care. Strategies to overcome barriers to accessing care require immediate attention. The systematic review evidence base is limited by combining heterogeneous migrant, asylum seeker and refugee populations, inconsistent use of definitions and limited data on some perinatal outcomes and risk factors. Future research needs to overcome these limitations to improve data quality and address inequalities. Systematic review registration number: PROSPERO CRD42017073315 .

Is legal status impacting outcomes of group therapy for posttraumatic stress disorder with male asylum seekers and refugees from Iran and Afghanistan?

PubMed Central

2013-01-01

Background Legal status and other resettlement stressors are known to impact mental health of asylum seekers and refugees. However, the ways in which they interact with treatment of posttraumatic stress disorder (PTSD) with these populations is still poorly understood. The aim of this study was to examine whether legal status and other resettlement stressors influence outcomes of a trauma-focused group PTSD treatment within a day-treatment setting with asylum seekers and refugees. Methods Sixty six male Iranian and Afghan patients with PTSD residing in the Netherlands were assessed with self-rated symptom checklists for PTSD, anxiety and depression, and a demographic questionnaire one week before and two weeks after the treatment. Multivariate linear regression analysis was used to examine the impact of legal status and living arrangements on the treatment outcomes per symptom domain. Results The results suggest that both asylum seekers and refugees can be helped with their mental health complaints with a trauma-focused group therapy for PTSD regardless of their legal status. Obtaining a refugee status in a course of the treatment appears to improve the treatment outcomes. Conclusions Legal status is impacting outcomes of group therapy for PTSD with male asylum seekers and refugees. Asylum seekers may benefit from group treatment regardless of unstable living conditions. PMID:23705873

Satisfaction with daily occupations amongst asylum seekers in Denmark.

PubMed

Morville, Anne-Le; Erlandsson, Lena-Karin; Danneskiold-Samsøe, Bente; Amris, Kirstine; Eklund, Mona

2015-05-01

The aim of this study was to describe asylum seekers' satisfaction with daily occupations and activity level while in a Danish asylum centre, and whether this changed over time. Another aim was to describe whether exposure to torture, self-rated health measures, and ADL ability were related to their satisfaction with daily occupations and activity level. A total of 43 asylum seekers at baseline and 17 at follow-up were included. The questionnaires Satisfaction with Daily Occupations, Major Depression Inventory, WHO-5 Wellbeing, Pain Detect, a questionnaire covering torture, and basic social information were used as well as Assessment of Motor and Process Skills. The results showed a low level of satisfaction with daily occupations at both baseline and follow-up. There was no statistically significant change in satisfaction or activity level between baseline and the follow-up. Associations between AMPS process skills--education, worst pain and activity level--were present at baseline, as was a relationship between AMPS process skills and satisfaction. At follow-up, associations between WHO-5 and satisfaction and activity level and between MDI scores and activity level were found. Asylum seekers experience a low level of satisfaction with daily occupations, both at arrival and after 10 months in an asylum centre. There is a need for further research and development of occupation-focused rehabilitation methods for the asylum seeker population.

Screening for infectious diseases among newly arrived asylum seekers, Bavaria, Germany, 2015

PubMed Central

Ackermann, Nikolaus; Marosevic, Durdica; Hörmansdorfer, Stefan; Eberle, Ute; Rieder, Gabriele; Treis, Bianca; Berger, Anja; Bischoff, Heribert; Bengs, Katja; Konrad, Regina; Hautmann, Wolfgang; Schönberger, Katharina; Belting, Anne; Schlenk, Gisela; Margos, Gabriele; Hoch, Martin; Pürner, Friedrich; Fingerle, Volker; Liebl, Bernhard; Sing, Andreas

2018-01-01

Background and aim As a consequence of socioeconomic and political crises in many parts of the world, many European Union/European Economic Area (EU/EEA) countries have faced an increasing number of migrants. In the German federal state of Bavaria, a mandatory health screening approach is implemented, where individuals applying for asylum have to undergo a medical examination that includes serological testing for HIV and hepatitis B, screening for tuberculosis, and until September 2015, stool examination for Salmonella spp. and Shigella spp.. Methods: Data from mandatory screening of all first-time asylum seekers in Bavaria in 2015 was extracted from the mandatory notification and laboratory information system and evaluated. Results: The HIV positivity and hepatitis B surface antigen (HBsAg) positivity rate of tested samples from asylum seekers were 0.3% and 3.3%, respectively, while detection rate of active tuberculosis was between 0.22% and 0.38%. The rates for HIV, hepatitis B, and tuberculosis among asylum seekers were similar to the corresponding prevalence rates in most of their respective countries of birth. Only 47 Salmonella spp. (0.1%) were isolated from stool samples: 45 enteric and two typhoid serovars. Beyond mandatory screening, louse-borne relapsing fever was found in 40 individuals. Conclusions: These results show that mandatory screening during 2015 in Bavaria yielded overall low positivity rates for all tested infectious diseases in asylum seekers. A focus of mandatory screening on specific diseases in asylum seekers originating from countries with higher prevalence of those diseases could facilitate early diagnosis and provision of treatment to affected individuals while saving resources. PMID:29536830

Screening for infectious diseases among newly arrived asylum seekers, Bavaria, Germany, 2015.

PubMed

Ackermann, Nikolaus; Marosevic, Durdica; Hörmansdorfer, Stefan; Eberle, Ute; Rieder, Gabriele; Treis, Bianca; Berger, Anja; Bischoff, Heribert; Bengs, Katja; Konrad, Regina; Hautmann, Wolfgang; Schönberger, Katharina; Belting, Anne; Schlenk, Gisela; Margos, Gabriele; Hoch, Martin; Pürner, Friedrich; Fingerle, Volker; Liebl, Bernhard; Sing, Andreas

2018-03-01

Background and aimAs a consequence of socioeconomic and political crises in many parts of the world, many European Union/European Economic Area (EU/EEA) countries have faced an increasing number of migrants. In the German federal state of Bavaria, a mandatory health screening approach is implemented, where individuals applying for asylum have to undergo a medical examination that includes serological testing for HIV and hepatitis B, screening for tuberculosis, and until September 2015, stool examination for Salmonella spp. and Shigella spp.. Methods : Data from mandatory screening of all first-time asylum seekers in Bavaria in 2015 was extracted from the mandatory notification and laboratory information system and evaluated. Results : The HIV positivity and hepatitis B surface antigen (HBsAg) positivity rate of tested samples from asylum seekers were 0.3% and 3.3%, respectively, while detection rate of active tuberculosis was between 0.22% and 0.38%. The rates for HIV, hepatitis B, and tuberculosis among asylum seekers were similar to the corresponding prevalence rates in most of their respective countries of birth. Only 47 Salmonella spp. (0.1%) were isolated from stool samples: 45 enteric and two typhoid serovars. Beyond mandatory screening, louse-borne relapsing fever was found in 40 individuals. Conclusions : These results show that mandatory screening during 2015 in Bavaria yielded overall low positivity rates for all tested infectious diseases in asylum seekers. A focus of mandatory screening on specific diseases in asylum seekers originating from countries with higher prevalence of those diseases could facilitate early diagnosis and provision of treatment to affected individuals while saving resources.

Supporting Asylum Seekers: Clinician Experiences of Documenting Human Rights Violations Through Forensic Psychological Evaluation.

PubMed

Baranowski, Kim A; Moses, Melissa H; Sundri, Jasmine

2018-05-22

The United States permits foreign nationals to apply for asylum if they have experienced persecution or have a fear of future persecution. In order to meet the criteria for persecution, the harm inflicted upon the asylum seeker does not need to be or have been physical and can include psychological sequelae. In an effort to document persecution, lawyers seek the assistance of health professionals when preparing their clients' asylum applications. Mental health professionals work to corroborate psychological evidence of the asylum seeker's report of ill treatment through evaluation and presentation of their findings in the form of legal affidavits. This study gathered the experiences of 15 mental health clinicians who conduct forensic psychological evaluations and document the impact of torture and other human rights violations on asylum seekers. We analyzed the resulting interview transcripts using a consensual qualitative research (CQR) approach. The results of the study highlight challenges associated with this work, suggest recommendations for training, and encourage advocacy endeavors by mental health professionals who provide these services. Copyright © 2018 International Society for Traumatic Stress Studies.

Yield of active screening for tuberculosis among asylum seekers in Germany: a systematic review and meta-analysis

PubMed Central

Bozorgmehr, Kayvan; Razum, Oliver; Saure, Daniel; Joggerst, Brigitte; Szecsenyi, Joachim; Stock, Christian

2017-01-01

All asylum seekers in Germany undergo upon-entry screening for tuberculosis TB, but comprehensive evidence on the yield is lacking. We compared the national estimates with the international literature in a systematic review and meta-analysis of studies reporting the yield of TB, defined as the fraction of active TB cases detected among asylum seekers screened in Germany upon entry. We searched 11 national and international databases for empirical studies and the internet for grey literature published in English or German without restrictions on publication time. Among 1,253 screened articles, we identified six articles reporting the yield of active TB based on German data, ranging from 0.72 (95% confidence interval (CI): 0.45–1.10) to 6.41 (95% CI: 4.19–9.37) per 1,000 asylum seekers. The pooled estimate across all studies was 3.47 (95% CI: 1.78–5.73; I2 = 94.9%; p < 0.0001) per 1,000 asylum seekers. This estimate was in line with international evidence (I2 = 0%; p for heterogeneity 0.55). The meta-analysis of available international estimates resulted in a pooled yield of 3.04 (95% CI: 2.24–3.96) per 1,000. This study provides an estimate across several German federal states for the yield of TB screening in asylum seekers. Further research is needed to develop more targeted screening programmes. PMID:28367795

Nutritional vulnerability seen within asylum seekers in Australia.

PubMed

O'Reilly, Sharleen; O'Shea, Tess; Bhusumane, Sibusiso

2012-04-01

To examine the extent of nutritional vulnerability seen in a cohort of asylum seekers in Australia. Twenty-one asylum seekers (15 males, 6 females) that used a food bank were interviewed over a 6 week period at the Melbourne based Asylum Seeker Resource Centre about foods consumed in the previous 24-h and any non food bank foods obtained. A basket audit was conducted after participants accessed the food bank on the day of interview, Participants obtained significantly less than the minimum requirements for the Australian Guide to Healthy Eating in the vegetables and legumes (P < .001, 95% CI -3.5, -1.7) fruits (P < .001, 95% CI -1.7, -.1.2), dairy (P < .001, 95% CI -1.8, -1.5) and meat and meat alternatives core food groups (P = .001, 95% CI -0.8, -0.3) using foods accessed from the food bank, their primary or sole food source. A high level of nutritional vulnerability was seen in this cohort due to their inability to meet minimum nutritional requirements from their primary food access point. Health professionals working with asylum seeker populations need to be aware of this issue and the resulting potential for longer term ill health as a consequence.

Effects on asylum seekers of ill treatment in Zaïre.

PubMed Central

Peel, M. R.

1996-01-01

To describe the health effects of the political system in Zaïre on asylum seekers seen at the Medical Foundation for the Care of Victims of Torture a retrospective study was performed of the records of 92 asylum seekers from Zaïre who were seen for medical reports at the medical foundation in 1993 and 1994. Eighty one had been imprisoned; the others had been severely treated at home by the security services. Sixty six had been detained for up to one year. Prison conditions were invariably unsanitary, and food of poor quality when provided. All had been beaten on arrest, and all but two had been beaten repeatedly in prison. Nearly all the women and some of the men described sexual abuse. Almost all left prison through bribery or because a guard had a similar background. Seventy two asylum seekers had scarring, consider to be consistent with the history, and 70 were considered to have suffered persistent psychological damage. Asylum seekers from Zaïre will have health effects from experiences unimaginable to the ordinary Briton. An understanding of the background will help clinicians manage them. PMID:8611788

Effects on asylum seekers of ill treatment in Zaïre.

PubMed

Peel, M R

1996-02-03

To describe the health effects of the political system in Zaïre on asylum seekers seen at the Medical Foundation for the Care of Victims of Torture a retrospective study was performed of the records of 92 asylum seekers from Zaïre who were seen for medical reports at the medical foundation in 1993 and 1994. Eighty one had been imprisoned; the others had been severely treated at home by the security services. Sixty six had been detained for up to one year. Prison conditions were invariably unsanitary, and food of poor quality when provided. All had been beaten on arrest, and all but two had been beaten repeatedly in prison. Nearly all the women and some of the men described sexual abuse. Almost all left prison through bribery or because a guard had a similar background. Seventy two asylum seekers had scarring, consider to be consistent with the history, and 70 were considered to have suffered persistent psychological damage. Asylum seekers from Zaïre will have health effects from experiences unimaginable to the ordinary Briton. An understanding of the background will help clinicians manage them.

Large measles outbreak introduced by asylum seekers and spread among the insufficiently vaccinated resident population, Berlin, October 2014 to August 2015

PubMed Central

Werber, Dirk; Hoffmann, Alexandra; Santibanez, Sabine; Mankertz, Annette; Sagebiel, Daniel

2017-01-01

The largest measles outbreak in Berlin since 2001 occurred from October 2014 to August 2015. Overall, 1,344 cases were ascertained, 86% (with available information) unvaccinated, including 146 (12%) asylum seekers. Median age was 17 years (interquartile range: 4–29 years), 26% were hospitalised and a 1-year-old child died. Measles virus genotyping uniformly revealed the variant ‘D8-Rostov-Don’ and descendants. The virus was likely introduced by and initially spread among asylum seekers before affecting Berlin’s resident population. Among Berlin residents, the highest incidence was in children aged < 2 years, yet most cases (52%) were adults. Post-exposure vaccinations in homes for asylum seekers, not always conducted, occurred later (median: 7.5 days) than the recommended 72 hours after onset of the first case and reached only half of potential contacts. Asylum seekers should not only have non-discriminatory, equitable access to vaccination, they also need to be offered measles vaccination in a timely fashion, i.e. immediately upon arrival in the receiving country. Supplementary immunisation activities targeting the resident population, particularly adults, are urgently needed in Berlin. PMID:28857043

Exercise and physical activity in asylum seekers in Northern England; using the theoretical domains framework to identify barriers and facilitators.

PubMed

Haith-Cooper, Melanie; Waskett, Catherine; Montague, Jane; Horne, Maria

2018-06-19

Many asylum seekers have complex mental health needs which can be exacerbated by the challenging circumstances in which they live and difficulties accessing health services. Regular moderate physical activity can improve mental health and would be a useful strategy to achieve this. Evidence suggests there are barriers to engaging black and minority ethnic groups in physical activity, but there is little research around asylum seekers to address the key barriers and facilitators in this group. A two stage qualitative study used semi-structured interviews underpinned by the Theoretical Domains Framework. The interviews were conducted in voluntary sector groups in four towns/ cities in Northern England. Purposive sampling recruited 36 asylum seekers from 18 different countries. Interviews were audio recorded, transcribed verbatim and subject to framework analysis. Stage two involved a nominal group technique with five key stakeholders including asylum seekers and those that work with them. They followed a four stage process to rank and reach consensus on the key barrier to undertaking physical activity/ exercise that could be addressed locally through a future intervention. A number of barriers and facilitators were identified including a lack of understanding of the term physical activity and recommended levels but knowledge of the health benefits of physical activity/ exercise and the motivation to increase levels having engaged with activities back home. Living as an asylum seeker was considered a barrier due to the stress, poverty and temporary nature of living in an unfamiliar place. The outcome of the nominal group technique was that a lack of knowledge of facilities in the local area was the prevailing barrier that could be addressed. Public health practitioners could develop interventions which capitalise on the motivation and knowledge of asylum seekers to encourage an increase in physical activity which may in turn reduce the breadth and depth of mental health needs of this group.

Immunity against measles, mumps, rubella, varicella, diphtheria, tetanus, polio, hepatitis A and hepatitis B among adult asylum seekers in the Netherlands, 2016.

PubMed

Freidl, Gudrun S; Tostmann, Alma; Curvers, Moud; Ruijs, Wilhelmina L M; Smits, Gaby; Schepp, Rutger; Duizer, Erwin; Boland, Greet; de Melker, Hester; van der Klis, Fiona R M; Hautvast, Jeannine L A; Veldhuijzen, Irene K

2018-03-14

Asylum seekers are a vulnerable population for contracting infectious diseases. Outbreaks occur among children and adults. In the Netherlands, asylum seeker children are offered vaccination according to the National Immunization Program. Little is known about protection against vaccine-preventable diseases (VPD) in adult asylum seekers. In this 2016 study, we assessed the immunity of adult asylum seekers against nine VPD to identify groups that might benefit from additional vaccinations. We invited asylum seekers from Syria, Iran, Iraq, Afghanistan, Eritrea and Ethiopia to participate in a serosurvey. Participants provided informed consent and a blood sample, and completed a questionnaire. We measured prevalence of protective antibodies to measles, mumps, rubella, varicella, diphtheria, tetanus, polio type 1-3 and hepatitis A and B, stratified them by country of origin and age groups. The median age of the 622 participants was 28 years (interquartile range: 23-35), 81% were male and 48% originated from Syria. Overall, seroprotection was 88% for measles (range between countries: 83-93%), 91% for mumps (81-95%), 94% for rubella (84-98%), 96% for varicella (92-98%), 82% for diphtheria (65-88%), 98% for tetanus (86-100%), 91% (88-94%) for polio type 1, 95% (90-98%) for polio type 2, 82% (76-86%) for polio type 3, 84% (54-100%) for hepatitis A and 27% for hepatitis B (anti-HBs; 8-42%). Our results indicate insufficient protection against certain VPD in some subgroups. For all countries except Eritrea, measles seroprotection was below the 95% threshold required for elimination. Measles seroprevalence was lowest among adults younger than 25 years. In comparison, seroprevalence in the Dutch general population was 96% in 2006/07. The results of this study can help prioritizing vaccination of susceptible subgroups of adult asylum seekers, in general and in outbreak situations. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Persecution Experiences and Mental Health of LGBT Asylum Seekers.

PubMed

Hopkinson, Rebecca A; Keatley, Eva; Glaeser, Elizabeth; Erickson-Schroth, Laura; Fattal, Omar; Nicholson Sullivan, Melba

2017-01-01

Asylum seekers are a unique population, particularly those who have endured persecution for their sexual orientation or gender identity. Little data exist about the specific experiences and needs of asylum seekers persecuted due to lesbian, gay, bisexual, or transgender (LGBT) identity. Quantitative data were gathered regarding demographics, persecution histories, and mental health of 61 clients from a torture survivors program in New York City who reported persecution due to LGBT identity. Thirty-five clients persecuted due to their LGBT identity were matched by country of origin and sex with clients persecuted for other reasons to explore how persecution and symptoms may differ for LGBT clients. LGBT asylum seekers have a higher incidence of sexual violence, persecution occurring during childhood, persecution by family members, and suicidal ideation. Understanding the type of persecution experiences and how these influence mental health outcomes is an essential step toward designing and delivering effective treatments.

Challenges of Combining Perspectives.

PubMed

Sundvall, Maria; Titelman, David; Bäärnhielm, Sofie

2018-02-23

Asylum seekers have increased risk of suicide and suicidal behavior, with differences related to origin, gender, and age. There are barriers to communication in clinical encounters between asylum seekers and clinicians. There is insufficient knowledge about how communication in the clinical encounter affects the suicide risk in female asylum seekers. To explore the documented communication between female asylum-seeking suicide attempters and clinicians and how it affects treatment. The medical records of 18 asylum-seeking women who had attempted suicide were analyzed with content analysis. Communication between patients and clinicians was affected by: the unbearable realities of the women; difficulties for clinicians in decoding languages of distress, and understanding trauma and subjective meanings of suicide; challenges of combining patients' and clinicians' perspectives; and a sense of shared powerlessness. The medical records did not give direct access to the patient's experience, only to the patient as documented by the clinician. The results suggest that clinicians working with asylum seekers who have attempted suicide need to develop an understanding of social and cultural factors and of trauma issues. A question for further study is how an enhanced integration of context and subjectivity in psychiatric practice would equip clinicians for the specific challenges encountered.

Sexual health is dead in my body: participatory assessment of sexual health determinants by refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands

PubMed Central

2014-01-01

Background Although migrants constitute an important proportion of the European population, little is known about migrant sexual health. Existing research mainly focuses on migrants’ sexual health risks and accessibility issues while recommendations on adequate sexual health promotion are rarely provided. Hence, this paper explores how refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands define sexual health, search for sexual health information and perceive sexual health determinants. Methods Applying Community-based Participatory Research as the overarching research approach, we conducted 223 in-depth interviews with refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands. The Framework Analysis Technique was used to analyse qualitative data. We checked the extensiveness of the qualitative data and analysed the quantitative socio-demographic data with SPSS. Results Our results indicate that gender and age do not appear to be decisive determinants. However, incorporated cultural norms and education attainment are important to consider in desirable sexual health promotion in refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands. Furthermore, our results demonstrate that these migrants have a predominant internal health locus of control. Yet, most of them feel that this personal attitude is hugely challenged by the Belgian and Dutch asylum system and migration laws which force them into a structural dependent situation inducing sexual ill-health. Conclusion Refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands are at risk of sexual ill-health. Incorporated cultural norms and attained education are important determinants to address in desirable sexual health promotion. Yet, as their legal status demonstrates to be the key determinant, the prime concern is to alter organizational and societal factors linked to the Belgian and Dutch asylum system. Refugees, asylum seekers and undocumented migrants in Belgium and the Netherlands should be granted the same opportunity as Belgian and Dutch citizens have, to become equally in control of their sexual health and sexuality. PMID:24886093

Overgeneral memory in asylum seekers and refugees.

PubMed

Graham, Belinda; Herlihy, Jane; Brewin, Chris R

2014-09-01

Studies in western samples have shown that post-traumatic stress disorder (PTSD) and depression are associated with overgeneral autobiographical memory retrieval. This study assesses whether this association extends to asylum seekers and refugees from diverse cultural backgrounds. We discuss implications for those providing testimony of their experiences when seeking asylum. 38 asylum seekers and refugees were recruited through clinics and community groups. Clinical interviews assessed PTSD and depression and participants completed a test of autobiographical memory specificity. When accounting for omissions, participants with PTSD and depression recalled a lower proportion of specific memories. Those with PTSD also failed more frequently to report any memory. The sample did not permit separate evaluation of the effects of PTSD and depression on specificity. Lower memory specificity observed in people experiencing PTSD and depression in western populations extends to asylum seekers and refugees from diverse cultural backgrounds. This study adds to the literature suggesting that being recognised as a refugee fleeing persecution is more difficult for those with post-traumatic symptoms and depression. Copyright © 2014 Elsevier Ltd. All rights reserved.

The association between acculturation patterns and mental health symptoms among Eritrean and Sudanese asylum seekers in Israel.

PubMed

Nakash, Ora; Nagar, Maayan; Shoshani, Anat; Lurie, Ido

2015-07-01

Past research has documented the role acculturation plays in the process of adjustment to new cultures among migrants. Yet little attention has been paid thus far to the role of acculturation in the context of forced migration. In this study we examined the association between acculturation patterns and mental health symptoms among a convenience sample of Eritrean and Sudanese asylum seekers (n = 118) who accessed health services at the Physicians for Human Rights Open-Clinic in Israel. Participants completed measures on sociodemographic information as well as detention history, mental health symptoms, exposure to traumatic events, and acculturation pattern, in their native language upon accessing services. Consistent with our predictions, findings showed that acculturation predicted depressive symptoms among asylum seekers beyond the effect of history of detention and reports of experiences of traumatic events. Assimilated compared with integrated asylum seekers reported higher depressive symptoms. Findings draw attention to the paradox of assimilation, and the mental health risks it poses among those wishing to integrate into the new culture at the expanse of their original culture. Asylum seekers may be particularly vulnerable to the risks of assimilation in the restrictive policies that characterize many industrial countries in recent years. (c) 2015 APA, all rights reserved).

Finding "hard to find" literature on hard to find groups: A novel technique to search grey literature on refugees and asylum seekers.

PubMed

Enticott, Joanne; Buck, Kimberly; Shawyer, Frances

2018-03-01

There is a lack of information on how to execute effective searches of the grey literature on refugee and asylum seeker groups for inclusion in systematic reviews. High-quality government reports and other grey literature relevant to refugees may not always be identified in conventional literature searches. During the process of conducting a recent systematic review, we developed a novel strategy for systematically searching international refugee and asylum seeker-related grey literature. The approach targets governmental health departments and statistical agencies, who have considerable access to refugee and asylum seeker populations for research purposes but typically do not publish findings in academic forums. Compared to a conventional grey literature search strategy, our novel technique yielded an eightfold increase in relevant high-quality grey sources that provided valuable content in informing our review. Incorporating a search of the grey literature into systematic reviews of refugee and asylum seeker research is essential to providing a more complete view of the evidence. Our novel strategy offers a practical and feasible method of conducting systematic grey literature searches that may be adaptable to a range of research questions, contexts, and resource constraints. Copyright © 2017 John Wiley & Sons, Ltd.

"If I speak English, what am I? I am full man, me": Emotional impact and barriers for refugees and asylum seekers learning English.

PubMed

Salvo, Tania; de C Williams, Amanda C

2017-01-01

Lack of proficiency in the language of the host country predicts distress among refugees, but many refugees and asylum seekers in the United Kingdom have less than functional English. This study examined how learning English affected refugees' and asylum seekers' lives, particularly their emotional wellbeing, to explore what factors, particularly psychological ones, facilitated or impeded their learning English. We recruited 16 refugees and asylum seekers from an inner-city National Health Service trauma service and from a charity providing one-to-one English classes. All participants were interviewed in English. Interview data were analysed using thematic analysis from a critical realist perspective. Interviewees provided consistent accounts of their efforts to learn English, integrated into often unsettled and difficult lives. The analysis generated six themes in two domains. The impact of learning English was mainly positive, associated with autonomy, sense of achievement, and aspirations. Barriers to learning English consisted of other problems affecting refugees' capacity to learn, limited opportunities to speak English, and a sense of shame associated with perceived lack of English language competence. Findings highlight the need to provide adequate psychological support for refugees and asylum seekers learning English, recognising its importance in promoting both their integration in the UK and their individual psychological well-being.

Psychopathology and resident status - comparing asylum seekers, refugees, illegal migrants, labor migrants, and residents.

PubMed

Heeren, Martina; Wittmann, Lutz; Ehlert, Ulrike; Schnyder, Ulrich; Maier, Thomas; Müller, Julia

2014-05-01

This study aimed to describe, compare, and predict mental health outcomes of different migrant groups and native residents in Switzerland. Asylum seekers (n=65); refugees holding permanent protection visas (n=34); illegal migrants (n=21); labor migrants (n=26); and residents (n=56) completed an assessment by questionnaire. Main outcome variables were symptoms of posttraumatic stress, anxiety and depression. It was tested whether resident status predicted psychopathology over and above the influence of control variables including social desirability, traumatic event types and post-migration resources. Asylum seekers (54.0%) and refugees (41.4%) fulfilled criteria of PTSD most frequently. Clinically relevant symptoms of anxiety and depression were most frequently reported by asylum seekers (84.6% and 63.1%, resp.) and illegal migrants (both 47.6%). Resident status contributed to psychopathology over and above the influence of control variables. Overall, asylum seekers, refugees, and illegal migrants showed high psychiatric morbidity. Differences in resident status appear to be specifically associated with mental health outcomes. This association persists even when controlling for social desirability, post-migration resources and traumatic events. This emphasizes the importance of current socio-political living conditions for mental health, even with respect to the psychopathological sequelae of past traumatic experiences. Copyright © 2014 Elsevier Inc. All rights reserved.

Assisting asylum seekers in a time of global forced displacement: Five clinical cases.

PubMed

McKenzie, Katherine C; Thomas, Arielle

2017-07-01

According to the United Nations High Commissioner on Refugees, over 65 million people were displaced from their homes due to conflict and persecution in 2015. Many physicians express an interest in human rights and a desire to assist this group of refugees and asylum seekers. Physicians are able to use their unique skills by performing medical forensic evaluations of individuals seeking asylum. Some asylum seekers have psychological or physical scars or functional abnormalities relating to injuries or ill-treatment they experience due to persecution. Documenting these findings can significantly improve the likelihood that they will be granted asylum. This manuscript outlines the historical and legal background of asylum. Each of the individuals presented in this paper experienced persecution in different forms. One person was tortured due to his political opinion and one was assaulted because he was gay. One woman sought asylum due to domestic violence, another woman because she had been subjected to female genital mutilation/cutting (FGM/C) and the last suffered severe psychological trauma related to a forced marriage. Five typical clinical cases of medical forensic evaluations are outlined, each with different forms of persecution and physical or psychological findings. Physicians have an interest in using their expertise to help this underserved population. They report that working with asylum seekers is rewarding, intellectually stimulating and a novel way to use their training and skills. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Reproductive health care for asylum-seeking women - a challenge for health professionals.

PubMed

Kurth, Elisabeth; Jaeger, Fabienne N; Zemp, Elisabeth; Tschudin, Sibil; Bischoff, Alexander

2010-11-01

Dealing with pregnancy, childbirth and the care of newborn babies is a challenge for female asylum seekers and their health care providers. The aim of our study was to identify reproductive health issues in a population of women seeking asylum in Switzerland, and to examine the care they received. The women were insured through a special Health Maintenance Organisation (HMO) and were attending the Women's Clinic of the University Hospital in Basel. We also investigated how the health professionals involved perceived the experience of providing health care for these patients. A mixed methods approach combined the analysis of quantitative descriptive data and qualitative data obtained from semi-structured interviews with health care providers and from patients' files. We analysed the records of 80 asylum-seeking patients attending the Women's Clinic insured through an HMO. We conducted semi-structured interviews with 10 care providers from different professional groups. Quantitative data were analysed descriptively. Qualitative data analysis was guided by Grounded Theory. The principal health problems among the asylum seekers were a high rate of induced abortions (2.5 times higher than in the local population), due to inadequate contraception, and psychosocial stress due to the experience of forced migration and their current difficult life situation. The language barriers were identified as a major difficulty for health professionals in providing care. Health care providers also faced major emotional challenges when taking care of asylum seekers. Additional problems for physicians were that they were often required to act in an official capacity on behalf of the authorities in charge of the asylum process, and they also had to make decisions about controlling expenditure to fulfil the requirements of the HMO. They felt that these decisions sometimes conflicted with their duty towards the patient. Health policies for asylum seekers need to be designed to assure access to adequate contraception, and to provide psychological care for this vulnerable group of patients. Care for asylum seekers may be emotionally very challenging for health professionals.

The Occurrence of Diseases and Related Factors in a Center for Asylum Seekers in Italy.

PubMed

Firenze, Alberto; Aleo, Nicola; Ferrara, Clara; Maranto, Marianna; LA Cascia, Caterina; Restivo, Vincenzo

2016-03-01

Italy is the main recipient of asylum seekers in the European region, and Sicily is their first point of arrival. This geographical position creates a large job for Health Authorities to identify and deal with the health of immigrants. This study evaluates the prevalence of disease among asylum seekers, assessing which are associated factors. A cross-sectional study was conducted to analyse demographic and clinical data in an Acceptance Centres for Asylum Seekers from February 2012 to May 2013. All variables that were found to be significant on unvariable analysis for the most frequent pathologies were included in a multivariable logistic regression model. Post-traumatic stress disorders with 17.4% and major depression with 7.3% were the most frequent diseases. The factors associated with post-traumatic stress disorders among asylum seekers were: major depression diagnosis (OR=2.91, p=0.004), Pakistan as a country of origin (OR=3.88, p<0.001), the largest number of medical visits (OR=1.02, p=0.033) and refugee status (OR=1.97, p=0.036). The variables linked with the diagnosis of major depression from the multivariable analysis were: suffering from post-traumatic stress disorders (OR=3.83, p<0.001), Pakistan as a country of origin (OR=3.45, p=0.004) and the highest number of visits to psychologist (OR=1.15, p<0.001). The mental wellbeing of asylum seekers needs special attention, and interventions should be done to prevent the consolidation of psychiatric morbidity. A short psychological screening after the arrival might prove helpful here. Moreover, carefully designed longitudinal studies should be carried out when political recommendations try to change the organization of psychological and healthcare services.

The Occurrence of Diseases and Related Factors in a Center for Asylum Seekers in Italy

PubMed Central

FIRENZE, Alberto; ALEO, Nicola; FERRARA, Clara; MARANTO, Marianna; LA CASCIA, Caterina; RESTIVO, Vincenzo

2016-01-01

Introduction Italy is the main recipient of asylum seekers in the European region, and Sicily is their first point of arrival. This geographical position creates a large job for Health Authorities to identify and deal with the health of immigrants. This study evaluates the prevalence of disease among asylum seekers, assessing which are associated factors. Methods A cross-sectional study was conducted to analyse demographic and clinical data in an Acceptance Centres for Asylum Seekers from February 2012 to May 2013. All variables that were found to be significant on unvariable analysis for the most frequent pathologies were included in a multivariable logistic regression model. Results Post-traumatic stress disorders with 17.4% and major depression with 7.3% were the most frequent diseases. The factors associated with post-traumatic stress disorders among asylum seekers were: major depression diagnosis (OR=2.91, p=0.004), Pakistan as a country of origin (OR=3.88, p<0.001), the largest number of medical visits (OR=1.02, p=0.033) and refugee status (OR=1.97, p=0.036). The variables linked with the diagnosis of major depression from the multivariable analysis were: suffering from post-traumatic stress disorders (OR=3.83, p<0.001), Pakistan as a country of origin (OR=3.45, p=0.004) and the highest number of visits to psychologist (OR=1.15, p<0.001). Conclusions The mental wellbeing of asylum seekers needs special attention, and interventions should be done to prevent the consolidation of psychiatric morbidity. A short psychological screening after the arrival might prove helpful here. Moreover, carefully designed longitudinal studies should be carried out when political recommendations try to change the organization of psychological and healthcare services. PMID:27647085

Adult Asylum Seekers from the Middle East Including Syria in Central Europe: What Are Their Health Care Problems?

PubMed

Pfortmueller, Carmen Andrea; Schwetlick, Miriam; Mueller, Thomas; Lehmann, Beat; Exadaktylos, Aristomenis Konstantinos

2016-01-01

Forced displacement related to persecution and violent conflict has reached a new peak in recent years. The primary aim of this study is to provide an initial overview of the acute and chronic health care problems of asylum seekers from the Middle East, with special emphasis on asylum seekers from Syria. Our retrospective data analysis comprised adult patients presenting to our emergency department between 01.11.2011 and 30.06.2014 with the official resident status of an "asylum seeker" or "refugee" from the Middle East. In total, 880 patients were included in the study. Of these, 625 (71.0%) were male and 255 (29.0%) female. The median age was 34 (range 16-84). 222 (25.2%) of our patients were from Syria. The most common reason for presentation was surgical (381, 43.3%), followed by medical (321, 36.5%) and psychiatric (137, 15.6%). In patients with surgical presentations, trauma-related problems were most common (n = 196, 50.6%). Within the group of patients with medical presentation, acute infectious diseases were most common (n = 141, 43.9%), followed by neurological problems (n = 70, 21.8%) and gastrointestinal problems (n = 47, 14.6%). There were no differences between Syrian and non-Syrian refugees concerning surgical or medical admissions. The most common chronic disorder of unclear significance was chronic gastrointestinal problems (n = 132, 15%), followed by chronic musculoskeletal problems (n = 108, 12.3%) and chronic headaches (n = 78, 8.9%). Patients from Syria were significantly younger and more often suffered from a post-traumatic stress disorder than patients of other nationalities (p<0.0001, and p = 0.05, respectively). Overall a remarkable number of our very young group of patients suffered from psychiatric disorders and unspecified somatic symptoms. Asylum seekers should be carefully evaluated when presenting to a medical facility and physicians should be aware of the high incidence of unspecified somatic symptoms in this patient population.In general, there is no major difference between asylum seekers from Syria when compared to other nationalities of asylum seekers from the Middle East.

A cross-sectional survey of the mental health needs of refugees and asylum seekers attending a refugee health clinic: a study protocol for using research to inform local service delivery.

PubMed

Shawyer, Frances; Enticott, Joanne C; Doherty, Anne R; Block, Andrew A; Cheng, I-Hao; Wahidi, Sayed; Meadows, Graham N

2014-12-24

Refugees and asylum seekers have high rates of risk factors for mental disorders. In recent years, Australia has experienced a rapid increase in asylum seeker arrivals, creating new challenges for services in areas with high settlement numbers. This paper describes the design, including analytic framework, of a project set in a refugee health service in the state of Victoria, Australia, as part of their response to meeting the mental health needs of their burgeoning local population of refugees and asylum seekers. In order to assist service planning, the primary aim of this study is to determine: 1) an overall estimate of the prevalence of psychiatric disorders; 2) the specific prevalence of post-traumatic stress disorder 3) the perceived need and unmet need for mental health treatment. The secondary aim of the study is to establish matched risk ratios based on an Australian-born matched comparison group from the 2007 National Survey of Mental Health and Well-Being. A cross-sectional survey is used to estimate the prevalence of psychiatric disorders in refugees and asylum seekers attending a local refugee health service. Measures include the Kessler Psychological Distress Scale-10, the Post-Traumatic Stress Disorder-8, the General-practice User's Perceived-need Inventory together with service utilisation questions from the National Survey of Mental Health and Well-Being. Data collected from refugees and asylum seekers (n = 130) is matched to existing data from Australian-born residents drawn from the 2007 National Survey of Mental Health and Well-Being (n = 520) to produce estimates of the risk ratio. The paper describes a prototype for what is possible within regular services seeking to plan for and deliver high quality mental health care to refugees and asylum seekers. A novel project output will be the development and dissemination of an epidemiological methodology to reliably compare mental health status in a relatively small target sample with a matched comparator group.

The effectiveness of psychotherapy with refugees and asylum seekers: preliminary results from an Austrian study.

PubMed

Renner, Walter

2009-02-01

An Austrian Non-Governmental Organization (NGO) offered psychotherapy to 37 asylum seekers and refugees (21 of them female) with a mean age of 36.1 years (s = 7.5), with the majority of them from Chechnya or Afghanistan. Comparative data between the start of therapy and the time of evaluation revealed a highly significant positive effect (d = 0.77), while most therapies were still going on. By a retrospective measure of perceived change, 85% of the participants reported significant improvements. The results show that even under difficult conditions, when working with asylum seekers and refugees, psychotherapy can be effective.

Exploring the Relationship between Housing and Health for Refugees and Asylum Seekers in South Australia: A Qualitative Study

PubMed Central

Walsh, Moira

2017-01-01

Housing is an important social determinant of health; however, little is known about the impact of housing experiences on health and wellbeing for people from refugee and asylum-seeking backgrounds. In this paper, we outline a qualitative component of a study in South Australia examining these links. Specifically, interviews were conducted with 50 refugees and asylum seekers who were purposively sampled according to gender, continent and visa status, from a broader survey. Interviews were analysed thematically. The results indicated that housing was of central importance to health and wellbeing and impacted on health through a range of pathways including affordability, the suitability of housing in relation to physical aspects such as condition and layout, and social aspects such as safety and belonging and issues around security of tenure. Asylum seekers in particular reported that living in housing in poor condition negatively affected their health. Our research reinforces the importance of housing for both the physical and mental health for asylum seekers and refugees living in resettlement countries. Improving housing quality, affordability and tenure security all have the potential to lead to more positive health outcomes. PMID:28885594

Somali asylum seekers' perceptions of privacy in healthcare.

PubMed

Eklöf, Niina; Abdulkarim, Hibag; Hupli, Maija; Leino-Kilpi, Helena

2016-08-01

Privacy has been recognized as a basic human right and a part of quality of care. However, little is known about the privacy of Somali asylum seekers in healthcare, even though they are one of the largest asylum seeker groups in the world. The aim of the study was to describe the content and importance of privacy and its importance in healthcare from the perspective of Somali asylum seekers. The data of this explorative qualitative study were collected by four focus group interviews with 18 Somali asylum seekers with the help of an interpreter. The data were analysed by inductive content analysis. Research permissions were obtained from the director of the reception centre and from the Department of Social Services. Ethical approval was obtained from the Ethics Committee of Turku University. The content of privacy includes visual privacy, physical privacy and informational privacy. All contents can be shared with healthcare professionals. The importance of privacy includes respect, dignity and freedom. Privacy is strongly connected to the collectivism of Somali culture and religion. Unlike the Western cultures, privacy is not important only for the individual; most of all, it is seen to support collectivism. Even though all contents of privacy can be shared with healthcare professionals, it is important to recognize the cultural aspect of privacy especially when using interpreters with Somali background. © The Author(s) 2015.

Screening for infectious diseases among asylum seekers newly arrived in Germany in 2015: a systematic single-centre analysis.

PubMed

Kortas, A Z; Polenz, J; von Hayek, J; Rüdiger, S; Rottbauer, W; Storr, U; Wibmer, T

2017-12-01

During the migrant crisis in 2015, Germany was the largest single recipient of new asylum seekers in Europe. The German asylum law requires a screening examination for certain infectious diseases in asylum seekers upon arrival. The aim of this work was to analyse the rate of certain infectious diseases among asylum seekers screened at a reception centre in Southern Germany. Retrospective medical record review. Medical records of 2602 asylum seekers screened by a local public health authority in Germany in 2015 were systematically analysed. The majority of screened subjects came from Afghanistan and Syria. The mean age was 22.1 (±12.0) years. The majority of subjects were male (75.4%). Most individuals were of normal weight or overweight, more subjects were obese than underweight. A total of 78 (3.9%) individuals were infected with hepatitis B and eight (0.4%) with HIV. In 31 cases, chest radiographs suggested active tuberculosis (1.6%), which was confirmed in four cases (0.2%). The physical examination uncovered 44 (1.7%) cases of scabies, nine (0.3%) cases of lice, eight (0.3%) of upper respiratory tract infections, two (0.1%) of varicella and 13 (0.5%) of other skin infections. In the majority of subjects none of the screened infectious diseases were found. No evidence was found that the overall prevalence of certain infectious diseases screened for in the present analysis was considerably higher than in previous migration studies. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Performing Like an Asylum Seeker: Paradoxes of Hyper-Authenticity

ERIC Educational Resources Information Center

Jestrovic, Silvija

2008-01-01

This essay investigates performance events that feature actual refugees, asylum seekers and immigrants, but in instances where presence and embodiment are mediated and made ambiguous. My focus is a fashion show by Catalan designer Antonio Miro, who uses refugees from Senegal as models, and Christoph Schlingensief's public art project…

Living Outside the Gender Box in Mexico: Testimony of Transgender Mexican Asylum Seekers.

PubMed

Cheney, Marshall K; Gowin, Mary J; Taylor, E Laurette; Frey, Melissa; Dunnington, Jamie; Alshuwaiyer, Ghadah; Huber, J Kathleen; Garcia, Mary Camero; Wray, Grady C

2017-10-01

To explore preimmigration experiences of violence and postimmigration health status in male-to-female transgender individuals (n = 45) from Mexico applying for asylum in the United States. We used a document review process to examine asylum declarations and psychological evaluations of transgender Mexican asylum seekers in the United States from 2012. We coded documents in 2013 and 2014 using NVivo, a multidisciplinary team reviewed them, and then we analyzed them for themes. Mexican transgender asylum applicants experienced pervasive verbal, physical, and sexual abuse from multiple sources, including family, school, community, and police. Applicants also experienced discrimination in school and in the workplace. Applicants immigrated to the United States to escape persistent assaults and threats to their life. Applicants suffered health and psychological effects from their experiences in Mexico that affected opportunities in the United States for employment, education, and social inclusion. Additional social protections for transgender individuals and antidiscrimination measures in Mexican schools and workplaces are warranted as are increased mental health assessment and treatment, job training, and education services for asylum seekers in the United States.

The Relationship Between Post-Migration Stress and Psychological Disorders in Refugees and Asylum Seekers.

PubMed

Li, Susan S Y; Liddell, Belinda J; Nickerson, Angela

2016-09-01

Refugees demonstrate high rates of post-traumatic stress disorder (PTSD) and other psychological disorders. The recent increase in forcible displacement internationally necessitates the understanding of factors associated with refugee mental health. While pre-migration trauma is recognized as a key predictor of mental health outcomes in refugees and asylum seekers, research has increasingly focused on the psychological effects of post-migration stressors in the settlement environment. This article reviews the research evidence linking post-migration factors and mental health outcomes in refugees and asylum seekers. Findings indicate that socioeconomic, social, and interpersonal factors, as well as factors relating to the asylum process and immigration policy affect the psychological functioning of refugees. Limitations of the existing literature and future directions for research are discussed, along with implications for treatment and policy.

The impact of a long asylum procedure on quality of life, disability and physical health in Iraqi asylum seekers in the Netherlands.

PubMed

Laban, Cornelis J; Komproe, Ivan H; Gernaat, Hajo B P E; de Jong, Joop T V M

2008-07-01

Refugees in western countries often face long juridical procedures before their requests for a resident permit is granted. The, still scanty, literature shows high prevalence rates of psychopathology among asylum seekers, but there has been little interest for other impaired dimensions of health. The present study is part of a community-based mental health survey among Iraqi asylum seekers in the Netherlands, conducted between November 2000 and September 2001, on the risks of a long asylum procedure. The objectives of this study were to explore quality of life (QoL), disability and physical health and their relationships with psychopathology and pre- and post-migration variables. Two groups of pre-stratified (length of asylum procedure), randomly selected Iraqi asylum seekers (N = 143 and N = 151), were interviewed with fully structured, culturally validated questionnaires. Quality of life was examined with QoLWHO-Bref, functional disability with the Brief Disability Questionnaire and physical health with a newly developed questionnaire. Psychiatric (DSM IV) disorders were measured with the WHO Composite International Diagnostic Interview 2.1. Multivariate logistic regression analyses were used to estimate the relationships between the outcome measures and socio-demographics, adverse life events in Iraq, post-migration living problems (PMLP) and psychopathology. Respondents with a long asylum procedure reported significantly lower QoL, higher functional disability and more physical complaints. Multivariate regression shows that length of stay is the strongest predictor for a low overall QoL. In addition, lower QoL was predicted by psychopathology, higher age, adverse life events in the Netherlands and the PMLP-clusters: family issues, socio-economic living conditions and socio-religious aspects. Disability was predicted by psychopathology, higher age and the PMLP clusters: family issues and socio-religious aspects. Physical complaints were predicted by length of asylum procedure, psychopathology, female sex, adverse life events in Iraq and PMLP-family issues. A long asylum procedure has a negative impact on the overall health situation and the QoL of asylum seekers. The situation is not only harming the affected, but also interferes with the integration process in the Netherlands or elsewhere. The findings are important for health professionals, governments and human right specialists.

Assets, Aliens or Asylum Seekers? Immigration and the United Kingdom

ERIC Educational Resources Information Center

Haste, Helen

2006-01-01

British attitudes toward immigrants are complex. The United Kingdom has received regular waves of immigrants, both political and economic asylum seekers and, especially in recent decades, recruited labor from the former nations of the British Empire. Throughout its history, ambivalence among the Britons is seen due to these developments. In this…

Tough, but Where's the Love?

ERIC Educational Resources Information Center

Coussey, Mary

2008-01-01

Every government wants to appear to be tough on asylum seekers. But in failing to offer newcomers immediate access to English language learning one runs the risk of missing out on significant economic and social cohesion benefits. In this article, the author argues that asylum seekers need to get English language support in their first six months…

Anxiety, depression and PTSD in asylum-seekers: assocations with pre-migration trauma and post-migration stressors.

PubMed

Silove, D; Sinnerbrink, I; Field, A; Manicavasagar, V; Steel, Z

1997-04-01

Research into the mental health of refugees has burgeoned in recent times, but there is a dearth of studies focusing specifically on the factors associated with psychiatric distress in asylum-seekers who have not been accorded residency status. Forty consecutive asylum-seekers attending a community resource centre in Sydney, Australia, were interviewed using structured instruments and questionnaires. Anxiety scores were associated with female gender, poverty, and conflict with immigration officials, while loneliness and boredom were linked with both anxiety and depression. Thirty subjects (79%) had experienced a traumatic event such as witnessing killings, being assaulted, or suffering torture and captivity, and 14 subjects (37%) met full criteria for PTSD. A diagnosis of PTSD was associated with greater exposure to pre-migration trauma, delays in processing refugee applications, difficulties in dealing with immigration officials, obstacles to employment, racial discrimination, and loneliness and boredom. Although based on correlational data derived from'a convenient' sample, our findings raise the possibility that current procedures for dealing with asylum-seekers may contribute to high levels of stress and psychiatric symptoms in those who have been previously traumatised.

Refugee experiences of general practice in countries of resettlement: a literature review.

PubMed

Cheng, I-Hao; Drillich, Ann; Schattner, Peter

2015-03-01

Refugees and asylum seekers often struggle to use general practice services in resettlement countries. To describe and analyse the literature on the experiences of refugees and asylum seekers using general practice services in countries of resettlement. Literature review using systematic search and narrative data extraction and synthesis methodologies. International, peer-reviewed literature published in English language between 1990 and 2013. Embase, Ovid MEDLINE, PsycINFO, CSA Sociological Abstracts, and CINAHL databases were searched using the terms: refugee, asylum seeker, experience, perception, doctor, physician, and general practitioner. Titles, abstracts and full texts were reviewed and were critically appraised. Narrative themes describing the refugee or asylum seeker's personal experiences of general practice services were identified, coded, and analysed. From 8722 papers, 85 were fully reviewed and 23 included. These represented the experiences of approximately 864 individuals using general practice services across 11 countries. Common narrative themes that emerged were: difficulties accessing general practice services, language barriers, poor doctor-patient relationships, and problems with the cultural acceptability of medical care. The difficulties refugees and asylum seekers experience accessing and using general practice services could be addressed by providing practical support for patients to register, make appointments, and attend services, and through using interpreters. Clinicians should look beyond refugee stereotypes to focus on the needs and expectations of the individual. They should provide clear explanations about unfamiliar clinical processes and treatments while offering timely management. © British Journal of General Practice 2015.

Refugees and antimicrobial resistance: A systematic review.

PubMed

de Smalen, Allard Willem; Ghorab, Hatem; Abd El Ghany, Moataz; Hill-Cawthorne, Grant A

There is a large increase in the numbers of refugees and asylum seekers worldwide and a lack of data on the carriage of antimicrobial resistance in refugee/asylum seeking groups. This article aims to identify the impact of refugees and asylum seekers on the acquisition and transmission of antimicrobial resistance (AMR) through a literature search. The databases Embase, Medline, Pubmed, and Web of Science Core Collection were utilised and covered all articles before the 1st of October 2016. In total, 577 articles were identified, and studies were eligible if they met the selection criteria, including observational study design, English language, and AMR strains reported in absolute numbers. In total, 17 articles met the criteria, the majority were from the European region. Articles fitting the selection criteria exclusively reported AMR in bacterial species including Mycobacterium tuberculosis, Escherichia coli, Klebsiella pneumonia, K. oxytoca, Shigella spp., Staphylococcus aureus, Enterococcus faecium, and Acinetobacter baumannii. The analyses indicated that a high percentage of AMR strains, have been circulating among refugees and asylum seekers. The displacement of refugees and asylum seekers seem to play a key role in the transmission of AMR. Therefore, improved AMR control measures are essential. A knowledge gap was identified; further research is strongly recommended. Copyright © 2016 Elsevier Ltd. All rights reserved.

Impact of asylum interviews on the mental health of traumatized asylum seekers

PubMed Central

Schock, Katrin; Rosner, Rita; Knaevelsrud, Christine

2015-01-01

Background Asylum interviews within the asylum procedure are associated with psychological stress for traumatized asylum seekers. This study investigates the impact of asylum interviews on the mental health in a sample of 40 traumatized asylum seekers. The comparison group consisted of refugees (N=10) that had not been invited to an asylum interview. Additionally, the moderating effects of trial-related variables such as perceived justice of the trial, stress of giving testimony, and stress of waiting for the asylum interview were examined. Method Participants were assessed on average 10 days before (t1) and 16 days after (t2) the asylum interview. Chi-square tests for dichotomous and categorical variables were used to compare the descriptive statistics of the two groups. To investigate symptom changes from t1 to t2, paired t-tests were calculated. The magnitude of effects was measured by Cohen's effect size d within groups. Hierarchical regression analyses were conducted for demographic and trial variables predicting posttraumatic intrusions, avoidance, and hyperarousal. Results Data showed a significant increase in posttraumatic intrusions and a significant decrease in posttraumatic avoidance and hyperarousal symptoms from t1 to t2. No significant symptom changes in the posttraumatic stress disorder subscales were found in the comparison group. The results of hierarchical regression analyses revealed perceived justice of the interview to predict the increase of intrusions and the number of experienced traumata and testimony stress to predict posttraumatic avoidance. Conclusions The present findings underline the stressful impact of asylum interviews on traumatized refugees. They indicate that the asylum interview might decrease posttraumatic avoidance and trigger posttraumatic intrusions, thus highlight the importance of ensuring that the already vulnerable group of traumatized refugees needs to be treated with empathy during their asylum interview. PMID:26333540

Negligible import of enteric pathogens by newly-arrived asylum seekers and no impact on incidence of notified Salmonella and Shigella infections and outbreaks in Rhineland-Palatinate, Germany, January 2015 to May 2016.

PubMed

Ehlkes, Lutz; George, Maja; Knautz, Donald; Burckhardt, Florian; Jahn, Klaus; Vogt, Manfred; Zanger, Philipp

2018-05-01

IntroductionThe 2015 refugee crisis raised concerns about an import of infectious diseases affecting the German population. Aims: To evaluate public and individual health benefits of stool screening, and explore whether importation of enteric pathogens by newly-arrived asylum seekers impacts on the host population. Methods : We used data from mandatory stool screening to determine the overall, age, sex, and country-specific prevalence of enteric bacteria and helminths. We used surveillance data to assess whether the number of incoming asylum seekers influenced notifications of salmonellosis and shigellosis in Rhineland-Palatinate. Results : Salmonella were found in 0.2% (95% confidence interval (CI) 0.2-0.3%) of 23,410 samples collected from January 2015 to May 2016. Prevalence was highest in children under 5 years (0.8%; 95% CI: 0.5-1.3%). No Shigella or invasive Salmonella spp. were detected. In a subset of 14,511 samples, the prevalence of helminth infestation was 2.4% (95% CI: 2.1-2.6%), with highest proportions detected in adolescents (4.6%; 95% CI 3.8-5.4%) and among Eritreans (9.3%; 95% CI: 7.0-12.0%); in the latter particularly Schistosoma mansoni and Taenia spp. The increase in asylum applications did not increase notifications of salmonellosis and shigellosis. No transmission from asylum seekers to German residents was notified. Conclusion : Public health risk associated with imported enteric pathogens is very low overall. Addressing individual and public health risks, we recommend replacing stool screening of all newly-arrived asylum seekers by a targeted approach, with target groups and approaches being adapted if necessary. Target groups supported by our data are children, adolescents, and Eritreans.

Acute health problems in African refugees: ten years' experience in a Swiss emergency department.

PubMed

Pfortmueller, Carmen A; Graf, Fabienne; Tabbara, Malek; Tabarra, Malek; Lindner, Gregor; Zimmermann, Heinz; Exadaktylos, Aristomenis K

2012-09-01

Over the last two decades, the total number of applications from Africans for asylum in the countries of the European Union has increased from 578,000 to more than 2.9 million. About 20 % (7,196/36,100) of the asylum seekers in Switzerland originate from Africa. The disease profile of African asylum seekers is remarkably different from that of the native population in the country of application. We have therefore conducted an analysis of African asylum seekers presenting themselves to our emergency department. In a retrospective analysis, the central patient registry database was searched for patients originating from Africa admitted from 1 January 2000 to 30 November 2011 and labelled as "Asylbewerber" (asylum seeker) or "Flüchtling" (refugee). Three thousand six hundred and seventy-five African asylum seekers were admitted to our emergency department between 2000 and 2010. Thirty-four percent (n = 1,247) were female and 66 % (n = 2,426) male. Eighty percent (n = 1,940) of the men and 70 % (n = 823) of the women were younger than 40 years. Most of our patients originated from Algeria (n = 612). Forty-five percent (n = 1,628) of all patients presented with internal medical problems, 40 % (n = 1,487) with injuries. 3.5 % (n = 130) of all patients presented with psychiatric problems. Admission for psychiatric problems increased steadily from 2 % (n = 4) in 2001 to 10 % (n = 35) in 2011. The causes of presentation are manifold, including internal medical problems and injuries. Admissions for psychiatric problems are increasing. Establishing simple screening scores for somatization should be a key priority in providing more focused treatment in emergency departments.

The Right to Education of Children and Youngsters from Refugee Families in Europe

ERIC Educational Resources Information Center

Essomba, Miquel Àngel

2017-01-01

The right to education of children and youth from asylum seeker and refugee families is currently being threatened in Europe. Two factors explain this: the sudden and disorganised arrival of large numbers of asylum seeker families, and the inconsistent integration of those seeking refugee status and those who have gained such status. The actual…

Politicised Notions of Professional Identity and Psychosocial Practice among Practitioners Working with Asylum Seekers and Refugees

ERIC Educational Resources Information Center

Apostolidou, Zoe

2015-01-01

This is the first study undertaken in the UK that investigates the notion of professional identity among practitioners who work with asylum seekers and refugees. Drawing on a social constructionist epistemology and a Foucauldian theoretical and methodological framework of power and discourse, I analysed extracts from semi-structured interviews…

Teaching in Fractured Classrooms: Refugee Education, Public Culture, Community and Ethics

ERIC Educational Resources Information Center

Hattam, Robert; Every, Danielle

2010-01-01

During the last decade or so, schooling policy has had to increasingly grapple with processes that have a global reach. One significant aspect of globalisation has been the global flows of asylum seekers and refugees. Although Australia has a long history of accepting asylum seekers and refugees, in recent times, concerns about national security…

Inclusive Democracy: A Consideration of Playback Theatre with Refugee and Asylum Seekers in Australia

ERIC Educational Resources Information Center

Dennis, Rea

2007-01-01

Community-based performance often facilitates participation through story-based processes and in this way could be seen as enacting a form of inclusive democracy. This paper examines a playback theater performance with a refugee and asylum seeker audience and questions whether inclusive, democratic participation can be fostered. It presents a…

Asylum Seekers, Violence and Health: A Systematic Review of Research in High-Income Host Countries

PubMed Central

Hossain, Mazeda; Kiss, Ligia; Zimmerman, Cathy

2013-01-01

We performed a systematic review of literature on violence and related health concerns among asylum seekers in high-income host countries. We extracted data from 23 peer-reviewed studies. Prevalence of torture, variably defined, was above 30% across all studies. Torture history in clinic populations correlated with hunger and posttraumatic stress disorder, although in small, nonrepresentative samples. One study observed that previous exposure to interpersonal violence interacted with longer immigration detention periods, resulting in higher depression scores. Limited evidence suggests that asylum seekers frequently experience violence and health problems, but large-scale studies are needed to inform policies and services for this vulnerable group often at the center of political debate. PMID:23327250

Refugees, asylum-seekers and undocumented migrants and the experience of parenthood: a synthesis of the qualitative literature.

PubMed

Merry, Lisa; Pelaez, Sandra; Edwards, Nancy C

2017-09-19

To synthesize the recent qualitative literature and identify the integrative themes describing the parenthood experiences of refugees, asylum-seekers and undocumented migrants. We searched seven online databases for the period January 2006 to February 2017. We included English and French published peer-reviewed articles and graduate-level dissertations, which qualitatively examined the parenthood experiences of refugees, asylum-seekers and undocumented migrants. We summarized study characteristics and performed a thematic analysis across the studies. One hundred thirty eight studies met inclusion criteria. All but three were conducted in high-income countries, mainly in the US. Migrants studied were mostly undocumented from Latin America and refugees from Sub-Saharan Africa. Almost all studies (93%) included mothers; about half (47%) included fathers; very few (5%) included extended family members. We identified three integrative themes: 1) experiencing hardship and/or loss in the context of precarious migration and past traumas; 2) building resilience and strength by bridging language, norms and expectations; and 3) living transnationally: obligations, challenges and resources. Each theme contributed to shaping the parenthood experience; the transnationalism theme intersected with the themes on hardship and loss and resilience and strength. More research is needed with fathers, extended family members, asylum-seekers and in the LMIC context. A transnational lens needs to be applied to programs, policies and future research for refugee, asylum-seeker and undocumented migrant parents. Addressing transnational concerns (family separation and reunification), acknowledging transnational resources, fostering a transnational family identity and conducting transnational and longitudinal studies are potentially pivotal approaches for this sub-population of parents.

Seeking Refuge: Implications When Integrating Refugee and Asylum Seeker Students into a Mainstream Australian School

ERIC Educational Resources Information Center

Wiseman, Martin; O'Gorman, Shannon

2017-01-01

This article describes one school's response to the inclusion and education of refugee and asylum seeker students within a mainstream educational setting. Australian government statistics released on 31 March 2016 stated that there were presently 50 children being held on Nauru, 17 children held in detention on the mainland and 317 children held…

Telling Tales of Torture: Repositioning Young Adults' Views of Asylum Seekers

ERIC Educational Resources Information Center

Watts, Michael F.

2004-01-01

This paper explores the changing attitudes of a group of young adults towards asylum seekers in the UK. Based on the experience of sixth form students attending a workshop hosted by a former refugee from Pinochet's Chile, it argues for the importance of personal stories and their wider contexts and suggests that each is necessary to enable…

Practitioners' Perspectives on the Use of Clinical Supervision in Their Therapeutic Engagement with Asylum Seekers and Refugee Clients

ERIC Educational Resources Information Center

Apostolidou, Zoe; Schweitzer, Robert

2017-01-01

The present study is the first study undertaken in Australia that seeks to explore practitioners' perspectives on the use of clinical supervision in their therapeutic engagement with asylum seekers and refugees. We used thematic analysis to analyse extracts of interviews that were conducted with nine professionals who worked therapeutically with…

Digital Storytelling: Putting Young Asylum Seekers at the Heart of the Story

ERIC Educational Resources Information Center

López-Bech, Laura; Zúñiga, Rodolfo

2017-01-01

As new stories from asylum seekers and refugees permeate the reality of European societies today, a whole new set of challenges and opportunities arise for building a common sense of belonging. Spaces for intercultural dialogue become crucial in connecting us all in a way that allows us to discover "the other" through our own process of…

Age determination of unaccompanied asylum seeking minors in the European Union: a health law perspective.

