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

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Constantine Bloch-Infanger

Full Text Available 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.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.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.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.

Transition from an asylum seeker-specific health service to mainstream primary care for community-based asylum seekers: a qualitative interview study.

Science.gov (United States)

Fair, Genevieve L; Harris, Mark F; Smith, Mitchell M

2018-03-15

Transition of asylum seekers from special-purpose health services to mainstream primary care is both necessary and difficult. This study explores the issues encountered by asylum seekers undergoing this transition in Sydney, Australia. Qualitative semistructured interviews were conducted with nine asylum seeker patients and nine staff working in the sector. Asylum seekers faced significant challenges in the transition to mainstream primary care. Contributing factors included the complexity of health and immigration systems, the way in which asylum seeker-specific services provide care, lack of understanding and accommodation by mainstream general practioner (GP) services, asylum seekers' own lack of understanding of the health system, mental illness, and social and financial pressures. There is a need for better preparation of asylum seekers for the transition to mainstream primary care. Mainstream GPs and other providers need more education and support so that they can better accommodate the needs of asylum seeker patients. This is an important role for Australia's refugee health services and Primary Health Networks.

Daily Occupations among asylum seekers

DEFF Research Database (Denmark)

Morville, Anne-Le

2014-01-01

which might even influence their identity. Such deprivation can eventually lead to dissatisfaction with everyday life and to occupational dysfunction, i.e. a decline in ADL ability. Asylum seekers are a group who are more likely to suffer from health problems than the background population. Especially...... torture survivors suffer from ill health. Pain and psychological symptoms are among the most frequent health issues for both asylum seekers and torture survivors and may cause occupation-related problems. The overarching aim of this thesis was to investigate how staying in an asylum centre influenced...... was to assess whether torture had an influence on the occupational satisfaction and performance, and whether this had changed after ten-months. Forty-three asylum seekers from Afghanistan, Iran and Syria participated at baseline and ten months later 17 were available for inclusion in follow-up studies. Study I...

Asylum vs sovereignty in the 21st century: How nation-state's breach international law to block access to asylum.

OpenAIRE

Campbell, John

2015-01-01

Asylum was created by the international community in the 20th century to provide legal protection to individuals fleeing persecution by nation states; but the ability to secure asylum has been fundamentally reshaped by sovereign national interests in the 21st century. This paper has two objectives. First it explores the various ways in which nation-states have adopted policies and pursued agendas which prevent asylum seekers from gaining access to countries of asylum, which criminalize many w...

[Psychiatric expert opinions on asylum seekers in Germany].

Science.gov (United States)

Sieberer, Marcel; Ziegenbein, Marc; Eckhardt, Gudrun; Machleidt, Wielant; Calliess, Iris T

2011-01-01

To investigate the frequency of traumatisation, suicidality and given diagnoses in expert opinions on asylum seekers and to describe the sociodemographic characteristics of this population. The psychiatric expert opinions on asylum seekers, furnished in an 8-year-period at Hannover Medical School, were analysed retrospectively for qualitative and quantitative characteristics. 62 psychiatric expert opinions on asylum seekers were included in this study. The asylum seekers originated from 18 different countries, mainly from Turkey and former Yugoslavia. Most expert opinions were given in secondary asylum procedures, i. e. after the initial asylum request had been rejected. The asylum seekers reported on traumatisation in 82.3 %. The most frequently reported forms of traumatisation were rape in female, and torture in male persons. According to ICD-10 or DSM-IV-R criteria posttraumatic stress disorder (PTSD) was the most frequent diagnosis (74.1 %) in this study. The second most common diagnoses were depressive disorders (ICD-10: F32.x in 33.9 % and ICD-10: F33.x in 25.9 %). Suicidal tendency was found in 56.5 % of the asylum seekers. Cultural differences, language barriers, a heavy burden by psychological symptoms, and clinical severity are difficulties in the process of psychiatric assessment of refugees in legal asylum procedures. © Georg Thieme Verlag KG Stuttgart · New York.

Transition from an asylum seeker–specific health service to mainstream primary care for community-based asylum seekers: a qualitative interview study

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Genevieve L Fair

2018-03-01

Full Text Available Background and aim: Transition of asylum seekers from special-purpose health services to mainstream primary care is both necessary and difficult. This study explores the issues encountered by asylum seekers undergoing this transition in Sydney, Australia. Methods: Qualitative semistructured interviews were conducted with nine asylum seeker patients and nine staff working in the sector. Results: Asylum seekers faced significant challenges in the transition to mainstream primary care. Contributing factors included the complexity of health and immigration systems, the way in which asylum seeker–specific services provide care, lack of understanding and accommodation by mainstream general practioner (GP services, asylum seekers’ own lack of understanding of the health system, mental illness, and social and financial pressures. Conclusions: There is a need for better preparation of asylum seekers for the transition to mainstream primary care. Mainstream GPs and other providers need more education and support so that they can better accommodate the needs of asylum seeker patients. This is an important role for Australia’s refugee health services and Primary Health Networks.

Exploring the relationship between postmigratory stressors and mental health for asylum seekers and refused asylum seekers in the UK.

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Morgan, Gareth; Melluish, Steve; Welham, Alice

2017-01-01

Numerous studies have linked the high rates of traumatic events experienced by refugees to the elevated rate of mental health problems in these populations. A growing body of evidence has also highlighted the importance of considering postmigratory stressors when making sense of displaced person distress. This study explored the relationship between mental health and postmigratory stress for asylum seekers and refused asylum seekers in Britain. The study further examined if those refused asylum experienced elevated distress and postmigratory stress compared to those awaiting the outcome of asylum applications. Results indicated that participants ( N = 97) had endured a range of pre- and postmigratory stressors and had high scores on measures of anxiety, depression, and PTSD. A postmigratory factor comprising items associated with isolation, restrictive policies, and stressors associated with having an insecure immigration status, was significantly associated with PTSD scores. This relationship remained when controlling for the variance accounted for by premigratory trauma predictors. Being refused asylum was the strongest predictor of depression and anxiety. Those refused asylum scored higher on a factor associated with barriers to accessing services. Social materialist theories of distress are drawn upon to contextualise the heightened vulnerability of those refused asylum. The paper concludes by emphasising the problems associated with taking an exclusively trauma-focussed approach when working with asylum seekers and argues for community orientated interventions to support displaced people to cope with the various stressors endured in exile.

Transition from an asylum seeker–specific health service to mainstream primary care for community-based asylum seekers: a qualitative interview study

OpenAIRE

Genevieve L Fair; Mark F Harris; Mitchell M Smith

2018-01-01

Background and aim: Transition of asylum seekers from special-purpose health services to mainstream primary care is both necessary and difficult. This study explores the issues encountered by asylum seekers undergoing this transition in Sydney, Australia. Methods: Qualitative semistructured interviews were conducted with nine asylum seeker patients and nine staff working in the sector. Results: Asylum seekers faced significant challenges in the transition to mainstream primary care. C...

Context, evidence and attitude: the case for photography in medical examinations of asylum seekers in the Netherlands.

Science.gov (United States)

Park, Rebekah; Oomen, Janus

2010-07-01

Can photographs of scars serve as evidence of torture? Amnesty International's Medical Examination Group in the Netherlands (AI-MEG) has, for more than a decade, been photographing torture scars to supplement the testimonies of asylum seekers who have been denied refuge. AI-MEG only intervenes at this point, when asylum seekers face extradition. Proving allegations of torture is of vital importance, as asylum seekers face rising anti-immigrant sentiment in European countries. All victims examined by AI-MEG present a combination of mental, physical and emotional scars. We summarize five cases where AI-MEG used photography in their medical examinations, and consider the ethical role physicians play in helping asylum seekers obtain refuge. Though photographs cannot capture all forms of trauma, as visual documents, they are a compelling form of concrete evidence of torture. In this way, photographs complement verbal testimonies and help doctors and immigration authorities to see and understand physical scars left by various forms of torture. AI-MEG explains in medical terms the connections between the visible late sequelae of torture and victims' testimonies. They then assess whether or not the physical scars are consistent with the forms of torture recounted by victims, using the terminology of the Istanbul Protocol (1999), the United Nations-adopted manual of guidelines that explains how to document torture. This paper outlines the medical examination process and argues for the use of photography as medical evidence on behalf of asylum seekers. Copyright 2010 Elsevier Ltd. All rights reserved.

Should she be granted asylum? Examining the justifiability of the persecution criterion and nexus clause in asylum law

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Noa Wirth Nogradi

2016-10-01

Full Text Available The current international asylum regime recognizes only persecuted persons as rightful asylum applicants. The Geneva Convention and Protocol enumerate specific grounds upon which persecution is recognized. Claimants who cannot demonstrate a real risk of persecution based on one of the recognized grounds are unlikely to be granted asylum. This paper aims to relate real-world practices to normative theories, asking whether the Convention’s restricted preference towards persecuted persons is normatively justified. I intend to show that the justifications of the persecution criterion also apply to grounds currently lacking recognition. My main concern will be persecution on the grounds of gender.The first section introduces the dominant standpoints in theories of asylum, which give different answers to the question of who should be granted asylum, based on different normative considerations. Humanitarian theories base their claims on the factual neediness of asylum-seekers, holding that whoever is in grave danger of harm or deprivation should be granted asylum. Political theories base their justifications on conceptions of legitimacy and membership, holding that whoever has been denied membership in their original state should be granted asylum. Under political theories, Matthew Price’s theory will be discussed, which provides a normative justification of the currently recognized persecution criterion. The second section provides a descriptive definition of persecution based on Kuosmanen (2014, and evaluates the normative relevance of the different elements of this definition based on the theories presented previously. The third section is devoted to the examination of the normative justifiability of the nexus clause’s exclusive list of the bases (grounds upon which persons might be persecuted. The section argues that while the clause does not recognize that persecution might be based on gender, in fact many women experience harms based on

Diplomatic asylum and the Assange case

NARCIS (Netherlands)

den Heijer, M.

2013-01-01

This article traces the place and development of diplomatic asylum in international law in close connection with the more specific questions raised by the case of Julian Assange, who was granted asylum in the Ecuador embassy in London on 16 August 2012. After discussing the historical rise and

Resilience among asylum seekers living with HIV

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Orton Lois

2012-10-01

Full Text Available Abstract 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

An Overview of the Romanian Asylum Policies

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Oana Vasile

2018-05-01

Full Text Available Migration flows affecting Europe over recent years have generated a wave of solidarity but also fear and threats. European countries are divided into host countries or countries of transit due to their economic attractiveness but from the beginning, it was clear that asylum policies were far from similar and insufficiently flexible. Although Romania is considered as one of the transit countries for immigrants heading to Western Europe and it has not been confronted with an influx of refugees, it has developed specific policies in line with the acquis communautaire in order to be prepared for any situation of influx. The purpose of this research is to assess how asylum policies have been implemented in Romania and what improvements are necessary in order for them to become more sustainable. In Romania’s case, we used a SWOT analysis in our research methodology. This study aims to address relevant topics regarding the recent increasing trends of asylum applications and to analyse how the asylum policies in Romania can generate an adequate response. Furthermore, specialized institutions may consider our recommendations on how to improve the management of the asylum system in Romania.

Ukrainian asylum seekers and a Polish immigration paradox

OpenAIRE

Marta Szczepanik; Ewelina Tylec

2016-01-01

The recognition rate for Ukrainian asylum seekers in Poland remains at an extremely low level, with the concept of ‘internal flight alternative’ serving as the legal basis for rejection of many asylum applications.

Occupational deprivation in an asylum centre:

DEFF Research Database (Denmark)

Morville, Anne-Le; Erlandsson, Lena-Karin

2013-01-01

This article presents a study of three asylum-seeking men from Iran and Afghanistan. It aimed to explore how and if they experienced occupations as occupations in a Danish asylum centre and how their life experience shaped their choice and value of current occupations. In-depth narrative interviews...... explored the participants’ occupational history and its influence on their occupations in the asylum centre. A thematic analysis showed that the participants had been subjected to occupational disruption and deprivation by politically oppressive systems even before their flight. Their occupations...... in Denmark were to a certain extent influenced by their earlier occupations and the current occupational deprivation they all experienced was due to limited possibilities in the centre. Although they tried their best to fill their days and create structure, there was a loss of valued occupations...

Usage of psychiatric emergency services by asylum seekers

DEFF Research Database (Denmark)

Reko, Amra; Bech, Per; Wohlert, Cathrine

2015-01-01

predominantly male and married. The group consisted primarily (61%) of failed asylum seekers. Most patients (81%) presented with relevant mental health problems. The main reasons for presenting to the acute psychiatric emergency service were suicidal ideation and/or behaviour (60%). The most frequent diagnosis...... by asylum seekers in Denmark shows some of the acute mental health needs asylum seekers present with. The findings of high levels of suicidal ideation and possible diagnostic difficulties are discussed, as well as possible improvements of the referral and psychiatric evaluation processes....

Ukrainian asylum seekers and a Polish immigration paradox

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Marta Szczepanik

2016-01-01

Full Text Available The recognition rate for Ukrainian asylum seekers in Poland remains at an extremely low level, with the concept of ‘internal flight alternative’ serving as the legal basis for rejection of many asylum applications.

Problems Faced by Mexican Asylum Seekers in the United States

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J. Anna Cabot

2014-12-01

Full Text Available Violence in Mexico rose sharply in response to President Felipe Calderón’s military campaign against drug cartels which began in late 2006. As a consequence, the number of Mexicans who have sought asylum in the United States has grown significantly. In 2013, Mexicans made up the second largest group of defensive asylum seekers (those in removal proceedings in the United States, behind only China (EOIR 2014b. Yet between 2008 and 2013, the grant rate for Mexican asylum seekers in immigration court fell from 23 percent to nine percent (EOIR 2013, 2014b. This paper examines—from the perspective of an attorney who represented Mexican asylum seekers on the US-Mexico border in El Paso, Texas—the reasons for low asylum approval rates for Mexicans despite high levels of violence in and flight from Mexico from 2008 to 2013. It details the obstacles faced by Mexican asylum seekers along the US-Mexico border, including placement in removal proceedings, detention, evidentiary issues, narrow legal standards, and (effectively judicial notice of country conditions in Mexico. The paper recommends that asylum seekers at the border be placed in affirmative proceedings (before immigration officials, making them eligible for bond. It also proposes increased oversight of immigration judges.

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

Science.gov (United States)

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

Overgeneral memory in asylum seekers and refugees.

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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.

Impact of national policy on the health of people seeking asylum.

Science.gov (United States)

Joels, Claire

Recent Department of Health policy has modified the stage in the application process that people seeking asylum are entitled to free NHS health care. This has caused confusion, not only among asylum seekers and settled refugees, but also among healthcare professionals. In turn, this has led to increased difficulty for people seeking asylum in accessing healthcare services. This article identifies when in the process asylum seekers are entitled to free NHS care. It considers how current legislation and the government stance on immigration are having a negative effect on the health of people seeking asylum while they are in the U.K., and to what extent nurses and other health professionals can help.

Emergency mental health nursing for self-harming refugees and asylum seekers.

Science.gov (United States)

Procter, Nicholas G

2005-09-01

This article describes the structure and function of emergency mental health nursing practice for self-harming refugees and asylum seekers on Temporary Protection Visas. Emergency nurses working in accident and emergency departments or as part of crisis intervention teams will see self-harming refugees and asylum seekers at the very point of their distress. This clinical paper is intended to support nurses in their practice should they encounter an adult asylum seeker needing emergency mental health care. Practical strategies are highlighted to help mental health nurses assess, care, and comfort refugees and asylum seekers in this predicament. Mental health nurses should, where possible, work closely with asylum seekers, their support workers, and accredited interpreters and translators to ensure the appropriate use of language when dealing with mental and emotional health issues without further isolating the asylum seeker from appropriate services. To help strengthen continuity and integration of mental health supports for refugees and asylum seekers, well-resourced care must be experienced as coherent and connected. A coherent, interdisciplinary and team-orientated approach will synthesize different viewpoints to shape clinical practice and create workable solutions in local situations.

Scientific activity and working hours of physicians in university hospitals: results from the Innsbruck and Salzburg physician lifestyle assessment (TISPLA).

Science.gov (United States)

Steger, Bernhard; Colvin, Hans Peter; Rieder, Josef

2009-01-01

Controllable lifestyle has become an important factor influencing career decision-making among physicians. In academic medicine, doctors are required to combine both patient care and research in their daily routine. Insufficient release of clinicians for research during contracted work hours may lead to increased weekly working hours in academic medical centers and deter medical graduates from academia. We tested for an association between numbers of scientific publications and an increased hourly workload among physicians. This was a cross-sectional online survey among all salaried physicians working in the university hospitals of Innsbruck and Salzburg, Austria. The main outcome measures were the self-reported total number of scientific papers published in peer-reviewed medical journals over the past two years and self-reported working hours. Of 590 returned surveys, 393 were fully completed and included in the study. The sample was stratified into three groups according to scientific output in the past two years: Group A, >/= 6 publications; Group B, 1-5 publications; Group C, no publications. Men were more likely than women to have a scientific publication: in Group A there was a male predominance of 75%, whereas in Group C only 48% were men (P = 0.0034). A total of 59% (n = 232) of all participants had not published a scientific article in the past two years (Group C) and worked a mean of 58.3 +/- 12 h/week. Physicians in Group B (n = 113) had published 2.4 +/- 1.4 papers and worked 62.8 +/- 12.9 h/week; those in Group A (n = 48) had published 11.5 +/- 6.6 papers and worked 73 +/- 13.1 h/week (P work time but for 60% of overtime hours, reflecting the fact that research was mainly performed during overtime. Research activity among clinicians in academic medical centers is associated with significantly increased overtime hours. Measures need to be taken to allow medical graduates an academic career at reasonable impairment of personal lifestyle.

The role of mental health professionals in political asylum processing.

Science.gov (United States)

Meffert, Susan M; Musalo, Karen; McNiel, Dale E; Binder, Renée L

2010-01-01

Applying for asylum in the United States can be a strenuous process for both applicants and immigration attorneys. Mental health professionals with expertise in asylum law and refugee trauma can make important contributions to such cases. Not only can mental health professionals provide diagnostic information that may support applicants' claims, but they can evaluate how culture and mental health symptoms relate to perceived deficits in credibility or delays in asylum application. They can define mental health treatment needs and estimate the possible effects of repatriation on mental health. Mental health professionals can also provide supportive functions for clients as they prepare for testimony. Finally, in a consultative role, mental health experts can help immigration attorneys to improve their ability to elicit trauma narratives from asylum applicants safely and efficiently and to enhance their resilience in response to vicarious trauma and burnout symptoms arising from work with asylum seekers.

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

Science.gov (United States)

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

Nutritional vulnerability seen within asylum seekers in Australia.

Science.gov (United States)

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 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.

An Overview of Pending Asylum and Refugee Legislation in the US Congress

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Melanie Nezer

2014-05-01

Full Text Available There has been no significant legislation related to the asylum process enacted in Congress in nearly a decade.  In 1996, the Illegal Immigration Reform and Immigration Responsibility Act (IIRIRA became law, rolling back protections for asylum seekers by including a one-year deadline for filing asylum applications, subjecting asylum seekers to “expedited removal” procedures, and expanding the detention of asylum seekers. In 2005, Congress enacted the REAL ID Act, which created additional legal barriers to asylum, including new requirements for proving an asylum claim. During the past several sessions of Congress, bills have been introduced that would make significant changes to the country’s asylum laws and refugee admissions program. This paper provides an overview of the pending legislation and the changes proposed.  This overview is instructive in understanding (1 which members of Congress have demonstrated interest and leadership in refugee and asylum issues; (2 which refugee and asylum reform issues have been of most interest to members of Congress in recent years; (3 the different approaches to refugee and asylum issues by members of Congress who have shown leadership on these issues; and (4 which provisions have been enacted, which have gained traction, and which remain pending without significant movement through the legislative process.While it is difficult to imagine in the current partisan climate how any asylum or refugee legislation could be enacted into law, some legislative provisions have been reintroduced over a number of sessions of Congress and some have a history of bipartisan support.  Legislation focused on a group of particular interest or concern to members of Congress could gain traction.  A more comprehensive legislative approach framed by the need generally to improve the system could be less effective, particularly in the context of the years-long stalemate on comprehensive immigration reform

The Asylum Centre as “Just Another Local Institution”

DEFF Research Database (Denmark)

Larsen, Birgitte Romme

2019-01-01

This article investigates everyday practices of co-residency and ‘institutional neighbourliness’ amongst asylum seekers and local inhabitants in the small Danish town of Jelling. Where asylum centres in Denmark are sometimes faced with local opposition and are often isolated from nearby settlements...... an ethnographic exploration of how over time and outside of an urban, cosmopolitan setting processes of multiethnic co-residency are shaped, interacted, and narrated, through everyday physical meetings in public space. The article shows how local cultural history proves paramount for understanding the present......-day migratory encounter and outcome in Jelling in its complexity, including the mundane neighbourly routines and pragmatic workings through which the institutions of ‘the local community’ and ‘the asylum centre’ have spatially and socially merged. Today the asylum centre has become “just another local...

A Patient’s Tale of Incarceration in a Victorian Lunatic Asylum

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Carol Berkencotter

2011-06-01

Full Text Available Using the archival admissions records and the case history of a patient at a British asylum in the 1870s, the author compares two genres. The first of these is two medical certificates written and signed by two physicians attesting that the patient was of unsound mind and needed to be confined and treated. The second genre is the patient’s oral testimony to Parliament’s Select Committee on Lunacy Laws (1877, a narrative he delivered the year following his release from the asylum. Both genres are legal texts; however, it is the patient’s narrative of personal experience, as transcribed in the committee report, that allows the reader a glimpse of the misery imposed by confinement in a “lunatic” asylum. The two medical certificates have considerably more illocutionary force, however; as speech acts they most often resulted in confinement until the patient was determined to have recovered, was transferred to another asylum, or died.Utilizando el archivo de registros de admisión y la historia clínica de un paciente en un psiquiátrico británico de los años 1870, se comparan dos géneros. El primero consiste en dos certificados médicos escritos y firmados por dos psiquiatras certificando que el paciente estaba mentalmente incapacitado y necesitaba confinación y tratamiento. El segundo género se trata del testimonio oral del paciente ante el Parliament’s Select Committee on Lunacy Laws (1877, pronunciado al año siguiente de su alta. Ambos géneros son textos legales, sin embargo, es la narración de la experiencia personal del paciente, transcrita en el informe del comité, lo que permite obtener una visión de las miserias impuestas por el encierro en un sanatorio de lunáticos. Los certificados médicos tienen una fuerza ilocutiva considerablemente mayor, pero como actos del habla resultaban en la reclusión del paciente hasta que se determinaba su recuperación, su traslado a otro

Asylum for persecuted homosexuals in the Republic of Korea

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Andrew Wolman

2013-04-01

Full Text Available Two recent successful claims for asylum suggest that the Republic of Korea may be prepared to serve in the future as an important country of asylum for those suffering persecution due to their sexual orientation.

