Browsing by Subject "Refugees"
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Item Infections in refugees from Southeast Asia(1980-06-05) Smith, James W.Item [News](1980-06-09) Williams, AnnItem Palliative Care for Refugees and Asylees: A Systematic Review and Single-Institution Analysis of Healthcare Utilization(2021-05-01T05:00:00.000Z) Tao, Zoe Renee; Gimpel, Nora; McGregor, Tamara; Dussel, Veronica; Wang, WinnieBACKGROUND: Palliative care addresses physical, psychosocial, and spiritual dimensions of suffering. Palliative care may have significant impact for populations such as refugees and asylees, who flee conflict and persecution and may have a high burden of chronic and life-limiting illness. OBJECTIVES: The goal of this systematic review was to synthesize existing observational studies on palliative care for refugees and asylees. Additionally, the goal of the accompanying single-institution review was to analyze healthcare access and utilization in a safety net refugee outreach clinic. METHODS: A systematic review was undertaken using PRISMA guidelines. Six full-length articles were selected for review. National Consensus Project palliative care domains were utilized for thematic analysis. A retrospective chart review was undertaken for refugee patients establishing care between 2014-2016. Data was extracted on demographics, insurance status, and outpatient clinic and emergency department (ED) visits. RESULTS: Articles selected for systematic review covered heterogeneous research methodology and refugee populations, with all investigators originating from high-income nations. Identified Challenges and Practices to palliative care encompassed all NCP domains, and Recommendations for palliative care for refugees and asylees encompassed all but the Ethical and Legal aspects of care. In our single-institution review, we found that most refugee patients were able to maintain healthcare insurance and attended follow-up primary care visits, with few relying on the ED for primary care. CONCLUSIONS: Greater attention and funding should be allocated to lower-income nations for addressing refugee palliative care needs. Increased focus should be given to studying ethical, legal, and systemic barriers to care. Outpatient care in safety net hospitals may be an important means of addressing refugee and asylee palliative care in well-resourced settings.Item Promoting Resilience in Unaccompanied Asylum-Seeking and Refugee Minors(2020-03-17) NiƱo, Ana Patricia; Mihalic, Angela; Loria, Hilda; Patterson, Abigail M.BACKGROUND: In 2018, the European Union received 20,000 applications from unaccompanied asylum-seeking minors (UAMs) applying for international protection, and 60,000 UAMs from Central America were apprehended at the US-Mexico border. These unaccompanied minors are vulnerable, and the traumas they face impact their mental health. As such, it is important to design mental health interventions that promote resilience and address the unique mental health needs of unaccompanied minors. OBJECTIVE: This literature review will summarize the existing literature to identify mental health interventions and other resilience factors that can promote the mental health of UAMs resettled in Europe and the United States. METHODS: Scopus was searched for articles published in Europe and the US. Titles and abstracts were screened based on the inclusion and exclusion criteria, which resulted in 41 qualitative and quantitative studies of interest. RESULTS: In addition to violence, poverty and war in their countries of origin and extreme physical hardships in their migration journeys, UAMs also faced adjustment and acculturation- specific stressors in the host country. All of these factors negatively impacted UAMs' mental health. The average number of traumatic experiences for each UAM ranged from 6-9. The prevalence of mental health pathology was 24-38% for anxiety, 15-43% for depression and 16- 73% for post-traumatic stress disorder. In addition, UAMs faced unique barriers to mental health service utilization, which included low perceived need of mental health services and distrust of both mental health services and providers. Group psychotherapeutic interventions promoted social interactions and trust-building in UAMs but showed no clinically significant decrease in PTSD symptoms. Individual trauma-based psychotherapeutic interventions clinically improved PTSD symptoms in 66-83.3% of participants. Lastly, strong social bonds, high-support housing, continued spiritual-practice and access to education were protective factors that promoted UAMs' resilience. CONCLUSION: Although UAMs have faced multiple adversities, both in their countries of origin and host countries, there are potential interventions to promote resilience and treat mental health pathologies. Culturally- adjusted, individual trauma-focused therapy has shown the best mental health outcomes for UAMs with clinical PTSD. Considerations and suggestions for future research are discussed.