PubMed

Abbing, Henriette D C Roscam

2011-01-01

In the European Union, unaccompanied asylum seekers below 18 years of age are entitled to specific treatment. Age assessment practices to verify the age-statement by the asylum seeker differ between EU Member States. Medical methods in use raise questions about accuracy, reliability and safety. The medical, legal and ethical acceptability of invasive methods (notably X-rays) in particular is controversial. Human rights are at stake. The lack of common practices results in different levels of protection (discrimination). The absence ofstandardisation is an obstacle for the functioning of the Common European Asylum System. EU Best Practice Guidelines should remedy the situation; such guidelines should reflect the best interest of the child.

Psychiatric ethics and a politics of compassion.

PubMed

Zion, Deborah; Briskman, Linda; Loff, Bebe

2012-03-01

Australia has one of the harshest regimes for the processing of asylum seekers, people who have applied for refugee status but are still awaiting an answer. It has received sharp rebuke for its policies from international human rights bodies but continues to exercise its resolve to protect its borders from those seeking protection. One means of doing so is the detention of asylum seekers who arrive in Australia by boat. Health care providers who care for asylum seekers in these conditions experience a conflict of "dual loyalty," whereby their role in preserving and maintaining the health of patients can run counter to their employment in detention facilities. Many psychiatrists who have worked in the detention setting engage in forms of political activism in order to change the process of seeking refuge.

Positive thinking elevates tolerance: Experimental effects of happiness on adolescents' attitudes toward asylum seekers.

PubMed

Tenenbaum, Harriet R; Capelos, Tereza; Lorimer, Jessica; Stocks, Thomas

2018-04-01

Inducing emotional reactions toward social groups can influence individuals' political tolerance. This study examines the influence of incidental fear and happiness on adolescents' tolerant attitudes and feelings toward young Muslim asylum seekers. In our experiment, 219 16- to 21-year-olds completed measures of prejudicial attitudes. After being induced to feel happiness, fear, or no emotion (control), participants reported their tolerant attitudes and feelings toward asylum-seeking young people. Participants assigned to the happiness condition demonstrated more tolerant attitudes toward asylum-seeking young people than did those assigned to the fear or control conditions. Participants in the control condition did not differ from participants in the fear condition. The participants in the happiness condition also had more positive feelings toward asylum-seeking young people than did participants in the control condition. The findings suggest that one way to increase positive attitudes toward asylum-seeking young people is to improve general emotional state.

Challenges and facilitators for health professionals providing primary healthcare for refugees and asylum seekers in high-income countries: a systematic review and thematic synthesis of qualitative research

PubMed Central

Robertshaw, Luke; Dhesi, Surindar

2017-01-01

Objectives To thematically synthesise primary qualitative studies that explore challenges and facilitators for health professionals providing primary healthcare for refugees and asylum seekers in high-income countries. Design Systematic review and qualitative thematic synthesis. Methods Searches of MEDLINE, EMBASE, PsycINFO, CINAHL and Web of Science. Search terms were combined for qualitative research, primary healthcare professionals, refugees and asylum seekers, and were supplemented by searches of reference lists and citations. Study selection was conducted by two researchers using prespecified selection criteria. Data extraction and quality assessment using the Critical Appraisal Skills Programme tool was conducted by the first author. A thematic synthesis was undertaken to develop descriptive themes and analytical constructs. Results Twenty-six articles reporting on 21 studies and involving 357 participants were included. Eleven descriptive themes were interpreted, embedded within three analytical constructs: healthcare encounter (trusting relationship, communication, cultural understanding, health and social conditions, time); healthcare system (training and guidance, professional support, connecting with other services, organisation, resources and capacity); asylum and resettlement. Challenges and facilitators were described within these themes. Conclusions A range of challenges and facilitators have been identified for health professionals providing primary healthcare for refugees and asylum seekers that are experienced in the dimensions of the healthcare encounter, the healthcare system and wider asylum and resettlement situation. Comprehensive understanding of these challenges and facilitators is important to shape policy, improve the quality of services and provide more equitable health services for this vulnerable group. PMID:28780549

Ethical aspects of medical age assessment in the asylum process: a Swedish perspective.

PubMed

Malmqvist, Erik; Furberg, Elisabeth; Sandman, Lars

2018-05-01

According to European regulations and the legislations of individual member states, children who seek asylum have a different set of rights than adults in a similar position. To protect these rights and ensure rule of law, migration authorities are commonly required to assess the age of asylum seekers who lack reliable documentation, including through various medical methods. However, many healthcare professionals and other commentators consider medical age assessment to be ethically problematic. This paper presents a simplified and amended account of the main findings of a recent ethical analysis of medical age assessment in the asylum process commissioned by the Swedish National Board of Health and Welfare. A number of ethical challenges related to conflicting goals, equality and fairness, autonomy and informed consent, privacy and integrity, and professional values and roles are identified and analysed. It is concluded that most of these challenges can be met, but that this requires a system where the assessment is sufficiently accurate and where adequate safeguards are in place. Two important ethical questions are found to warrant further analysis. The first is whether asylum seekers' consent to the procedure can be considered genuinely voluntary. The second is whether and how medical age assessments could affect negative public attitudes towards asylum seekers or discriminatory societal views more generally.

Monitoring for Equality? Asylum Seekers and Refugees' Retention and Achievement in English for Speakers of Other Languages (ESOL)

ERIC Educational Resources Information Center

Phillimore, Jenny

2011-01-01

Interest in the integration of refugees has grown with the increase in numbers of asylum seekers dispersed across the UK. The ability to communicate effectively in English is seen as the key priority in facilitating integration, while a lack of English language is seen as one of the major barriers to refugee employment. Some 267 million British…

Refugee experiences of general practice in countries of resettlement: a literature review

PubMed Central

Cheng, I-Hao; Drillich, Ann; Schattner, Peter

2015-01-01

Background Refugees and asylum seekers often struggle to use general practice services in resettlement countries. Aim To describe and analyse the literature on the experiences of refugees and asylum seekers using general practice services in countries of resettlement. Design and setting Literature review using systematic search and narrative data extraction and synthesis methodologies. International, peer-reviewed literature published in English language between 1990 and 2013. Method Embase, Ovid MEDLINE, PsycINFO, CSA Sociological Abstracts, and CINAHL databases were searched using the terms: refugee, asylum seeker, experience, perception, doctor, physician, and general practitioner. Titles, abstracts and full texts were reviewed and were critically appraised. Narrative themes describing the refugee or asylum seeker’s personal experiences of general practice services were identified, coded, and analysed. Results From 8722 papers, 85 were fully reviewed and 23 included. These represented the experiences of approximately 864 individuals using general practice services across 11 countries. Common narrative themes that emerged were: difficulties accessing general practice services, language barriers, poor doctor–patient relationships, and problems with the cultural acceptability of medical care. Conclusion The difficulties refugees and asylum seekers experience accessing and using general practice services could be addressed by providing practical support for patients to register, make appointments, and attend services, and through using interpreters. Clinicians should look beyond refugee stereotypes to focus on the needs and expectations of the individual. They should provide clear explanations about unfamiliar clinical processes and treatments while offering timely management. PMID:25733438

An outbreak of chickenpox in an asylum seeker centre in Italy: outbreak investigation and validity of reported chickenpox history, December 2015-May 2016.

PubMed

Vairo, Francesco; Di Bari, Virginia; Panella, Vincenzo; Quintavalle, Giuseppe; Torchia, Saul; Serra, Maria Cristina; Sinopoli, Maria Teresa; Lopalco, Maurizio; Ceccarelli, Giancarlo; Ferraro, Federica; Valle, Sabrina; Bordi, Licia; Capobianchi, Maria Rosaria; Puro, Vincenzo; Scognamiglio, Paola; Ippolito, Giuseppe

2017-11-01

An outbreak of chickenpox occurred between December 2015 and May 2016 among asylum seekers in a reception centre in Latium, Italy. We describe the epidemiological and laboratory investigations, control measures and validity of reported history of chickenpox infection. Serological screening of all residents and incoming asylum seekers was performed, followed by vaccine offer to all susceptible individuals without contraindication. Forty-six cases were found and 41 were associated with the outbreak. No complications, hospitalisations or deaths occurred. Serological testing was performed in 1,278 individuals and 169 were found to be susceptible, with a seroprevalence of 86.8%. A questionnaire was administered to 336 individuals consecutively attending the CARA health post to collect their serological result. The sensitivity, specificity and the positive and negative predictive value (PPV and NPV) of the reported history of chickenpox were 45.0%, 76.1%, 88.3% and 25.6%, respectively. We observed an increasing trend for the PPV and decreasing trend for the NPV with increasing age. Our report confirms that, in the asylum seeker population, chickenpox history is not the optimal method to identify susceptible individuals. Our experience supports the need for additional prevention and control measures and highlights the importance of national and local surveillance systems for reception centres.

[Development and implementation of an outpatient clinic at an initial reception centre for asylum seekers in the German federal state of Baden-Wuerttemberg].

PubMed

Nikendei, Christoph; Huhn, Daniel; Adler, Guido; von Rose, Peta Becker; Eckstein, Torsten M; Fuchs, Birgit; Gewalt, Sandra C; Greiner, Bernhard; Günther, Thomas; Herzog, Wolfgang; Junghanss, Thomas; Krczal, Thomas; Lorenzen, Detlef; Lutz, Thomas; Manigault, Meryl A; Reinhart, Nico; Rodenberg, Michiko; Schelletter, Iris; Szecsenyi, Joachim; Steen, Rainer; Straßner, Cornelia; Thomsen, Mirjam; Wahedi, Katharina; Bozorgmehr, Kayvan

2017-10-01

In 2015, more than 890,000 asylum seekers were registered in Germany. The provision of medical and psychosocial care for asylum seekers is facing numerous obstacles. Access to health care is mostly insufficient, particularly in initial reception centres. The present article describes the development and implementation of an interdisciplinary outpatient clinic for asylum seekers at the main registration authority in the state of Baden-Wuerttemberg operated by physicians of the University Hospital of Heidelberg and the local Medical Association in Heidelberg. A steering committee was appointed to plan and implement the interdisciplinary outpatient clinic. Semi-structured interviews with nine steering committee members were conducted to elucidate perceived barriers during the planning and implementation phase. The steering committee's strong personal commitment and the health authorities' impartial management were cited as the main contributing factors to the success of the implementation process. Significant barriers were seen in the funding of personnel, equipment, and language mediation as well as in legal liability and billing-related aspects. Results are discussed with a focus on financing, administrative and legal framework as well as language mediation, documentation and further matters that are essential to ensure high-quality care. Copyright © 2017. Published by Elsevier GmbH.

Helping professionals and Border Force secrecy: effective asylum-seeker healthcare requires independence from callous policies.

PubMed

Dudley, Michael

2016-02-01

To examine the Australian Border Force Act (BFA) and its context, its implications for asylum-seeker healthcare and professionals, and contemporary and historical parallels. Prolonged immigration detention and policies aiming to deter irregular migration cause maritime asylum-seekers undeniable, well-publicised harms and (notwithstanding claims about preventing drownings) show reckless indifference and calculated cruelty. Service personnel may be harmed. Such policies misuse helping professionals to underwrite state abuses and promote public numbing and indifference, resembling other state abuses in the 'war on terror' and (with qualification) historical counterparts, e.g. Nazi Germany. Human service practitioners and organisations recently denounced the BFA that forbids disclosure about these matters.Continuing asylum-seeker healthcare balances the likelihood of effective care and monitoring with lending credibility to abuses. Boycotting it might sacrifice scrutiny and care, fail to compel professionals and affect temporary overseas workers. Entirely transferring healthcare from immigration to Federal and/or State health departments, with resources augmented to adequate standard, would strengthen clinical independence and quality, minimise healthcare's being securitised and politicised, and uphold ethical codes. Such measures will not resolve detention's problems, but coupled with independent auditing, would expose and moderate detention's worst effects, promoting changes in national conversation and policy-making. © The Royal Australian and New Zealand College of Psychiatrists 2016.

Refugee blues: a UK and European perspective

PubMed Central

Turner, Stuart

2015-01-01

In this paper, the numbers of refugees travelling to the European Union are set in a global context. It is argued that the increasing restrictions placed on asylum seekers from the 1980s onwards in the UK and the associated culture of deterrence and prohibition have had the perverse effect of supporting the economic market for people smuggling. It appears that these restrictions were initially designed to deter people, most of whom would have been granted humanitarian assistance had they managed to arrive in the UK, so as to prevent them from accessing the decision-making process on asylum. Policy changes concerning travel, benefits, and other pressures on asylum seekers are also considered in the context of deterrence. The problems facing asylum seekers do not end with their arrival in a safe country. The current methods of determining refugee status are alarmingly weak. Indeed there is evidence suggesting that those who are most traumatised before arrival face systematic disadvantage. The focus of this paper is on the United Kingdom but its conclusions apply to most Western European countries. The paper concludes with some tentative suggestions for change. PMID:26514159

Experiencing 'pathologized presence and normalized absence'; understanding health related experiences and access to health care among Iraqi and Somali asylum seekers, refugees and persons without legal status.

PubMed

Fang, Mei Lan; Sixsmith, Judith; Lawthom, Rebecca; Mountian, Ilana; Shahrin, Afifa

2015-09-19

Asylum seekers, refugees and persons without legal status have been reported to experience a range of difficulties when accessing public services and supports in the UK. While research has identified health care barriers to equitable access such as language difficulties, it has not considered the broader social contexts of marginalization experienced through the dynamics of 'othering'. The current study explores health and health care experiences of Somali and Iraqi asylum seekers, refugees and persons without legal status, highlighting 'minoritization' processes and the 'pathologization' of difference as analytical lenses to understand the multiple layers of oppression that contribute to health inequities. For the study, qualitative methods were used to document the lived experiences of asylum seekers, refugees and persons without legal status. Thirty-five in-depth interviews and five focus groups were used to explore personal accounts, reveal shared understandings and enable social, cognitive and emotional understandings of on-going health problems and challenges when seeking treatment and care. A participatory framework was undertaken which inspired collaborative workings with local organizations that worked directly with asylum seekers, refugees and persons without legal status. The analysis revealed four key themes: 1) pre-departure histories and post-arrival challenges; 2) legal status; 3) health knowledges and procedural barriers as well as 4) language and cultural competence. Confidentiality, trust, wait times and short doctor-patient consultations were emphasized as being insufficient for culturally specific communications and often translating into inadequate treatment and care. Barriers to accessing health care was associated with social disadvantage and restrictions of the broader welfare system suggesting that a re-evaluation of the asylum seeking process is required to improve the situation. Macro- and micro-level intersections of accustomed societal beliefs, practices and norms, broad-level legislation and policy decisions, and health care and social services delivery methods have affected the health and health care experiences of forced migrants that reside in the UK. Research highlights how 'minoritization processes,' influencing the intersections between social identities, can hinder access to and delivery of health and social services to vulnerable groups. Similar findings were reported here; and the most influential mechanism directly impacting health and access to health and social services was legal status. Equitable health care provision requires systemic change that incorporate understandings of marginalization, 'othering' processes and the intersections between the past histories and everyday realities of asylum seekers, refugees and persons without legal status.

Health status of and health-care provision to asylum seekers in Germany: protocol for a systematic review and evidence mapping of empirical studies.

PubMed

Schneider, Christine; Mohsenpour, Amir; Joos, Stefanie; Bozorgmehr, Kayvan

2014-11-29

There are more than 100,000 asylum seekers registered in Germany, who are granted limited access to health services. This study aims to provide a systematic overview of the empirical literature on the health status of and health-care provision to asylum seekers in Germany in order to consolidate knowledge, avoid scientific redundance, and identify research gaps. A systematic review and evidence mapping of empirical literature on the health status of and health-care provision to asylum seekers in Germany will be performed. We will apply a three-tiered search strategy: 1. search in databases (PubMed/MEDLINE, Web of Science, IBSS, Sociological Abstracts, Worldwide Political Science Abstracts, CINAHL, Sowiport, Social Sciences Citation Index, ASSIA, MedPilot, DNB), dissertation and theses databases, and the internet (Google); 2. screening references of included studies; 3. contacting authors and civil society organizations for grey literature. Included will be studies which report quantitative and/or qualitative data or review articles on asylum seekers in Germany, published in German or English language. Outcome measures will include physical, mental, or social well-being, and all aspects of health-care provision (access, availability, affordability, and quality). Search results will be screened for eligibility by screening titles, abstracts and full texts. Data extraction comprises information on study characteristics, research aims, and domains of health or health-care services analyzed. The quality of studies will be appraised and documented by appropriate assessment tools. A descriptive evidence map will be drawn by categorizing all included articles by research design and the health conditions and/or domains of health-care provision analyzed. The body of evidence will be evaluated, and a narrative evidence synthesis will be performed by means of a multi-level approach, whereby quantitative and qualitative evidence are analyzed as separate streams and the product of each stream is configured in a final summary. This systematic review will provide an evidence map and synthesis of available research findings on the health status of and health-care provision to asylum seekers in Germany. In anticipation of identifying areas which are amenable to health-care interventions, deserve immediate action, or further exploration, this review will be of major importance for policy-makers, health-care providers, as well as researchers. PROSPERO 2014: CRD42014013043.

The effect of the medico-legal evaluation on asylum seekers in the Metropolitan City of Milan, Italy: a pilot study.

PubMed

Franceschetti, L; Magli, F; Merelli, V G; Muccino, E A; Gentilomo, A; Agazzi, F; Gibelli, D M; Gambarana, M; De Angelis, D; Kustermann, A; Cattaneo, C

2018-05-26

In the present-day situation, the clinical forensic documentation of an asylum seeker's narrative and his or her examination, together with the physical and psychological findings, may have very important effects on the outcome of the request for political asylum. Since 2012, the Municipality of Milan, the University Institute of Legal Medicine, and other institutions have assembled a team with the task of examining vulnerable asylum seekers and preparing a medical report for the Territorial Commission for International Protection (Prefecture, Ministry of Interiors), who will assess the application. We compared medico-legal reports and outcomes of 57 cases which were evaluated by the Commission after having undergone a medico-legal evaluation through the Istanbul Protocol criteria and examined, in particular, which medico-legal variables seem associated to the outcome. The results show that forensic assessment seems to have a significant and interesting correlation with the final assessment given by the Commission. For example, the higher the level of consistency, according to the Istanbul Protocol, the more frequently protection is granted. These data show how important clinical forensic medicine can be in such scenarios and how the presence of clinical forensic experts should be encouraged in such evaluations, as has been recently enshrined in Italy in the guidelines of a Ministerial Decree of April 3rd, 2017 for the assistance and the rehabilitation as well as the treatment of psychiatric disorders in refugees and asylum seekers who have undergone torture, rape, and other severe forms of psychological, physical, or sexual violence.

An outbreak of chickenpox in an asylum seeker centre in Italy: outbreak investigation and validity of reported chickenpox history, December 2015–May 2016

PubMed Central

Vairo, Francesco; Di Bari, Virginia; Panella, Vincenzo; Quintavalle, Giuseppe; Torchia, Saul; Serra, Maria Cristina; Sinopoli, Maria Teresa; Lopalco, Maurizio; Ceccarelli, Giancarlo; Ferraro, Federica; Valle, Sabrina; Bordi, Licia; Capobianchi, Maria Rosaria; Puro, Vincenzo; Scognamiglio, Paola; Ippolito, Giuseppe

2017-01-01

An outbreak of chickenpox occurred between December 2015 and May 2016 among asylum seekers in a reception centre in Latium, Italy. We describe the epidemiological and laboratory investigations, control measures and validity of reported history of chickenpox infection. Serological screening of all residents and incoming asylum seekers was performed, followed by vaccine offer to all susceptible individuals without contraindication. Forty-six cases were found and 41 were associated with the outbreak. No complications, hospitalisations or deaths occurred. Serological testing was performed in 1,278 individuals and 169 were found to be susceptible, with a seroprevalence of 86.8%. A questionnaire was administered to 336 individuals consecutively attending the CARA health post to collect their serological result. The sensitivity, specificity and the positive and negative predictive value (PPV and NPV) of the reported history of chickenpox were 45.0%, 76.1%, 88.3% and 25.6%, respectively. We observed an increasing trend for the PPV and decreasing trend for the NPV with increasing age. Our report confirms that, in the asylum seeker population, chickenpox history is not the optimal method to identify susceptible individuals. Our experience supports the need for additional prevention and control measures and highlights the importance of national and local surveillance systems for reception centres. PMID:29162209

Getting out of (self-) harm's way: A study of factors associated with self-harm among asylum seekers in Australian immigration detention.

PubMed

Hedrick, Kyli

2017-07-01

The monitoring of self-harm among asylum seekers in Australian immigration detention has not occurred routinely or transparently. Thus whilst concerns regarding rates of self-harm among asylum seekers have been frequently raised, a paucity of systematic information regarding key factors associated with self-harm among asylum seekers exists. The present study was designed therefore to fill a number of gaps in government monitoring by examining the government's own archived self-harm data. Via a descriptive analysis of self-harm incident reports from all operational Australian immigration detention facilities over a 20-month period to May 2011, obtained under Freedom of Information, the present study identified that 959 incidents of self-harm occurred during this period. A gender bias towards men was also found. In addition to this, 10 different methods of self-harm were identified, the four most common being: cutting (47%), attempted hanging (19%), head hitting (12%) and self-poisoning by medication (6%). Seven different precipitating factors for self-harm were also identified, the four most common were: detention conditions (39%), processing arrangements (27%), negative decisions (24%) and family separation (3%). These findings point strongly to the health benefits of considering alternatives to held immigration detention, such as community based processing. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

[Asylum in Switzerland. Some aspects of refugee migration].

PubMed

Bolzman, C; Musillo, I

1987-06-01

"Switzerland is the European country which, after Sweden, has received the highest number of refugees (30,000) in proportion to its population. Asylum seekers have increased considerably since 1979. They are coming mostly from Third World, politically unsettled countries. The essay presents the results of a survey conducted in Geneva on a sample of 549 asylum seekers assisted by public welfare agencies from 1974 to 1983. These refugees belong to the younger age bracket of the active population. About half of them have completed their secondary or tertiary education. But their professional, social and cultural adjustment poses some problems. The vast majority of them, in fact, are employed in unqualified occupations in the tertiary sectors." (SUMMARY IN ENG) excerpt

Resilience among asylum seekers living with HIV

PubMed Central

2012-01-01

Background A small body of evidence demonstrates the challenges faced by migrant communities living with HIV but has yet to consider in-depth the experience of asylum seekers whose residency status is undetermined. The overall aim of our study was to explore the experiences of those who are both living with HIV and seeking asylum. This paper focuses on the stressors precipitated by the HIV diagnosis and by going through the asylum system; as well as participants’ resilience in responding to these stressors and the consequences for their health and wellbeing. Methods We conducted an ethnographic study. Fieldwork took place in the UK between 2008–2009 and included: 350 hours of observation at voluntary services providing support to black and minority ethnic groups living with HIV; 29 interviews and four focus group discussions with those who were seeking asylum and living with HIV; and 15 interviews with their health and social care providers. Data were analysed using the constant comparative method. Results There were three main stressors that threatened participants’ resilience. First, migration caused them to leave behind many resources (including social support). Second, stigmatising attitudes led their HIV diagnosis to be a taboo subject furthering their isolation. Third, they found themselves trapped in the asylum system, unable to influence the outcome of their case and reliant on HIV treatment to stay alive. Participants were, however, very resourceful in dealing with these experiences. Resilience processes included: staying busy, drawing on personal faith, and the support received through HIV care providers and voluntary organisations. Even so, their isolated existence meant participants had limited access to social resources, and their treatment in the asylum system had a profound impact on perceived health and wellbeing. Conclusions Asylum seekers living with HIV in the UK show immense resilience. However, their isolation means they are often unable to deal with their treatment in the asylum system, with negative consequences for their perceived health and wellbeing. PMID:23110402

Inside truths: 'truth' and mental illness in the Australian asylum seeker and detention debates.

PubMed

Maglen, Krista

2007-10-01

This article examines some of the key debates and interactions between the Australian government and medical profession in relation to the mental health consequences of the policy of mandatory detention of asylum seekers. It explores how, in a series of episodes between 2001 and 2005, each side claimed to represent accurately the 'true' nature of the detention system through asserting superior 'objectivity' and commitment to 'scientific truth' in their representations of the mental health of asylum seekers. Placing these debates within the particular political objectives of the Liberal Party during John Howard's term as Prime Minister, the article explores how science and medical advocacy have been characterized and made to signify larger conflicts within the Australian political arena. It shows how populist political ideas of 'elitism' have been used by the government to represent as 'elitist untruths' psychiatric research which has demonstrated a direct causal links between government border control policies and mental ill-health.

The moderating role of socially desirable responding in implicit-explicit attitudes toward asylum seekers.

PubMed

Anderson, Joel R

2017-07-04

Implicit and explicit attitudes correlate under certain conditions and researchers are interested in the moderating factors of this relationship. This paper explored the role of socially desirable responding in this relationship by testing the hypothesis that impression management (IM; i.e., deliberate response modification) and self-deceptive enhancement (SDE; i.e., positive self-bias) play moderating roles in the relationship of implicit-explicit attitudes toward asylum seekers in Australia. Seventy-four students responded to a battery of measures and the results revealed that IM (but not SDE) moderated this relationship to the extent that higher IM scores weakened the correspondence between implicit and explicit attitude scores. This suggests that attitudes toward asylum seekers might be susceptible to socially desirable response tendencies and in combination with the finding that IM was negatively related to explicit attitudes, it is argued that self-presentation concerns result in the deliberate attenuation of reported negative explicit attitudes. © 2017 International Union of Psychological Science.

Health and health care utilisation among asylum seekers and refugees in the Netherlands: design of a study

PubMed Central

Gerritsen, Annette AM; Bramsen, Inge; Devillé, Walter; van Willigen, Loes HM; Hovens, Johannes E; van der Ploeg, Henk M

2004-01-01

Background This article discusses the design of a study on the prevalence of health problems (both physical and mental) and the utilisation of health care services among asylum seekers and refugees in the Netherlands, including factors that may be related to their health and their utilisation of these services. Methods/Design The study will include random samples of adult asylum seekers and refugees from Afghanistan, Iran and Somali (total planned sample of 600), as these are among the largest groups within the reception centres and municipalities in the Netherlands. The questionnaire that will be used will include questions on physical health (chronic and acute diseases and somatization), mental health (Hopkins Symptoms Checklist-25 and Harvard Trauma Questionnaire), utilisation of health care services, pre- and post-migratory traumatic experiences, life-style, acculturation, social support and socio-demographic background. The questionnaire has gone through a translation process (translation and back-translation, several checks and a pilot-study) and cross-cultural adaptation. Respondents will be interviewed by bilingual and bicultural interviewers who will be specifically trained for this purpose. This article discusses the selection of the study population, the chosen outcome measures, the translation and cross-cultural adaptation of the measurement instrument, the training of the interviewers and the practical execution of the study. The information provided may be useful for other researchers in this relatively new field of epidemiological research among various groups of asylum seekers and refugees. PMID:15070416

Health and health care utilisation among asylum seekers and refugees in the Netherlands: design of a study.

PubMed

Gerritsen, Annette A M; Bramsen, Inge; Devillé, Walter; van Willigen, Loes H M; Hovens, Johannes E; van der Ploeg, Henk M

2004-03-10

This article discusses the design of a study on the prevalence of health problems (both physical and mental) and the utilisation of health care services among asylum seekers and refugees in the Netherlands, including factors that may be related to their health and their utilisation of these services. The study will include random samples of adult asylum seekers and refugees from Afghanistan, Iran and Somali (total planned sample of 600), as these are among the largest groups within the reception centres and municipalities in the Netherlands. The questionnaire that will be used will include questions on physical health (chronic and acute diseases and somatization), mental health (Hopkins Symptoms Checklist-25 and Harvard Trauma Questionnaire), utilisation of health care services, pre- and post-migratory traumatic experiences, life-style, acculturation, social support and socio-demographic background. The questionnaire has gone through a translation process (translation and back-translation, several checks and a pilot-study) and cross-cultural adaptation. Respondents will be interviewed by bilingual and bicultural interviewers who will be specifically trained for this purpose. This article discusses the selection of the study population, the chosen outcome measures, the translation and cross-cultural adaptation of the measurement instrument, the training of the interviewers and the practical execution of the study. The information provided may be useful for other researchers in this relatively new field of epidemiological research among various groups of asylum seekers and refugees.

Infectious disease health services for refugees and asylum seekers during a time of crisis: A scoping study of six European Union countries.

PubMed

Bozorgmehr, Kayvan; Samuilova, Mariya; Petrova-Benedict, Roumyana; Girardi, Enrico; Piselli, Pierluca; Kentikelenis, Alexander

2018-04-11

Systematic information on infectious disease services provided to refugees and asylum seekers in the European Union (EU) is sparse. We conducted a scoping study of experts in six EU countries in order to map health system responses related to infectious disease prevention and control among refugees and asylum seekers. We conducted 27 semi-structured in-depth interviews with first-line staff and health officials to collect information about existing guidelines and practices at each stage of reception in first-entry (Greece/Italy), transit (Croatia/Slovenia), and destination countries (Austria/Sweden). Thematic coding was used to perform a content analysis of interview material. Guidance on infectious disease screening and health assessments lack standardisation across and-partly-within countries. Data collection on notifiable infectious diseases is mainly reported to be performed by national public health institutions, but is not stratified by migrant status. Health-related information is not transferred in a standardized way between facilities within a single country. International exchange of medical information between countries along the migration route is irregular. Services were reported to be fragmented, and respondents mentioned no specific coordination bodies beyond health authorities at different levels. Infectious disease health services provided to refugees and asylum seekers lack standardisation in health assessments, data collection, transfer of health-related information and (partly) coordination. This may negatively affect health system performance including public health emergency preparedness. Copyright © 2018 Elsevier B.V. All rights reserved.

Meeting the health and social needs of pregnant asylum seekers, midwifery students' perspectives: part 1; dominant discourses and midwifery students.

PubMed

Haith-Cooper, Melanie; Bradshaw, Gwendolen

2013-09-01

Current literature has indicated a concern about standards of maternity care experienced by pregnant women who are seeking asylum. As the next generation of midwives, it is important that students are educated in a way that prepares them to effectively care for these women. To understand how this can be achieved, it is important to explore what asylum seeking means to midwifery students. This article is the first of three parts and reports on one objective from a wider doctorate study. It identifies dominant discourses that influenced the perceptions of a group of midwifery students' about the pregnant asylum seeking woman. The study was designed from a social constructivist perspective, with contextual knowledge being constructed by groups of people, influenced by underpinning dominant discourses, depending on their social, cultural and historical positions in the world. In a United Kingdom University setting, during year two of a pre-registration midwifery programme, eleven midwifery students participated in the study. Two focus group interviews using a problem based learning scenario as a trigger for discussion were conducted. In addition, three students were individually interviewed to explore issues in more depth and two students' written reflections on practice were used to generate data. Following a critical discourse analysis, dominant discourses were identified which appeared to influence the way in which asylum seekers were perceived. The findings suggested an underpinning ideology around the asylum seeker being different and of a criminal persuasion. Although the pregnant woman seeking asylum was considered as deserving of care, the same discourses appeared to influence the way in which she was constructed. However, as the study progressed, through reading alternative sources of literature, some students appeared to question these discourses. These findings have implications for midwifery education in encouraging students to challenge negative discourses and construct positive perceptions of asylum seeking. Copyright © 2012 Elsevier Ltd. All rights reserved.

Mental health and trauma in asylum seekers landing in Sicily in 2015: a descriptive study of neglected invisible wounds.

PubMed

Crepet, Anna; Rita, Francesco; Reid, Anthony; Van den Boogaard, Wilma; Deiana, Pina; Quaranta, Gaia; Barbieri, Aurelia; Bongiorno, Francesco; Di Carlo, Stefano

2017-01-01

In 2015, Italy was the second most common point of entry for asylum seekers into Europe after Greece. The vast majority embarked from war-torn Libya; 80,000 people claimed asylum that year. Their medical conditions were assessed on arrival but their mental health needs were not addressed in any way, despite the likelihood of serious trauma before and during migration. Médecins sans Frontières (MSF), in agreement with the Italian Ministry of Health, provided mental health (MH) assessment and care for recently-landed asylum seekers in Sicily. This study documents mental health conditions, potentially traumatic events and post-migratory living difficulties experienced by asylum seekers in the MSF programme in 2014-15. All asylum seekers transiting the 15 MSF-supported centres were invited to a psycho-educational session. A team of psychologists and cultural mediators then provided assessment and care for those identified with MH conditions. Potentially traumatic events experienced before and during the journey, as well as post-migratory living difficulties, were recorded. All those diagnosed with MH conditions from October 2014 to December 2015 were included in the study. Among 385 individuals who presented themselves for a MH screening during the study period, 193 (50%) were identified and diagnosed with MH conditions. Most were young, West African males who had left their home-countries more than a year prior to arrival. The most common MH conditions were post traumatic stress disorder (31%) and depression (20%). Potentially traumatic events were experienced frequently in the home country (60%) and during migration (89%). Being in a combat situation or at risk of death, having witnessed violence or death and having been in detention were the main traumas. Lack of activities, worries about home, loneliness and fear of being sent home were the main difficulties at the AS centres. MH conditions, potentially traumatic events and post-migratory living difficulties are commonly experienced by recently-arrived ASs, this study suggests that mental health and psychosocial support and improved living circumstances should be integrated into European medical and social services provided by authorities in order to fulfil their humanitarian responsibility and reduce the burden of assimilation on receiving countries.

The Importance of Being Gay: The Perils and Possibilities of LGBTI Asylum Seekers' Involvement in "Rights of Passage"

ERIC Educational Resources Information Center

Summerskill, Clare

2018-01-01

In order to claim asylum in the UK, lesbians and gay men are required to 'prove' their sexual orientation during an interview, demonstrating the dangers that their sexuality poses for them in their countries of origin. Playwrights who create verbatim theatre addressing LGBTI asylum issues will also interview contributors eliciting personal…

High Manifestations of Mental Distress in Arabic Asylum Seekers Accommodated in Collective Centers for Refugees in Germany

PubMed Central

Georgiadou, Ekaterini; Morawa, Eva; Erim, Yesim

2017-01-01

The number of asylum seekers in Germany has significantly increased in the last two years. Coming from regions of political conflict and war, the refugees have often experienced traumatic events which designate them as a high risk group for mental disorders. In a sample of Arabic speaking asylum seekers in collective accommodation centers in Erlangen, Germany, we estimated the extent of posttraumatic stress, depression, and anxiety. A further objective of the study was to test the comprehensibility and cultural appropriateness of the Arabic translations of the questionnaires in this sample. Between August and September 2016, 56 Arabic speaking asylum seekers placed among three collective accommodation centers in Erlangen completed self-report questionnaires assessing posttraumatic stress disorder (Essen Trauma-Inventory, ETI), and symptoms of depression (Patient Health Questionnaire—depression module, PHQ-9) and anxiety (Generalized Anxiety Disorder, GAD-7). The prevalence of participants with personally and/or witnessed traumatic events was 80.4% (n = 45). About one-third of the examinees (35.7%, n = 20) endorsed symptoms of PTSD (posttraumatic stress disorder). The total score for depression in this sample was M = 11.9 (SD = 7.9, range: 0–27). Moderate to severe depression (PHQ-9 score ≥ 15) was found in 35.7% (n = 20) of our sample and severe depression (PHQ-9 score ≥ 20) was found in 23.2% (n = 13). The total score for anxiety was M = 8.8 (SD = 6.9, range: 0–21), with 26.8% (n = 15) of the sample showing symptoms of severe anxiety (GAD-7 score ≥ 15). No significant difference between women and men with respect to frequency and symptom scores of PTSD, depression, and anxiety was found. Amongst asylum seekers of the presented sample, the rates of traumatic events as well as the prevalence of possible PTSD, depression, and anxiety were significantly higher than in the German population. This indicates that the refugee population is in need of culturally sensitive psychological interventions. However, more studies are required to improve the understanding of mental health among this particularly vulnerable population. PMID:28590438

Students in Action.

ERIC Educational Resources Information Center

Insights on Law & Society, 2001

2001-01-01

Includes three articles that focus on people affected by immigration: (1) "Locked Up Tight" (Margaret Graham Tebo); (2) "Asylum May Be a Matter of Life and Death" (Mary Meg McCarthy); and (3) "The Next Gideon?" (Siobhan Morrissey). Includes adult detainees, asylum seekers, and refugee minors. (CMK)

[What do Interpreters Cost? - A Retrospective Analysis of the Costs for Interpreters in Treatment of Refugees in a Psychiatric Outpatient Clinic in Berlin].

PubMed

Schreiter, Stefanie; Winkler, Johanna; Bretz, Joachim; Schouler-Ocak, Meryam

2016-09-01

Clinical diagnostics of mental disorders especially among refugees and asylum seekers come with unique difficulties: language barriers, different forms of expression and concepts of the understanding of mental illness as well as a different cultural background. Therefore professional interpreters are needed but associated with a higher effort related to costs and time. We conducted a retrospective analysis of costs, which incurred by the use of professional interpreters in our outpatient clinic in Berlin, Germany, in the first quarter 2016 for the treatment of refugees and asylum seekers. The sample consisted of 110 refugees and asylum seekers; the highest costs in the use of interpreters incurred among Neurotic, stress-related and somatoform disorders (53.04%), especially Posttraumatic Stress Disorder (39.04%), as well as affective disorders (38.47%), especially major depressive episodes (25.23%). Our data point out the crucial need of a regulation of costs with regard to the service of professional interpreters in Germany. © Georg Thieme Verlag KG Stuttgart · New York.

How the Spectre of Societal Homogeneity Undermines Equitable Healthcare for Refugees

PubMed Central

Razum, Oliver; Wenner, Judith; Bozorgmehr, Kayvan

2017-01-01

Recourse to a purported ideal of societal homogeneity has become common in the context of the refugee reception crisis – not only in Japan, as Leppold et al report, but also throughout Europe. Calls for societal homogeneity in Europe originate from populist movements as well as from some governments. Often, they go along with reduced social support for refugees and asylum seekers, for example in healthcare provision. The fundamental right to health is then reduced to a citizens’ right, granted fully only to nationals. Germany, in spite of welcoming many refugees in 2015, is a case in point: entitlement and access to healthcare for asylum seekers are restricted during the first 15 months of their stay. We show that arguments brought forward to defend such restrictions do not hold, particularly not those which relate to maintaining societal homogeneity. European societies are not homogeneous, irrespective of migration. But as migration will continue, societies need to invest in what we call "globalization within." Removing entitlement restrictions and access barriers to healthcare for refugees and asylum seekers is one important element thereof. PMID:28812828

[Decision Support for the Therapy Planning for Young Refugees and Asylum-Seekers with Posttraumatic Disorders].

PubMed

Reher, Cornelia; Metzner, Franka

2016-12-01

Decision Support for the Therapy Planning for Young Refugees and Asylum-Seekers with Posttraumatic Disorders Due to the Convention on the Rights of the Child and § 6 of the Asylum Seekers' Benefit Act, there are legal and ethical obligations for the care of minor refugees suffering from trauma-related disorders. In Germany, psychotherapeutic care of adolescent refugees is provided by specialized treatment centers and Child and Adolescent psychiatries with specialized consultation-hours for refugees. Treatment of minor refugees is impeded by various legal and organizational barriers. Many therapists have reservations and uncertainties regarding an appropriate therapy for refugees due to a lack of experience. This means that only a fraction of the young refugees with trauma-related disorders find an ambulatory therapist. In a review of international literature, empirical findings on (interpreter-aided) diagnostics and therapy of young refugees were presented. Practical experiences on therapeutic work with traumatized young refugees were summarized in a decision tree for therapy planning in the ambulatory setting. The decision tree was developed to support therapists in private practices by structuring the therapy process.

Louse-borne relapsing fever in Finland in two asylum seekers from Somalia.

PubMed

Hytönen, Jukka; Khawaja, Tamim; Grönroos, Juha O; Jalava, Anna; Meri, Seppo; Oksi, Jarmo

2017-01-01

We report two cases of louse-borne relapsing fever (LBRF) in young Somali asylum seekers having recently arrived to Finland. They had sought medical attention for a febrile illness. Blood smears were examined for suspected malaria, but instead, spirochete shaped bacteria were observed. The bacteria were confirmed as Borrelia recurrentis by PCR and sequencing. The patients survived, but their treatment was complicated by Jarisch-Herxheimer reaction. We conclude that LBRF must be considered as a diagnostic option in febrile refugees also in the northernmost parts of Europe. © 2016 APMIS. Published by John Wiley & Sons Ltd.

How Do Countries' Health Information Systems Perform in Assessing Asylum Seekers' Health Situation? Developing a Health Information Assessment Tool on Asylum Seekers (HIATUS) and Piloting It in Two European Countries.

PubMed

Bozorgmehr, Kayvan; Goosen, Simone; Mohsenpour, Amir; Kuehne, Anna; Razum, Oliver; Kunst, Anton E

2017-08-08

Background: Accurate data on the health status, health behaviour and access to health care of asylum seekers is essential, but such data is lacking in many European countries. We hence aimed to: (a) develop and pilot-test an instrument that can be used to compare and benchmark the country health information systems (HIS) with respect to the ability to assess the health status and health care situation of asylum seekers and (b) present the results of that pilot for The Netherlands (NL) and Germany (DE). Materials and Methods : Reviewing and adapting existing tools, we developed a Health Information Assessment Tool on Asylum Seekers (HIATUS) with 50 items to assess HIS performance across three dimensions: (1) availability and detail of data across potential data sources; (2) HIS resources and monitoring capacity; (3) general coverage and timeliness of publications on selected indicators. We piloted HIATUS by applying the tool to the HIS in DE and NL. Two raters per country independently assessed the performance of country HIS and the inter-rater reliability was analysed by Pearson's rho and the intra-class correlation (ICC). We then applied a consensus-based group rating to obtain the final ratings which were transformed into a weighted summary score (range: 0-97). We assessed HIS performance by calculating total and domain-specific HIATUS scores by country as well as absolute and relative gaps in scores within and between countries. Results : In the independent rating, Pearson's rho was 0.14 (NL) and 0.30 (DE), the ICC yielded an estimated reliability of 0.29 (NL) and 0.83 (DE) respectively. In the final consensus-based rating, the total HIATUS score was 47 in NL and 15 in DE, translating into a relative gap in HIS capacity of 52% (NL) and 85% (DE) respectively. Shortfalls in HIS capacity in both countries relate to the areas of HIS coordination, planning and policies, and to limited coverage of specific indicators such as self-reported health, mental health, socio-economic status and health behaviour. The relative gap in the HIATUS component "data sources and availability" was much higher in Germany (92%) than in NL (28%). Conclusions : The standardised tool (HIATUS) proved useful for assessment of country HIS performance in two countries by consensus-based rating. HIATUS revealed substantial limitations in HIS capacity to assess the health situation of asylum seekers in both countries. The tool allowed for between-country comparisons, revealing that capacities were lower in DE relative to NL. Monitoring and benchmarking gaps in HIS capacity in further European countries can help to strengthen HIS in the future.

The gap between entitlement and access to healthcare: An analysis of "candidacy" in the help-seeking trajectories of asylum seekers in Montreal.

PubMed

Chase, Liana E; Cleveland, Janet; Beatson, Jesse; Rousseau, Cécile

2017-06-01

In 2012 the Canadian government made significant cuts to its historically strong federal refugee health coverage plan. While this policy had negligible effects on the level of coverage provided to asylum seekers in Quebec, there is evidence that this group nonetheless experienced reduced healthcare access during the period of polarized national debate that ensued. This study engaged the "candidacy" model of healthcare access to illuminate factors contributing to the observed gap between entitlement and access. Twenty-five semi-structured interviews were conducted with asylum seekers in Montreal to elicit narrative accounts of difficulties encountered in the pursuit of healthcare. Thematic content analysis in conjunction with a holistic examination of help-seeking trajectories revealed several important barriers to obtaining care, including widespread confusion and misinformation about refugee health coverage, cumbersome administrative procedures specific to asylum seekers, and long wait times. Feelings of marginalization and insecurity associated with precarious migratory status appeared to amplify the effects of these barriers to care such that even a minor access difficulty could have dramatic effects on future help-seeking and access outcomes. Demonstrating awareness of public discourses interrogating their deservingness of health coverage, participants often interpreted access difficulties as evidence of health professionals' unwillingness to serve them. Such interpretations conspired with fears associated with the asylum claim process to suppress self-advocacy, further help-seeking, and at times even information-seeking. This finding is particularly significant in that it suggests a mechanism through which hostile public representations of forced migrants-increasingly prevalent in Western host countries-can themselves endanger the physical, psychological, and social health of highly disadvantaged populations, even in the presence of strong entitlement policies. We close with reflections on how theoretical models of healthcare access might be adjusted to better accommodate the unique experiences of precarious status migrants. Copyright © 2017 Elsevier Ltd. All rights reserved.

Exploring physical activity engagement and barriers for asylum seekers in Australia coping with prolonged uncertainty and no right to work.

PubMed

Hartley, Lisa; Fleay, Caroline; Tye, Marian E

2017-05-01

This paper explores the engagement in physical activity as a potential coping strategy for asylum seekers living in the Australian community without the right to work and with prolonged uncertainty, and benefits or barriers to undertaking such activity. Semi-structured in-depth interviews were held with 29 asylum seekers who had arrived to Australia by boat and were living in the community in the cities of Perth, Sydney or Melbourne in July-October 2013 after their release from immigration detention. The ratio of the numbers of men and women interviewed (23 men and 6 women) was comparable to the ratio of men and women who came by boat to Australia seeking asylum in 2012-2013. Nine participants reported that they participated in physical activity as a coping strategy. Seven other participants were so worried about their future and their families that they did not have the mental or physical energy to engage in physical activity. A further six wanted to participate in physical activity but faced a number of barriers to doing so. The seven remaining participants were either not asked about their physical activity engagement because they focused their discussion on other challenges or did not elaborate on why they were not engaging in physical activity. The findings suggest that physical activity, coupled with other coping strategies, are important for some asylum seekers in trying to manage the distress of being denied the right to work and living with prolonged uncertainty. In addition, these findings highlight the critical barrier that government policy plays in disabling engagement in physical activity, which further compounds social exclusion. This includes the lack of welfare support provided, which hinders people's financial ability to access activities and support in the community. © 2017 John Wiley & Sons Ltd.

The Wright Institute Sanctuary Project: Development and Proposed Evaluation of a Graduate Training Program Providing Clinical Services to Asylum Seekers in the Bay Area

ERIC Educational Resources Information Center

Padilla, Brenda Lisa

2012-01-01

This study highlights the development of a graduate training program at The Wright Institute in Berkeley, CA, which provides assessment services for undocumented immigrants seeking asylum. This program focuses on the needs of a general asylum seeking population, with a specific relevance to some of the populations that may be served in the…

Being Through Doing: The Self-Immolation of an Asylum Seeker in Switzerland

PubMed Central

Womersley, Gail; Kloetzer, Laure

2018-01-01

In April 2016, Armin,1 an asylum seeker in a village of Switzerland, set himself alight in the public square of the town, one of a few cases reported across Europe. He performed the act following a denied request for asylum and was saved by bystanders. We present the results of two qualitative interviews conducted with Armin, his translator and his roommate following the incident. The act is theorized through the lens of a dialogical analysis focusing on the concept of social recognition. The notion of trauma is considered as a key mediating mechanism, theorized as creating ruptures in time, memory, language, and social connections to an Other. We conclude this communicative act to represent both “being-toward-death” and a relational striving toward life; a “destruction as the cause of coming into being.” PMID:29686628

Psychosocial interventions for post-traumatic stress disorder in refugees and asylum seekers resettled in high-income countries: Systematic review and meta-analysis

PubMed Central

Nosè, Michela; Ballette, Francesca; Bighelli, Irene; Turrini, Giulia; Purgato, Marianna; Tol, Wietse; Priebe, Stefan; Barbui, Corrado

2017-01-01

Treatment of post-traumatic stress disorder (PTSD) in refugees and asylum seekers resettled in high-income countries presents specific challenges. This systematic review examined the effectiveness of psychosocial interventions for this group. We searched the Cochrane Central Register of randomised trials, CINAHL, EMBASE, PILOTS, PsycINFO, PubMed and Web of Science up to July 2016. Studies included randomised and controlled clinical trials comparing psychosocial interventions with waiting list or treatment as usual in adult refugees and asylum seekers with PTSD resettled in high-income countries. PTSD symptoms post-intervention was the primary outcome. We computed standardized mean differences (SMD) with 95% confidence intervals (CI). This study is registered with PROSPERO: CRD42015027843. Twelve studies were included in the meta-analysis. Psychosocial interventions were effective in decreasing PTSD symptoms relative to control groups (SMD -1·03, 95% CI -1·55 to -0·51; number needed to treat 4·4; I2 86%; 95% CI 77 to 91). Narrative exposure therapy, a manualized short-term variant of cognitive behavioural therapy with a trauma focus, was the best-supported intervention (5 RCTs, 187 participants, SMD -0·78, 95% CI -1·18 to -0·38, I2 37%; 95% CI 0 to 77). Methodological quality of the included studies was limited. Overall, psychosocial interventions for asylum seekers and refugees with PTSD resettled in high-income countries were found to provide significant benefits in reducing PTSD symptoms. Yet, the number of studies is small and their methodological quality limited, so that more rigorous trials should be conducted in the future. PMID:28151992

Psychosocial interventions for post-traumatic stress disorder in refugees and asylum seekers resettled in high-income countries: Systematic review and meta-analysis.

PubMed

Nosè, Michela; Ballette, Francesca; Bighelli, Irene; Turrini, Giulia; Purgato, Marianna; Tol, Wietse; Priebe, Stefan; Barbui, Corrado

2017-01-01

Treatment of post-traumatic stress disorder (PTSD) in refugees and asylum seekers resettled in high-income countries presents specific challenges. This systematic review examined the effectiveness of psychosocial interventions for this group. We searched the Cochrane Central Register of randomised trials, CINAHL, EMBASE, PILOTS, PsycINFO, PubMed and Web of Science up to July 2016. Studies included randomised and controlled clinical trials comparing psychosocial interventions with waiting list or treatment as usual in adult refugees and asylum seekers with PTSD resettled in high-income countries. PTSD symptoms post-intervention was the primary outcome. We computed standardized mean differences (SMD) with 95% confidence intervals (CI). This study is registered with PROSPERO: CRD42015027843. Twelve studies were included in the meta-analysis. Psychosocial interventions were effective in decreasing PTSD symptoms relative to control groups (SMD -1·03, 95% CI -1·55 to -0·51; number needed to treat 4·4; I2 86%; 95% CI 77 to 91). Narrative exposure therapy, a manualized short-term variant of cognitive behavioural therapy with a trauma focus, was the best-supported intervention (5 RCTs, 187 participants, SMD -0·78, 95% CI -1·18 to -0·38, I2 37%; 95% CI 0 to 77). Methodological quality of the included studies was limited. Overall, psychosocial interventions for asylum seekers and refugees with PTSD resettled in high-income countries were found to provide significant benefits in reducing PTSD symptoms. Yet, the number of studies is small and their methodological quality limited, so that more rigorous trials should be conducted in the future.

The impact of the asylum process on mental health: a longitudinal study of unaccompanied refugee minors in Norway.

PubMed

Jakobsen, Marianne; Meyer DeMott, Melinda Ashley; Wentzel-Larsen, Tore; Heir, Trond

2017-06-21

To examine the mental health of unaccompanied refugee minors prospectively during the asylum-seeking process, with a focus on specific stages in the asylum process, such as age assessment, placement in a supportive or non-supportive facility and final decision on the asylum applications. This was a2½ year follow-up study of unaccompanied minors (UM) seeking asylum in Norway. Data were collected within three weeks (n=138) and at 4 months (n=101), 15 months (n=84) and 26 months (n=69) after arrival. Initially in an observation and orientation centre for unaccompanied asylum-seeking adolescents, and subsequently wherever the UM were located in other refugee facilities in Norway. Male UM from Afghanistan, Somalia, Algeria and Iran. Mental health symptoms assessed by Hopkins Symptom Checklist-25 and Harvard Trauma Questionnaire. At the group level, the young asylum seekers reported high levels of psychological distress on arrival and symptom levels that stayed relatively unchanged over time. According to age-assessment procedures, 56% of the population were not recognised as minors. Subsequent placement in a low-support facility was associated with higher levels of psychological distress in the follow-up period. Those who were placed in a reception centre for adults had higher levels of psychological distress symptoms both after 15 months and 26 months compared with the remaining participants who were placed in reception centres for youth. Refusal of asylum was highly associated with higher levels of psychological distress. Mental health trajectory of young asylum seekers appears to be negatively affected by low support and refusal of asylum. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The impact of the asylum process on mental health: a longitudinal study of unaccompanied refugee minors in Norway

PubMed Central

Jakobsen, Marianne; Meyer DeMott, Melinda Ashley; Wentzel-Larsen, Tore; Heir, Trond

2017-01-01

Objectives To examine the mental health of unaccompanied refugee minors prospectively during the asylum-seeking process, with a focus on specific stages in the asylum process, such as age assessment, placement in a supportive or non-supportive facility and final decision on the asylum applications. Design This was a2½ year follow-up study of unaccompanied minors (UM) seeking asylum in Norway. Data were collected within three weeks (n=138) and at 4 months (n=101), 15 months (n=84) and 26 months (n=69) after arrival. Setting Initially in an observation and orientation centre for unaccompanied asylum-seeking adolescents, and subsequently wherever the UM were located in other refugee facilities in Norway. Participants Male UM from Afghanistan, Somalia, Algeria and Iran. Main outcome measures Mental health symptoms assessed by Hopkins Symptom Checklist-25 and Harvard Trauma Questionnaire. Results At the group level, the young asylum seekers reported high levels of psychological distress on arrival and symptom levels that stayed relatively unchanged over time. According to age-assessment procedures, 56% of the population were not recognised as minors. Subsequent placement in a low-support facility was associated with higher levels of psychological distress in the follow-up period. Those who were placed in a reception centre for adults had higher levels of psychological distress symptoms both after 15 months and 26 months compared with the remaining participants who were placed in reception centres for youth. Refusal of asylum was highly associated with higher levels of psychological distress. Conclusion Mental health trajectory of young asylum seekers appears to be negatively affected by low support and refusal of asylum. PMID:28637731

Post-traumatic stress in asylum seekers and refugees from Chechnya, Afghanistan, and West Africa: gender differences in symptomatology and coping.

PubMed

Renner, Walter; Salem, Ingrid

2009-03-01

Internationally, a high number of refugees are in need of help as a consequence of post-traumatic stress or acculturation problems. The present study investigated the gender-specific requirements for such interventions taking clinical symptoms as well as coping strategies into account. Five psychometric instruments assessing anxiety, depression, posttraumatic stress, somatic symptoms, and social adaptation were administered and semi-structured interviews with n = 150 asylum seekers and refugees from Chechnya, Afghanistan, and West Africa were conducted. On the level of total test scores, women reported significantly more somatic symptoms than men but there were no further gender differences. On the item level of the questionnaires as well as with respect to the categories obtained from the interview data, marked gender differences were found. Women, as compared to men, reported more somatic symptoms, emotional outbursts, and loss of sexual interest, while men reported detachment. For women, typical coping strategies were concentrating on their children and various indoor activities, while men preferred looking for work and socializing. Social psychiatric interventions should take gender-specific symptoms and coping strategies into account. For asylum seekers and refugees, same gender client-therapist dyads and groups are highly recommended.

The health status of asylum seekers screened by Auckland Public Health in 1999 and 2000.

PubMed

Hobbs, Mark; Moor, Catherine; Wansbrough, Tony; Calder, Lester

2002-08-23

Approximately 1500 to 1800 applications for refugee status are made to the New Zealand Immigration Service each year. Approximately one third of these asylum seekers receive health screening from Auckland Public Health. We report here key findings from this screening programme for the period 1999 to 2000. The files of patients attending the Auckland Public Health Protection Asylum Seekers Screening Clinic at Green Lane Hospital were reviewed. Data on demographics, medical examination, diagnostic testing and referrals were analysed. Nine hundred people, mainly from Middle Eastern countries, received screening. Important findings were: symptoms of psychological illness (38.4%); Mantoux skin test positivity ( 36.4%); active tuberculosis (0.6%); TB infection requiring chemoprophylaxis (18%) or chest X-ray monitoring (15%); gut parasite infection; carrier state for alpha and beta thalassaemia and the heterozygous states for HbS and HbE; incomplete immunisation; and the need for referral to a secondary care service (32.6%). Immigrant communities in New Zealand have special healthcare needs, as well as experiencing language barriers, cultural differences and economic difficulties. Healthcare providers should be alert to these needs. Appropriate resources are required to address these issues in a timely fashion.

[Effects of asylum seekers on external migration].

PubMed

Zakee, R

1992-02-01

Data concerning requests for asylum from migrants to the Netherlands are discussed. The author finds an increase from around 1,000 such requests per year in the early 1980s to over 20,000 for 1990 and 1991. It is also noted that, although women and children have a good chance of being granted asylum, most requests are rejected. The effect of this on the number of illegal aliens in the country is examined. (SUMMARY IN ENG)

Barriers to contraceptive careseeking: the experience of Eritrean asylum-seeking women in Israel.

PubMed

Gebreyesus, Tsega; Gottlieb, Nora; Sultan, Zebib; Ghebrezghiabher, Habtom Mehari; Tol, Wietse; Winch, Peter J; Davidovitch, Nadav; Surkan, Pamela J

2017-12-28

In recent years, there has been a mass migration of Eritreans (many seeking political asylum) into Israel after precarious irregular movement across international borders. This study qualitatively explores the structural barriers to family planning (i.e. contraceptive services) for Eritrean women in Israel that are rooted in their temporary legal status and the patchwork of family planning services. From December 2012 to September 2013, we interviewed 25 key informants (NGO workers, researchers, Eritrean community activists, International NGO representatives and Ministry of Health officials) and 12 Eritrean asylum seekers. We also conducted 8 focus groups with Eritrean asylum seekers. Data were analyzed using both inductive and deductive coding. We identified 7 main barriers to accessing family planning services: (1) distance to health facilities; (2) limited healthcare resources; (3) fragmentation of the healthcare system; (4) cost of contraceptive services; (5) low standard of care in private clinics; (6) discrimination; and (7) language barriers. The political, economic and social marginalization of Eritrean asylum-seeking women in Israel creates structural barriers to family planning services. Their marginalization complicates providers' efforts (NGO and governmental) to provide them with comprehensive healthcare, and hinders their ability to control their sexual and reproductive health. Failure to act on this evidence may perpetuate the pattern of unwanted pregnancies and social and economic disparities in this population.

Experiences of Young (Minor) Asylum Seekers in Further Education in Malta

ERIC Educational Resources Information Center

Spiteri, Damian

2015-01-01

This study appraises the particular challenges that minor asylum-seeking migrants who are in the 16-18 age category confront when pursuing their studies in a vocational college in Malta, a central Mediterranean island which is the smallest EU member state. The study explores how they exercise resilience in their desire to forge a future for…

Asylum seekers, refugees, and the politics of access to health care: a UK perspective

PubMed Central

Taylor, Keith

2009-01-01

The UK government has recently consulted on proposals to prohibit access to health care for some asylum seekers. This discussion paper considers the wider ethical, moral, and political issues that may arise from this policy. In particular, it explores the relationship between immigration and health and examines the impact of forced migration on health inequalities. It will be argued that it is both unethical and iniquitous to use health policy as a means of enforcing immigration policy. Instead, the founding principle of the NHS of equal access on the basis of need should be borne in mind when considering how to meet the needs of this population. PMID:19732492

Refugees, the asylum system and mental healthcare in Ireland

PubMed Central

O’Connell, Molly; Duffy, Richard

2016-01-01

The number of people seeking refugee status in Ireland is increasing year on year and the burden of mental illness experienced by refugees and asylum seekers is high. The College of Psychiatrists of Ireland has recommended the establishment of a number of specialist refugee mental health teams. In this paper we discuss the Irish asylum system, the Irish evidence regarding mental illness in this population, and current health service policy regarding refugee mental health. We propose a model of specialist refugee mental healthcare delivery. PMID:29093895

The Social Determinants of Refugee Mental Health in the Post-Migration Context: A Critical Review.

PubMed

Hynie, Michaela

2018-05-01

With the global increase in the number of refugees and asylum seekers, mental health professionals have become more aware of the need to understand and respond to the mental health needs of forced migrants. This critical review summarizes the findings of recent systematic reviews and primary research on the impact of post-migration conditions on mental disorders and PTSD among refugees and asylum seekers. Historically, the focus of mental health research and interventions with these populations has been on the impact of pre-migration trauma. Pre-migration trauma does predict mental disorders and PTSD, but the post-migration context can be an equally powerful determinant of mental health. Moreover, post-migration factors may moderate the ability of refugees to recover from pre-migration trauma. The importance of post-migration stressors to refugee mental health suggests the need for therapeutic interventions with psychosocial elements that address the broader conditions of refugee and asylum seekers' lives. However, there are few studies of multimodal interventions with refugees, and even fewer with control conditions that allow for conclusions about their effectiveness. These findings are interpreted using a social determinants of health framework that connects the risk and protective factors in the material and social conditions of refugees' post-migration lives to broader social, economic and political factors.

Forensic age assessment of asylum seekers in Finland.

PubMed

Metsäniitty, Mari; Varkkola, Olli; Waltimo-Sirén, Janna; Ranta, Helena

2017-01-01

In Finland, forensic age assessment is strictly regulated by legislation. According to the Aliens Act (301/2004) and the amendment of the Act (549/2010), the police authorities, the frontier guard authorities, and the immigration authorities have the right to refer asylum seekers to the University of Helsinki, Department of Forensic Medicine, for age assessment. These assessments are especially performed to solve if the person is of major age, the cutoff being 18 completed years. The forensic age assessment is largely based on dental development, since the special permit of the Radiation and Nuclear Safety Authority (STUK) to the Department of Forensic Medicine of the University of Helsinki, allowing the use of ionizing radiation for non-medical purposes, includes dental and hand X-rays. Forensic age assessment is always performed by two forensic odontologists. In 2015, the total number of forensic age assessment examinations was 149, and the countries of origin of the asylum seekers were most commonly Iraq, Afghanistan, and Somalia. The current legislation on forensic age assessment has been well received and approved. Radiological and other examinations can be performed in different parts of Finland, but the forensic odontologist at the University of Helsinki is always involved in the process and ensures joint quality standards for the forensic age assessment.