LGBTI asylum claims: the Central and Eastern European perspective

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Krzysztof Śmiszek

2013-04-01

Full Text Available Recent research indicates that CEE countries still lag far behind therest of Europe in their asylum practices in relation to LGBTI asylumclaims. Low levels of awareness, lack of guidance and cultural hostility are jeopardising asylum seekers’ prospects for fair treatment.

Cultural competence among nurse practitioners working with asylum seekers

NARCIS (Netherlands)

Suurmond, Jeanine; Seeleman, Conny; Rupp, Ines; Goosen, Simone; Stronks, Karien

2010-01-01

Asylum seekers often have complex medical needs. Little is known about the cultural competences health care providers should have in their contact with asylum seekers in order to meet their needs. Cultural competence is generally defined as a combination of knowledge about certain cultural groups,

Problems Faced by Mexican Asylum Seekers in the United States

OpenAIRE

J. Anna Cabot

2014-01-01

Violence in Mexico rose sharply in response to President Felipe Calderón’s military campaign against drug cartels which began in late 2006. As a consequence, the number of Mexicans who have sought asylum in the United States has grown significantly. In 2013, Mexicans made up the second largest group of defensive asylum seekers (those in removal proceedings) in the United States, behind only China (EOIR 2014b). Yet between 2008 and 2013, the grant rate for Mexican asylum seekers in immigration...

Public health metaphors in Australian policy on asylum seekers.

Science.gov (United States)

Koutroulis, Glenda

2009-02-01

To analyse the way in which a public health metaphor has been incorporated into Australian political practice to justify the exclusion or mistreatment of unwelcome non-citizens, giving particular attention to recent asylum seekers. Starting with a personal experience of working in an immigration detention centre and then drawing on media reports and published scholarship, I critique political rhetoric and policy on asylum seekers, arguing that the significance of a public health metaphor lies in its effectiveness in persuading the public that refugees and asylum seekers are a moral contaminant that threatens the nation and has to be contained. Acceptance of the metaphor sanctions humanly degrading inferences, policies and actions. Public health professionals therefore have a responsibility to challenge the political use of public health and associated metaphors. Substituting the existing metaphor for one that is more morally acceptable could help to redefine refugees and asylum seekers more positively and promote compassion in political leaders and the community.

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

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Carmen Andrea Pfortmueller

Full Text Available 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

Fake passports and appointed communities: Nation and transnationalism in the Danish asylum system

DEFF Research Database (Denmark)

Whyte, Zachary

2003-01-01

Nationality underwrites a great deal of the Danish asylum process, and of the refugee regime as a whole. The housing and care of asylum seekers, handled by the Danish Red Cross, is based on classifications by nationality. Bending a phrase from Benedict Anderson, these might be called "appointed...... communities". While the Danish asylum system in principle performs individual determination procedures for asylum seekers, granting refugee status on a case-by-case basis, in practice those identified as Iraqi or Afghani have had a very high acceptance rate. However, it is clearly the case that not all asylum...... seekers have citizenship of the countries they claim to come from, or indeed feel they come from the countries of which they have citizenship. In this context, we must enquire about the mechanics of determining nationality and about how asylum seekers themselves relate to national identities. I argue...

THE ASYLUM, BETWEEN HUMANITARIAN RESPONSE AND POLITICAL INSTRUMENT

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CATRINEL BRUMAR

2012-05-01

Full Text Available At 9 November 2010, the European Court of Justice, in a preliminary ruling, decided to depart from the interpretation promoted by the United Nations High Commissioner for Refugees, in the matter of the application of the exclusion clauses. The European Court considered that no proportionality test between human rights protection and gravity of a crime is to be applied in the case of a person suspected of having committed an act contrary to the principles and purposes of the United Nations. By eliminating this test, the Court is sending a signal on rethinking the asylum institution, from a humanitarian tool that it became, to a political instrument. This decision could not be read alone; corroborated to the concerns already raised on the suitable use of the asylum instrument to address massive humanitarian needs, it would indicate a reorientation in the interpretation of international norms governing the refugee law. Still, the human rights organs and the European Court of Human Rights continue to refer to the asylum as a situation where a humanitarian perspective, reflected in the proportionality test, or for those mechanisms the risk of human rights violation probability test, is still valid. The two apparently divergent directions will need to converge in the implementation of the European Union regulations on asylum. This paper is exploring the possible reinterpretation of the European norms, trying to identify the new trends in the political perspective of asylum and the limitations to these trends that the respect for human rights is establishing.

The Impact of Detention on the Health of Asylum Seekers

DEFF Research Database (Denmark)

Filges, Trine; Montgomery, Edith; Kastrup, Marianne

2016-01-01

Objectives: This review assesses the evidence about the effects of detention on the mental and physical health and social functioning of asylum seekers. Method and Analysis: We followed Campbell Collaboration guidelines to conduct a systematic review. Meta-analytic methods were used...... to quantitatively synthesize the study results.  Results: Primary study effect sizes for post-traumatic stress disorder, depression, and anxiety, while the asylum seekers were still detained lies in the range 0.35–0.99, all favoring the nondetained asylum group. Author’s Conclusions: There is some evidence...... to suggest an independent adverse effect of detention on the mental health of asylum seekers. The conclusions should however be interpreted with caution as they are based on few studies. More research is needed in order to fully investigate the effect of detention on mental health....

Head injury in asylum seekers and refugees referred with psychological trauma

OpenAIRE

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

2016-01-01

Objective. 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. Method. Participants were 115 adult ASR referred ...

Perspectives on Erving Goffman's "Asylums" fifty years on.

Science.gov (United States)

Adlam, John; Gill, Irwin; Glackin, Shane N; Kelly, Brendan D; Scanlon, Christopher; Mac Suibhne, Seamus

2013-08-01

Erving Goffman's "Asylums" is a key text in the development of contemporary, community-orientated mental health practice. It has survived as a trenchant critique of the asylum as total institution, and its publication in 1961 in book form marked a further stage in the discrediting of the asylum model of mental health care. In this paper, some responses from a range of disciplines to this text, 50 years on, are presented. A consultant psychiatrist with a special interest in cultural psychiatry and mental health legislation, two collaborating psychotherapists in adult and forensic mental health, a philosopher, and a recent medical graduate, present their varying responses to the text. The editors present these with the hope of encouraging further dialogue and debate from service users, carers, clinicians, and academics and researchers across a range of disciplines.

Psychological evaluation of asylum seekers as a therapeutic process.

Science.gov (United States)

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.

From morality to madness: a reappraisal of the asylum movement in psychiatry 1800-1940.

Science.gov (United States)

Kosky, R

1986-06-01

This essay outlines the history of the asylum movement in psychiatry, but from a somewhat different angle than usual. It attempts to delineate the historical interactions between perceptions of morality and of madness. Changes in these interactions relate to the rise of the asylum movement, around 1800, and its demise, just after World War II. I argue that, whilst insanity was defined against the rational, secular morality of the eighteenth century, it could be separated from immorality and put aside into its asylum. Once mechanistic science and medical scientism began, during the nineteenth century, to include immorality in the systems of disease, the distinction could not hold. The asylums became flooded with the immoral, and management became custodial and nihilistic. This nexus was broken when the asylums were defined, by a few revolutionary superintendents, as instruments of social control. Nevertheless, intellectual paradigms derived from asylum psychiatry persist.

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

Science.gov (United States)

Canetti, Daphna; Snider, Keren L G; Pedersen, Anne; Hall, Brian J

2016-12-01

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.

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

Science.gov (United States)

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

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

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William W Bostock

2009-11-01

Full Text Available William W BostockSchool of Government, University of Tasmania, Hobart, Tasmania, AustraliaAbstract: 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.Keywords: collective depression syndrome, psychiatric profession, political intervention, asylum seeker, Australian national identity

Multimorbidity in adult asylum seekers: a first overview.

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Carmen A Pfortmueller

Full Text Available PRINCIPALS: Over the last two decades, the total annual number of applications for asylum in the countries of the European Union has increased from 15,000 to more than 300,000 people. The aim of this study was to give a first overview on multimorbidity of adult asylum seekers. METHODS: Our retrospective Swiss single center data analysis examined multimorbidity of adult asylums seekers admitted to our ED between 1 January 2000 and 31 December 2012. RESULTS: A total of 3170 patients were eligible for the study; they were predominantly male (2392 male, 75.5% versus 778 female, 24.5. The median age of the patients was 28 years (range 28-82. The most common region of origin was Africa (1544, 48.7%, followed by the Middle East (736, 23.6%. 2144 (67.6% of all patients were not multimorbid. A total of 1183 (37.7% of our patients were multimorbid. The mean Charlson comorbidity index was 0.25 (SD 1.1, range 0-12. 634 (20% of all patients sufferem from psychiatric diseases, followed by chronic medical conditions (12.6%, 399 and infectious diseases (4.7%, 150. Overall, 11% (349 of our patients presented as a direct consequence of prior violence. Patients from Sri Lanka/India most often suffered from addictions problems (50/240, 20.8%, p<0.0001. Infectious diseases were most frequent in patients from Africa (6.6%, followed by the Balkans and Eastern Europe/Russia (each 3.8%. CONCLUSION: The health care problems of asylum seekers are manifold. More than 60% of the study population assessed in our study did not suffer from more than one disease. Nevertheless a significant percentage of asylum seekers is multimorbid and exhibits underlying psychiatric, infectious or chronic medical conditions despite their young age.

"Infiltrators" or refugees? An analysis of Israel's policy towards African asylum seekers

OpenAIRE

Campbell, John; Yaron, Hadas; Hashimshony-Yaffe, Nurit

2013-01-01

This article adopts a genealogical approach in examining Israeli immigration policy by focusing on the situation confronting African asylum seekers who have been forced back into Egypt, detained and deported but who have not had their asylum claims properly assessed. Based on immigration policies formulated at the time of Israeli independence, whose principle objective was to secure a Jewish majority state, we argue that Israel’s treatment of African asylum seekers as ‘infiltrators’/economic ...

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

Science.gov (United States)

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.

Increase in imported malaria in the Netherlands in asylum seekers and VFR travellers.

Science.gov (United States)

de Gier, Brechje; Suryapranata, Franciska S T; Croughs, Mieke; van Genderen, Perry J J; Keuter, Monique; Visser, Leo G; van Vugt, Michele; Sonder, Gerard J B

2017-02-02

Malaria is a notifiable disease in the Netherlands, a non-endemic country. Imported malaria infections occur regularly among travellers, migrants and visitors. Surveillance data were analysed from 2008 to 2015. Trends in amounts of notifications among risk groups were analysed using Poisson regression. For asylum seekers, yearly incidence was calculated per region of origin, using national asylum request statistics as denominator data. For tourists, denominator data were used from travel statistics to estimate incidence per travel region up to 2012. A modest increase in overall imported malaria notifications occurred in 2008-2015 (from 222 in 2008 to 344 in 2015). Notably, in 2014 and 2015 sharp increases were seen in malaria among travellers visiting friends and relatives (VFR), and in asylum seekers. Of all Plasmodium falciparum infections, most (1254/1337; 93.8%) were imported from Africa; 1037/1337 (77.6%) were imported from Central and West Africa. Malaria in VFR was mostly caused by P. falciparum infection after visiting Ghana (22%) or Nigeria (19%). Malaria in asylum seekers was mostly caused by Plasmodium vivax infection from the Horn of Africa. The large number of notifications in asylum seekers resulted from both an increase in number of asylum seekers and a striking increase of malaria incidence in this group. Incidence of malaria in asylum seekers from the Horn of Africa ranged between 0.02 and 0.3% in 2008-2013, but rose to 1.6% in 2014 and 1.3% in 2015. In 2008-2012, incidence in tourists visiting Central and West Africa dropped markedly. Imported malaria is on the rise again in the Netherlands, most notably since 2013. This is mostly due to immigration of asylum seekers from the Horn of Africa. The predominance of P. vivax infection among asylum seekers warrants vigilance in health workers when a migrant presents with fever, as relapses of this type of malaria can occur long after arrival in the Netherlands.

A Content Analysis on the Representation of Syrian Asylum Seekers in the Turkish Press

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Müzeyyen Pandır

2015-11-01

Full Text Available This article is a content analysis of the representation of Syrian asylum seekers in the Turkish press. The research sample includes news reports, columns and visuals published in 2014 in five national newspapers with the highest circulation figures (“Hürriyet”, “Sabah”, “Posta”, “Sözcü”, “Zaman”. The article is part of a larger research project, which is funded by TÜBİTAK, investigating the representation of Syrian asylum seekers between 2011 and 2015 in Turkish newspapers. Analysing news texts and columns is widely held in research projects. However, conducting a visual analysis on news photographs is usually overlooked. This study investigates news texts and news photographs together. The study shows that the coverage of Syrian asylum seekers has usually a positive or neutral content. However, the results also point out the ambivalence in the representations of asylum seekers. The representations of Syrian asylum seekers portray these individuals mostly as “poor” people “in need of help” as well as “threats” for social security. These frequently repeated representations and ambivalence show that the representation of Syrian asylum seekers in Turkish newspapers reproduces the stereotypical representation of asylum seekers as defined in international studies.

Treatment of Chechen IDPs, asylum-seekers and refugees in Europe

OpenAIRE

Rimmer, Clare

2008-01-01

In March 2007, the European Council on Refugees and Exiles (ECRE) launched updated Guidelines on the Treatment of Chechen Internally Displaced Persons (IDPs), Asylum Seekers and Refugees in Europe. This article analyses the treatment of Chechen IDPs, asylum seekers and refugees in Europe, concentrating on these groups of people from the Chechen Republic outside of the Russian Federation.

Moral urbanism, asylum, and the politics of critique

OpenAIRE

Jonathan Darling

2013-01-01

The city of Sheffield was the UK’s first ‘City of Sanctuary’, an identification which suggested that the city would act to welcome asylum seekers and refugees through promoting a ‘culture of hospitality’. In this paper I seek to interrogate such claims and explore how the promotion of a language of hospitality marks a form of ‘moral urbanism’ through which the city is linked to specific values and obligations that enable the governmental ordering of responses to asylum. In exploring public st...

Acute admissions among immigrants and asylum seekers to a psychiatric hospital in Norway.

Science.gov (United States)

Iversen, Valentina Cabral; Morken, Gunnar

2003-09-01

The purpose of the present study was to compare admission rates, including admission by coercion, length of hospital stay and diagnosis among immigrants, asylum seekers and Norwegian-born patients. All admissions (n=3053) to Østmarka Hospital during the period 1995-2000 were examined. A sample including all immigrants (94) and asylum seekers (39) as well as a control group of 133 Norwegians was analysed. Immigrants and Norwegians had the same relative risk of admission (1.07). The relative risk of admission was higher for asylum seekers compared to Norwegians (8.84). There were differences in the diagnoses given at discharge in the three groups of patients, both among men (chi2=22.33, df=6, pimmigrants. The number of admissions by coercion was highest among immigrants, and lowest among asylum seekers (chi2=12.03, df=2, pimmigrants, asylum seekers had high admission rates and low frequency of admissions by coercion. Schizophrenia was frequent among female immigrants admitted to hospital.

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

Science.gov (United States)

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.

[Suicide and suicidal behavior among asylum seekers in Denmark during the period 2001-2003. A retrospective study].

Science.gov (United States)

Staehr, Mia Antoni; Munk-Andersen, Ebbe

2006-04-24

Our aim was to examine suicidal behaviours among asylum seekers in Denmark. A retrospective quantitative analysis of data from reports to the Danish Red Cross Asylum Department on suicidal behaviours among persons over 15 years of age in the period 2001-2003 and from 54 medical records of suicidal asylum seekers in Denmark in 2001 was carried out. The number of suicide attempts by asylum seekers in 2001 was 3.4 times higher than by Danish residents. Furthermore, the rate of suicide attempts by asylum seekers grew in the following two years. Suicidal behaviours are most frequent among asylum seekers between 30 and 39 years of age. There are national differences. The preferred method of suicide attempt is intake of medicine. Stress-related diagnoses constitute three fourths of all diagnoses. One analysis suggests that the long waiting time (average 20.8 months) faced by asylum seekers combined with rejection of asylum cases may trigger a rapid suicidal reaction. Other factors may also be active, as 44% of suicide attempts occur within six months after arrival in the country. The results are discussed in relation to other research on the vulnerability of refugees, immigrants and asylum seekers and also in relation to length of waiting time, growing mental morbidity and the increasing number of rejections of asylum applications during recent years, a period characterized by a reduction of staff at the asylum centers. It is recommended that prevention of suicidal behaviour shall be given higher legal and administrative priority.

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

Science.gov (United States)

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 209.2 - Adjustment of status of alien granted asylum.

Science.gov (United States)

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...

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

Science.gov (United States)

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.

Persecution Experiences and Mental Health of LGBT Asylum Seekers.

Science.gov (United States)

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.

Safeguarding vulnerable families: work with refugees and asylum seekers.

Science.gov (United States)

Burchill, John

2011-02-01

This paper will highlight one of the key findings of a qualitative study based on the analysis of in-depth interviews with 14 health visitors describing their experiences working with refugees and asylum seekers. Despite changes in government legislation to improve children's services in order to prevent harm to children, this recent study demonstrated that health visitors were working with the complexities of needs among refugees and asylum seekers related to safeguarding both children and vulnerable women. The health visitors often worked with families and individuals with no support from other professional services, they worked with failed asylum seekers who were unable to access other forms of support and they worked with women and children who were caught in a cycle of domestic abuse due to their immigration status. They were also working with families who would disappear from the systems in place to safeguard children.

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

Science.gov (United States)

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.

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

Science.gov (United States)

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.

Seroprevalence of Hepatitis B, C and HIV/AIDS in Asylum Seekers in Istanbul

Directory of Open Access Journals (Sweden)

Kadriye Kart Yaşar

2014-03-01

Full Text Available Objective:This study aimed to determine prevalence of hepatitis B, C and HIV/AIDS in asylum seekers in Istanbul, Turkey. Methods: The data about asylum seekers who applied in Istanbul between March 2008 and March 2010 were evaluated retrospectively. Demographic features and markers of blood borne infections (HBsAg, anti-HCV and anti-HIV results of asylum seekers were reviewed. Results: In total 3043 asylum seekers were included into the study. The leading origin countries of the refugees were from Afghanistan, Turkmenistan and Azerbaijan and majority of them (2328 people, 77% were male. The young adults between 25 and 45 years constituted the most crowded group. Overall prevalence of HCV, HBsAg and HIV/AIDS were 12.2%, 5.9% and 0.7%, respectively. The highest seropositivity rate for anti-HCV, HBsAg and anti-HIV were found in Georgian males (47.1%; in Moldovan males (13.2% and in Somali males (3.1%, respectively. Conclusion:Mostly asylum seekers who have migrated to our country were young adult males from Asia. The highest prevalence rate of HCV was found in Georgian males. Therefore, the increased potential of migration to our country along the recent years necessitates development of an appropriate health approach concerning asylum seekers. J Microbiol Infect Dis 2014;4(1: 20-25

Governmental mobility : the power effects of the movement of detained asylum seekers around Britain's detention estate.

OpenAIRE

Gill, Nicholas

2009-01-01

This paper explores the ways in which mobility can have governmental effects in the context of the management of asylum seekers awaiting deportation from the UK. Drawing upon the case of Campsfield House Immigration Removal Centre, a facility for the incarceration of immigration deportees near Oxford, the paper makes the case that the way asylum seekers are moved between detention centres within the UK has implications for the way they are represented to both asylum activists and asylum secto...

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

Science.gov (United States)

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.

[The end of the asylum, a change in representations].

Science.gov (United States)

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.

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

Science.gov (United States)

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.

‚Getting Asylum Seekers into Employment‘? – Ein Allheilmittel für die Europäische Einwanderungspolitik?

OpenAIRE

Tausch, Arno

2012-01-01

The cross-national empirics of the international asylum system are in their infancy. While Hatton, 2009, and Neumayer, 2005, 2006a and 2006b provided important and valuable cross-national insights on the drivers of the asylum seeking process, as yet little is known in terms of hard-core evidence about the effects of asylum-driven migration processes on the recipient countries. But such analyses are necessary, since asylum plays such an important role in the overall South-North migration proce...

Asylansøgeres muligheder for at komme i arbejde: Asylum seekers opportunities to enter the labour market

OpenAIRE

Al-Adhami, Adnan Ibrahim; Thøgersen, Dicte Bjarup; Mikkelsen, Laura Barfoed; Robrahn, Pernille Viola

2015-01-01

The purpose of this paper is to highlight the challenges that asylum seekers meet in the asylum system, when they want to enter the labour market. Furthermore, this paper wants to examine the issues that are connected to these challenges, and whether it has an impact on the integration, when asylum seekers are left outside of the labor market. To investigate our research question we have primarily used interviews, including a qualitative research interview with an asylum seeker, Nora, and two...

Central American victims of gang violence as asylum seekers: the role of the forensic expert.

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De Jesús-Rentas, Gilberto; Boehnlein, James; Sparr, Landy

2010-01-01

Individuals fleeing persecution have the right to asylum. This most fundamental right was guaranteed by the 1951 United Nations (UN) Convention Relating to the Status of Refugees and was implemented in the 1967 UN protocol regarding refugee status. The United States codified refugee protection and the procedures for asylum in the Refugee Act of 1980, which was made part of the Immigration and Nationality Act (INA). In claiming refugee status, the burden of proof rests with the asylum seeker and is often a daunting task, given language and cultural barriers, lack of knowledge about U.S. legal procedures, and the reality that oppressive states do not document their intentions to persecute dissidents. Forensic psychiatrists may be asked to provide mental health assessment in immigration cases. In this article, an example of a Central American man with a nontraditional but increasingly common request for asylum is presented, the asylum process is described, and the role of the forensic psychiatric expert before the immigration court is explored.

Humanitarian Power – Rough Care: National politics of asylum in the humanitarian (biopolitical framework

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Duško Petrović

2016-06-01

Full Text Available Based on a short field research conducted at the refugee transit center in Slavonski Brod, the paper analyzes contemporary asylum policies in Croatia. The author is suggesting that the structure and function of a centre plays a crucial role in the securitization and humanitarization of the asylum policy. The analysis has shown that the asylum policy in Croatia has the same structure as the dominant asylum policies in Europe. Both of them oscillate between two poles: compassion and repression. Humanitarian policy in Croatia is more restrictive and is based on radical inequality, nationalism, racism, the suspension of rights and the normalization of structural violence. Due to its exclusive national focus, it will not provide any long term solutions for dealing with refugees in the future.

'Amusements are provided': asylum entertainment and recreation in Australia and New Zealand c.1860-c.1945.

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MacKinnon, Dolly

2009-01-01

This chapter examines the official 'entertainment', in all its forms, provided to inmates in Australian and New Zealand asylums--later mental hospitals--between c.1860 and c.1945. Visitors came into asylum grounds and patients were permitted periods of leave, all for the purposes of entertainment and recreation. Surviving recreation buildings, their grounds and institutional archives, bear silent witness to the noisy and lively recreational activities of past patients, staff and visitors. This chapter reconstructs these practices in twenty public and three private asylums from this period by examining a diverse range of sources, including archives, histories of asylums and newspaper articles.

Coercive Population Control and Asylum in the U.S.

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Connie Oxford

2017-11-01

Full Text Available In 1980, China implemented one of the most controversial population policies in modern times. China’s one-child policy shaped population politics for thirty-five years until its dissolution in 2015. During this time, many women were subjected to routine gynecological examinations, pregnancy testing, abortions, and sterilizations, which were often forced upon them by family planning officials. Some women fled China and sought refuge in the United States after having experienced a forced abortion or forced sterilization or feared that they would be subjected to a forced abortion or forced sterilization. This article focuses on how the U.S. government responded to China’s one-child policy through the passage of immigration laws and policies that made asylum a viable option for Chinese nationals who had been persecuted or feared persecution because of coercive population control policies. Based on observations of asylum hearings and interviews with immigration judges and immigration attorneys, this article uses feminist ethnographic methods to show how China’s one-child policy and U.S. asylum laws shape the gender politics of reproduction and migration.

Postnational or National Europe? European Asylum Policies and Immigration Controls

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Vedrana Baričević

2011-01-01

Full Text Available The paper deals with the theories of the transformation of the modern functions of the nation state and the immigrant membership associated with the (legally defined status of community members exemplified by asylum policies. In the process, two fundamental approaches to the issue are distinguished: the first one emphasizing changes in the institution of the traditional national citizenship and competences of the nation state, while stressing a predominantly national character of the institution of citizenship, and the second one, which emphasizes the transformation of traditional citizenships, stressing the weakening of the role of the nation state. Therefore, in the latter case, there is increasingly more talk about postnationalism, which is a term denoting the transformation of the substantive aspects of citizenship in the EU countries. The mentioned theoretical approaches are applied to three groups of issues. First, the impact of the EU on the processes of the globalisation of the rights of asylum migrants are examined. Second, the paper works out the details of the way of formulating the policy of asylum membership in the EU member states. Third, the question of whether universal postnational inclusion of asylum migrants is at work in the EU member states, or whether the status of this group of immigrants should be found within the limits of the traditional theory of state membership and national sovereignty is addressed

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

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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.

The epidemiology of tuberculosis among asylum seekers in The Netherlands: implications for screening.

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van Burg, J L; Verver, S; Borgdorff, M W

2003-02-01

To identify low-risk groups among asylum seekers in the Netherlands that may be excluded from tuberculosis (TB) screening at entry or during follow-up. A retrospective cohort study of medical records of asylum seekers entering the country between January 1994 and March 1997. Medical records were available for 46,424 of the 96,000 asylum seekers (48%) in this period. One hundred and three pulmonary TB cases were diagnosed at entry (prevalence 222/100,000). Risk factors were age >11 years, history of imprisonment and country of origin at war or with TB incidence >100/100,000. During a mean follow-up period of 10 months, 51 pulmonary TB cases were diagnosed (incidence 134/100,000 person-years). Risk factors were age >11 years, old lesions on entry X-ray, and country of origin whose asylum seekers had a prevalence of TB at entry >200/100,000. We conclude that 1) those with abnormal X-ray at entry should receive preventive therapy after exclusion of active TB, or undergo intensive follow-up, 2) periodic screening is not indicated for immigrants from countries whose asylum seekers have a low prevalence of pulmonary TB at entry, and 3) children <12 years can be excluded from screening.

The mental health needs of asylum seekers and refugees - challenges and solutions.

Science.gov (United States)

Sen, Piyal

2016-05-01

Global events like wars and natural disasters have led to the refugee population reaching numbers not seen since the Second World War. Attitudes to asylum have hardened, with the potential to compromise the mental health needs of asylum seekers and refugees. The challenges in providing mental healthcare for asylum seekers and refugees include working with the uncertainties of immigration status and cultural differences. Ways to meet the challenges include cultural competency training, availability of interpreters and cultural brokers as well as appropriately adapting modes of therapy. Service delivery should support adjustment to life in a foreign country. Never has the need been greater for psychiatrists to play a leadership role in the area.

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

Science.gov (United States)

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

Elevated hair cortisol concentrations in recently fled asylum seekers in comparison to permanently settled immigrants and non-immigrants.

Science.gov (United States)

Mewes, R; Reich, H; Skoluda, N; Seele, F; Nater, U M

2017-03-07

Recently fled asylum seekers generally live in stressful conditions. Their residency status is mostly insecure and, similar to other immigrants, they experience stress due to acculturation. Moreover, they often suffer from traumatization and posttraumatic stress disorder (PTSD). All of these factors can result in chronic maladaptive biological stress responses in terms of hyper- or hypocortisolism and, ultimately, illness. We believe the current study is the first to compare hair cortisol concentration (HCC) of recently fled asylum seekers with PTSD to those without PTSD, and to compare HCC of asylum seekers to HCC of permanently settled immigrants and non-immigrant individuals. HCC of the previous 2 months was compared between 24 asylum seekers without PTSD, 32 asylum seekers with PTSD, 24 permanently settled healthy Turkish immigrants and 28 non-immigrant healthy Germans as the reference group. Statistical comparisons were controlled for age, sex and body mass index. No significant difference in HCC was found between asylum seekers with and without PTSD. However, the asylum seekers showed a 42% higher HCC than the reference group. In contrast, the permanently settled immigrants exhibited a 23% lower HCC than the reference group. We found relative hypercortisolism in recently fled asylum seekers, but no difference between persons with and without PTSD. These findings add to the very few studies investigating HCC in groups with recent traumatization and unsafe living conditions. Contrary to the findings in asylum seekers, permanently settled immigrants showed relative hypocortisolism. Both hyper- and hypocortisolism may set the stage for the development of stress-related illnesses.

Elevated hair cortisol concentrations in recently fled asylum seekers in comparison to permanently settled immigrants and non-immigrants

Science.gov (United States)

Mewes, R; Reich, H; Skoluda, N; Seele, F; Nater, U M

2017-01-01

Recently fled asylum seekers generally live in stressful conditions. Their residency status is mostly insecure and, similar to other immigrants, they experience stress due to acculturation. Moreover, they often suffer from traumatization and posttraumatic stress disorder (PTSD). All of these factors can result in chronic maladaptive biological stress responses in terms of hyper- or hypocortisolism and, ultimately, illness. We believe the current study is the first to compare hair cortisol concentration (HCC) of recently fled asylum seekers with PTSD to those without PTSD, and to compare HCC of asylum seekers to HCC of permanently settled immigrants and non-immigrant individuals. HCC of the previous 2 months was compared between 24 asylum seekers without PTSD, 32 asylum seekers with PTSD, 24 permanently settled healthy Turkish immigrants and 28 non-immigrant healthy Germans as the reference group. Statistical comparisons were controlled for age, sex and body mass index. No significant difference in HCC was found between asylum seekers with and without PTSD. However, the asylum seekers showed a 42% higher HCC than the reference group. In contrast, the permanently settled immigrants exhibited a 23% lower HCC than the reference group. We found relative hypercortisolism in recently fled asylum seekers, but no difference between persons with and without PTSD. These findings add to the very few studies investigating HCC in groups with recent traumatization and unsafe living conditions. Contrary to the findings in asylum seekers, permanently settled immigrants showed relative hypocortisolism. Both hyper- and hypocortisolism may set the stage for the development of stress-related illnesses. PMID:28267148

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

Science.gov (United States)

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.

Obesity in asylum seekers' children in The Netherlands - the use of national reference charts

NARCIS (Netherlands)

Stellinga-Boelen, Annette A. M.; Wiegersma, P. Auke; Bijleveld, Charles M. A.; Verkade, Henkjan J.

2007-01-01

Background: Growth assessment can be used to monitor health at individual and population level. For asylum seekers children with different geographic backgrounds, growth reference values are frequently not available. We assessed nutritional condition and growth of asylum seekers children upon

The Principle of Non-Refoulement and Access to Asylum System: Two Sides of the Same Coin

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Goranka Lalić Novak

2015-12-01

Full Text Available The European Union and other countries on the Balkan route for migrants have recorded a large increase in the number of asylum seekers. In parallel with the increased number of refugees trying to enter the territory of the EU, measures for migration management have tightened, and the right to asylum at the level of the Member States has been interpreted more and more restrictive. Search for protection from persecution has become a reason for closing borders and disabling access to territory and asylum system. However, access to asylum system is the first step in the realization of the right to asylum as guaranteed by international, European and national law. In addition to allowing access to territory and asylum system, which implies an obligation of states to accept refugees in order to confirm the need for international protection in a fair and efficient procedure, the states are obliged to respect the principle of non-refoulement. The aim of this paper is to clarify the connection between providing access to asylum system and respect for the principle of non-refoulement. Analysis in the paper was done by legal-dogmatic method of research and interpretation of legal acts and other authorities, as well as of UNHCR relevant recommendations and documents. The assumption is that without the provision of access to territory and asylum system the principle of non-refoulement cannot be respected. Apart from the international refugee law and doctrinal interpretations, it derives from the practice of the European Court of Human Rights regarding the prohibition of torture or other inhuman treatment or punishment guaranteed by the Convention for the Protection of Human Rights and Fundamental Freedoms. The conclusion is that the states must take into account international and European standards regarding the protection of the principle of non-refoulement when considering the introduction of new measures to manage migration movements.

Pedagogical work with asylum-seeking and refugee children in Denmark

DEFF Research Database (Denmark)

Moldenhawer, Bolette

Interpersonal and emotional aspects of pedagogical work have during the last decades been of great interest among educational researchers. This paper offers an analysis of social and moral dimensions of education by using professional interactions with asylum-seeking and refugee children...... as a privileged prism through which to study the emotional aspects of pedagogical work. The paper argues that the link between education and emotion is well addressed by considering the positioning of asylum-seeking and refugee children as a particularly vulnerable group characterized by anxiety and insecurity...

Coercion, prohibition and great expectations: The continuing failure of the Common European Asylum System

NARCIS (Netherlands)

den Heijer, M.; Rijpma, J.; Spijkerboer, T.

2016-01-01

This contribution explains the European asylum policy crisis from three structural weaknesses of the Common European Asylum System: its reliance on coercion within the EU, its unrealistic expectations of what borders can achieve and the premise of prohibition of refugee movement in its external

Refugees at Our Border. The U.S. Response to Asylum Seekers. Issue Brief.

Science.gov (United States)

Frelick, Bill

This report examines the background of and the newest developments in U.S. asylum policy in relation to Haitian, Central American, and Vietnamese refugees. The following background areas are explored: (1) the change in policy to stop the influx of asylum seekers; and (2) internal policy debate at the Immigration and Naturalization Service (INS)…

The Diplomatic Asylum: From Haya De La Torre to The "WikiLeaks" Case

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Agustina Vázquez

2018-03-01

Full Text Available The WikiLeaks’ founder represents not only a challenge to freedom of information, but also to International Law related to the diplomatic asylum. Julian Assange has been living in the Ecuadorian embassy in London for five years. In the last weeks, news surfaced that Sweden has ceased to request his extradition, the fact that caused much of the case under study. Assange’s situation seems to be diametrically different from Edward Snowden’s; however, both are labeled as "refugees for political reasons". While Assange looks forward to an improvement in his situation in the Ecuadorian embassy in London, Snowden still lives in Russia. Is the diplomatic asylum a usual practice? How to understand the diplomatic asylum in Latin America? What about England? In this paper, the analysis will assume that the concept of asylum is not recognized as a universal practice of International Law. However, in Latin America, it seems to be a usual practice since the judgment of the International Court of Justice on Haya de la Torre’s case.

Post-deportation risks for failed asylum seekers

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Jill Alpes

2017-02-01

Full Text Available What happens to people who are deported after their asylum applications have failed? Many who are deported are at risk of harm when they return to their country of origin but there is little monitoring done of deportation outcomes.

Adaptation of Harvard Trauma questionnaire for working with refugees and asylum seekers in Serbia

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Vukčević Maša

2016-01-01

Full Text Available The number of refugees and asylum seekers in Serbia is significantly increasing. Many have experienced traumatic events and suffer from posttraumatic stress disorder and depression. In order to provide them with adequate assistance, caregivers need adjusted assessment tools. The main goal of this research was the adaptation of the Harvard Trauma Questionnaire for working with refugees and asylum seekers in Serbia. A total of 16 focus groups were interviewed in two phases in order to create an adequate list of traumatic events for this population. The adapted list was subsequently administered to 226 persons seeking asylum in Serbia, along with the remaining parts of HTQ, HSCL-25 and BDI-II. Results show that the adapted list of traumatic events, as well as a shorter version, has good validity and other metric properties. The adaptation of the first assessment tool for working with refugees and asylum seekers in Serbia has significant practical implications.

Cure and guard. Chronicity in Insane Asylum La Castañeda, Mexico City, 1910-1968

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Cristina Sacristán

2017-12-01

Full Text Available The article questions the binomial that associates the chronicity and incurability of mental illness with the custodialism of the asylum through a case study, Asylum La Castañeda in Mexico, from 1910 to 1968. We contrast the discourses about the cure and chronicity constructed by Mexican psychiatrists and the statistical trends of patients admitted: new admissions, readmissions, discharges, length of stay, and diagnoses in the light of new treatments. We concluded that according to the doctors, the asylum therapeutic function was severely affected by chronicity and overpopulation, but according to statistics, 80% of the patients had only one admission with a 15-month hospitalization and the long-term confinement rates of readmissions did not impact statistically; two-thirds of the patients left the asylum, and since the 1950s in the context of new therapeutics.

Gender stereotyping in the Dutch asylum procedure: ‘independent’ men versus ‘dependent’ women

NARCIS (Netherlands)

Mascini, P.; van Bochove, M.

2009-01-01

Attention for discrimination against women in asylum law has grown considerably during the last few decades. Yet it is male claimants who have had smaller success Rates in the asylum procedures of different countries. Using administrative data from the Dutch INS, we show this difference is caused by

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

Science.gov (United States)

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…

Physician-owned companies.

Science.gov (United States)

Kostuik, John P

2007-05-15

The author relates his experience in the development of a spinal implant development company (K2M) that is significantly advised by physicians. To provide information about the development of a spinal implant company (K2M) advised by a group of professional spinal surgeons. To relate the federal laws (STARK and anti-kickback) as they pertain to surgeon-influenced companies. To discuss the role of a scientific advisory board. A self-developed company was developed together with significant, but minority physician financial input and majority scientific advice. A privately owned spinal implant development corporation (K2M) was developed 3 years ago. Physician financial participation was less than 20% (Stark laws state no more than 40%). Users of product are greater than 60% non-investor physicians. The development of a large scientific advisory board has been very influential in product development. A privately owned spinal implant company (K2M) has been developed strictly within Federal laws. Its board of scientific advisors that receives recompense commissurate only with effort significantly impacts the company policy.

Serbian migration policy concerning irregular migration and asylum in the context of the EU integration process

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Marta Stojić-Mitrović

2016-02-01

Full Text Available In this paper I would like to present Serbian migration policy concerning irregular migration and asylum in the context of the attempts of the Serbian state to become a member of the European Union. I would describe the history of the asylum system prior and after the implementation of the independent asylum system in Serbia in 2008. My presentation of the Serbian migration policy would be channelled by the analysis of some particular political issues, such as the externalization of the EU borders’ control, as well as some relevant elements of the European integration process, like visa liberalization. The second, more culturally specific dimension of the issue would be accessed through the demonstration of both legislative and public conceptualizations of the irregular migrants, asylum seekers and refugees in Serbia.

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

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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…

[Psychotherapeutic treatment of accompanied and unaccompanied minor refugees and asylum seekers with trauma-related disorders in Germany].

Science.gov (United States)

Metzner, Franka; Reher, Cornelia; Kindler, Heinz; Pawils, Silke

2016-05-01

Germany is one of the most important host countries for minor refugees and asylum seekers in Europe. The number of children who leave their home country has significantly risen worldwide in recent years; a further rise is to be expected due to the increasing number of crisis zones. A literature review demonstrates the state of research on traumatization, post-traumatic stress disorders and psychotherapy in minor refugees and asylum seekers. Many minor refugees and asylum seekers have made mainly interpersonal traumatic experiences within their home country or during their flight and develop simple or complex post-traumatic stress disorders. Left untreated, there is a risk of chronification. The psychotherapeutic treatment of minor refugees and asylum seekers in Germany takes place primarily in specialized psychosocial treatment centers. For an involvement of therapists in private practices, a reduction of organizational barriers as well as evidence-based treatment methods for interpreter-aided psychotherapy of minor refugees and asylum seekers that also consider their developmental state, are still lacking. In research, as well as in practice, there is further need for an early and systematic identification and treatment of minor refugees and asylum seekers with post-traumatic stress disorders or high risk of disease in Germany.

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

Science.gov (United States)

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.

Safe in our hands?: a study of suicide and self-harm in asylum seekers.

Science.gov (United States)

Cohen, Juliet

2008-05-01

This study examined the incidence of suicide and self-harm in asylum seekers in the UK, both those in detention and in the community. The investigation revealed that data recording is seriously flawed or sometimes non-existent. However, the scanty data those were available from Immigration Removal Centres, coroners' records and Prison Ombudsman's reports showed high levels of self-harm and suicide for detained asylum seekers as compared with the United Kingdom prison population. It is suggested that this could be attributed to routine failure to observe and mitigate risk factors. The author makes the following recommendations: coroners should record asylum seeker status and ethnicity of deceased, self-harm monitoring in the community should record asylum seeker status and ethnicity, health care in immigration removal centres should meet the same standards as UK prisons as a minimum, allegation of torture by immigration detainees should trigger a case management review and risk assessment for continued detention, and this process should be open to audit, and interpreters should be used for mental state examinations unless their English has been shown to the fluent.

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

Science.gov (United States)

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.

Dietary intake in asylum seeker children in The Netherlands, strongly related to age and origin

NARCIS (Netherlands)

Stellinga-Boelen, A. A. M.; Wiegersma, P. A.; Bijleveld, C. M. A.

Objective: To monitor the dietary intake of energy, macro- and micronutrients in asylum seeker children. Design and setting: Cross-sectional study in three asylum seeker centres in The Netherlands. Subjects: Hundred and sixteen children 2-12 years old (86% of the study cohort) provided a dietary

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.

Science.gov (United States)

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.

Science and the common good: indefinite, non-reviewable mandatory detention of asylum seekers and the research imperative.

Science.gov (United States)

Steel, Zachary; Silove, Derrick

2004-10-01

Despite a strong historical record of resettling and providing care for refugee populations, the Australian Federal Government has increasingly implemented harsh and restrictive policies regarding the treatment and management of asylum seekers. Most controversial of these has been the mandatory detention of asylum seekers, a policy applied indiscriminately and without discretion where individual cases have not been subject to judicial review or time constraints. From the outset health professionals have raised concerns about the possible adverse mental health impacts of prolonged detention. In contrast, government representatives have characterized conditions in detention as benign and comfortable, and have consistently contested criticism of detention, often citing a lack of scientific evidence as tacit support for the continuation of the policy. Nevertheless, requests for access to the detention centres to undertake rigorous scientific investigations have gone unheeded. In this context we argue that the Australian Government has failed to uphold its commitment to good governance by allowing transparency, openness and a willingness to have the impact of its policies scrutinized by scientists. The manifest conflict of interest in the government position leads to a breach in the normal social contract between mental health researchers and those responsible for the policy of detention. There is, we argue, a legitimate moral imperative in such situations for clinical researchers to breach the walls of enforced silence and give a voice to those who are afflicted. This imperative, however, must be carefully balanced against the risks that may face detainees agreeing to participate in such research.

The relationship between trauma, post-migration problems and the psychological well-being of refugees and asylum seekers.

Science.gov (United States)

Carswell, Kenneth; Blackburn, Pennie; Barker, Chris

2011-03-01

There is growing evidence of the impact of post-migration factors on the mental health of refugees. To date, few UK studies have been conducted. The study investigated the relationship between trauma, post-migration problems, social support and the mental health of refugees and asylum seekers. Refugees and asylum seekers (n = 47) were recruited mainly from clinical settings. Self-report measures of post-migration problems, mental health problems and social support were completed in an interview. Bivariate associations were identified between increased symptoms and number of traumas, adaptation difficulties, loss of culture and support and confidant support. In multivariate analyses post-migration problems were significantly associated with post-traumatic stress disorder symptoms and emotional distress. There was no significant association of symptoms and number of traumas or social support. The results suggest that clinical services should provide holistic interventions within a phased approach when working with refugees and asylum seekers. At a policy level, the results suggest the need for asylum policies that reduce post-migration problems and provide support for refugees and asylum seekers.

Adherence to antiretrovirals in refugees and asylum seekers.

Science.gov (United States)

Nwoguh, Francisca

Adherence to antiretroviral regimes is essential in effective management of HIV. The cultural, social, religious and immigration status of refugees and asylum seekers can have an impact on their understanding of their care needs and maintenance of their treatment regimen.

Forensic dental investigations and age assessment of asylum seekers.