Meeting the health and social care needs of pregnant asylum seekers; midwifery students' perspectives: part 3; "the pregnant woman within the global context"; an inclusive model for midwifery education to address the needs of asylum seeking women in the UK.

PubMed

Haith-Cooper, Melanie; Bradshaw, Gwendolen

2013-09-01

to describe the conceptualisation and development of an inclusive educational model. The model is designed to facilitate pre-registration midwifery students' learning around the health and social care needs of pregnant women seeking asylum in the United Kingdom. current literature has identified a concern about the standard of maternity care experienced by asylum seeking women accessing maternity services in the United Kingdom. In response to this, a doctorate study was undertaken which focused on examining the way in which a group of midwifery students approached the provision of care for asylum seekers. This study revealed difficulties that these students had both in identifying these women's needs and also in the wider care issues in practice. Consequently, one of the recommendations was to ameliorate these difficulties through midwifery education. the key findings from this study were used together with relevant supporting literature to construct "the pregnant woman within the global context" model for midwifery education. The model is designed to facilitate a holistic assessment of need rather than focusing on the physical assessment at the expense of other aspects of care. It incorporates wider factors, on a global level, which could impact on the health and social care needs of a pregnant woman seeking asylum. It also prompts students to consider the influence of dominant discourses on perceptions of asylum seek;ing and is designed to encourage students' to question these discourses. this model can be used in midwifery education to prepare students in caring for pregnant women seeking asylum. It may be especially helpful when students have close contact with pregnant women seeking asylum, for example through caseloading. Further research is recommended to evaluate the effectiveness of this model in enhancing the care of asylum seeking women in the United Kingdom. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Experiences of refugees and asylum seekers in general practice: a qualitative study

PubMed Central

Bhatia, Ravi; Wallace, Paul

2007-01-01

Background There has been much debate regarding the refugee health situation in the UK. However most of the existing literature fails to take account of the opinions of refugees themselves. This study was established to determine the views of asylum seekers and refugees on their overall experiences in primary care and to suggest improvements to their care. Methods Qualitative study of adult asylum seekers and refugees who had entered the UK in the last 10 years. The study was set in Barnet Refugee Walk in Service, London. 11 Semi structured interviews were conducted and analysed using framework analysis. Results Access to GPs may be more difficult for failed asylum seekers and those without support from refugee agencies or family. There may be concerns amongst some in the refugee community regarding the access to and confidentiality of professional interpreters. Most participants stated their preference for GPs who offered advice rather than prescriptions. The stigma associated with refugee status in the UK may have led to some refugees altering their help seeking behaviour. Conclusion The problem of poor access for those with inadequate support may be improved by better education and support for GPs in how to provide for refugees. Primary Care Trusts could also supply information to newly arrived refugees on how to access services. GPs should be aware that, in some situations, professional interpreters may not always be desired and that instead, it may be advisable to reach a consensus as to who should be used as an interpreter. A better doctor-patient experience resulting from improvements in access and communication may help to reduce the stigma associated with refugee status and lead to more appropriate help seeking behaviour. Given the small nature of our investigation, larger studies need to be conducted to confirm and to quantify these results. PMID:17711587

Descriptive, inferential, functional outcome data on 9,025 torture survivors over six years in the United States.

PubMed

2015-01-01

The National Consortium of Torture Treatment Programs conducted a large voluntary research project among torture rehabilitation centers in the United States (US). Its goal is to fill the void in the literature on demographic and diagnostic data of torture survivors across a large country. Twenty-three centers across the US collaborated over six years, utilizing training and making decisions via conference calls and webinars. A data use agreement signed by all the participating centers governed plans and the use of the data. This study reports on torture survivors from 125 countries, 109 of which signed the United Nations Convention against Torture (UNCAT). Of the 9,025 torture survivors represented, most came from Africa and Asia and reported an average of 3.5 types of torture. Asylum seekers have different immigration experiences and show significantly higher rates of major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) than refugees. Torture survivors at high risk of PTSD and MDD in this sample reported three or more types of torture, reported rape, and had the immigration status of asylum seeker. At one and two years after beginning treatment, both asylum seekers and refugees reported increased rates of employment and improvements in their immigration status. This longitudinal project provides basic data on a large number of torture survivors who accessed services in the US, and provides a foundation for long-term follow up on immigration status, employment status, diagnostic status, medical diagnoses, and eventually, the effectiveness of treatment for torture survivors in the US. This article shares demographic and diagnostic findings useful for informing programmatic and policy decisions. However, these findings on refugees and asylum seekers in the US may not reflect the experience in other receiving countries. Collaboration with other researchers across continents is required to provide a much needed, more complete picture of torture survivors seeking rehabilitation across the world.

Self-represented witnessing: the use of social media by asylum seekers in Australia’s offshore immigration detention centres

PubMed Central

Rae, Maria; Holman, Rosa; Nethery, Amy

2017-01-01

The act of witnessing connects audiences with distant suffering. But what happens when bearing witness becomes severely restricted? External parties, including the mainstream news media, are constrained from accessing Australia’s offshore immigration detention centres. The effect is that people seeking asylum are hidden from the public and excluded from national debates. Some detainees have adopted social media as a platform to communicate their stories of flight, and their experiences of immigration detention, to a wider audience. This article examines the ways in which social media, and particularly Facebook, has facilitated what we call self-represented witnessing. We analyse two public Facebook pages to assess how detainees use such social media networks to document their experiences, and we observe the interaction between detainees, other social media users and mainstream media. Significantly, these social media networks enable detained asylum seekers to conduct an unmediated form of self-represented witnessing that exposes human rights abuses and documents justice claims. PMID:29782576

Self-represented witnessing: the use of social media by asylum seekers in Australia's offshore immigration detention centres.

PubMed

Rae, Maria; Holman, Rosa; Nethery, Amy

2018-05-01

The act of witnessing connects audiences with distant suffering. But what happens when bearing witness becomes severely restricted? External parties, including the mainstream news media, are constrained from accessing Australia's offshore immigration detention centres. The effect is that people seeking asylum are hidden from the public and excluded from national debates. Some detainees have adopted social media as a platform to communicate their stories of flight, and their experiences of immigration detention, to a wider audience. This article examines the ways in which social media, and particularly Facebook, has facilitated what we call self-represented witnessing. We analyse two public Facebook pages to assess how detainees use such social media networks to document their experiences, and we observe the interaction between detainees, other social media users and mainstream media. Significantly, these social media networks enable detained asylum seekers to conduct an unmediated form of self-represented witnessing that exposes human rights abuses and documents justice claims.

Social factors ameliorate psychiatric disorders in community-based asylum seekers independent of visa status.

PubMed

Hocking, Debbie C; Kennedy, Gerard A; Sundram, Suresh

2015-12-15

The impact of industrialised host nations' deterrent immigration policies on the mental health of forced migrants has not been well characterised. The present study investigated the impact of Australia's refugee determination process (RDP) on psychiatric morbidity in community-based asylum-seekers (AS) and refugees. Psychiatric morbidity was predicted to be greater in AS than refugees, and to persist or increase as a function of time in the RDP. The effect on mental health of demographic and socio-political factors such as health cover and work rights were also investigated. Psychiatric morbidity was measured prospectively on five mental health indices at baseline (T1, n=131) and an average of 15.7 months later (T2, n=56). Psychiatric morbidity in AS significantly decreased between time points such that it was no longer greater than that of refugees at T2. Caseness of PTSD and demoralisation reduced in AS who gained protection; however, those who maintained asylum-seeker status at T2 also had a significant reduction in PTS and depression symptom severity. Reduced PTS and demoralisation symptoms were associated with securing work rights and health cover. Living in the community with work rights and access to health cover significantly improves psychiatric symptoms in forced migrants irrespective of their protection status. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A cross-sectional survey on gender-based violence and mental health among female urban refugees and asylum seekers in Kampala, Uganda.

PubMed

Morof, Diane F; Sami, Samira; Mangeni, Maria; Blanton, Curtis; Cardozo, Barbara Lopes; Tomczyk, Barbara

2014-11-01

To assess gender-based violence and mental health outcomes among a population of female urban refugees and asylum seekers. In a questionnaire-based, cross-sectional study conducted in 2010 in Kampala, Uganda, a study team interviewed a stratified random sample of female refugees and asylum seekers aged 15-59 years from the Democratic Republic of Congo and Somalia. Questionnaires were used to collect information about recent and lifetime exposure to sexual and physical violence, and symptoms of depression and post-traumatic stress disorder (PTSD). Among the 500 women selected, 117 (23.4%) completed interviews. The weighted lifetime prevalences of experiencing any (physical and/or sexual) violence, physical violence, and sexual violence were 77.5% (95% CI 66.6-88.4), 76.2% (95% CI 65.2-87.2), and 63.3% (95% CI 51.2-75.4), respectively. Lifetime history of physical violence was associated with PTSD symptoms (P<0.001), as was lifetime history of sexual violence (P=0.014). Overall, 112 women had symptoms of depression (weighted prevalence 92.0; 95% CI 83.9-100) and 83 had PTSD symptoms (weighted prevalence 71.1; 95% CI 59.9-82.4). Prevalences of violence, depression, and PTSD symptoms among female urban refugees in Kampala are high. Additional services and increased availability of psychosocial programs for refugees are needed. Published by Elsevier Ireland Ltd.

Susceptibility to measles in migrant population: implication for policy makers.

PubMed

Ceccarelli, Giancarlo; Vita, Serena; Riva, Elisabetta; Cella, Eleonora; Lopalco, Maurizio; Antonelli, Francesca; De Cesaris, Marina; Fogolari, Marta; Dicuonzo, Giordano; Ciccozzi, Massimo; Angeletti, Silvia

2018-01-01

Despite a large measles outbreak is taking place in WHO European region, currently no data are available on measles immunization coverage in the asylum seeker and migrants hosted in this area. Two hundred and fifty-six migrants upon their arrival in Italy on March, April and May 2016 were screened for measles virus IgG antibodies by chemiluminescence immunoassay (Liaison XL analyzer, Diasorin, Italy). The virus susceptibility in this cohort, the differences between the official country reported and the observed measles immunization coverage and the impact of current measles outbreak on the asylum seekers hosted in the largest Asylum Seeker centres of Italy, were evaluated. The prevalence of subjects with positive result for measles IgG antibodies ranged between 79.9% and 100%. In Senegal, Mali, Nigeria, Pakistan and Bangladesh, the measles IgG seroprevalence observed was greater than the vaccinal coverage reported by WHO after I dose of vaccine. Based on data regarding the II dose coverage, the ASs population presented a seroprevalence greater to that expected. On the basis of the results obtained, extraordinary screening and vaccination campaigns in the migrant population, especially in the course of large outbreaks, could represent a resource to reach an adequate measles immunization coverage and to control this infectious disease. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

The impact of direct provision accommodation for asylum seekers on organisation and delivery of local primary care and social care services: A case study

PubMed Central

2011-01-01

Background Many western countries have policies of dispersal and direct provision accommodation (state-funded accommodation in an institutional centre) for asylum seekers. Most research focuses on its effect on the asylum seeking population. Little is known about the impact of direct provision accommodation on organisation and delivery of local primary care and social care services in the community. The aim of this research is to explore this issue. Methods In 2005 a direct provision accommodation centre was opened in a rural area in Ireland. A retrospective qualitative case study was designed comprising in-depth interviews with 37 relevant stakeholders. Thematic analysis following the principles of framework analysis was applied. Results There was lack of advance notification to primary care and social care professionals and the community about the new accommodation centre. This caused anxiety and stress among relevant stakeholders. There was insufficient time to plan and prepare appropriate primary care and social care for the residents, causing a significant strain on service delivery. There was lack of clarity about how primary care and social care needs of the incoming residents were to be addressed. Interdisciplinary support systems developed informally between healthcare professionals. This ensured that residents of the accommodation centre were appropriately cared for. Conclusions Direct provision accommodation impacts on the organisation and delivery of local primary care and social care services. There needs to be sufficient advance notification and inter-agency, inter-professional dialogue to manage this. Primary care and social care professionals working with asylum seekers should have access to training to enhance their skills for working in cross-cultural consultations. PMID:21575159

The impact of direct provision accommodation for asylum seekers on organisation and delivery of local primary care and social care services: a case study.

PubMed

Pieper, Hans-Olaf; Clerkin, Pauline; MacFarlane, Anne

2011-05-15

Many western countries have policies of dispersal and direct provision accommodation (state-funded accommodation in an institutional centre) for asylum seekers. Most research focuses on its effect on the asylum seeking population. Little is known about the impact of direct provision accommodation on organisation and delivery of local primary care and social care services in the community. The aim of this research is to explore this issue. In 2005 a direct provision accommodation centre was opened in a rural area in Ireland. A retrospective qualitative case study was designed comprising in-depth interviews with 37 relevant stakeholders. Thematic analysis following the principles of framework analysis was applied. There was lack of advance notification to primary care and social care professionals and the community about the new accommodation centre. This caused anxiety and stress among relevant stakeholders. There was insufficient time to plan and prepare appropriate primary care and social care for the residents, causing a significant strain on service delivery. There was lack of clarity about how primary care and social care needs of the incoming residents were to be addressed. Interdisciplinary support systems developed informally between healthcare professionals. This ensured that residents of the accommodation centre were appropriately cared for. Direct provision accommodation impacts on the organisation and delivery of local primary care and social care services. There needs to be sufficient advance notification and inter-agency, inter-professional dialogue to manage this. Primary care and social care professionals working with asylum seekers should have access to training to enhance their skills for working in cross-cultural consultations.

[Systematic review and evidence mapping of empirical studies on health status and medical care among refugees and asylum seekers in Germany (1990-2014)].

PubMed

Bozorgmehr, Kayvan; Mohsenpour, Amir; Saure, Daniel; Stock, Christian; Loerbroks, Adrian; Joos, Stefanie; Schneider, Christine

2016-05-01

Owing to a lack of routine statistics on the health status and medical care of asylum seekers, empirical studies play a major role in the mapping of these aspects. The aim of this review is to provide a comprehensive overview of the research landscape in this area, synthesizing knowledge from empirical studies and identifying evidence gaps. A three-tiered search strategy included searching for empirical studies in national/international databases and on the internet, screening reference lists, and contacting experts. Studies meeting predefined inclusion criteria were thematically organized and described in a narrative synthesis. The searches generated 1,190 hits; 52 articles met the inclusion criteria. Of these, 41 were quantitative studies (78.9 %), 10 qualitative (19.2 %), and 1 was a review (1.9 %). A total of 30 primary articles (58.9 %) analyzed mental health aspects, followed by infectious diseases (n = 12, 23.5 %). Qualitative studies, mainly ethnographies and case studies, explored mental health and social determinants of health, providing evidence for the impact of living conditions on health and medical care. Few studies analyzed chronic diseases (n = 3) or childhood illnesses (n = 6). No studies analyzed the health needs or medical care of asylum-seeking women during pregnancy and child birth. In 62.7 % of the primary studies, a single sampling point was used to recruit asylum seekers. Nationwide external validity was given in two quantitative studies. The priority research areas identified are chronic diseases and childhood and maternal health. The divergency and heterogeneity of the studies hamper a comprehensive and comparable acquisition of knowledgeand emphasize the  need for collaborative research to close the existing evidence gaps.

[Health examination of asylum seekers: A nationwide analysis of state policies in Germany : § 62 of the asylum law].

PubMed

Wahedi, Katharina; Nöst, Stefan; Bozorgmehr, Kayvan

2017-01-01

A health examination of newly arrived asylum seekers, aimed at detecting infectious diseases and preventing disease outbreaks in accommodation facilities, is mandated by national law in all German states. Due to the decentralized German federal system, different state policies are in place and lead to substantial variation in the content and implementation of the health examination. To compare health examination policies in the 16 German states with a focus on conducted tests, preventive measures and the general procedure. A comparative content analysis of policy documents addressing the health examination was conducted. Relevant documents were identified through a nationwide search (conducted June-October 2015) through public sources, inquiries at responsible authorities and interviews with representatives of public health services. In the study period, relevant policy documents for 13 states were identified, of which eight were administrative decrees of the responsible state ministries. Policies differed strongly with respect to the content of the health examination and the selection of compulsory screening measures. We identified three main groups: (A) states with compulsory screening limited to measures enshrined in federal law, (B) states with extended tuberculosis screening for children and pregnant women, and (C) states with extended mandatory screening measures for further infectious diseases beyond tuberculosis. Considerable differences were also found with regard to the implementation of the examinations, and the purchasing and re-imbursement policies. The stark heterogeneity in health examination policies between the states cannot be rationally explained from a public health perspective. The indication for certain measures remains unclear. A broad discussion of the medical necessity of screening tests, combined with further systematic analyses, is necessary in order to develop nationwide evidence-based recommendations and decision-making tools for the conduct of health examinations of asylum seekers.

[Unseen Suffering - Therapy for Traumatized Refugee Children].

PubMed

Mattenschlager, Andreas; Nahler, Stefanie; Reisinger, Regine

2016-12-01

Unseen Suffering - Therapy for Traumatized Refugee Children In March 2015 the psychological counselling service (Psychologische Familien- und Lebensberatung) of Caritas Ulm initiated a psychotherapy project for traumatized minor refugees. Besides individual and group therapy, networking and qualification of qualified personnel and volunteers, in autumn 2015 we started offering our services on-site in a large collective accommodation for asylum seekers in Ulm. This was mainly because - in contrast to unaccompanied, mostly adolescent, minor refugees - our services appeared to reach children only by chance. In our opinion this is mostly due to the fact that children's suffering is often far less noticed. This paper describes our first year's project work, followed by reports on the use of psychodrama groups with refugee children and on the therapeutic work in a collective accommodation for asylum seekers.

Social Support from Sponsorships as a Moderator of Acculturative Stress: Predictors of Effects on Refugees and Asylum Seekers.

PubMed

Renner, Walter; Laireiter, Anton-Rupert; Maier, Marco J

2012-01-01

N = 63 refugees and asylum seekers, 27 women and 36 men with a mean age of 33.08 years (SD = 10.3) from Chechnya and Afghanistan were granted sponsorships for six months and were randomized to an intervention and a waiting-list control group. Only participants with a history of traumatization benefited from the intervention. For the traumatized sub-sample, sponsorships led to a significant and stable decrease in anxiety, depression, and psychological problems as compared to the control group, with effect sizes comparable to those of psychotherapy. The effects being rather palliative than instrumental, however, sponsorships did not instigate improvements in acculturation, societal contact, or coping capability. Women benefited more from the intervention than men, and Afghans more than Chechen.

Social Support from Sponsorships as a Moderator of Acculturative Stress: Predictors of Effects on Refugees and Asylum Seekers

PubMed Central

Renner, Walter; Laireiter, Anton-Rupert; Maier, Marco J.

2011-01-01

N = 63 refugees and asylum seekers, 27 women and 36 men with a mean age of 33.08 years (SD = 10.3) from Chechnya and Afghanistan were granted sponsorships for six months and were randomized to an intervention and a waiting-list control group. Only participants with a history of traumatization benefited from the intervention. For the traumatized sub-sample, sponsorships led to a significant and stable decrease in anxiety, depression, and psychological problems as compared to the control group, with effect sizes comparable to those of psychotherapy. The effects being rather palliative than instrumental, however, sponsorships did not instigate improvements in acculturation, societal contact, or coping capability. Women benefited more from the intervention than men, and Afghans more than Chechen. PMID:22318290

Graduate public health training in healthcare of refugee asylum seekers and clinical human rights: evaluation of an innovative curriculum.

PubMed

Asgary, Ramin

2016-04-01

An innovative curriculum was developed to equip public health students with appropriate attitude and skills to address healthcare of asylum seekers. Implemented in 2005 the curriculum included: (1) didactic sessions covering epidemiology and health sequelae of torture, asylum laws, and approaches to identify survivors' healthcare needs; (2) panel discussions with survivors and advocates; and (3) participating in medico-legal process of asylum seeking. Complementary mixed methods evaluations included pre- and post-curriculum questionnaires, formal curriculum evaluations, final papers and oral presentations. 125 students participated. Students showed improved knowledge regrading sequelae of abuse and survivors' healthcare needs (P < 0.01), improved attitudes towards working with survivors (P < 0.05) and self-efficacy in identifying at-risk populations and addressing healthcare of survivors (P < 0.05). Students reported increased desire to pursue global health and human rights careers. As an advocacy and cultural competency training in public health practice addressing healthcare of refugees domestically, this curriculum was well received and effective, and will also help students better serve other similar populations. Population case-based domestic opportunities to teach global health and health and human rights should be effectively utilized to develop a well-equipped global health corps.

Head injury in asylum seekers and refugees referred with psychological trauma.

PubMed

Doherty, S M; Craig, R; Gardani, M; McMillan, T M

2016-01-01

Individuals who seek asylum are frequently fleeing violent persecution and may experience head injury (HI). However, little is known about the prevalence of HI in asylum seekers and refugees (ASR) despite the potential for HI to significantly affect cognitive and emotional functioning and to compromise asylum outcomes. This preliminary study investigates the prevalence of HI in ASR referred to a complex psychological trauma service. Participants were 115 adult ASR referred to a community psychological trauma service with moderate to severe mental health problems associated with psychological trauma. They were screened for a history of HI using a questionnaire developed for the study. Interpreters were used when required. The overall prevalence of HI was 51%. At least 38% of those with HI had a moderate-severe HI that could cause persisting disability. In 53% of those with HI, the cause was torture, human trafficking or domestic violence. Repeat HI can have cumulative effects on function; it was common, and was reported in 68% of those with HI. An injury to the head was not known to mental health clinicians prior to screening in 64% of cases. The emotional and cognitive consequences of HI in ASR may increase the vulnerability of this disadvantaged group, and can be associated with neurobehavioural problems affecting daily life and may compromise asylum outcomes. Routine screening for HI in ASR is needed, as are links to neuropsychology and brain injury services for advice, assessment and intervention.

Bibliometric analysis of medicine - related publications on refugees, asylum-seekers, and internally displaced people: 2000 - 2015.

PubMed

Sweileh, Waleed M

2017-03-20

Wars and violent domestic conflicts have forced millions of people to move outside their homes. Meeting the basic health needs of those people requires an understanding of research activity and research output on this topic. The objective of this study was to shed light on the quantity and impact of medicine - related publications on refugees, asylum seekers and internally displaced people (IDP). Scopus database was used to retrieve required data. Specifically, the number of publications, top productive countries and institutions, highly cited articles, citation analysis, international collaboration, and journals involved in publishing articles on refugees, asylum seekers and IDP were reviewed and analyzed. The time span for the study was set from year 2000 to 2015. Two thousands five hundred and thirty publications were retrieved. The h-index of retrieved articles was 64. A steep rise in number of publications was noticed after 2011. Top productive countries were the United States of America, Australia and the United Kingdom. The American public health institute (Centers for Disease Control and Prevention) and the United Nations refugee agency were among the top active organizations on this topic. Active journals in publishing on health of refugees, asylum seekers and IDP were those on mental health, psychology, public health and general medicine. Publications on Somali, Afghani, Iraqi, and Syrian refugees received a significant share of medicine-related publications. Analysis of publications based on region showed that publications on refugees from Middle East is rising sharply and is approaching those on African refugees. Bibliometric analysis reveals that research publications on refugees have been increasing in a dramatic way and articles are being published in journals with high impact factor and international reputation, not only in general medicine and public health, but also mental health and psychology journals. Analysis of publications related to refugees can be helpful to international health agencies and governments not only to document the psychological trauma of fled people, but also to identify best mental health programs to face the consequences of wars and aggression that led to this refugee crisis.

Hunger strikers: historical perspectives from the emergency management of refugee camp asylum seekers.

PubMed

Burkle, Frederick M; Chan, Jimmy T S; Yeung, Richard D S

2013-12-01

The treatment of hunger strikers is always contentious, chaotic and complex. The management is particularly difficult for health professionals as it raises unprecedented clinical, ethical, moral, humanitarian, and legal questions. There are never any easy answers. The current situation of prisoners from the Iraq and Afghanistan Wars currently at the Guantanamo Bay Detention Center in Cuba demands unprecedented transparency, accountability and multilevel coordination to ensure that the rights of the strikers are properly met. There are scant references available in the scientific literature on the emergency management of these tragedies. This historical perspective documents the complex issues faced by emergency physicians in Hong Kong surrounding refugee camp asylum seekers from Vietnam in 1994 and is offered as a useful adjunct in understanding the complex issues faced by emergency health providers and managers.

How the Spectre of Societal Homogeneity Undermines Equitable Healthcare for Refugees Comment on "Defining and Acting on Global Health: The Case of Japan and the Refugee Crisis".

PubMed

Razum, Oliver; Wenner, Judith; Bozorgmehr, Kayvan

2016-10-17

Recourse to a purported ideal of societal homogeneity has become common in the context of the refugee reception crisis - not only in Japan, as Leppold et al report, but also throughout Europe. Calls for societal homogeneity in Europe originate from populist movements as well as from some governments. Often, they go along with reduced social support for refugees and asylum seekers, for example in healthcare provision. The fundamental right to health is then reduced to a citizens' right, granted fully only to nationals. Germany, in spite of welcoming many refugees in 2015, is a case in point: entitlement and access to healthcare for asylum seekers are restricted during the first 15 months of their stay. We show that arguments brought forward to defend such restrictions do not hold, particularly not those which relate to maintaining societal homogeneity. European societies are not homogeneous, irrespective of migration. But as migration will continue, societies need to invest in what we call "globalization within." Removing entitlement restrictions and access barriers to healthcare for refugees and asylum seekers is one important element thereof. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Refugee movements and Turkey.

PubMed

Kirisci, K

1991-12-01

There has been a long tradition in the Ottoman Empire and the Turkish Republic of receiving refugees. There were Jewish refugees from the Spanish Inquisition, Hungarians and Poles fleeing revolts in 1848-9, and those of Turkish descent and usually from the Balkans. Concurrent with this trend is the history of refugees and immigrants leaving Turkey, such as many Armenians, Greeks and Jews leaving at the turn of the century, and after 1923 and the Treaty of Lausanne. Little is currently published on the topic. This article defines a refugee; provides an overview of the refugee problems of the 1980's due to Bulgarian, Kurdish, and Turkish refugees; and the legal and political aspects. As a country of origin, there is discussion of the political and economic aspects of Turkish asylum seekers in Europe. The potential refugee flows to and from Turkey are also examined. I) For this study, refugees are victims of political violence and are persecuted for political or religious beliefs, ethnic or racial background, or war. In Turkey, there are national refugees, international refugees outside the Convention, and UNHCR Convention refugees. During the 1980's all 3 groups were arriving: from eastern Europe, Iranian Kurds, Iraqis, and ethnic Turks from Bulgaria and Afghanistan. The Turkish restricted acceptance of the 1951 Convention on Refugees creates serious humanitarian and security consequences for refugees other than those from eastern Europe and of Turkish ethnicity. Political considerations play an important role in treatment where security threats outweigh humanitarian need. The case is given for Kurdish refugees. II) Asylum seekers from Turkey in Western Europe was determined between 1986-90 to be 185,000 from applications. These figures have risen steadily due to the political instability and military activity of areas bordering Iraq and Syria, the Emergency Region. In addition there are economic and employment problems, and there has been a suspension of human rights. Europe in return has tightened legislation and procedures to differentiate economically motivated refugees from authentic political asylum seekers. Further research is needed to investigate refugee problems. Further refugees may come due to the promotion of a Black Sea Cooperation Region and easier crossings of borders to the former Soviet Republics. Ethnic Turks in Moldavia or Romania or Bulgaria may leave due to unrest. Factors affecting asylum seekers are improvements in Turkey's human rights record, repeal of bans of the Kurdish language, completion of the South Eastern Development Project, and the European government policy on asylum.

"Their Stories Have Changed My Life": Clinicians' Reflections on Their Experience with and Their Motivation to Conduct Asylum Evaluations.

PubMed

Mishori, Ranit; Hannaford, Alisse; Mujawar, Imran; Ferdowsian, Hope; Kureshi, Sarah

2016-02-01

Many clinicians perform asylum evaluations yet no studies describe the motivation to perform them or their perceived rewards. The number of asylum seekers in the US is increasing and more clinicians are needed as evaluators. A survey to an asylum evaluators' network asked participants to qualitatively reflect on their experience and motivation. Answers were analyzed for themes and sentiment. Respondents cited commitment to humanistic and moral values, noted personal and family experiences, having skills, expertise, and career interests as drivers. They found the experience very rewarding personally and professionally, and in their perceived benefit to asylees. Negative sentiment was less frequent and centered on emotions related to client narratives. Process-oriented frustrations were also noted. This is the first published study describing clinicians' motivation and experience with asylum evaluations. It may illuminate clinicians' drive to volunteer, and serve as a resource for organizations for recruitment and education.

Beyond resettlement: long-term care for people who have had refugee-like experiences.

PubMed

Phillips, Christine

2014-11-01

Since 1945, more than 700 000 refugees and displaced persons, survivors of conflicts in over 60 countries, have resettled in Australia. Every general practitioner (GP) will have patients who have had refugee-like experiences. To describe the health needs of survivors of war and conflict in the immediate and long-term resettlement periods. In the immediate post-settlement period, refugees and asylum seekers will need assessment, catch-up primary healthcare and, in some cases, psychological support. Although refugees are generally a resilient group, enhanced support may be needed over key life periods: childbirth, rearing of young children and entering frail age. Asylum seekers (who do not have permanent visas) often face structural impediments to healthcare access and may be unable to meet basic health needs; GPs need to be aware of the enhanced need for psychological safety in addition to catch-up healthcare in this population.

Nursing care of vulnerable populations using a framework of cultural competence, social justice and human rights.

PubMed

Pacquiao, Dula F

2008-04-01

The article attempts to present a model linking cultural competence with advocacy for social justice and protection of human rights in caring for vulnerable groups such as refugees and asylum seekers. Using the human rights principle focuses the moral obligation to address social inequities and suffering of vulnerable populations. Cultural competent care and culturally-congruent actions place the universal principles of social justice and protection of human rights within the cultural contexts of people's lives and the environment in which they are situated. Compassion is identified as the key component for culturally-competent advocacy for social justice and human rights protection. Compassion compels actions advocating social justice and protection of human rights for marginalised and powerless groups. Educational strategies for developing compassion are centered on collaboration, partnership and advocacy. Integration of experiential and didactic learning relevant to cultural competent care for refugees and asylum seekers are recommended.

Health Assessment and the Right to Health in Sweden: Asylum Seekers’ Perspectives

PubMed Central

Lobo Pacheco, Lubin; Jonzon, Robert; Hurtig, Anna-Karin

2016-01-01

Background Swedish law entitles asylum seekers to a voluntary health assessment and to “health care that cannot be postponed”. The last expression suggests, however, restrictions on the entitlement, and what it may or may not include remains ultimately a decision for health professionals in the specific case. Indeed, the health assessment constitutes the sole active effort from Swedish authorities to fulfill this right. This study was therefore aimed at assessing how the information, procedures and services related to the health assessment are accessible and acceptable to fulfill the right to health of asylum seekers, from their own perspective. Methods The study has a cross-sectional design. A questionnaire was administrated in 16 language schools for immigrants, in four counties of Sweden. Three hundred eighty-six individuals fulfilled the inclusion criteria. The frequency of their answers was tabulated to estimate how the information, procedures and services related to the health assessment correspond to the criteria for accessibility and acceptability regarding the right to health. Findings Forty-eight (12.4%) respondents did not undergo the health assessment. Thirty-one of them did not even receive the invitation letter. They said they lost the opportunity to know their health status, to obtain treatment for or advice about their health problems. Additionally, 55.2% of those who attended the health assessment indicated that their needs were overlooked, particularly when these were of a psychological nature. Two in three participants also considered the health assessment to be a communicable disease control, rather than an effort to take care of their health needs. Nevertheless, the respondents had a positive attitude towards the health assessment as such. Conclusions Although being an important contribution, the health assessment does not suffice to fulfill the right to health of asylum seekers because there are shortcomings regarding the accessibility and acceptability of the information, procedures and services that it includes. PMID:27589238

The oral health of refugees and asylum seekers: a scoping review.

PubMed

Keboa, Mark Tambe; Hiles, Natalie; Macdonald, Mary Ellen

2016-10-07

Improving the oral health of refugees and asylum seekers is a global priority, yet little is known about the overall burden of oral diseases and their causes for this population. To synthesize available evidence on the oral health of, and access to oral health care by this population. Using a scoping review methodology, we retrieved 3321 records from eight databases and grey literature; 44 publications met the following inclusion criteria: empirical research focused on refugees and/or asylum seekers' oral health, published between 1990 and 2014 in English, French, Italian, Portuguese, or Spanish. Analysis included descriptive and thematic analysis, as well as critical appraisal using the Critical Appraisal Skills Programme (CASP) criteria for quantitative and qualitative studies. The majority of publications (86 %) were from industrialized countries, while the majority of refugees are resettled in developing countries. The most common study designs were quantitative (75 %). Overall, the majority of studies (76 %) were of good quality. Studies mainly explored oral health status, knowledge and practices; a minority (9 %) included interventions. The refugee populations in the studies showed higher burden of oral diseases and limited access to oral health care compared to even the least privileged populations in the host countries. Minimal strategies to improve oral health have been implemented; however, some have impressive outcomes. Oral health disparities for this population remain a major concern. More research is needed on refugees in developing countries, refugees residing in refugee camps, and interventions to bridge oral health disparities. This review has utility for policymakers, practitioners, researchers, and other stakeholders working to improve the oral health of this population.

The childbearing health and related service needs of newcomers (CHARSNN) study protocol

PubMed Central

Gagnon, Anita J; Wahoush, Olive; Dougherty, Geoffrey; Saucier, Jean-François; Dennis, Cindy-Lee; Merry, Lisa; Stanger, Elizabeth; Stewart, Donna E

2006-01-01

Background Refugee and asylum-seeking women in Canada may have significant harmful childbearing health outcomes and unmet health and social care needs. The most vulnerable of these women are: those who have left their countries by force (e.g., war, rape or abuse histories), are separated from their families, have limited knowledge of the host country languages, and are visible minorities. Asylum-seekers face additional stresses related to their unknown future status and are marginalized with regards to access to provincial health care systems. The prevalence and severity of health issues in this population is not known nor is the extent of response from social service and health care systems (including variation in provincial service delivery). Understanding the magnitude of health and social concerns of newcomers requires data from a representative sample of childbearing refugee and asylum-seeking women resettling in Canada to permit comparisons to be made with non-refugee immigrant and Canadian-born women. Our research questions are: (1) Do refugee or asylum-seeking women and their infants, experience a greater number or a different distribution of harmful health events during pregnancy, at birth, and during the postpartum period than non-refugee immigrant or Canadian-born women? (2) Are the harmful health events experienced postpartum by asylum-seeking women and their infants, addressed less often (compared to refugees, non-refugee immigrants, and Canadian-born women) by the Canadian health care system as delivered in each of the three major receiving cities for newcomers? Methods/design This is a four-year multi-site prospective cohort study (pregnancy to 4 months postpartum). We will seek to recruit 2400 women [200 in each of 4 groups (refugees, asylum-seekers, non-refugee immigrants, and Canadian-born) from 1 of 12 postpartum hospital units across the 3 largest receiving cities for newcomers to Canada – Montreal, Toronto, and Vancouver]. Discussion Knowledge of the extent of harmful health events occurring to asylum-seeking, refugee, immigrant, and Canadian-born women, and the response of the health care system to those events and group differences, if they exist, will inform immigration and health policy makers as well as providers of services. PMID:17190589

The Moral Economy of Lying: Subjectcraft, Narrative Capital, and Uncertainty in the Politics of Asylum.

PubMed

Beneduce, Roberto

2015-01-01

Based on narratives of asylum-seekers from sub-Saharan Africa in northern Italy, in this article I analyze the narrative strategies used by immigrants to meet the eligibility criteria established by asylum law. For many of them, this means "arranging" biographical details within what I call "a moral economy of lying." The first question I discuss is what types of experience and 'subject positions' these narrative strategies reveal or generate. I then examine the arbitrariness and the bureaucratic violence of the asylum evaluation process, and the role of these procedures in the making of nation-language and current technologies of citizenship. Finally, I consider the politics of testification, recognition, and memory these discourses and practices combine to shape. I analyze these issues from an historical point of view of the politics of identity, truth, and falsehood as imposed in a recent past by colonizers onto the colonized.

Mental health screening in immigration detention: A fresh look at Australian government data.

PubMed

Young, Peter; Gordon, Michael S

2016-02-01

The poor mental health of asylum seekers and refugees in immigration detention has consistently been reported in peer-reviewed literature internationally; however, data on the mental health of asylum seekers and refugees detained in Australian immigration has been very limited. We re-analysed mental health screening data obtained by the Human Rights Commission. Longer time in detention was associated with higher self-reported depression scores, with female individuals being more vulnerable to time in detention than those of male gender. Approximately one-half of the refugee group who agreed to complete the Harvard Trauma Questionnaire had post-traumatic stress disorder symptoms. On clinician-rated measures, one-third of the children, adolescents and adults suffered with clinical symptoms requiring tertiary outpatient assessment. This paper consolidates the findings of the 2014 Australian Human Rights Commission report and it provides an argument for public reporting of refugee data. © The Royal Australian and New Zealand College of Psychiatrists 2016.

Displacement Identity in Transit: A Nauru Case Study

ERIC Educational Resources Information Center

Donehue, Tracey E.

2017-01-01

Based on Darvin and Norton's (2015) reconceptualization of identity theory highlighting the recursive relationship between identity, capital, and ideology, this study posits that refugee and asylum seeker adolescents and adults in transit on Nauru are ascribed a 'displacement identity' through externally imposed normative ideologies. In addressing…

The Banality of Exclusion in Australian Universities

ERIC Educational Resources Information Center

White, Julie

2017-01-01

The systematic exclusion of asylum seekers from Australian higher education reveals much about present day Australia. This essay begins with a brief context and outline of the international refugee crisis and Australia's reaction. Next, consideration is given to how this nation has identified itself historically and how it has behaved in recent…

Counselling Refugee Young People: An Exploration of Therapeutic Approaches

ERIC Educational Resources Information Center

Warr, Sally

2010-01-01

This paper presents and discusses the key findings from a study that considered significant issues that affect refugees and asylum-seekers, and explored beneficial counselling approaches relevant to this group. In-depth narrative interviews were conducted with three counsellors and three specialist children's support advisors. Data were analysed…

Policies of access to healthcare services for accompanied asylum-seeking children in the Nordic countries.

PubMed

Sandahl, Hinuga; Norredam, Marie; Hjern, Anders; Asher, Henry; Nielsen, Signe Smith

2013-08-01

Asylum-seeking children constitute a vulnerable group with high prevalence and risk for mental health problems. The aim of this study was to compare policies of access to healthcare services, including physical examination and screening for mental health problems on arrival, for accompanied asylum-seeking children in the Nordic countries. This study was based on the national reports "Reception of refugee children in the Nordic countries" written by independent national experts for the Nordic Network for Research on Refugee Children, supplemented by information from relevant authorities. In Sweden, Norway and Iceland, asylum-seeking children had access to healthcare services equal to children in the general population. On a policy level, Denmark imposed restrictions on non-acute hospitalisations and prolonged specialist treatments. Regarding health examinations, Sweden deviated from the Nordic pattern by not performing these systematically. In Denmark, Iceland, and some counties in Sweden, but not in Norway, screening for mental health problems was offered to asylum-seeking children. Access to healthcare services for asylum-seeking children differs in the Nordic countries; the consequences of these systematic differences for the individual asylum-seeking child are unknown. For asylum-seeking children, access to healthcare has to be considered in a wider context that includes the core conditions of being an asylum-seeker. A comparative study at policy level needs to be supplemented with empirical follow-up studies of the well-being of the study population to document potential consequences of policies in practice.

Resettlement experiences and resilience in refugee youth in Perth, Western Australia.

PubMed

Earnest, Jaya; Mansi, Ruth; Bayati, Sara; Earnest, Joel Anthony; Thompson, Sandra C

2015-06-10

In Australia, the two major pathways of refugee entry are the United Nations High Commissioner for Refugees resettlement programme and irregular maritime arrivals (IMAs) seeking asylum. The Australian Government's policies towards IMAs since July 2013 are controversial, uncompromising and consistently harsh, with asylum seekers held in detention centres for prolonged periods. Refugees and asylum seekers have distinct and unique stressors that make resettlement difficult. This exploratory study examines resettlement experiences for refugee youth in Western Australia using the psychosocial conceptual framework and qualitative methods. Focus group discussions and key informant interviews were undertaken with verbatim transcripts analysed using thematic analysis to identify themes. Themes documented that language and its impact, and experience with education, health, and social activities, support structures provided to youth and supporting future aspirations as critical to successful resettlement. This exploratory study contributes to developing a broader understanding of the resettlement experiences of refugee youth, drawing on their current and past experiences, cultural differences and mechanisms for coping. Fluency in English language, especially spoken, was a facilitator of successful resettlement. Our results align with previous studies documenting that support programs are vital for successful resettlement. Although faced with immense difficulties refugee youth are resilient, want to succeed and have aspirations for the future. Strategies and recommendations suggested by refugee youth themselves could be used for developing interventions to assist successful resettlement.

International migration to Canada: the post-birth health of mothers and infants by immigration class.

PubMed

Gagnon, Anita J; Dougherty, Geoffrey; Wahoush, Olive; Saucier, Jean-François; Dennis, Cindy-Lee; Stanger, Elizabeth; Palmer, Becky; Merry, Lisa; Stewart, Donna E

2013-01-01

There are over 214 million international migrants worldwide, half of whom are women, and all of them assigned by the receiving country to an immigration class. Immigration classes are associated with certain health risks and regulatory restrictions related to eligibility for health care. Prior to this study, reports of international migrant post-birth health had not been compared between immigration classes, with the exception of our earlier, smaller study in which we found asylum-seekers to be at greatest risk for health concerns. In order to determine whether refugee or asylum-seeking women or their infants experience a greater number or a different distribution of professionally-identified health concerns after birth than immigrant or Canadian-born women, we recruited 1127 migrant (and in Canada <5 years) women-infant pairs, defined by immigration class (refugee, asylum-seeker, immigrant, or Canadian-born). Between February 2006 and May 2009, we followed them from childbirth (in one of eleven birthing centres in Montreal or Toronto) to four months and found that at one week postpartum, asylum-seeking and immigrant women had greater rates of professionally-identified health concerns than Canadian-born women; and at four months, all three migrant groups had greater rates of professionally-identified concerns. Further, international migrants were at greater risk of not having these concerns addressed by the Canadian health care system. The current study supports our earlier findings and highlights the need for case-finding and services for international migrant women, particularly for psychosocial difficulties. Policy and program mechanisms to address migrants' needs would best be developed within the various immigration classes. Copyright © 2012 Elsevier Ltd. All rights reserved.

Brief Psychoeducational Group Treatment with Re-Traumatized Refugees and Asylum Seekers

ERIC Educational Resources Information Center

Akinsulure-Smith, Adeyinka M.

2009-01-01

This article describes the implementation of a psychoeducational group treatment with students with a history of refugee trauma, war, and human rights abuses who were further traumatized by the 9/11 attacks in New York City. The rationale for group intervention and specific techniques utilized to promote emotional and behavioral stabilization and…

Pedagogy of Refuge: Education in a Time of Dispossession

ERIC Educational Resources Information Center

Perumal, Juliet Christine

2013-01-01

Despite its chequered history in relation to human rights issues, South Africa has been playing host to peoples displaced and dispossessed by geographies of anger and war, poverty, economic meltdown and other human rights atrocities. Perceiving South Africa as a sanctuary, there has been a steady wave of immigrants, asylum seekers and refugees…

Supporting Refugee Students in Schools: What Constitutes Inclusive Education?

ERIC Educational Resources Information Center

Taylor, Sandra; Sidhu, Ravinder Kaur

2012-01-01

The worldwide rise in numbers of refugees and asylum seekers suggests the need to examine the practices of those institutions charged with their resettlement in host countries. In this paper, we investigate the role of one important institution--schooling--and its contribution to the successful resettlement of refugee children. We begin with an…

Parenting in Direct Provision: Parents' Perspectives Regarding Stresses and Supports

ERIC Educational Resources Information Center

Ogbu, Helen Uchechukwu; Brady, Bernadine; Kinlen, Louise

2014-01-01

The Irish direct provision system for asylum seekers is acknowledged as providing a very challenging and exclusionary living environment for adults and children. To date, there has been little research focused specifically on the ways in which the direct provision environment impacts on the parenting role. This qualitative study explores the…

Supporting Schools to Create an Inclusive Environment for Refugee Students

ERIC Educational Resources Information Center

Block, Karen; Cross, Suzanne; Riggs, Elisha; Gibbs, Lisa

2014-01-01

In a context of increasing numbers of refugees and asylum seekers globally, recognition of the importance of the school environment for promoting successful settlement outcomes and inclusion for refugee-background young people is growing. Yet schools may be poorly equipped to recognise and respond to the multiple challenges faced by children and…

LADO as a Language Test: Issues of Validity

ERIC Educational Resources Information Center

McNamara, Tim; Van Den Hazelkamp, Carolien; Verrips, Maaike

2016-01-01

This article brings together the theoretical field of language testing and the practical field of language analysis for the determination of the origin of asylum seekers. It considers what it would mean to think of language analysis as a form of language test, subject to the same validity constraints, and proposes a research agenda.

Combining Academia and Activism: Common Obstacles and Useful Tools

ERIC Educational Resources Information Center

Flood, Michael; Martin, Brian; Dreher, Tanja

2013-01-01

Academics can engage in and contribute to activism in various ways. Some are involved in action groups on issues such as climate change and treatment of asylum seekers. Some undertake research and speak to the media about indigenous, environmental, gender and other issues. Others campaign on matters of concern within universities, including…

Solidarity.com: is there a link between offline behavior and online donations?

PubMed

Eller, Anja

2008-10-01

Solidarity websites, such as The Hunger Site, where people can donate food at no financial cost and minimal effort, have become immensely popular and effective since 1999. These new forms of philanthropy are characterized by wide participation and direct assistance and feedback. The present longitudinal, quasi-experimental study aimed to examine whether online solidarity can be predicted by offline contact with, attitudes about, and altruistic behavior tendencies towards a population in need, asylum seekers. Fifty-seven university students completed two surveys, separated by 1 year. Prior to T1, only 9% of respondents had visited solidarity websites, while at T2 47% reported clicking. Multiple regression analysis showed that T2 visits to solidarity websites were (negatively) predicted by T1 quantity of contact, and marginally, by T1 general evaluation of asylum seekers. These long-term, offline-to-online effects are intriguing, although there were no effects of offline contact quality and altruistic behavior tendencies. Future research should further investigate the causal direction between offline and online behavior and the factors that might influence the link between offline and online attitudes and behavior.

Transcultural telepsychiatry and its impact on patient satisfaction.

PubMed

Mucic, Davor

2010-01-01

A telepsychiatry project was conducted to improve access to culturally appropriate care providers (i.e. culturally competent, bilingual clinicians) by the use of videoconferencing. A self-completed retrospective questionnaire survey was conducted with asylum seekers, refugees and migrants. The purpose of the referral was either for diagnostic assessment with a subsequent treatment recommendation, or for treatment via telepsychiatry. The service was free of charge for the patients involved. Over a period of 34 months (starting in January 2005), 61 patients participated in the pilot project. The patients' residency status was: refugees (n = 45), asylum seekers (n = 12), migrants (n = 3) and domestic (n = 1). A total of 318 telepsychiatry sessions (lasting 35-45 min) was conducted, with an average of 5.2 sessions per patient. Nine languages were spoken during the study period (Danish, Arabic, Farsi, Somali, Kurdish, Polish, Bosnian, Serbian and Croatian). A total of 52 patients completed the questionnaire. Patients reported a high level of satisfaction and willingness to use telepsychiatry again and recommend it to others. They preferred telepsychiatry via their mother tongue, rather than interpreter-assisted care.

Medical advocacy on behalf of detained immigrants.

PubMed

Venters, Homer D; Foote, Mary; Keller, Allen S

2011-06-01

Detention of immigrants by Immigration and Customs Enforcement (ICE) is a rapidly growing form of incarceration in the U.S. with almost 400,000 people detained in 2008 (Schriro in Immigration and Customs Enforcement, 2009, http://www.ice.gov/doclib/091005_ice_detention_report-final.pdf ). ICE detainees are predominantly from Mexico and Latin America and only a small minority of detainees are asylum seekers. Immigrant detainees lack a legal guarantee of medical care (unlike criminal arrestees and prisoners) and face challenges in receiving medical care, particularly those with chronic medical conditions (Venters and Keller in J Health Care Poor Underserved 20:951-957, 2009). Although we and others have long been involved in advocating for detained asylum seekers, few resources are dedicated to medical advocacy for the broader population of ICE detainees. At the NYU Center for Health and Human Rights (CHHR), a program of medical advocacy was initiated in 2007 on behalf of ICE detainees focused on improvement of care in detention and medical parole. Our preliminary efforts reveal a pressing need for more involvement by physicians and other health advocates in this area.

Health visiting and refugee families: issues in professional practice.

PubMed

Drennan, Vari M; Joseph, Judy

2005-01-01

This paper reports on the perceptions of experienced health visitors working with refugee families in Inner London. Women who are refugees and asylum seekers in the United Kingdom are more likely to experience depression than either non-refugee women or male asylum seekers. Health visitors provide a universal public health service to all women on the birth of a child, or with children aged under five, and as such are well placed to identify emotional and mental health problems of women who are refugees. Despite successive waves of refugees to the United Kingdom in the 20th century, there are no empirical studies of health visiting practice with this vulnerable group. There is also no body of evidence to inform the practice of health visitors new to working with asylum seekers and refugees. An exploratory study was undertaken in Inner London in 2001. Semi-structured interviews were conducted with a purposive sample of 13 health visitors experienced in working with women and families who are refugees. A range of structural challenges was identified that mediated against the development of a health-promoting relationship between health visitors and refugee women. With refugee families, who were living in temporary accommodation, health visitors were prioritizing basic needs that had to be addressed: in addition, they prioritized the needs of children before those of women. Health visitors were aware of the emotional needs of women and had strategies for addressing these with women in more settled circumstances. Health visitors considered themselves ill-prepared to deal with the complexities of working with women in these situations. This study identifies issues for further exploration, not least from the perspective of refugee women receiving health visiting services. Health visitors in countries receiving refugee women are framing their work with these women in ways that reflect Maslow's theory of a hierarchy of needs. This study suggests ways that public health nursing practice could be improved, and identifies issues for further study.

Using Group Work to Rebuild Family and Community Ties among Displaced African Men

ERIC Educational Resources Information Center

Akinsulure-Smith, Adeyinka M.

2012-01-01

The number of refugees and asylum seekers admitted to the United States has grown, with significant numbers arriving from sub-Saharan Africa. Given this reality, it is important that mental health professionals are equipped to provide culturally relevant services. This article describes the development and implementation of a group treatment model…

Visualizing Intercultural Literacy: Engaging Critically with Diversity and Migration in the Classroom through an Image-Based Approach

ERIC Educational Resources Information Center

Arizpe, Evelyn; Bagelman, Caroline; Devlin, Alison M.; Farrell, Maureen; McAdam, Julie E.

2014-01-01

Accessible forms of language, learning and literacy, as well as strategies that support intercultural communication are needed for the diverse population of refugee, asylum seeker and migrant children within schools. The research project "Journeys from Images to Words" explored the potential of visual texts to address these issues.…

Navigating Unfreedoms & Re-Imagining Ethical Counter-Conducts: Caring about Refugees & Asylum Seekers

ERIC Educational Resources Information Center

Sidhu, Ravinder

2017-01-01

This article uses Foucault's concept of the care of the self to interrogate the accounts of ethical agency provided by professionals involved in the settlement of refugees, in a global and national context marked by fear of the stranger and the embrace of neoliberal political rationalities. An argument is made to "free the professional…

A study of HIV positive undocumented African migrants' access to health services in the UK.

PubMed

Whyte, James; Whyte, Maria D; Hires, Kimberly

2015-01-01

Newly immigrated persons, whatever their origin, tend to fall in the lower socioeconomic levels. In fact, failure of an asylum application renders one destitute in a large proportion of cases, often resulting in a profound lack of access to basic necessities. With over a third of HIV positive failed asylum seekers reporting no income, and the remainder reporting highly limited resources, poverty is a reality for the vast majority. The purpose of the study was to determine the basic social processes that guide HIV positive undocumented migrant's efforts to gain health services in the UK. The study used the Grounded Theory Approach. Theoretical saturation occurred after 16 participants were included in the study. The data included reflections of the prominent factors related to the establishment of a safe and productive life and the ability of individuals to remain within the UK. The data reflected heavily upon the ability of migrants to enter the medical care system during their asylum period, and on an emerging pattern of service denial after loss on immigration appeal. The findings of this study are notable in that they have demonstrated sequence of events along a timeline related to the interaction between the asylum process and access to health-related services. The results reflect that African migrants maintain a degree of formal access to health services during the period that they possess legal access to services and informal access after the failure of their asylum claim. The purpose of this paper is to examine the basic social processes that characterize efforts to gain access to health services among HIV positive undocumented African migrants to the UK. The most recent estimates indicate that there are a total of 618,000 migrants who lack legal status within the UK. Other studies have placed the number of undocumented migrants within the UK in the range of 525,000-950,000. More than 442,000 are thought to dwell in the London metropolitan area. Even in cases where African migrants enter the UK legally, they often face considerable difficulty in their quest to gain legal employment due to barriers inherent to the system that grants work permits. With over a third of HIV positive failed asylum seekers reporting no income, and the remainder reporting highly limited resources, poverty is a reality for the vast majority.

Assessing reported cases of sexual and gender-based violence, causes and preventive strategies, in European asylum reception facilities.

PubMed

Oliveira, Charlotte; Keygnaert, Ines; Oliveira Martins, Maria do Rosário; Dias, Sónia

2018-05-09

Sexual and gender-based violence (SGBV) is a widespread public health problem and a violation of human rights rooted in gender and power inequities. Refugees, asylum-seekers and migrants living in European asylum reception facilities (EARF) are especially vulnerable to SGBV. To contribute to closing the gap on systematic and accurate evidence on SGBV, we aim to explore reported cases of SGBV, causes and preventable measures described by residents and professionals from EARF. We developed a cross-sectional study using the Senperforto project database. Semi-structured interviews were conducted with residents (refugees, asylum-seekers and unaccompanied minors) and professionals (service and health care providers) at EARF, in 7 European countries. We used IBM® SPSS software to analyze our data. Further, statistical tests - Chi-square Test and Fisher's exact test (5% significance level) were conducted. In total 562 respondents: 375 residents (R) and 187 professionals (P) participated in the study. The majority of respondents were male (56.9%), aged 19 to 39 years (67.3%). Respondents described 698 cases of SGBV (R 328, P 370), comprising 1110 acts of multi-types of violence. Respondents from Malta (160) and Belgium (143) reported the highest number of SGBV cases. The main reported causes were frustration and stress (R 23.6%, P 37.6%, p 0.008) and differences related with cultural background (R 19.3%, P 20.3%, p 0.884). Respondents assumed that these acts of violence could be prevented by SGBV prevention interventions (R 31.5%, P 24.7%, p 0.293); improving living conditions (R 21.7%, P 15.3%, p 0.232); and promoting communication (R 16.1%, P 28.2%, p 0.042). The majority of R were not aware of existing preventable measures in the asylum facility or host country. While the majority of P were aware of existing preventable measures in the asylum facility or country. Proposed SGBV prevention strategies in EARF included SGBV sensitization and awareness, improving living conditions and improving communication between R and P. In the EARF context, SGBV is characterized by multi-types of violence acts, yet R and P believe that prevention is possible. Our results call for urgent integrative prevention strategies that are in line with country-level and international regulations.

Returning to history: the ethics of researching asylum seeker health in Australia.

PubMed

Zion, Deborah; Briskman, Linda; Loff, Bebe

2010-02-01

Australia's policy of mandatory indefinite detention of those seeking asylum and arriving without valid documents has led to terrible human rights abuses and cumulative deterioration in health for those incarcerated. We argue that there is an imperative to research and document the plight of those who have suffered at the hands of the Australian government and its agents. However, the normal tools available to those engaged in health research may further erode the rights and well being of this population, requiring a rethink of existing research ethics paradigms to approaches that foster advocacy research and drawing on the voices of those directly affected, including those bestowed with duty of care for this population.

At Home, Song, and "Fika"--Portraits of Swedish Choral Initiatives amidst the Refugee Crisis

ERIC Educational Resources Information Center

de Quadros, Andre; Vu, Kinh T.

2017-01-01

With the unprecedented worldwide refugee crisis, to what extent can music play a role in welcoming? In particular, how does choral music have a role in mobilising communities, generating intercultural understanding, and lifting some of the barriers that confront refugees and asylum seekers? How can such activity be seen as a benefit to the…

"What We Might Become": The Lives, Aspirations, and Education of Young Migrants in the London Area

ERIC Educational Resources Information Center

Cooke, Melanie

2008-01-01

This article draws on three in-depth interviews with teenage migrants, two asylum seekers and one from Portugal. The interviews reveal experiences particular to young new arrivals attempting to find ways of being in a global city where they find themselves living in multicultural localities that are occasionally the sites of conflict as well as…

Compassion, Caring and Justice: Teachers' Strategies to Maintain Moral Integrity in the Face of National Hostility to the "Non-Citizen"

ERIC Educational Resources Information Center

Arnot, Madeleine; Pinson, Halleli; Candappa, Mano

2009-01-01

Refugees commonly have just one remaining identity--that of being stateless and statusless. They represent the ultimate "other in our midst". The humanism of our teachers in helping the children of asylum-seekers and refugees is tested by the state, especially its immigration policy. This paper offers preliminary research findings on…

"I Am a Human Being like You": An Identification Strategy to Maintain Continuity in a Cultural Contact Zone

ERIC Educational Resources Information Center

O'Sullivan-Lago, Ria; de Abreu, Guida; Burgess, Mark

2008-01-01

In this article, we discuss a qualitative study carried out in a cultural contact zone. Irish nationals, immigrants, and asylum seekers in Cork, Ireland, were interviewed about their cultural identities and future trajectories. Cultural Continuity theory was used as a model to offer an insight into the processes and strategies of the Dialogical…

Intercreativity: Mapping Online Activism

NASA Astrophysics Data System (ADS)

Meikle, Graham

How do activists use the Internet? This article maps a wide range of activist practice and research by applying and developing Tim Berners-Lee's concept of ‘intercreativity' (1999). It identifies four dimensions of Net activism: intercreative texts, tactics, strategies and networks. It develops these through examples of manifestations of Net activism around one cluster of issues: support campaigns for refugees and asylum seekers.

Unusual microorganisms and antimicrobial resistances in a group of Syrian migrants: Sentinel surveillance data from an asylum seekers centre in Italy.

PubMed

Angeletti, Silvia; Ceccarelli, Giancarlo; Vita, Serena; Dicuonzo, Giordano; Lopalco, Maurizio; Dedej, Etleva; Blasi, Aletheia; Antonelli, Francesca; Conti, Alessia; De Cesaris, Marina; Farchi, Francesca; Lo Presti, Alessandra; Ciccozzi, Massimo

2016-01-01

Three years of civil war in Syria have caused death and increase of communicable diseases. The suffering population has been forced to migrate creating a fertile condition for epidemic spread of infection within the refugee camps. Forty-eight Syrian migrants, upon their arrival in Italy, were accommodated at the asylum seekers centre of Castelnuovo di Porto. They received a physical examination and were subjected to microbiological surveillance by blood, rectal, pharyngeal and nasal swabs collection and delivering to the Clinical Pathology and Microbiology Laboratory of the University Campus Bio-Medico of Rome. All refugees resulted negative for HBV, HCV and HIV infections. In swabs a large number of unusual gram-negative bacteria species were isolated, such as Pseudomonas putida, Pseudomonas monteilii, Pseudomonas fulva, Pseudomonas moselii, Aeromonas veronii, Aeromonas caviae, Aeromonas hydrophila, Acinteobacter guilloviae, Acinteobacter lowffii; Acinetobacter johnsonii; Acinteobacter tjernbergae; Pantoea agglomerans; Pantoea calida. Among isolates, strains resistant to carbapenems, ESBL producers and methicillin resistant were found. The microbiological surveillance performed represents a useful action to understand refugees health status and to trace unusual microorganisms movement even carriers of antimicrobial resistance during migrants traveling. Copyright © 2016 Elsevier Ltd. All rights reserved.

Do resettlement variables predict psychiatric treatment outcomes in a sample of asylum-seeking survivors of torture?

PubMed

Whitsett, David; Sherman, Martin F

2017-12-01

Mental health clinicians who work with asylum seekers provide services to patients who face stressful everyday living conditions. However, little is known about how these problems potentially impact psychiatric treatment within these populations. The purpose of this study was thus to examine whether resettlement factors predict outcomes of a mental health intervention for a sample of asylum-seeking survivors of torture. The study included data from a US outpatient clinic that specialized in treating asylum-seeking survivors of torture. Patients (primarily from Iraq, Afghanistan and African Countries) were evaluated on demographic factors at intake and psychiatric symptoms throughout the course of treatment. Patients experienced significant reductions in depression, anxiety and trauma symptoms, although symptoms still remained near or above clinical thresholds. Stable, uncrowded housing conditions significantly predicted lower depression, anxiety and trauma symptoms at follow-up. These findings support the hypotheses that individuals seeking asylum within the United States who have survived torture can benefit from psychiatric treatment and emphasize the importance of stable living conditions in improving treatment effectiveness. This suggests the need for further research on social predictors of treatment outcomes, as well as the need for clinicians and policymakers to target improved housing as a potentially important tool to reduce psychiatric problems related to torture and forced migration.

Sexual and gender-based violence in the European asylum and reception sector: a perpetuum mobile?