Science.gov (United States)

Nuzzolese, Emilio; Di Vella, Giancarlo

2008-06-01

Age estimation is useful in forensic investigations to aid in the process of identifying unknown victims as well as living individuals. In many countries age estimation is commonly used to assist immigration authorities in deciding whether refugees or illegal migrants have reached that designated age that separates a juvenile from an adult. This is particularly important for the protection of unaccompanied minors. Italy is a country of great appeal for immigration as people from other Mediterranean countries can easily reach Italian coasts. In Italy, as in other western world countries, unaccompanied asylum seekers deemed to be under 18 face a very different path through the immigration system. They cannot be deported and are sent through a juvenile system where they have access to education programmes and may be granted a residence permit. The Section of Legal Medicine of the University of Bari was approached by Judges and Immigration Police with the question to assess the age of unaccompanied asylum seekers who claim to be below 18 years of age. The contribution of forensic odontologists for age estimation was recognised and since November 2006 age estimation of asylum seekers in Bari (Italy) relies on clinical and dental examination together with skeletal maturation as seen on radiographs of the left hand and wrist, the pelvis for iliac crests and root development and mineralisation of third molars as seen on an orthopantomogram.

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

Science.gov (United States)

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.

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

OpenAIRE

Malmqvist, Erik; Furberg, Elisabeth; Sandman, Lars

2018-01-01

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 problema...

A state of limbo--in transition between two contexts: Health assessments upon arrival in Sweden as perceived by former Eritrean asylum seekers.

Science.gov (United States)

Jonzon, Robert; Lindkvist, Pille; Johansson, Eva

2015-07-01

National statistics have shown that only about 40% of asylum seekers actually attend the optional health assessment offered upon their arrival in Sweden, but the reasons for this have not been fully explored. Health assessments for newly arrived asylum seekers have become a regular practice in most EU countries, but what is performed, how it is organized and whether it is mandatory or not varies between countries. The aim of the study was to explore and improve our understanding of how former asylum seekers from Eritrea perceived and experienced the health assessment during their asylum-seeking process. We used a qualitative research approach guided by grounded theory. Semi-structured interviews were conducted with 11 former asylum seekers from Eritrea. Data were analysed based on constant comparative analysis. The asylum seekers expressed feelings of ambiguity and mistrust and felt that they were seen only as objects by the Swedish healthcare system during their asylum-seeking process. Poor communication and inability to overcome language and cultural barriers seemed to be the most important findings in the narratives. The core category was defined as 'A state of limbo - in transition between two contexts'. There are reasons to believe that these issues with communication negatively affected both the quality of the health assessment and the number of asylum seekers attending the health assessment. Improved communication by the authorities towards the asylum seekers is, therefore, of vital importance. © 2015 the Nordic Societies of Public Health.

Exposure to Traumatic Experiences Among Asylum Seekers from Eritrea and Sudan During Migration to Israel.

Science.gov (United States)

Nakash, Ora; Langer, Benjamin; Nagar, Maayan; Shoham, Shahar; Lurie, Ido; Davidovitch, Nadav

2015-08-01

Little is known about the experiences of displaced individuals en route to destination countries. We investigated the reported prevalence of exposure to traumatic experiences during migration among a consecutive sample of adult asylum seekers (n = 895 Eritrean, n = 149 Sudanese) who sought health services in the Physicians for Human Rights Open-Clinic in Israel. Percentage of Eritrean and Sudanese men and women who reported witnessing violence (Eritrea: men: 41.3 %, women: 29.3 %; Sudan: men: 16.8 %, women: 22.2 %) and/or being a victim of violence (Eritrea: men: 56.0 %, Women: 34.9 %; Sudan: men: 51.9 % women: 44.4 %) during migration varied by gender and country of origin. Findings highlight the need for a well-coordinated international cooperation to document and prevent these transgressions.

Suicide death and hospital-treated suicidal behaviour in asylum seekers in the Netherlands: a national registry-based study

Directory of Open Access Journals (Sweden)

van Oostrum Irene EA

2011-06-01

Full Text Available Abstract Background Several suicide and suicidal behaviour risk factors are highly prevalent in asylum seekers, but there is little insight into the suicide death rate and the suicidal behaviour incidence in this population. The main objective of this study is to assess the burden of suicide and hospital-treated non-fatal suicidal behaviour in asylum seekers in the Netherlands and to identify factors that could guide prevention. Methods We obtained data on cases of suicide and suicidal behaviour from all asylum seeker reception centres in the Netherlands (period 2002-2007, age 15+. The suicide death rates in this population and in subgroups by sex, age and region of origin were compared with the rate in the Dutch population; the rates of hospital-treated suicidal behaviour were compared with that in the population of The Hague using indirect age group standardization. Results The study included 35 suicide deaths and 290 cases of hospital-treated suicidal behaviour. The suicide death rate and the incidence of hospital-treated suicidal behaviour differed between subgroups by sex and region of origin. For male asylum seekers, the suicide death rate was higher than that of the Dutch population (N = 32; RR = 2.0, 95%CI 1.37-2.83. No difference was found between suicide mortality in female asylum seekers and in the female general population of the Netherlands (N = 3; RR = 0.73; 95%CI 0.15-2.07. The incidence of hospital-treated suicidal behaviour was high in comparison with the population of The Hague for males and females from Europe and the Middle East/South West Asia, and low for males and females from Africa. Health professionals knew about mental health problems prior to the suicidal behaviour for 80% of the hospital-treated suicidal behaviour cases in asylum seekers. Conclusions In this study the suicide death rate was higher in male asylum seekers than in males in the reference population. The incidence of hospital-treated suicidal behaviour

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

Science.gov (United States)

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

When is return voluntary? Conditions of asylum in Lebanon

Directory of Open Access Journals (Sweden)

Amy Keith

2018-02-01

Full Text Available The decision of Syrian refugees in Lebanon to return to Syria must not be based on a deteriorating quality of asylum that creates physical, social and material pressures on decisions to return.

Community-based interventions for building social inclusion of refugees and asylum seekers in Australia: A systematic review

Directory of Open Access Journals (Sweden)

Di Mahoney

2017-12-01

Full Text Available As refugee and asylum seeker numbers increase in Australia, their effective integration into society is facilitated by inclusion in social, economic and community life. This systematic review of the literature explored community-based programs that contribute to inclusion and social participation of refugees and asylum seekers in Australia. Four scholarly databases were searched for articles published between 2007 and 2017 resulting in five articles which met inclusion criteria. Although the studies identified were of variable quality, the findings suggest a number of factors that facilitate program effectiveness. These included where: (a English language and communications skills were considered; (b programs built on refugees’ own skills and experience prior to resettlement; (c volunteers and mentors were involved; and (d participants engaged in diverse projects that enabled new connections. The review highlights the paucity of well-researched interventions that build social inclusion of refugees and asylum seekers in Australia. Emerging evidence suggests that community-based programs can positively increase social inclusion and connectedness amongst refugees and asylum seekers. Additional well-designed programs and evaluation of such programs are needed to better understand and identify effective interventions targeting social inclusion of refugees and asylum seekers.

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

Directory of Open Access Journals (Sweden)

Firenze Alberto

2016-03-01

Full Text Available 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.

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

Science.gov (United States)

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.

Refugee reception and pedagogical work with asylum-seeking and refugee children in Denmark

DEFF Research Database (Denmark)

Moldenhawer, Bolette

on family reunification, cuts to social benefits, and granting more temporary or subsidiary forms of protection, with fewer rights attached (ibid. 106). In this paper, the aim is to illuminate how this broad range of restrictive policies is informing the professional work with asylum-seeking and refugee...... children. Since children in the asylum system are regarded as part of the family's unity and are not heard independently in asylum cases, such as for example in Norway (Vitus 2011, 147), I argue that children – along with their families – are in a position of permanent temporality; a position that at all...... and immigration system is ambiguous because it officially does express a concern for preparing applicants for a life in Denmark, but in reality, “the more powerful and concerted political will is directed at keeping the applicants at a distance, socially disconnected, so as to facilitate their possible...

Detention in Kenya: risks for refugees and asylum seekers

OpenAIRE

Lucy Kiama; Dennis Likule

2013-01-01

Refugees and asylum seekers detained in Kenya risk multiple convictions and protracted detention due to poor coordination between immigration officials, police and prison officers, coupled with lack of interpreters and low levels of knowledge among government officers.

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

Science.gov (United States)

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.

In their own words: a synthesis of the qualitative research on the experiences of adults seeking asylum. A systematic review of qualitative findings in forced migration.

Science.gov (United States)

Hoare, Thomas; Vidgen, Andrew; Roberts, Neil

2017-12-01

Quantitative research indicates that some forced migrants have mental health needs. Asylum seekers are a group of forced migrants applying for asylum status in a host country, and are often subject to rights restrictions and threat of deportation, though little is known about subjective experiences of the asylum journey and process of claiming asylum. The current paper therefore describes a systematic review of the qualitative literature, examining asylum seekers experiences of asylum journey, from country of origin, to arrival and adaptation to host countries. A search of four databases yielded 122 studies. Inclusion/exclusion criteria were applied and 15 studies were retained and critically appraised. The country where research was conducted, study aims, sample characteristics and methodological approaches were all critically reviewed for included studies. Study aims fell into four themes; 'an aspect of the asylum seeker journey'; 'psychological distress and wellbeing'; 'cultural identity and adaptation to new environment' and 'social welfare, employment and housing'. Studies were generally high quality and indicate issues around choice of asylum destination, distress created by uncertainty around asylum decision and hostile reactions of host communities. However, few studies have examined the experiences of asylum seekers specifically, which is important given the unique circumstances of this population.

The need for a rights-based public health approach to Australian asylum seeker health.

Science.gov (United States)

Durham, Jo; Brolan, Claire E; Lui, Chi-Wai; Whittaker, Maxine

2016-01-01

Public health professionals have a responsibility to protect and promote the right to health amongst populations, especially vulnerable and disenfranchised groups, such as people seeking asylum and whose health care is frequently compromised. As at 31 March 2016, there was a total of 3707 people (including 384 children) in immigration detention facilities or community detention in Australia, with 431 of them detained for more than 2 years. The Public Health Association of Australia and the Australian Medical Association assert that people seeking asylum in Australia have a right to health in the same way as Australian citizens, and they denounce detention of such people in government facilities for prolonged and indeterminate periods of time. The position of these two professional organisations is consistent with the compelling body of evidence demonstrating the negative impact detention has on health. Yet in recent years, both the Labour and Liberal parties-when at the helm of Australia's Federal Government-have implemented a suite of regressive policies toward individuals seeking asylum. This has involved enforced legal restrictions on dissenting voices of those working with these populations, including health professionals. This paper outlines Australia's contemporary offshore immigration detention policy and practices. It summarises evidence on asylum seeker health in detention centres and describes the government's practice of purposeful silencing of health professionals. The authors examine how Australia's treatment of asylum seekers violates their health rights. Based on these analyses, the authors call for concrete action to translate the overwhelming body of evidence on the deleterious impacts of immigration detention into ethical policy and pragmatic interventions. To this end, they provide four recommendations for action.

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

Science.gov (United States)

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

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

Science.gov (United States)

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.

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

NARCIS (Netherlands)

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

2018-01-01

BACKGROUND: 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

Detention in Kenya: risks for refugees and asylum seekers

Directory of Open Access Journals (Sweden)

Lucy Kiama

2013-09-01

Full Text Available Refugees and asylum seekers detained in Kenya risk multiple convictions and protracted detention due to poor coordination between immigration officials, police and prison officers, coupled with lack of interpreters and low levels of knowledge among government officers.

Asylum migration and the construction of the European Common Foreign and Security Policy: evidence from the Greek case

Directory of Open Access Journals (Sweden)

Silvia Lucía Forero Castañeda

2015-12-01

Full Text Available This article examines how the recent evolution of asylum migration has affected the construction of the European Common Foreign and Security Policy (EU-CFSP, taking the Greek case during the 2001-2012 period as a starting point. With this in mind, the normative progress of the EU-CFSP facing the reception of asylum seekers in Greece is analyzed, under the scope of what Barry Buzan and Ole Waever would call Securitization Process. Both legal and political frameworks on asylum migration in Greece and in the European Union are approached, in the context of the evolution of the EU-CFSP in three main areas: Neighborhood Policy, Development and Cooperation Policy, and Human Rights Protection. The conclusión points toward the partial influence of asylum migration in the configuration of the UE-CFSP during the studied period.

The common European asylum system and the rights of the child : an exploration of meaning and compliance

NARCIS (Netherlands)

Smyth, Ciara Mary

2013-01-01

This thesis addresses the question of whether the EU Common European Asylum System (CEAS) complies with the rights of the child. A significant proportion of people seeking asylum in EU countries are children. These children may be totally alone, with people who are not their customary caregivers

Sanctioning international protection applicants for choosing the country of asylum

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Polona Mozetič

2016-06-01

Full Text Available Major disparities in the regulation and application of international protection exist among EU member states. Therefore, applicants for international protection want to choose the state where they lodge an application. Instead of harmonizing law on international protection, member states sanction applicants for international protection who lodge an application in the preferred member states and not in the one responsible under the Dublin III Regulation. According to the New International Protection Act, implementing EU procedural directive, it may be assumed that an applicant implicitly withdrew her/his application, if s/he left the asylum home without authorisation, and in that case the procedure is discontinued. If an applicant lodges a subsequent application after more than nine months or more than once, her/his application will possibly not be subject of a substantial examination.In order to prevent ”asylum shopping” EU allows for the possibility that some applicants, who would be entitled to refugee status or subsidiary protection, are never granted such protection. However, this is contrary to the principle of non-refoulement as developed in the case-law of the ECtHR and the Constitutional Court of the Republic of Slovenia. Mechanisms that aim to prevent ”asylum shopping” may be contrary to the well-established principles of human rights protection, unfair or unreasonable and affect the most marginalized applicants for international protection.

HIV positive asylum seekers receiving the order to leave the Belgian territory.

Science.gov (United States)

Demeester, Remy; Legrand, Jean-Claude

2014-01-01

In a human rights based approach, the Parliamentary Assembly of the Council of Europe has recently released a resolution about migrants and refugees and the fight against HIV (1). It states that "an HIV positive migrant should never be expelled when it is clear that he will not receive adequate health care and assistance in the country to which he is being sent back. To do otherwise would amount to a death sentence for that person." Nevertheless, in Belgium, for the last 2 years, none of the HIV-infected migrants in care in the AIDS Reference Centers (ARC) received the right to stay in Belgium for medical reasons. We identified all HIV-infected asylum seekers in care between 1 July 2012 and 1 July 2014 in the ARC of Charleroi, Belgium, and we analyzed their medical and social files. Among the 302 patients in active follow up in our ARC, 45 HIV positive asylum seekers were in care during the last 2 years. Male/female ratio was 0/96. Mean age was 35 years. Countries of origin and reasons for migration are detailed in the Table 1. 18% (8/45) knew their seropositivity before arriving in Europe. All the patients introduced an asylum request, 29 (64%) have received a negative answer and an order to leave the territory, 4 (9%) were regularized for non-medical reasons (see Table 1), 4 (9%) are waiting for an answer and for 8 (18%) outcome is unknown due to lost follow up (LFU). 31 (69%) patients have also introduced a request to stay for medical reasons: 18 (58%) have received a refusal, 7 (23%) are still waiting for an answer, and 6 (19%) are LFU. Only 23 (51%) patients are still in care in our ARC on 1 July 2014 (see Table 1). The immigration office bases its decisions on availability of the treatment in the country even if accessible only to a limited number of patients. Decisions taken by the Belgian authorities for the last two years concerning HIV-infected asylum seekers do not guarantee the continuity of care of those patients and push them towards illegality. Such

Comparison of self-reported health & healthcare utilisation between asylum seekers and refugees: an observational study.

LENUS (Irish Health Repository)

Toar, Magzoub

2009-01-01

BACKGROUND: Adult refugees and asylum seekers living in Western countries experience a high prevalence of mental health problems, especially post traumatic stress disorder (PTSD), depression and anxiety. This study compares and contrasts the prevalence of health problems, and potential risk factors as well as the utilisation of health services by asylum seekers and refugees in the Irish context. METHODS: Cross sectional study using validated self reported health status questionnaires of adult asylum seekers (n = 60) and refugees (n = 28) from 30 countries, living in Ireland. Outcome measures included: general health status (SF-36), presence of PTSD symptoms and anxiety\\/depression symptoms. Data on chronic conditions and pre or post migration stressors are also reported. The two groups are compared for utilisation of the health care system and the use of over the counter medications. RESULTS: Asylum seekers were significantly more likely than refugees to report symptoms of PTSD (OR 6.3, 95% CI: 2.2-17.9) and depression\\/anxiety (OR 5.8, 95% CI: 2.2-15.4), while no significant difference was found in self-reported general health. When adjusted by multivariable regression, the presence of more than one chronic disease (OR 4.0, 95%CI: 1.3-12.7; OR 3.4, 95% CI: 1.2-10.1), high levels of pre migration stressors (OR 3.6, 95% CI: 1.1-11.9; OR 3.3, 95% CI: 1.0-10.4) or post migration stressors (OR 17.3, 95% CI: 4.9-60.8; OR 3.9, 95% CI: 1.2-12.3) were independent predictors of self reported PTSD or depression\\/anxiety symptoms respectively, however, residence status was no longer significantly associated with PTSD or depression\\/anxiety. Residence status may act as a marker for other explanatory variables; our results show it has a strong relationship with post migration stressors (chi2 = 19.74, df = 1, P < 0.001).In terms of health care utilisation, asylum seekers use GP services more often than refugees, while no significant difference was found between these groups

Comparison of self-reported health & healthcare utilisation between asylum seekers and refugees: an observational study

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Fahey Tom

2009-06-01

Full Text Available Abstract Background Adult refugees and asylum seekers living in Western countries experience a high prevalence of mental health problems, especially post traumatic stress disorder (PTSD, depression and anxiety. This study compares and contrasts the prevalence of health problems, and potential risk factors as well as the utilisation of health services by asylum seekers and refugees in the Irish context. Methods Cross sectional study using validated self reported health status questionnaires of adult asylum seekers (n = 60 and refugees (n = 28 from 30 countries, living in Ireland. Outcome measures included: general health status (SF-36, presence of PTSD symptoms and anxiety/depression symptoms. Data on chronic conditions and pre or post migration stressors are also reported. The two groups are compared for utilisation of the health care system and the use of over the counter medications. Results Asylum seekers were significantly more likely than refugees to report symptoms of PTSD (OR 6.3, 95% CI: 2.2–17.9 and depression/anxiety (OR 5.8, 95% CI: 2.2–15.4, while no significant difference was found in self-reported general health. When adjusted by multivariable regression, the presence of more than one chronic disease (OR 4.0, 95%CI: 1.3–12.7; OR 3.4, 95% CI: 1.2–10.1, high levels of pre migration stressors (OR 3.6, 95% CI: 1.1–11.9; OR 3.3, 95% CI: 1.0–10.4 or post migration stressors (OR 17.3, 95% CI: 4.9–60.8; OR 3.9, 95% CI: 1.2–12.3 were independent predictors of self reported PTSD or depression/anxiety symptoms respectively, however, residence status was no longer significantly associated with PTSD or depression/anxiety. Residence status may act as a marker for other explanatory variables; our results show it has a strong relationship with post migration stressors (χ2 = 19.74, df = 1, P In terms of health care utilisation, asylum seekers use GP services more often than refugees, while no significant difference was found

Age assessment of young asylum seekers

DEFF Research Database (Denmark)

Hjern, Anders; Brendler-Lindqvist, Maria; Nørredam, Marie Louise

2012-01-01

to be of real use in this decision. Unclear guidelines and arbitrary practices may lead to alarming shortcomings in the protection of this high-risk group of children and adolescents in Europe. Medical participation, as well as non-participation, in these dubious decisions raises a number of ethical questions....... CONCLUSION: To improve care for young asylum seekers with undetermined age, we suggest better legal procedures for the determination of age and a more flexible approach to chronological age....

Irish midwives' experiences of providing maternity care to non-Irish women seeking asylum

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Tobin CL

2014-01-01

Full Text Available Carolyn L Tobin,1 Jo Murphy-Lawless2 1Department of Nursing, College of Health and Human Services, University of New Hampshire, Durham, NH, USA; 2School of Nursing and Midwifery, Trinity College, Dublin, Ireland 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

Mental health of asylum seekers: a cross-sectional study of psychiatric disorders

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Heeren Martina

2012-08-01

Full Text Available Abstract Background Asylum procedures are known to be protracted, stretching to over ten years in many host countries. International research shows high levels of distress for asylum seekers. Little is known about actual psychiatric morbidity in this population, especially during the first few years postmigration. Methods The mental health status of two groups of asylum seekers was assessed: Group 1 (n = 43 had arrived in Switzerland 2.9 (SD 1.1 months prior to assessment, while Group 2 (n = 43 had arrived 15.5 (SD 3.2 months prior to assessment. Psychiatric disorders were diagnosed using the Mini International Neuropsychiatric Interview (MINI. Symptom severity of posttraumatic stress disorder (Posttraumatic Diagnostic Scale, anxiety (Hopkins Symptom Checklist, depression (Hopkins Symptom Checklist, and pain (Verbal Rating Scale were assessed using self-report questionnaires. Postmigratory factors such as German language proficiency and social contacts were also assessed. Interviews were conducted with the assistance of trained interpreters. Results Four out of ten participants met diagnostic criteria for at least one DSM-IV disorder. Groups did not differ with respect to psychiatric morbidity or symptom levels. Major depression (31.4% and PTSD (23.3% were diagnosed most frequently. The number of experienced traumatic event types was highly correlated with psychiatric morbidity. Conclusions Psychiatric morbidity in asylum seekers in the first two years after arrival is high, with no indication of a decrease in mental distress over time. Traumatic experiences seem to play a major role in morbidity during this time. Considering the magnitude of clinically relevant distress, a short psychological screening upon arrival with a focus on traumatic experiences may be warranted.