PubMed

Keygnaert, Ines; Dias, Sonia F; Degomme, Olivier; Devillé, Walter; Kennedy, Patricia; Kováts, András; De Meyer, Sara; Vettenburg, Nicole; Roelens, Kristien; Temmerman, Marleen

2015-02-01

Refugees, asylum seekers and undocumented migrants are at risk of sexual and gender-based violence (SGBV) and subsequent ill-health in Europe; yet, European minimum reception standards do not address SGBV. Hence, this paper explores the nature of SGBV occurring in this sector and discusses determinants for 'Desirable Prevention'. Applying community-based participatory research, we conducted an SGBV knowledge, attitude and practice survey with residents and professionals in eight European countries. We conducted logistic regression using mixed models to analyse the data in R. Of the 562 respondents, 58.3% reported cases of direct (23.3%) or peer (76.6%) victimization. Our results indicate that when men were involved, it most likely concerned sexual perpetration (adjusted odds ratio [aOR]: 4.09, confidence interval [CI]: 1.2; 13.89) and physical victimization (aOR: 2.57, CI: 1.65; 4), compared with females, who then rather perpetrated emotional violence (aOR: 1.85, CI: 1.08; 3.13) and underwent sexual victimization (aOR: 7.14, CI: 3.33; 16.67). Compared with others, asylum seekers appeared more likely to perpetrate physical (aOR 7.14, CI: 4; 12.5) and endure socio-economic violence (aOR: 10, CI: 1.37; 100), whereas professionals rather bore emotional (aOR: 2.01, CI: 0.98; 4.12) and perpetrated socio-economic violence (aOR: 25.91, CI: 13.41; 50.07). When group perpetration (aOR: 2.13, CI: 1.27; 3.58) or victimization (aOR: 1.84, CI: 1.1; 3.06) occurred, it most likely concerned socio-economic violence. Within the European asylum reception sector, residents and professionals of both sexes experience SGBV victimization and perpetration. Given the lack of prevention policies, our findings call for urgent Desirable Prevention programmes addressing determinants socio-ecologically. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Wer kann, darf und soll bleiben?. Lokale Re-Konfigurationen im Fluchtmigrations- und Integrationsdiskurs

NASA Astrophysics Data System (ADS)

Engel, Susen; Deuter, Marie-Sophie

2018-04-01

The current discourse on a limitation of immigration is characterized by social and symbolic boundaries, that allow some statements about the (un)desirability of certain immigrants and asylum seekers. The article uses the example of the city of Altena to show how, based on strategic approaches to urban development, refugee migration and its impacts are (re) interpreted at the local level.

Preparing Teachers for Diversity: The Role of Initial Teacher Education. Executive Summary of the Final Report to DG Education, Youth, Sport and Culture of the European Commission

ERIC Educational Resources Information Center

European Commission, 2017

2017-01-01

Although the cultural, linguistic and religious diversity found in European societies is not a new phenomenon, its nature is rapidly changing. Europe is becoming increasingly diverse due to intra-European mobility, international migration, including recently an increased influx of refugees and asylum-seekers. These societal changes create both…

Wer kann, darf und soll bleiben? - Lokale Re-Konfigurationen im Fluchtmigrations- und Integrationsdiskurs

NASA Astrophysics Data System (ADS)

Engel, Susen; Deuter, Marie-Sophie

2018-03-01

The current discourse on a limitation of immigration is characterized by social and symbolic boundaries, that allow some statements about the (un)desirability of certain immigrants and asylum seekers. The article uses the example of the city of Altena to show how, based on strategic approaches to urban development, refugee migration and its impacts are (re) interpreted at the local level.

Management of breast cancer in an Asian man with post-traumatic stress disorder: a case report.

PubMed

Patel, Faaizah; Achuthan, Rajgopal; Hyklova, Lucie; Hanby, Andrew M; Speirs, Valerie

2016-03-29

Migration to the UK has increased considerably, which is reflected in the diverse multicultural population which includes asylum seekers and economic migrants. Differences in ethnic and cultural values between the host and newcomer populations could impact on effective health care provision, especially in gender-biased conditions such as breast cancer. Breast cancer is rare in men and the diagnosis is often met with disbelief. This case report describes an unusual case of breast cancer in an Afghan man who is an asylum seeker of Asian ethnic origin. A focused ethnographic case study and in-depth interview was used to gain qualitative data and insight into the personal experiences of a male Afghan asylum seeker, age unknown (estimated to be in his 30s), with post-traumatic stress disorder who was electively admitted into hospital for the investigation of a suspicious lump in his left breast, which was subsequently found to be breast cancer. He was extremely reluctant to accept a breast cancer diagnosis and initially would not consent to any treatment, preferring to seek further opinion. During consultation with various members of the breast team he continually declined to accept the diagnosis and felt there was an error in the investigative protocol. Through the involvement of a Muslim nurse, fluent in Urdu and knowledgeable of the Afghan culture and religious background, we learned about his experiences and feelings; he opened up to her about his experiences in Afghanistan, detailing his experiences of trauma as a result of war, and disclosing that he had been diagnosed as having post-traumatic stress disorder by his physician. He saw breast cancer as a "woman's disease" which deeply affected his feelings of masculinity and left him feeling vulnerable. While sensitivity is undoubtedly required when diagnosing gender-biased conditions such as breast cancer in men, our experience showed this is exacerbated in ethnic minority groups where language barriers often exist and awareness of cultural differences is required. Awareness of the possibility of post-traumatic stress disorder in migrant populations from conflict-torn areas is also recommended during consultation.

Detention and deception: limits of ethical acceptability in detention research.

PubMed

Minas, I H

2004-10-01

The core of Australia's response to asylum seekers who arrive in an unauthorised manner has been to detain them in immigration detention centres until they are judged to engage Australia's protection obligations or, if they do not, until they are returned to their country of origin. For a number of asylum seekers this has resulted in very prolonged detention. This policy has aroused a storm of controversy with very polarised positions being taken by participants in the debate. In particular, the claim has frequently been made (including by this author) that the circumstances and duration of immigration detention cause substantial harm to the mental health of a significant number of detained asylum seekers. A rational debate on the effects of detention has been hampered by the fact that the Australian government has not allowed researchers access to the detention centres in spite of persistent requests for access by professional bodies. This paper is written in response to the following questions posed by the Journal: Is there a case to be made for individuals agreeing to participate in research studies and for the wider population of current and future detainees to be involved in research without informing either the detention provider or the host nation? Is is legitimate for a researcher to engage in potentially deceptive actions in order to obtain access to such detention facilities to undertake research? What ethical framework should underpin such research? Although there is very little guidance in the literature on the ethical conduct of research in settings such as immigration detention centres, a consideration of the ethical implications of carrying out research in the manner raised by these questions leads this author to conclude that such research cannot be ethically justified. Governments must be persuaded to allow, and to provide substantial support for, ethically conducted research on all aspects of detention. There is also a need for the development of an explicit ethical framework for the conduct of research in settings characterised by a very problematic human rights context.

One psychiatrist's experience of visiting offshore processing centres for people seeking asylum in Australia.

PubMed

Adler, Robert

2016-02-01

To describe the author's experience of visiting Christmas Island and Nauru offshore detention centres as a visiting child and adolescent psychiatrist in the context of his own experience as a refugee from Europe after WWII. Following a visit to Nauru the author wrote to the Prime Minister and leader of the Opposition expressing his objections to the policies of recent Coalition and Labor Governments. His actions have led to the author not being invited to return to these centres as a visiting psychiatrist. The author acknowledges the importance of stopping the boats and proposes that a more humane approach is needed for asylum seekers who arrive by boat. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Beyond the Culture of Exclusion: Using Critical Race Theory to Examine the Perceptions of British "Minority Ethnic" and Eastern European "Immigrant" Young People in English Schools

ERIC Educational Resources Information Center

Thomas, Emel

2012-01-01

In England there are minority ethnic students with past family connections to the former British Empire, as well as recent Eastern European students, economic migrants, asylum seekers and refugees. One may wish to ask, do newly emerging racial identities conceptualise race and race relations in similar ways to existing minority ethnic communities?…

Ethnicity and Healthcare Practice - A Guide for the Primary Care Team Dyson Simon Culley Lorraine Ethnicity and Healthcare Practice - A Guide for the Primary Care Team 150 Quay Books 9781856423663 1856423662 [Formula: see text].

PubMed

2010-06-02

How could a book exploring culture and ethnicity not interest a nurse? Chapters cover ethnicity, the diversity of UK ethnic groups, managing diversity in health care, communication, the effects of disease on family and community, mental health, substance misuse and refugees and asylum seekers.

Screening for Infectious Diseases among Newly Arrived Migrants in EU/EEA Countries—Varying Practices but Consensus on the Utility of Screening

PubMed Central

Kärki, Tommi; Napoli, Christian; Riccardo, Flavia; Fabiani, Massimo; Dente, Maria Grazia; Carballo, Manuel; Noori, Teymur; Declich, Silvia

2014-01-01

Screening is one possible tool for monitoring infectious diseases among migrants. However, there is limited information on screening programmes targeted for newly arrived migrants in EU/EEA countries. Our aim was to investigate the implementation, practices and usefulness of these programmes. We conducted a survey among country experts from EU/EEA countries and Switzerland, asking whether their countries had implemented screening programmes. We also estimated the association between the implementation of these programmes and the rate of asylum-seekers in the population. Of the countries, 16 (59%) had implemented screening programmes and 15 (56%) had national guidelines. The rate of asylum-seekers was associated with implementation of screening programmes (p = 0.014). Screening was performed most often for tuberculosis; most commonly on holding level, and was targeted to specific migrant groups in over half of the countries performing screening. Twenty-five of all the country experts (96%) considered screening among migrants useful, and 24 (92%) would welcome EU level guidelines for screening. The implementation of screening programmes varied, and the practices were different among countries. Our survey suggests, that establishing EU level guidelines for screening would be useful, although they would have to take into account differences between individual countries. PMID:25337945

Active Tuberculosis Case Finding Interventions Among Immigrants, Refugees and Asylum Seekers in Italy

PubMed Central

Schepisi, Monica Sañé; Gualano, Gina; Piselli, Pierluca; Mazza, Marta; D’Angelo, Donatella; Fasciani, Francesca; Barbieri, Alberto; Rocca, Giorgia; Gnolfo, Filippo; Olivani, Piefranco; Ferrarese, Maurizio; Codecasa, Luigi Ruffo; Palmieri, Fabrizio; Girardi, Enrico

2016-01-01

In Italy tuberculosis (TB) is largely concentrated in vulnerable groups such as migrants and in urban settings. We analyzed three TB case finding interventions conducted at primary centers and mobile clinics for regular/irregular immigrants and refugees/asylum seekers performed over a four-year period (November 2009-March 2014) at five different sites in Rome and one site in Milan, Italy. TB history and presence of symptoms suggestive of active TB were investigated by verbal screening through a structured questionnaire in migrants presenting for any medical condition to out-patient and mobile clinics. Individuals reporting TB history or symptoms were referred to a TB clinic for diagnostic workup. Among 6347 migrants enrolled, 891 (14.0%) reported TB history or symptoms suggestive of active TB and 546 (61.3%) were referred to the TB clinic. Of them, 254 (46.5%) did not present for diagnostic evaluation. TB was diagnosed in 11 individuals representing 0.17% of those screened and 3.76% of those evaluated. The overall yield of this intervention was in the range reported for other TB screening programs for migrants, although we recorded an unsatisfactory adherence to diagnostic workup. Possible advantages of this intervention include low cost and reduced burden of medical procedures for the screened population. PMID:27403270

"Sharing One's Destiny": Effects of austerity on migrant health provisioning in the Mediterranean borderlands.

PubMed

Carney, Megan A

2017-08-01

Italy has been on the frontlines of the European Union's "migration crisis," intercepting hundreds of thousands of migrants and asylum-seekers at sea and on its shores. Yet it has lacked adequate resources to ensure humane reception, as other forms of welfare state provisioning have also been rolled back through recent and ongoing austerity measures enforced by the EU and the IMF. While Italians face fewer employment opportunities, lower pensions, and higher taxes, migrants of precarious legal status and asylum-seekers struggle to navigate the weakened bureaucratic apparatus of the Italian state, including the health system. Drawing on ethnographic fieldwork conducted in the Italian provinces of Lazio and Sicily in early 2014 and 2016, this article documents the imbricated economic and health struggles of Italian citizens and noncitizens, and alludes to lived experiences of and community responses to economic austerity characterizing much of the Mediterranean borderlands. I argue that marginalization by the state of both citizens and noncitizens in this setting undergirds some of the local and community responses to economic austerity. Moreover, I suggest that contemporary struggles in this geopolitical context intersect in important ways with the repercussions of austerity legacies that have contributed to widespread displacement in neighboring regions and subsequent migration into the EU. Copyright © 2017 Elsevier Ltd. All rights reserved.

Female genital mutilation/cutting in Italy: an enhanced estimation for first generation migrant women based on 2016 survey data.

PubMed

Ortensi, Livia Elisa; Farina, Patrizia; Leye, Els

2018-01-12

Migration flows of women from Female Genital Mutilation/Cutting practicing countries have generated a need for data on women potentially affected by Female Genital Mutilation/Cutting. This paper presents enhanced estimates for foreign-born women and asylum seekers in Italy in 2016, with the aim of supporting resource planning and policy making, and advancing the methodological debate on estimation methods. The estimates build on the most recent methodological development in Female Genital Mutilation/Cutting direct and indirect estimation for Female Genital Mutilation/Cutting non-practicing countries. Direct estimation of prevalence was performed for 9 communities using the results of the survey FGM-Prev, held in Italy in 2016. Prevalence for communities not involved in the FGM-Prev survey was estimated using to the 'extrapolation-of-FGM/C countries prevalence data method' with corrections according to the selection hypothesis. It is estimated that 60 to 80 thousand foreign-born women aged 15 and over with Female Genital Mutilation/Cutting are present in Italy in 2016. We also estimated the presence of around 11 to 13 thousand cut women aged 15 and over among asylum seekers to Italy in 2014-2016. Due to the long established presence of female migrants from some practicing communities Female Genital Mutilation/Cutting is emerging as an issue also among women aged 60 and over from selected communities. Female Genital Mutilation/Cutting is an additional source of concern for slightly more than 60% of women seeking asylum. Reliable estimates on Female Genital Mutilation/Cutting at country level are important for evidence-based policy making and service planning. This study suggests that indirect estimations cannot fully replace direct estimations, even if corrections for migrant socioeconomic selection can be implemented to reduce the bias.

Psychological evaluation of asylum seekers as a therapeutic process.

PubMed

Gangsei, David; Deutsch, Anna C

2007-01-01

Torture survivors are often reluctant to tell their stories. They typically make every effort to forget this painful, traumatic experience. Often they do not share with family, friends or healthcare professionals the fact that they have been beaten, raped or subjected to electrical shocks and other terrors. Talking means retrieving memories, triggering the feelings and emotions that accompanied the torture itself. Furthermore, refugee torture survivors feel that people won't understand or believe their experiences. However, survivors who escape their country may need to reveal their torture experience as they apply for asylum in the host country. When they prepare for the asylum process, it may well be the first time that they talk about the torture. Mental health professionals are often called upon to evaluate survivors and prepare affidavits for the asylum process, documenting the effects of torture. This creates a unique and priviliged opportunity to help survivors to address the devastating consequences of torture. Winning asylum is essential to recovery for a torture survivor in a country of refuge. Psychological evaluations of the consequences of torture can present information and evidence to asylum adjudicators which significantly increases understanding of the survivors' background and experiences as well as their manner of self-presentation in the courtroom or interview. They can empower the torture survivor to present his/her experiences more fully and confidently. Even apart from winning asylum, the process of the evaluation has many potential benefits for the survivor's emotional well-being. This includes helping the survivor understand the necessity of telling the story, illuminating the often poorly perceived link between current emotional suffering and past torture, facilitating the development of cognitive and emotional control, and healing the wounds of mistrust, humiliation, marginalization and fear.

Demographic Trends in the European Union: Political and Strategic Implications

DTIC Science & Technology

2004-06-01

male attitudes if they do not. What is happening in Italy, Spain and Japan is the war of women against male chauvinism . Women are winning. If the...light of the unfunded pension liabilities in most European countries. Small cohorts of draft-age males will mean that European countries, including...banning head scarves for public school teachers .52 Moreover, In the Netherlands, long a haven for tolerance, 26,000 mostly Muslim asylum seekers are

The mental health and wellbeing of first generation migrants: a systematic-narrative review of reviews.

PubMed

Close, Ciara; Kouvonen, Anne; Bosqui, Tania; Patel, Kishan; O'Reilly, Dermot; Donnelly, Michael

2016-08-25

First generation migrants are reportedly at higher risk of mental ill-health compared to the settled population. This paper systematically reviews and synthesizes all reviews on the mental health of first generation migrants in order to appraise the risk factors for, and explain differences in, the mental health of this population. Scientific databases were searched for systematic reviews (inception-November 2015) which provided quantitative data on the mental ill-health of first generation migrants and associated risk factors. Two reviewers screened titles, abstracts and full text papers for their suitability against pre-specified criteria, methodological quality was assessed. One thousand eight hundred twenty articles were identified, eight met inclusion criteria, which were all moderate or low quality. Depression was mostly higher in first generation migrants in general, and in refugees/asylum seekers when analysed separately. However, for both groups there was wide variation in prevalence rates, from 5 to 44 % compared with prevalence rates of 8-12 % in the general population. Post-Traumatic Stress Disorder prevalence was higher for both first generation migrants in general and for refugees/asylum seekers compared with the settled majority. Post-Traumatic Stress Disorder prevalence in first generation migrants in general and refugees/ asylum seekers ranged from 9 to 36 % compared with reported prevalence rates of 1-2 % in the general population. Few studies presented anxiety prevalence rates in first generation migrants and there was wide variation in those that did. Prevalence ranged from 4 to 40 % compared with reported prevalence of 5 % in the general population. Two reviews assessed the psychotic disorder risk, reporting this was two to three times more likely in adult first generation migrants. However, one review on the risk of schizophrenia in refugees reported similar prevalence rates (2 %) to estimates of prevalence among the settled majority (3 %). Risk factors for mental ill-health included low Gross National Product in the host country, downward social mobility, country of origin, and host country. First generation migrants may be at increased risk of mental illness and public health policy must account for this and influencing factors. High quality research in the area is urgently needed as is the use of culturally specific validated measurement tools for assessing migrant mental health.

The effects of perceived torture controllability on symptom severity of posttraumatic stress, depression and anger in refugees and asylum seekers: A path analysis.

PubMed

Le, Lillian; Morina, Naser; Schnyder, Ulrich; Schick, Matthis; Bryant, Richard A; Nickerson, Angela

2018-06-01

Torture is associated with greater psychopathology, however, the specific mechanisms underlying the effects of torture remain unclear. Research suggests that the perceived uncontrollable nature of, rather than the exposure to, torture, influences the development of psychological disorders. Perceived distress during torture has also been shown to influence psychological outcomes. This cross-sectional study explored the relationship between perceived torture controllability, emotions (i.e., anger and fear) during torture, and current posttraumatic stress (PTS), depression and anger symptoms, controlling for the effects of post-migration living difficulties. Data were collected from 108 refugees and asylum seekers in treatment at two psychiatric clinics in Zurich, Switzerland. Path analyses revealed negative correlations between PTS, depression and anger symptoms, and perceived torture controllability, and positive correlations with anger and fear during torture. Furthermore, the effects of perceived torture controllability on PTS and depression symptoms were mediated by fear during torture, and on anger symptoms via anger during torture. This was over and above the effects of post-migration living difficulties on psychological symptoms. The study provides preliminary evidence that perceived uncontrollability and distress during torture might be significant risk factors for current mental health of torture survivors. These findings may have implications for informing interventions for torture survivors. Copyright © 2018 Elsevier B.V. All rights reserved.

The Effects of the Refugee Crisis on Age Estimation Analysis over the Past 10 Years: A 16-Country Survey

PubMed Central

Sykes, Leanne; Bhayat, Ahmed; Bernitz, Herman

2017-01-01

Dental age estimation (AE) tests are routinely done on living and deceased persons. There is anecdotal evidence suggesting an increase in age estimations due to the refugee crisis. Our aim is to determine the reasons and methods for performing dental AE tests in both living and deceased individuals. Global trends in AE over the past 10 years were also investigated. A database of all forensic laboratories was obtained and an electronic questionnaire was sent to all of them. The questionnaire was self-developed and included questions on the reasons for performing AE tests, the preferred methods used in living and deceased individuals, and the people/organizations who requested these AE tests. The number of tests performed annually varied between 0 and 500 and the majority were on asylum seekers, refugees, and for adoption cases. Most units used multiple techniques to determine the age among the living, but seldom used more than three techniques for the deceased. The majority of tests were requested by coroners and the legal fraternity. There has been an increase in the number of dental AEs carried out and this has been mostly due to asylum seekers and refugees. The most common techniques for the living were variations of Demirjian’s technique while country specific techniques were used for the deceased. PMID:28608845

[Health care of refugees in 2015 - Evaluation of an ambulance for refugees in a Cologne emergency accommodation (Cologne Model)].

PubMed

Borgschulte, H S; Bunte, A; Neuhann, F; Weber, L T; Wiesmüller, G A

2016-12-01

Access to medical care is a core element in the care of refugees and asylum seekers, and should therefore be guaranteed in a barrier-free way. In practice, there are usually numerous access barriers and the first contact with the German Health Care System takes place in form of a statutory examination to exclude infectious diseases. In addition to the introduction of health insurance cards for refugees, an offer of medical consultation for several hours a week in the municipal emergency accommodations provides an opportunity for low threshold access to primary care and a bridging function to the integration into the regular health care system. This offer is independent of the obligatory initial examination according to § 62 Asylum Law (AsylG) 1. The evaluation of the first year of such a health care center is presented. © Georg Thieme Verlag KG Stuttgart · New York.

The role of social support in the acculturation and mental health of unaccompanied minor asylum seekers.

PubMed

Oppedal, Brit; Idsoe, Thormod

2015-04-01

There is a lack of knowledge about psychosocial resources that may sustain post-resettlement psychological adjustment among unaccompanied minor asylum-seekers. The aim of this study is to investigate the impact of social support from family abroad and friends on acculturation, discrimination, and mental health among these vulnerable children and youth. Questionnaire data were collected from a population-based multi-ethnic sample involving 895 unaccompanied minors resettled in municipalities in all regions of the country. They met in groups in their local communities. The informants were on average 18.6 years, and had an average length of stay in Norway of 3.5 years. The findings showed that the participants suffered from high levels of ongoing war related intrusive symptoms and depression. Still, at the same time they engaged in adaptation processes that are normative to youth with immigrant backgrounds, in terms of constructing supportive networks and developing culture competence. In accordance with the main effect hypothesis, social support had direct effects on depression and indirect effects by increasing culture competence that may aid the young refugees in dealing with discrimination. However, there were no effects of social support on symptoms of PTSD. The findings give direction to areas of interventions, beyond dealing with the sequel of the traumas the unaccompanied minors have been exposed to, not only for clinicians, but also social workers and school personnel. © 2015 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Health profile and disease determinants among asylum seekers: a cross-sectional retrospective study from an Italian reception centre.

PubMed

Russo, Gianluca; Vita, Serena; Miglietta, Alessandro; Terrazzini, Nadia; Sannella, Alessandra; Vullo, Vincenzo

2016-06-01

Data on diseases' determinants and health status of asylum seekers (ASs) are limited. We performed a cross-sectional retrospective study in a large ASs centre in Italy. Data were collected during a 1-year period. Descriptive statistics were calculated. A χ(2) test was used to assess the association between socio-demographics characteristics of ASs and screening test results. A multiple logistic regression analysis was performed to identify diseases' predictors by using ICD-10 diagnoses classification as outcome variable, socio-demographic characteristics as independent variable and visits' number as confounding variable. Overall, data on 792 ASs (mean age 27 years, 80% males, 58% from Africa) were assessed, 43% underwent voluntary infectious diseases screening and 2843 diagnoses were recorded. The most frequent diagnoses were: respiratory diseases, symptoms/signs not elsewhere classified, digestive diseases and infectious diseases. Gender was the most frequent predictor of ICD-10 diagnoses, while African origin, civil status and education were, respectively, predictive of cardiovascular and infectious diseases, genitourinary diseases and pregnancy-related disorders. Higher mean age was associated with syphilis, HIV and HCV infection and African origin with HIV infection. Communicable diseases were not prevalent in the ASs population we analysed. A stronger cultural mediation support is needed to facilitate prevention, access and continuity of care for ASs. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Father-involvement in a refugee sample: relations between posttraumatic stress and caregiving.

PubMed

van Ee, Elisa; Sleijpen, Marieke; Kleber, Rolf J; Jongmans, Marian J

2013-12-01

Despite increased attention to the role of fathers within families, there is still a dearth of studies on the impact of trauma on father-involvement. This study investigates the quantity of father-involvement and the influence of posttraumatic stress on the quality of involvement in a refugee and asylum seeker population. Eighty refugees and asylum seekers and their young children (aged 18-42 months) were recruited. Measures included assessment of parental trauma (Harvard Trauma Questionnaire), quantity and quality of involvement (quantity of caregiving and Emotional Availability Scales), and perception of the father-child relationship (interview). The results show that fathers were less involved in caregiving tasks and play activities than mothers. No parental gender differences were found on each of the Emotional Availability Scales. Traumatic stress symptoms negatively affected the perception and the actual quality of parent-child interaction (sensitivity, structuring, nonhostility). Nevertheless, almost all fathers described their relationship with their child as good and their child as very important to them. As the quality of father-involvement is of importance to the development of the child, traumatized fathers are as much in need of clinical intervention as mothers. Despite the impact of posttraumatic stress, refugee fathers clearly are involved in the lives of their children. Mechanisms such as a deliberate withdrawal when stressed and compensation might enable affected fathers to step into the interaction when needed, raise the quality of involvement with their child, and diminish the negative impact of stress resulting from trauma and migration. © FPI, Inc.

Subjective Social Status in select Ukrainians, Vietnamese, and Mongolians living in the Czech Republic.

PubMed

Vacková, Jitka; Veleminsky, Milos; Brabcová, Iva; Záleská, Veronika

2014-01-01

This article discusses methods of examining subjective social status (SSS), which is based on the concept of social determinants of health described by Wilkinson and Marmot in 1998. SSS research was conducted with Cooperation from the Scientific and Technical Research (COST) program, with financial support from the Czech Ministry of Education, Youth and Sports. This study is part of a project entitled the "Health and Social Status of Immigrants and Asylum Seekers in the Czech Republic" (registration number OC 10031), which was started in 2010 and concluded in May 2011. The study included 246 respondents of which: 69 (28.1%) had emigrated from Vietnam; 93 (37.8%) from the Ukraine; and 84 (34.1%) from Mongolia. In terms of qualitative strategies, 13 individual immigrants and asylum seekers were personally interviewed. This research was thus conceived as being both quantitative-qualitative, which included the use of the appropriate technical tools (i.e., questionnaires and interviews with select immigrants and asylum seekers). SSS was determined using the Pearson's chi-square test, as well as through correspondence and cluster analyzes. Sign schemes were used to detect select significant relationships in contingency tables. The minimum significance level chosen was α ≤ 0.05. When examining the SSS of select nationalities, differences were observed in the perception of subjective social status. The correspondence analysis results clearly show that Ukrainians best perceived their social status (within the selected parameters). One measure of subjectively perceived social status related to Czech language proficiency (i.e., one criterion was the comprehension of spoken Czech; e.g., whether the respondent could read or speak Czech, or how they assessed their own Czech proficiency). The SSS study clearly revealed typical links among select nationalities living in the Czech Republic, and highlighted risks related to the degree of integration (and its relationship to social exclusion). This study served as a pilot project for follow-up research conducted by the second COST project entitled: "Social Determinants of Health and their Impact on the Health of Immigrants Living in the Czech Republic" (registration number LD 13044 COST). The follow-up study included 1 000 respondents of Slovak, Vietnamese, Ukrainian, Russian and Polish nationality and is currently underway at the Faculty of Health and Social Studies at the University of South Bohemia in the Czech Republic. The methodological tools used were taken from the COST pilot project (which is the topic of this article) and were adjusted as needed (i.e., both objective and subjective criteria were used for examining social status).

Alien smuggling: East to West.

PubMed

Walsh, J H

1987-01-01

This year untold millions of illegal aliens will enter Western Europe, Canada, and the US; in 1986, the US alone made 1.7 million apprehensions. Because of the numbers involved and the hard currency exchanged, alien smuggling has become big business--a lucrative track in desparate human beings. West Germany's open door asylum policy has been a boon to the smugglers, and West Berlin is currently a favored port of entry. The government provides social benefits--apartments, food, a stipend, and clothing--for asylum seekers. Smuggling operations appear to fit 3 categories: 1) state-sponsored alien smugglers, with a sub-category of terrorists; 2) ethnic smugglers with a history of terrorist spinoffs; and 3) independent smugglers, who are profit oriented, and willing to handle ethnic aliens and terrorists. In West Germany, immigration investigations begin at the border. West German officials often know that as they cause the Eastern border to be tightened, the flow will gravitate south toward Austria. Redirecting the trasit of Third Worlders from East Berlin away from West Germany, Sweden, and Denmark will be a stop-gap measure at best. Part of West Germany's immigration problem can be traced to the Basic Law that provides asylum for those who claim persecution (political, racial, ethnic, or religious). Yet, any attempt to change asylum would result in an admission of defeat in the quest for a unified Germany. Should Austria move to tighten its immigration laws, agreements similar to those between East and West Germany will likely follow.

The psychiatric profession and the Australian government: the debate over collective depression syndrome among asylum-seeking detainees

PubMed Central

Bostock, William W

2009-01-01

Psychiatrists have long had involvement with the political process, both individually and as a profession. They have made valuable contributions to debate over such issues as war, conflict, terrorism, torture, human rights abuse, drug abuse, suicide and other public health issues. However, they have also been complicit in some gross atrocities. Over several years there has been debate over the Australian Government’s treatment of asylum seekers, and the Royal Australian and New Zealand College of Psychiatrists took the unusual step of publicly criticizing the Australian Government’s policy on grounds of its toxicity leading to a diagnosis of collective depression syndrome, particularly among child detainees, but also adult detainees. The official Ministerial response was to deny that collective depression exists and to assert that the concept is meaningless. Can this intervention by psychiatrists be interpreted as a product of earlier political behaviors by psychiatrists? The willingness of psychiatrists to cooperate with other professions, notably psychologists, pediatricians, physicians and lawyers, is noted, as is presence of minority voices within the Australian psychiatric profession. The significance of the debate over the mental condition of asylum-seeking detainees is that its outcome has implications for how Australia sees itself and is seen by the rest of the world, that is, its national identity. PMID:22110326

Main topics in transcultural psychiatric research in the Netherlands during the past decade.

PubMed

Laban, Cornelis J; van Dijk, Rob

2013-12-01

The population of the Netherlands has become increasingly diverse in terms of ethnicity and religion, and anti-immigrant attitudes have become more apparent. At the same time, interest in issues linked to transcultural psychiatry has grown steadily. The purpose of this article is to describe the most important results in Dutch transcultural psychiatric research in the last decade and to discuss their relationship with relevant social and political developments in the Netherlands. All relevant PhD theses (N = 27) between 2000 and 2011 were selected. Screening of Dutch journals in the field of transcultural psychiatry and medical anthropology and a PubMed query yielded additional publications. Forensic and addiction psychiatry were excluded from this review. The results of the review indicate three main topics: (a) the prevalence of psychiatric disorders and their relation to migration issues as social defeat and ethnic density, showing considerable intra- and interethnic differences in predictors and prevalence rates, (b) the social position of refugees and asylum seekers, and its effect on mental health, showing especially high risk among asylum seekers, and (c) the patterns of health-seeking behaviour and use of mental health services, showing a differentiated picture among various migrant groups. Anthropological research brought additional knowledge on all the above topics. The overall conclusion is that transcultural psychiatric research in the Netherlands has made a giant leap since the turn of the century. The results are of international importance and invite redefinition of the relationship between migration and mental health, and reconsideration of its underlying mechanisms in multiethnic societies.

Outcomes analysis of new entrant screening for active tuberculosis in Heathrow and Gatwick airports, United Kingdom 2009/2010.

PubMed

Severi, Ettore; Maguire, Helen; Ihekweazu, Chikwe; Bickler, Graham; Abubakar, Ibrahim

2016-04-22

In 2012, the United Kingdom (UK) Government announced that the new entrant screening for active tuberculosis (TB) in Heathrow and Gatwick airports would end. Our study objective was to estimate screening yield and diagnostic accuracy, and identify those at risk of active TB after entry. We designed a retrospective cohort study and linked new entrants screened from June 2009 to September 2010 through probabilistic matching with UK Enhanced TB Surveillance (ETS) data (June 2009 to December 2010). Yield was the proportion of cases reported to ETS within three months of airport screening in the screened population. To estimate screening diagnostic accuracy we assessed sensitivity, specificity, positive and negative predictive values. Through Poisson regression we identified groups at increased risk of TB diagnosis after entry. We identified 200,199 screened entrants, of these 59 had suspected TB at screening and were reported within 3 months to ETS (yield = 0.03 %). Sensitivity was 26 %; specificity was 99.7 %; positive predictive value was 13.2 %; negative predictive value was 99.9 %. Overall, 350 entrants were reported in ETS. Persons from countries with annual TB incidence higher than 150 cases per 100,000 population and refugees and asylum seekers were at increased risk of TB diagnosis after entry (population attributable risk 77 and 3 % respectively). Airport screening has very low screening yields, sensitivity and positive predictive value. New entrants coming from countries with annual TB incidence higher than 150 per 100,000 population, refugees and asylum seekers should be prioritised at pre- or post-entry screening.

Explaining Australian immigration.

PubMed

Betts, K

1996-11-01

"This article reviews the post-Second World War literature on explanations for Australia's immigration program. It discovers three main schools of thought based on net pull factors: the official explanation and two unofficial explanations which focus on migrants as workers and on migrants as consumers. However the growing importance of net push factors after 1974 means that some of this work is less relevant today. Explanations focusing on net push factors have yet to cohere into a distinct perspective (or perspectives) but some research has been done on chain migration and family-based migration strategies, asylum seekers, temporary movement, and migration and the law." excerpt

Limited access to hepatitis B/C treatment among vulnerable risk populations: an expert survey in six European countries.

PubMed

Falla, Abby M; Veldhuijzen, Irene K; Ahmad, Amena A; Levi, Miriam; Hendrik Richardus, Jan

2017-04-01

To investigate access to treatment for chronic hepatitis B/C among six vulnerable patient/population groups at-risk of infection: undocumented migrants, asylum seekers, people without health insurance, people with state insurance, people who inject drugs (PWID) and people abusing alcohol. An online survey among experts in gastroenterology, hepatology and infectious diseases in 2012 in six EU countries: Germany, Hungary, Italy, the Netherlands, Spain and the UK. A four-point ordinal scale measured access to treatment (no, some, significant or complete restriction). From 235 recipients, 64 responses were received (27%). Differences in access between and within countries were reported for all groups except people with state insurance. Most professionals, other than in Spain and Hungary, reported no or few restrictions for PWID. Significant/complete treatment restriction was reported for all groups by the majority in Hungary and Spain, while Italian respondents reported no/few restrictions. Significant/complete restriction was reported for undocumented migrants and people without health insurance in the UK and Spain. Opinion about undocumented migrants in Germany and the Netherlands was divergent. Although effective chronic hepatitis B/C treatment exists, limited access among vulnerable patient populations was seen in all study countries. Discordance of opinion about restrictions within countries is seen, especially for groups for whom the health care system determines treatment access, such as undocumented migrants, asylum seekers and people without health insurance. This suggests low awareness, or lack, of entitlement guidance among clinicians. Expanding treatment access among risk groups will contribute to reducing chronic viral hepatitis-associated avoidable morbidity and mortality. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association.

Psychiatric care in restricted conditions for work migrants, refugees and asylum seekers: experience of the Open Clinic for Work Migrants and Refugees, Israel 2006.

PubMed

Lurie, Ido

2009-01-01

In the last few decades, the State of Israel has become a target for work migrants, refugees, asylum seekers and victims of human trafficking, as part of the trend of world immigration. Immigration is a process of loss and change with significant socio-psychological stress, with possible effects on the immigrants' mental health. The Physicians for Human Rights - Israel (PHR) Association operates a psychiatric clinic as part of the Open Clinic for Work Migrants and Refugees. This article will present major clinical issues regarding psychiatry and immigration in Israel according to the data collected at the clinic. Trauma and stress-related psychopathology was found to have a high prevalence in immigrant patients treated at the clinic; prevalence of PTSD (post-traumatic stress disorder) in immigrants was high (23%) and even higher in refugees (33%). Female immigrants are at higher risk for psychiatric hospitalization. The relative rate of African patients at the clinic is significantly higher than patients from other continents. A significant association was found between psychiatric hospitalization and suicide attempts. Immigrant patients present a combination of psychiatric, socio-economic and general medical conditions, which demands a holistic view of the patient. The evaluation of an immigrant patient must take into account the stress related to immigration, gender, culture of origin and the risk for suicide and hospitalization. Treatment recommendations include awareness of cultural diversities, acquiring information regarding the pre-immigration history, preferably using cultural consultants with background in the immigrants' culture and community. Decision-making about medication and diagnostic evaluation should be as inexpensive as possible. Basic human needs (food, shelter) and family support should be included in the decisions about treatment.

The Australasian Society for Infectious Diseases and Refugee Health Network of Australia recommendations for health assessment for people from refugee-like backgrounds: an abridged outline.

PubMed

Chaves, Nadia J; Paxton, Georgia A; Biggs, Beverley-Ann; Thambiran, Aesen; Gardiner, Joanne; Williams, Jan; Smith, Mitchell M; Davis, Joshua S

2017-04-17

In 2009, the Australasian Society of Infectious Diseases published guidelines on the post-arrival health assessment of recently arrived refugees. Since then, the number of refugees and asylum seekers reaching Australia has increased substantially (17 555 refugees in 2015-16) and the countries of origin have changed. These groups are likely to have had poor access to health care pre-arrival and, consequently, are at risk of a range of chronic and infectious diseases. We established an advisory group that included infectious diseases physicians, general practitioners, public health specialists, paediatricians and refugee health nurses to update the 2009 guidelines.Main recommendations: All people from refugee-like backgrounds, including children, should be offered a tailored comprehensive health assessment and management plan, ideally within 1 month of arrival in Australia. This can be offered at any time if initial contact with a GP or clinic is delayed. Recommended screening depends on history, examination and previous investigations, and is tailored based on age, gender, countries of origin and transit and risk profile. The full version of the guidelines is available at http://www.asid.net.au/documents/item/1225.Changes in management as a result of this guideline: These guidelines apply to all people from refugee-like backgrounds, including asylum seekers. They provide more information about non-communicable diseases and consider Asia and the Middle East as regions of origin as well as Africa. Key changes include an emphasis on person-centred care; risk-based rather than universal screening for hepatitis C virus, malaria, schistosomiasis and sexually transmissible infections; updated immunisation guidelines; and new recommendations for other problems, such as nutritional deficiencies, women's health and mental health.

Assessing chronological age of unaccompanied minors in southern Italy.

PubMed

Nuzzolese, Emilio; Solarino, Biagio; Liuzzi, Claudia; Di Vella, Giancarlo

2011-09-01

The increasing volume of, and subsequent complexities resulting from, migratory flows in the broader context of globalization has led to a range of problems, not only the protection of human rights and disease control but also the identification of those with the right to apply for refugee status and the age assessment of unaccompanied minors. Italy is a magnet for immigration from other countries bordering the Mediterranean Sea because the Italian coasts are within easy reach. In Italy, as in other western countries, unaccompanied asylum seekers deemed to be younger than 18 years face a very different path through the immigration system from that experienced by adults. Generally, adults are subject to immediate deportation or detention in jail. Minors are processed through the juvenile system, where detection is not mandatory; they will often have access to educational programs and may be granted a residency permit. The Section of Legal Medicine of the University of Bari was approached by immigration police authorities and judges to explore the possibility of examining unaccompanied asylum seekers, who claim do be younger than 18 years, to assess their age. A group of forensic pathologists and odontologists performed this evaluation relying on the skeletal maturation as seen on radiographs of the wrist and the pelvis for iliac crests and on an orthopantomograph, together with background information and clinical examination of each individual. Case studies are presented. This article does not attempt to give a definitive account of the different scientific methods for the assessment of age. It is important to understand some of the methods that may be used in an attempt to assess developmental maturity and from which it may be possible to "read off" an approximate chronological age.

[Medical Treatment of Newly Arrived Refugees in Erlangen: A Study of Drug Prescription Rates Focused on Psychotropic Drugs].

PubMed

Kahl, Fabian; Frewer, Andreas

2017-04-01

Background: In 2015 the number of refugees who sought asylum in Germany has increased dramatically. Therefore, the medical care for these refugees faces huge challenges. The treatment of mental illness of refugees is a particular difficult topic. Objective of this study is the acquisition of the outpatient prescriptions of drugs for newly arrived refugees in Erlangen, focused on psychotropic drugs. Methods: Evaluation of all outpatient prescribed drugs (n=1 137), which were prescribed between 10/01/2014 and 09/30/2015 for asylum seekers living in the refugee center in Erlangen, a branch of the "Central Admission Institution" ("ZAE") Zirndorf. Funding organization of this treatment is the City of Erlangen. Settlement documents of the City of Erlangen were used for the analysis. Results: The prescribed drugs cover the spectrum of acute primary care. Big parts of the prescription rates are antiinfectives (ATC-Code: J), medication for the respiratory system (ATC: R), as well as non-steroidal anti-inflammatory drug (NSAID's: ibuprofen, paracetamol, metamizole). The prescription of psychotropic drugs is relatively underrepresented. © Georg Thieme Verlag KG Stuttgart · New York.

“Son of the Soil … Daughters of the Land”: poetry writing as a strategy of citizen-making for lesbian, gay, and bisexual migrants and asylum seekers in Johannesburg

PubMed Central

Dill, LeConté J.; Vearey, Jo; Oliveira, Elsa; Castillo, Gabriela Martínez

2016-01-01

abstract South Africa’s Constitution, Bill of Rights, and Freedom Charter are globally ground-breaking for providing provisions of non-discrimination, and, of particular note, on the basis of sexual orientation. Since the introduction of these protective frameworks, lesbian, gay, bisexual, transgender, intersex, and queer (LGBTIQ) communities, allies, and advocates in the country have won major legal battles on these issues; however, in spite of these successes, LGBTIQ communities continue to face hostility and violence. As a result, South African LGBTIQ individuals often travel to urban centres, such as Johannesburg, in the hope that these spaces will be more tolerant of their sexual orientation and gender identity; the reality, however, suggests otherwise. Moreover, despite South Africa’s designation as a safe haven for LGBTIQ communities, migrants from other African countries — where same-sex relationships are criminalised — are overwhelmingly met with xenophobic verbal, emotional, physical, and political violence. This article describes the authors’ engagement with nine lesbian, gay and bisexual (LGB) migrants and asylum seekers from Zimbabwe, Malawi, and elsewhere in South Africa during a weeklong poetry workshop exploring their lived experiences in Johannesburg. This workshop followed a body mapping and narrative writing workshop held previously with the same participants. This article investigates the themes identified from the body mapping process that guided the poems produced: migration, violence, citizenship, and freedom. The poetry created during the workshop illuminates how lesbian, gay, and bisexual migrants in Johannesburg work on a daily basis to build social trust as they demand to be seen and recognised, to enact their rights, to make and remake homes, to show up in public as Black people, as LGB individuals, and as human beings. We explore these strategies of citizen-making as informed by the LGB poets with whom we had the opportunity to work. PMID:28058030

Risk Factors and Health Profiles of Recent Migrant Women Who Experienced Violence Associated with Pregnancy

PubMed Central

Gagnon, Anita J.; Merry, Lisa A.; Dennis, Cindy-Lee

2012-01-01

Abstract Background Violence associated with pregnancy is a major public health concern, but little is known about it in recent migrant women. This study looked at (1) risk factors for violence associated with pregnancy among newly arrived migrant women in Canada and (2) if those who experienced violence associated with pregnancy had a different health profile or use of healthcare services for themselves or their infants during pregnancy and up to 4 months postpartum compared to other childbearing migrant women. Methods Pregnant migrant women in Canada <5 years were recruited in 12 hospitals in 3 large cities between 2006 and 2009 and followed to 4 months postpartum. Data were collected on maternal background, migration history, violence associated with pregnancy, maternal and infant physical and mental health, and services used. Results Of a total of 774 pregnant migrant women, 59 (7.6%) women reported violence associated with pregnancy. Migrant women who experienced violence, compared to those who did not, were at increased risk of violence if they lived without a partner, were asylum seekers, migrated <2 years ago, or had less than high school education. Women who reported violence were less likely to have up-to-date vaccinations, take folic acid before pregnancy, more likely to commence prenatal care after 3 months gestation and to not use contraceptives after birth. They were also more likely to have a history of miscarriage and report more postpartum pain and increased bleeding. They were also more likely to have inadequate social support and report more depression, anxiety, somatization, and posttraumatic stress disorder (PTSD) on standardized tests. No differences were found in the health status of the infants of women who experienced violence compared to those who did not. Conclusions Clinicians should sensitively ask recent migrant women (asylum seekers, refugees, and nonrefugee immigrants) about violence associated with pregnancy and appropriately assess, treat, and refer them. PMID:22900928

[Health disparities: local realities and future challenges].

PubMed

Bodenmann, P; Green, A R

2012-11-28

Since 1887, the Policlinique Médicale Universitaire (PMU) has brought care to vulnerable populations who are at risk of poor physical, mental and social health. These include marginalised Swiss natives and immigrant communities (asylum seekers, undocumented immigrants). These patients are at risk of health disparities given their poor access to the health care system and lack of adapted quality care. Clinical approach must address these potential disparities, reinforced by a research describing them in order to explain their cause, and propose possible solutions, and a medical training addressing these topics from the undergraduate to the attending level. Through those holistic clinical approach, robust research and improved medical training, health providers will contribute to give quality care to all citizens, without exception!

Migration and AIDS.

PubMed

1998-01-01

This article presents the perspectives of UNAIDS and the International Organization for Migration (IOM) on migration and HIV/AIDS. It identifies research and action priorities and policy issues, and describes the current situation in major regions of the world. Migration is a process. Movement is enhanced by air transport, rising international trade, deregulation of trade practices, and opening of borders. Movements are restricted by laws and statutes. Denial to freely circulate and obtain asylum is associated with vulnerability to HIV infections. A UNAIDS policy paper in 1997 and IOM policy guidelines in 1988 affirm that refugees and asylum seekers should not be targeted for special measures due to HIV/AIDS. There is an urgent need to provide primary health services for migrants, voluntary counseling and testing, and more favorable conditions. Research is needed on the role of migration in the spread of HIV, the extent of migration, availability of health services, and options for HIV prevention. Research must be action-oriented and focused on vulnerability to HIV and risk taking behavior. There is substantial mobility in West and Central Africa, economic migration in South Africa, and nonvoluntary migration in Angola. Sex workers in southeast Asia contribute to the spread. The breakup of the USSR led to population shifts. Migrants in Central America and Mexico move north to the US where HIV prevalence is higher.

Political representation for social justice in nursing: lessons learned from participant research with destitute asylum seekers in the UK.

PubMed

Cuthill, Fiona

2016-09-01

The concept of social justice is making a revival in nursing scholarship, in part in response to widening health inequalities and inequities in high-income countries. In particular, critical nurse scholars have sought to develop participatory research methods using peer researchers to represent the 'voice' of people who are living in marginalized spaces in society. The aim of this paper is to report on the experiences of nurse and peer researchers as part of a project to explore the experiences of people who find themselves destitute following the asylum process in the UK. In seeking to explore social injustice, three challenges are identified: lack of a robust political theory, institutional/professional constraints and an absence of skills to engage with the politics of social (in)justice. Each challenge is presented, opposing voices outlined and some possible solutions are suggested. The work of political theorist Nancy Fraser is used as a conceptual framework, in particular her focus on mis/framing and political representation for social justice. In addition, it is suggested that social justice needs to be further embedded in nursing policy and curriculum. Finally, nurses are encouraged to develop practical political skills to engage with both politics and the media in a neoliberal globalizing world. © 2016 John Wiley & Sons Ltd.

Training the next generation of psychotraumatologists: COllaborative Network for Training and EXcellence in psychoTraumatology (CONTEXT)

PubMed Central

Vallières, Frédérique; Hyland, Philip; Murphy, Jamie; Hansen, Maj; Shevlin, Mark; Elklit, Ask; Ceannt, Ruth; Armour, Cherie; Wiedemann, Nana; Munk, Mette; Dinesen, Cecilie; O’Hare, Geraldine; Cunningham, Twylla; Askerod, Ditte; Spitz, Pernille; Blackwell, Noeline; McCarthy, Angela; O’Dowd, Leonie; Scott, Shirley; Reid, Tracey; Mokake, Andreas; Halpin, Rory; Perera, Camila; Gleeson, Christina; Frost, Rachel; Flanagan, Natalie; Aldamman, Kinan; Tamrakar, Trina; Louison Vang, Maria; Sherwood, Larissa; Travers, Áine; Haahr-Pedersen, Ida; Walshe, Catherine; McDonagh, Tracey; Bramsen, Rikke Holm

2018-01-01

ABSTRACT In this paper we present a description of the Horizon2020, Marie Skłodowska-Curie Action funded, research and training programme CONTEXT: COllaborative Network for Training and EXcellence in psychoTraumatology. The three objectives of the programme are put forward, each of which refers to a key component of the CONTEXT programme. First, we summarize the 12 individual research projects that will take place across three priority populations: (i) refugees and asylum seekers, (ii) first responders, and (iii) perpetrators and survivors of childhood and gender-based violence. Second, we detail the mentoring and training programme central to CONTEXT. Finally, we describe how the research, together with the training, will contribute towards better policy, guidelines, and practice within the field of psychotraumatology. PMID:29372015

Ethical and legal issues in caring for asylum seekers and refugees in the UK.

PubMed

Hamill, M; McDonald, L; Brook, G; Murphy, S

2004-11-01

Inward migration to the UK remains topical and controversial as numbers continue to increase. Many immigrants have specific health care needs and may shoulder a large burden of infectious disease. Imposition of legal constraints can have a huge impact on the medical care afforded to immigrants. Currently UK policy is to treat, free of charge and with NHS resources, those who fulfil specific criteria. However an increasing number are being asked to pay for their treatment. Many health care professionals are confused as to current legal restrictions and require guidance on the associated ethical issues. We concentrate on provision of care to HIV positive individuals and use cases to illustrate some of the issues. However these issues are equally pertinent to practitioners in all branches of medicine.

Training the next generation of psychotraumatologists: COllaborative Network for Training and EXcellence in psychoTraumatology (CONTEXT).

PubMed

Vallières, Frédérique; Hyland, Philip; Murphy, Jamie; Hansen, Maj; Shevlin, Mark; Elklit, Ask; Ceannt, Ruth; Armour, Cherie; Wiedemann, Nana; Munk, Mette; Dinesen, Cecilie; O'Hare, Geraldine; Cunningham, Twylla; Askerod, Ditte; Spitz, Pernille; Blackwell, Noeline; McCarthy, Angela; O'Dowd, Leonie; Scott, Shirley; Reid, Tracey; Mokake, Andreas; Halpin, Rory; Perera, Camila; Gleeson, Christina; Frost, Rachel; Flanagan, Natalie; Aldamman, Kinan; Tamrakar, Trina; Louison Vang, Maria; Sherwood, Larissa; Travers, Áine; Haahr-Pedersen, Ida; Walshe, Catherine; McDonagh, Tracey; Bramsen, Rikke Holm

2018-01-01

In this paper we present a description of the Horizon2020, Marie Skłodowska-Curie Action funded, research and training programme CONTEXT: COllaborative Network for Training and EXcellence in psychoTraumatology. The three objectives of the programme are put forward, each of which refers to a key component of the CONTEXT programme. First, we summarize the 12 individual research projects that will take place across three priority populations: (i) refugees and asylum seekers, (ii) first responders, and (iii) perpetrators and survivors of childhood and gender-based violence. Second, we detail the mentoring and training programme central to CONTEXT. Finally, we describe how the research, together with the training, will contribute towards better policy, guidelines, and practice within the field of psychotraumatology.

The ILO and the new UN convention on migrant workers: the past and future.

PubMed

Bohning, R

1991-01-01

Migrant workers are less protected than nationals against the actions of states and employers. These workers therefore require special global protection of their rights while employed in countries other than their own. Accordingly, the UN International Labor Organization (ILO) is constitutionally charged with developing international measures to protect the interests of migrant workers from developing countries. The ILO, however, had little involvement in molding the International Convention on the protection of the Rights of All Migrants Workers and Members of their Families, adopted by the UN General Assembly in 1990. Instead, final adoption of the Convention stems largely from developing state dissatisfaction with the former 1975 ILO Migrant Workers Convention No. 143, and Mexican and Moroccan government machinations outside of the ILO in support of modifications. Convention No. 143 threatened to sever employment opportunities and hard foreign exchange remittances in North America and western Europe from illegally employed immigrant workers from developing countries. By working in the UN outside of the ILO, developing nations would enjoy automatic majority, and greater potential for success in reforming the Convention. Soon, developing nations squelched a delay tactic proffered by the Swedes, and succeeded in bringing the UN General Assembly to adopt resolution 34/172 in December 1979, which led to the establishment of an Open-Ended Working Group. This group then elaborated the 1990 Convention over 19 sessions. At the expense of the ILO and more developed nations, developing nations successfully challenged and changed the international order to benefit their peoples and national economies. Finally, the paper considers the interests of immigrant businesspeople and asylum seekers during or immediately upon entry to a foreign country, who are not specifically covered by the Convention. While the university of international humanitarian law suggests that businesspeople be included in the Convention, changes to the Convention will probably not be forthcoming. As for asylum seekers waiting for either refugee status or an interim-term engagement for work, the sensitive nature of this topic in certain countries precludes the adoption of inclusive documentation.

Effect of Restricting Access to Health Care on Health Expenditures among Asylum-Seekers and Refugees: A Quasi-Experimental Study in Germany, 1994–2013

PubMed Central

Bozorgmehr, Kayvan; Razum, Oliver

2015-01-01

Background Access to health care for asylum-seekers and refugees (AS&R) in Germany is initially restricted before regular access is granted, allegedly leading to delayed care and increasing costs of care. We analyse the effects of (a) restricted access; and (b) two major policy reforms (1997, 2007) on incident health expenditures for AS&R in 1994-2013. Methods and Findings We used annual, nation-wide, aggregate data of the German Federal Statistics Office (1994-2013) to compare incident health expenditures among AS&R with restricted access (exposed) to AS&R with regular access (unexposed). We calculated incidence rate differences (∆IRt) and rate ratios (IRRt), as well as attributable fractions among the exposed (AFe) and the total population (AFp). The effects of between-group differences in need, and of policy reforms, on differences in per capita expenditures were assessed in (segmented) linear regression models. The exposed and unexposed groups comprised 4.16 and 1.53 million person-years. Per capita expenditures (1994–2013) were higher in the group with restricted access in absolute (∆IRt = 375.80 Euros [375.77; 375.89]) and relative terms (IRR = 1.39). The AFe was 28.07% and the AFp 22.21%. Between-group differences in mean age and in the type of accommodation were the main independent predictors of between-group expenditure differences. Need variables explained 50-75% of the variation in between-group differences over time. The 1997 policy reform significantly increased ∆IRt adjusted for secular trends and between-group differences in age (by 600.0 Euros [212.6; 986.2]) and sex (by 867.0 Euros [390.9; 1342.5]). The 2007 policy reform had no such effect. Conclusion The cost of excluding AS&R from health care appears ultimately higher than granting regular access to care. Excess expenditures attributable to the restriction were substantial and could not be completely explained by differences in need. An evidence-informed discourse on access to health care for AS&R in Germany is needed; it urgently requires high-quality, individual-level data. PMID:26201017

Effect of Restricting Access to Health Care on Health Expenditures among Asylum-Seekers and Refugees: A Quasi-Experimental Study in Germany, 1994-2013.

PubMed

Bozorgmehr, Kayvan; Razum, Oliver

2015-01-01

Access to health care for asylum-seekers and refugees (AS&R) in Germany is initially restricted before regular access is granted, allegedly leading to delayed care and increasing costs of care. We analyse the effects of (a) restricted access; and (b) two major policy reforms (1997, 2007) on incident health expenditures for AS&R in 1994-2013. We used annual, nation-wide, aggregate data of the German Federal Statistics Office (1994-2013) to compare incident health expenditures among AS&R with restricted access (exposed) to AS&R with regular access (unexposed). We calculated incidence rate differences (∆IRt) and rate ratios (IRRt), as well as attributable fractions among the exposed (AFe) and the total population (AFp). The effects of between-group differences in need, and of policy reforms, on differences in per capita expenditures were assessed in (segmented) linear regression models. The exposed and unexposed groups comprised 4.16 and 1.53 million person-years. Per capita expenditures (1994-2013) were higher in the group with restricted access in absolute (∆IRt = 375.80 Euros [375.77; 375.89]) and relative terms (IRR = 1.39). The AFe was 28.07% and the AFp 22.21%. Between-group differences in mean age and in the type of accommodation were the main independent predictors of between-group expenditure differences. Need variables explained 50-75% of the variation in between-group differences over time. The 1997 policy reform significantly increased ∆IRt adjusted for secular trends and between-group differences in age (by 600.0 Euros [212.6; 986.2]) and sex (by 867.0 Euros [390.9; 1342.5]). The 2007 policy reform had no such effect. The cost of excluding AS&R from health care appears ultimately higher than granting regular access to care. Excess expenditures attributable to the restriction were substantial and could not be completely explained by differences in need. An evidence-informed discourse on access to health care for AS&R in Germany is needed; it urgently requires high-quality, individual-level data.

Immigrants’ use of emergency primary health care in Norway: a registry-based observational study

PubMed Central

2012-01-01

Background Emigrants are often a selected sample and in good health, but migration can have deleterious effects on health. Many immigrant groups report poor health and increased use of health services, and it is often claimed that they tend to use emergency primary health care (EPHC) services for non-urgent purposes. The aim of the present study was to analyse immigrants’ use of EPHC, and to analyse variations according to country of origin, reason for immigration, and length of stay in Norway. Methods We conducted a registry based study of all immigrants to Norway, and a subsample of immigrants from Poland, Germany, Iraq and Somalia, and compared them with native Norwegians. The material comprised all electronic compensation claims for EPHC in Norway during 2008. We calculated total contact rates, contact rates for selected diagnostic groups and for services given during consultations. Adjustments for a series of socio-demographic and socio-economic variables were done by multiple logistic regression analyses. Results Immigrants as a whole had a lower contact rate than native Norwegians (23.7% versus 27.4%). Total contact rates for Polish and German immigrants (mostly work immigrants) were 11.9% and 7.0%, but for Somalis and Iraqis (mostly asylum seekers) 31.8% and 33.6%. Half of all contacts for Somalis and Iraqis were for non-specific pain, and they had relatively more of their contacts during night than other groups. Immigrants’ rates of psychiatric diagnoses were low, but increased with length of stay in Norway. Work immigrants suffered less from respiratory and gastrointestinal infections, but had more injuries and higher need for sickness certification. All immigrant groups, except Germans, were more often given a sickness certificate than native Norwegians. Use of interpreter was reduced with increasing length of stay. All immigrant groups had an increased need for long consultations, while laboratory tests were most often used for Somalis and Iraqis. Conclusions Immigrants use EPHC services less than native Norwegians, but there are large variations among immigrant groups. Work immigrants from Germany and Poland use EPHC considerably less, while asylum seekers from Somalia and Iraq use these services more than native Norwegians. PMID:22958343

Tolerance by Surprise: Evidence for a Generalized Reduction in Prejudice and Increased Egalitarianism through Novel Category Combination

PubMed Central

Vasiljevic, Milica; Crisp, Richard J.

2013-01-01

Prejudices towards different groups are interrelated, but research has yet to find a way to promote tolerance towards multiple outgroups. We devise, develop and implement a new cognitive intervention for achieving generalized tolerance based on scientific studies of social categorization. In five laboratory experiments and one field study the intervention led to a reduction of prejudice towards multiple outgroups (elderly, disabled, asylum seekers, HIV patients, gay men), and fostered generalized tolerance and egalitarian beliefs. Importantly, these effects persisted outside the laboratory in a context marked by a history of violent ethnic conflict, increasing trust and reconciliatory tendencies towards multiple ethnic groups in the Former Yugoslav Republic of Macedonia. We discuss the implications of these findings for intervention strategies focused on reducing conflict and promoting peaceful intergroup relations. PMID:23483895

Testimony therapy: treatment method for traumatized victims of organized violence.

PubMed

van Dijk, Janie A; Schoutrop, Mirjam J A; Spinhoven, Philip

2003-01-01

Former political prisoners in Chile gave testimony of their traumatic experiences, which resulted in diminishing their posttraumatic symptoms. Based on this experience, testimony therapy has been developed and used in treatment of traumatized victims of war or other organized violence. This short-term therapy, as it applied in the treatment of traumatized asylum seekers and refugees in Centrum '45/De Vonk in the Netherlands, is described in this article. The therapy consists of 12 sessions in which patients tell their life stories, including the traumatic experiences. The narrative is reflected in a written document that, for example, can be read to family and friends, or be sent to a historical archive. This article discusses the preliminary research data on the effects of testimony therapy. Finally, hypotheses on the working mechanisms of testimony therapy are offered.

WPA guidance on mental health and mental health care in migrants

PubMed Central

BHUGRA, DINESH; GUPTA, SUSHAM; BHUI, KAMALDEEP; CRAIG, TOM; DOGRA, NISHA; INGLEBY, J. DAVID; KIRKBRIDE, JAMES; MOUSSAOUI, DRISS; NAZROO, JAMES; QURESHI, ADIL; STOMPE, THOMAS; TRIBE, RACHEL

2011-01-01

The purpose of this guidance is to review currently available evidence on mental health problems in migrants and to present advice to clinicians and policy makers on how to provide migrants with appropriate and accessible mental health services. The three phases of the process of migration and the relevant implications for mental health are outlined, as well as the specific problems of groups such as women, children and adolescents, the elderly, refugees and asylum seekers, and lesbian, gay, bisexual and transgender individuals. The concepts of cultural bereavement, cultural identity and cultural congruity are discussed. The epidemiology of mental disorders in migrants is described. A series of recommendations to policy makers, service providers and clinicians aimed to improve mental health care in migrants are provided, covering the special needs of migrants concerning pharmacotherapies and psychotherapies. PMID:21379345

The hidden epidemic of schistosomiasis in recent African immigrants and asylum seekers to Italy.

PubMed

Beltrame, Anna; Buonfrate, Dora; Gobbi, Federico; Angheben, Andrea; Marchese, Valentina; Monteiro, Geraldo Badona; Bisoffi, Zeno

2017-08-01

The prevalence of schistosomiasis among recent refugees from sub-Saharan Africa in Italy is unknown. This is a retrospective review of African immigrants screened at Centre for Tropical Diseases of Negrar from March 2014 to February 2016. Of the 373 immigrants tested, 34% were positive at least at one schistosomiasis test. The proportion of positive ELISA serology was 103/373 (27.6%). At microscopy, infected subjects were 65/373 (17.4%), (51% Schistosoma haematobium, 38% Schistosoma mansoni, 11% both). CCA antigen for S. mansoni was positive in 47/373 individuals (12.6%). We found a particularly high positivity rate in subjects from Mali (72.1%) and Ivory Coast (48%). This "hidden epidemic" of schistosomiasis cannot be longer neglected, considering the risk of severe complications, and the effective and inexpensive treatment available.

A systematic review of questionnaires measuring the health of resettling refugee women.

PubMed

Gagnon, Anita J; Tuck, Jodi; Barkun, Laurie

2004-02-01

Because many ethnically diverse refugee women resettle in industrialized countries, several biopsychosocial factors need to be considered in caring for them. This systematic review of studies conducted with female refugees, asylum-seekers, or "unspecified" immigrants based on six electronic databases was conducted to determine which questionnaires best measure relevant variables. Questionnaires were reviewed for measurement properties, application of translation theory, and quality of representation. Studies must have included > or = 1 measure of the following: general health; torture, abuse, sex-and-gender-based violence (SGBV); depression; stress; posttraumatic stress disorder (PTSD); anxiety; somatization; migration history; social support; socioeconomic status; discrimination; or mother-child interactions. Fifty-six studies using 47 questionnaires were identified; only five had strong evidence for use with resettling refugee women. Thus, few high-quality tools are available to measure concepts relevant to resettling refugee women's health.

Sexual maltreatment of unaccompanied asylum-seeking minors from the Horn of Africa: a mixed method study focusing on vulnerability and prevention.

PubMed

Lay, Margaret; Papadopoulos, Irena

2009-10-01

The study described in this paper sought to identify the social, cultural, and political factors that effect African unaccompanied asylum-seeking minors' (UASM) vulnerability to sexual maltreatment in England. It aimed to illuminate how child protection measures could be strengthened for this highly marginalized group. A mixed method approach was used. Former UASM from Ethiopia, Eritrea and Somalia who had been sexually maltreated in the UK were interviewed in-depth. Prior to the interviews they all completed a questionnaire which captured their biographical details as well as sensitive but factual information. Of the 53 (N=53) former UASM who participated in the study only 2 were males. Most arrived in the UK aged 15-17. A range of sexual maltreatment, from sexual harassment to rape was reported. Three quarters experienced more than 1 incident. Most initial incidents happened in the first 12 months of their arrival in the UK. Two perpetrators were female carers. Many participants reported being groomed and sexually maltreated by people from their own country. Many described being seriously sexually maltreated, particularly by groups of young males living in the same accommodation or nearby, some reportedly also asylum seekers. Participants that had been warned of the dangers of sexual maltreatment were more likely to both disclose and to seek professional help. Professionals should assume that UASM will suffer sexual maltreatment in their host country if not protected adequately, which they are unlikely to disclose. They are likely to need more protection from outside sources and help to develop their personal resources than many have received in the past. Preventative measures include provision of safer environments, ideally single sex housing; more monitoring and supervision; more opportunities to develop trustworthy relationships and have emotional needs met; greater opportunities to develop language skills/access to interpretation; early information regarding the social system, culture, and sexual maltreatment; and improved professional awareness and competence in dealing with minors from other cultures.

Psychological Distress in Afghan Refugees: A Mixed-Method Systematic Review

PubMed Central

Alemi, Qais; James, Sigrid; Cruz, Romalene; Zepeda, Veronica; Racadio, Michael

2013-01-01

Mental health problems disproportionately affect Afghan refugees and asylum seekers who continue to seek international protection with prolonged exposure to war. We performed a systematic review aimed at synthesizing peer-reviewed literature pertaining to mental health problems among Afghans resettled in industrialized nations. We used five databases to identify studies published between 1979 and 2013 that provided data on distress levels, and subjective experiences with distress. Seventeen studies met our inclusion criteria consisting of 1 mixed-method, 7 qualitative, and 9 quantitative studies. Themes from our qualitative synthesis described antecedents for distress being rooted in cultural conflicts and loss, and also described unique coping mechanisms. Quantitative findings indicated moderate to high prevalence of depressive and posttraumatic symptomatology. These findings support the need for continued mental health research with Afghans that accounts for: distress among newly resettled groups, professional help-seeking utilization patterns, and also culturally relevant strategies for mitigating distress and engaging Afghans in research. PMID:23784146

The legal and ethical aspects of the right to health of migrants in Switzerland.

PubMed

Marks-Sultan, Géraldine; Kurt, Stefanie; Leyvraz, Didier; Sprumont, Dominique

The right to health of migrant populations, whether they are foreign nationals, foreign workers, tourists, asylum seekers or refugees, is enshrined in international human rights treaties. The effectiveness of the implementation of this fundamental right thus lies in national legal frameworks. In spite of its long humanitarian tradition, Switzerland has a strict migration policy, and while it has established a non-discriminatory legal framework for the protection and promotion of the right to health, its laws and regulations sometimes codify differences in treatment between foreign nationals and Swiss residents based on distinct situations. On the basis of shared responsibilities between the Federal State and the 26 cantons, this article describes the Swiss legal and regulatory approach to the right to health, the ways it is currently implemented and the possible vectors for an improved integration of migrants into the health system.

Ignoring the "Itch": The Global Health Problem of Scabies.

PubMed

Stamm, Lola V; Strowd, Lindsay C

2017-12-01

Infestation with Sarcoptes scabiei var. hominis is a common human parasitic affliction endemic in tropical developing countries. Scabies is transmitted by close person-person contact, and outbreaks have been reported in reception centers for asylum seekers. Scabies presents clinically as extremely pruritic excoriated papules and linear burrows in the skin. This infestation predisposes to bacterial skin infections that can result in serious complications affecting the kidneys and possibly the heart. Treatment of individuals with scabies and their close contacts involves the use of antiparasitic agents. First-line treatment is topical 5% permethrin cream. Community mass drug administration, followed by active case finding with targeted treatment, is a promising approach that can reduce the prevalence of both scabies and bacterial skin infections. Organizations such as the International Alliance for the Control of Scabies are advocating for the development of integrated disease control strategies in an effort to decrease scabies infestation worldwide.

Review of child and adolescent refugee mental health.

PubMed

Lustig, Stuart L; Kia-Keating, Maryam; Knight, Wanda Grant; Geltman, Paul; Ellis, Heidi; Kinzie, J David; Keane, Terence; Saxe, Glenn N

2004-01-01

To review stressful experiences and stress reactions among child and adolescent refugees, as well as interventions and ethical considerations in research and clinical work, within the framework of the chronological experiences of child refugees; namely, the phases of preflight, flight, and resettlement. Highlighted are special refugee populations such as unaccompanied minors, asylum seekers, and former child soldiers. Pertinent medical findings are summarized. The authors reviewed articles from 1990 to 2003 addressing the topics above. Literature was gathered from databases including PsycINFO, Medline, and SocioFile. Pertinent earlier papers and those from other disciplines cited in database-identified articles were also included. Child and adolescent refugees suffer from significant conflict-related exposures. Reactions to stress may be mediated by coping strategies, belief systems, and social relations. More research is needed on interventions, specifically on efficacy and cultural relevance. Interventions that have an impact on multiple ecological levels need further development and evaluation.

[Solidarity in health. Report on the 2017 Poverty and Health Congress].

PubMed

Waldhauer, Julia; Amler, Marion; Böhme, Nicole; Janella, Maren; Pospiech, Stefan; Lampert, Thomas

2017-08-01

The annual congress Armut und Gesundheit (Poverty and Health), which is organized by Gesundheit Berlin-Brandenburg e. V. and takes place at the Technical University of Berlin has become one of the biggest public health events in Germany. It constitutes an exchange platform for sciences, practice, and politics. This year's congress topic was solidarity in health, aiming to emphasize the responsibility that society and its actors have to bear in order to warrant health equity. Overall, 121 activities took place, with more than 500 experts and moderators discussing a wide range of subjects and questions including regional disparities in poverty, ethics in public health, the current situation of homeless and people without insurance, time trends in health inequalities, health and healthcare of refugees and asylum seekers, and the current progress and challenges in connection with the German prevention act.

Gender-related mental health differences between refugees and non-refugee immigrants - a cross-sectional register-based study

PubMed Central

2011-01-01

Background Being an immigrant in a high-income country is a risk factor for severe mental ill health. Studies on mental ill health among immigrants have found significant differences in mental health outcome between immigrants from high income countries and low-income countries. Being an asylum seeker or a refugee is also associated with mental ill health. This study aimed to assess if there is a difference in mental ill health problems between male and female refugee and non-refugee immigrants from six low-income countries in Sweden. Methods A cross-sectional, population-based study design was used comparing refugees with non-refugees. The study size was determined by the number of persons in Sweden fulfilling the inclusion criteria at the time of the study during 2006. Outcome: Mental ill health, as measured with the proxy variable psychotropic drugs purchased. Refugee/Non-refugee: Sweden grants asylum to refugees according to the Geneva Convention and those with a well-grounded fear of death penalty, torture or who need protection due to an internal or external armed conflict or an environmental disaster. The non-refugees were all family members of those granted asylum in Sweden. Covariates: Gender and origin. Potential confounders: Age, marital status, education and duration of stay in Sweden. Background variables were analysed using chi square tests. The association between outcome, exposure and possible confounders was analysed using logistic regression analyses. Multiple logistic regression analysis was used to adjust for potential confounders. Results The study population comprised 43,168 refugees and non-refugees, of whom 20,940 (48.5%) were women and 24,403 (56.5%) were refugees. Gender, age, origin, marital status and education were all associated with the outcome. For female, but not male, refugees there was a significantly higher likelihood of purchasing psychotropic drugs than non-refugees (OR = 1.27, 95% CI = 1.15 - 1.40). Conclusions Female refugees from low-income countries seem to be a risk group among immigrant women from low-income countries, whereas male refugees had the same risk patterns as non-refugee immigrants from low-income countries. This underlines the need for training of clinicians in order to focus on pre-migration stress and the asylum process, among female newcomers. PMID:21435212

Gender-related mental health differences between refugees and non-refugee immigrants--a cross-sectional register-based study.

PubMed

Hollander, Anna-Clara; Bruce, Daniel; Burström, Bo; Ekblad, Solvig

2011-03-24

Being an immigrant in a high-income country is a risk factor for severe mental ill health. Studies on mental ill health among immigrants have found significant differences in mental health outcome between immigrants from high income countries and low-income countries. Being an asylum seeker or a refugee is also associated with mental ill health. This study aimed to assess if there is a difference in mental ill health problems between male and female refugee and non-refugee immigrants from six low-income countries in Sweden. A cross-sectional, population-based study design was used comparing refugees with non-refugees. The study size was determined by the number of persons in Sweden fulfilling the inclusion criteria at the time of the study during 2006. Mental ill health, as measured with the proxy variable psychotropic drugs purchased. Refugee/Non-refugee: Sweden grants asylum to refugees according to the Geneva Convention and those with a well-grounded fear of death penalty, torture or who need protection due to an internal or external armed conflict or an environmental disaster. The non-refugees were all family members of those granted asylum in Sweden. Covariates: Gender and origin. Potential confounders: Age, marital status, education and duration of stay in Sweden. Background variables were analysed using chi square tests. The association between outcome, exposure and possible confounders was analysed using logistic regression analyses. Multiple logistic regression analysis was used to adjust for potential confounders. The study population comprised 43,168 refugees and non-refugees, of whom 20,940 (48.5%) were women and 24,403 (56.5%) were refugees. Gender, age, origin, marital status and education were all associated with the outcome. For female, but not male, refugees there was a significantly higher likelihood of purchasing psychotropic drugs than non-refugees (OR = 1.27, 95% CI = 1.15-1.40). Female refugees from low-income countries seem to be a risk group among immigrant women from low-income countries, whereas male refugees had the same risk patterns as non-refugee immigrants from low-income countries. This underlines the need for training of clinicians in order to focus on pre-migration stress and the asylum process, among female newcomers.

What the eye does not see: a critical interpretive synthesis of European Union policies addressing sexual violence in vulnerable migrants.

PubMed

Keygnaert, Ines; Guieu, Aurore

2015-11-01

In Europe, refugees, asylum seekers and undocumented migrants are more vulnerable to sexual victimisation than European citizens. They face more challenges when seeking care. This literature review examines how legal and policy frameworks at national, European and international levels condition the prevention of and response to sexual violence affecting these vulnerable migrant communities living in the European Union (EU). Applying the Critical Interpretive Synthesis method, we reviewed 187 legal and policy documents and 80 peer-reviewed articles on migrant sexual health for elements on sexual violence and further analysed the 37 legal and 12 peer-reviewed articles among them that specifically focused on sexual violence in vulnerable migrants in the EU-27 States. Legal and policy documents dealing with sexual violence, particularly but not exclusively in vulnerable migrants, apply 'tunnel vision'. They ignore: a) frequently occurring types of sexual violence, b) victimisation rates across genders and c) specific risk factors within the EU such as migrants' legal status, gender orientation and living conditions. The current EU policy-making paradigm relegates sexual violence in vulnerable migrants as an 'outsider' and 'female only' issue while EU migration and asylum policies reinforce its invisibility. Effective response must be guided by participatory rights- and evidence-based policies and a public health approach, acknowledging the occurrence and multiplicity of sexual victimisation of vulnerable migrants of all genders within EU borders. Copyright © 2015 Elsevier Inc. All rights reserved.

Epidemiology of Substance Use among Forced Migrants: A Global Systematic Review.

PubMed

Horyniak, Danielle; Melo, Jason S; Farrell, Risa M; Ojeda, Victoria D; Strathdee, Steffanie A

2016-01-01

Forced migration is occurring at unprecedented levels. Forced migrants may be at risk for substance use for reasons including coping with traumatic experiences, co-morbid mental health disorders, acculturation challenges and social and economic inequality. This paper aimed to systematically review the literature examining substance use among forced migrants, and identify priority areas for intervention and future research. Seven medical, allied health and social science databases were searched from inception to September 2015 in accordance with PRISMA guidelines to identify original peer-reviewed articles describing any findings relating to alcohol and/or illicit drug use among refugees, internally displaced people (IDPs), asylum seekers, people displaced by disasters and deportees. A descriptive synthesis of evidence from quantitative studies was conducted, focusing primarily on studies which used validated measures of substance use. Synthesis of evidence from qualitative studies focused on identifying prominent themes relating to the contexts and consequences of substance use. Critical Appraisal Skills Programme (CASP) checklists were used to assess methodological quality of included studies. Forty-four quantitative (82% cross-sectional), 16 qualitative and three mixed-methods studies were included. Ten studies were rated as high methodological quality (16%), 39 as moderate quality (62%) and 14 as low quality (22%). The majority of research was conducted among refugees, IDPs and asylum seekers (n = 55, 87%), predominantly in high-income settings. The highest-quality prevalence estimates of hazardous/harmful alcohol use ranged from 17%-36% in camp settings and 4%-7% in community settings. Few studies collected validated measures of illicit drug use. Seven studies compared substance use among forced migrants to other migrant or native-born samples. Among eight studies which conducted multivariable analysis, male sex, trauma exposure and symptoms of mental illness were commonly identified correlates of substance use. Our understanding of substance use among forced migrants remains limited, particularly regarding persons displaced due to disasters, development and deportation. Despite a growing body of work among refugee-background populations, few studies include refugees in low and middle-income countries, where over 80% of the global refugee population resides. Findings suggest a need to integrate substance use prevention and treatment into services offered to forced migrants, particularly in camp settings. Efforts to develop and evaluate interventions to reduce substance use and related harms are needed.

Epidemiology of Substance Use among Forced Migrants: A Global Systematic Review

PubMed Central

Horyniak, Danielle; Melo, Jason S.; Farrell, Risa M.; Ojeda, Victoria D.; Strathdee, Steffanie A.

2016-01-01

Introduction Forced migration is occurring at unprecedented levels. Forced migrants may be at risk for substance use for reasons including coping with traumatic experiences, co-morbid mental health disorders, acculturation challenges and social and economic inequality. This paper aimed to systematically review the literature examining substance use among forced migrants, and identify priority areas for intervention and future research. Methods Seven medical, allied health and social science databases were searched from inception to September 2015 in accordance with PRISMA guidelines to identify original peer-reviewed articles describing any findings relating to alcohol and/or illicit drug use among refugees, internally displaced people (IDPs), asylum seekers, people displaced by disasters and deportees. A descriptive synthesis of evidence from quantitative studies was conducted, focusing primarily on studies which used validated measures of substance use. Synthesis of evidence from qualitative studies focused on identifying prominent themes relating to the contexts and consequences of substance use. Critical Appraisal Skills Programme (CASP) checklists were used to assess methodological quality of included studies. Results Forty-four quantitative (82% cross-sectional), 16 qualitative and three mixed-methods studies were included. Ten studies were rated as high methodological quality (16%), 39 as moderate quality (62%) and 14 as low quality (22%). The majority of research was conducted among refugees, IDPs and asylum seekers (n = 55, 87%), predominantly in high-income settings. The highest-quality prevalence estimates of hazardous/harmful alcohol use ranged from 17%-36% in camp settings and 4%-7% in community settings. Few studies collected validated measures of illicit drug use. Seven studies compared substance use among forced migrants to other migrant or native-born samples. Among eight studies which conducted multivariable analysis, male sex, trauma exposure and symptoms of mental illness were commonly identified correlates of substance use. Conclusion Our understanding of substance use among forced migrants remains limited, particularly regarding persons displaced due to disasters, development and deportation. Despite a growing body of work among refugee-background populations, few studies include refugees in low and middle-income countries, where over 80% of the global refugee population resides. Findings suggest a need to integrate substance use prevention and treatment into services offered to forced migrants, particularly in camp settings. Efforts to develop and evaluate interventions to reduce substance use and related harms are needed. PMID:27411086

The Rights of Children on the Move and the Budapest Declaration.

PubMed

Oberg, Charles

2018-05-17

It has been estimated that more than 50,000,000 children and youth have migrated across borders or been forcibly displaced within their own country. They consist of refugees, asylum seekers, internally displaced persons (IDP), economic migrants, and exploited trafficked children. They are virtually "stateless", children deprived of the protective structures of state and family that they need and deserve and unrecognized by either their country of origin or the international community. This opinion piece starts with the personal reflections of its author on his recent work in Middle East refugee camps. It then explores the prevalence and demographics of these children and their plight. It examines the United Nation's Convention on the Rights of the Child (CRC) and other international conventions designed to protect them. It also summarizes the International Society of Social Pediatrics and Child Health (ISSOP) Budapest Declaration on the Rights, Health and Well-Being of Children and Youth on the Move as a vehicle for improved care and vehicle for change.

[Splenomegaly in an Eritrean refugee: the hyper-reactive malaria splenomegaly syndrome.

PubMed

Cruijsen, M M; Reuling, I J; Keuter, M; Sauerwein, R W; van der Ven, A J; de Mast, Q

2016-01-01

Hyper-reactive malaria splenomegaly (HMS) is a rare and potentially severe complication of malaria. It is likely that the incidence of patients with HMS will rise in the Netherlands due to the recent increase in asylum-seekers from Sub-Saharan Africa. It can be difficult to diagnose this disease, as this case shows. A 31-year-old male from Eritrea was admitted with fever and dyspnea, caused by an influenza A-infection. The patient also presented with cachexia, pronounced hepatosplenomegaly and pancytopenia. Microscopic diagnostic analysis for malaria was negative. HMS was eventually diagnosed through high-sensitivity qPCR for malaria, which showed the presence of a very low level of Plasmodium falciparum parasitemia; furthermore, IgM levels were high and malaria serology was strongly positive. HMS should be considered in patients from malaria-endemic areas presenting with splenomegaly and pancytopenia. Because standard diagnostics for malaria are often negative in this population, malaria serology and sensitive qPCR play an important diagnostic role.

An Innovative Mobile Health System to Improve and Standardize Antenatal Care Among Underserved Communities: A Feasibility Study in an Italian Hosting Center for Asylum Seekers.

PubMed

Borsari, Lucia; Stancanelli, Giovanna; Guarenti, Laura; Grandi, Teresa; Leotta, Serena; Barcellini, Lucia; Borella, Paola; Benski, Anne Caroline

2017-11-16

Innovative migrant-friendly tools are needed to assist health personnel manage the high number of pregnancies within reception centers. This study tests functionality and acceptability of a new mHealth system in providing antenatal care amongst migrants. The study, carried out between 2014 and 2016, involved 150 pregnant women residing in the largest European migrant reception center in Sicily. A ticket tracking system assessed the system's functionality and a questionnaire assessed women's acceptability. The system facilitated the collection of clinical data, enabling the creation of electronic patient records and identifying 10% of pregnancies as high-risk. The application's digital format increased health providers' adherence to antenatal-care recommendations, while the graphic interface facilitated women's engagement and retention of the health education modules. The study recorded a 91.9% patient satisfaction rate. The system was efficient in providing comprehensive and high-quality antenatal care amongst migrants, facilitating the continuity of care for a population undergoing frequent relocations.

The Rights of Children on the Move and the Budapest Declaration

PubMed Central

2018-01-01

It has been estimated that more than 50,000,000 children and youth have migrated across borders or been forcibly displaced within their own country. They consist of refugees, asylum seekers, internally displaced persons (IDP), economic migrants, and exploited trafficked children. They are virtually “stateless”, children deprived of the protective structures of state and family that they need and deserve and unrecognized by either their country of origin or the international community. This opinion piece starts with the personal reflections of its author on his recent work in Middle East refugee camps. It then explores the prevalence and demographics of these children and their plight. It examines the United Nation’s Convention on the Rights of the Child (CRC) and other international conventions designed to protect them. It also summarizes the International Society of Social Pediatrics and Child Health (ISSOP) Budapest Declaration on the Rights, Health and Well-Being of Children and Youth on the Move as a framework for improved care and vehicle for change. PMID:29772813

Impact on and use of health services by international migrants: questionnaire survey of inner city London A&E attenders

PubMed Central

Hargreaves, Sally; Friedland, Jon S; Gothard, Philip; Saxena, Sonia; Millington, Hugh; Eliahoo, Joseph; Le Feuvre, Peter; Holmes, Alison

2006-01-01

Background Changing immigration trends pose new challenges for the UK's open access health service and there is considerable speculation that migrants from resource-poor countries place a disproportionate burden on services. Data are needed to inform provision of services to migrant groups and to ensure their access to appropriate health care. We compared sociodemographic characteristics and impact of migrant groups and UK-born patients presenting to a hospital A&E/Walk-In Centre and prior use of community-based General Practitioner (GP) services. Methods We administered an anonymous questionnaire survey of all presenting patients at an A&E/Walk-In Centre at an inner-city London hospital during a 1 month period. Questions related to nationality, immigration status, time in the UK, registration and use of GP services. We compared differences between groups using two-way tables by Chi-Square and Fisher's exact test. We used logistic regression modelling to quantify associations of explanatory variables and outcomes. Results 1611 of 3262 patients completed the survey (response rate 49.4%). 720 (44.7%) were overseas born, representing 87 nationalities, of whom 532 (73.9%) were new migrants to the UK (≤10 years). Overseas born were over-represented in comparison to local estimates (44.7% vs 33.6%; p < 0.001; proportional difference 0.111 [95% CI 0.087–0.136]). Dominant immigration status' were: work permit (24.4%), EU citizens (21.5%), with only 21 (1.3%) political asylum seekers/refugees. 178 (11%) reported nationalities from refugee-generating countries (RGCs), eg, Somalia, who were less likely to speak English. Compared with RGCs, and after adjusting for age and sex, the Australians, New Zealanders, and South Africans (ANS group; OR 0.28 [95% CI 0.11 to 0.71]; p = 0.008) and the Other Migrant (OM) group comprising mainly Europeans (0.13 [0.06 to 0.30]; p = 0.000) were less likely to have GP registration and to have made prior contact with GPs, yet this did not affect mode of access to hospital services across groups nor delay access to care. Conclusion Recently arrived migrants are a diverse and substantial group, of whom migrants from refugee-generating countries and asylum seekers comprise only a minority group. Service reorganisation to ensure improved access to community-based GPs and delivery of more appropriate care may lessen their impact on acute services. PMID:17134491

Features of public healthcare services provided to migrant patients in the Eastern Macedonia and Thrace Region (Greece).

PubMed

Tsitsakis, Christos A; Karasavvoglou, Anastasios; Tsaridis, Efstathios; Ramantani, Georgia; Florou, Giannoula; Polychronidou, Persefoni; Stamatakis, Stamatios

2017-03-01

The influx of migrants, refugees and asylum-seekers into European Union (EU) countries, especially into Greece, in the last 20 years is an issue of growing concern and requires a rational approach. The aim of this study is to chart the use of public health services by the migrants of the Eastern Macedonia and Thrace Region, which forms the northeastern border of Greece. We collected data from five of the six public hospitals in the specified region, and we carried out a per clinic cross tabulation analysis of admission diagnosis and citizenship variables in order to establish the frequency at which the various diagnoses emerge per distinct group of migrant and non-migrant patients in each clinic. The main limitation of the study was the lack of age-standardised data. An additional analysis of frequencies per clinic focusing on migrant patients yielded hospitalisation frequencies per country of origin. We also performed a t-test to compare the average length of stay per clinic between the two groups. Finally, we utilised our available data to map the insurance status of migrant patients. The results have indicated that the hospitalisation rate of migrant patients due to chronic medical conditions is statistically significantly lower compared to non-migrant patients, while the opposite is true when looking at accident-related diagnoses, certain infectious diseases and medical conditions pertaining to depression and alcohol abuse. The comparisons of the average length of stay showed no overall differences between migrants and non-migrants. Only 2.04% of the migrant patients were uninsured. One of the key issues raised by the influx of migrants settling in host countries is concerned with health policy. The knowledge afforded by the medical parameters that characterise the provision of healthcare to them and the findings of relevant studies can lead to a more efficient identification of health risk factors and more effective prevention and treatment. This knowledge also constitutes a particularly crucial and useful tool to help authorities shape their healthcare policies and modify national health systems, which are currently based on the size and characteristics of indigenous populations, to take into account the different conditions with regard to both the number of patients treated and the epidemiological characteristics of the migrants. A greater appreciation of the particular current and potential roles of non-governmental organisations (NGOs) can help to provide appropriate healthcare services to migrants, refugees and asylum-seekers, especially when these groups are excluded from the public health system. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The meaning and mental health consequences of long-term immigration detention for people seeking asylum.

PubMed

Coffey, Guy J; Kaplan, Ida; Sampson, Robyn C; Tucci, Maria Montagna

2010-06-01

The aim of the present research was to examine the experience of extended periods of immigration detention from the perspective of previously detained asylum seekers and to identify the consequences of these experiences for life after release. The study sample comprised seventeen adult refugees (sixteen male and one female; average age 42 years), who had been held in immigration detention funded by the Australian government for on average three years and two months. They were interviewed on average three years and eight months following their release and had been granted permanent visa status or such status was imminent. The study employed a combination of qualitative and quantitative methods to explore detention and post-detention experiences, and mental health some years after release. The qualitative component consisted of semi-structured interviews exploring psychological well-being, daily life, significant events, relationships, and ways of coping throughout these periods. This was supplemented with standardised quantitative measures of current mental health and quality of life. All participants were struggling to rebuild their lives in the years following release from immigration detention, and for the majority the difficulties experienced were pervasive. Participants suffered an ongoing sense of insecurity and injustice, difficulties with relationships, profound changes to view of self and poor mental health. Depression and demoralisation, concentration and memory disturbances, and persistent anxiety were very commonly reported. Standardised measures found high rates of depression, anxiety, PTSD and low quality of life scores. The results strongly suggest that the psychological and interpersonal difficulties participants were suffering at the time of interview were the legacy of their adverse experiences while detained. The current study assists in identifying the characteristics of prolonged immigration detention producing long-term psychological harm. Copyright 2010 Elsevier Ltd. All rights reserved.

Perinatal outcomes among migrant mothers in the United Kingdom: Is it a matter of biology, behaviour, policy, social determinants or access to health care?

PubMed

Puthussery, Shuby

2016-04-01

This paper examines trends in perinatal outcomes among migrant mothers in the UK, and it explores potential contributors to disparities focusing on pregnancy, birth and the first year of life. Trends in perinatal outcomes indicate that ethnic minority grouping, regardless of migrant status, is a significant risk factor for unfavourable outcomes. It is unclear whether migrant status per se adds to this risk as within-group comparisons between UK-born and foreign-born women show variable findings. The role of biological and behavioural factors in producing excess unfavourable outcomes among ethnic minority mothers, although indicated, is yet to be fully understood. UK policies have salient aspects that address ethnic inequalities, but their wide focus obscures provisions for migrant mothers. Direct associations between socio-economic factors, ethnicity and adverse infant outcomes are evident. Evidence is consistent about differential access to and utilisation of health services among ethnic minority mothers, in particular recently arrived migrants, refugees and asylum seekers. Copyright © 2015 Elsevier Ltd. All rights reserved.

Working for citizenship: the dangers of occupational deprivation.

PubMed

Hocking, Clare

2012-01-01

To examine published case examples of occupational deprivation in relation to Wilcock's 1989 theoretical proposal that it is caused by economic and political systems, institutional policies, or advances in technology that displace workers. Eleven accounts of occupational deprivation centering on access to or maintenance of a work role. A thematic review of articles reporting access to or maintenance of a worker role as a major concern were located in an electronic search of multiple databases using the keyword `occupational deprivation'. While no examples pertaining to technological change were located, legislation enacted to protect national security or redress the ongoing affects of colonisation, a philosophy of punishing prisoners, and healthcare and employment structures were identified as causes of occupational deprivation. Economic and political systems and institutional policies are confirmed to cause occupational deprivation of worker roles in prison and indigenous populations, migrant workers and older female immigrants, young women displaced by war, refugees and asylum seekers, and people with disabilities. The ongoing economic burden of wasting human potential and the loss of cultural practices that support productive occupations are two negative outcomes.

The basic principles of migration health: Population mobility and gaps in disease prevalence

PubMed Central

Gushulak, Brian D; MacPherson, Douglas W

2006-01-01

Currently, migrants and other mobile individuals, such as migrant workers and asylum seekers, are an expanding global population of growing social, demographic and political importance. Disparities often exist between a migrant population's place of origin and its destination, particularly with relation to health determinants. The effects of those disparities can be observed at both individual and population levels. Migration across health and disease disparities influences the epidemiology of certain diseases globally and in nations receiving migrants. While specific disease-based outcomes may vary between migrant group and location, general epidemiological principles may be applied to any situation where numbers of individuals move between differences in disease prevalence. Traditionally, migration health activities have been designed for national application and lack an integrated international perspective. Present and future health challenges related to migration may be more effectively addressed through collaborative global undertakings. This paper reviews the epidemiological relationships resulting from health disparities bridged by migration and describes the growing role of migration and population mobility in global disease epidemiology. The implications for national and international health policy and program planning are presented. PMID:16674820

Food security and child hunger among recently resettled Liberian refugees and asylum seekers: a pilot study.

PubMed

Hadley, Craig; Sellen, Daniel

2006-10-01

Little is known about the food insecurity situation among families resettled into the United States as part of the refugee resettlement program. This paper reports on a pilot study examining food insecurity among recently arrived refugee families (n=33). Objectives were to evaluate the usefulness and feasibility of methods to assess the prevalence of food insecurity and child hunger, and to examine associations between child hunger and measures of socio-economic status and measures of acculturation. Results indicated that 85% of households were food insecure, and 42% experienced child hunger. Hunger was more likely to be indicated in households using foods stamps, with lower income, and lower education. Hunger was also more likely to be indicated in households where the primary shopper experienced difficulty shopping and with language. Results are in broad agreement with those reported in other studies and highlight economic and information barriers to achieving food security. These data suggest that further study of food insecurity is warranted among recently resettled refugee communities resettled in the United States.

A comparison of Narrative Exposure Therapy and Prolonged Exposure therapy for PTSD.

PubMed

Mørkved, N; Hartmann, K; Aarsheim, L M; Holen, D; Milde, A M; Bomyea, J; Thorp, S R

2014-08-01

The purpose of this review was to compare and contrast Prolonged Exposure (PE) and Narrative Exposure Therapy (NET). We examined the treatment manuals to describe the theoretical foundation, treatment components, and procedures, including the type, manner, and focus of exposure techniques and recording methods used. We examined extant clinical trials to investigate the range of treatment formats reported, populations studied, and clinical outcome data. Our search resulted in 32 studies on PE and 15 studies on NET. Consistent with prior reviews of PTSD treatment, it is evident that PE has a solid evidence base and its current status as a first line treatment for the populations studied to this date is warranted. We argue that NET may have advantages in treating complex traumatization seen in asylum seekers and refugees, and for this population NET should be considered a recommended treatment. NET and PE have several commonalities, and it is recommended that studies of these treatments include a broader range of populations and trauma types to expand the current knowledge on the treatment of PTSD. Published by Elsevier Ltd.

Research ethics and the plight of refugees in detention.

PubMed

Kirmayer, Laurence J; Rousseau, Cecile; Crepeau, Francois

2004-10-01

Health researchers may have a strategic role to play in confronting the predicament of refugee detainees because they can lend their analytic skills and authority to document the personal cost and impact of this practice. The justification for such 'subversive' research comes from the discrepancy between the sources of legitimacy and legality for government action. The practice of detention may be legal but illegitimate, judged against the standards of international human rights. Hence, research to explore the consequences of this policy is both morally and politically legitimate. Morally, it reflects a commitment to uncover and oppose unjustified violence against others; politically, it represents an attempt to identify and challenge abuses of power by the state. However, doing research without official approval or with the use of deception raises concerns for the safety of detainees as vulnerable research subjects as well as the credibility of researchers and the research enterprise. Researchers also may face sanctions that will limit their future effectiveness. An international network of researchers working on issues of human rights and the health of asylum seekers can provide an institutional basis to support work that challenges local practices.

8 CFR 208.9 - Procedure for interview before an asylum officer.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Procedure for interview before an asylum... Procedure for interview before an asylum officer. (a) The Service shall adjudicate the claim of each asylum... of the Service. (b) The asylum officer shall conduct the interview in a nonadversarial manner and...

8 CFR 208.9 - Procedure for interview before an asylum officer.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Procedure for interview before an asylum... Procedure for interview before an asylum officer. (a) The Service shall adjudicate the claim of each asylum... of the Service. (b) The asylum officer shall conduct the interview in a nonadversarial manner and...

Lessons from history: asylum patients' Christmas experience.

PubMed

Carpenter, Diane

This article outlines the asylum building programme of the mid-to-late nineteenth century and focuses on case studies of the two Hampshire asylums built during this period, the subject of the author's doctoral thesis. It demonstrates the plight of 'pauper lunatic' before asylum reform and contrasts this with the improved quality of life provided by the Hampshire County Lunatic Asylum and the Borough of Portsmouth Lunatic Asylum respectively. Asylum care during this period followed the moral treatment regime which became the Victorian blueprint for mental health, components of which are illustrated. Criticism of this regime is addressed briefly and arguments are made against anachronistic analysis. Comparison with contemporary in-patient care and treatment is made concluding with a call to reconsider some of the better aspects of earlier care delivery. The particular experience of patients in Hampshire asylums at Christmas is used to exemplify the points raised.

'Insane criminals' and the 'criminally insane': criminal asylums in Norway, 1895-1940.

PubMed

Dahl, Hilde

2017-06-01

This article looks into the establishment and development of two criminal asylums in Norway. Influenced by international psychiatry and a European reorientation of penal law, the country chose to institutionalize insane criminals and criminally insane in separate asylums. Norway's first criminal asylum was opened in 1895, and a second in 1923, both in Trondheim. Both asylums quickly filled up with patients who often stayed for many years, and some for their entire lives. The official aim of these asylums was to confine and treat dangerous and disruptive lunatics. Goffman postulates that total institutions typically fall short of their official aims. This study examines records of the patients who were admitted to the two Trondheim asylums, in order to see if the official aims were achieved.

[Asylum: the Huge Psychiatric Hospital in the 19th century U.S].

PubMed

Kazano, Haruki

2012-01-01

The large-scale state psychiatric hospitals, referred to as "asylums," were built in the USA in the 19th century and generally have a bad reputation in Japan as institutions with an unpleasant environment for the patients. Asylums were not built for institutionalizing mental patients. The original meaning of the word asylum is a "retreat" or "sanctuary," and these institutions were originally built to act as sanctuaries for the protection of mental patients. The field of psychiatric medicine in western countries in the 19th century began to embrace the concept of "moral treatment" for mental patients, including no restraint of the patients and treating them in a more open environment. With this background, asylums were built according to the efforts of social activist Dorothea Dix with financial assistance from the Quakers. The psychiatrist Dr. Thomas Kirkbride had a large influence on asylum architecture, and believed that the hospital building and environment as well as location have healing effects on the patients, which he called the "therapeutic landscape". Kirkbridelater proposed an architectural plan that became the basis for subsequent mental hospital architecture, and many asylums were built according to this plan. As the architecture was considered part of the treatment, many leading architects and landscape architects at the time became involved in building asylums. In the later half of the 19th century, over 150 asylums were built across the USA. However, moral treatment fell out of favor toward the end of the 19th century, and the concept of therapeutic landscape was also neglected. The hospitals had many uncured patients, and caregivers became pessimistic about the efficacy of the treatments. Abuse and neglect of the patients were also common. The environment at the asylums deteriorated, which created the image of asylums that, we hold today. Many asylums have been demolished or abandoned. These early attempts at asylum failed due to insufficient treatment methods. However, the concept of the therapeutic landscape that comprehensively sees the architecture of the hospital building and landscape of the property as part of the treatment as well as the architectural beauty of asylum buildings may deserve reevaluation.

Impact of new traumatic or stressful life events on pre-existing PTSD in traumatized refugees: results of a longitudinal study.

PubMed

Schock, Katrin; Böttche, Maria; Rosner, Rita; Wenk-Ansohn, Mechthild; Knaevelsrud, Christine

2016-01-01

A significant proportion of trauma survivors experience an additional critical life event in the aftermath. These renewed experiences of traumatic and stressful life events may lead to an increase in trauma-related mental health symptoms. In a longitudinal study, the effects of renewed experiences of a trauma or stressful life event were examined. For this purpose, refugees seeking asylum in Germany were assessed for posttraumatic stress symptoms (PTS), Posttraumatic Stress Diagnostic Scale (PDS), anxiety, and depression (Hopkins Symptom Checklist [HSCL-25]) before treatment start as well as after 6 and 12 months during treatment ( N =46). Stressful life events and traumatic events were recorded monthly. If a new event happened, PDS and HSCL were additionally assessed directly afterwards. Mann-Whitney U -tests were performed to calculate the differences between the group that experienced an additional critical event (stressful vs. trauma) during treatment ( n =23) and the group that did not ( n =23), as well as differences within the critical event group between the stressful life event group ( n =13) and the trauma group ( n =10). Refugees improved significantly during the 12-month period of our study, but remained severely distressed. In a comparison of refugees with a new stressful life event or trauma, significant increases in PTS, anxiety, and depressive symptoms were found directly after the experience, compared to the group without a renewed event during the 12 months of treatment. With regard to the different critical life events (stressful vs. trauma), no significant differences were found regarding overall PTS, anxiety, and depression symptoms. Only avoidance symptoms increased significantly in the group experiencing a stressful life event. Although all clinicians should be aware of possible PTS symptom reactivation, especially those working with refugees and asylum seekers, who often experience new critical life events, should understand symptom fluctuation and address it in treatment.

Transdiagnostic culturally adapted CBT with Farsi-speaking refugees: a pilot study.

PubMed

Kananian, Schahryar; Ayoughi, Sarah; Farugie, Arieja; Hinton, Devon; Stangier, Ulrich

2017-01-01

Background : Approximately half of all asylum seekers suffer from trauma-related disorders requiring treatment, among them Posttraumatic Stress Disorder (PTSD), depression, anxiety, and somatic symptoms. There is a lack of easily accessible, low-threshold treatments taking the cultural background into account. Culturally Adapted CBT (CA CBT) is a well evaluated, transdiagnostic group intervention for refugees, using psychoeducation, meditation, and Yoga-like exercises. Objective: An uncontrolled pilot study with male Farsi-speaking refugees from Afghanistan and Iran was conducted to investigate feasibility with this ethnic group; a group for which no previous CBT trials have been reported. Method : The participants were nine Farsi-speaking, male refugees with M.I.N.I./DSM-IV diagnoses comprising PTSD, major depressive disorder, and anxiety disorders. Treatment components were adapted to the specific cultural framework of perception of symptoms, causes, ideas of healing, and local therapeutic processes. Before and after 12 weeks of treatment, the primary outcome was assessed using the General Health Questionnaire (GHQ-28). Secondary outcome measures were the Posttraumatic Checklist, Patient Health Questionnaire, Somatic Symptom Scale, World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), Affective Style Questionnaire (ASQ), and Emotion Regulation Scale (ERS). Results : Seven participants completed treatment. In the completer analysis, improvements were found on almost all questionnaires. Large effect sizes were seen for the GHQ-28 ( d  = 2.0), WHOQOL-BREF scales ( d  = 1.0-2.3), ASQ tolerating subscale ( d  = 2.2), and ERS ( d  = 1.7). With respect to feasibility, cultural adaptation seemed to be a crucial means to promote effectiveness. Conclusion : CA CBT may reduce general psychopathological distress and improve quality of life. Improvement in emotion regulation strategies may mediate treatment effects. More support should be provided to enhance coping with the uncertainty of asylum status and stressful housing conditions. CA CBT appears to be a promising transdiagnostic treatment, serving as an initial low-threshold therapy in a stepped care approach.

Transdiagnostic culturally adapted CBT with Farsi-speaking refugees: a pilot study

PubMed Central

Kananian, Schahryar; Ayoughi, Sarah; Farugie, Arieja; Hinton, Devon; Stangier, Ulrich

2017-01-01

ABSTRACT Background: Approximately half of all asylum seekers suffer from trauma-related disorders requiring treatment, among them Posttraumatic Stress Disorder (PTSD), depression, anxiety, and somatic symptoms. There is a lack of easily accessible, low-threshold treatments taking the cultural background into account. Culturally Adapted CBT (CA CBT) is a well evaluated, transdiagnostic group intervention for refugees, using psychoeducation, meditation, and Yoga-like exercises. Objective: An uncontrolled pilot study with male Farsi-speaking refugees from Afghanistan and Iran was conducted to investigate feasibility with this ethnic group; a group for which no previous CBT trials have been reported. Method: The participants were nine Farsi-speaking, male refugees with M.I.N.I./DSM-IV diagnoses comprising PTSD, major depressive disorder, and anxiety disorders. Treatment components were adapted to the specific cultural framework of perception of symptoms, causes, ideas of healing, and local therapeutic processes. Before and after 12 weeks of treatment, the primary outcome was assessed using the General Health Questionnaire (GHQ-28). Secondary outcome measures were the Posttraumatic Checklist, Patient Health Questionnaire, Somatic Symptom Scale, World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), Affective Style Questionnaire (ASQ), and Emotion Regulation Scale (ERS). Results: Seven participants completed treatment. In the completer analysis, improvements were found on almost all questionnaires. Large effect sizes were seen for the GHQ-28 (d = 2.0), WHOQOL-BREF scales (d = 1.0–2.3), ASQ tolerating subscale (d = 2.2), and ERS (d = 1.7). With respect to feasibility, cultural adaptation seemed to be a crucial means to promote effectiveness. Conclusion: CA CBT may reduce general psychopathological distress and improve quality of life. Improvement in emotion regulation strategies may mediate treatment effects. More support should be provided to enhance coping with the uncertainty of asylum status and stressful housing conditions. CA CBT appears to be a promising transdiagnostic treatment, serving as an initial low-threshold therapy in a stepped care approach. PMID:29163870

Human Capital, Values, and Attitudes of Persons Seeking Refuge in Austria in 2015

PubMed Central

Kohlenberger, Judith; Rengs, Bernhard; Al Zalak, Zakarya; Goujon, Anne; Striessnig, Erich; Potančoková, Michaela; Gisser, Richard; Testa, Maria Rita; Lutz, Wolfgang

2016-01-01

Since its inception in 2010, the Arab Spring has evolved into a situation of violent conflict in many countries, leading to high levels of migration from the affected region. Given the social impact of the large number of individuals applying for asylum across Europe in 2015, it is important to study who these persons are in terms of their skills, motivations, and intentions. DiPAS (Displaced Persons in Austria Survey) aims to uncover the socio-demographic characteristics of the persons seeking refuge who arrived in Austria in 2015, mainly originating from Syria, Iraq and Afghanistan. Particular focus is on human capital, attitudes and values. This survey, the first of its kind in Austria and possibly in Europe, was carried out among adult displaced persons, mostly residing in Vienna, yielding 514 completed interviews. Information gathered on spouses and children allows for the analysis of 972 persons living in Austria, and of further 419 partners and children abroad. Results indicate that the surveyed population comprised mainly young families with children, particularly those coming from Syria and Iraq. Their educational level is high compared with the average level in their country of origin. A vast majority of respondents are Muslims, rating their religiosity at medium levels. Judging from stated attitudes towards gender equity, interviewed men seem to have more liberal attitudes than their compatriots. The majority of respondents do not intend to return to their home countries, mostly because of the perception of permanent threat. DiPAS provides data for political decision-making and the on-going societal dialogue. Its findings can help to inform assessments about the integration potential of the displaced population into the host society. In addition, the applied methodological technique and experiences during the fieldwork provide valuable insights on sampling asylum seekers and refugees in the current European context. PMID:27662373

Emotional suppression in torture survivors: Relationship to posttraumatic stress symptoms and trauma-related negative affect.

PubMed

Nickerson, Angela; Garber, Benjamin; Ahmed, Ola; Asnaani, Anu; Cheung, Jessica; Hofmann, Stefan G; Huynh, Ly; Liddell, Belinda; Litz, Brett T; Pajak, Rosanna; Bryant, Richard A

2016-08-30

While clinical reports suggest that torture survivors may try to suppress their emotions during torture, little is known about the use of emotional suppression following torture. In this study, 82 refugees and asylum-seekers (including 33 torture survivors) completed self-report measures of trait suppression, PTSD symptoms and baseline negative affect before being exposed to images depicting scenes of interpersonal trauma. The use of suppression while viewing the images was indexed and negative affect was measured both immediately after viewing the images and following a five minute rest period. Findings indicated that torture survivors did not show higher rates of trait suppression or state emotional suppression during the experimental session compared to non-torture survivors. However, torture survivors who endorsed state suppression higher levels of distress, and this relationship was especially strong for those with more severe PTSD symptoms. In contrast, there was a negative relationship between state suppression and distress for non-torture survivors with high levels of PTSD symptoms. These findings suggest that, while torture exposure does not lead to greater use of suppression, it does influence the impact of suppression on emotional responses to stimuli. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[Torture survivor asylum seekers in Italy: the experience of the humanitarian association "Doctors Against Torture"].

PubMed

Di Napoli, A; Baglio, G; Bracci, C; Taviani, A; Zerbino, E; Romano, V

2005-01-01

In recent years, the arrival in Italy of people who suffered torture in their countries led a group of volunteer doctors to set up a humanitarian association, "Doctors Against Torture", to provide care and treatment for torture survivors present in Rome. The paper describes the characteristics of 354 persons having at least one access from 1-1-1999 to 31-12-2001. About 51% of the victims came from the Middle East, 43% from Africa. Mean age was 29.6 (SD 7.0). The victims have suffered beatings and other forms of blunt trauma (64%), suspension and other positional torture (14%), psychological violence (28%), inhuman conditions of detention (10%), burns/electric shock (21%), wet asphyxiation and water jets (11%), sexual violence (15%), amputation/penetrating injuries (22%), dental torture and traumatic removal of nails (6%) and 58% suffered more than one type of torture. The types of violence observed require a thorough analysis of our knowledge in the field, in order to help victims on their way to rehabilitation, which is long and uncertain; at the same time, it is fundamental that public health begins to make itself responsible for these persons.

Screening for tuberculosis in migrants and visitors from high incidence settings: present and future perspectives.

PubMed

Dobler, Claudia C; Fox, Greg J; Douglas, Paul; Viney, Kerri A; Ahmad Khan, Faiz; Temesgen, Zelalem; Marais, Ben J

2018-05-24

In most settings with a low incidence of tuberculosis (TB), foreign-born people make up the majority of TB cases, but the distribution of the TB risk among different migrant populations is often poorly quantified. In addition, screening practices for TB disease and latent TB infection vary widely. Addressing the risk of TB in international migrants is an essential component of TB prevention and care efforts in low incidence countries, and strategies to systematically screen for, diagnose, treat and prevent TB among this group contribute to national and global TB elimination goals.This review provides an overview and critical assessment of TB screening practices that are focused on migrants and visitors from high to low TB incidence countries, including pre-migration screening and post-migration follow-up of those deemed to be at an increased risk of developing TB. We focus mainly on migrants who enter the destination country via application for a long-stay visa, as well as asylum seekers and refugees, but briefly consider issues related to short-term visitors and those with long duration multiple-entry visas. Issues related to the screening of children and screening for latent TB infection are also explored. Copyright ©ERS 2018.

The global health concept of the German government: strengths, weaknesses, and opportunities.

PubMed

Bozorgmehr, Kayvan; Bruchhausen, Walter; Hein, Wolfgang; Knipper, Michael; Korte, Rolf; Razum, Oliver; Tinnemann, Peter

2014-01-01

Recognising global health as a rapidly emerging policy field, the German federal government recently released a national concept note for global health politics (July 10, 2013). As the German government could have a significant impact on health globally by making a coherent, evidence-informed, and long-term commitment in this field, we offer an initial appraisal of the strengths, weaknesses, and opportunities for development recognised in this document. We conclude that the national concept is an important first step towards the implementation of a coherent global health policy. However, important gaps were identified in the areas of intellectual property rights and access to medicines. In addition, global health determinants such as trade, economic crises, and liberalisation as well as European Union issues such as the health of migrants, refugees, and asylum seekers are not adequately addressed. Furthermore, little information is provided about the establishment of instruments to ensure an effective inter-ministerial cooperation. Finally, because implementation aspects for the national concept are critical for the success of this initiative, we call upon the newly elected 2013 German government to formulate a global health strategy, which includes a concrete plan of action, a time scale, and measurable goals.

Violence against women: the physician's role.

PubMed

Schmuel, E; Schenker, J G

1998-10-01

Violence against women is one reflection of the unequal power relationship between men and women in societies. Reflections of this inequality include marriage at a very young age, lack of information or choice about fertility control and forced pregnancy within marriage. The different forms of violence against women are: domestic violence and rape, genital mutilation or, gender-based violence by police and security forces, gender-based violence against women during armed conflict, gender-based violence against women refugees and asylum-seekers, violence associated with prostitution and pornography, violence in the workplace, including sexual harassment. Violence against women is condemned, whether it occurs in a societal setting or a domestic setting. It is not a private or family matter. The FIGO Committee for the Study of Ethical Aspects of Human Reproduction released statements to physicians treating women on this issue. Physicians are ethically obliged to inform themselves about the manifestations of violence and recognize cases, to treat the physical and psychological results of violence, to affirm to their patients that violent acts toward them are not acceptable and to advocate for social infrastructures to provide women the choice of seeking secure refuge and ongoing counselling.

Art therapy and mindfulness with survivors of political violence: A qualitative study.

PubMed

Kalmanowitz, Debra L; Ho, Rainbow T H

2017-08-01

This study's objective was to understand how art therapy and mindfulness meditation could be integrated together in the context of different cultures and political violence and in work with asylum seekers suffering from trauma. We conducted a qualitative phenomenological study based on the social construction paradigm. Twelve participants took part in 4 intensive full-day art therapy and mindfulness workshops. The study's setting was an art therapy and mindfulness studio ( Inhabited Studio ) in Hong Kong where participants engaged in art making and in mindfulness-meditation practice. Different aspects of the Inhabited Studio appealed to participants based on each individual's worldview, culture, religion, and coping style. Responses to the Inhabited Studio were organized into 7 thematic clusters. Five themes were categorized into 2 broad categories composed of personal elements (memory, identity) and mediating aspects (emotional/self-regulation, communication, and imagination). The final 2, resilience and worldview, spanned both areas. Participants found the Inhabited Studio culturally compatible and some of the skills they learned helpful in times of stress. This points to how this combination can contribute to building resilience. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Completing treatment for latent tuberculosis: patient background matters.

PubMed

Kan, B; Kalin, M; Bruchfeld, J

2013-05-01

Treatment of latent infection with Mycobacterium tuberculosis effectively reduces future activation and transmission of tuberculosis. However, patient adherence to preventive treatment influences its effectiveness. Treatment completion is commonly considered as a proxy for adherence. To identify factors associated with failure to complete preventive treatment. Data from 415 consecutive patients who started preventive treatment at the Karolinska University Hospital, Stockholm, Sweden, between 2002 and 2007 were collected and treatment completion was evaluated. Patients were classified as 'completers' or 'non-completers'. Association between treatment completion status and patient characteristics was assessed using logistic regression. Younger patients, patients originating from Somalia and asylum seekers were more likely to be non-completers. The proportion of completers increased from 71% in 2002 to 87% in 2007. However, this trend appears to be caused mostly by an increase in the proportion of European patients. The finding of a low rate of treatment completion among Somalis should be regarded as a call for intervention on the individual patient level, also taking into account socio-cultural aspects such as perceptions of health care by the Somali community. Treatment completion continues to be of concern as it is not improving among risk populations.

Geo-helminthiasis among migrants in Sicily: a possible focus for re-emerging neurocysticercosis in Europe.

PubMed

Patamia, Ildebrando; Nicotra, Piermario; Amodeo, Davide; Giuliano, Loretta; Cicero, Calogero Edoardo; Nicoletti, Alessandra

2017-06-01

A dramatic increasing immigration flow was recorded in Europe during the last years. Only in Sicily 120,239 people arrived in 2014. Immigrants may carry neglected tropical diseases endemic in their origin countries. The aim of our study was to evaluate the frequency of geo-helminthiasis, and in particular of intestinal taeniasis, in a sample of migrants hosted in a large asylum seeker centre in the province of Catania. A stool sample was obtained from all the enrolled subjects and a coproparasitological examination was performed. Out of the 274 enrolled subjects (249 men; mean age 26.4 ± 6.2), 30 (11%) carried at least one helminthic infestation. Ancylostomatidae, Trichuris trichiura and Taenia species (spp) were the most common, the latter found in 6 (2.16%) subjects. T. solium carriers can represent a focus of infection for the more complex neurocysticercosis. Even if coproparasitological examination did not allow us to differentiate Taenia spp, we cannot exclude the presence of T. solium carriers among these subjects. Further studies, including coproantigen ELISA to detect Taenia spp, should be carried out in larger samples to better estimate the real burden of T. solium carriers.

Development and Preliminary Validation of Refugee Trauma History Checklist (RTHC)—A Brief Checklist for Survey Studies

PubMed Central

Gottvall, Maria; Vaez, Marjan

2017-01-01

A high proportion of refugees have been subjected to potentially traumatic experiences (PTEs), including torture. PTEs, and torture in particular, are powerful predictors of mental ill health. This paper reports the development and preliminary validation of a brief refugee trauma checklist applicable for survey studies. Methods: A pool of 232 items was generated based on pre-existing instruments. Conceptualization, item selection and item refinement was conducted based on existing literature and in collaboration with experts. Ten cognitive interviews using a Think Aloud Protocol (TAP) were performed in a clinical setting, and field testing of the proposed checklist was performed in a total sample of n = 137 asylum seekers from Syria. Results: The proposed refugee trauma history checklist (RTHC) consists of 2 × 8 items, concerning PTEs that occurred before and during the respondents’ flight, respectively. Results show low item non-response and adequate psychometric properties Conclusions: RTHC is a usable tool for providing self-report data on refugee trauma history surveys of community samples. The core set of included events can be augmented and slight modifications can be applied to RTHC for use also in other refugee populations and settings. PMID:28976937

[Defence mechanisms and coping strategies in men and women: a comparative and structural study based on the artistic production of people suffering from a break-up of their life project].

PubMed

Schiltz, L; Ciccarello, A; Ricci-Boyer, L; Schiltz, J

2013-01-01

A comparative study of men and women suffering from a break-up of their life project allowed us examining the typically female and male manners to cope with trauma, anxiety, guilt, depression and internal destructivity. In a first stage, an exploratory study was focussed on 206 subjects, belonging to several clinical subgroups: people living in great precarity and long-term unemployed people, asylum seekers and refugees, drug addicts, prisoners and people coming out of prison. Secondly, arts therapeutic sessions were proposed with the aim of helping the participants finding an outlet to their situation. The artistic production (drawings and stories induced by music) was analysed with the help of original rating scales, constructed in a phenomenological and structural perspective. We will present a synthesis of our qualitative observations, as well as some results of typological and structural studies, computed with the help of non parametric statistical procedures on the data of N = 93 participants. The results allow us pointing to gender differences and defining typically male and female coping styles. Differential indications for psychotherapy can be extracted from these analyses.

The global health concept of the German government: strengths, weaknesses, and opportunities

PubMed Central

Bozorgmehr, Kayvan; Bruchhausen, Walter; Hein, Wolfgang; Knipper, Michael; Korte, Rolf; Razum, Oliver; Tinnemann, Peter

2014-01-01

Recognising global health as a rapidly emerging policy field, the German federal government recently released a national concept note for global health politics (July 10, 2013). As the German government could have a significant impact on health globally by making a coherent, evidence-informed, and long-term commitment in this field, we offer an initial appraisal of the strengths, weaknesses, and opportunities for development recognised in this document. We conclude that the national concept is an important first step towards the implementation of a coherent global health policy. However, important gaps were identified in the areas of intellectual property rights and access to medicines. In addition, global health determinants such as trade, economic crises, and liberalisation as well as European Union issues such as the health of migrants, refugees, and asylum seekers are not adequately addressed. Furthermore, little information is provided about the establishment of instruments to ensure an effective inter-ministerial cooperation. Finally, because implementation aspects for the national concept are critical for the success of this initiative, we call upon the newly elected 2013 German government to formulate a global health strategy, which includes a concrete plan of action, a time scale, and measurable goals. PMID:24560258

Noncommunicable diseases among urban refugees and asylum-seekers in developing countries: a neglected health care need

PubMed Central

2014-01-01

With the increasing trend in refugee urbanisation, growing numbers of refugees are diagnosed with chronic noncommunicable diseases (NCDs). However, with few exceptions, the local and international communities prioritise communicable diseases. The aim of this study is to review the literature to determine the prevalence and distribution of chronic NCDs among urban refugees living in developing countries, to report refugee access to health care for NCDs and to compare the prevalence of NCDs among urban refugees with the prevalence in their home countries. Major search engines and refugee agency websites were systematically searched between June and July 2012 for articles and reports on NCD prevalence among urban refugees. Most studies were conducted in the Middle East and indicated a high prevalence of NCDs among urban refugees in this region, but in general, the prevalence varied by refugees’ region or country of origin. Hypertension, musculoskeletal disease, diabetes and chronic respiratory disease were the major diseases observed. In general, most urban refugees in developing countries have adequate access to primary health care services. Further investigations are needed to document the burden of NCDs among urban refugees and to identify their need for health care in developing countries. PMID:24708876

8 CFR 1208.9 - Procedure for interview before an asylum officer.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Procedure for interview before an asylum... Withholding of Removal § 1208.9 Procedure for interview before an asylum officer. (a) The Service shall...)(3) and is within the jurisdiction of the Service. (b) The asylum officer shall conduct the interview...

8 CFR 1208.9 - Procedure for interview before an asylum officer.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Procedure for interview before an asylum... Withholding of Removal § 1208.9 Procedure for interview before an asylum officer. (a) The Service shall...)(3) and is within the jurisdiction of the Service. (b) The asylum officer shall conduct the interview...

Asylum and community: the Athens Lunatic Asylum in nineteenth-century Ohio.

PubMed

Ziff, Katherine K; Thomas, David O; Beamish, Patricia M

2008-12-01

This paper examines the role of the village of Athens, Ohio, USA, in the founding and operation of the Athens Lunatic Asylum during the nineteenth century. Taking as its sources official, personal and popular culture documents, the paper focuses on the function of this Asylum as a participant in the economy of its surrounding community. The Athens Lunatic Asylum was deeply connected with its community, functioning as a market for local goods and services as well as an employer. Connections between the Asylum and the community were supported by a physical infrastructure of transportation and utilities as well as a political infrastructure that operated locally and at the state level. Implications for mental health care and for community are proposed.

No Time for Nostalgia!: Asylum-Making, Medicalized Colonialism in British Columbia (1859-97) and Artistic Praxis for Social Transformation

ERIC Educational Resources Information Center

Roman, Leslie G.; Brown, Sheena; Noble, Steven; Wainer, Rafael; Young, Alannah Earl

2009-01-01

This article asks: How have disability, indigenous arts and cultural praxis transformed and challenged the historical sociological archival research into relationships among asylum-making, medicalized colonialism and eugenics in the Woodlands School, formerly the Victoria Lunatic Asylum, the Provincial Asylum for the Insane in Victoria, BC 1859-72…

Through the Looking-Glass: How Nineteenth Century Asylums Shaped School Architecture and Notions of Intellectual Abnormality Shaped Public Education

ERIC Educational Resources Information Center

Roof, David J.