Asylum Seekers and Resettled Refugees in Australia: Predicting Social Policy Attitude From Prejudice Versus Emotion

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Lisa K. Hartley

2015-07-01

Full Text Available While most of the world's refugees reside in developing countries, their arrival to western countries is highly politicised, giving rise to questions about the types of entitlements and rights that should, or should not, be granted. In this study, using a mixed-methods community questionnaire (N = 185, we examined attitudes towards social policies aimed at providing assistance to two categories of new arrivals to Australia: resettled refugees (who arrive via its official refugee resettlement program and asylum seekers (who arrive via boat and then seek refugee status. Social policy attitude was examined as a consequence of feelings of anger, fear, and threat, as well as levels of prejudice. Participants felt significantly higher levels of anger, fear, threat, and prejudice towards asylum seekers compared to resettled refugees. For both resettled refugees and asylum seekers, prejudice was an independent predictor of more restrictive social policy attitudes. For resettled refugees, fear and perceived threat were independent predictors for more restrictive social policy whereas for asylum seekers anger was an independent predictor of restrictive social policy. The qualitative data reinforced the quantitative findings and extended understanding on the appraisals that underpin negative attitudes and emotional responses. Practical implications relating to challenging community attitudes are discussed.

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

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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, pasylum 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

Violence against women: the physician's role.

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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.

Inspecting asylum seekers upon entry: a medico-ethical complex.

NARCIS (Netherlands)

Francois, G.; Hambach R.; Sprundel, M. van; Devillé, W.; Hal, G. van

2008-01-01

In September 2007, the UN Refugee Agency UNHCR summarized the main asylum application levels and trends during the first six months of the year in 36 industrialized countries, including 26 European Union (EU) Member States. Based on the assumption of unchanged yearly patterns, the total number of

Satisfaction with daily occupations amongst asylum seekers in Denmark

DEFF Research Database (Denmark)

Morville, Anne-Le; Erlandsson, Lena-Karin; Danneskiold-Samsøe, Bente

2015-01-01

to their satisfaction with daily occupations and activity level. METHODS: 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...

Between remembrance technology and the production of truth: memory and narrative in asylum politics

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Elisa Mencacci

2015-04-01

Full Text Available In the institutional pathway for recognition of asylum right, the narrative becomes, according to current regulations, the element to be sieved in order to ascertain title to international protection. The aim of this essay is analyzing the various declensions assumed by the narrative in this institutional process. Weaving together clinical and ethnographic data, drawn from the main phases that foreigners have to pass through in this event, I would like to highlight how, in the asylum system, the narrative takes the value of a tool directed, first of all at checking the applicant’s past, and second at co-producing a subject fitting to the media and legal dominant imaginary features. In this specific context, the treatment of traumatic injuries, recognized as basis of interrupted narratives, emerges as issue played in its turn on a double register: as adherence to specific schemes of "therapeutic governance" and as further control of specific events, experienced by asylum seekers in the past.

The Complexity of Survival: Asylum Seekers, Resilience and Religion

DEFF Research Database (Denmark)

Buch-Hansen, Gitte; Lorensen, Marlene Ringgaard

to a simple instrument to obtain asylum. In this article, we show how his recommendation ignores the complexity of motives involved in the change of religious affiliation. By our adjustment of Bourdieu’s theory of social capital, we demonstrate how conversion is also a way of existential survival...

Facilitating ‘reasonable hope’ with refugees and asylum seekers

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Greg Turner

2017-06-01

Full Text Available The loss of hope over time has led to despair and a mental health crisis for refugees and asylum seekers on Manus Island and Nauru. The use of the principle of ‘reasonable hope’, however, can support their mental health and well-being.  

Comparison of self-reported health & healthcare utilisation between asylum seekers and refugees: an observational study.

Science.gov (United States)

Toar, Magzoub; O'Brien, Kirsty K; Fahey, Tom

2009-06-30

Adult refugees and asylum seekers living in Western countries experience a high prevalence of mental health problems, especially post traumatic stress disorder (PTSD), depression and anxiety. This study compares and contrasts the prevalence of health problems, and potential risk factors as well as the utilisation of health services by asylum seekers and refugees in the Irish context. Cross sectional study using validated self reported health status questionnaires of adult asylum seekers (n = 60) and refugees (n = 28) from 30 countries, living in Ireland. Outcome measures included: general health status (SF-36), presence of PTSD symptoms and anxiety/depression symptoms. Data on chronic conditions and pre or post migration stressors are also reported. The two groups are compared for utilisation of the health care system and the use of over the counter medications. Asylum seekers were significantly more likely than refugees to report symptoms of PTSD (OR 6.3, 95% CI: 2.2-17.9) and depression/anxiety (OR 5.8, 95% CI: 2.2-15.4), while no significant difference was found in self-reported general health. When adjusted by multivariable regression, the presence of more than one chronic disease (OR 4.0, 95%CI: 1.3-12.7; OR 3.4, 95% CI: 1.2-10.1), high levels of pre migration stressors (OR 3.6, 95% CI: 1.1-11.9; OR 3.3, 95% CI: 1.0-10.4) or post migration stressors (OR 17.3, 95% CI: 4.9-60.8; OR 3.9, 95% CI: 1.2-12.3) were independent predictors of self reported PTSD or depression/anxiety symptoms respectively, however, residence status was no longer significantly associated with PTSD or depression/anxiety. Residence status may act as a marker for other explanatory variables; our results show it has a strong relationship with post migration stressors (chi2 = 19.74, df = 1, P refugees, while no significant difference was found between these groups for use of dentists, medication, hospitalisation or mental health services. Asylum seekers have a higher level of self reported

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

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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.

Consequences of tuberculosis among asylum seekers for health care workers in Germany.

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Diel, Roland; Loddenkemper, Robert; Nienhaus, Albert

2016-01-01

Immigrants have been contributing to the incidence of tuberculosis (TB) in Germany for many years. The current wave of migration of asylum seekers to Germany may increase that figure. Healthcare workers (HCW) who look after refugees not only in hospitals and medical practices but also in aid projects may be exposed to cases of TB. The incremental TB cases arising from imported TB as well as from TB cases that developed later in refugees were calculated in a Markov model over a period of 5 years. Infectious and non-infectious susceptible TB and multidrug-resistant TB (MDR-TB) cases were determined separately. In addition, the total amount of latent TB in contact persons and the risk of infection by HCW were estimated. Due to uncertainty of future refugee flows to Europe, different scenarios were considered in univariate and multivariate sensitivity analysis. Assuming a decrease in immigration by half each year to the bottom line of 2014, and in light of the current number of 800,000 asylum seekers, we calculated an additional 10,090 TB cases by the end of the fifth year (5976 cases of infectious pulmonary TB and 143 cases of pulmonary MDR-TB). In case of an unchanging influx of asylum seekers over the 5-year period, 19,031 TB cases would arise, 377 of which infectious MDR-TB. Eighty -seven ensuing TB cases would develop in HCW in the same period, 3 of which MDR-TB cases. Although the total number of TB cases in HCW expected to ensue from the current influx of asylum seekers is rather small, the 3 MDR-TB cases we calculated have to be taken seriously. We consider it essential to increase awareness of protective measures such as respiratory masks and, in the event of documented exposure, of supply-oriented occupational health screening.

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

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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.

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

Science.gov (United States)

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

Fleeing the Drug War Next Door: Drug-related Violence as a Basis for Refugee Protection for Mexican Asylum-Seekers

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Holly Buchanan

2011-02-01

Full Text Available The death toll in Mexico due to drug-related violence has continued to rise since President Felipe Calderón initiated the Mexican Government's crackdown on drug trafficking organizations in 2006. Pervasive corruption among state and local government officials and alleged human rights violations by the Mexican military have added to the gravity of the endemic drug-related violence in Mexico. In response to the continuous violence in Mexico perpetrated by drug trafficking organiza- tions, a substantial number of Mexican citizens have fled to the United States seeking asylum. Due to the strict requirements for refugee status under international law and asylum protection under U.S. law, individuals seeking protection based on drug-related violence face several legal obstacles. This Article addresses the extent to which drug-related violence may con- stitute a basis for refugee status protection under international refugee law and U.S. asylum law. It seeks to provide insight into the potential viability of claims for refugee status brought by Mexican asylum-seekers fleeing drug-related violence. This Article concludes with a discussion on complementary protection under the Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment for Mexican asylum-seekers.

Fleeing the Drug War Next Door: Drug-related Violence as a Basis for Refugee Protection for Mexican Asylum-Seekers

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Holly Buchanan

2011-02-01

Full Text Available The death toll in Mexico due to drug-related violence has continued to rise since President Felipe Calderón initiated the Mexican Government's crackdown on drug trafficking organizations in 2006. Pervasive corruption among state and local government officials and alleged human rights violations by the Mexican military have added to the gravity of the endemic drug-related violence in Mexico. In response to the continuous violence in Mexico perpetrated by drug trafficking organiza- tions, a substantial number of Mexican citizens have fled to the United States seeking asylum. Due to the strict requirements for refugee status under international law and asylum protection under U.S. law, individuals seeking protection based on drug-related violence face several legal obstacles. This Article addresses the extent to which drug-related violence may con- stitute a basis for refugee status protection under international refugee law and U.S. asylum law. It seeks to provide insight into the potential viability of claims for refugee status brought by Mexican asylum-seekers fleeing drug-related violence. This Article concludes with a discussion on complementary protection under the Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment for Mexican asylum-seekers.  

The regulation of British colonial lunatic asylums and the origins of colonial psychiatry, 1860-1864.

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Swartz, Sally

2010-05-01

In this paper I outline a brief period in the history of the British Empire, during which colonial lunatic asylum policy began to be formulated. I begin with a scandal that erupted in Jamaica and suggest that this set in motion processes that led to critical changes in asylum administration. The first of these processes was an audit of hospitals and asylums in the colonies. The results of the audit and the policy that emerged from it marked the beginning of systematic regulation of lunatic asylum practice across the British Empire. It revealed a formulation of policy that was intended to cut across the self-governing regimes that had up to this point been allowed to evolve. Drawing on the work of Michel Foucault and Nikolas Rose, I argue that the policy and the practices associated with it contribute to an understanding of the emergence of the psy-sciences in colonial settings. They illustrate the establishment of a panoptic gaze on previously neglected insane spaces. Systematic surveillance constituted government at a distance and made colonial lunacy administration a governable discursive space. The regulation of the medical officers, lunatic attendants, and hospital boards began the process of creating a professional psychiatric workforce. I conclude with a discussion of the implications and the mixed impact of this policy change for the mentally ill across the empire, over the ensuing decades.

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

Science.gov (United States)

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.

Tuberculosis screening and follow-up of asylum seekers in Norway: a cohort study

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Garåsen Helge

2009-05-01

Full Text Available Abstract Background About 80% of new tuberculosis cases in Norway occur among immigrants from high incidence countries. On arrival to the country all asylum seekers are screened with Mantoux test and chest x-ray aimed to identify cases of active tuberculosis and, in the case of latent tuberculosis, to offer follow-up or prophylactic treatment. We assessed a national programme for screening, treatment and follow-up of tuberculosis infection and disease in a cohort of asylum seekers. Methods Asylum seekers ≥ 18 years who arrived at the National Reception Centre from January 2005 to June 2006, were included as the total cohort. Those with a Mantoux test ≥ 6 mm or positive x-ray findings were included in a study group for follow-up. Data were collected from public health authorities in the municipality to where the asylum seekers had moved, and from hospital based internists in case they had been referred to specialist care. Individual subjects included in the study group were matched with the Norwegian National Tuberculosis Register which receive reports of everybody diagnosed with active tuberculosis, or who had started treatment for latent tuberculosis. Results The total cohort included 4643 adult asylum seekers and 97.5% had a valid Mantoux test. At least one inclusion criterion was fulfilled by 2237 persons. By end 2007 municipal public health authorities had assessed 758 (34% of them. Altogether 328 persons had been seen by an internist. Of 314 individuals with positive x-rays, 194 (62% had seen an internist, while 86 of 568 with Mantoux ≥ 15, but negative x-rays (16% were also seen by an internist. By December 31st 2006, 23 patients were diagnosed with tuberculosis (prevalence 1028/100 000 and another 11 were treated for latent infection. Conclusion The coverage of screening was satisfactory, but fewer subjects than could have been expected from the national guidelines were followed up in the community and referred to an internist. To

When lives are put on hold: Lengthy asylum processes decrease employment among refugees.

Science.gov (United States)

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

Science.gov (United States)

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

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

Science.gov (United States)

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.

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

Science.gov (United States)

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…

Iron deficiency among children of asylum seekers in the Netherlands

NARCIS (Netherlands)

Stellinga-Boelen, A. A. M.; Storm, H.; Wiegersma, P. A.; Bijleveld, C. M. A.; Verkade, H. J.

2007-01-01

Objectives: To investigate, in asylum seekers' children in the Netherlands, biochemical iron status and the prevalence of iron deficiency (ID) and anemia in relation to age, region of origin, length of stay in the Netherlands, body mass index (BMI), and dietary iron intake. Patients and Methods:

Iron deficiency among children of asylum seekers in the Netherlands

NARCIS (Netherlands)

Stellinga-Boelen, A. A. M.; Storm, H.; Wiegersma, P. A.; Bijleveld, C. M. A.; Verkade, H. J.

Objectives: To investigate, in asylum seekers' children in the Netherlands, biochemical iron status and the prevalence of iron deficiency (ID) and anemia in relation to age, region of origin, length of stay in the Netherlands, body mass index (BMI), and dietary iron intake. Patients and Methods:

Threat Perception and Modern Racism as Possible Predictors of Attitudes towards Asylum Seekers: Comparative Findings from Austria, Germany, and Slovakia

Directory of Open Access Journals (Sweden)

Walter Renner

2018-01-01

Full Text Available Autochthon Europeans reacted inconsistently to rising numbers of asylum applications in 2015 and 2016. While some of them welcomed asylum seekers enthusiastically, others reacted with hostility. The objective of this study was to test a predictive model of these individual differences by Structural Equation Modeling (SEM. Both, in a German-speaking (N = 349 Austrians and Germans and in a Slovak (N = 307 adult sample, the perception of "cultural threat" was a strong predictor of attitudes towards asylum seekers, whereas perceived "economic threat" and "modern racism" did not explain additional proportions of the variance.

The physical health status, service utilisation and barriers to accessing care for asylum seekers residing in the community: a systematic review of the literature.

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Hadgkiss, Emily J; Renzaho, Andre M N

2014-05-01

To document physical health problems that asylum seekers experience on settlement in the community and to assess their utilisation of healthcare services and barriers to care, in an international context. A systematic review of quantitative and qualitative studies was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. MEDLINE, PsycINFO, Embase and CINAHL databases were searched from 2002 to October 2012, focusing on adult asylum seekers residing in the community in high-income countries. The search yielded 1499 articles, of which 32 studies met the inclusion criteria - 23 quantitative and nine qualitative. Asylum seekers had complex health profiles spanning a range of infectious diseases, chronic non-communicable conditions, and reproductive-health issues. They appeared to utilise health services at a higher rate than the host population, yet faced significant barriers to care. The findings of this study highlight the health inequities faced by asylum seekers residing in the communities of host countries, internationally. National data on asylum seekers' health profiles, service utilisation and barriers to care, as well as cross-country policy comparisons, are urgently required for the development of effective Australian health programs and evidence-based policy. What is known about the topic? The clinical and political focus of asylum seekers' health has largely been on the higher incidence of mental disorders and the impact of immigration detention. Since policy changes made in late 2011, an increasing number of asylum seekers have been permitted to live in the community while their claims are processed. There is a paucity of research exploring the physical health needs of asylum seekers residing in the community. What does this paper add? The international literature highlights the complexity of asylum seekers' health profiles. Although they appear to utilise health services at a higher rate than the host population

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

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Anna Ziersch

2017-09-01

Full Text Available 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.

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

Science.gov (United States)

Ziersch, Anna; Walsh, Moira; Due, Clemence; Duivesteyn, Emily

2017-09-08

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.

Attitudes towards Immigrant Workers and Asylum Seekers in Eastern Croatia: Dimensions, Determinants and Differences

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Margareta Gregurović

2016-04-01

Full Text Available Croatia’s accession to the EU has brought new challenges and issues in researching and analysing migration flows and trends as well as attitudes and perceptions of real and potential newcomers. The aim of this paper is to explore attitudes of the residents of the two most easterly Croatian counties towards two distinct categories of newcomers: immigrant workers and asylum seekers. The research was conducted shortly after Croatia’s entry into the EU, in September 2013, and the presented data are a part of a larger survey that included various migration and ethnicity issues. The survey was applied on a convenience sample of 1 110 adult respondents in two counties: Osijek-Baranja and Vukovar-Srijem. Data were analysed in a series of multivariate procedures. Results indicated significant perceptions of immigrant workers within the dimension of cultural threat, along with the expression of a considerable degree of social distance towards them. Asylum seekers were further perceived as a security and economic threat. Within two analysed regression models, the effects on attitudes towards immigrant workers and asylum seekers were similar. Among the spectrum of socio-demographic variables, a statistically significant effect on both dependent variables came from age and political orientation, indicating that older and politically right-oriented respondents expressed more negative attitudes towards both groups. Among other socio-demographic variables, education was significant in predicting attitudes towards immigrant workers, while ethnicity was significant in predicting the attitudes towards asylum seekers. The second model analysed the effect of selected political attitudes and value orientations resulting in significant prediction of negative attitudes towards both groups by pronounced conservativism, support of aggression and submission, social-dominance, dominant submissive authoritarianism and social alienation, rejecting socially oriented

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

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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…

Transnational entanglements in the history of psychiatry. South Tyrolian patients in German asylums, c. 1940-1945

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Thomas Müller

2016-12-01

Full Text Available Object of this article is the destiny of psychiatric inmates in Wuerttemberg asylums, 1940-1945. These patients from Italian regions of Vicenza, Udine, Trento, Alto Adige and various locations more were delegated and, to a substantial number, illegally deported to the German asylums Zwiefalten, Schussenried and Weissenau, all in South Wuerttemberg, in 1940 and 1943. Attention is focused on the pioneering state pre-negotiations, and the so-called option treaties between the German Reich and Fascist Italy as part of the general aspect of National Socialist bio-Politics. The treatment of these South Tyrol patients in the asylums themselves, as well as their fate will be put into the context of the resettlement actions at the margins of the Third Reich, which started in 1939 and widely affected the European continent. It is referred to other sub-groups of migrating population from Italy to the German Reich as well, as a contrasting aspect of this contribution

Forensic age assessment of asylum seekers in Finland.

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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.

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

Science.gov (United States)

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.

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

Science.gov (United States)

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

2018-01-01

Background Germany 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. PMID:29560856

Human rights or security? Positions on asylum in European Parliament speeches

DEFF Research Database (Denmark)

Frid-Nielsen, Snorre Sylvester

2018-01-01

This study examines speeches in the European Parliament relating to asylum. Conceptually, it tests hypotheses concerning the relation between national parties and Members of European Parliament (MEPs). The computer-based content analysis method Wordfish is used to examine 876 speeches from 2004-2...

Psychological distress and the asylum process: a longitudinal study of forced migrants in Ireland.

Science.gov (United States)

Ryan, Dermot A; Benson, Ciarán A; Dooley, Barbara A

2008-01-01

Although asylum seeking has become a major political issue in the Western world, research on its psychological impact is still in its infancy. This study examined levels and predictors of distress among a community sample of persons who have sought asylum in Ireland. A key aim was to provide a longitudinal analysis of the relationship between legal status security and psychological distress. Distress was measured by the Symptom Checklist-90-Revised at Time 1 (N = 162) and its shorter version (the Brief Symptom Inventory) at Time 2 (N = 70). Levels of severe distress were high at both baseline (46%) and follow-up (36%). The only persons to show a decrease in distress were those who had obtained a secure legal status (e.g., refugee status or residency) between the study phases. Distress risk factors included female gender, an insecure legal status, separation from children, discrimination, and postmigration stress. Protective factors were social support (Time 1) and the presence of a partner. The findings suggest that asylum seekers are a high-risk group for distress. This risk can be reduced by appropriate policy changes and interventions to increase social resources.

The impact of the refugee decision on the trajectory of PTSD, anxiety, and depressive symptoms among asylum seekers: a longitudinal study.

Science.gov (United States)

Silove, Derrick; Steel, Zachary; Susljik, Ina; Frommer, Naomi; Loneragan, Celia; Chey, Tien; Brooks, Robert; le Touze, Dominique; Ceollo, Mariano; Smith, Mitchell; Harris, Elizabeth; Bryant, Richard

2007-01-01

To examine prospectively the trajectory of trauma-related psychiatric symptoms and disability amongst asylum seekers over the course of the refugee determination process. To identify the direct impact of the refugee decision on psychiatric symptoms by adjusting for other variables, namely sociodemographic characteristics, past trauma, and ongoing postmigration stresses. A prospective cohort study of asylum seekers recruited from a random sample of immigration agents in Sydney, Australia. Consecutive asylum seekers were referred for interview by immigration agents. Interviews were undertaken after the initial application and on average, 3.8 months after the refugee decision. Measures assessed premigration trauma and postmigration stressors. Mental health status was assessed using the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist-25. Functional impairment was assessed with the Medical Outcomes Study-Short Form 12. Sixty-two of 73 asylum seekers were retained at follow-up. The accepted (16) and rejected (46) groups did not differ on premigration trauma or baseline psychiatric symptoms. Postdecision, the accepted group showed substantial improvements in posttraumatic stress disorder, anxiety, depression, and in mental health functioning, whereas the rejected group maintained high levels of symptoms on all psychiatric indices. Establishing secure residency status for asylum seekers may be important to their recovery from trauma-related psychiatric symptoms. The practical and theoretical implications are discussed.

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

NARCIS (Netherlands)

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

2018-01-01

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

People Seeking Asylum in Australia and their Access to Employment: Just What Do We Know?

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Caroline Fleay

2016-07-01

Full Text Available Public and political claims about the employment of people from a refugee background in Australia do not always reflect the research findings in this area. For example, recent claims by a senior Coalition Government Minister about people seeking asylum who arrived to Australia by boat during the previous Labor Government’s terms in office (2007-13 posit that many have limited employment prospects. However, given there is little research or government reporting on the experiences of asylum seekers who arrived during this time, and none that focuses specifically on their employment, there is no evidence to support this. A review of research on the employment experiences of people from a refugee background, and Australian policies, suggests a more nuanced picture. This includes research that found while initially people from a refugee background are more likely to be unemployed, have temporary jobs and lower incomes than other newly arrived immigrants, second-generation refugees have higher levels of labour market participation than the general population. Research also highlights that refugees may experience a range of barriers to accessing employment, including discrimination, and a review of Australian policies indicates these are likely to have exacerbated some of these barriers for asylum seekers who arrived to Australia by boat. In addition, given previous findings that public attitudes can be influenced by representations made in public and political discourses, the public statements of senior Ministers may be further deepening barriers to accessing employment faced by asylum seekers who arrived by boat.