2017-01-01

This paper utilizes Henri Lefebvre's work to examine nineteenth century school architecture, in relation to asylums. The deployment of the asylums occurred in unison with the development of public schools. Based on archival research this paper seeks an examination of this interrelated development. The social/spatial arrangement of asylums and…

A profile of inactive information seekers on influenza prevention: a survey of health care workers in Central Kentucky.

PubMed

Kim, Sujin; Real, Kevin

2016-09-01

This study developed a profile of inactive information seekers by characterising how they are different from active seekers, identifying possible determinants of inactive seekers and understanding characteristics of frequently asked influenza-related questions. A survey and follow-up interviews were conducted between December 2010 and January 2011. A total of 307 health care workers in three hospitals in Central Kentucky (USA) are included. Four study groups were formed based on their information-seeking and vaccination uptake status: (1) Inactive Seekers with Vaccination (N = 141); (2) Inactive Seekers without Vaccination (N = 49); (3) Active Seekers with Vaccination (N = 107); and (4) Active Seekers without Vaccination (N = 10). Inactive Seekers without Vaccination are found to be least responsive to health outcomes. Inactive Seeker groups do not prefer to use sources such as Internet or family/friends. In predicting inactive seekers, Information Needs and Knowledge Perception made significant contributions to prediction. The most frequently asked questions included information about survival duration of influenza virus (N = 25) followed by the incubation period for influenza (N = 24). Profiling inactive seekers can serve as a way to better design customised influenza information sources and services for health care workers, thus giving hospitals through medical libraries additional tools to reduce the spread of influenza. © 2016 Health Libraries Group.

1. View of Asylum (Western) Avenue viaduct in setting from ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. View of Asylum (Western) Avenue viaduct in setting from northwest, facing southeast. - Asylum Avenue Viaduct, Spanning Second Creek & Southern Railroad at State Route 62, Knoxville, Knox County, TN

3. Threequarter elevation view of Asylum (Western) viaduct from southwest, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

3. Three-quarter elevation view of Asylum (Western) viaduct from southwest, facing northeast. - Asylum Avenue Viaduct, Spanning Second Creek & Southern Railroad at State Route 62, Knoxville, Knox County, TN

2. Threequarter elevation view of Asylum (Western) Avenue viaduct from ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

2. Three-quarter elevation view of Asylum (Western) Avenue viaduct from northwest, facing southeast. - Asylum Avenue Viaduct, Spanning Second Creek & Southern Railroad at State Route 62, Knoxville, Knox County, TN

9. Overall underneath view of Asylum (Western) Avenue viaduct, from ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

9. Overall underneath view of Asylum (Western) Avenue viaduct, from east end/downtown toward west, facing northwest. - Asylum Avenue Viaduct, Spanning Second Creek & Southern Railroad at State Route 62, Knoxville, Knox County, TN

6. Through/barrel view of Asylum (Western) Avenue bridge from west ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. Through/barrel view of Asylum (Western) Avenue bridge from west end looking east/downtown, facing southeast. - Asylum Avenue Viaduct, Spanning Second Creek & Southern Railroad at State Route 62, Knoxville, Knox County, TN

4. Threequarter view of Asylum (Western) Avenue viaduct and ramp ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. Three-quarter view of Asylum (Western) Avenue viaduct and ramp on southeast corner of bridge, facing northwest. - Asylum Avenue Viaduct, Spanning Second Creek & Southern Railroad at State Route 62, Knoxville, Knox County, TN

5. Through/barrel view of Asylum (Western) Avenue viaduct from downtown/east ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. Through/barrel view of Asylum (Western) Avenue viaduct from downtown/east end looking west, facing northwest. - Asylum Avenue Viaduct, Spanning Second Creek & Southern Railroad at State Route 62, Knoxville, Knox County, TN

Medical and psychological examination of women seeking asylum: documentation of human rights abuses.

PubMed

Laws, A; Patsalides, B

1997-01-01

Human rights abuses of women are ubiquitous throughout the world. Those perpetrated by governments entitle women to seek political asylum, and many women refugees do so in the United States. The asylum process often requires medical or psychological evaluations to corroborate women's reports of torture or other abuses. This article provides an overview of how to conduct such examinations and how to document findings for the asylum process.

'I am very glad and cheered when I hear the flute': The Treatment of Criminal Lunatics in Late Victorian Broadmoor.

PubMed

Shepherd, Jade

2016-10-01

Through an examination of previously unseen archival records, including patients' letters, this article examines the treatment and experiences of patients in late Victorian Broadmoor Criminal Lunatic Asylum and stakes the place of this institution within the broader history of therapeutic regimes in British asylums. Two main arguments are put forth. The first relates to the evolution of treatment in Victorian asylums. Historians tend to agree that in the 1860s and 1870s 'psychiatric pessimism' took hold, as the optimism that had accompanied the growth of moral treatment, along with its promise of a cure for insanity, abated. It has hitherto been taken for granted that all asylums reflected this change. I question this assumption by showing that Broadmoor did not sit neatly within this framework. Rather, the continued emphasis on work, leisure and kindness privileged at this institution into the late Victorian period was often welcomed positively by patients and physicians alike. Second, I show that, in Broadmoor's case, moral treatment was determined not so much by the distinction between the sexes as the two different classes of patients - Queen's pleasure patients and insane convicts - in the asylum. This distinction between patients not only led to different modes of treatment within Broadmoor, but had an impact on patients' asylum experiences. The privileged access to patients' letters that the Broadmoor records provide not only offers a new perspective on the evolution of treatment in Victorian asylums, but also reveals the rarely accessible views of asylum patients and their families on asylum care.

Parsimony, power, and prescriptive legislation: the politics of pauper lunacy in Northamptonshire, 1845-1876.

PubMed

Smith, Catherine

2007-01-01

The Northampton General Lunatic Asylum opened in 1836 and was funded through local subscriptions. Unlike many other subscription asylums, it did not become a county asylum after the 1845 Lunacy Acts, but was registered as a charitable hospital. This article explores the dynamics that resulted in the Northamptonshire authorities' successfully evading their responsibility to build a county asylum. The loopholes in the supposedly mandatory legislation are examined, with the implications this had for the relationship between the Commissioners in Lunacy and the NGLA governors, as well as the conflict between the local magistrates and the NGLA governors that eventually forced Northamptonshire to conform and build its own specific county asylum in 1876.

Samuel Alderman Lomas (1838-1901) the man with two gravestones, his brother Muscot Atkin Lomas (1840-1907) and their lives in Victorian asylums.

PubMed

Hilton, Claire; Hilton, Benjamin

2009-05-01

Samuel Alderman Lomas died in the Hertfordshire County Asylum, Hill End, St Albans in 1901. He was buried in the asylum cemetery where two gravestones bear his name. This paper traces his life history and that of his brother Muscot Atkin Lomas. Both were classed as idiots in Victorian society and spent most of their lives -- from childhood until death -- in asylums.

Rediscovering the Concept of Asylum for Persons with Serious Mental Illness.

PubMed

Lamb, H Richard; Weinberger, Linda E

2016-03-01

Treating persons with serious mental illness is a complex and challenging endeavor. One intervention that has received little attention in recent years is the need for asylum. Asylum means a sanctuary, a place that lowers levels of stress and provides protection, safety, security, and social support, as well as an array of treatment services. The concept of "asylum" may have lost favor because it was equated with the abysmal conditions found in the state psychiatric hospitals of the past. Among the reasons persons with serious mental illness have been arrested and incarcerated is society's failure to provide adequate levels of asylum. With the release of tens of thousands of mentally ill inmates from state and federal jails and prisons, it is time to revisit this concept, not only for these persons but for those who have not been criminalized. Asylum can be found in various settings, including with family in the patient's home, in a board-and-care facility, or in a psychiatric hospital if necessary. Not all persons with a major mental illness are capable of achieving high levels of social and vocational functioning; however, living in a place that provides asylum can promote a higher quality of life. The value of asylum for many persons with serious mental illness should not be underestimated. © 2016 American Academy of Psychiatry and the Law.

Psychiatric institutions, their architecture, and the politics of regional autonomy in the Austro-Hungarian monarchy.

PubMed

Topp, Leslie

2007-12-01

This paper examines the planning process and architecture of two public psychiatric institutions built around 1900 in Trieste and Lower Austria. From 1864, the building of new asylums was the responsibility of Crown land governments, which by the end of the nineteenth century had emerged as sites of power and self-presentation by minority groups and new political parties. At the same time, the area of asylum planning was establishing itself as a branch of asylum psychiatry and promoting the idea of the asylum as model settlement, contributing to social reform. I analyse the interaction of psychiatrists, architects and government officials involved in planning the two institutions in the context of Crown land governments' self-positioning within the empire and internationally (especially in relation to Italy and Germany). The Trieste asylum planners were working for a government controlled by Italian nationalists, but their desire for a 'modern' asylum turned them towards German models. The Christian Social government in Lower Austria sought to supplant Germany as the leader in this branch of science. The spatial arrangement and visual articulation of the two asylums is interpreted in the context of the interaction of psychiatry and the politics of regional autonomy.

‘I am very glad and cheered when I hear the flute’: The Treatment of Criminal Lunatics in Late Victorian Broadmoor

PubMed Central

Shepherd, Jade

2016-01-01

Through an examination of previously unseen archival records, including patients’ letters, this article examines the treatment and experiences of patients in late Victorian Broadmoor Criminal Lunatic Asylum and stakes the place of this institution within the broader history of therapeutic regimes in British asylums. Two main arguments are put forth. The first relates to the evolution of treatment in Victorian asylums. Historians tend to agree that in the 1860s and 1870s ‘psychiatric pessimism’ took hold, as the optimism that had accompanied the growth of moral treatment, along with its promise of a cure for insanity, abated. It has hitherto been taken for granted that all asylums reflected this change. I question this assumption by showing that Broadmoor did not sit neatly within this framework. Rather, the continued emphasis on work, leisure and kindness privileged at this institution into the late Victorian period was often welcomed positively by patients and physicians alike. Second, I show that, in Broadmoor’s case, moral treatment was determined not so much by the distinction between the sexes as the two different classes of patients – Queen’s pleasure patients and insane convicts – in the asylum. This distinction between patients not only led to different modes of treatment within Broadmoor, but had an impact on patients’ asylum experiences. The privileged access to patients’ letters that the Broadmoor records provide not only offers a new perspective on the evolution of treatment in Victorian asylums, but also reveals the rarely accessible views of asylum patients and their families on asylum care. PMID:27628858

8 CFR 1208.11 - Comments from the Department of State.

Code of Federal Regulations, 2010 CFR

2010-01-01

....11 Section 1208.11 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS PROCEDURES FOR ASYLUM AND WITHHOLDING OF REMOVAL Asylum and Withholding of... relevant. (c) Asylum officers and immigration judges may request specific comments from the Department of...

Vitamin D deficiency in refugees in Italy.

PubMed

De Filippis, L G; Trombetta, I; Novella, T; Alampi, M

2017-09-21

The objective of the research is to determine 25[OH]D serum levels in refugees in Italy. In the following research we have taken into consideration the results of the monitoring of Vitamin D levels in 46 refugees of the Italian Service for protection of refugees and asylum seekers (SPRAR) system. The indicator of overall vitamin D status used was the circulating serum level of 25(OH)D. Data was analyzed using Microsoft Excel. In the refugees tested, the mean level of 25(OH)D resulted 9.18 ng/mL. The standard deviation was 4.8, with a minimal level of 4.3 and a maximum of 27.4. This figure indicates a clear condition of hypovitaminosis in refugees. While it is general assumption that migratory phenomena may induce the spread of tropical or infectious diseases, widely attested literature demonstrates how chronic pathologies and diseases related to altered lifestyles are the most relevant for Italian case records. Indeed, among the aforementioned diseases, Vitamin D deficiency so far lacks acknowledgement at a national level. Considering the results of lower-than-desirable vitamin D levels found in refugees in Italy, it is necessary to take this parameter into consideration when analyzing individuals who have faced migratory phenomena in order to mitigate the effects of hypovitaminosis D.

Food Insecurity in Homeless Families in the Paris Region (France): Results from the ENFAMS Survey

PubMed Central

Martin-Fernandez, Judith; Lioret, Sandrine; Vuillermoz, Cécile; Vandentorren, Stéphanie

2018-01-01

The number of families living in shelters in the Paris region (France) has increased by a factor of three in 10 years. In 2013, a survey was performed on homeless families in order to characterize their living conditions, their health needs, and the developmental problems in children. This probability survey was conducted in 17 languages among 801 homeless families sheltered in emergency centers for asylum-seekers, emergency housing centers, social rehabilitation centers, and social hotels in the Paris region. Among the 772 families that provided data on food security only 14.0% were with food security, whereas 43.3% were with low food security and 9.8% with very low food security (a situation where children are also affected). Stratified multivariate robust Poisson models showed that some characteristics are associated with a higher risk of food insecurity and/or of falling into very low food security, such as residential instability, single parenthood, having more than three children, depressive symptoms, housing in social hostels, and difficult access to cheap or free food locally. Given the wealth of the Paris region, resources and programs should be concentrated on improving the living situation of this vulnerable population. It needs better detection of these families, a closer social follow-up, and an increase in food aid. PMID:29495563

Disintegration of the self and the regeneration of 'psychic skin' in the treatment of traumatized refugees.

PubMed

Luci, Monica

2017-04-01

This paper presents a tentative understanding of the characteristics of the extreme traumas, elsewhere called 'complex PTSD', that some refugees and asylum-seekers bring into therapy. It suggests that these kinds of traumas suffered during adulthood may involve a disintegration of the self and a loss of 'psychic skin'. This conceptualization is derived from the treatment of a refugee who survived multiple extreme traumas and with whom efforts were made in therapy to identify a complex methodology making use of supplementary therapeutic tools in addition to individual psychotherapy. The case demonstrates how the disintegration of self implies not only a deep somato-psychic dissociation, but also a loss of intrapsychic and interpersonal space. In the treatment this was worked through via repetition of the victim-aggressor dynamics at multiple levels. In the end, the therapeutic context was structured like a set of concentric layers, creating a 'bandage' over the patient's wounds whilst his 'psychic skin' was able to regenerate. The conditions triggered by extreme traumas in refugees challenge some of the cornerstones of individual psychoanalytic technique, as well as the idea that individual therapy may be thought of as existing in an environmental vacuum. © 2017, The Society of Analytical Psychology.

Evaluation of a community arts installation event in support of public health.

PubMed

Philipp, Robin; Gibbons, Nigel; Thorne, Pam; Wiltshire, Laura; Burrough, June; Easterby, John

2015-01-01

This study is set in the context of recent arts and health developments. It evaluates the worth for public health of a ten day community arts installation event held in Bristol, England, in support of new immigrants, refugees and asylum seekers. Action research methods were used by members of a creative writing group to elicit among 434 public visitors their free-text reflections on the project and/or their reactions to the event. Based on the three themes of the event, 'Homes', 'Histories' and 'Hope', three independent researchers coded the material for analysis. Participants addressed the theme of hope much more frequently than home or histories. Responses to all three themes were mostly positive. What they hoped was principally for opportunities for themselves and others to be able to enjoy life more and in non-material ways. In all, 45% of them expressed appreciation for the event helping to raise awareness and understanding of the roles of arts and culture in the community. Despite its methodological limitations, the study identified non-material ways individuals can be enabled to feel better supported in society and more positive in their outlooks. From the findings, to help strengthen social capital, community cohesion and constructive citizenship, the outline of a proposed educational tool is presented. © Royal Society for Public Health 2014.

Struggling with imaginaries of trauma and trust: the refugee experience in Switzerland.

PubMed

Gross, Corina Salis

2004-06-01

This article discusses some effects of migration politics on asylum seekers and refugees and on the Swiss health services. It is based on multisited ethnographic research that tracked interpretative concepts of the refugee experience. Following a grounded theory approach, it identifies imaginaries of trauma and trust as key categories in the field of transnational migration and health. The psychiatric concept of trauma and a more popularized discourse of traumatic memory are strongly emphasized in all of the investigated field sites: the providers of primary health care and psychosocial services and representatives of social welfare agencies and law-making bodies use this "diagnosis" extensively. This leads refugees to develop tactics of a) identifying with the trauma discourse in order to become "good refugees" and achieve legal status in Switzerland; b) struggling with the ascribed pathologies and suffering from retraumatizing effects of these predominant trauma policies; and c) trying to refuse or subvert them by emphasizing the existence of structural violence in the receiving countries. An analysis of the interactions of health providers and refugees shows that it takes place in an environment of social and economic insecurity and in a shared imaginary of (mis)trust, putting at stake the moral economy of recent migration politics and the refugee experience.

Posttraumatic stress disorder among refugees: Measurement invariance of Harvard Trauma Questionnaire scores across global regions and response patterns.

PubMed

Rasmussen, Andrew; Verkuilen, Jay; Ho, Emily; Fan, Yuyu

2015-12-01

Despite the central role of posttraumatic stress disorder (PTSD) in international humanitarian aid work, there has been little examination of the measurement invariance of PTSD measures across culturally defined refugee subgroups. This leaves mental health workers in disaster settings with little to support inferences made using the results of standard clinical assessment tools, such as the severity of symptoms and prevalence rates. We examined measurement invariance in scores from the most widely used PTSD measure in refugee populations, the Harvard Trauma Questionnaire (HTQ; Mollica et al., 1992), in a multinational and multilingual sample of asylum seekers from 81 countries of origin in 11 global regions. Clustering HTQ responses to justify grouping regional groups by response patterns resulted in 3 groups for testing measurement invariance: West Africans, Himalayans, and all others. Comparing log-likelihood ratios showed that while configural invariance seemed to hold, metric and scalar invariance did not. These findings call into question the common practice of using standard cut-off scores on PTSD measures across culturally dissimilar refugee populations. In addition, high correlation between factors suggests that the construct validity of scores from North American and European measures of PTSD may not hold globally. (c) 2015 APA, all rights reserved).

A systematic review of psychosocial interventions for adult refugees and asylum seekers.

PubMed

Tribe, Rachel H; Sendt, Kyra-Verena; Tracy, Derek K

2017-05-09

Europe is in the midst of the largest refugee migration since the Second World War; there is an urgent need to provide an updated systematic review of the current best evidence for managing mental distress in refugee populations. The aim of this review is to provide an exhaustive summary of the current literature on psychosocial interventions, both trauma- and non-trauma-focused, for refugee populations experiencing post-traumatic stress disorder (PTSD), depressive or anxiety symptoms. To produce recommendations for future research and current clinical practice. Searches were conducted in PubMed, PsychINFO (Hosted by Ovid), PILOTS and Social Services Abstracts; 5305 articles were screened and 40 were included. This review found medium to high quality evidence supporting the use of narrative exposure therapy (NET). A lack of culturally adapted treatments was apparent and there was less evidence to support standard cognitive behavioural therapy (CBT), Eye Movement Desensitisation and Reprocessing (EMDR) and multidisciplinary treatments. NET produced positive outcomes in refugees from a diverse range of backgrounds and trauma types. There is a general dearth of research in all intervention types: further research should include more "real-world" multidisciplinary interventions that better model clinical practice. Recommendations for evaluating local need, and creating a culturally sensitive workforce are discussed.

Segment of brick perimeter wall extending around the naval asylum ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Segment of brick perimeter wall extending around the naval asylum grounds at twenty-fourth street with Gray's Ferry Avenue branching to the left and Bainbridge Street to the right, looking southwest. - U. S. Naval Asylum, Biddle Hall, Gray's Ferry Avenue, Philadelphia, Philadelphia County, PA

8 CFR 1209.2 - Adjustment of status of alien granted asylum.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 8 Aliens and Nationality 1 2012-01-01 2012-01-01 false Adjustment of status of alien granted asylum. 1209.2 Section 1209.2 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS ADJUSTMENT OF STATUS OF REFUGEES AND ALIENS GRANTED ASYLUM § 1209...

8 CFR 1209.2 - Adjustment of status of alien granted asylum.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 8 Aliens and Nationality 1 2014-01-01 2014-01-01 false Adjustment of status of alien granted asylum. 1209.2 Section 1209.2 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS ADJUSTMENT OF STATUS OF REFUGEES AND ALIENS GRANTED ASYLUM § 1209...

8 CFR 1209.2 - Adjustment of status of alien granted asylum.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Adjustment of status of alien granted asylum. 1209.2 Section 1209.2 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS ADJUSTMENT OF STATUS OF REFUGEES AND ALIENS GRANTED ASYLUM § 1209...

8 CFR 1209.2 - Adjustment of status of alien granted asylum.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 8 Aliens and Nationality 1 2013-01-01 2013-01-01 false Adjustment of status of alien granted asylum. 1209.2 Section 1209.2 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS ADJUSTMENT OF STATUS OF REFUGEES AND ALIENS GRANTED ASYLUM § 1209...

8 CFR 1209.2 - Adjustment of status of alien granted asylum.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Adjustment of status of alien granted asylum. 1209.2 Section 1209.2 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS ADJUSTMENT OF STATUS OF REFUGEES AND ALIENS GRANTED ASYLUM § 1209...

8 CFR 1208.20 - Determining if an asylum application is frivolous.

Code of Federal Regulations, 2010 CFR

2010-01-01

... frivolous. 1208.20 Section 1208.20 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS PROCEDURES FOR ASYLUM AND WITHHOLDING OF REMOVAL Asylum and... only if a final order by an immigration judge or the Board of Immigration Appeals specifically finds...

The Politics of Childhood and Asylum in the UK

ERIC Educational Resources Information Center

Giner, Clotilde

2007-01-01

This article considers the general treatment of asylum-seeking families with children in the UK, focusing on the government's practices and public reactions to these measures. It first describes both the exclusive asylum framework, based on institutionalised suspicion, welfare restrictions and detention, and the inclusive child policy framework,…

Hearing Voices: Lessons from the History of Psychiatry in Ireland.

PubMed

Kelly, B D

2017-03-10

The history of psychiatry is a history of therapeutic enthusiasm, with all of the triumph and tragedy, hubris and humility that such enthusiasm brings. During the 1800s and early 1900s, Ireland-s public asylums were routinely overcrowded, unhygienic and, quite commonly, fatal. The asylums became all-too-convenient options for a society with an apparently insatiable hunger for institutions, incarceration and control. The emergence of clinical professionals, both medical and nursing, was inevitably a factor in this complex mix, but the effects of any search for professional prestige were dwarfed by asylum doctors' clear outrage at what the asylum system became. There were powerful, non-medical, vested interests in keeping large asylums open. Irish society consistently failed to generate solutions to real human suffering (mental illness, disability, disease, poverty, ill fortune) other than the extraordinary network of institutions that characterised so much of Irish history: orphanages, industrial schools, reformatories, workhouses, laundries, borstals, prisons and asylums. As a result, Ireland's remarkable asylum system was primarily a social creation rather than a medical one. Notwithstanding this complex history, Ireland's mental health services have been transformed over the past five decades, although real challenges remain, especially in relation to the homeless mentally ill, the mentally ill in prison, and providing meaningful support to families.

Vitamin D status in recently arrived immigrants from Africa and Asia: a cross-sectional study from Norway of children, adolescents and adults

PubMed Central

Eggemoen, Åse R; Knutsen, Kirsten V; Dalen, Ingvild; Jenum, Anne K

2013-01-01

Objectives To estimate the prevalence of vitamin D deficiency (25(OH)D) <50 nmol/L among recently arrived immigrants from Africa and Asia in Oslo, and to explore 25(OH)D levels according to origin, gender and age. Design A cross-sectional study. Setting Primary healthcare unit in Oslo, Norway, offering family immigrants, asylum seekers, United Nations (UN) refugees or individuals granted asylum a free medical examination on arrival. Participants All individuals from African and Asian countries (n=591) referred to the Centre of Migrant Health, Health Agency, Oslo, Norway in 2010, estimated to cover 60% of the targeted population. Results 25(OH)D <50 nmol/L was very prevalent in immigrants from the Middle East (81% (95% CI 75.4% to 86.6%)), South Sahara Africa (73% (CI 67.5% to 78.5%)) and South Asia (75% (CI 64.0% to 86.0%)), in contrast to East Asians (24% (CI 12.6% to 35.4%)), p<0.001 for differences. The prevalence of 25(OH)D<25 nmol/L was lower but followed the same pattern (Middle East: 38% (CI 31.1% to 45.0%), South Sahara Africa: 24% (CI 18.7% to 29.3%) and South Asia: 35% (CI 22.9% to 47.1%), although it was not observed in East Asians (p<0.001 for differences)). The ethnic differences persisted after adjusting for the duration of residence, seasonality and residence status in multiple linear regression analyses. Female adolescents from South Asia, the Middle East and South Sahara Africa had the lowest levels of 25(OH)D. Further, country-specific median levels of 25(OH)D were low (24–38 nmol/L) among groups from Somalia, Eritrea, Afghanistan and Iraq, the countries with the largest number of immigrants in our study. Conclusions The majority of recently settled immigrant groups from the Middle East, South Asia and Africa had 25(OH)D <50 nmol/L, in contrast to East Asians. Female adolescents from these regions had the lowest levels of 25(OH)D. PMID:24157818

Reiterating "Asylum Archive": Documenting Direct Provision in Ireland

ERIC Educational Resources Information Center

Nedeljkovic, Vukasin

2018-01-01

Originally a coping mechanism for an artist housed in a Direct Provision Centres while seeking asylum in Ireland, "Asylum Archive" has become much more than that. In 2018, it is now a collaborative archive, interactive and intermedial online document, and a scholarly research project. This iteration includes five new images of Railway…

8 CFR 209.2 - Adjustment of status of alien granted asylum.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 8 Aliens and Nationality 1 2013-01-01 2013-01-01 false Adjustment of status of alien granted asylum. 209.2 Section 209.2 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS ADJUSTMENT OF STATUS OF REFUGEES AND ALIENS GRANTED ASYLUM § 209.2 Adjustment of status of alien...

8 CFR 209.2 - Adjustment of status of alien granted asylum.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 8 Aliens and Nationality 1 2012-01-01 2012-01-01 false Adjustment of status of alien granted asylum. 209.2 Section 209.2 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS ADJUSTMENT OF STATUS OF REFUGEES AND ALIENS GRANTED ASYLUM § 209.2 Adjustment of status of alien...

8 CFR 209.2 - Adjustment of status of alien granted asylum.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Adjustment of status of alien granted asylum. 209.2 Section 209.2 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS ADJUSTMENT OF STATUS OF REFUGEES AND ALIENS GRANTED ASYLUM § 209.2 Adjustment of status of alien...

8 CFR 209.2 - Adjustment of status of alien granted asylum.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Adjustment of status of alien granted asylum. 209.2 Section 209.2 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS ADJUSTMENT OF STATUS OF REFUGEES AND ALIENS GRANTED ASYLUM § 209.2 Adjustment of status of alien...

8 CFR 209.2 - Adjustment of status of alien granted asylum.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 8 Aliens and Nationality 1 2014-01-01 2014-01-01 false Adjustment of status of alien granted asylum. 209.2 Section 209.2 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS ADJUSTMENT OF STATUS OF REFUGEES AND ALIENS GRANTED ASYLUM § 209.2 Adjustment of status of alien...

8 CFR 1208.31 - Reasonable fear of persecution or torture determinations involving aliens ordered removed under...

Code of Federal Regulations, 2010 CFR

2010-01-01

... OFFICE FOR IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS PROCEDURES FOR ASYLUM AND... provide the alien with an opportunity to correct errors therein. The asylum officer shall create a written... the authority described in § 1208.9(c). (e) Referral to Immigration Judge. If an asylum officer...

8 CFR 240.67 - Procedure for interview before an asylum officer.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Procedure for interview before an asylum... Procedure for interview before an asylum officer. (a) Fingerprinting requirements. The Service will notify each applicant 14 years of age or older to appear for an interview only after the applicant has...

8 CFR 240.67 - Procedure for interview before an asylum officer.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Procedure for interview before an asylum... Procedure for interview before an asylum officer. (a) Fingerprinting requirements. The Service will notify each applicant 14 years of age or older to appear for an interview only after the applicant has...

32 CFR 700.939 - Granting of asylum and temporary refuge.

Code of Federal Regulations, 2010 CFR

2010-07-01

... of the Secretary of the Navy or higher authority. Persons seeking political asylum should be afforded... for political asylum in the United States will not be received on board, but will be advised to apply... voice communications will be used where possible, but must be confirmed as soon as possible with an...

[Jonathan Swift's asylum in Dublin--Ireland's introduction to institutional psychiatry 250 years ago].

PubMed

Reuber, M

1995-09-01

250 years ago, the satirical writer and clergyman Jonathan Swift from Dublin (1667-1745) founded the first Irish lunatic asylum. Rejecting the theories put forward by the English philosopher Thomas Hobbes and the doctor Thomas Willis, he was influenced by the ideas of the Scottish doctor and the "enlightened" thinker John Locke. Swift's St. Patrick's Hospital did not, however, realise a new philosophical concept: architecture and therapeutic approach of the new institution were clearly modelled on the much older Hospital of St. Mary of Bethlehem ( = Bedlam). Despite its conservative conceptual basis, the first institution dedicated to the mentally ill and intellectually subnormal in Ireland became a starting point for the apparantly unstoppable expansion of the, at one time, most comprehensive asylum system in the world. After Swift's Hospital had been enlarged twice at the tax-payers' expense (1778, 1793), the administration decided to relieve the institution by erecting the Richmond Asylum (1810), the first public asylum in Ireland. When this establishment also became overcrowded, in 1817, legislation was passed which led to the establishment of the oldest system of public asylums in Europe.

Managing job seekers' organizational image beliefs: the role of media richness and media credibility.

PubMed

Cable, Daniel M; Yu, Kang Yang Trevor

2006-07-01

In this article, the authors assessed job seekers' organizational image beliefs before and after they experienced 3 recruitment media. The authors examined whether perceptions of media richness and credibility were related to improvements in the correspondence between job seekers' image beliefs and firms' projected images. Both media richness and credibility perceptions were associated with correspondence between job seekers' image beliefs and firms' projected images. However, results revealed that richness and credibility perceptions were likely to enhance job seekers' initial beliefs about firms' images when their beliefs were positive but did not diminish job seekers' beliefs about firms' images when their initial impressions were too positive. ((c) 2006 APA, all rights reserved).

Occult Genres and the Certification of Madness in a 19th-Century Lunatic Asylum

ERIC Educational Resources Information Center

Berkenkotter, Carol; Hanganu-Bresch, Cristina

2011-01-01

Using archival admissions records and case histories of patients at a British asylum from the 1860s to the 1870s, the authors examine the medical certification process leading to the asylum confinement of individuals judged to be "of unsound mind." These institutional texts are, the authors suggest, "occult genres" that…

Advocacy and Surveillance: Primary Schools Teachers' Relationships with Asylum-Seeking Mothers in Ireland

ERIC Educational Resources Information Center

Martin, Shirley; Horgan, Deirdre; O'Riordan, Jacqui; Christie, Alastair

2018-01-01

The article analyses the findings of a small-scale qualitative study in Ireland that examines interactions between asylum-seeking mothers and primary school teachers, and highlights the significance of teachers' understandings of asylum in shaping home-school communications. Mothers and children in this study were living in Direct Provision,…

8 CFR 208.10 - Failure to appear at an interview before an asylum officer or failure to follow requirements for...

Code of Federal Regulations, 2011 CFR

2011-01-01

... asylum officer or failure to follow requirements for fingerprint processing. 208.10 Section 208.10 Aliens... asylum officer or failure to follow requirements for fingerprint processing. Failure to appear for a... right to an interview. Failure to comply with fingerprint processing requirements without good cause may...

8 CFR 208.10 - Failure to appear at an interview before an asylum officer or failure to follow requirements for...

Code of Federal Regulations, 2010 CFR

2010-01-01

... asylum officer or failure to follow requirements for fingerprint processing. 208.10 Section 208.10 Aliens... asylum officer or failure to follow requirements for fingerprint processing. Failure to appear for a... right to an interview. Failure to comply with fingerprint processing requirements without good cause may...

8 CFR 208.10 - Failure to appear at an interview before an asylum officer or failure to follow requirements for...

Code of Federal Regulations, 2013 CFR

2013-01-01

... asylum officer or failure to follow requirements for fingerprint processing. 208.10 Section 208.10 Aliens... asylum officer or failure to follow requirements for fingerprint processing. Failure to appear for a... right to an interview. Failure to comply with fingerprint processing requirements without good cause may...

8 CFR 208.10 - Failure to appear at an interview before an asylum officer or failure to follow requirements for...

Code of Federal Regulations, 2014 CFR

2014-01-01

... asylum officer or failure to follow requirements for fingerprint processing. 208.10 Section 208.10 Aliens... asylum officer or failure to follow requirements for fingerprint processing. Failure to appear for a... right to an interview. Failure to comply with fingerprint processing requirements without good cause may...

8 CFR 208.10 - Failure to appear at an interview before an asylum officer or failure to follow requirements for...

Code of Federal Regulations, 2012 CFR

2012-01-01

... asylum officer or failure to follow requirements for fingerprint processing. 208.10 Section 208.10 Aliens... asylum officer or failure to follow requirements for fingerprint processing. Failure to appear for a... right to an interview. Failure to comply with fingerprint processing requirements without good cause may...

8 CFR 1240.67 - Procedure for interview before an asylum officer.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Procedure for interview before an asylum... 203 of Pub. L. 105-100 § 1240.67 Procedure for interview before an asylum officer. (a) Fingerprinting requirements. The Service will notify each applicant 14 years of age or older to appear for an interview only...

8 CFR 1240.67 - Procedure for interview before an asylum officer.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Procedure for interview before an asylum... 203 of Pub. L. 105-100 § 1240.67 Procedure for interview before an asylum officer. (a) Fingerprinting requirements. The Service will notify each applicant 14 years of age or older to appear for an interview only...

Death and the dead-house in Victorian asylums: necroscopy versus mourning at the Royal Edinburgh Asylum, C. 1832-1901.

PubMed

Andrews, Jonathan

2012-03-01

This article examines the management and meaning of post-mortem examinations, and the spatial ordering of patients' death, dissection and burial at the Victorian asylum, referencing a range of institutional contexts and exploiting a case study of the Royal Edinburgh Asylum. The routinizing of dissection and the development of the dead-house from a more marginal asylum sector to a lynchpin of laboratory medicine is stressed. External and internal pressure to modernize pathological research facilities is assessed alongside governmental, public and professional critiques of variable necroscopy practices. This is contextualized against wider issues and attitudes surrounding consent and funereal rituals. Onus is placed on tendencies in anatomizing insanity towards the conversion of deceased lunatics--pauper lunatics especially--into mere pathological specimens. On the other hand, significant but compromised resistance on the part of a minority of practitioners, relatives and the wider public is also identified.

Application of optical limiting materials in laser seeker

NASA Astrophysics Data System (ADS)

Niu, Yan-xiong; Wu, Dong-sheng; Zhang, Peng; Duan, Xiao-feng

2005-01-01

Seeker is the key component in the laser guided weapons. Although the seeker has many anti-jamming measures such as the narrowband filter in the front of the seeker and the tracking gate processing circuit in signal processing part, and these anti-jamming measures are always effective for the low power jamming laser. As far as the high power laser which can pass though the filter is concerned, it is easy to make the detector saturate, which will lead the seeker into losing the capturing and tracking capability for the target. In the past ten years, the applied research of organic nonlinear materials which is according to the optical limiting effect has had great development in the laser technology field. And some of these materials have been put into practicability phase. This kind of materials is characterized by its wide absorption spectrum, obvious nonlinear effect and quick response speed, all of which excel the mineral. If this kind of materials can be applied into the laser seeker, it will remedy the laser seeker's defect that its protective capability is weak for the high power jamming laser. The whole applied scheme is present in this paper. And the anti-jamming capability of seeker is analysed constructively before and after the organic matter is applied in the laser seeker. The result indicates that this kind of method is viable in theory.

Internet health information seeking is a team sport: analysis of the Pew Internet Survey.

PubMed

Sadasivam, Rajani S; Kinney, Rebecca L; Lemon, Stephenie C; Shimada, Stephanie L; Allison, Jeroan J; Houston, Thomas K

2013-03-01

Previous studies examining characteristics of Internet health information seekers do not distinguish between those who only seek for themselves, and surrogate seekers who look for health information for family or friends. Identifying the unique characteristics of surrogate seekers would help in developing Internet interventions that better support these information seekers. To assess differences between self seekers versus those that act also as surrogate seekers. We analyzed data from the cross-sectional Pew Internet and American Life Project November/December 2008 health survey. Our dependent variable was self-report of type of health information seeking (surrogate versus self seeking). Independent variables included demographics, health status, and caregiving. After bivariate comparisons, we then developed multivariable models using logistic regression to assess characteristics associated with surrogate seeking. Out of 1250 respondents who reported seeking health information online, 56% (N=705) reported being surrogate seekers. In multivariable models, compared with those who sought information for themselves only, surrogate seekers were more likely both married and a parent (OR=1.57, CI=1.08, 2.28), having good (OR=2.05, CI=1.34, 3.12) or excellent (OR=2.72, CI=1.70, 4.33) health status, being caregiver of an adult relative (OR=1.76, CI=1.34, 2.30), having someone close with a serious medical condition (OR=1.62, CI=1.21, 2.17) and having someone close to them facing a chronic illness (OR=1.55, CI=1.17, 2.04). Our findings provide evidence that information needs of surrogate seekers are not being met, specifically of caregivers. Additional research is needed to develop new functions that support surrogate seekers. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Awareness of treatment history in family and friends, and mental health care seeking propensity.

PubMed

Thériault, François L; Colman, Ian

2017-04-01

Many adults suffering from mental disorders never receive the care they need. The role of family and friends in overcoming mental health treatment barriers is poorly understood. We investigated the association between awareness of lifetime mental health treatment history in one's family or friends, and likelihood of having recently received mental health care for oneself. Using Canadian Community Health Survey 2012-Mental Health data, we defined care seekers as individuals who talked about mental health issues to at least one health professional in the past 12 months. Seekers were matched to non-seekers based on estimated care seeking propensity, and 1933 matched pairs were created. Reported awareness of lifetime treatment history in family and friends was compared between seekers and non-seekers. There were no differences in the distribution of any confounder of interest between seekers and non-seekers. 73% of seekers were aware of treatment history in family or friends, compared to only 56% of non-seekers (RR 1.3; 95% CI 1.2, 1.3). Awareness of treatment history in family members had nearly identical associations with care seeking as awareness of treatment history in friends. We have found a social clustering of mental health care seeking behavior; individuals who were aware of lifetime treatment history in family or friends were more likely to have recently sought care for themselves. These novel results are consistent with a social learning model of care seeking behavior, and could inform efforts to bridge the current mental health treatment gap.

'Visitation by God': rationalizing death in the Victorian asylum.

PubMed

Smith, Cathy

2012-03-01

This article argues that death from insanity raised serious questions for the medical profession and for those who promoted the public asylum movement in the nineteenth century. While the medical emphasis on the somatic origins of insanity was increasingly accepted, limited observable signs of disease in the brain at post-mortem made it difficult to explain cause of death. This posed problems for a growing county asylum movement which was justified on the basis that insanity was a treatable disease and thus mortality rates would naturally decline. As asylum populations continued to grow and mortality rates remained little changed, statistics on lunacy ultimately became not the predicted measure of success but instead clear evidence of failure.

Health information-seeking on behalf of others: characteristics of "surrogate seekers".

PubMed

Cutrona, Sarah L; Mazor, Kathleen M; Vieux, Sana N; Luger, Tana M; Volkman, Julie E; Finney Rutten, Lila J

2015-03-01

Understanding the behaviors of surrogate seekers (those who seek health information for others) may guide efforts to improve health information transmission. We used 2011-2012 data from the Health Information National Trends Survey to describe behaviors of online surrogate seekers. Respondents were asked about use of the Internet for surrogate-seeking over the prior 12 months. Data were weighted to calculate population estimates. Two thirds (66.6%) reported surrogate-seeking. Compared to those who sought health information online for only themselves, surrogate seekers were more likely to live in households with others (weighted percent 89.4 vs. 82.5% of self-seekers; p < 0.05); no significant differences in sex, race, income or education were observed. Surrogate seekers were more likely to report activities requiring user-generated content: email communication with healthcare providers; visits to social networking sites to read and share about medical topics and participation in online health support groups. On multivariate analysis, those who had looked online for healthcare providers were more likely to be surrogate seekers (OR 1.67, 95% CI 1.08-2.59). In addition to seeking health information, surrogate seekers create and pass along communications that may influence medical care decisions. Research is needed to identify ways to facilitate transmission of accurate health information.

Death and the dead-house in Victorian asylums: necroscopy versus mourning at the Royal Edinburgh Asylum, c. 1832–1901

PubMed Central

Andrews, Jonathan

2014-01-01

This article examines the management and meaning of post-mortem examinations, and the spatial ordering of patients’ death, dissection and burial at the Victorian asylum, referencing a range of institutional contexts and exploiting a case study of the Royal Edinburgh Asylum. The routinizing of dissection and the development of the dead-house from a more marginal asylum sector to a lynchpin of laboratory medicine is stressed. External and internal pressure to modernize pathological research facilities is assessed alongside governmental, public and professional critiques of variable necroscopy practices. This is contextualized against wider issues and attitudes surrounding consent and funereal rituals. Onus is placed on tendencies in anatomizing insanity towards the conversion of deceased lunatics – pauper lunatics especially – into mere pathological specimens. On the other hand, significant but compromised resistance on the part of a minority of practitioners, relatives and the wider public is also identified. PMID:22701924

Migration and determinants of health: clinical epidemiological characteristics of migrants in Malta (2010-11).

PubMed

Padovese, Valeska; Egidi, Ada Maristella; Melillo Fenech, Tanya; Podda Connor, Marika; Didero, Daniele; Costanzo, Gianfranco; Mirisola, Concetta

2014-09-01

Over recent years Malta has experienced a growing influx of migrants from Africa. With the aim of defining demographic characteristics and assessing the prevalence of conditions of public health significance among asylum seekers in Malta, a clinical research study was implemented in the framework of the European Union project 'Mare nostrum'. From August 2010 to June 2011 a dermatologist and an infectious diseases specialist performed general and specialist health assessment of migrants hosted in open centres. Migrants included in the study were 2216, 82.7% were males, their mean age was 25 years and 70.1% were from Somalia. Out of the total females, 42.5% had undergone some type of Female Genital Mutilation/Cutting. A total of 5077 diagnoses were set, most common were skin diseases (21.9%), respiratory diseases (19.8%) and gastro-enteric diseases (14.2%), whereas 31% of migrants reported good health conditions. Immigrants have a lower morbidity burden compared with their fellow countrymen living in the origin country. However, living conditions during the journey, in transit countries and after arrival can influence their health status. The present study provides a comprehensive picture of this growing population that is in need for health promotion, mental health services and fair policy planning. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Change in visa status amongst Mandaean refugees: relationship to psychological symptoms and living difficulties.

PubMed

Nickerson, Angela; Steel, Zachary; Bryant, Richard; Brooks, Robert; Silove, Derrick

2011-05-15

Policies of deterrence, including the use of detention and temporary visas, have been widely implemented to dissuade asylum seekers from seeking protection in Western countries. The present study examined the impact of visa status change on the mental health of 97 Mandaean refugees resettled in Australia. At the time of the first survey (2004), 68 (70%) participants held temporary protection visas (TPVs) and 29 (30%) held permanent residency (PR) status, whereas by the second survey (2007), 97 (100%) participants held PR status. We tested a meditational model to determine whether the relationship between change in visa status and change in psychological symptoms was mediated by change in living difficulties associated with the visa categories. The conversion of visa status from TPV to PR status was associated with significant improvements in PTSD and depression symptoms, and increases in mental health-related quality of life (MHR-QOL). The relationship between change in visa status and reduced PTSD and depression symptoms was mediated by reductions in living difficulties. In contrast, the relationship between change in visa status and increased MHR-QOL was not mediated by changes in living difficulties. These results suggest that restriction of rights and access to services related to visa status negatively affect the mental health of refugees. Implications for government policies regarding refugees are discussed. Copyright © 2010. Published by Elsevier Ireland Ltd.

Applicability of T1-weighted MRI in the assessment of forensic age based on the epiphyseal closure of the humeral head.

PubMed

Ekizoglu, Oguzhan; Inci, Ercan; Ors, Suna; Kacmaz, Ismail Eralp; Basa, Can Doruk; Can, Ismail Ozgur; Kranioti, Elena F

2018-05-26

This work investigates the value of magnetic resonance imaging analysis of proximal epiphyseal fusion in research examining the growth and development of the humerus and its potential utility in establishing forensic age estimation. In this study, 428 proximal humeral epiphyses (patient age, 12-30 years) were evaluated with T1-weighted turbo spin echo (T1 TSE) sequences in coronal oblique orientation on shoulder MRI images. A scoring system was created following a combination of the Schmeling and Kellinghaus methods. Spearman's rank correlation analysis revealed a significant positive relationship between age and ossification stage of the proximal humeral epiphysis (all subjects: rho = 0.664, p < 0.001; males: 0.631, p < 0.001; females: rho = 0.651, p < 0.001). The intra- and inter-observer reliability assessed using Cohen's kappa statistic was κ = 0.898 and κ = 0.828, respectively. The earliest age of epiphysis closure was 17 years for females and 18 years for males. MRI of the proximal humeral epiphysis can be considered advantageous for forensic age estimation of living individuals in a variety of situations, ranging from monitoring public health to estimating the age of illegal immigrants/asylum seekers, minors engaged in criminal activities, and illegal participants in competitive sports, without the danger of radiation exposure.

Angle Measurement of Objects outside the Linear Field of View of a Strapdown Semi-Active Laser Seeker.

PubMed

Zheng, Yongbin; Chen, Huimin; Zhou, Zongtan

2018-05-23

The accurate angle measurement of objects outside the linear field of view (FOV) is a challenging task for a strapdown semi-active laser seeker and is not yet well resolved. Considering the fact that the strapdown semi-active laser seeker is equipped with GPS and an inertial navigation system (INS) on a missile, in this work, we present an angle measurement method based on the fusion of the seeker’s data and GPS and INS data for a strapdown semi-active laser seeker. When an object is in the nonlinear FOV or outside the FOV, by solving the problems of space consistency and time consistency, the pitch angle and yaw angle of the object can be calculated via the fusion of the last valid angles measured by the seeker and the corresponding GPS and INS data. The numerical simulation results demonstrate the correctness and effectiveness of the proposed method.

A 'Scottish Poor Law of Lunacy'? Poor Law, Lunacy Law and Scotland's parochial asylums.

PubMed

Farquharson, Lauren

2017-03-01

Scotland's parochial asylums are unfamiliar institutional spaces. Representing the concrete manifestation of the collision between two spheres of legislation, the Poor Law and the Lunacy Law, six such asylums were constructed in the latter half of the nineteenth century. These sites expressed the enduring mandate of the Scottish Poor Law 1845 over the domain of 'madness'. They were institutions whose very existence was fashioned at the directive of the local arm of the Poor Law, the parochial board, and they constituted a continuing 'Scottish Poor Law of Lunacy'. Their origins and operation significantly subverted the intentions and objectives of the Lunacy Act 1857, the aim of which had been to institute a public district asylum network with nationwide coverage.

[Communication and mental health: a discursive analysis of posters of the National Anti-Asylum Campaign Movement in Brazil].

PubMed

Espirito Santo, Wanda; Araujo, Inesita Soares de; Amarante, Paulo

2016-01-26

The article analyzes two posters that with the same slogan - "Asylums nevermore" - promote National Anti-Asylum Day. The analysis was based on principles of the symptomatology of social discourse, articulating analytical concepts and practices arising from the French School and the pragmatic dimension of discourse analysis. The results revealed affirmation strategies of the movement for the qualification and exacerbation of the issues of the enunciation and other enunciators, namely political actors of the anti-asylum movement and their allies. It also reveals the attempt to disqualify competitive discourse, especially that which discloses the serious problems of its institutional models, but also by juxtaposing the positive presence of the issuers and enunciators of the posters.

Interactions and user-perceived helpfulness in diet information social questions & answers.

PubMed

Zhang, Yin; Wang, Peilin

2016-12-01

Online health information seeking using social questions and answers (Social Q&A) sites has been increasingly popular in recent years. It calls for better understanding of health information seeking behaviour and interactions between information seekers and information providers. The study investigates how diet information seekers interact with information providers on WebMD Answers, which is a Social Q&A site devoted to health-related topics, and examines the factors that constitute a 'helpful' answer from an information seeker's perspective. Bales' interaction process analysis was applied as the framework to analyse 568 diet-related Q&As from WebMD Answers to identify interaction patterns. Most diet information seekers post questions anonymously and without any detailed description. Individual experts or health organisations provide most answers. Overall, answers are positively received and had a high satisfaction rating. It was also found that information seeker-perceived helpfulness does not depend on who answered the question but to how an information seeker posted the question. This study indicates that answers at WebMD Answers are helpful for diet information seekers. It sheds new light on the interactions during the Q&A process, preferred site functions and important factors that contribute to perceived helpful answers. © 2016 Health Libraries Group.

Asylum applications respond to temperature fluctuations.

PubMed

Missirian, Anouch; Schlenker, Wolfram

2017-12-22

International negotiations on climate change, along with recent upsurges in migration across the Mediterranean Sea, have highlighted the need to better understand the possible effects of climate change on human migration-in particular, across national borders. Here we examine how, in the recent past (2000-2014), weather variations in 103 source countries translated into asylum applications to the European Union, which averaged 351,000 per year in our sample. We find that temperatures that deviated from the moderate optimum (~20°C) increased asylum applications in a nonlinear fashion, which implies an accelerated increase under continued future warming. Holding everything else constant, asylum applications by the end of the century are predicted to increase, on average, by 28% (98,000 additional asylum applications per year) under representative concentration pathway (RCP) scenario 4.5 and by 188% (660,000 additional applications per year) under RCP 8.5 for the 21 climate models in the NASA Earth Exchange Global Daily Downscaled Projections (NEX-GDDP). Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

The architecture of psychological management: the Irish asylums (1801-1922).

PubMed

Reuber, M

1996-11-01

This analysis examines some of the psychological, philosophical and sociological motives behind the development of pauper lunatic asylum architecture in Ireland during the time of the Anglo-Irish union (1801-1922). Ground plans and structural features are used to define five psycho-architectonic generations. While isolation and classification were the prime objectives in the first public asylum in Ireland (1810-1814), a combination of the ideas of a psychological, 'moral', management and 'panoptic' architecture led to a radial institutional design during the next phase of construction (1817-1835). The asylums of the third generation (1845-1855) lacked 'panoptic' features but they were still intended to allow a proper 'moral' management of the inmates, and to create a therapeutic family environment. By the time the institutions of the fourth epoch were erected (1862-1869) the 'moral' treatment approach had been given up, and asylums were built to allow a psychological management by 'association'. The last institutions (1894-1922) built before Ireland's acquisition of Dominion status (1922) were intended to foster the development of a curative society.

Bloody technology: the sphygmograph in asylum practice

PubMed Central

Wallis, Jennifer

2017-01-01

The sphygmograph, an instrument to measure and visually chart the pulse, was used by a number of asylum researchers in the late nineteenth century in an attempt to better understand mental disease. In charting the use of such a medical technology in the asylum, this article explores the utility of a practice-oriented approach in the history of psychiatry – as a window onto the alienist profession and as a means of investigating how new medical technologies were assimilated into everyday practice. PMID:28361548

Mass Media Strategies Targeting High Sensation Seekers: What Works and Why

ERIC Educational Resources Information Center

Stephenson, Michael T.

2003-01-01

Objectives: To examine strategies for using the mass media effectively in drug prevention campaigns targeting high sensation seekers. Methods: Both experimental lab and field studies were used to develop a comprehensive audience segmentation strategy targeting high sensation seekers. Results: A 4-pronged targeting strategy employed in an…

Identification of Workplace Dress by Low-Income Job Seekers

ERIC Educational Resources Information Center

Saiki, Diana

2013-01-01

The author examined how low-income job seekers participating in a workplace dress program identified traditional business and business casual dress. Seventy low-income job seekers identified clothing items as traditional business (e.g., suits, ties), similar to identifications made by professionals and image consultants in previous literature.…

Health information seeking on behalf of others: Characteristics of ‘surrogate seekers’

PubMed Central

Cutrona, Sarah L.; Mazor, Kathleen M.; Vieux, Sana N.; Luger, Tana M.; Volkman, Julie E.; Finney Rutten, Lila J.

2014-01-01

Understanding the behaviors of surrogate-seekers (those who seek health information for others) may guide efforts to improve health information transmission. We used 2011–2012 data from the Health Information National Trends Survey to describe behaviors of online surrogate-seekers. Respondents were asked about use of the Internet for surrogate-seeking over the prior 12 months. Data were weighted to calculate population estimates. Two-thirds (66.6%) reported surrogate-seeking. Compared to those who sought health information online for only themselves, surrogate-seekers were more likely to live in households with others (weighted percent 89.4% vs. 82.5% of self-seekers; p < 0.05); no significant differences in sex, race, income or education were observed. Surrogate-seekers were more likely to report activities requiring user-generated content: email communication with healthcare providers; visits to social networking sites to read and share about medical topics and participation in online health support groups. On multivariate analysis, those who had looked online for healthcare providers were more likely to be surrogate-seekers (OR 1.67, 95% CI 1.08–2.59). In addition to seeking health information, surrogate-seekers create and pass along communications that may influence medical care decisions. Research is needed to identify ways to facilitate transmission of accurate health information. PMID:24989816

Too little, too late or too much, too early? Differential hemodynamics of response inhibition in high and low sensation seekers

PubMed Central

Collins, Heather R.; Corbly, Christine R.; Liu, Xun; Kelly, Thomas H.; Lynam, Donald; Joseph, Jane E.

2012-01-01

High sensation seeking is associated with strong approach behaviors and weak avoidance responses. The present study used functional magnetic resonance imaging (fMRI) to further characterize the neurobiological underpinnings of this behavioral profile using a Go/No-go task. Analysis of brain activation associated with response inhibition (No-go) versus response initiation and execution (Go) revealed the commonly reported right lateral prefrontal, insula, cingulate, and supplementary motor area network. However, right lateral activation was associated with greater No-go than Go responses only in low sensation seekers. High sensation seekers showed no differential activation in these regions but a more pronounced Go compared to No-go response in several other regions that are involved in salience detection (insula), motor initiation (anterior cingulate) and attention (inferior parietal cortex). Temporal analysis of the hemodynamic response for Go and No-go conditions revealed that the stronger response to Go than No-go trials in high sensation seekers occurred in in the earliest time window in the right middle frontal gyrus, right mid-cingulate and right precuneus. In contrast, the greater No-go than Go response in low sensation seekers occurred in the later time window in these same regions. These findings indicate that high sensation seekers more strongly attend to or process Go trials and show delayed or minimal inhibitory responses on No-go trials in regions that low sensation seekers use for response inhibition. Failure to engage such regions for response inhibition may underlie some of the risky and impulsive behaviors observed in high sensation seekers. PMID:22902769

Food refusal and insanity: sitophobia and anorexia nervosa in Victorian asylums.

PubMed

van Deth, R; Vandereycken, W

2000-05-01

Although anorexia nervosa emerged as a new syndrome in the second half of the 19th century, this clinical picture seemed to be unknown in the psychiatric hospitals or asylums. In asylum medicine, the commonly used concept of sitophobia to designate food refusal in the insane covered a wide variety of mental disturbances and cannot be plainly equated with anorexia nervosa. A major difference is the occurrence of hallucinations and delusions specifically centered around religion and digestion. Most probably, anorectic patients were not treated in asylums, but at home, in the doctor's office, or in general hospitals. This pattern may be partly attributed to the fact that both patients and doctors were focusing on symptoms of self-starvation like emaciation, constipation, and amenorrhea, which were primarily interpreted as referring to somatic diseases. Additionally, wealthy families probably preferred private care in water-cure establishments, sanatoria, and rest homes to the stigmatizing referral of their anorectic daughter to an asylum. Hence, the fact that late 19th-century institutionalized psychiatry was only incidentally confronted with anorexia nervosa may explain its lack of interest in the emerging syndrome. Copyright 2000 by John Wiley & Sons, Inc.

[The end of the asylum, a change in representations].

PubMed

Gelly, Frédéric

Through the major changes which the psychiatric hospital has undergone throughout history, the question is raised of the identity of caregivers, what the psychiatric asylum provides as a response to mental illness, and the function of the asylum as a place for receiving and then caring for patients, within society. These radical changes, which undermine the narcissism of caregivers, have consequences both within the psychiatric hospital and society as a whole. Consequences which question the very notion of care in a post-modern society. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

StrainSeeker: fast identification of bacterial strains from raw sequencing reads using user-provided guide trees.

PubMed

Roosaare, Märt; Vaher, Mihkel; Kaplinski, Lauris; Möls, Märt; Andreson, Reidar; Lepamets, Maarja; Kõressaar, Triinu; Naaber, Paul; Kõljalg, Siiri; Remm, Maido

2017-01-01

Fast, accurate and high-throughput identification of bacterial isolates is in great demand. The present work was conducted to investigate the possibility of identifying isolates from unassembled next-generation sequencing reads using custom-made guide trees. A tool named StrainSeeker was developed that constructs a list of specific k -mers for each node of any given Newick-format tree and enables the identification of bacterial isolates in 1-2 min. It uses a novel algorithm, which analyses the observed and expected fractions of node-specific k -mers to test the presence of each node in the sample. This allows StrainSeeker to determine where the isolate branches off the guide tree and assign it to a clade whereas other tools assign each read to a reference genome. Using a dataset of 100 Escherichia coli isolates, we demonstrate that StrainSeeker can predict the clades of E. coli with 92% accuracy and correct tree branch assignment with 98% accuracy. Twenty-five thousand Illumina HiSeq reads are sufficient for identification of the strain. StrainSeeker is a software program that identifies bacterial isolates by assigning them to nodes or leaves of a custom-made guide tree. StrainSeeker's web interface and pre-computed guide trees are available at http://bioinfo.ut.ee/strainseeker. Source code is stored at GitHub: https://github.com/bioinfo-ut/StrainSeeker.

8 CFR 208.21 - Admission of the asylee's spouse and children.

Code of Federal Regulations, 2013 CFR

2013-01-01

... REGULATIONS PROCEDURES FOR ASYLUM AND WITHHOLDING OF REMOVAL Asylum and Withholding of Removal § 208.21... his or her spouse or child(ren) by filing a separate Request for Refugee/Asylee Relative for each...

8 CFR 208.21 - Admission of the asylee's spouse and children.

Code of Federal Regulations, 2014 CFR

2014-01-01

... REGULATIONS PROCEDURES FOR ASYLUM AND WITHHOLDING OF REMOVAL Asylum and Withholding of Removal § 208.21... his or her spouse or child(ren) by filing a separate Request for Refugee/Asylee Relative for each...

8 CFR 208.21 - Admission of the asylee's spouse and children.

Code of Federal Regulations, 2012 CFR

2012-01-01

... REGULATIONS PROCEDURES FOR ASYLUM AND WITHHOLDING OF REMOVAL Asylum and Withholding of Removal § 208.21... his or her spouse or child(ren) by filing a separate Request for Refugee/Asylee Relative for each...

Science Seeker: A New Model for Teaching Information Literacy to Entry-Level Biology Undergraduates

ERIC Educational Resources Information Center

Petzold, Jacquelyn; Winterman, Brian; Montooth, Kristi

2010-01-01

In order to integrate library instruction seamlessly into an introductory biology course, two librarians collaborated with a biology faculty member to create a three-part series of instruction sessions known as the Science Seeker. The Science Seeker taught students about the structure of scientific information by tracing the path that discoveries…

Fear versus humor: the impact of sensation seeking on physiological, cognitive, and emotional responses to antialcohol abuse messages.

PubMed

Lee, Moon J; Shin, Mija

2011-01-01

This study investigates the differences in physiological, cognitive, and emotional responses to existing emotional antialcohol abuse advertisements (fear vs. humor appeal) between high and low sensation seekers. A 2 (Message Type) x 2 (Sensation-Seeking Tendency) x 4 (Message Repetition) mixed-model experiment with repeated measures was conducted with 71 college students. The results, based on self-reports, indicated that fear messages generated more interest and perceived danger of excessive drinking regardless of sensation-seeking tendency, whereas humorous messages were rated as more likeable than fear messages, and the difference was bigger among low sensation seekers than among high sensation seekers. One interesting finding was that for both fear and humor appeals, low sensation seekers showed greater emotional responses (greater corrugators activities and greater zygomatic activities) than high sensation seekers overall. The implications of the current study as well as suggestions for future study were discussed.

[Josephinism in medicine: the General Hospital in Vienna and the "Narrenturm" (insane asylum)].

PubMed

Sablik, K

1991-01-01

The spirit of enlightened absolutism was realized through the personal engagement of Emperor Joseph II in the foundation of the Vienna General Hospital, the asylum for the insane called "Narrenturm" and the maternity home.

Mental health problems among conflict-affected adults in Grozny, Chechnya: a qualitative study.

PubMed

Nguyen, Amanda J; Feo, Concetta; Idrisov, Kyuri; Pintaldi, Giovanni; Lenglet, Annick; Tsatsaeva, Zalina; Bolton, Paul; Bass, Judith

2016-01-01

A decade of conflict in Chechnya destroyed infrastructure and resulted in widespread exposure to violence. Amidst substantial reconstruction, periodic violence has contributed to an ongoing atmosphere of insecurity. We conducted a qualitative study to understand the mental health and psychosocial problems affecting adult Chechens in this context to inform development of assessment tools for an evaluation study related to individual counseling. Data were collected in July 2014. A convenience sample of 59 Chechen adults was asked to Free List all problems affecting people in the area. Four problems were explored further in 19 Key Interviewee (KI) interviews, with respondents identified using snowball sampling. Data analysis was conducted in Russian by the Chechen interviewers. Multiple mental health and psychosocial problems emerged, including 'bad psychological health', 'depression', 'stress and nervous people', and 'problems in the family'. Aggression, 'emotional blowing', and 'not adequate' behavior were frequently reported indicators of these problems, with negative effects on the whole family. Chechens reported seeking help through informal social networks, psychiatric and psychological services, and Islamic Centers. Chechens reported mental health and psychosocial problems similar to those experienced in other post-conflict settings. The description of 'emotional blowing' mirrored prior findings in Chechen asylum seekers and fits within a cluster of cultural concepts of distress featuring anger that has been identified in other conflict-affected populations. Further exploration of the nature and prevalence of this construct, as well as evaluations of interventions aimed at reducing these symptoms, is warranted.