A foot in the door: access to asylum in South Africa

NARCIS (Netherlands)

Vigneswaran, D.

2008-01-01

Asylum seekers in South Africa experience extreme difficulties lodging their claimsat the Department of Home Affairs. This paper utilises new survey data to measurethe extent of the Department’s failures to provide access to the status determination process. The principal finding is that South

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

Science.gov (United States)

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.

A foot in the door: access to asylum in South Africa

NARCIS (Netherlands)

Vigneswaran, D.

2008-01-01

Asylum seekers in South Africa experience extreme difficulties lodging their claims at the Department of Home Affairs. This paper utilizes new survey data to measure the extent of the Department’s failures to provide access to the status determination process. The principal finding is that South

Unaccompanied adolescents seeking asylum: Poorer mental health under a restrictive reception

NARCIS (Netherlands)

Reijneveld, S.A.; Boer, J.B.de; Bean, T.; Korfker, D.G.

2005-01-01

We assessed the effects of a stringent reception policy on the mental health of unaccompanied adolescent asylum seekers by comparing the mental health of adolescents in a restricted campus reception setting and in a setting offering more autonomy (numbers [response rates]: 69 [93%] and 53 [69%],

The Impact of Externalization of Migration Controls on the Rights of Asylum Seekers and Other Migrants

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Bill Frelick

2016-12-01

Full Text Available Wars, conflict, and persecution have forced more people to flee their homes and seek refuge and safety elsewhere than at any time since the end of World War II. As displaced people and other migrants increasingly move out of the conflict-ridden and less developed regions of their displacement and into relatively rich and stable regions of the world, the countries of destination are increasingly working to contain and even stem the migration flow before it reaches their shores. Perversely, countries that have developed generally rights-sensitive standards and procedures for assessing protection claims of asylum seekers within their jurisdictions have simultaneously established barriers that prevent migrants, including asylum seekers, from setting foot on their territories or otherwise triggering protection obligations. Consequently, those who would otherwise have been able to avail themselves of asylum procedures, social support, and decent reception conditions are often relegated to countries of first arrival or transit that have comparatively less capacity to ensure protection of human rights in accordance with international standards.This paper seeks to develop a working definition of the externalization of migration controls and how such externalization of the border implicates the human rights of migrants, and asylum seekers in particular. Although the majority of those migrants seeking legal protections stay in countries neighboring their own, hundreds of thousands continue their journeys in search of protection and stability in more distant states, including in the European Union, the United States, and Australia. In response to the significant increase in asylum seekers arriving at their borders, all three entities have significantly increased deterrence measures with the hopes of keeping new arrivals from entering. This paper will thus highlight a number of the most troubling externalization strategies used by the European Union, the

To deter, distance and dehumanise: mandatory immigration detention and offshore processing of asylum seekers under Australian law

OpenAIRE

Penovic, Tania

2017-01-01

This thesis examines the law and practice concerning two key policies directed at asylum seekers who arrive or attempt to arrive in Australia by boat; immigration detention and offshore processing. It is comprised of four parts. Part 1 provides an overview of the thesis, consolidating the published material with reference to political theory. A summary of the chapters is provided in Part II. Part III considers the contribution maoe by my work to the literature on asylum seeker policy in...

Protection of asylum seekers and illegal migrants human rights: Practice of the European Court of Human Rights

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Đukanović Anđela

2015-01-01

Full Text Available Protection of asylum seeker and Illegal migrants human rights, has often been difficult due to the need of states to regulate unwanted migration flows. European Court of Human Rights plays an important role in protecting the rights of these individuals, through a set of human rights. Requests for interim measures under Rule 39 of the Rules of Court also have great importance. In cases involving illegal migrants and asylum-seekers, Court was often in difficult position, given the contradictions that could arise from the protection of human rights and the legitimate aim of the Contracting States to control the entry, residence and expulsion of aliens. Recent Courts judgment in case of M. S. S. against Belgium is particularly important, because of its remarkable influence on the perception of a common asylum system in the EU, as well as the judgment in the case of Jama Hirsi and Others v. Italy.

The Refugee Health Nurse Liaison: a nurse led initiative to improve healthcare for asylum seekers and refugees.

Science.gov (United States)

McBride, Jacquie; Russo, Alana; Block, Andrew

2016-12-01

Asylum seekers and refugees experience a range of barriers to health service access and competent use. The Refugee Health Nurse Liaison initiative was piloted at a hospital in a high-settlement region of Victoria, Australia. This initiative aimed to build capacity within the health sector to more effectively respond to the needs of asylum seekers and refugees. A mixed-methods evaluation was undertaken to: describe issues encountered by asylum seekers and refugees within the hospital setting; capture the nature of the Refugee Health Nurse Liaison position; and document key outputs. Throughout the pilot period, 946 patients were referred to the role, of which 99% received an assessment of physical, mental, and social health. Refugee Health Nurse Liaisons effectively provided clinical support, advocacy, education, referrals, and both formal and informal capacity building. Learnings from this model are transferable to services in high-settlement regions, and could have application in improving patient care more broadly.

Health services for asylum seekers and refugees in Europe: consequences for policymaking.

NARCIS (Netherlands)

Devillé, W.; Goosen, S.

2006-01-01

Reception and integration of asylum seekers and refugees are high on the political agenda in most European countries. Reception conditions, including the provision of health care, differ considerably between countries. The European Commission tries to harmonise the reception standards in the

Image of Refugees and Asylum-Seekers in the Media: An Evaluation on Media Politics

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Suat Kolukırık

2009-06-01

Full Text Available The case of refugees and asylum-seekers constitutes one of the most important problems of today’s developed and developing countries. Immigration and sanctuary which arise generally from economic causes have reached a more intensified state due to deficiencies in the process of democratization and establishment of an environment of peace. Although it is difficult to provide an exact number, it is observed that a population of more than 10 million people in the world today continue their lives outside their home countries and seek new environments for survival. It is known that refugee mobility follows a route from the south to northern countries and in the case of Turkey it is realized along the coastal lines and through east/south highways, and occupies a significant area of coverage in the Turkish printed media. This article aims to analyze and evaluate the media language and discourse on the lives of refugees or asylum seekers through the perspective of democratization and human rights. Critical discourse analysis will be used to analyze the main axes of enquiry which include the news released in the Turkish printed media on refugees and asylum seekers, the approach adopted in shaping such news coverage, the messages they convey, and their role in molding public opinion

Discursive Representations of Asylum Seekers and Illegal Immigrants in Ireland

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Elaine Burroughs

2013-12-01

Full Text Available Migrants are often referred to as an all encompassing group of people and the “many faces of migration”, the variety of people, legalities and complexities involved, can be overlooked. The same can be said for non-EU migrants in the Irish context. Non-EU migrants (or those that are not Caucasian are generally viewed to be a distinct cohort of comparable migrants. Indeed, these migrants are often portrayed in a broadly negative way by key Irish institutions (such as the parliament or the media, and these representations impact upon how Irish society views non-EU migration and indeed migration in general. While Ireland is by no means the only European country in which this type of practice occurs, this paper aims to draw attention to generalized, inaccurate and misleading representations of non-EU migrants in Ireland, by specifically examining representations of asylum seekers and illegal immigrants. There can be an overlap in how these “types” of migrants are conceptualized and this paper therefore aims to develop an understanding of the implications involved for migrants categorized as an “asylum seeker” or an “illegal immigrant.” Furthermore, these topics are under-researched within the Irish context, yet they receive much political and public attention. At the same time however, this paper aims to challenge the labels assigned to non-EU migrants and the terminology that is used to define their identity so concretely. In the Irish context there is much confusion in relation to the multiple “faces” of non-EU migration, as a range of terminology is used to refer to them. This terminology is often used in an interchangeable manner, in an array of societal contexts. There is a consistent (whether this happens intentionally or unintentionally is debatable misuse of categories and migration terminology in Irish institutional discourses. Quite often those seeking asylum are referred to as illegal immigrants and vice versa

Stool screening of Syrian refugees and asylum seekers in Germany, 2013/2014: Identification of Sabin like polioviruses.

Science.gov (United States)

Böttcher, Sindy; Neubauer, Katrin; Baillot, Armin; Rieder, Gabriele; Adam, Maja; Diedrich, Sabine

2015-10-01

Germany is a partner of the Global Polio Eradication Initiative. Assurance of polio free status is based on enterovirus surveillance, which focuses on patients with signs of acute flaccid paralysis or aseptic meningitis/encephalitis, representing the key symptoms of poliovirus infection. In response to the wild poliovirus outbreak in Syria 2013 and high number of refugees coming from Syria to Germany, stool samples from 629 Syrian refugees/asylum seekers aged Syrian refugees and asylum seekers at that time. Copyright © 2015 Elsevier GmbH. All rights reserved.

Asylum seekers, violence and health: a systematic review of research in high-income host countries.

Science.gov (United States)

Kalt, Anne; Hossain, Mazeda; Kiss, Ligia; Zimmerman, Cathy

2013-03-01

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.

Contact tracing using DNA fingerprinting in an asylum seeker with pulmonary tuberculosis.

NARCIS (Netherlands)

Loenhout-Rooyackers, J.H. van; Sebek, M.M.; Verbeek, A.L.M.

2002-01-01

BACKGROUND: The diagnosis of tuberculosis in asylum seekers is followed by contact tracing, which is routinely performed by the Municipal Health Service (MHS). We investigated cases of tuberculosis whose symptoms became apparent after closure of regular contact tracing. METHODS: Analysis of data

78 FR 19077 - Forwarding of Asylum Applications to the Department of State

Science.gov (United States)

2013-03-29

... officers can better utilize their time and resources toward accomplishing their asylum responsibilities... form of post-traumatic stress or depression that affects long-term memory, making credibility... specific protection claims will allow DOS to better focus its limited resources. The existing process is...

Pro-asylum Advocacy in the EU: Challenging the State of Exception

NARCIS (Netherlands)

H.M. Hintjens (Helen); R. Kumar (Rajiv); A. Pouri (Ahmed)

2011-01-01

textabstractIntroduction. This chapter explores examples of how pro-asylum advocates challenge the harsh measures used to punish those who try to enter or reside in the EU illegally, taking examples from The Netherlands and the UK. We explore organized resistance to the ‘3-Ds’, which are so typical

8 CFR 1240.33 - Applications for asylum or withholding of deportation.

Science.gov (United States)

2010-01-01

... immigration judge shall: (1) Advise the alien that he or she may apply for asylum in the United States or..., DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS PROCEEDINGS TO DETERMINE REMOVABILITY OF ALIENS IN THE UNITED... determination of excludability from the United States pursuant to this subpart, and the alien has not been...

Reconstructing Harry: a genealogical study of a colonial family 'inside' and 'outside' the Grahamstown Asylum, 1888-1918.

Science.gov (United States)

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.

Harming asylum seekers’ chances through poor use of human rights treaties

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Stephen Meili

2013-05-01

Full Text Available Over the past decade, UK courts and administrative tribunals havebecome increasingly comfortable relying on international human rightstreaties in cases where non-citizens claim asylum or other means ofprotection from persecution. However, this trend does not mean thatthese treaties have always been deployed by refugee lawyers in wayswhich benefit their clients.

Involuntary sterilization among HIV-positive Garifuna women from Honduras seeking asylum in the United States: Two case reports.

Science.gov (United States)

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.

Value of Developing Plain Language Summaries of Scientific and Clinical Articles: A Survey of Patients and Physicians.

Science.gov (United States)

Pushparajah, Daphnee S; Manning, Elizabeth; Michels, Erik; Arnaudeau-Bégard, Catherine

2017-01-01

We sought to determine the value and feasibility of developing plain language summaries (PLS) of peer-reviewed articles for patients. Members of the European Patients Academy on Therapeutic Innovation or UCB Pharma (N = 74) with a diagnosis of chronic disease, as well as a group of randomly selected neurologists in the US (N = 90) participated in online surveys. Two physicians, 5 patients, and 1 caregiver participated in interviews. Patient survey and interview participants reported that they routinely sought health-related information online. Articles in scientific journals were ranked the third most important source in the survey (47%), after general Internet searches (61%) and patient-specific websites (57%). Survey physicians were equivocal in their views; 46% rated PLS as valuable, 46% as neutral, and 8% as not valuable; however, 60% reported they would use them. A predominant theme emerging in patient interviews was the importance of knowledge and the sense of empowerment it engenders. Patients viewed PLS as tools to facilitate knowledge sharing and making important information accessible. In interviews, physicians noted the value of PLS in generating dialogue, saving time and streamlining communication with patients, as patients are not completely dependent on them for information. Our results indicate PLS could play an important role in the patient-physician dialogue. Although patients in this study tended to be more informed and engaged than the general patient population, with continued expansion of online platforms and open-access publishing, it is likely that greater numbers of patients will seek more specialized health-related information in the future.

Turning Asylum Seekers into ‘Dangerous Criminals’: Experiences of the Criminal Justice System of those Seeking Sanctuary

Directory of Open Access Journals (Sweden)

Monish Bhatia

2015-10-01

Full Text Available Since the events of 9/11 in the US in 2001 and, four years later, the 7/7 London bombings in the UK, warnings of terrorist attacks are high on the public agenda in many western countries. Politicians and tabloid press in the UK have continued to make direct and indirect connections between asylum seekers, terrorism and crime. This has increasingly resulted in harsh policy responses to restrict the movement of ‘third-world’ nationals, criminalisation of immigration and asylum policy, and making the violation of immigration laws punishable through criminal courts. This paper largely highlights the narratives of five asylum seekers who committed ‘crime’ by breaching immigration laws and were consequently treated as ‘dangerous criminals’ by the state authorities. More importantly it shows how these individuals experienced this treatment. The aim of this paper is to give voice to the victims of state abuse, claim space for victim agency, gather victim testimonies, challenge official explanations and in the process confront criminal and racist state practices.

The asylum-jihadism nexus: non-government actors and detection of jihadism among asylum seekers. : A case study of the Dutch Refugee Council and the guardianship organization for unaccompanied minors (Nidos).

NARCIS (Netherlands)

van Wijk, J.; Bolhuis, M.P.

2017-01-01

This article explores why, how and to what extent two non-government organizations working with asylum seekers in the Netherlands engage in the detection of jihadism. It concludes that the organizations acknowledge the importance of sharing possible signs of jihadism with relevant governmental

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

Science.gov (United States)

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.

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.

Science.gov (United States)

Keygnaert, Ines; Vettenburg, Nicole; Roelens, Kristien; Temmerman, Marleen

2014-05-01

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. 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. 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. 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

Discrepancies in autobiographical memories— implications for the assessment of asylum seekers: repeated interviews study

Science.gov (United States)

Herlihy, Jane; Scragg, Peter; Turner, Stuart

2002-01-01

Objective To investigate the consistency of autobiographical memory of people seeking asylum, in light of the assumption that discrepancies in asylum seekers' accounts of persecution mean that they are fabricating their stories. Design Repeated interviews. Setting England, 1999 and 2000. Participants Community sample of 27 Kosovan and 12 Bosnian refugees. Main outcome measures Discrepancies in repeated descriptions of one traumatic and one non-traumatic event, including specific details, rated as central or peripheral to the event. Self report measures of post-traumatic stress disorder and depression. Results Discrepancies between an individual's accounts were common. For participants with high levels of post-traumatic stress, the number of discrepancies increased with length of time between interviews. More discrepancies occurred in details peripheral to the account than in details that were central to the account. Conclusion The assumption that inconsistency of recall means that accounts have poor credibility is questionable. Discrepancies are likely to occur in repeated interviews. For refugees showing symptoms of high levels of post-traumatic stress, the length of the application process may also affect the number of discrepancies. Recall of details rated by the interviewee as peripheral to the account is more likely to be inconsistent than recall of details that are central to the account. Thus, such inconsistencies should not be relied on as indicating a lack of credibility. What is already known on this topicDiscrepancies between accounts of an event are often used to judge the credibility of asylum seekersWhat this study addsDiscrepancies arise between two accounts of the same event even when there is no reason for fabricationRefugees with high levels of post-traumatic stress are more likely to give inconsistent accounts if they have a long time to wait between interviewsInterviewees are more likely to be inconsistent in details that they rate as peripheral

ETHICAL ASPECTS OF THE COOPERATION BETWEEN PHYSICIAN AND PHARMACEUTICAL INDUSTRY

Directory of Open Access Journals (Sweden)

Jože Drinovec

2001-09-01

Full Text Available Background. It is not possible to isolated ethical aspects and norms in the work of physician from the professional and scientific ones. The physician will not act contrary to ethical principles if he will work for the interests of the patient and in accordance with scientific knowledge.Present situation and possible solutions. Every physician, especially if working in university institution is co-operating with pharmaceutical industry, at least he is makes the prescriptions and chooses one drug of the possible ones. There are also other aspects of co-operation: clinical trials, writing expertise and lectures at scientific meetings, sponsored by pharmaceutical industry. There are guidelines and codex in Western countries for more than ten years, which regulate the relation between physician and pharmaceutical industry. The most important ones are those from World Health Organisation, European Federation of Pharmaceutical Industries’ Associations’, and International Federation of Pharmaceutical Manufacturers Associations’. Scientific independence of lecturers and writers is tried to be achieved by disclosure of relevant financial relation with pharmaceutical corporation in advance.Conclusions. Physician working with pharmaceutical industry has o follow the guidelines of international professional associations. He/she has to be independent relaying only upon scientific and professional principles seeing primary the benefit of the patient.

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

Science.gov (United States)

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.

Refugee, Asylum Seeker and Immigrant Women Mental Health

Directory of Open Access Journals (Sweden)

Ayse Devrim Basterzi

2017-12-01

Full Text Available Social situation, social networks, power relationships, socioeconomic conditions, education and physical environment of people affect to encounter with trauma and disasters. These social factors also have an effect on traumatized people’s mental health. Gender roles are affected these entire social context and mental disorders. War and migration frequently lead to increasing inequality between men and women. This article reviews the studies about refugee, asylum seeker and immigrant’s women mental health and gender roles. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(4.000: 379-387

The Asylum-Seeker and Refugee Experience - An Interpretative Phenomenological Analysis of Interview Data Elicited Through the Use of Artefacts

OpenAIRE

Allan, J; Williams, G; Charura, D; Cohen, E; Meth, F; Shaw, M; Taylor, S

2017-01-01

Theme 3: Protection of the ‘most vulnerable’ - children, young people growing up in ‘austerity’ older people, migrants Background: There is a pressing need to understand the experiences of those who undertake forced migration. The UNHCR (2016) has reported that “one in every 113 people globally is now either an asylum-seeker, internally displaced or a refugee” - this is at its highest level since the Second World War. Aims: This study sought to explore the lived experiences of asylum-seekers ...

The Impact of Detention on the Health of Asylum Seekers: A Systematic Review

DEFF Research Database (Denmark)

Filges, Trine; Montgomery, Edith; Kastrup, Marianne

2015-01-01

and relevant reviews were also searched. SELECTION CRITERIA All study designs that used a well-defined control group were eligible for inclusion. Studies that utilized qualitative approaches were not included. DATA COLLECTION AND ANALYSIS The total number of potential relevant studies constituted 11,376 hits....... A total of nine studies, consisting of 12 papers, met the inclusion criteria and were critically appraised by the review authors. The final selection comprised nine studies from four different countries. Two studies reported on the same sample of asylum seekers in Australia at different time points after...... detained, and one study provided data less than a year after release. The total number of participants in these three studies was 359. We performed analyses separately for these time points. All outcomes were measured such that a negative effect size favours the detained asylum seekers, i.e. when an effect...

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

Science.gov (United States)

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 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.

Seeking asylum in Australia: immigration detention, human rights and mental health care.

Science.gov (United States)

Newman, Louise; Proctor, Nicholas; Dudley, Michael

2013-08-01

The article aims to discuss the impact of mandatory detention and human rights violations on the mental health of asylum seekers and the implications for psychiatrists and health professionals. Advocacy for human rights and engagement in social debate are core ethical and professional responsibilities. Clinicians need to maintain a focus on ethical obligations.

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

Science.gov (United States)

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.

Unaccompanied Asylum-Seeking Refugee Children’s Forced Repatriation: Social Workers’ and Police Officers’ Health and Job Characteristics

Science.gov (United States)

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

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

Science.gov (United States)

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…

76 FR 67099 - Forwarding of Asylum Applications to the Department of State

Science.gov (United States)

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...

An exploration of the connection between two meaning perspectives: an evidence-based approach to health information delivery to vulnerable groups of Arabic- and Somali-speaking asylum seekers in a Swedish context.

Science.gov (United States)

Ekblad, Solvig; Linander, Andrea; Asplund, Maria

2012-09-01

The right to health care is significant for asylum seekers, particularly as many of them have experienced traumatic life events in their home country, during flight or in their host country. Post-migration living conditions have more impact than pre-migration conditions on ill health among asylum seekers, which underscores the importance of health care-related refugee reception policies. The purpose of this article is to explore the perceived meaning of comprehensive health information provided by a nurse to Arabic- and Somali-speaking adult asylum seekers, in a Swedish context, during its introduction at the Migration Board. In our study, the endpoint was whether asylum seekers found such health information relevant, understandable and respectful. Following an oral presentation, participants filled in a questionnaire consisting of three close-ended questions. A total of 39 groups of presentation attendees included 626 asylum seekers (415 Arabic- and 211 Somali-speaking). Data were analysed with descriptive statistics. Comments underwent content analysis. We also present some socio-demographic data on these asylum seekers. Independently of gender and language, the participants expressed their gratitude for and the meaningfulness of receiving professional, fact-based information, as well as being treated with concern and respect. They indicated a great need for this and felt relieved by being listened to. They liked the pedagogic group method, the opportunity for dialogue and to practice exercising their rights. These promising results indicate that exercising the asylum-seekers' right to receive such health information would improve future reception policies not only in Sweden, but throughout the EU. A renewed focus on communication and pedagogic skills, instead of just cultural training, should be considered for health care professionals assisting asylum seekers.

Clinical trials attitudes and practices of Latino physicians.

Science.gov (United States)

Ramirez, Amelie G; Wildes, Kimberly; Talavera, Greg; Nápoles-Springer, Anna; Gallion, Kipling; Pérez-Stable, Eliseo J

2008-07-01

Ethnic differences in physicians' attitudes and behaviors related to clinical trials might partially account for disparities in clinical trial participation among Latino patients. Literature regarding Latino physicians' clinical trials attitudes and practices, in comparison to White physicians, was lacking. Cross-sectional data from randomly selected physicians (N=695), stratified by ethnicity, were analyzed to test associations of ethnicity with physicians' participation in and attitudes toward referral of patients to clinical trials. Chi-square analyses showed significant (pLatino physicians were significantly less involved in clinical trials than White physicians and found less scientific value in them, highlighting areas for future education and intervention.

Case Report: Access to Personal Data and the Right to Good Governance during Asylum Procedures after the CJEU’s YS. and M. and S. judgment

NARCIS (Netherlands)

Brouwer, E.R.; Zuiderveen Borgesius, F.J.

2015-01-01

In the YS. and M. and S. judgment, the Court of Justice of the European Union ruled on three procedures in which Dutch judges asked for clarification on the right of asylum seekers to have access to the documents regarding the decision on asylum applications. The judgment is relevant for

Awareness Trainings and Detecting Jihadists among Asylum Seekers: A Case Study from the Netherlands

NARCIS (Netherlands)

van Wijk, J.; Bolhuis, M.P.

2017-01-01

Dutch frontline professionals who work with asylum seekers receive awareness training to assist them in identifying possible signs of jihadist convictions. During these training sessions, they are provided with a complex, ambiguous, and multi-interpretable advice on how to detect such convictions.

Language Analysis in the Context of the Asylum Process: Procedures, Validity, and Consequences

Science.gov (United States)

Reath, Anne

2004-01-01

In 1993, the language section of the Swedish Migration Board initiated the production of documents they called "language analyses" to aid in the processing of asylum seekers. Today, 11 years later, 2 privately owned companies in Stockholm produce these documents. These companies have produced language analyses not only for the Swedish…

[Germany's unique panoptical asylum--an appreciation of the first Bavarian mental home in Erlangen].

Science.gov (United States)

Braun, B; Kornhuber, J

2013-03-01

There are only two edifices left that represent one of the most impressive cultural monuments of mental homes in Middle Europe. Government and institutions are removing these historical buildings to establish a modern "Translational Research Centre". Our objective is to illustrate the significance of the asylum in the history of psychiatric architecture. In the context of the history of psychiatry we analysed and interpreted relevant primary sources, secondary literature and selected illustrations. Several panoptical asylums were built in Great Britain. In France, Italy and Germany, a unique example was realised. The entire ward could be checked from a central room. This ensured the optimal surveillance of the patients and enabled the minimisation of staff. In contrast to the vicinal emergent industrial cities Erlangen disposed of enough building ground. There, Johann Michael Leupoldt (1794-1874) gave lectures dealing only with psychiatry. Thanks to his advice, the first Bavarian mental home was completed within only 12 years. The cruciform floor plan was supplemented by cross buildings. This constituted a relevant modification of the panoptical system. Although the "H-design" has been evaluated as more adequate, the obsolete architectural "concept of rays" was chosen for the asylum in Erlangen. Did financial distress play a decisive role? Neither the files nor Leupoldt's autobiography take a firm stand on this point. As the TRC-project may serve as a document for future medical progress, it is important to remember the "Kreis-Irrenanstalt Erlangen" as a milestone in the evolution of psychiatric architecture. © Georg Thieme Verlag KG Stuttgart · New York.

Communities of belonging in the temporariness of the Danish Asylum System: Shalini’s anchoring points

DEFF Research Database (Denmark)

Verdasco, Andrea

2018-01-01

Refugees often find themselves in a protracted situation of temporariness, as applications for asylum are processed, deportations negotiated and possible extensions of temporary protection status considered within the context of increasingly restrictive governmental policies across Europe. Through...

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

Science.gov (United States)

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

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

Science.gov (United States)

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 (pSyria when compared to other nationalities of asylum seekers from the Middle East.

Responses to language barriers in consultations with refugees and asylum seekers: a telephone survey of Irish general practitioners.

LENUS (Irish Health Repository)

MacFarlane, Anne

2008-01-01

BACKGROUND: Refugees and asylum seekers experience language barriers in general practice. Qualitative studies have found that responses to language barriers in general practice are ad hoc with use of both professional interpreters and informal interpreters (patients\\' relatives or friends). However, the scale of the issues involved is unknown. This study quantifies the need for language assistance in general practice consultations and examines the experience of, and satisfaction with, methods of language assistance utilized. METHODS: Data were collected by telephone survey with general practitioners in a regional health authority in Ireland between July-August 2004. Each respondent was asked a series of questions about consulting with refugees and asylum seekers, the need for language assistance and the kind of language assistance used. RESULTS: There was a 70% (n = 56\\/80) response rate to the telephone survey. The majority of respondents (77%) said that they had experienced consultations with refugees and asylum seekers in which language assistance was required. Despite this, general practitioners in the majority of cases managed without an interpreter or used informal methods of interpretation. In fact, when given a choice general practitioners would more often choose informal over professional methods of interpretation despite the fact that confidentiality was a significant concern. CONCLUSION: The need for language assistance in consultations with refugees and asylum seekers in Irish general practice is high. General practitioners rely on informal responses. It is necessary to improve knowledge about the organisational contexts that shape general practitioners responses. We also recommend dialogue between general practitioners, patients and interpreters about the relative merits of informal and professional methods of interpretation so that general practitioners\\' choices are responsive to the needs of patients with limited English.

Reconstructing Harry: A Genealogical Study of a Colonial Family ‘Inside’ and ‘Outside’ the Grahamstown Asylum, 1888–1918

Science.gov (United States)

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

A Home at the End of the World: Eritrean and Sudanese Asylum Seekers in Tel Aviv, Israel

Directory of Open Access Journals (Sweden)

David Clinton Wills

2017-04-01

Full Text Available This paper explores the ways in which national culture intersects with urban environs to produce multinational subjectivity. Specifically, this paper shows the activity of Eritrean and Sudanese asylum seekers in Tel Aviv, Israel, as particularly generative of the life world building of Southern Tel Aviv (known as Little Africa. Juxtaposing these spaces of urban life, this paper also looks at the Holot Detention Facility as a space of life as well, situating the asylum seeker along various, migratory paths towards citizenship. With the near-total recreation of African life, this paper examines the Neve Sha’anan neighborhood as supportive of the LGBT and migrant communities, evidencing the flourishing of national culture outside of traditional boundaries. Particularly, this paper looks at “The Prevention of Infiltration Law” to discuss ideas of “infiltrators” using frameworks from Foucault, Merleau-Ponty, Levinas, Jean-Luc Nancy and Achille Mbembe. Examining ideas of space, place, ethics, embodiment, law, the body, street art, border fences, architecture, and minimalism, this paper juxtaposes BLM (Black Lives Matter and BDS (Boycott, Divestment, Sanctions from a transnational perspective of world-building, asking the question of where can one call a place, home.    Keywords: Tel Aviv, Eritrea, Sudan, asylum seekers, infiltration

"What if No One Had Spoken out Against this Policy?" The Rise of Asylum Seeker and Refugeee Advocacy in Australia

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Diane Gosden

2006-02-01

Full Text Available This paper examines the rise of an asylum seeker and refugee advocacy movement in Australia in recent years. It situates this phenomenon within Alberto Melucci's understanding of social movements as variable and diffuse forms of social action involved in challenging the logic of a system. Following this theoretical framework, it explores the empirical features of this particular collective action, as well as the struggle to redefine the nature of the relationship between citizens of a sovereign state and 'the other' in the personage of asylum seekers and refugees.

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

Science.gov (United States)

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.

'At variance with the most elementary principles': the state of British colonial lunatic asylums in 1863.

Science.gov (United States)

Brunton, Warwick

2015-06-01

In 1863 the Colonial Office reviewed colonial hospitals and lunatic asylums in those parts of the British Empire it administered - probably the first and widest international comparative study up to that date. This article outlines the background, process and scope of the review of asylums, and considers its significance. The resulting 'digest' is an important source to explain how, why, when and by whom metropolitan ideas acquired official endorsement and spread throughout the British world. Using the review's general findings and suggestions, a tool is provided for comparing inter-colonial achievements. With New Zealand as a case study, the article concludes that, relative to other influences, the digest played a limited and largely indirect part in shaping New Zealand's mental health policy before 1876. © The Author(s) 2015.

Seeking asylum in Denmark: Refugee children's mental health and exposure to violence

DEFF Research Database (Denmark)

Montgomery, Edith; Foldspang, Anders

2005-01-01

Aims: The aim of this study was to compare profiles of present mental health and previous exposure to violence among refugee children from the Middle East, whose asylum seeking families either did or did not obtain permission to stay in Denmark. Methods: Shortly after arrival in Denmark, the pare......Aims: The aim of this study was to compare profiles of present mental health and previous exposure to violence among refugee children from the Middle East, whose asylum seeking families either did or did not obtain permission to stay in Denmark. Methods: Shortly after arrival in Denmark...... in a refugee camp, and seven out of 10 had witnessed violence. Half of the children had a tortured parent. Considerably more children of families who did not get a residence permit had lost a parent (30.6% versus 13.7%; P , 0.001). In both groups about two-thirds suffered from anxiety and about 30% from sleep...... exposure to violence and their present mental health. There seems to be good reason to systematically integrate evidence on the children of refugee families in the treatment of applications for permission to stay....

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.

Science.gov (United States)

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

The National Asylum for the Insane in the Rio de Janeiro press (1903-1911

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Ana Teresa A. Venancio

2017-12-01

Full Text Available During the first decade of the twentieth century, the press of the republican capital disseminated representations and helped to form opinions about the National Hospice of Alienated Persons (HNA, the first Brazilian psychiatric institution, which began to function in the city of Rio de Janeiro in 1852. For this investigation we have analyzed the news about the hospice in two newspapers - O Paiz and Correio da Manhã. We follow here the most recent Brazilian historiography, as well as the history of psychiatry in Ibero-American countries, to discuss the emphasis given to the social control function of the asylum and to point out its hybrid and multifaceted character in the news that circulated in the press of the federal capital. In the two newspapers, the varied set of references to the HNA puts into circulation three points of view: the first two express how the institutional life, in its different aspects (administrative, welfare, scientific is described and portrayed by the press; while the third point of view brings together the situations in which the hospice is considered as a solution for events that disturb the life of the city.

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

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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.

Review of infectious diseases in refugees and asylum seekers—current status and going forward

DEFF Research Database (Denmark)

Eiset, Andreas Halgreen; Wejse, Christian

2017-01-01

(up to 11%), and hepatitis B (up to 12%). The same population had low prevalence of malaria (7%) and hepatitis C (up to 5%). There have been recent case reports from European countries of cutaneous diphtheria, louse-born relapsing fever, and shigella in the asylum-seeking and refugee population...

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

Science.gov (United States)

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

Post-traumatic stress disorder among asylum seekers and refugees in Istanbul may be predicted by torture and loss due to violence.

Science.gov (United States)

Tufan, Ali Evren; Alkin, Melis; Bosgelmez, Sukriye

2013-06-01

Turkey is both a source and target for asylum seekers seeking refugee status in countries of European Union. There is a scarcity of research on the mental health issues of asylum seekers and refugees residing in Turkey. This study aimed: 1) to provide clinical and demographic information on asylum seekers and refugees receiving mental health services from a non-governmental refugee support program in Istanbul between 2005 and 2007, and 2) to evaluate the differences between patients diagnosed with post-traumatic stress disorder (PTSD) with those who did not meet criteria. The study was conducted at the Mental Health Division of the Refugee Advocacy Support Group. Between July 2005 and February 2007, 1209 asylum seekers applied to the support group; 75 of these individuals (6.2%) were referred for psychiatric evaluation while 57 were diagnosed as having a psychopathology. The number of analyzed subjects was 57. PTSD and major depressive disorder were the most common diagnoses (55.2% for both). The most common criteria of PTSD reported were problems in concentration and social isolation (97.3% for both). Suffering torture and losing a significant other due to violence were found to be associated with a diagnosis of PTSD. This study is the first of its kind to be conducted on a mixed refugee population residing in Turkey and focusing on their mental health problems. Our results should be tested within larger samples of refugees residing in different cities of Turkey.

Negotiating Narratives, Accessing Asylum: Evaluating Language Policy as Multi-Level Practice, Beliefs and Management

Science.gov (United States)

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…

Being Able to Play: Experiences of Social Inclusion and Exclusion Within a Football Team of People Seeking Asylum

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Darko Dukic

2017-06-01

Full Text Available Australian policy makers and funding organisations have relied heavily on sport as a vehicle for achieving the goals of social cohesion and social inclusion. The generally accepted premise that sport includes individuals in larger social contexts, and in doing so creates positive social outcomes, remains largely untested and uncontested. This article considers the ways in which playing in an asylum seeker football team, located in Melbourne, Australia, facilitates both inclusive and exclusive experiences for its participants. Drawing on ethnographic fieldwork, life histories, and policy analysis, this article identifies the often-ignored importance of a sporting habitus and physical capital in individuals’ experiences of playing. The success or failure of the asylum seeker team to foster social inclusion is somewhat tenuous as the logic of competition can create conditions counter to those that would be recognised as inclusive. Further, such programmes are faced with sustainability problems, as they are heavily reliant on individuals within the organisation and community to “make things happen”. However, we suggest that for many men, the asylum seeker team provides an important site for the development and appreciation of ‘poly-cultural’ capital that contributes to forms of resilience and the achievement of other indicators of social inclusion.

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

OpenAIRE

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

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 outb...

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

NARCIS (Netherlands)

Keygnaert, I.; Dias, S.F.; Degomme, O.; Devillé, W.; Kennedy, P.; Kovats, A.; Meyer, S. de; Vettenburg, N.; Roelens, K.; Temmerman, M.

2015-01-01

Background: 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

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

NARCIS (Netherlands)

Keygnaert, I.; Dias, S.F.; Degomme, O.; Devillé, W.; Kennedy, P.; Kováts, A.; De Meyer, S.; Vettenburg, N.; Roelens, K.; Temmerman, M.

2014-01-01

Background: 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

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

NARCIS (Netherlands)

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

2015-01-01

Background: 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

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

NARCIS (Netherlands)

Slobodin, O.; de Jong, J.T.V.M.

2015-01-01

Background: 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

'They first killed his heart (then) he took his own life'. Part 1: a review of the context and literature on mental health issues for refugees and asylum seekers.

Science.gov (United States)

Procter, Nicholas G

2005-12-01

This is the first in a two-part series of papers examining mental health issues for refugees and asylum seekers. Beginning with the suicide of an asylum seeker in Scotland, the paper emphasizes mental health issues for adult and child asylum seekers, stress and memory, suicide, self-harm, risk and protective factors, compulsory health treatments and the prevention of mental illness. It sets the scene for the second paper by drawing implications for nursing practice in the community. Although most literature on refugee and asylum seeker mental health exists outside of nursing scholarship, a majority of the issues reviewed in this paper are mutual challenges for all in the health and helping professions. Nurses interested in refugee and migration issues face two intertwined challenges: that of how to assist migrants with their diverse mental health needs and how, at the same time, to contribute to a society that can promote mental health for all by taking on both the difficulties and opportunities posed by cultural diversity.

The expected well-being of urban refugees and asylum-seekers in Johannesburg

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Talita Greyling

2016-05-01

Full Text Available The influx of asylum-seekers and refugees from across Africa into democratic South Africa has increased significantly. The aim of this paper is to determine the factors that influences the expect well-being of this unique group. Expected well-being is an important determinant of both the decision to migrate and the choice of a country of destination. Knowledge about this determinant therefore informs refugee policies. The results show that only a few of the factors found in the literature explaining the expected well-being of voluntary migrants also explain the expected well-being of forced migrants. However, a number of factors found in the literature that explain the subjective well-being and well-being in general of refugees and asylum-seekers also went towards explaining the expected well-being of this group. These factors include: government assistance, culture, the time spent in South Africa, economic factors, crime, refugee status, reasons for leaving the home countries and the number of people staying in a house in the receiving country. The findings of this study emphasise the differences between forced and voluntary migrants and highlight the factors that influence the expected well-being of forced migrants. These in turn shed light on migration decisions and the choice of destination countries.

HIV positive refugees/asylum seekers and clinical trials: some ethical issues

OpenAIRE

McDonald, Linda

2014-01-01

The aim of this thesis was to identify some of the ethical issues of HIV positive asylum seekers and refugees participating in clinical trials in Britain. While all individuals are to some degree vulnerable in clinical trials, I have shown in this thesis that this group is particularly vulnerable in a number of areas. Many will not have English as a first language and while they may be able to understand everyday language, the participant information sheet (PIS) may be difficult to comprehend...

Interviewing to assess credibility in the Swedish asylum procedure: analyzing question style, type and theme

NARCIS (Netherlands)

van Veldhuizen, T.S.; Horselenberg, R.; Landström, S.; Granhag, P.A.; van Koppen, P.J.

2017-01-01

The aim of the current vignette study is to map the style, type, and themes of questions that are asked when assessing the credibility of asylum seekers' claims. Sixty-five officials from the Swedish Migration Agency (Migrationsverket), were asked to respond to one out of four different vignettes

75 FR 409 - Privacy Act of 1974; United States Citizenship and Immigration Services-010 Asylum Information...

Science.gov (United States)

2010-01-05

... 1974; United States Citizenship and Immigration Services--010 Asylum Information and Pre-Screening... system of records to the Department of Homeland Security's inventory, entitled Unites States Citizenship... Citizenship and Immigration Services (202-272-1663), 20 Massachusetts Avenue, NW., 3rd Floor, Washington, DC...

Making Sense of Pain: Delusions, Syphilis, and Somatic Pain in London County Council Asylums, c. 1900

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Louise Hide

2012-12-01

Full Text Available During the late nineteenth century, a high percentage of male deaths in asylums was attributed to various forms of tertiary syphilis, most notably General Paralysis of the Insane (GPI and tabes dorsalis. It was not unusual for patients to present symptoms of both conditions, the latter of which could be agonizingly painful. Some patients also suffered from persecutory delusions, believing that electricity was running through them or that their limbs were gnawed by lions and wolves at night. Drawing on a theory advanced by a number of key alienists and pathologists of the period, I suggest that these delusions were misinterpretations of felt sensations and, as such, illusions rather than delusions. Despite the well-known problems around using these historical sources, I contend that recorded delusions in asylum case notes can be treated as narratives of pain that provide invaluable insights into patients' subjective experiences.

LIFE IN A BACKPACK: THE EU’S ASYLUM POLICIES AND ITS IMPACT ON THE MACEDONIAN ASYLUM LEGISLATION

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Angelina Stanojoska

2015-09-01

Full Text Available Starting the Arab spring in 2010 and going through the latest and ongoing Syrian conflict and crises, Balkans and Macedonian railways have been and are a place where many human destinies cross their paths walking to the Member States of the European Union. On the other side, Macedonia is struggling with an influx of refugees, finding itself in a status quo position, even looking as it does not know how to solve the situation. Migrants were killed on railways every day not being able to use any kind of public transportation; their smuggling became a normal business for organized crime groups; Macedonian citizens started to earn money on refugees’ misfortune. The paper using the comparative method and document analysis, gives an overview of the EU’s legislation in the area, its improvement and current impact on things, all of it concluded with the Macedonian legal solutions regarding asylum and authors’ recommendations.

Non-clinicians' judgments about asylum seekers' mental health: how do legal representatives of asylum seekers decide when to request medico-legal reports?

Science.gov (United States)

Wilson-Shaw, Lucy; Pistrang, Nancy; Herlihy, Jane

2012-01-01

Procedures for determining refugee status across Europe are being speeded up, despite the high prevalence of mental health difficulties among asylum seekers. An assurance given is that ''vulnerable applicants'' will be identified and excluded from accelerated procedures. Although experts have recommended assessments to be undertaken by experienced clinicians, this is unlikely to happen for political and financial reasons. Understanding how non-clinically qualified personnel perform assessments of mental health issues is timely and crucial. Misrecognition of refugees due to the inappropriate use of accelerated procedures involves the risk of returning the very people who have the right to protection from further persecution. To examine the decision making of immigration lawyers, who are an example of a group of nonclinicians who decide when and whether to refer asylum-seekers for psychiatric assessment. Semi-structured interviews were conducted with 12 legal representatives working with people seeking refugee or human rights protection in the United Kingdom. The resultant material was analysed using Framework Analysis. Themes clustered around the legal case, the client, the representative and the systems, all with sub-themes. A mapping exercise integrated these themes to show how representatives brought together questions of (1) evidential reasons for a report, influenced by their legal, psychological and case law knowledge, and (2) perceived evidence of mental distress, influenced by professional and personal experiences and expectations. The legal representatives interviewed were well-informed and trained in psychological issues as well as clearly dedicated to their clients. This helped them to attempt quasi-diagnoses of common mental health problems. They nonetheless demonstrated stereotypical understanding of post-traumatic stress disorder and other possible diagnoses and the role of subjectivity. The study has implications for other groups - particularly those

Non-clinicians’ judgments about asylum seekers’ mental health: how do legal representatives of asylum seekers decide when to request medico-legal reports?

Directory of Open Access Journals (Sweden)

Lucy Wilson-Shaw

2012-10-01

Full Text Available Background : Procedures for determining refugee status across Europe are being speeded up, despite the high prevalence of mental health difficulties among asylum seekers. An assurance given is that ‘‘vulnerable applicants’’ will be identified and excluded from accelerated procedures. Although experts have recommended assessments to be undertaken by experienced clinicians, this is unlikely to happen for political and financial reasons. Understanding how non-clinically qualified personnel perform assessments of mental health issues is timely and crucial. Misrecognition of refugees due to the inappropriate use of accelerated procedures involves the risk of returning the very people who have the right to protection from further persecution. Objective : To examine the decision making of immigration lawyers, who are an example of a group of nonclinicians who decide when and whether to refer asylum-seekers for psychiatric assessment. Method : Semi-structured interviews were conducted with 12 legal representatives working with people seeking refugee or human rights protection in the United Kingdom. The resultant material was analysed using Framework Analysis. Results : Themes clustered around the legal case, the client, the representative and the systems, all with sub-themes. A mapping exercise integrated these themes to show how representatives brought together questions of (1 evidential reasons for a report, influenced by their legal, psychological and case law knowledge, and (2 perceived evidence of mental distress, influenced by professional and personal experiences and expectations. Conclusions : The legal representatives interviewed were well-informed and trained in psychological issues as well as clearly dedicated to their clients. This helped them to attempt quasi-diagnoses of common mental health problems. They nonetheless demonstrated stereotypical understanding of post-traumatic stress disorder and other possible diagnoses and the

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

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Devillé Walter

2004-03-01

Full Text Available Abstract 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.