When and why should mentally ill prisoners be transferred to secure hospitals: a proposed algorithm.

PubMed

Vogel, Tobias; Lanquillon, Stefan; Graf, Marc

2013-01-01

For reasons well known and researched in detail, worldwide prevalence rates for mental disorders are much higher in prison populations than in general, not only for sentenced prisoners but also for prisoners on remand, asylum seekers on warrant for deportation and others. Moreover, the proportion of imprisoned individuals is rising in most countries. Therefore forensic psychiatry must deal not only with the typically young criminal population, vulnerable to mental illness due to social stress and at an age when rates of schizophrenia, suicide, drug abuse and most personality disorders are highest, but also with an increasingly older population with age-related diseases such as dementia. While treatment standards for these mental disorders are largely published and accepted, and scientific evidence as to screening prisoners for mental illness is growing, where to treat them is dependent on considerations for public safety and local conditions such as national legislation, special regulations and the availability of treatment facilities (e.g., in prisons, in special medical wards within prisons or in secure hospitals). While from a medical point of view a mentally ill prisoner should be treated in a hospital, the ultimate decision must consider these different issues. In this article the authors propose an algorithm comprising screening procedures for mental health and a treatment chain for mentally ill prisoners based on treatment facilities in prison, medical safety, human rights, ethics, and the availability of services at this interface between prison and medicine. Copyright © 2013 Elsevier Ltd. All rights reserved.

Emigration dynamics from and within South Asia.

PubMed

Shah, N M

1995-01-01

This review of current knowledge about emigration dynamics from and within South Asia (Bangladesh, India, Pakistan, and Sri Lanka) opens with a brief history of the three phases of emigration from the area since the 1830s (plantation labor; postindependence to the UK, US, Canada, and Australia; and labor migration to the oil-exporting countries). The influence of the creation of Pakistan and Bangladesh is also covered as are British colonial and commonwealth policies. It is noted that migration data are incomplete and that India exhibits an ambivalence about collecting such information. The discussion then turns to emigration since 1970 and considers permanent migration from South Asia to the traditional receivers; South Asian asylum seekers in Europe; South Asian refugees, illegal migrants, migrant workers (flows and destinations), the stock of contract migrant workers (and their characteristics); returnee migrant workers; and skill levels. Analysis is provided of macro level determinants of emigrations such as gross national product (level and growth), the general demographic and social situation, labor force growth and structure, poverty and inequality, and internal and international migration. Environmental factors causing displacement in Southern Asia include floods, cyclones, river bank erosion, drought, and desertification. Global warming could displace millions of people in the region, and development projects have contributed to displacement. The remainder of the report covers political and ethnic factors, micro-factors influencing migration decision-making, the policies of sending and receiving countries, the consequences of emigration, and the potential for migration in the future.

Contesting the cruel treatment of abortion-seeking women.

PubMed

Fletcher, Ruth

2014-11-01

This article draws on legal arguments made by civil society organisations to challenge the legal reasoning that apparently produced the decision in the Ms Y case in Ireland in August 2014. I show how legal standards of reasonableness and practicality ought to be interpreted in ways that are respectful of the patient's wishes and rights. The case concerned a decision by the Health Service Executive, the Irish public health authority, to refuse an abortion to a pregnant asylum seeker and rape survivor on the grounds that a caesarean section and early live delivery were practicable and reasonable alternatives justified by the need to protect fetal life. I argue that the abortion refusal may not have been a reasonable decision, as required by the terms of relevant legislation, for four different reasons. First, the alternative of a caesarean section and early live delivery was not likely to avert the risk of suicide, and in fact did not do so. Second, the consent to the caesarean section alternative may not have been a real consent in the legal sense if it was not voluntary. Third, an abortion refusal and forcible treatment fall below the norms of good medical practice as interpreted through a patient-centred perspective. Fourth, an abortion refusal that entails forms of cruel, inhumane and degrading treatment ought not to be a reasonable action under the legislation. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Human trafficking: Role of oral health care providers.

PubMed

Nuzzolese, E

2014-11-30

Trafficking in human beings is a modern form of slavery and is a well-known phenomenon throughout the European Union and beyond. After drug dealing and the weapons industry, human trafficking is the second largest criminal activity in the world today and it is a growing crime. The aim of governmental and non-governmental agencies, which are either directly or indirectly involved in combating trafficking in human beings, is the identification and referral of victims of trafficking and also to encourage self-referrals. Identification is the most important step to provide protection and assistance to victims of trafficking. Victims often have a variety of physical and mental health needs, including psychological trauma, injuries from violence, head and neck trauma, sexually transmitted infections and other gynaecological problems, dental/oral problems and have poor nutrition. The author's experience in the field of community dentistry in presented within. Volunteer dental services are offered to non-European Union patients held in a centre for asylum seekers in Bari (Italy). Dental professionals can, in fact, contribute to the identification, assistance and protection of trafficked persons, as well as offering forensic services to assist the police investigation in order to identify crimes and find the criminal organizations behind them. As for domestic violence and child abuse cases, there are ethical concerns involved in the identification and protection of the trafficked persons, as well as the need for interdisciplinary work and awareness. Adequate training in behavioural science and intercultural learning is paramount in order to avoid misunderstandings and increase sensitivity.

Predictors of emergency cesarean delivery among international migrant women in Canada.

PubMed

Gagnon, Anita J; Merry, Lisa; Haase, Kristen

2013-06-01

To determine the predictors of emergency cesarean delivery among international migrant women. Between February 2006 and May 2009, 1025 postpartum migrant women were recruited from 12 hospitals in Toronto, Montreal, and Vancouver. Logistic regression was used to model migration, social, health service, and biomedical factors predictive of emergency cesarean. Overall, 14% percent of participants underwent emergency cesarean. The greatest risk was for women having their first delivery (odds ratio [OR], 5.9; 95% confidence interval [CI], 3.1-11.3); newborns weighing 4000g or more (OR, 3.5; 95% CI, 1.9-6.5); no health insurance (OR, 2.8; 95% CI, 1.2-6.4); delivery on a Friday (OR, 2.2; 95% CI, 1.2-3.9); incomes of less than 30 000 Canadian dollars (OR, 1.9; 1.2-3.0); and induced labor (OR, 1.8; 95% CI, 1.1-3.0). Compared with immigrants, asylum seekers (OR, 0.3; 95% CI, 0.2-0.6) and refugees (OR, 0.5; 95% CI, 0.2-1.0) were protected against emergency cesarean. Indicators specific to, or more common among, migrants were informative in assessing the likelihood of emergency cesarean. The risk associated with being uninsured, day of delivery, income, and immigration class suggests the importance of considering non-biomedical factors in reducing the need for emergency cesarean among migrants. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Mental health, health care utilisation of migrants in Europe.

PubMed

Lindert, J; Schouler-Ocak, M; Heinz, A; Priebe, S

2008-01-01

Migration during the 1990s has been high and has been characterised by new migrations. Migration has been a key force in the demographic changes of the European population. Due to the different condition of migration in Europe, variables related to mental health of migrants are: motivation for migration, living conditions in the home and in the host country. To give an overview on (i) prevalence of mental disorders; suicide; alcohol and drug abuse; (ii) access to mental health and psychosocial care facilities of migrants in the European region, and (iii) utilisation of health and psychosocial institution of these migrants. Non-system review of the literature concerning mental health disorders of migrants and their access to and their consumption of health care and psychosocial services in Europe. It is impossible to consider "migrants" as a homogeneous group concerning the risk for mental illness. The literature showed (i) mental health differs between migrant groups, (ii) access to psychosocial care facilities is influenced by the legal frame of the host country; (iii) mental health and consumption of care facilities is shaped by migrants used patterns of help-seeking and by the legal frame of the host country. Data on migrant's mental health is scarce. Longitudinal studies are needed to describe mental health adjusting for life conditions in Europe to identify those factors which imply an increased risk of psychiatric disorders and influence help seeking for psychosocial care. In many European countries migrants fall outside the existing health and social services, particularly asylum seekers and undocumented immigrants.

The Experience of Emotions during the Job Search and Choice Process among Novice Job Seekers

ERIC Educational Resources Information Center

Bonaccio, Silvia; Gauvin, Natalie; Reeve, Charlie L.

2014-01-01

The authors investigate the role of emotions in the job search and choice process of novice job seekers. Results of qualitative analyses of the first-person accounts of 41 job seekers indicate that participants whose recollections of their job search contained emotional language were more likely to display a haphazard job search strategy than…

[A state without memory. The ideological abolition of the insane asylum in Mexico (1945-1968)].

PubMed

Sacristán, Cristina

2011-01-01

The present article analyzes a campaign by the Mexican government, among the public and the medical profession, to disseminate a health care reform that culminated with the opening of thirteen Farms for the mentally ill and the ideological abolition of the insane asylum in the sixties of the twentieth century. To do this, renowned psychiatrists who held public positions built a black legend over the most emblematic insane asylum of the country, pointing out as the main cause of failure the constraint to which patients were subjected. In doing so, they resembled the mental hospital to a prison and the insane to a social threat, because they reduced that institution's function and denied the many experiences that would ?t in it: a place of confinement and refuge, a therapeutic and knowledge production space. Even though Mexican psychiatry was professionalized in the space of the asylum, the State wanted to erase the memory of that past to suggest the establishment of a new era in mental health, where the patients would no longer be subject to any restrictions which could curtail their freedom. Overcoming the asylum model meant creating "open door" therapeutic alternatives, but the decision was to distort the past to exalt the future.

Dying to get out of the asylum: mortality and madness in four mental hospitals in Victorian Canada, c. 1841-1891.

PubMed

Wright, David; Jacklin, Laurie; Themeles, Tom

2013-01-01

This article examines the status of lunatic cadavers during the second half of the nineteenth century. The first section summarizes cause of death data of over three thousand patients who were admitted to the four principal lunatic asylums in the province of Ontario (Canada). The results illuminate the alleged causes of death, revealing, among other factors, the impact of tuberculosis and general paralysis of the insane. The data also suggest that there was a steady increase in life chances of those entering the mental hospital over the five decades under study. The second section of the article investigates the tension between medical schools and asylum superintendents as educational requirements for nineteenth-century medical education necessitated more and more material for dissection, elevating the status of alienists as gatekeepers to cadavers. The article then concludes by reflecting on what implications these findings have for our understanding of the Victorian lunatic asylum.

Optical Correlation Seeker.

DTIC Science & Technology

1980-05-05

not include noncoherent imaging optics 15 .-1 - Figure 13 shows a correlator design contained within a transparent solid. This monolithic...HARTMAN UNCLASSIFIED DRSMI/RR-SO-A-TR SBIE-AD-E950 083 N MMI LEYEL~ TECHNICAL REPORT RR-80-4 1l OPTICAL CORRELATION SEEKER Charles R. Christensen Richard L...Report RR-80-4 ! 4. TITLE (end Subtitle) S. TYPE OF REPORT & PERIOD COVERED OPTICAL CORRELATION SEEKER 6. PERFORMING ORG. REPORT NUMBER 7. AUTHOR(.) 8

Consumer behaviors towards ready-to-eat foods based on food-related lifestyles in Korea

PubMed Central

Bae, Hyun-Joo; Chae, Mi-Jin

2010-01-01

The purpose of this study was to examine consumers' behaviors toward ready-to-eat foods and to develop ready-to-eat food market segmentation in Korea. The food-related lifestyle and purchase behaviors of ready-to-eat foods were evaluated using 410 ready-to-eat food consumers in the Republic of Korea. Four factors were extracted by exploratory factor analysis (health-orientation, taste-orientation, convenience-orientation, and tradition-orientation) to explain the ready-to eat food consumers' food-related lifestyles. The results of cluster analysis indicated that "tradition seekers" and "convenience seekers" should be regarded as the target segments. Chi-square tests and t-tests of the subdivided groups showed there were significant differences across marital status, education level, family type, eating-out expenditure, place of purchase, and reason for purchase. In conclusion, the tradition seekers consumed more ready-to-eat foods from discount marts or specialty stores and ate them between meals more often than the convenience seekers. In contrast, the convenience seekers purchased more ready-to-eat foods at convenience stores and ate them as meals more often than the tradition seekers. These findings suggest that ready-to-eat food market segmentation based on food-related lifestyles can be applied to develop proper marketing strategies. PMID:20827350

Searching for a job: Cardiac responses to acute stress and the mediating role of threat appraisal in young people.

PubMed

Zandara, M; Garcia-Lluch, M; Villada, C; Hidalgo, V; Salvador, A

2018-02-01

Being unemployed and looking for a job has become a source of stress for many people in several European countries. However, little attention has been paid to the impact of this stressful situation on the individuals' psychophysiological stress responses. The aim of this study was to investigate the effect of being an unemployed job seeker on cognitive threat appraisal and cardiac responses to a psychosocial stressor. We exposed a group of unemployed job seekers (N = 42) and a matched group of unemployed non-job seekers (N = 40) to a standardized social stressor in form of job interview, the Trier Social Stress Test. Our results showed that unemployed job seekers manifest lower cardiac responses, along with a lower cognitive threat appraisal, compared to non-job seekers. Moreover, we observed a full mediating role of cognitive threat appraisal on the relationship between being an unemployed job seeker and cardiac responses to stress. These findings reveal that being unemployed and looking for a job has an effect on physiological responses to acute stress, as well as the importance of psychological process related to the situation. These responses might lead to negative health and motivational consequences. Theoretical and practical implications are discussed. Copyright © 2017 John Wiley & Sons, Ltd.

Consumer behaviors towards ready-to-eat foods based on food-related lifestyles in Korea.

PubMed

Bae, Hyun-Joo; Chae, Mi-Jin; Ryu, Kisang

2010-08-01

The purpose of this study was to examine consumers' behaviors toward ready-to-eat foods and to develop ready-to-eat food market segmentation in Korea. The food-related lifestyle and purchase behaviors of ready-to-eat foods were evaluated using 410 ready-to-eat food consumers in the Republic of Korea. Four factors were extracted by exploratory factor analysis (health-orientation, taste-orientation, convenience-orientation, and tradition-orientation) to explain the ready-to eat food consumers' food-related lifestyles. The results of cluster analysis indicated that "tradition seekers" and "convenience seekers" should be regarded as the target segments. Chi-square tests and t-tests of the subdivided groups showed there were significant differences across marital status, education level, family type, eating-out expenditure, place of purchase, and reason for purchase. In conclusion, the tradition seekers consumed more ready-to-eat foods from discount marts or specialty stores and ate them between meals more often than the convenience seekers. In contrast, the convenience seekers purchased more ready-to-eat foods at convenience stores and ate them as meals more often than the tradition seekers. These findings suggest that ready-to-eat food market segmentation based on food-related lifestyles can be applied to develop proper marketing strategies.

Effects of 24 hours of tobacco withdrawal and subsequent tobacco smoking among low and high sensation seekers.

PubMed

Lee, Dustin C; Perkins, Kenneth A; Zimmerman, Eli; Robbins, Glenn; Kelly, Thomas H

2011-10-01

Previous studies have indicated that high sensation seekers are more sensitive to the reinforcing effects of nicotine, initiate smoking at an earlier age, and smoke greater amounts of cigarettes. This study examined the influence of sensation-seeking status on tobacco smoking following deprivation in regular tobacco users. Twenty healthy tobacco-smoking volunteers with low or high impulsive sensation-seeking subscale scores completed 2 consecutive test days per week for 3 consecutive weeks. Each week, a range of self-report, performance, and cardiovascular assessments were completed during ad libitum smoking on Day 1 and before and after the paced smoking of a tobacco cigarette containing 0.05, 0.6, or 0.9 mg of nicotine following 24 hr of tobacco deprivation on Day 2. In addition, self-administration behavior was analyzed during a 2-hr free access period after the initial tobacco administration. In high sensation seekers, tobacco smoking independent of nicotine yield ameliorated deprivation effects, whereas amelioration of deprivation effects was dependent on nicotine yield among low sensation seekers. However, this effect was limited to a small subset of measures. Subsequent cigarette self-administration increased in a nicotine-dependent manner for high sensation seekers only. Compared with low sensation seekers, high sensation seekers were more sensitive to the withdrawal relieving effects of nonnicotine components of smoking following 24 hr of deprivation on selective measures and more sensitive to nicotine yield during subsequent tobacco self-administration. These results are consistent with studies suggesting that factors driving tobacco dependence may vary as a function of sensation-seeking status.

Effects of 24 Hours of Tobacco Withdrawal and Subsequent Tobacco Smoking Among Low and High Sensation Seekers

PubMed Central

Perkins, Kenneth A.; Zimmerman, Eli; Robbins, Glenn; Kelly, Thomas H.

2011-01-01

Introduction: Previous studies have indicated that high sensation seekers are more sensitive to the reinforcing effects of nicotine, initiate smoking at an earlier age, and smoke greater amounts of cigarettes. This study examined the influence of sensation-seeking status on tobacco smoking following deprivation in regular tobacco users. Methods: Twenty healthy tobacco-smoking volunteers with low or high impulsive sensation-seeking subscale scores completed 2 consecutive test days per week for 3 consecutive weeks. Each week, a range of self-report, performance, and cardiovascular assessments were completed during ad libitum smoking on Day 1 and before and after the paced smoking of a tobacco cigarette containing 0.05, 0.6, or 0.9 mg of nicotine following 24 hr of tobacco deprivation on Day 2. In addition, self-administration behavior was analyzed during a 2-hr free access period after the initial tobacco administration. Results: In high sensation seekers, tobacco smoking independent of nicotine yield ameliorated deprivation effects, whereas amelioration of deprivation effects was dependent on nicotine yield among low sensation seekers. However, this effect was limited to a small subset of measures. Subsequent cigarette self-administration increased in a nicotine-dependent manner for high sensation seekers only. Conclusions: Compared with low sensation seekers, high sensation seekers were more sensitive to the withdrawal relieving effects of nonnicotine components of smoking following 24 hr of deprivation on selective measures and more sensitive to nicotine yield during subsequent tobacco self-administration. These results are consistent with studies suggesting that factors driving tobacco dependence may vary as a function of sensation-seeking status. PMID:21690318

The radiology job market: analysis of the ACR jobs board.

PubMed

Prabhakar, Anand M; Oklu, Rahmi; Harvey, H Benjamin; Harisinghani, Mukesh G; Rosman, David A

2014-05-01

The aim of this study was to assess the status of the radiology job market as represented by the ACR Jobs Board from October 2010 to June 2013. With the assistance of the ACR, data from the ACR Jobs Board from October 2010 through June 2013, including the numbers of monthly new job seekers, new job postings, and job posting clicks, were gathered and used to calculate a monthly competitive index, defined as the ratio of new job seekers to new job postings. During the study period, the mean number of new job seekers was 168 per month, which was significantly greater than the 84 average new job postings for any given month (P = .0002). There was no significant difference between 2011 and 2012 with regard to the number of new job seekers or job postings. Over the time period assessed, more new job seekers registered in October and November 2010, August to November 2011, and October and November 2012. These periods were also associated with the highest competitive index values. There were less job seekers in the winter and spring of 2011, 2012, and 2013, periods associated with lower competitive index values. ACR Jobs Board activity, measured by job posting clicks, was significantly higher in 2012 than in 2011 (P < .004). On the basis of the ACR Jobs Board, there were consistently more new job seekers than job postings throughout the study period, and fall is the period in the year most associated with the highest competitive index for radiologist employment. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Function, health and psychosocial needs in job-seekers with anxiety, mood, and psychotic disorders who access disability employment services.

PubMed

Matthews, Lynda R; Harris, Lynne M; Jaworski, Alison; Alam, Ashraful; Bozdag, Gokcen

2014-01-01

Labour force participation of people with mental disorders varies according to the nature of their disorder. Research that compares function and psychosocial need in job-seekers with different mental disorders, however, is scant especially in the Australian setting. Identifying rehabilitation needs of job-seekers with mental disorders receiving employment services is of interest to providers of disability employment services in Australia. This study sought to identify differences in health, social needs and function in people with anxiety, mood, or psychotic disorders accessing disability employment services to inform disability service providers of vocational rehabilitation interventions. 106 adult job-seekers with anxiety (29%), mood (51%), and psychotic (20%) disorders receiving job placement services from a disability employment service provider consented to participate in this study. Self-report measures and the Executive Interview (EXIT) were used to document function. Differences between disorders were determined using one-way analysis of variance. Significantly better estimates of social functioning as measured by the Behaviour and Symptom Identification Scale (BASIS-32) were reported by job-seekers with psychotic disorders compared to those with anxiety or mood disorders. However, job-seekers with psychotic disorders reported longer periods of unemployment compared to those with mood disorders and longer estimates of the time it would take to obtain work compared to both the other groups. Perceived psychosocial problems, such as poor social function in job-seekers with anxiety and mood disorders and perceptions of poor employability in those with psychotic disorders, should be considered when developing vocational rehabilitation interventions, or where additional support may be required once employment is obtained.

Beyond memory problems: multiple obstacles to health and quality of life in older people seeking help for subjective memory complaints.

PubMed

Rotenberg Shpigelman, Shlomit; Sternberg, Shelley; Maeir, Adina

2017-08-29

Preliminary evidence suggests that older people who seek medical help for subjective memory complaints (SMC) may be at risk for depression, poor quality of life (QoL), and functional limitations. This study aims to: (1) further investigate bio-psycho-social characteristics, participation in personally meaningful activities and QoL of help-seekers; and (2) examine the relationship of these characteristics to QoL, and explore the unique contribution of participation to QoL. Cognitive, meta-cognitive, emotional, social, participation, and QoL measures were used to compare 51 help-seekers referred from geriatric clinics to 40 age-matched controls who did not seek help for memory problems. Help-seekers exhibited lower participation and QoL, had lower mean cognitive scores, reported more memory mistakes and negative memory-beliefs, more depression, worse self-efficacy, and less positive social interaction than non-help-seekers. Quality of life in help-seekers was significantly correlated with most variables. Participation contributed to the explained variance of QoL in help-seekers, beyond that accounted for by cognition and emotional status. Help-seekers with SMC exhibited a complex health condition that includes not only SMC, but also objective memory impairment, depression, functional restrictions, negative memory beliefs, low perception of memory abilities, reduced self-efficacy and insufficient social interactions, all associated with lower QoL. This multi-faceted condition should be considered in the treatment of help-seekers. Implications for Rehabilitation Older people who seek help for subjective memory complaints may be facing a larger problem involving bio-psycho-social factors, affecting participation in meaningful activities and quality of life. Quality of life may be improved via treatment of depression, functional restrictions, memory beliefs, self-efficacy, and positive social interactions. Participation in meaningful activities is an especially important target for improving health and quality of life in this population. Interventions for older adults seeking help for subjective memory complaints will benefit from adopting a bio-psycho-social rehabilitation perspective.

Ebola's Would-be Refugees: Performing Fear and Navigating Asylum During a Public Health Emergency.

PubMed

Lawrance, Benjamin N

2018-04-20

Chronic and acute illnesses sit uncomfortably with asylum claiming and refugee mobilities. The story of a Sierra Leonean, an athlete who feared Ebola and sought refuge in the UK, provides an opening to examine protection discourses that invoke fear, trauma, and crisis metaphors, to understand how asylum claims are performed, and how related petitions are adjudicated during public health emergencies of international concern. Ebola is revealed as a novel claim strategy, and thus a useful subject matter to investigate the shifting modalities of migrant agency, the unstable fabric of medical humanitarianism, and knowledge production in moments of exceptionality.

8 CFR 1208.23 - Restoration of status.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Restoration of status. 1208.23 Section 1208.23 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS PROCEDURES FOR ASYLUM AND WITHHOLDING OF REMOVAL Asylum and Withholding of Removal § 1208.23...

Unaccompanied Asylum-Seeking Children: Whose Perspective?

ERIC Educational Resources Information Center

Wernesjo, Ulrika

2012-01-01

Recent years have seen increasing attention being paid to unaccompanied asylum-seeking children. This article provides an overview of research in the field and its implications for an understanding of these children as a particularly vulnerable category. The existing research focuses primarily on investigating the children's emotional well-being…

“Confinement of the Higher Orders”: The Social Role of Private Lunatic Asylums in Ireland, c. 1820–60

PubMed Central

Mauger, Alice

2012-01-01

The period 1820–60 marked an era of transition and diversity in Ireland that rapidly transformed the face of Irish society. Inextricably linked with these processes was the expansion of Ireland's private asylum system. This system diverged from its British counterpart both in the socioeconomic cohort it served and in the role it played within the mental health-care system as a whole. The implementation of the 1842 Private Asylums (Ireland) Act, the first legislative measure geared exclusively toward the system, highlighted the growing importance of private care in Ireland as well as providing for the licensing and regulation of these institutions for the first time. To date, historians of Irish medicine have focused almost exclusively on the pauper insane. This article aims to shift this emphasis toward other categories of the Irish insane through exploration of the Irish private asylum system, its growth throughout the period, and the social profile of private patients. I shall also interrogate the trade in lunacy model through exploration of financial considerations, discharge and recovery rates, and conditions of care and argue that while Irish private institutions were a lucrative business venture, the quality of care upheld was apparently high. Finally, I shall argue that Irish private asylums catered primarily for the upper classes and briefly explore alternative provisional measures for other non-pauper sectors of society. PMID:21355010

Design trade-offs for homing missiles

NASA Astrophysics Data System (ADS)

Spencer, Allen; Moore, William

1992-05-01

Major design considerations, trade-offs and technology issues for future hypervelocity, anti-missile interceptors are presented in an overview format. Two classes of interceptors are considered: a low altitude interceptor using an active radar seeker for defense against tactical ballistic missiles (TBMs) and a higher altitude interceptor using a passive infra-red seeker for defense against ICBMs. Considerations are presented in the areas of mission requirements, seeker selection, aerodynamic and aerothermal environments, control systems, and guidance performance.

6 CFR 37.3 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... resident status in the United States; who has an approved application for asylum in the United States or... United States; who has a pending application for asylum in the United States; who has a pending or approved application for temporary protected status (TPS) in the United States; who has approved deferred...

6 CFR 37.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... resident status in the United States; who has an approved application for asylum in the United States or... United States; who has a pending application for asylum in the United States; who has a pending or approved application for temporary protected status (TPS) in the United States; who has approved deferred...

8 CFR 1240.33 - Applications for asylum or withholding of deportation.

Code of Federal Regulations, 2010 CFR

2010-01-01

... deportation. 1240.33 Section 1240.33 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS PROCEEDINGS TO DETERMINE REMOVABILITY OF ALIENS IN THE UNITED... referred to the immigration judge by an asylum officer in accordance with § 1208.14(b) of this chapter, the...

The Use of English as Ad Hoc Institutional Standard in the Belgian Asylum Interview

ERIC Educational Resources Information Center

Maryns, Katrijn

2017-01-01

In institutional settings of globalization, labelled languages are generally preferred over multilingual repertoires and mobile language resources. Drawing on linguistic-ethnographic analysis of the way English is treated as an invariable "ad hoc" idiom in the Belgian asylum interview, this article demonstrates how institutional measures…

Contribution of Communication Inequalities to Disparities in Human Papillomavirus Vaccine Awareness and Knowledge

PubMed Central

Emmons, Karen M.; Puleo, Elaine; Viswanath, K.

2012-01-01

Objectives. We examined the association of Internet-related communication inequalities on human papillomavirus (HPV) vaccine awareness and infection knowledge. Methods. We drew data from National Cancer Institute’s 2007 Health Information National Trends Survey (n = 7674). We estimated multivariable logistic regression models to assess Internet use and Internet health information seeking on HPV vaccine awareness and infection knowledge. Results. Non–Internet users, compared with general Internet users, had significantly lower odds of being aware of the HPV vaccine (odds ratio [OR] = 0.42; 95% confidence interval [CI] = 0.34, 0.51) and knowing that HPV causes cervical cancer (OR = 0.70; 95% CI = 0.52, 0.95). Among general health information seekers, non–Internet seekers compared with Internet information seekers exhibit significantly lower odds of HPV vaccine awareness (OR = 0.59; 95% CI = 0.46, 0.75), and of knowing about the link between HPV infection and cervical cancer (OR = 0.79; 95% CI = 0.63, 0.99) and the sexual transmission of HPV (OR = 0.71; 95% CI = 0.57, 0.89). Among cancer information seekers, there were no differences in outcomes between Internet seekers and non–Internet seekers. Conclusions. Use of a communication channel, such as the Internet, whose use is already socially and racially patterned, may widen observed disparities in vaccine completion rates. PMID:22970692

The fractured history of the mental hospital in Delhi.

PubMed

Jain, Sanjeev; Sarin, Alok

2018-02-01

The history of the mental hospital in Delhi is a fascinating story. Set up in colonial times, the asylum in Delhi seems to reflect the tumultuous and chaotic history of the city itself. It was perhaps established in the early 19 th century, and functions till 1857, when it is ransacked in the Mutiny. It is subsequently merged with the asylum at Lahore in 1861, set up again, and incredibly, closed again at the turn of the century. Subject to the whims of administrators and policy makers, the asylum then ceases to exist till the 1960s when a new avatar appears. In it's non continuity is the story of the neglect of mental illness.

An Effective Model of Institutional Taxation: Lunatic Asylums in Nineteenth-Century England

PubMed Central

Stebbings, Chantal

2011-01-01

The compulsory establishment of large public lunatic asylums under Act of parliament in the nineteenth century to address the enormous increase in the number of the insane raised legal and practical challenges in relation to their status within the law of tax. As a result of their therapeutic and custodial objectives, these novel institutions required extensive landed property and very specific systems of governance, the fiscal consequences of which potentially undermined those very objectives. This article examines and analyses the nature and legal process of the application of the tax regime to these asylums, concluding that it constituted a rare and effective model of institutional taxation. PMID:21552307

Family and Nation: Cherokee Orphan Care, 1835-1903

ERIC Educational Resources Information Center

Reed, Julie L.

2010-01-01

On November 17, 1903, fifteen miles from the nearest railway station and fifty miles northwest of the capital of the Cherokee Nation in Tahlequah, a fire engulfed the Cherokee Orphan Asylum. After the fire the Cherokee Nation relocated the homeless children to the nation's Insane Asylum in Tahlequah, where Sequoyah School stands today. The…

When Children Seek Asylum from Their Parents: A Canadian Case Study

ERIC Educational Resources Information Center

Bossin, Michael; Demirdache, Laila

2012-01-01

When children seek asylum from alleged abuse by a custodial parent, the notion that family reunification is always in the best interests of independent child migrants is undermined. In this chapter, the authors discuss the legal tensions between the Refugee Convention, the Convention on the Civil Aspects of International Child Abduction (the…

Waiting Time: The De-Subjectification of Children in Danish Asylum Centres

ERIC Educational Resources Information Center

Vitus, Kathrine

2010-01-01

This article analyses the relationship between time and subjectification, focusing on the temporal structures created within Danish asylum centres and politics, and on children's experiences of and reactions to open-ended waiting. Such waiting leads to existential boredom which manifests in the children as restlessness, fatigue and despair. The…

8 CFR 1208.24 - Termination of asylum or withholding of removal or deportation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... fundamental change in circumstances relating to the original claim, the alien's life or freedom no longer... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Termination of asylum or withholding of removal or deportation. 1208.24 Section 1208.24 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION...

8 CFR 208.24 - Termination of asylum or withholding of removal or deportation.

Code of Federal Regulations, 2012 CFR

2012-01-01

... original claim, the alien's life or freedom no longer would be threatened on account of race, religion... 8 Aliens and Nationality 1 2012-01-01 2012-01-01 false Termination of asylum or withholding of removal or deportation. 208.24 Section 208.24 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY...

8 CFR 1208.24 - Termination of asylum or withholding of removal or deportation.

Code of Federal Regulations, 2013 CFR

2013-01-01

... fundamental change in circumstances relating to the original claim, the alien's life or freedom no longer... 8 Aliens and Nationality 1 2013-01-01 2013-01-01 false Termination of asylum or withholding of removal or deportation. 1208.24 Section 1208.24 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION...

8 CFR 1208.24 - Termination of asylum or withholding of removal or deportation.

Code of Federal Regulations, 2012 CFR

2012-01-01

... fundamental change in circumstances relating to the original claim, the alien's life or freedom no longer... 8 Aliens and Nationality 1 2012-01-01 2012-01-01 false Termination of asylum or withholding of removal or deportation. 1208.24 Section 1208.24 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION...

8 CFR 1208.24 - Termination of asylum or withholding of removal or deportation.

Code of Federal Regulations, 2014 CFR

2014-01-01

... fundamental change in circumstances relating to the original claim, the alien's life or freedom no longer... 8 Aliens and Nationality 1 2014-01-01 2014-01-01 false Termination of asylum or withholding of removal or deportation. 1208.24 Section 1208.24 Aliens and Nationality EXECUTIVE OFFICE FOR IMMIGRATION...

75 FR 409 - Privacy Act of 1974; United States Citizenship and Immigration Services-010 Asylum Information...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-05

... System of Records AGENCY: Privacy Office; DHS. ACTION: Notice of Privacy Act systems of records. SUMMARY... system of records to the Department of Homeland Security's inventory, entitled Unites States Citizenship and Immigration Services-010 Asylum Information and Pre- Screening System of Records. This new system...

Othered Voices: Asylum-Seeking Mothers and Early Years Education

ERIC Educational Resources Information Center

Whitmarsh, Judy

2011-01-01

Strengthening the home-school partnership is a strategy to raise achievement levels and to engage "hard-to-reach" parents with education in the UK, however this political ideal has been critiqued as exclusive and based on a white, middle class model. This article explores how six asylum-seeking mothers manage their children's early years…

Involuntary sterilization among HIV-positive Garifuna women from Honduras seeking asylum in the United States: Two case reports.

PubMed

Atkinson, Holly G; Ottenheimer, Deborah

2018-05-01

Voluntary sterilization is one of the most widely used forms of contraception by women worldwide; however, involuntary sterilization is considered a violation of multiple human rights and grounds for asylum in the United States. Women have been disproportionately affected by this practice. We report two cases of involuntary sterilization in HIV-positive Garifuna women from Honduras who sought asylum in America and were medically evaluated at the request of their attorneys. Key lessons can be drawn from these cases with regard to the importance of medical evaluations in establishing persecution. These include the need for a detailed account of the events surrounding sterilization, radiologic proof of tubal blockage if at all possible, and confirmation of significant and enduring mental distress as a result of the involuntary sterilization. Immigration attorneys and medical evaluators need to be attuned to the possibility of a history of involuntary sterilization among at risk women seeking asylum in the United States. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Institutionalising senile dementia in 19th-century Britain.

PubMed

Andrews, Emily Stella

2017-02-01

This article explains how old, poor people living with dementia came to be institutionalised in 19th-century Britain (with a focus on London), and how they were responded to by the people who ran those institutions. The institutions in question are lunatic asylums, workhouses and charitable homes. Old people with dementia were admitted to lunatic asylums, workhouses and charitable homes, but were not welcome there. Using the records of Hanwell lunatic asylum, published texts of psychiatric theory, and the administrative records that all of these institutions generated at local and national levels, this article argues that 'the senile' were a perpetual classificatory residuum in the bureaucracy of 19th-century health and welfare. They were too weak and unresponsive to adhere to the norms of the asylum regime, yet too challenging in their behaviour to conform to that of the workhouse, or the charitable home. Across all of these institutions, old people with dementia were represented as an intractable burden, many decades before the 'ageing society' became a demographic reality. © 2017 Foundation for the Sociology of Health & Illness.

Reconstructing Harry: a genealogical study of a colonial family 'inside' and 'outside' the Grahamstown Asylum, 1888-1918.

PubMed

Wilbraham, Lindy

2014-04-01

Recent scholarship has explored the dynamics between families and colonial lunatic asylums in the late nineteenth century, where families actively participated in the processes of custodial care, committal, treatment and release of their relatives. This paper works in this historical field, but with some methodological and theoretical differences. The Foucauldian study is anchored to a single case and family as an illness narrative that moves cross-referentially between bureaucratic state archival material, psychiatric case records, and intergenerational family-storytelling and family photographs. Following headaches and seizures, Harry Walter Wilbraham was medically boarded from his position as Postmaster in the Cape of Good Hope Colony of South Africa with a 'permanent disease of the brain', and was committed to the Grahamstown Asylum in 1910, where he died the following year, aged 40 years. In contrast to writings about colonial asylums that usually describe several patient cases and thematic patterns in archival material over time and place, this study's genealogical lens examines one white settler male patient's experiences within mental health care in South Africa between 1908 and 1911. The construction of Harry's 'case' interweaves archival sources and reminiscences inside and outside the asylum, and places it within psychiatric discourse of the time, and family dynamics in the years that followed. Thus, this case study maps the constitution of 'patient' and 'family' in colonial life, c.1888-1918, and considers the calamity, uncertainty, stigma and silences of mental illness.

Migration and mental health in Europe (the state of the mental health in Europe working group: appendix 1)

PubMed Central

2005-01-01

Background This paper is a part of the work of the group that carried out the report "The state of the mental health in Europe" (European Commission, DG Health and Consumer Protection, 2004) and deals with the mental health issues related to the migration in Europe. Methods The paper tries to describe the social, demographical and political context of the emigration in Europe and tries to indicate the needs and (mental) health problems of immigrants. A review of the literature concerning mental health risk in immigrant is also carried out. The work also faces the problem of the health policy toward immigrants and the access to health care services in Europe. Results Migration during the 1990s has been high and characterised by new migrations. Some countries in Europe, that have been traditionally exporters of migrants have shifted to become importers. Migration has been a key force in the demographic changes of the European population. The policy of closed borders do not stop migration, but rather seems to set up a new underclass of so-called "illegals" who are suppressed and highly exploited. In 2000 there were also 392.200 asylum applications. The reviewed literature among mental health risk in some immigrant groups in Europe concerns: 1) highest rate of schizophrenia; suicide; alcohol and drug abuse; access of psychiatric facilities; risk of anxiety and depression; mental health of EU immigrants once they returned to their country; early EU immigrants in today disadvantaged countries; refugees and mental health Due to the different condition of migration concerning variables as: motivation to migrations (e.g. settler, refugees, gastarbeiters); distance for the host culture; ability to develop mediating structures; legal residential status it is impossible to consider "migrants" as a homogeneous group concerning the risk for mental illness. In this sense, psychosocial studies should be undertaken to identify those factors which may under given conditions, imply an increased risk of psychiatric disorders and influence seeking for psychiatric care. Comments and Remarks Despite in the migrants some vulnerable groups were identified with respect to health problems, in many European countries there are migrants who fall outside the existing health and social services, something which is particularly true for asylum seekers and undocumented immigrants. In order to address these deficiencies, it is necessary to provide with an adequate financing and a continuity of the grants for research into the multicultural health demand. Finally, there is to highlight the importance of adopting an integrated approach to mental health care that moves away from psychiatric care only. PMID:16135246

Migration and mental health in Europe (the state of the mental health in Europe working group: appendix 1).

PubMed

Carta, Mauro Giovanni; Bernal, Mariola; Hardoy, Maria Carolina; Haro-Abad, Josep Maria

2005-08-31

This paper is a part of the work of the group that carried out the report "The state of the mental health in Europe" (European Commission, DG Health and Consumer Protection, 2004) and deals with the mental health issues related to the migration in Europe. The paper tries to describe the social, demographical and political context of the emigration in Europe and tries to indicate the needs and (mental) health problems of immigrants. A review of the literature concerning mental health risk in immigrant is also carried out. The work also faces the problem of the health policy toward immigrants and the access to health care services in Europe. Migration during the 1990s has been high and characterised by new migrations. Some countries in Europe, that have been traditionally exporters of migrants have shifted to become importers. Migration has been a key force in the demographic changes of the European population. The policy of closed borders do not stop migration, but rather seems to set up a new underclass of so-called "illegals" who are suppressed and highly exploited. In 2000 there were also 392,200 asylum applications. The reviewed literature among mental health risk in some immigrant groups in Europe concerns: 1) highest rate of schizophrenia; suicide; alcohol and drug abuse; access of psychiatric facilities; risk of anxiety and depression; mental health of EU immigrants once they returned to their country; early EU immigrants in today disadvantaged countries; refugees and mental health. Due to the different condition of migration concerning variables as: motivation to migrations (e.g. settler, refugees, gastarbeiters); distance for the host culture; ability to develop mediating structures; legal residential status it is impossible to consider "migrants" as a homogeneous group concerning the risk for mental illness. In this sense, psychosocial studies should be undertaken to identify those factors which may under given conditions, imply an increased risk of psychiatric disorders and influence seeking for psychiatric care. COMMENTS AND REMARKS: Despite in the migrants some vulnerable groups were identified with respect to health problems, in many European countries there are migrants who fall outside the existing health and social services, something which is particularly true for asylum seekers and undocumented immigrants. In order to address these deficiencies, it is necessary to provide with an adequate financing and a continuity of the grants for research into the multicultural health demand. Finally, there is to highlight the importance of adopting an integrated approach to mental health care that moves away from psychiatric care only.

Norway.

PubMed

1992-08-01

Norway with a territory of 386,000 sq. km or 150,000 sq. miles is slightly larger than New Mexico. In 1991 the population was estimated at 4.3 million with an annual growth rate of .5% and a literacy rate of 100%. The infant mortality rate is 7/1000 live births, and lie expectancy is 73 years for men and 80 years for women. Norway's government is a hereditary constitutional monarchy since independence n 1905. Ethnically, Norwegians are predominantly Germanic, but there are indigenous communities of Sami (Lapps) in the north, and in recent years almost 150,000 immigrants, foreign workers, and asylum-seekers have settled there. Norway's health system includes free hospital care, physicians compensation, cash benefits during illness and pregnancy, and other medical and dental plans. Until the 1981 election, Norway has been governed by Labor Party governments since 1935, except for 3 periods (1963, 1965-71, and 1972-73). Gro Harlem Brundtland is again the prime minister after forming her 3rd government in 10 years. Norway holds national elections in September 1993. Norway's large shipping fleet is modern; metals, pulp and paper products, chemicals, shipbuilding, and fishing are traditional industries, and major oil and gas discoveries in the mid-1970s transformed the economy. High oil prices in the 1983-85 period raised consumer spending, wages, and inflation. Norway is aspiring to restructure its nonoil economy in favor of efficient, nontraditional industry. The prime minister has indicated that Norway may apply for European Community (EC) membership before the end of 1992. Its main trading partners are the EC countries and its Scandinavian neighbors with the US in 5th place.

Makassar city government’s urban refugee policy: filling in the gap?

NASA Astrophysics Data System (ADS)

Gabiella, D.; Putri, R. A. A. K.

2018-03-01

Indonesia is home to 13,829 refugees and asylum seekers by the end of January 2017. In general, the number could be dichotomized into two categories: camp-based refugees and urban refugees. There are approximately 70.83% of urban refugees living in several cities across the country. The existence of refugees in urban environments has been considered as either bringing promise or peril to urban development. Makassar is one among the most populated cities by refugees in Indonesia. In the middle of the inadequacy of legal framework at the national level, the Makassar City Government initiated a policy to address the issues of refugees staying in the city specifically. In 2005, the Mayor of Makassar signed a Memorandum of Understanding with International Organization for Migration (IOM) to accommodate the needs for funding allocated from Regional Budget that could not be dispensed due to the absence of legal basis. The city also constituted a Joint Committee Monitoring (JCM), which comprises of various government agencies, to support the Immigration Office in monitoring the refugees. These initiatives allow refugees to access basic services that are not made available to them in other cities. Against this backdrop, this paper mainly discusses the initiatives and refugee policy of Makassar City Government, which had emulated the national government’s policy to refugee management before the recently signed Presidential Decree No. 25 / 2016. It argues that the proactive and relatively integrative approach of the City Government alongside the social inclusion by the local community have contributed positively to the livelihoods of urban refugees in Makassar.

Immunization Strategies Targeting Newly Arrived Migrants in Non-EU Countries of the Mediterranean Basin and Black Sea

PubMed Central

Giambi, Cristina; Del Manso, Martina; Dente, Maria Grazia; Napoli, Christian; Montaño-Remacha, Carmen; Riccardo, Flavia; Declich, Silvia

2017-01-01

Background: The World Health Organization recommends that host countries ensure appropriate vaccinations to refugees, asylum seekers and migrants. However, information on vaccination strategies targeting migrants in host countries is limited. Methods: In 2015–2016 we carried out a survey among national experts from governmental bodies of 15 non-EU countries of the Mediterranean and Black Sea in order to document and share national vaccination strategies targeting newly arrived migrants. Results: Four countries reported having regulations/procedures supporting the immunization of migrants at national level, one at sub-national level and three only targeting specific population groups. Eight countries offer migrant children all the vaccinations included in their national immunization schedule; three provide only selected vaccinations, mainly measles and polio vaccines. Ten and eight countries also offer selected vaccinations to adolescents and adults respectively. Eight countries provide vaccinations at the community level; seven give priority vaccines in holding centres or at entry sites. Data on administered vaccines are recorded in immunization registries in nine countries. Conclusions: Although differing among countries, indications for immunizing migrants are in place in most of them. However, we cannot infer from our findings whether those strategies are currently functioning and whether barriers to their implementation are being faced. Further studies focusing on these aspects are needed to develop concrete and targeted recommendations for action. Since migrants are moving across countries, development of on-line registries and cooperation between countries could allow keeping track of administered vaccines in order to appropriately plan immunization series and avoid unnecessary vaccinations. PMID:28441361

Immunization Strategies Targeting Newly Arrived Migrants in Non-EU Countries of the Mediterranean Basin and Black Sea.

PubMed

Giambi, Cristina; Del Manso, Martina; Dente, Maria Grazia; Napoli, Christian; Montaño-Remacha, Carmen; Riccardo, Flavia; Declich, Silvia; Network For The Control Of Cross-Border Health Threats In The Mediterranean Basin And Black Sea For The ProVacMed Project

2017-04-25

Background : The World Health Organization recommends that host countries ensure appropriate vaccinations to refugees, asylum seekers and migrants. However, information on vaccination strategies targeting migrants in host countries is limited. Methods : In 2015-2016 we carried out a survey among national experts from governmental bodies of 15 non-EU countries of the Mediterranean and Black Sea in order to document and share national vaccination strategies targeting newly arrived migrants. Results : Four countries reported having regulations/procedures supporting the immunization of migrants at national level, one at sub-national level and three only targeting specific population groups. Eight countries offer migrant children all the vaccinations included in their national immunization schedule; three provide only selected vaccinations, mainly measles and polio vaccines. Ten and eight countries also offer selected vaccinations to adolescents and adults respectively. Eight countries provide vaccinations at the community level; seven give priority vaccines in holding centres or at entry sites. Data on administered vaccines are recorded in immunization registries in nine countries. Conclusions : Although differing among countries, indications for immunizing migrants are in place in most of them. However, we cannot infer from our findings whether those strategies are currently functioning and whether barriers to their implementation are being faced. Further studies focusing on these aspects are needed to develop concrete and targeted recommendations for action. Since migrants are moving across countries, development of on-line registries and cooperation between countries could allow keeping track of administered vaccines in order to appropriately plan immunization series and avoid unnecessary vaccinations.

Using 'reverse triage' to create hospital surge capacity: Royal Darwin Hospital's response to the Ashmore Reef disaster.

PubMed

Satterthwaite, Peter S; Atkinson, Carol J

2012-02-01

This report analyses the impact of reverse triage, as described by Kelen, to rapidly assess the need for continuing inpatient care and to expedite patient discharge to create surge capacity for disaster victims. The Royal Darwin Hospital was asked to take up to 30 casualties suffering from blast injuries from a boat carrying asylum seekers that had exploded 840 km west of Darwin. The hospital was full, with a backlog of cases awaiting admission in the emergency department. The Disaster Response Team convened at 10:00 to develop the surge capacity to admit up to 30 casualties. By 14:00, 56 beds (16% of capacity) were predicted to be available by 18:00. The special circumstances of a disaster enabled staff to suspend their usual activities and place a priority on triaging inpatients' suitability for discharge. The External Disaster Plan was activated and response protocols were followed. Normal elective activity was suspended. Multidisciplinary teams immediately assessed patients and completed the necessary clinical and administrative requirements to discharge them quickly. As per the Plan there was increased use of community care options: respite nursing home beds and community nursing services. Through a combination of cancellation of all planned admissions, discharging 19 patients at least 1 day earlier than planned and discharging all patients earlier in the day surge capacity was made available in Royal Darwin Hospital to accommodate blast victims. Notably, reverse triage resulted in no increase in clinical risk with only one patient who was discharged early returning for further treatment.

Impact of migration on illness experience and help-seeking strategies of patients from Turkey and Bosnia in primary health care in Basel.

PubMed

Gilgen, D; Maeusezahl, D; Salis Gross, C; Battegay, E; Flubacher, P; Tanner, M; Weiss, M G; Hatz, C

2005-09-01

Migration, particularly among refugees and asylum seekers, poses many challenges to the health system of host countries. This study examined the impact of migration history on illness experience, its meaning and help-seeking strategies of migrant patients from Bosnia and Turkey with a range of common health problems in general practice in Basel, Switzerland. The Explanatory Model Interview Catalogue, a data collection instrument for cross-cultural research which combines epidemiological and ethnographic research approaches, was used in semi-structured one-to-one patient interviews. Bosnian patients (n=36) who had more traumatic migration experiences than Turkish/Kurdish (n=62) or Swiss internal migrants (n=48) reported a larger number of health problems than the other groups. Psychological distress was reported most frequently by all three groups in response to focussed queries, but spontaneously reported symptoms indicated the prominence of somatic, rather than psychological or psychosocial, problems. Among Bosnians, 78% identified traumatic migration experiences as a cause of their illness, in addition to a range of psychological and biomedical causes. Help-seeking strategies for the current illness included a wide range of treatments, such as basic medical care at private surgeries, outpatients department in hospitals as well as alternative medical treatments among all groups. Findings provide a useful guide to clinicians who work with migrants and should inform policy in medical care, information and health promotion for migrants in Switzerland as well as further education of health professionals on issues concerning migrants health.

From Kraepelin to a modern and integrative scientific discipline: the development of transcultural psychiatry in Germany.

PubMed

Machleidt, Wielant; Sieberer, Marcel

2013-12-01

The roots of transcultural psychiatry in Germany can be traced back to Emil Kraepelin, who made the first culturally comparative observations on mental disorders in Southeast Asia at the start of the 20th century. Since the beginning of the 1970s, contributors to the literature of transcultural psychiatry in Germany have been predominantly concerned with the mental health of migrant workers from Mediterranean countries, particularly the practical difficulties and therapeutic implications of inpatient psychiatric treatment of these migrant groups. The inauguration of the Section on Transcultural Psychiatry of the German Association for Psychiatry and Psychotherapy 20 years ago reflected an increasing scientific interest in this topic. In addition to the psychic impact of migration, research into transcultural care is currently focused on disparities in the utilization of health care and conjectured barriers to access to health and mental health care among migrants. Furthermore, studies based on epidemiological approaches have been carried out in order to resolve the question of whether migrants are as affected by mental disorders as the ethnic German population, and which issues contribute to the so-called "healthy migrant" effect. Other topics that have been explored in the last 10 years are the particular psychosocial situation of asylum seekers and refugees in Germany, and the effects of inadequate integration and discrimination on their mental health. In summary, after a short historical and theoretical overview, this article reviews the current major themes in transcultural research in German contemporary psychiatry, and concludes with an overview of future developments in this field.

Rates, risk factors & methods of self harm among minority ethnic groups in the UK: a systematic review

PubMed Central

Bhui, Kamaldeep; McKenzie, Kwame; Rasul, Farhat

2007-01-01

Background Studies suggest that the rates of self harm vary by ethnic group, but the evidence for variation in risk factors has not been synthesised to inform preventive initiatives. Methods We undertook a systematic literature review of research about self harm that compared at least two ethnic groups in the United Kingdom. Results 25 publications from 1765 titles and abstracts met our inclusion criteria. There was higher rate of self harm among South Asian women, compared with South Asian men and White women. In a pooled estimate from two studies, compared to their white counterparts, Asian women were more likely to self harm (Relative Risk 1.4, 95%CI: 1.1 to 1.8, p = 0.005), and Asian men were less likely to self harm (RR 0.5, 95% CI: 0.4 to 0.7, p < 0.001). Some studies concluded that South Asian adults self-harm impulsively in response to life events rather than in association with a psychiatric illness. Studies of adolescents showed similar methods of self harm and interpersonal disputes with parents and friends across ethnic groups. There were few studies of people of Caribbean, African and other minority ethnic groups, few studies took a population based and prospective design and few investigated self harm among prisoners, asylum seekers and refugees. Conclusion This review finds some ethnic differences in the nature and presentation of self harm. This argues for ethnic specific preventive actions. However, the literature does not comprehensively cover the UK's diverse ethnic groups. PMID:18021438

Representations and coverage of non-English-speaking immigrants and multicultural issues in three major Australian health care publications

PubMed Central

2010-01-01

Background No recent Australian studies or literature, provide evidence of the extent of coverage of multicultural health issues in Australian healthcare research. A series of systematic literature reviews in three major Australian healthcare journals were undertaken to discover the level, content, coverage and overall quality of research on multicultural health. Australian healthcare journals selected for the study were The Medical Journal of Australia (MJA), The Australian Health Review (AHR), and The Australian and New Zealand Journal of Public Health (ANZPH). Reviews were undertaken of the last twelve (12) years (1996-August 2008) of journal articles using six standard search terms: 'non-English-speaking', 'ethnic', 'migrant', 'immigrant', 'refugee' and 'multicultural'. Results In total there were 4,146 articles published in these journals over the 12-year period. A total of 90 or 2.2% of the total articles were articles primarily based on multicultural issues. A further 62 articles contained a major or a moderate level of consideration of multicultural issues, and 107 had a minor mention. Conclusions The quantum and range of multicultural health research and evidence required for equity in policy, services, interventions and implementation is limited and uneven. Most of the original multicultural health research articles focused on newly arrived refugees, asylum seekers, Vietnamese or South East Asian communities. While there is some seminal research in respect of these represented groups, there are other communities and health issues that are essentially invisible or unrepresented in research. The limited coverage and representation of multicultural populations in research studies has implications for evidence-based health and human services policy. PMID:20044938

Age estimation standards for a Western Australian population using the coronal pulp cavity index.

PubMed

Karkhanis, Shalmira; Mack, Peter; Franklin, Daniel

2013-09-10

Age estimation is a vital aspect in creating a biological profile and aids investigators by narrowing down potentially matching identities from the available pool. In addition to routine casework, in the present global political scenario, age estimation in living individuals is required in cases of refugees, asylum seekers, human trafficking and to ascertain age of criminal responsibility. Thus robust methods that are simple, non-invasive and ethically viable are required. The aim of the present study is, therefore, to test the reliability and applicability of the coronal pulp cavity index method, for the purpose of developing age estimation standards for an adult Western Australian population. A total of 450 orthopantomograms (220 females and 230 males) of Australian individuals were analyzed. Crown and coronal pulp chamber heights were measured in the mandibular left and right premolars, and the first and second molars. These measurements were then used to calculate the tooth coronal index. Data was analyzed using paired sample t-tests to assess bilateral asymmetry followed by simple linear and multiple regressions to develop age estimation models. The most accurate age estimation based on simple linear regression model was with mandibular right first molar (SEE ±8.271 years). Multiple regression models improved age prediction accuracy considerably and the most accurate model was with bilateral first and second molars (SEE ±6.692 years). This study represents the first investigation of this method in a Western Australian population and our results indicate that the method is suitable for forensic application. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

The staying power of pain. A comparison of torture survivors from Bosnia and Colombia and their rates of anxiety, depression and PTSD.

PubMed

Alexander, Abigail; Blake, Stacie; Bernstein, Michael A

2007-01-01

The article describes symptoms of anxiety, depression and PTSD among Bosnian (n=17) and Colombian (n=17) torture survivors served by the Florida Center for Survivors of Torture, a programme of Gulf Coast Jewish Family Services, Inc. Information from clients enrolled in the programme for six months or more was collated over a 14 month period in order to better prioritize and design services for the two distinct populations. On average, the Bosnians in this sample experienced torture approximately 14 years ago while the Colombians'experience was approximately six years ago. Types of torture experienced by clients are documented using HURIDOCS and the number of family and friends affected by extreme trauma are counted. Employment and education levels attained are also identified. Findings show that 100% of Bosnians are symptomatic for depression and over half possess symptoms of PTSD compared to 35% of Colombians for depression and 18% for PTSD, despite the differences in years since trauma occurred. High incidences of torture experienced by Bosnian clients and high numbers of family and friends affected support the high rates of symptoms. For the Colombian clients, high rates of employment and years of education, as well as earlier intervention, may contribute to their lower rates of symptoms. The two client groups are distinguished by the unique circumstances experienced by each, including punctuated wartime versus a prolonged insurgency, as well as the refugee versus asylum seeker experience. This exploratory project informs the torture treatment model while recognizing the importance of ethnic, political and cultural perspectives affecting the healing process.

National Health Service Principles as Experienced by Vulnerable London Migrants in "Austerity Britain": A Qualitative Study of Rights, Entitlements, and Civil-Society Advocacy

PubMed Central

Rafighi, Elham; Poduval, Shoba; Legido-Quigley, Helena; Howard, Natasha

2016-01-01

Background: Recent British National Health Service (NHS) reforms, in response to austerity and alleged ‘health tourism,’ could impose additional barriers to healthcare access for non-European Economic Area (EEA) migrants. This study explores policy reform challenges and implications, using excerpts from the perspectives of non-EEA migrants and health advocates in London. Methods: A qualitative study design was selected. Data were collected through document review and 22 in-depth interviews with non-EEA migrants and civil-society organisation representatives. Data were analysed thematically using the NHS principles. Results: The experiences of those ‘vulnerable migrants’ (ie, defined as adult non-EEA asylum-seekers, refugees, undocumented, low-skilled, and trafficked migrants susceptible to marginalised healthcare access) able to access health services were positive, with healthcare professionals generally demonstrating caring attitudes. However, general confusion existed about entitlements due to recent NHS changes, controversy over ‘health tourism,’ and challenges registering for health services or accessing secondary facilities. Factors requiring greater clarity or improvement included accessibility, communication, and clarity on general practitioner (GP) responsibilities and migrant entitlements. Conclusion: Legislation to restrict access to healthcare based on immigration status could further compromise the health of vulnerable individuals in Britain. This study highlights current challenges in health services policy and practice and the role of non-governmental organizations (NGOs) in healthcare advocacy (eg, helping the voices of the most vulnerable reach policy-makers). Thus, it contributes to broadening national discussions and enabling more nuanced interpretation of ongoing global debates on immigration and health. PMID:27694650

National Health Service Principles as Experienced by Vulnerable London Migrants in "Austerity Britain": A Qualitative Study of Rights, Entitlements, and Civil-Society Advocacy.

PubMed

Rafighi, Elham; Poduval, Shoba; Legido-Quigley, Helena; Howard, Natasha

2016-05-08

Recent British National Health Service (NHS) reforms, in response to austerity and alleged 'health tourism,' could impose additional barriers to healthcare access for non-European Economic Area (EEA) migrants. This study explores policy reform challenges and implications, using excerpts from the perspectives of non-EEA migrants and health advocates in London. A qualitative study design was selected. Data were collected through document review and 22 in-depth interviews with non-EEA migrants and civil-society organisation representatives. Data were analysed thematically using the NHS principles. The experiences of those 'vulnerable migrants' (ie, defined as adult non-EEA asylum-seekers, refugees, undocumented, low-skilled, and trafficked migrants susceptible to marginalised healthcare access) able to access health services were positive, with healthcare professionals generally demonstrating caring attitudes. However, general confusion existed about entitlements due to recent NHS changes, controversy over 'health tourism,' and challenges registering for health services or accessing secondary facilities. Factors requiring greater clarity or improvement included accessibility, communication, and clarity on general practitioner (GP) responsibilities and migrant entitlements. Legislation to restrict access to healthcare based on immigration status could further compromise the health of vulnerable individuals in Britain. This study highlights current challenges in health services policy and practice and the role of non-governmental organizations (NGOs) in healthcare advocacy (eg, helping the voices of the most vulnerable reach policy-makers). Thus, it contributes to broadening national discussions and enabling more nuanced interpretation of ongoing global debates on immigration and health. © 2016 by Kerman University of Medical Sciences

The obstetric performance of United Kingdom asylum seekers from Somalia: a case-control study and literature review.

PubMed

Yoong, W; Kolhe, S; Karoshi, Mahantesh; Ullah, M; Nauta, M

2005-01-01

Little published research exists regarding obstetric performance of immigrant women in the United Kingdom. The aim of this study was to evaluate the obstetric performance and fetal outcomes of Somalian women who received prenatal care and requested to deliver at a teaching hospital in North London. This is a case-control study in which consecutive Somalian women were identified as index cases and the subsequent British-born Caucasian women listed in the delivery book served as controls. 69 index and 69 control cases were analyzed. Fifty-five percent of the Somalian women spoke little or no English. Half (50%) had undergone circumcision, the majority being type I WHO classification of female genital circumcision, which did not require significant surgical intervention prior to labor; 13% had cesarean sections, 13% instrumental vaginal deliveries, and 74% had vaginal deliveries. The Somalian women had higher parity (2.35 vs. 1.18) and were more likely to be grand multiparous (9/69 vs. 1/69) compared to controls. Epidural use was less frequent in Somalian women, but otherwise there were no significant differences between the two groups with regard to maternal age, rates of induction of labor, cesarean sections, duration of labor, premature deliveries, instrumental deliveries, and birth weights. The demographic characteristics of the Somalian female population appear to exert minimal effect on obstetric and fetal outcomes. This may be due to the increased vigilance exercised by health professionals as well as to the fact that recent arrivals are from more urban and westernized areas in Somalia.

Millennium Mindsets.

ERIC Educational Resources Information Center

Kaye, Beverly L.

1999-01-01

Describes primary career mindsets that characterize the next millennium: inquirer, imaginer, player, congruence seeker, feedback junkie, reputation regulator, change chaser, trend tracker, alert anthropologist, global framer, accomplished juggler, ambiguity survivor, risk taker, anxiety appreciator, and aha! seeker. (Author/JOW)

The utilization of traditional Chinese medicine in patients with dysfunctional uterine bleeding in Taiwan: a nationwide population-based study.

PubMed

Lin, Yi-Rong; Wu, Mei-Yao; Chiang, Jen-Huai; Yen, Hung-Rong; Yang, Su-Tso

2017-08-29

Many patients with gynecological disorders seek traditional medicine consultations in Asian countries. This study intended to investigate the utilization of traditional Chinese medicine (TCM) in patients with dysfunctional uterine bleeding (DUB) in Taiwan. We analyzed a cohort of one million individuals randomly selected from the National Health Insurance Research Database in Taiwan. We included 46,337 subjects with newly diagnosed DUB (ICD-9-CM codes 626.8) from January 1, 1997 to December 31, 2010. The patients were categorized into TCM seekers and non-TCM seekers according to their use of TCM. Among the subjects, 41,558 (89.69%) were TCM seekers and 4,779 (10.31%) were non-TCM seekers. Patients who were younger tended to be TCM seekers. Most of the patients had also taken Western medicine, especially tranexamic acid and non-steroidal anti-inflammatory drugs (NSAIDs). More than half of TCM seekers (55.41%) received combined treatment with both Chinese herbal remedies and acupuncture. The most commonly used TCM formula and single herb were Jia-Wei-Xiao-Yao-San (Bupleurum and Peony Formula) and Yi-Mu-Cao (Herba Leonuri), respectively. The core pattern of Chinese herbal medicine for DUB patients consisted of Jia-Wei-Xiao-Yao-San, Xiang-Fu (Rhizoma Cyperi), and Yi-Mu-Cao (Herba Leonuri). TCM use is popular among patients with DUB in Taiwan. Further pharmacological investigations and clinical trials are required to validate the efficacy and safety of these items.

Negotiating Narratives, Accessing Asylum: Evaluating Language Policy as Multi-Level Practice, Beliefs and Management

ERIC Educational Resources Information Center

Smith-Khan, Laura

2017-01-01

Theories of language policy increasingly emphasise focusing on the specific contexts in which language management occurs. In government settings, policy seeks to shape how individuals interact with officials. Australian asylum procedure is an area where policy aims at tight control. I examine how communication is managed in this setting, in which…

Performing Home in Barcelona: A Practice-Based Photo Essay

ERIC Educational Resources Information Center

Pons, Esther Belvis

2018-01-01

During the winter of 2016, I carried out an artistic project in Barcelona entitled 'Performing Home' that aimed to explore the affective and social challenges that artists in political asylum or refuge cope with. The project began with a simple question: "where in public spaces do artists in asylum feel 'at home'?" It explored how public…

8 CFR 208.24 - Termination of asylum or withholding of removal or deportation.

Code of Federal Regulations, 2013 CFR

2013-01-01

... relating to the original claim, the alien's life or freedom no longer would be threatened on account of... 8 Aliens and Nationality 1 2013-01-01 2013-01-01 false Termination of asylum or withholding of removal or deportation. 208.24 Section 208.24 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY...

8 CFR 208.24 - Termination of asylum or withholding of removal or deportation.

Code of Federal Regulations, 2014 CFR

2014-01-01

... relating to the original claim, the alien's life or freedom no longer would be threatened on account of... 8 Aliens and Nationality 1 2014-01-01 2014-01-01 false Termination of asylum or withholding of removal or deportation. 208.24 Section 208.24 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY...

8 CFR 208.24 - Termination of asylum or withholding of removal or deportation.

Code of Federal Regulations, 2011 CFR

2011-01-01

... relating to the original claim, the alien's life or freedom no longer would be threatened on account of... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Termination of asylum or withholding of removal or deportation. 208.24 Section 208.24 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY...

The P, A and R of Participatory Action Research with Unaccompanied Girls

ERIC Educational Resources Information Center

Kaukko, Mervi

2016-01-01

This article discusses the possibilities and the challenges of conducting participatory action research (PAR) with unaccompanied asylum-seeking children and youth. Drawing from a PAR project with 12 unaccompanied asylum-seeking girls in a Finnish reception centre, the paper explores the P, A and R of PAR asking the following questions: what kind…

76 FR 67099 - Forwarding of Asylum Applications to the Department of State

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-31

... #0;notices is to give interested persons an opportunity to participate in #0;the rule making prior to... Immigration Review 8 CFR Parts 1208 and 1240 [EOIR Docket No. 173; AG Order No. 3307-2011] RIN 1125-AA65 Forwarding of Asylum Applications to the Department of State AGENCY: Executive Office for Immigration Review...

'Colour-Evasiveness' and Racism without Race: The Disablement of Asylum-Seeking Children at The Edge of Fortress Europe

ERIC Educational Resources Information Center

Migliarini, Valentina

2018-01-01

This article explores discriminatory discourses articulated by Italian professionals operating in educational, health and social services for refugees in Rome, in relation to the educational and social inclusion of unaccompanied asylum-seeking and refugee children. It locates such narratives within the historical 'concealment and invisibilisation…

8 CFR 208.30 - Credible fear determinations involving stowaways and applicants for admission found inadmissible...

Code of Federal Regulations, 2011 CFR

2011-01-01

... credible fear interviews, determinations, and reviews under section 235(b)(1)(B) of the Act. Prior to... or she expresses such a desire. (c) Authority. Asylum officers conducting credible fear interviews shall have the authorities described in § 208.9(c). (d) Interview. The asylum officer, as defined in...

8 CFR 208.30 - Credible fear determinations involving stowaways and applicants for admission found inadmissible...

Code of Federal Regulations, 2010 CFR

2010-01-01

... credible fear interviews, determinations, and reviews under section 235(b)(1)(B) of the Act. Prior to... or she expresses such a desire. (c) Authority. Asylum officers conducting credible fear interviews shall have the authorities described in § 208.9(c). (d) Interview. The asylum officer, as defined in...

[For the good of the nation's economy: therapeutic work and public assistance at La Castañeda asylum in Mexico City, 1929-32].

PubMed

Sacristán, Cristina

2005-01-01

Founded in 1910, by 1930 Mexico City's La Castañeda insane asylum was grappling with the problem of a massive number of chronic patients, a situation that earned it an image as a warehouse for the sick more than a place of treatment. Psychiatrists endeavored to restore the asylum's legitimacy by publicizing a nineteenth-century treatment which projected the public image that the mentally ill could be as productive as anyone else: work therapy. The government born of the Mexican revolution supported this proposal because the guiding objective behind public assistance for underprivileged groups was to make them part of the country's productive life via the market.

The bones of the insane

PubMed Central

2013-01-01

This article examines alienist explanations for fracture among British asylum patients in the late nineteenth to early twentieth centuries. A series of deaths in asylums came to light in the 1870s which, in placing the blame for such incidents on asylum staff, called for a response from the psychiatric profession. This response drew upon other medical fields and employed novel pathological techniques to explain why fractures occurred among the insane, in many cases aligning bone fragility with particular forms of insanity (namely, General Paralysis of the Insane). Although such research aimed to provide a medical explanation for the ‘fracture death’, it also called into question the value of pathological research and the utility of quantitative measurement in understanding mental disease. PMID:24573259

Old and mad in Victorian Oxford: a study of patients aged 60 and over admitted to the Warneford and Littlemore Asylums in the nineteenth century.

PubMed

Yorston, Graeme; Haw, Camilla

2005-12-01

This is a historical case note analysis of older patients admitted to the Warneford and Littlemore Asylums in nineteenth-century Oxford. Of 1044 admissions to the Warneford, 93 patients were aged over 60 (8.9%). At Littlemore, 998 of a total of 5464 admissions were aged over 60 (18.3%). High levels of psychopathology were found, as in other studies examining patients of all ages, and were similar for the two institutions. The largest difference was in the death rate, which was much higher for Littlemore Asylum. This resulted from the preponderance of patients with organic diagnoses who were admitted to Littlemore, many of whom died shortly afterwards.

Jamming effect analysis of infrared reticle seeker for directed infrared countermeasures

NASA Astrophysics Data System (ADS)

Bae, Tae-Wuk; Kim, Byoung-Ik; Kim, Young-Choon; Ahn, Sang-Ho

2012-09-01

In directed infrared countermeasures (DIRCM), the purpose of jamming toward missiles is making missiles miss the target (aircraft of our forces) in the field of view. Since the DIRCM system directly emits the pulsing flashes of infrared (IR) energy to missiles, it is more effective than present flare method emitting IR source to omni-direction. In this paper, we implemented a reticle seeker simulation tool using MATLAB-SIMULINK, in order to analyze jamming effect of spin-scan and con-scan reticle missile seeker used widely in the world, though it was developed early. Because the jammer signal has influence on the missile guidance system using its variable frequency, it is very important technique among military defense systems protecting our forces from missiles of enemy. Simulation results show that jamming effect is greatly influenced according to frequency, phase and intensity of jammer signal. Especially, jammer frequency has the largest influence on jamming effect. Through our reticle seeker simulation tool, we can confirm that jamming effect toward missiles is significantly increased when jammer frequency is similar to reticle frequency. Finally, we evaluated jamming effect according to jammer frequencies, by using correlation coefficient as an evaluation criterion of jamming performance in two reticle missile seekers.

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis.

PubMed

Nellums, Laura B; Thompson, Hayley; Holmes, Alison; Castro-Sánchez, Enrique; Otter, Jonathan A; Norredam, Marie; Friedland, Jon S; Hargreaves, Sally

2018-05-17

Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I 2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I 2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I 2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I 2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I 2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I 2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I 2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Reconstructing Harry: A Genealogical Study of a Colonial Family ‘Inside’ and ‘Outside’ the Grahamstown Asylum, 1888–1918

PubMed Central

Wilbraham, Lindy

2014-01-01

Recent scholarship has explored the dynamics between families and colonial lunatic asylums in the late nineteenth century, where families actively participated in the processes of custodial care, committal, treatment and release of their relatives. This paper works in this historical field, but with some methodological and theoretical differences. The Foucauldian study is anchored to a single case and family as an illness narrative that moves cross-referentially between bureaucratic state archival material, psychiatric case records, and intergenerational family-storytelling and family photographs. Following headaches and seizures, Harry Walter Wilbraham was medically boarded from his position as Postmaster in the Cape of Good Hope Colony of South Africa with a ‘permanent disease of the brain’, and was committed to the Grahamstown Asylum in 1910, where he died the following year, aged 40 years. In contrast to writings about colonial asylums that usually describe several patient cases and thematic patterns in archival material over time and place, this study’s genealogical lens examines one white settler male patient’s experiences within mental health care in South Africa between 1908 and 1911. The construction of Harry’s ‘case’ interweaves archival sources and reminiscences inside and outside the asylum, and places it within psychiatric discourse of the time, and family dynamics in the years that followed. Thus, this case study maps the constitution of ‘patient’ and ‘family’ in colonial life, c.1888–1918, and considers the calamity, uncertainty, stigma and silences of mental illness. PMID:24775428

Characteristics of Patients with Alcohol Dependence Seeking Baclofen Treatment in France: A Two-Centre Comparative Cohort Study.

PubMed

Simioni, Nicolas; Preda, Cristian; Deken, Valérie; Bence, Camille; Cottencin, Olivier; Rolland, Benjamin

2016-11-01

To characterize the profile of patients seeking baclofen treatment for alcohol dependence in France. We compared retrospectively baclofen seekers and baclofen non-seekers within a cohort of consecutive outpatients with alcohol dependence who attended a first appointment for alcohol treatment at two French addiction centres between September 2012 and March 2014. We documented socio-demographic characteristics; comorbid psychiatric, addiction, alcohol dependence features; patients' initial drinking goal, and referral status; and treatment retention at 6 and 12 months. Of the 289 patients identified, 107 were baclofen seekers and 182 were baclofen non-seekers. The only parameters significantly associated with baclofen seekers in multivariate analyses were a greater baseline alcohol consumption (β = 15.4, 95% CI: 0.18-30.65, P = 0.05), a controlled-drinking initial goal (OR = 14.9, 95% CI: 7.7-29, P < 0.0001) and self-referral (OR = 6.6, 95% CI: 3.7-12, P < 0.0001), baclofen seekers being eight times more likely to be self-referred and treatment-naïve (OR = 8.8, 95% CI: 4.1-18.9, P < 0.0001). Baclofen seekers were more likely to be retained in treatment at 6 months (OR = 3.5, 95% CI: 1.8-6.7, P < 0.0001) and 12 months (OR = 1.9, 95% CI: 1.1-3.2, P = 0.019). In France, the perspective of controlled drinking offered by baclofen treatment may have attracted more self-referred patients, including those without previous alcohol treatment, to attend treatment, than the usual treatment options. These findings raise the question as to whether future public health strategies on alcohol should more prominently promote some aspects of alcohol treatment, such as patient's preference and treatment options, in order to reduce the treatment gap in alcohol dependence. © The Author 2016. Medical Council on Alcohol and Oxford University Press. All rights reserved.

Asylum, Participation and the Best Interests of the Child: New Lessons from Norway

ERIC Educational Resources Information Center

Liden, Hilde; Rusten, Hilde

2007-01-01

This article discusses Norway's implementation of the Convention on the Rights of the Child (CRC) in relation to the field of asylum. In particular, we explore the dilemmas and challenges posed by efforts to realise children's right to express their views and have these views given due weight in decision-making processes as stipulated in Article…

Sexual Maltreatment of Unaccompanied Asylum-Seeking Minors from the Horn of Africa: A Mixed Method Study Focusing on Vulnerability and Prevention

ERIC Educational Resources Information Center

Lay, Margaret; Papadopoulos, Irena

2009-01-01

Objectives: The study described in this paper sought to identify the social, cultural, and political factors that effect African unaccompanied asylum-seeking minors' (UASM) vulnerability to sexual maltreatment in England. It aimed to illuminate how child protection measures could be strengthened for this highly marginalized group. Methods: A mixed…

When lives are put on hold: Lengthy asylum processes decrease employment among refugees.

PubMed

Hainmueller, Jens; Hangartner, Dominik; Lawrence, Duncan

2016-08-01

European governments are struggling with the biggest refugee crisis since World War II, but there exists little evidence regarding how the management of the asylum process affects the subsequent integration of refugees in the host country. We provide new causal evidence about how one central policy parameter, the length of time that refugees wait in limbo for a decision on their asylum claim, affects their subsequent economic integration. Exploiting exogenous variation in wait times and registry panel data covering refugees who applied in Switzerland between 1994 and 2004, we find that one additional year of waiting reduces the subsequent employment rate by 4 to 5 percentage points, a 16 to 23% drop compared to the average rate. This deleterious effect is remarkably stable across different subgroups of refugees stratified by gender, origin, age at arrival, and assigned language region, a pattern consistent with the idea that waiting in limbo dampens refugee employment through psychological discouragement, rather than a skill atrophy mechanism. Overall, our results suggest that marginally reducing the asylum waiting period can help reduce public expenditures and unlock the economic potential of refugees by increasing employment among this vulnerable population.

When lives are put on hold: Lengthy asylum processes decrease employment among refugees

PubMed Central

Hainmueller, Jens; Hangartner, Dominik; Lawrence, Duncan

2016-01-01

European governments are struggling with the biggest refugee crisis since World War II, but there exists little evidence regarding how the management of the asylum process affects the subsequent integration of refugees in the host country. We provide new causal evidence about how one central policy parameter, the length of time that refugees wait in limbo for a decision on their asylum claim, affects their subsequent economic integration. Exploiting exogenous variation in wait times and registry panel data covering refugees who applied in Switzerland between 1994 and 2004, we find that one additional year of waiting reduces the subsequent employment rate by 4 to 5 percentage points, a 16 to 23% drop compared to the average rate. This deleterious effect is remarkably stable across different subgroups of refugees stratified by gender, origin, age at arrival, and assigned language region, a pattern consistent with the idea that waiting in limbo dampens refugee employment through psychological discouragement, rather than a skill atrophy mechanism. Overall, our results suggest that marginally reducing the asylum waiting period can help reduce public expenditures and unlock the economic potential of refugees by increasing employment among this vulnerable population. PMID:27493995

Unaccompanied Asylum-Seeking Refugee Children's Forced Repatriation: Social Workers' and Police Officers' Health and Job Characteristics.

PubMed

Sundqvist, Johanna; Hansson, Jonas; Ghazinour, Mehdi; Ögren, Kenneth; Padyab, Mojgan

2015-04-19

During the past ten years the number of unaccompanied asylum-seeking refugee children has dramatically increased in Sweden. Some of them are permitted to stay in the receiving country, but some are forced back to their country of origin. Social workers and police officers are involved in these forced repatriations, and such complex situations may cause stressful working conditions. This study aimed to bridge the gap in knowledge of the relationship between general mental health and working with unaccompanied asylum-seeking refugee children who are due for forced repatriation. In addition, the role of psychosocial job characteristics in such relationships was investigated. A questionnaire including sociodemographic characteristics, the Swedish Demand-Control-Support Questionnaire, and the 12-item General Mental Health Questionnaire were distributed nationally. Univariate and multivariable regression models were used. Poorer mental health was associated with working with unaccompanied asylum-seeking refugee children among social workers but not among police officers. Psychological job demand was a significant predictor for general mental health among social workers, while psychological job demand, decision latitude, and marital status were predictors among police officers. Findings are discussed with special regard to the context of social work and police professions in Sweden.

Analyzing the effectiveness of flare dispensing programs against pulse width modulation seekers using self-organizing maps

NASA Astrophysics Data System (ADS)

Şahingil, Mehmet C.; Aslan, Murat Š.

2013-10-01

Infrared guided missile seekers utilizing pulse width modulation in target tracking is one of the threats against air platforms. To be able to achieve a "soft-kill" protection of own platform against these type of threats, one needs to examine carefully the seeker operating principle with its special electronic counter-counter measure (ECCM) capability. One of the cost-effective ways of soft kill protection is to use flare decoys in accordance with an optimized dispensing program. Such an optimization requires a good understanding of the threat seeker, capabilities of the air platform and engagement scenario information between them. Modeling and simulation is very powerful tool to achieve a valuable insight and understand the underlying phenomenology. A careful interpretation of simulation results is crucial to infer valuable conclusions from the data. In such an interpretation there are lots of factors (features) which affect the results. Therefore, powerful statistical tools and pattern recognition algorithms are of special interest in the analysis. In this paper, we show how self-organizing maps (SOMs), which is one of those powerful tools, can be used in analyzing the effectiveness of various flare dispensing programs against a PWM seeker. We perform several Monte Carlo runs for a typical engagement scenario in a MATLAB-based simulation environment. In each run, we randomly change the flare dispending program and obtain corresponding class: "successful" or "unsuccessful", depending on whether the corresponding flare dispensing program deceives the seeker or not, respectively. Then, in the analysis phase, we use SOMs to interpret and visualize the results.

Effectiveness of job search interventions: a meta-analytic review.

PubMed

Liu, Songqi; Huang, Jason L; Wang, Mo

2014-07-01

The current meta-analytic review examined the effectiveness of job search interventions in facilitating job search success (i.e., obtaining employment). Major theoretical perspectives on job search interventions, including behavioral learning theory, theory of planned behavior, social cognitive theory, and coping theory, were reviewed and integrated to derive a taxonomy of critical job search intervention components. Summarizing the data from 47 experimentally or quasi-experimentally evaluated job search interventions, we found that the odds of obtaining employment were 2.67 times higher for job seekers participating in job search interventions compared to job seekers in the control group, who did not participate in such intervention programs. Our moderator analysis also suggested that job search interventions that contained certain components, including teaching job search skills, improving self-presentation, boosting self-efficacy, encouraging proactivity, promoting goal setting, and enlisting social support, were more effective than interventions that did not include such components. More important, job search interventions effectively promoted employment only when both skill development and motivation enhancement were included. In addition, we found that job search interventions were more effective in helping younger and older (vs. middle-aged) job seekers, short-term (vs. long-term) unemployed job seekers, and job seekers with special needs and conditions (vs. job seekers in general) to find employment. Furthermore, meta-analytic path analysis revealed that increased job search skills, job search self-efficacy, and job search behaviors partially mediated the positive effect of job search interventions on obtaining employment. Theoretical and practical implications and future research directions are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Midwives caring for asylum-seeking women: research findings.

PubMed

Bennett, Sarah; Scammell, Janet

2014-01-01

Over the past decade, the numbers of women seeking asylum in the United Kingdom (UK) and requiring midwifery care have increased significantly (Office for National Statistics (ONS) 2012). This article describes findings from a small study that explored the experiences of midwives caring for asylum seeking women. Time and communication emerged as significant factors impacting on quality of care and these are the focus of this article. Caring for these women was emotionally challenging and at times frustrating due to poor access to information and support. In conclusion, whilst considerable knowledge and skills were required to care for this vulnerable group, these appeared to be learned almost solely 'on the job': Implications for service delivery and education are explored and recommendations made to improve experiences for women and midwives.

Moral Treatment of the Insane: Provisions for Lifelong Learning, Cultural Engagement, and Creativity in Nineteenth-Century Asylums

ERIC Educational Resources Information Center

Park, Maureen; Hamilton, Robert

2010-01-01

The current interest in the role of lifelong learning and cultural engagement for change is not new. This article looks at a most unusual precedent and a neglected area in the historiography of adult education--the use of cultural education provision in asylums in the nineteenth century to promote cure and restoration of the "insane" to…

Assessing the Relationship between Community Education, Political Efficacy and Electoral Participation: A Case Study of the Asylum Seeking Community in Cork

ERIC Educational Resources Information Center

Harris, Clodagh; Murphy, Philip

2012-01-01

This paper assesses the relationship between community education and internal political efficacy. In particular it examines the association between voter/civic programmes run in advance of the 2009 local elections in Ireland and internal political efficacy amongst the asylum seeking community in Cork. A survey is used to test this relationship.…

Irish midwives’ experiences of providing maternity care to non-Irish women seeking asylum

PubMed Central

Tobin, Carolyn L; Murphy-Lawless, Jo

2014-01-01

Background Immigration and asylum seeking has been an important social and political phenomenon in Ireland since the mid 1990s. Inward migration to Ireland was seen in unprecedented numbers from 1995 onward, peaking in 2002 with 11,634 applications for refugee status. Asylum and immigration is an issue of national and international relevance as the numbers of displaced people worldwide continues to grow, reaching the highest level in 20 years at 45.2 million in 2012. Midwives provide the majority of care to childbearing women around the world, whether working as autonomous practitioners or under the direction of an obstetrician. Limited data currently exist on the perspectives of midwives who provide care to childbearing women while they are in the process of seeking asylum. Such data are important to midwifery leaders, educators, and policy-makers. The aims of this study were to explore midwives’ perceptions and experiences of providing care to women in the asylum process and to gain insight into how midwives can be equipped and supported to provide more effective care to this group in the future. Methods Data were collected via indepth unstructured interviews with a purposive sample of ten midwives from two sites, one a large urban inner city hospital, and the second, a smaller more rural maternity hospital. The interviews were audio-recorded and transcribed verbatim. The data were analyzed using content analysis. Results Five themes emerged from the data, barriers to communication, understanding cultural difference, challenges of caring for women who were unbooked, the emotional cost of caring, and structural barriers to effective care. Conclusion Findings highlight a need to focus on support and education for midwives, improved maternity services for immigrant women, and urgent policy revision. PMID:24516340

Job Seeker's Aids: A Systematic Approach for Organizing Employer Contacts

ERIC Educational Resources Information Center

Ugland, Richard P.

1977-01-01

Job Seeker's Aids is a step-by-step procedure that can be used by rehabilitation counselors to help clients locate and visit manufacturing, institutional, and other places of employment for the purpose of identifying and applying for job openings. (Author)

Study of jamming of the frequency modulation infrared seekers

NASA Astrophysics Data System (ADS)

Qian, Fang; Guo, Jin; Shao, Jun-feng; Wang, Ting-feng

2013-09-01

The threat of the IR guidance missile is a direct consequence of extensive proliferation of the airborne IR countermeasure. The aim of a countermeasure system is to inject false information into a sensor system to create confusion. Many optical seekers have a single detector that is used to sense the position of its victim in its field of view. A seeker has a spinning reticle in the focal plane of the optical system that collects energy from the thermal scene and focuses it on to the detector. In this paper, the principle of the conical-scan FM reticle is analyzed. Then the effect that different amplitude or frequency modulated mid-infrared laser pulse acts on the reticle system is simulated. When the ratio of jamming energy to target radiation (repression) gradually increases, the azimuth error and the misalignment angle error become larger. The results show that simply increasing the intensity of the jamming light achieves little, but it increases the received signal strength of the FM reticle system ,so that the target will be more easily exposed. A slow variation of amplitude will warp the azimuth information received by the seeker, but the target can't be completely out of the missile tracking. If the repression and the jamming frequency change at the same time, the jamming effects can be more obvious. When the jamming signal's angular frequency is twice as large as the carrier frequency of the reticle system, the seeker will can't receive an accurate signal and the jamming can be achieved. The jamming mechanism of the conical-scan FM IR seeker is described and it is helpful to the airborne IR countermeasure system.

Subjectivation, Agency and the Schooling of Raced and Dis/Abled Asylum-Seeking Children in the Italian Context

ERIC Educational Resources Information Center

Migliarini, Valentina

2017-01-01

This paper intends to address the challenges that the Italian education system is facing in terms of policies and practices relating to dis/abled asylum-seeking and refugee children, in order to make sense of the politics of daily life inside schools and the network of social services for forced migrants, and to pay renewed attention to the notion…

Unaccompanied Asylum-Seeking Refugee Children’s Forced Repatriation: Social Workers’ and Police Officers’ Health and Job Characteristics

PubMed Central

Sundqvist, Johanna; Hansson, Jonas; Ghazinour, Mehdi; Ögren, Kenneth; Padyab, Mojgan

2015-01-01

During the past ten years the number of unaccompanied asylum-seeking refugee children has dramatically increased in Sweden. Some of them are permitted to stay in the receiving country, but some are forced back to their country of origin. Social workers and police officers are involved in these forced repatriations, and such complex situations may cause stressful working conditions. This study aimed to bridge the gap in knowledge of the relationship between general mental health and working with unaccompanied asylum-seeking refugee children who are due for forced repatriation. In addition, the role of psychosocial job characteristics in such relationships was investigated. A questionnaire including sociodemographic characteristics, the Swedish Demand-Control-Support Questionnaire, and the 12-item General Mental Health Questionnaire were distributed nationally. Univariate and multivariable regression models were used. Poorer mental health was associated with working with unaccompanied asylum-seeking refugee children among social workers but not among police officers. Psychological job demand was a significant predictor for general mental health among social workers, while psychological job demand, decision latitude, and marital status were predictors among police officers. Findings are discussed with special regard to the context of social work and police professions in Sweden. PMID:26153185

Making It Work.

ERIC Educational Resources Information Center

Brotherton, Phaedra

2000-01-01

The Racine Workforce Development Center pools resources and personnel to create a successful one-stop shop for job seekers and employers alike. Self-directed services for job seekers include a resource room, an academic improvement center, information about job openings, and free resume and cover letter preparation. (Author/JOW)

Countermeasure effectiveness against a man-portable air-defense system containing a two-color spinscan infrared seeker

NASA Astrophysics Data System (ADS)

Jackman, James; Richardson, Mark; Butters, Brian; Walmsley, Roy

2011-12-01

Man-portable air-defense (MANPAD) systems have developed sophisticated counter-countermeasures (CCM) to try and defeat any expendable countermeasure that is deployed by an aircraft. One of these is a seeker that is able to detect in two different parts of the electromagnetic spectrum. Termed two-color, the seeker can compare the emissions from the target and a countermeasure in different wavebands and reject the countermeasure. In this paper we describe the modeling process of a two-color infrared seeker using COUNTERSIM, a missile engagement and countermeasure software simulation tool. First, the simulations model a MANPAD with a two-color CCM which is fired against a fast jet model and a transport aircraft model releasing reactive countermeasures. This is then compared to when the aircraft releases countermeasures throughout an engagement up to the hit point to investigate the optimum flare firing time. The results show that the release time of expendable decoys as a countermeasure against a MANPAD with a two-color CCM is critical.

Homophily in an Anonymous Online Community: Sociodemographic Versus Personality Traits.

PubMed

Kang, Jeong-Han; Chung, Da Young

2017-06-01

In what traits do people interact with others who are similar to them in completely anonymous online communication? Can those traits contribute to greater exchange of opinion and information across the sociodemographic boundaries that often limit interaction between social strata? To answer this question concerning online homophily, we combined survey data on 7,287 users (aged 18 and above) of a Korean online dating advice platform with their behavioral data from June 2015 to August 2015 and explored whether advice exchange occurred between users with similar sociodemographic and personality traits. On this platform, two types of interactions occurred as follows: (1) responses to a randomly distributed problem submitted by an advice seeker and (2) the seeker's indication of approval of any of the responses given. The study found that (1) a receiver was more likely to respond to problems submitted by seekers of a comparable age and that (2) seekers were more likely to approve of a response if the seeker and receiver had similar educational backgrounds. By contrast, homophily based on personality traits was not observed even though some personality traits significantly affected the likelihood of both response and approval. Our findings suggest that online communication may breed sociodemographic homophily, whether based on age or education, more than expected or intended while not easily fostering alternative forms of homophily, such as personality homophily, which can potentially cut across borders dividing sociodemographic groups.

WordSeeker: concurrent bioinformatics software for discovering genome-wide patterns and word-based genomic signatures

PubMed Central

2010-01-01

Background An important focus of genomic science is the discovery and characterization of all functional elements within genomes. In silico methods are used in genome studies to discover putative regulatory genomic elements (called words or motifs). Although a number of methods have been developed for motif discovery, most of them lack the scalability needed to analyze large genomic data sets. Methods This manuscript presents WordSeeker, an enumerative motif discovery toolkit that utilizes multi-core and distributed computational platforms to enable scalable analysis of genomic data. A controller task coordinates activities of worker nodes, each of which (1) enumerates a subset of the DNA word space and (2) scores words with a distributed Markov chain model. Results A comprehensive suite of performance tests was conducted to demonstrate the performance, speedup and efficiency of WordSeeker. The scalability of the toolkit enabled the analysis of the entire genome of Arabidopsis thaliana; the results of the analysis were integrated into The Arabidopsis Gene Regulatory Information Server (AGRIS). A public version of WordSeeker was deployed on the Glenn cluster at the Ohio Supercomputer Center. Conclusion WordSeeker effectively utilizes concurrent computing platforms to enable the identification of putative functional elements in genomic data sets. This capability facilitates the analysis of the large quantity of sequenced genomic data. PMID:21210985

A Predominant Variable-Number Tandem-Repeat Cluster of Mycobacterium tuberculosis Isolates among Asylum Seekers in the Netherlands and Denmark, Deciphered by Whole-Genome Sequencing

PubMed Central

de Neeling, Albert; Rasmussen, Erik Michael; Norman, Anders; Mulder, Arnout; van Hunen, Rianne; de Vries, Gerard; Haddad, Walid; Anthony, Richard; Lillebaek, Troels; van der Hoek, Wim; van Soolingen, Dick

2017-01-01

ABSTRACT In many countries, Mycobacterium tuberculosis isolates are routinely subjected to variable-number tandem-repeat (VNTR) typing to investigate M. tuberculosis transmission. Unexpectedly, cross-border clusters were identified among African refugees in the Netherlands and Denmark, although transmission in those countries was unlikely. Whole-genome sequencing (WGS) was applied to analyze transmission in depth and to assess the precision of VNTR typing. WGS was applied to 40 M. tuberculosis isolates from refugees in the Netherlands and Denmark (most of whom were from the Horn of Africa) that shared the exact same VNTR profile. Cluster investigations were undertaken to identify in-country epidemiological links. Combining WGS results for the isolates (all members of the central Asian strain [CAS]/Delhi genotype), from both European countries, an average genetic distance of 80 single-nucleotide polymorphisms (SNPs) (maximum, 153 SNPs) was observed. The few pairs of isolates with confirmed epidemiological links, except for one pair, had a maximum distance of 12 SNPs. WGS divided this refugee cluster into several subclusters of patients from the same country of origin. Although the M. tuberculosis cases, mainly originating from African countries, shared the exact same VNTR profile, most were clearly distinguished by WGS. The average genetic distance in this specific VNTR cluster was 2 times greater than that in other VNTR clusters. Thus, identical VNTR profiles did not represent recent direct M. tuberculosis transmission for this group of patients. It appears that either these strains from Africa are extremely conserved genetically or there is ongoing transmission of this genotype among refugees on their long migration routes from Africa to Europe. PMID:29167288

A Predominant Variable-Number Tandem-Repeat Cluster of Mycobacterium tuberculosis Isolates among Asylum Seekers in the Netherlands and Denmark, Deciphered by Whole-Genome Sequencing.

PubMed

Jajou, Rana; de Neeling, Albert; Rasmussen, Erik Michael; Norman, Anders; Mulder, Arnout; van Hunen, Rianne; de Vries, Gerard; Haddad, Walid; Anthony, Richard; Lillebaek, Troels; van der Hoek, Wim; van Soolingen, Dick

2018-02-01

In many countries, Mycobacterium tuberculosis isolates are routinely subjected to variable-number tandem-repeat (VNTR) typing to investigate M. tuberculosis transmission. Unexpectedly, cross-border clusters were identified among African refugees in the Netherlands and Denmark, although transmission in those countries was unlikely. Whole-genome sequencing (WGS) was applied to analyze transmission in depth and to assess the precision of VNTR typing. WGS was applied to 40 M. tuberculosis isolates from refugees in the Netherlands and Denmark (most of whom were from the Horn of Africa) that shared the exact same VNTR profile. Cluster investigations were undertaken to identify in-country epidemiological links. Combining WGS results for the isolates (all members of the central Asian strain [CAS]/Delhi genotype), from both European countries, an average genetic distance of 80 single-nucleotide polymorphisms (SNPs) (maximum, 153 SNPs) was observed. The few pairs of isolates with confirmed epidemiological links, except for one pair, had a maximum distance of 12 SNPs. WGS divided this refugee cluster into several subclusters of patients from the same country of origin. Although the M. tuberculosis cases, mainly originating from African countries, shared the exact same VNTR profile, most were clearly distinguished by WGS. The average genetic distance in this specific VNTR cluster was 2 times greater than that in other VNTR clusters. Thus, identical VNTR profiles did not represent recent direct M. tuberculosis transmission for this group of patients. It appears that either these strains from Africa are extremely conserved genetically or there is ongoing transmission of this genotype among refugees on their long migration routes from Africa to Europe. Copyright © 2018 Jajou et al.

Access to mental health in primary care: a qualitative meta-synthesis of evidence from the experience of people from 'hard to reach' groups.

PubMed

Lamb, Jonathan; Bower, Peter; Rogers, Anne; Dowrick, Christopher; Gask, Linda

2012-01-01

Knowledge about depression, access and help-seeking has increasingly been influenced from a range of disciplines including clinical and applied social science. A range of interventions can improve outcomes of depression and anxiety. However, many in need do not seek help, or their interaction with care-givers does not address their needs. We carried out a systematic search for qualitative articles focusing on the experiences of eight exemplar groups with exceptional problems in access (the homeless, long-term unemployed, adolescents with eating disorders, depressed elderly people, advanced cancer sufferers, patients with medically unexplained symptoms, asylum seekers and people from black and minority ethnic groups). Twenty articles representing these groups were selected, findings were then developed using qualitative meta-synthesis, this suggested a range of mechanisms accounting for poor access among these groups. Many regarded their mental health problems as rooted in social problems and employed a variety of self-management strategies to maintain function. These strategies could involve social withdrawal, focusing available resources on close family relationships and work roles. Over-investment in these roles could result in a sense of insecurity as wider networks were neglected. Material disadvantage affected both the resources people could bring to performing social roles and influenced help-seeking. A tacit understanding of the material, psychological and social 'costs' of engagement by patients and health professionals could influence decisions to seek and offer help. These costs were felt to be proportionally higher in deprived, marginalized and minority communities, where individual resources are limited and the stigma attached to mental ill-health is high.

Return of separated children: the impact of Dutch policies.

PubMed

Kromhout, Mariska

2011-01-01

In many European countries, both the voluntary and the forced return of rejected asylum seekers are problematic. In the case of separated children, the difficulties seem to be even greater. In the Netherlands, many of these children disappear from the reception centres for unknown destinations, instead of returning to their home country. The new, stricter return policies adopted by the Dutch government in recent years have not (yet) changed this situation.In an explorative study of separated children aged between 15 and 18, the implementation and results of these policies were studied. The impact of the activities designed to promote voluntary return appeared to be very limited. Most separated young people did not want to consider return and did not take any action in this regard. Forced return rarely constituted a viable alternative. These findings may be explained by several factors. Among other things, considerations pertaining to personal security, family circumstances, and structural conditions in the countries of origin influence both the attitudes and behaviours of separated children, and host government policies. Moreover, many children were not willing to discuss their return with the youth care workers who were supposed to discuss and promote a voluntary return with them. The fact that most of the young people were allowed to stay in the reception centres until their eighteenth birthday enabled them to postpone making a final decision. A forced return was hindered by such obstacles as the absence of documents and the lack of appropriate care in the country of origin. More insight into the backgrounds of separated children and the (im)possibilities regarding their return seems necessary to be able to design more effective return policies.

Health Challenges in Refugee Reception: Dateline Europe 2016.

PubMed

Blitz, Brad K; d'Angelo, Alessio; Kofman, Eleonore; Montagna, Nicola

2017-11-30

The arrival of more than one million migrants, many of them refugees, has proved a major test for the European Union. Although international relief and monitoring agencies have been critical of makeshift camps in Calais and Eidomeni where infectious disease and overcrowding present major health risks, few have examined the nature of the official reception system and its impact on health delivery. Drawing upon research findings from an Economic and Social Research Council (ESRC) funded project, this article considers the physical and mental health of asylum-seekers in transit and analyses how the closure of borders has engendered health risks for populations in recognised reception centres in Sicily and in Greece. Data gathered by means of a survey administered in Greece (300) and in Sicily (400), and complemented by in-depth interviews with migrants (45) and key informants (50) including representatives of government offices, humanitarian and relief agencies, NGOs and activist organisations, are presented to offer an analysis of the reception systems in the two frontline states. We note that medical provision varies significantly from one centre to another and that centre managers play a critical role in the transmission of vital information. A key finding is that, given such disparity, the criteria used by the UNHCR to grade health services reception do not address the substantive issue that prevent refugees from accessing health services, even when provided on site. Health provision is not as recorded in UNHCR reporting but rather there are critical gaps between provision, awareness, and access for refugees in reception systems in Sicily and in Greece. This article concludes that there is a great need for more information campaigns to direct refugees to essential services.

From Multidrug- to Extensively Drug-Resistant Tuberculosis: Upward Trends as Seen from a 15-Year Nationwide Study

PubMed Central

Stoffels, Karolien; Allix-Béguec, Caroline; Groenen, Guido; Wanlin, Maryse; Berkvens, Dirk; Mathys, Vanessa; Supply, Philip; Fauville-Dufaux, Maryse

2013-01-01

Background Emergence of extensively drug-resistant tuberculosis (XDR-TB) represents an enormous challenge to Public Health globally. Methods Progression towards XDR-TB was investigated in Belgium, a country with a typically low TB incidence, by analyzing the magnitude, characteristics, and treatment success of multidrug-resistant tuberculosis (MDR-TB) through a population-based study from 1994 to 2008. Results Among the 174 MDR-TB patients, 81% were foreign-born, 48% of these being asylum seekers. Although the number of MDR-TB patients remained stable through the study period at around 15 new cases annually, frequencies of resistance of the patients’ first MDR-TB isolate to second-line drugs increased, as well as the total number of antibiotics it was resistant to (p<0.001). XDR-TB cases were detected from 2002 onwards. For 24 patients, additional resistance to several second-line drugs was acquired during treatment. Molecular-guided investigations indicated little to no contribution of in-country clonal spread or exogenous re-infection. The increase of pre-XDR and XDR cases could be attributed to rising proportions of patients from Asia and Central and Eastern Europe (p<0.001) and an increase in the isolation of Beijing strains in these groups (p<0.001). Despite augmented resistance, the treatment success rate improved from 63.0% to 75.8% (p = 0.080) after implementation in 2005 of improved surveillance measures and therapeutic access. Conclusions Increasing severity in drug resistance patterns leading to more XDR- and “panresistant” TB cases in a country with a low TB incidence like Belgium represents a strong alert on worsening situations in other world regions and requires intense public health measures. PMID:23671662

Does multidisciplinary rehabilitation of tortured refugees represent 'value-for-money'? A follow-up of a Danish case-study.

PubMed

Bager, Line; Hansen, Kristian Schultz; Andersen, Carit Jacques; Wang, Shr-Jie

2018-05-18

The recent surge of asylum seekers in the European Union (EU) is raising questions about the EU's ability to integrate newcomers into the economy and into society; particularly those who need specialized services for the treatment of severe trauma. This study investigated whether rehabilitating traumatised refugees represents 'value-for-money' (VfM) in terms of intervention cost per health gain and in a long-term and societal perspective. The economic evaluation comprised a cost-utility analysis (CUA) and a partial cost-benefit analysis (CBA). The CUA incorporated data on Quality Adjusted Life Years (QALY) for 45 patients who were treated at the Rehabilitation and Research Centre for Torture Victims, Copenhagen, Denmark, in 2001-2004 and followed for up to 2 years, to determine the incremental cost effectiveness ratio (ICER). For the CBA, data was collected for 44 patients who completed treatment between 2001 and 2004 and 44 matched controls on the waiting list, for the patients' primary health care utilisation, and personal and family labour income from 2001 to 2014. This was analysed to evaluate the Net Social Benefit (NSB) of the programme. The average cost of treatment was found to be about 32,000 USD per patient (2016 prices) with an average gain in QALY of 0.82. The treatment was cost effective according to the ICER threshold suggested by the National Institute of Health and Care Excellence (UK). At the individual level, the NSB remained negative throughout the study period. However, at the family income level the intervention proved to have been beneficial after 3 years. The implication of the study is, that providing rehabilitation to severely traumatised refugee families can be an economically viable strategy, considering the economic effects observed at the family level.

Toward immigration reform.

PubMed

Franken, Mark

2005-01-01

For the most part, immigrants in the United States do not have access to the very safety-net benefits supported by their taxes, nor to essential due-process rights, simply because they are not citizens or legal residents. Contemporary demographics of immigration and post-9/11 security concerns have colored our traditional hospitality as a nation of immigrants and made life more difficult for immigrants. The Catholic Church has a rich history of scriptural and social teaching that addresses the question of immigration. Stories of forced migration in the Pentateuch led to commandments regarding strangers and the responsibility to be welcoming. In the New Testament, we see that the Holy Family themselves were refugees. The Gospel of St. Matthew tells us that we will be judged by the way we respond to migrants and others in need. In Exsul Familia, Pope Pius XII reaffirms the commitment of the church to care for pilgrims, aliens, exiles, and migrants. In Ecclesia in America, Pope John Paul II states that the ultimate solution to illegal immigration is the elimination of global underdevelopment and that, in the meantime, the human rights of all migrants must be respected. In 2003, the bishops of Mexico and the United States jointly issued the pastoral letter Strangers No Longer: Together on the Journey of Hope. In this letter, the bishops say that U.S. immigration policy should protect the human rights and dignity of immigrants and asylum seekers. The bishops also offer a number of proposed public policy responses toward that end. To advance the principles contained in Strangers No Longer, the bishops have decided to mount a national campaign designed to unite and mobilize a growing network of Catholic organizations and individuals, as well as others of good faith. In addition, the campaign will seek to dispel myths and misperceptions about immigrants.

Migration and schizophrenia: the challenges for European psychiatry and implications for the future.

PubMed

Hutchinson, Gerard; Haasen, Christian

2004-05-01

The last decade of the twentieth century has seen an unprecedented increase in the number of reports in the psychiatric literature documenting increased rates of psychotic illness among migrants in a range of European countries. In countries where high rates of immigration have been long-standing such as Britain and the Netherlands, these increased rates have also been seen in the second generation of migrants. This has impacted on psychiatry significantly with regard to the aetiology, diagnosis, and treatment of schizophrenia. We reviewed the literature to summarise the available evidence about the phenomenon across the European countries where these findings have been reported. Comparisons of the findings between countries were highlighted to establish their impact on psychiatry and to identify areas and implications for future research. The history of this kind of research is longest in Britain and has established increased risk for non-white migrants, with Caribbean and African patients being especially vulnerable. Caribbean migrants to the Netherlands have also been found to be at increased risk, but they are predominantly of Indo-Caribbean ethnicity. In the other European countries, East and West African migrants have been implicated in some countries, while European migrants have been implicated in other countries. Social inequalities, family fragmentation and urbanicity seem to be the main hypotheses proposed for these increased rates, though, in some countries where asylum seekers and refugees form the largest group of migrants, the stress of the migratory process itself may be implicated. These may all interact with genetic vulnerability and substance abuse. Ethnicity and differences in dominant language emerge as major structural references in this new epistemology of psychosis and both the causes and the effects on psychopathology may be filtered through an experience of social disadvantage in an urban environment.

Predicting post-traumatic stress disorder treatment response in refugees: Multilevel analysis.

PubMed

Haagen, Joris F G; Ter Heide, F Jackie June; Mooren, Trudy M; Knipscheer, Jeroen W; Kleber, Rolf J

2017-03-01

Given the recent peak in refugee numbers and refugees' high odds of developing post-traumatic stress disorder (PTSD), finding ways to alleviate PTSD in refugees is of vital importance. However, there are major differences in PTSD treatment response between refugees, the determinants of which are largely unknown. This study aimed at improving PTSD treatment for adult refugees by identifying PTSD treatment response predictors. A prospective longitudinal multilevel modelling design was used to predict PTSD severity scores over time. We analysed data from a randomized controlled trial with pre-, post-, and follow-up measurements of the safety and efficacy of eye movement desensitization and reprocessing and stabilization in asylum seekers and refugees suffering from PTSD. Lack of refugee status, comorbid depression, demographic, trauma-related and treatment-related variables were analysed as potential predictors of PTSD treatment outcome. Treatment outcome data from 72 participants were used. The presence (B = 6.5, p = .03) and severity (B = 6.3, p < .01) of a pre-treatment depressive disorder predicted poor treatment response and explained 39% of the variance between individuals. Refugee patients who suffer from PTSD and severe comorbid depression benefit less from treatment aimed at alleviating PTSD. Results highlight the need for treatment adaptations for PTSD and comorbid severe depression in traumatized refugees, including testing whether initial targeting of severe depressive symptoms increases PTSD treatment effectiveness. There are differences in post-traumatic stress disorder (PTSD) treatment response between traumatized refugees. Comorbid depressive disorder and depression severity predict poor PTSD response. Refugees with PTSD and severe depression may not benefit from PTSD treatment. Targeting comorbid severe depression before PTSD treatment is warranted. This study did not correct for multiple hypothesis testing. Comorbid depression may differentially impact alternative PTSD treatments. © 2016 The British Psychological Society.

Seroprevalence of antibodies and antigens against hepatitis A-E viruses in refugees and asylum seekers in Germany in 2015.

PubMed

Jablonka, Alexandra; Solbach, Philipp; Wöbse, Michael; Manns, Michael P; Schmidt, Reinhold E; Wedemeyer, Heiner; Cornberg, Markus; Behrens, Georg M N; Hardtke, Svenja

2017-08-01

Migration because of miscellaneous political crises in countries in the Middle East and Africa is a global challenge for whole Europe from an economic, social, and public health view. There is an urgent need to generate comprehensive, evidence-based data to expedite further screening and vaccination strategies. A total of 604 individuals ranging in age from 2 to 68 years who enrolled at a single reception center were tested for the prevalence of serologic markers for hepatitis virus types A, B, C, D, and E (HAV, HBV, HCV, HDV, HEV), respectively. Anti-HAV antibody prevalence was 91.2 and 70.3% in children younger than 18 years of age. The prevalence of anti-HEV antibodies was 20.1% among the individuals. 3.0% were positive for hepatitis B surface antigen, whereas 15.2% tested positive for anti-hepatitis B core antigen. None of the refugees tested positive for anti-HDV. 14.1% of refugees were vaccinated against hepatitis B and had a protective anti-hepatitis B surface level of at least 10 mIU/ml. Significant differences in vaccination status were found between the regions (Eastern Mediterranean Region with 77/482 (16.0%; 95% confidence interval=12.7-19.3%) versus African Region with 1/55 (1.8%; 95% confidence interval=0-5.0%). The prevalence of anti-HCV antibodies was 1.2% (n=7), with 0.7% HCV RNA positivity; 16.7% of hepatitis B surface antigen-positive individuals were HCV coinfected (n=3). The prevalence of refugees with previous exposure to hepatitis viruses was higher than that in the general German population, but lower than in other migrant populations in Germany. The vaccination status against hepatitis B was poor.

Rehabilitation of torture survivors in five countries: common themes and challenges

PubMed Central

2010-01-01

Background Torture continues to be a global problem and there is a need for prevention and rehabilitation efforts. There is little available data on torture survivors from studies designed and conducted by health professionals in low income countries. This study is a collaboration between five centres from Gaza, Egypt, Mexico, Honduras and South Africa who provide health, social and legal services to torture survivors, advocate for the prevention of torture and are part of the network of the International Rehabilitation Council for Torture Victims (IRCT). Methods Socio-demographic, clinical and torture exposure data was collected on the torture survivors attending the five centres at presentation and then at three and six month follow-up periods. This sample of torture survivors is presented using a range of descriptive statistics. Change over time is demonstrated with repeated measures analysis of variance. Results Of the 306 torture survivors, 23% were asylum seekers or refugees, 24% were socially isolated, 11% in prison. A high level of traumatic events was experienced. 64% had suffered head injury whilst tortured and 24% had ongoing torture injury problems. There was high prevalence of symptoms of anxiety, depression, post traumatic stress as well as medically unexplained somatic symptoms. The analysis demonstrates a modest drop in symptoms over the six months of the study. Conclusions Data showed that the torture survivors seen in these five centres had high levels of exposure to torture events and high rates of clinical symptoms. In order to provide effective services to torture survivors, health professionals at torture rehabilitation centres in low income countries need to be supported to collect relevant data to document the needs of torture survivors and to evaluate the centres' interventions. PMID:20565852

Migration experiences, employment status and psychological distress among Somali immigrants: a mixed-method international study.

PubMed

Warfa, Nasir; Curtis, Sarah; Watters, Charles; Carswell, Ken; Ingleby, David; Bhui, Kamaldeep

2012-09-07

The discourse about mental health problems among migrants and refugees tends to focus on adverse pre-migration experiences; there is less investigation of the environmental conditions in which refugee migrants live, and the contrasts between these situations in different countries. This cross-national study of two samples of Somali refugees living in London (UK) and Minneapolis, Minnesota, (USA) helps to fill a gap in the literature, and is unusual in being able to compare information collected in the same way in two cities in different countries. There were two parts to the study, focus groups to gather in-depth qualitative data and a survey of health status and quantifiable demographic and material factors. Three of the focus groups involved nineteen Somali professionals and five groups included twenty-eight lay Somalis who were living in London and Minneapolis. The quantitative survey was done with 189 Somali respondents, also living in London and Minneapolis. We used the MINI International Neuropsychiatric Interview (MINI) to assess ICD-10 and DSM-IV mental disorders. The overall qualitative and quantitative results suggested that challenges to masculinity, thwarted aspirations, devalued refugee identity, unemployment, legal uncertainties and longer duration of stay in the host country account for poor psychological well-being and psychiatric disorders among this group. The use of a mixed-methods approach in this international study was essential since the quantitative and qualitative data provide different layers and depth of meaning and complement each other to provide a fuller picture of complex and multi-faceted life situations of refugees and asylum seekers. The comparison between the UK and US suggests that greater flexibility of access to labour markets for this refugee group might help to promote opportunities for better integration and mental well-being.

Clinton administration forging population-foreign policy links.

PubMed

De Sherbinin, A

1994-12-01

In the US, the Clinton administration has renewed the link between global population and national security issues. These so-called "soft security issues" receive attention from the Under-Secretary of State for Global Affairs, Tim Wirth, and the senior director of the Global Environmental Affairs branch of the National Security Council, Eileen Claussen. Wirth and Claussen draft the US response to soft security issues such as environmental security, refugee and migration movements, political instability, and religious and ethnic conflict as well as the other nonmilitary threats of illegal drug trafficking, terrorism, and international organized crime. Population was first considered a foreign policy concern in the 1960s. By 1965, President Johnson decided that the US would provide family planning supplies and technical assistance to any country which asked for help. The initial justification for assuming a leading role in developing innovative population strategies for less developed countries was a humanitarian desire to forward economic development, the self-interest of maintaining access to resources, and concern that rapid growth produced more communists. Today the US remains concerned about resource access and economic development and is also wary of spill-over environmental effects, economic migration, diminished US trade opportunities, political asylum seekers and refugees, and increasing demand for US peacekeepers. It is also believed that rapid population growth leads to political destabilization. Critics of these views blame the development difficulties of less developed countries on poor governing decisions (inadequate institutions, trade barriers, or indifference). Women's reproductive rights advocates fear that using security as a rationale for population assistance could lead to restrictions on women's rights to choose the number and spacing of births. Despite such objections, the belief that population growth is an underlying problem in imploding states like Haiti, Rwanda, and Somalia has turned the attention of US policy-makers to these soft security issues.

Patterns and predictors of posttraumatic stress disorder in refugees: A latent class analysis.

PubMed

Minihan, Savannah; Liddell, Belinda J; Byrow, Yulisha; Bryant, Richard A; Nickerson, Angela

2018-05-01

Although elevated rates of posttraumatic stress disorder (PTSD) have been well-documented in refugees, no study has investigated the heterogeneity of DSM-5 PTSD symptomatology in such populations. This study aimed to determine whether there are unique patterns of DSM-5 defined PTSD symptomatology in refugees, and investigate whether factors characteristic of the refugee experience, including trauma exposure and post-migration stress, predict symptom profiles. Participants were 246 refugees and asylum-seekers from an Arabic-, English-, Farsi-, or Tamil-speaking background who had been resettled in Australia. Participants completed measures of post-migration living difficulties, trauma exposure, PTSD symptoms and functional disability. Latent class analysis was used to identify PTSD symptom profiles, and predictors of class membership were elucidated via multinomial logistic regression. Four classes were identified: a high-PTSD class (21.3%), a high-re-experiencing/avoidance class (15.3%), a moderate-PTSD class (23%), and a no PTSD class (40.3%). Trauma exposure and post-migration stress significantly predicted class membership and classes differed in degree of functional disability. The current study employed a cross-sectional design, which precluded inferences regarding the stability of classes of PTSD symptomatology. This study provides evidence for distinct patterns of PTSD symptomatology in refugees. We identified a novel class, characterized by high-re-experiencing and avoidance symptoms, as well as classes characterized by pervasive, moderate, and no symptomatology. Trauma exposure and post-migration stress differentially contributed to the emergence of these profiles. Individuals with high and moderate probability of PTSD symptoms evidenced substantial disability. These results support conceptualizations of PTSD as a heterogeneous construct, and highlight the importance of considering sub-clinical symptom presentations, as well as the post-migration environment, in clinical contexts. Copyright © 2018. Published by Elsevier B.V.

Migration experiences, employment status and psychological distress among Somali immigrants: a mixed-method international study

PubMed Central

2012-01-01

Background The discourse about mental health problems among migrants and refugees tends to focus on adverse pre-migration experiences; there is less investigation of the environmental conditions in which refugee migrants live, and the contrasts between these situations in different countries. This cross-national study of two samples of Somali refugees living in London (UK) and Minneapolis, Minnesota, (USA) helps to fill a gap in the literature, and is unusual in being able to compare information collected in the same way in two cities in different countries. Methods There were two parts to the study, focus groups to gather in-depth qualitative data and a survey of health status and quantifiable demographic and material factors. Three of the focus groups involved nineteen Somali professionals and five groups included twenty-eight lay Somalis who were living in London and Minneapolis. The quantitative survey was done with 189 Somali respondents, also living in London and Minneapolis. We used the MINI International Neuropsychiatric Interview (MINI) to assess ICD-10 and DSM-IV mental disorders. Results The overall qualitative and quantitative results suggested that challenges to masculinity, thwarted aspirations, devalued refugee identity, unemployment, legal uncertainties and longer duration of stay in the host country account for poor psychological well-being and psychiatric disorders among this group. Conclusion The use of a mixed-methods approach in this international study was essential since the quantitative and qualitative data provide different layers and depth of meaning and complement each other to provide a fuller picture of complex and multi-faceted life situations of refugees and asylum seekers. The comparison between the UK and US suggests that greater flexibility of access to labour markets for this refugee group might help to promote opportunities for better integration and mental well-being. PMID:22954304

Tuberculosis in migrants in low-incidence countries: epidemiology and intervention entry points.

PubMed

Lönnroth, K; Mor, Z; Erkens, C; Bruchfeld, J; Nathavitharana, R R; van der Werf, M J; Lange, C

2017-06-01

As tuberculosis (TB) rates continue to decline in native populations in most low TB incidence countries, the proportion of TB patients born outside their country of residence ('foreign-born') increases. Some low-incidence countries have experienced a substantial increase in TB rates related to recent increases in the number of asylum seekers and other migrants from TB-endemic countries. However, average TB rates among the foreign-born in low-incidence countries declined moderately in 2009-2015. TB in foreign-born individuals is commonly the result of reactivation of latent infection with Mycobacterium tuberculosis acquired outside the host country. Transmission is generally low in low-incidence countries, and transmission from migrants to the native population is often modest. Variations in levels and trends in TB notifications among the foreign-born are likely explained by differences and fluctuations in the number and profile of migrants, as well as by variations in TB control, health and social policies in the host countries. To optimise TB care and prevention in migrants from endemic to low-incidence countries, we propose a framework for identifying possible TB care and prevention interventions before, during and after migration. Universal access to high-quality care along the entire migration pathway is critical. Screening for active TB and latent tuberculous infection should be tailored to the TB epidemiology, adapted to the needs of specific migrant groups and linked to treatment. Ultimately, the long-term TB elimination goal can be reached only if global health and socio-economic inequalities are dramatically reduced. Low-incidence countries, most of which are among the wealthiest nations, need to contribute through international assistance.

[Environmental dependencies, architecture and psychiatry: is the asylum back?].

PubMed

Severo, Donato

2012-01-01

From the time of the asylum as an "instrument of healing" to the present day, history has shown the importance of architecture in the design and organisation of psychiatric care. It manifests itself in many different ways, from the organisation of the therapeutic area, the typologies of the care facilities, to the relationship with the town, the area and nature. There is a close link between the care facility and the town.

Insanity, philanthropy and emigration: dealing with insane children in late-nineteenth-century north-west England.

PubMed

Taylor, Steven J

2014-06-01

The historiography of asylums and insanity is dense, and some topics have received much scholarly attention but others, such as insanity among children, have been largely neglected. Children by no means formed the majority of asylum populations, but they still suffered from mental impairment and were admitted to these institutions in significant numbers. Identifying the various experiences of insane children is the central goal of this research, but the asylum will not be the sole emphasis. The focus is to place child mental deficiency within a broader context of extramural care. By examining workhouses, the role of family, and philanthropic attempts to deal with insane children, this article will move beyond current historical thinking on the topic; traditional views of childhood, insanity and charity will be challenged, and will show that a much wider world than the locality was accessible to the insane child. © The Author(s) 2014.

[The province of East Prussia and "euthanasia" during national socialism: the SS-"Aktion Lange" and "Aktion T4"].

PubMed

Topp, Sascha; Fuchs, Petra; Hohendorf, Gerrit; Richter, Paul; Rotzoll, Maike

2008-01-01

During World War II, psychiatric patients hospitalized in asylums in Eastern Prussia became victims of two separate killing programmes: first, by the SS-special command Lange, second by the centrally (in Berlin) organized "euthanasia"-"Aktion T4". By an analysis of the patient files of the victims, the present paper shows that the historical actors responsible for the killings were communicating with each other. It is now also possible to reconstruct the exact dynamic in time and space of the killings. A comparative analysis of the selection criteria within the total population of the asylums documents that in both programs, the responsible historical actors included physicians and provincial administrative personnel; it further shows that under the conditions of war, only patients who were able to contribute to the asylum work and economy, and were behaviourally adapted could survive.

Stuck in a Loop: Individual and System Barriers for Job Seekers with Disabilities

ERIC Educational Resources Information Center

Hall, Jean P.; Parker, Kathy

2010-01-01

Research conducted within Temporary Assistance to Needy Families (Personal Responsibility and Work Opportunity Reconciliation Act of 1996) and Workforce Investment Act of 1998 systems indicates pervasive issues hindering program effectiveness for job seekers with disabilities. This population frequently experiences employment barriers beyond those…

Question-Negotiation and Information Seeking in Libraries

ERIC Educational Resources Information Center

Taylor, Robert S.

2015-01-01

Seekers of information in libraries either go through a librarian intermediary or they help themselves. When they go through librarians they must develop their questions through four levels of need, referred to here as the visceral, conscious, formalized, and compromised needs. In his pre-search interview with an information-seeker the reference…

Job Seekers' Perceptions of Teleworking: A Cognitive Mapping Approach.

ERIC Educational Resources Information Center

Kerrin, Maire; Hone, Kate

2001-01-01

College students (n=40) and nonstudent job seekers (n=20) rated four dimensions of telework. Results were plotted in cognitive maps. Students preferred office work to telework, citing lack of social interaction. Nonstudents, slightly older and more likely to be parents, slightly preferred telework. Targeting recruitment to account for these…

How Job Seekers Should Approach the New Job Market.

ERIC Educational Resources Information Center

Mangumn, William T.

1996-01-01

Used data from three annual surveys to describe the gap between job seekers' skills and skills that employers want. Employers are seeking broader and greater skill levels and career counselors can help candidates meet these expectations. Reviews employers' suggestions for job hunters and some of the skills in demand. (RJM)

Employment Support as Knowledge Creation

ERIC Educational Resources Information Center

O'Brien, John; Callahan, Michael

2010-01-01

Traditional practice in employment of persons with disabilities has been to assess the skills and interests of the job seeker in relation to normative standards or to others. That comparative approach often results in job seekers with significant developmental disabilities being viewed as having few skills and lacking requisite work readiness,…