Explaining violent behavior against asylum-seekers among border police officers: A Macedonia and Serbia case study

NARCIS (Netherlands)

Schot, Suzanne; Bruijn, Larissa Michelle

2017-01-01

During the 2015 refugee crisis border police officers engaged in violent behavior against asylum-seekers travelling through transit countries to reach the European Union. In Macedonia and Serbia, the violence included beatings, violent assaults, and the use of excessive force in form of stun

Human rights or security? Positions on asylum in European Parliament speeches

DEFF Research Database (Denmark)

Frid-Nielsen, Snorre Sylvester

2018-01-01

parties’ general ‘right-left’ preferences, and duration of EU membership. Generally, MEPs from Central and Eastern Europe and the European People's Party take up pro-security stances. Wordfish was effective and valid, confirming the relevance of automated content analysis for studying the EU.......-2014, scaling MEPs along a unidimensional policy space. Debates on asylum predominantly concern positions for or against European Union (EU) security measures. Surprisingly, national party preferences for EU integration were not the dominant factor. The strongest predictors of MEPs' positions are their national...

Roundway, Wiltshire County Asylum attendants and nurses, 1881-1905: a window onto Victorian sobriety.

Science.gov (United States)

Russell, D

2000-01-01

The only detailed surving Male and Female Registers of Roundway provide a rich documentary glimpse of nineteenth century mental health care staff. An analysis is made of what constituted desirable behavior and problems occurring in the workplace. More primary source material has been gathered from visitors books, medical superintendents' reports, patient case records, admission/discharge registers and account books. An attempt will be made to show how the dominant characteristics of Victorianism shaped the lives of the staff. Religion, morality and personal qualities appear more influential than scientific inquiry in determining the pattern of events. The 'Asylum for the Pauper Insane of the County of Wiltshire' later came to be called 'Roundway Hospital'. It is commonly remembered as 'Roundway' and that is how it is referred to here. The nursing staff changed their titles in minor ways during the period considered, but for convenience the dominant titles - 'attendants' for men and 'nurses' for women - are used. The period chosen, 1881-1905, begins from when Dr John Bowes was appointed Medical Superintendent and started to write in the new Staff Registers. The period finishes when he ceased to make entries. There are no detailed registers for any other nineteenth century period.

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

Science.gov (United States)

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.

Policies of exclusion and practices of inclusion: how municipal governments negotiate asylum policies in the Netherlands

NARCIS (Netherlands)

Kos, S.; Maussen, M.; Doomernik, J.

2016-01-01

There is a major gap in Dutch refugee and immigration control policies between its ambitions and outcomes. It results in considerable numbers of rejected asylum seekers who, while they cannot be expelled from the country, are excluded from government support and from opportunities to work in the

Access to Personal Data and the Right to Good Governance during Asylum Procedures after the CJEU’s YS and M. and S. judgment (C-141/12 and C-372/12)

NARCIS (Netherlands)

Brouwer, E.; Zuiderveen Borgesius, F.

2015-01-01

In the YS. and M. and S. judgment, the Court of Justice of the European Union ruled on three procedures in which Dutch judges asked for clarification on the right of asylum seekers to have access to the documents regarding the decision on asylum applications. The judgment is relevant for

Haiti, insecurity, and the politics of asylum.

Science.gov (United States)

James, Erica Caple

2011-09-01

In this article, I seek to show how states of insecurity provoked by ongoing social, economic, and political ruptures in Haiti can disorder individual subjectivity and generate the flight of individuals seeking asylum within and across borders. Nongovernmental actors working in Haiti and with Haitians in the diaspora frequently managed the long-term psychosocial effects of insecurity. Their interventions can range from repressive to compassionate and influence the formation of identity and the embodied experiences of trauma for vulnerable Haitians. The case of a young Haitian refugee who was repatriated to Haiti from the United States in the 1990s demonstrates how insecurity is both an existential state reflecting the disordering of embodied experience, as well as a collective sociopolitical condition the effects of which cannot be managed or contained within national borders. The case is emblematic of the plight of thousands of Haitians affected by the January 12, 2010, earthquake.

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

Science.gov (United States)

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.

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

Science.gov (United States)

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…

The EU-Turkey Deal and the Safe Third Country Concept before the Greek Asylum Appeals Committees

NARCIS (Netherlands)

Gkliati, M.

2017-01-01

This article discusses the first case law issued on the EU-Turkey deal from April to June 2016, which authoritatively answers the question whether Turkey constitutes a safe third country for refugees. In 390 out of 393 decisions, the Greek Asylum Appeals Committees ruled that Safe Third Country

The Role of the Physician-Scientist in Our Evolving Society

OpenAIRE

Michael R. Rosen

2011-01-01

The physician-scientist represents the medical-scientific version of the ?triple threat? athlete. Yet, in medicine as in sports, specialization and business are ever more in the forefront. As the field of medicine evolves, it is likely that the role of the physician, the scientist, and the physician-scientist will continue to change. Whether this is for the good or bad will only be known in hindsight.

Physician to investigator: clinical practice to clinical research--ethical, operational, and financial considerations.

Science.gov (United States)

Pierre, Christine

2008-01-01

Physicians who participate in clinical research studies gain benefits for themselves, their practice, and their patients. Historically, private practice physicians have chosen to defer to their counterparts in academic medicine when it comes to contributing to scientific advancement through clinical studies. A growing number of private practice physicians are now taking a serious second look and deciding that there are unique benefits for both the practice and the patient. Physicians who decide to participate in clinical research should give serious consideration to the time and resources that are required to meet both federal regulations and industry standards. In addition, ethical and scientific principles for assuring the protection of human research subjects must be a paramount commitment.

Information demands of occupational health physicians and their attitude towards evidence-based medicine.

Science.gov (United States)

Schaafsma, Frederieke; Hulshof, Carel; van Dijk, Frank; Verbeek, Jos

2004-08-01

This study assessed the extent and nature of information demands among occupational health physicians and their attitude towards the application of evidence-based medicine in occupational health. A questionnaire survey was carried out among a random sample of 159 physicians practicing occupational medicine in The Netherlands. The questionnaire investigated the type and number of questions encountered in daily practice, the actions taken in response, the physicians' experience in using scientific databases on the Internet, and their attitude towards evidence-based medicine. The occupational health physicians' questions concerned medical, legal, and rehabilitation topics in particular. In pursuing answers to their questions, they generally chose to contact colleagues. Scientific databases were not consulted very often, although, in general, the attitude towards evidence-based medicine was positive. In addition to known barriers for practicing evidence-based medicine, occupational health physicians perceive a lack of scientific evidence in their field. The extensiveness of the field of knowledge in occupational health care was not regarded as an obstacle to their application of evidence-based medicine. Occupational health physicians have a demand for information on a broad range of topics, and, in most cases, their attitude towards evidence-based medicine is fairly positive. Besides education and training in evidence-based medicine, access to the Internet and the presence of a good knowledge infrastructure would help occupational health physicians use evidence-based medicine.

Where is the Frame? : Victims and Intruders in the Belgian Press Coverage of the Asylum Issue

NARCIS (Netherlands)

Gorp, B. van

2005-01-01

In this article an empirically oriented conceptualization of frames is developed, using the issue of asylum and illegal immigration in the Belgian press as a test case. The methodological focus of this study is on the question of how these frames can be detected in the coverage. How can they be

[General features of the patient-physician relationship].

Science.gov (United States)

Baeza, H; Bueno, G

1997-03-01

The communication between physicians and patients is often deficient. Little time is devoted to it and the patient receives scanty information with a low emotional content. Some features of our medicine can explain this situation. The rationalist and mechanistic biological model, allows to study only those things that can be undertaken with the scientific method. Psychological, social and spiritual aspects are surpassed. It only looks at material aspects of people, limiting the communication. Patients express their symptoms in an emotional way, with multiple beliefs and fears. The physician converts them to a precise, scientific, measurable and rational medical logical type. This language is not understood by patients, generating hesitancy in the communication. The paternalism is based in the power that physicians have over patients. We give knowledge and ask the patient to subordinate and accept our power. The patient loses his moral right to be informed, to ask, to have doubts or to disagree. Our personal communication is almost always formal, unemotional and with no explanations, further limiting communication.

What drives 'soft deportation'? Understanding the rise in Assisted Voluntary Return among rejected asylum seekers in the Netherlands

NARCIS (Netherlands)

A.S. Leerkes (Arjen); van Os, R. (Rianne); Boersema, E. (Eline)

2017-01-01

textabstractStates experience difficulties in realizing the return of rejected asylum seekers, but migration control policies are becoming increasingly sophisticated. Against this background, we consider explanations for the increase in Assisted Voluntary Return from the Netherlands in the 2005-2011

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

NARCIS (Netherlands)

Gerritsen, A.A.M.; Bramsen, I.; Devillé, W.; Willigen, L.H.M. van; Hovens, J.E.; Ploeg, H.M. van der

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

Could the BIC-Q be a decision-support tool to predict the development of asylum-seeking children?

NARCIS (Netherlands)

Zijlstra, A. Elianne; Kalverboer, Margrite E.; Post, Wendy J.; Ten Brummelaar, Mijntje D. C.; Knorth, Erik J.

2013-01-01

The Best Interest of the Child Questionnaire (BIC-Q) is an instrument to measure the quality of the childrearing environment. We used a sample of asylum-seeking children (N = 79) in the Netherlands to determine the relationship between the quality of the childrearing environment and the child's

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

Science.gov (United States)

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.

A Lie More Disastrous than the Truth: Asylum and the identification of trafficked women in the UK

Directory of Open Access Journals (Sweden)

Abigail Stepnitz

2012-06-01

Full Text Available This article explores the impact that nationality can have on a person’s experience of being identified as a victim of trafficking in the UK. Responses to individuals and disparities in rates of recognition depending on nationality are cause for great concern. The rhetoric and the response to women who have experienced trafficking varies considerably depending upon the citizenship, residency and documentation status of the individual, particularly highlighting the differential treatment of trafficking cases of British women, European Union nationals, and third-country (non UK, non EU nationals, the majority of whom are also asylum seekers. This differential treatment is played out in multiple ways, many of which result in women’s inability to realise procedural and substantive rights. The article examines the use of official “identification” mechanisms that place women into the administrative category of “victim”, and the central role of the asylum system in all areas of UK anti-trafficking responses.

[Scientific publication output of Spanish emergency physicians from 2005 to 2014: a comparative study].

Science.gov (United States)

Fernández-Guerrero, Inés María; Martín-Sánchez, Francisco Javier; Burillo-Putze, Guillermo; Miró, Òscar

2017-10-01

To analyze the research output of Spanish emergency physicians between 2005 and 2014 and to compare it to their output in the previous 10-year period (1995-2004) as well as to that of emergency physicians in other countries and Spanish physicians in other specialties. Original articles indexed in the Science Citation Index Expanded of the Web of Science were included. Documents from Spanish emergency physicians were identified by combining the word Spain and any other search term identifying an emergency service or unit in Spain. To identify articles from 7 other Spanish specialties (hematology, endocrinology, cardiology, pneumology, digestive medicine, pediatrics, surgery and orthopedic medicine or traumatology) and emergency physicians in 8 other countries (United States, United Kingdom, Ireland, Italy, France, Germany, Netherlands, Belgium) we used similar strategies. Information about production between 1995 and 2004 was extracted from a prior publication. Spanish emergency physicians signed 1254 articles (mean [SD], 125 [44] articles/y) between 2005 and 2014. That level of productivity was greater than in the 1995-2004 period (mean, 26 [14] articles/y), although the annual growth rate fell from 12.5% in the previous 10-year period to 5.2% in the most recent one. Emergency medicine was among the least productive Spanish specialties we studied, but our discipline's annual growth rate of 5.2% was the highest. Spanish emergency medicine occupies an intermediate position (ranking fifth) among the 9 countries studied, although the population-adjusted rank was higher (fourth). When output was adjusted for gross domestic product, Spain climbed higher in rank, to second position. The annual growth rate was the fourth highest among countries, after Germany (9.9%), the Netherlands (7.3%), and Italy (6.0%). The research output of Spanish emergency physicians continues to be quantitatively lower than that of other Spanish specialties and of emergency physicians in other

Swiss family physicians' perceptions and attitudes towards knowledge translation practices.

Science.gov (United States)

Bengough, Theresa; Bovet, Emilie; Bécherraz, Camille; Schlegel, Susanne; Burnand, Bernard; Pidoux, Vincent

2015-12-11

Several studies have been performed to understand the way family physicians apply knowledge from medical research in practice. However, very little is known concerning family physicians in Switzerland. In an environment in which information constantly accumulates, it is crucial to identify the major sources of scientific information that are used by family physicians to keep their medical knowledge up to date and barriers to use these sources. Our main objective was to examine medical knowledge translation (KT) practices of Swiss family physicians. The population consisted of French- and German-speaking private practice physicians specialised in family medicine. We conducted four interviews and three focus groups (n = 25). The interview guides of the semi-structured interviews and focus groups focused on (a) ways and means used by physicians to keep updated with information relevant to clinical practice; (b) how they consider their role in translating knowledge into practice; (c) potential barriers to KT; (d) solutions proposed by physicians for effective KT. Family physicians find themselves rather ambivalent about the translation of knowledge based on scientific literature, but generally express much interest in KT. They often feel overwhelmed by "information floods" and perceive clinical practice guidelines and other supports to be of limited usefulness for their practice. They often combine various formal and informal information sources to keep their knowledge up to date. Swiss family physicians report considering themselves as artisans, caring for patients with complex needs. Improved performance of KT initiatives in family medicine should be tailored to actual needs and based on high quality evidence-based sources.

The physician executive in a changing world.

Science.gov (United States)

Kaiser, L R

1999-01-01

Physicians are losing their historic franchise as sole and primary providers of medical care. In addition to eroding moral and scientific authority, physicians are also losing income and status. It is no wonder that physicians are retrenching--confused and angry about the increasing marginalization of their profession and about society's changing expectations. Physicians are caught in a transition zone between the world that was and the one that will soon be. This is destabilizing and causes great anxiety. Rather than being buffeted by changing social and cultural definitions of health care, physicians must become proactively involved in the future of their profession. Physicians can only do this by offering a better mental model of health, medicine, and the community. This cannot be a defensive retreat from engagement. Rather, it must be an imaginative vision, vigorously set forth--a vision that will enlist the support of all constituencies involved in the effort to improve the health and well-being of all members of our society. The physician executive needs to work with physicians to orchestrate this effort to create a new vision of health in the 21st century.

Ethics and exclusion: representations of sovereignty in Australia’s approach to asylum-seekers

OpenAIRE

Gelber, Katherine; McDonald, Matt

2006-01-01

From 2001, the Australian government has justified a hard-line approach to asylum-seekers on the basis of the need to preserve its sovereignty. This article critically evaluates this justification, arguing that the conception of sovereignty as the ‘right to exclude’ involves a denial of responsibility to the most vulnerable in global politics. We particularly focus here on the ways in which the Australian government has attempted to create support for this conception of sovereignty and ethica...

Disciplinary power and the role of the subject at a nineteenth-century Danish asylum

DEFF Research Database (Denmark)

Hamre, Bjørn

2010-01-01

the study draws upon Foucauldian concepts like disciplinary power, confession, pastoral power and subjectivation. I will argue that the critique of the patient provides us with an example of the way that disciplinary power works in the case of an informal indictment of the methods and practice at an asylum....... A key issue is whether the critique is not itself a part of the self-legitimation of disciplinary power....

Understanding the co-production of public services: the case of asylum seekers in Glasgow

OpenAIRE

Strokosch, Kirsty

2013-01-01

This thesis explores the co-production of public services in the case of asylum seekers in Glasgow. It makes contributions on the theoretical and empirical levels. First, it integrates two theoretical standpoints on co-production from the public administration/management and services management literatures. This integration forms the basis for the development of an original conceptual framework which differentiates three modes of co-production at the level of the individual ser...

“To be without a home, like a rolling stone”: Anticipating the global management of forced migration flows and the social integration of asylum seekers

DEFF Research Database (Denmark)

Albu, Oana Brindusa

The study investigates the practices of different forms of anticipatory knowledge of actors involved in the global management of forced migration flows in ‘migration hotspots’ (European Parliament, 2016). The study draws on an ongoing multi-sited study of professionals working in IGOs, NGOs......—all for estimating the movements and framing the choices, freedoms and rights of asylum seekers. The study shows how anticipatory practices constitute asylum seekers as ‘global problems’ which reinforce dominance relations of ‘vulnerability’ and remove individuals’ agency while providing them with life...

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

Science.gov (United States)

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.

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.

Science.gov (United States)

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

Hospital and asylum visiting in historical perspective: themes and issues.

Science.gov (United States)

Mooney, Graham; Reinarz, Jonathan

2009-01-01

Compared to doctors, patients and institutions, visitors are an understudied constituency in medical history. The collection of essays in this book situates the historical practice of hospital and asylum visiting in broad social, cultural and geographical perspectives. This introduction loosely categorises visitors into four groups: patient visitors, including family and friends; public visitors, such as entertainers, tourists and the clergy, who have no direct formal ties with the institution or the patients; house visitors involved with the management and government of the hospital; and official visitors, who have inspectorial responsibilities. Discussion of the wider historical significance of visiting draws attention to issues such as urban governance, philanthropy, the public sphere, civil society and citizenship.

[Sherlock Holmes as amateur physician].

Science.gov (United States)

Madsen, S

1998-03-30

The medical literature contains numerous articles dealing with Sherlock Holmes and his companion Dr. Watson. Some of the articles are concerned with the medical and scientific aspects of his cases. Other articles adopt a more philosophical view: They compare the methods of the master detective with those of the physician--the ideal clinician should be as astute in his profession as the detective must be in his. It this article the author briefly reviews the abilities of Sherlock Holmes as an amateur physician. Often Holmes was brilliant, but sometimes he made serious mistakes. In one of his cases (The Adventure of the Lion's Mane) he misinterpreted common medical signs.

Self-reported feeding advice by physicians for common childhood illnesses.

Science.gov (United States)

Nizami, S Q; Bhutta, Z A

1999-12-01

A nutritious diet is important for recovery during illnesses. Dietary advice by physicians and consumption of food by the patients are often based upon their hot and cold concepts and beliefs about various foods rather than on scientific basis. To look at the food-advising behaviour of physicians during illnesses and to know the maternal concepts about various foods being hot or cold. A questionnaire was served to the physicians participating in a continuous medical education session held at the Aga Khan University and Hospital, asking them to write the foods they advise or restrict during different illnesses such as fever, jaundice etc. Mothers of sick children suffering from diarrhea and other illnesses were also interviewed to know their concepts about various foods. Six (10%) out of sixty physicians believed in hot and cold concepts of the food. A variety of common foods were either restricted or strongly recommended by 10% to 50% of these physicians without any scientific basis, 23% physicians restricted fatty foods in jaundice, 17% physicians restricted in cough and cold. Although the interviewed mothers believed in hot-cold concepts of food but 55-63% of them were not sure what is meant by hot or cold food. In spite of that 70-80% of these mothers classified chicken, meat, egg, brinjal, masoor and mangoes are hot foods and rice, yogurt, moong, banana and orange as cold foods. Hot-Cold concept of food exists not only in mothers but also in physicians. Proper education regarding food intake is mandatory for both mothers and physicians to ascertain adequate intake of calories during sickness.

Unaccompanied adolescents seeking asylum - Poorer mental health under a restrictive reception : poorer mental health under a restrictive reception

NARCIS (Netherlands)

Reijneveld, S.A.; de Boer, J.B.; Bean, T.; Korfker, D.G.

2005-01-01

We assessed the effects of a stringent reception policy on the mental health of unaccompanied adolescent asylum seekers by comparing the mental health of adolescents in a restricted campus reception setting and in a setting offering more autonomy (numbers [response rates]: 69 [93%] and 53 [69%],

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

Science.gov (United States)

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.

[Burnout in physicians].

Science.gov (United States)

Kurzthaler, Ilsemarie; Kemmler, Georg; Fleischhacker, W Wolfgang

2017-06-01

Burnout is a syndrome characterized by emotional exhaustion, depersonalization and low personal accomplishment. The primary objective of this study was to investigate both the prevalence and severity of burnout symptoms in a sample of clinical physicians from different speciality disciplines. A total of 69 clinical physicians ≤55 years who are working at the Medical University/regional Hospital Innsbruck were included into a cross-sectional study. Next to the assessment of sociodemographic and work-related variables the Maslach Burnout Inventory (MBI) was used to investigate burnout symtoms. Overall, 8.8% of the study population showed high emotional exhaustion with high or moderate depersonalization and low personal accomplishment and therefore had a high risk to develop a burnout syndrom. 11.8% showed a moderade burnout risk. Neither sociodemographic variables nor the degree of educational qualification or speciality discipline had an influence on burnout symptoms. However, there was a positive correlation between scientific activity and personal accomplihment. Our results suggest that the dimension of burnout symtoms among clinical physicians in Austria has be taken seriously. Further research is needed to develop specific programs in terms of burnout prevention and burnout therapy.

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

Science.gov (United States)

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.

Knowledge of Primary Care Physicians Regarding Domestic Violence.

African Journals Online (AJOL)

Knowledge of Primary Care Physicians Regarding Domestic Violence. ... prevalence of DV, and 4 main aspects relevant to DV, namely deprivation, psychological, ... and instructions about DV from scientific formal sources as medical schools, ...

A Longitudinal Study of Changes in Asylum Seekers Ability Regarding Activities of Daily Living During Their Stay in the Asylum Center

DEFF Research Database (Denmark)

Morville, Anne-Le; Amris, Kirstine; Eklund, Mona

2015-01-01

participated. ADL-ability was measured using Assessment of Motor and Process Skills and questionnaires about exposure to torture, self-reported mental health and pain. ADL motor and process measures, well-being and self-rated health declined from baseline to follow-up. Measures of pain and depression increased......The aim was to assess change in activities of daily living (ADL) ability amongst asylum seekers and if there were any difference between tortured and non-torture following a 10 months post-arrival period, and if self-reported health and exposure to torture were factors related to change in ADL....... Exposure to physical torture and change in ADL motor (r = 0.525) measures were associated, as well as change in current pain and change in ADL process (r = 0.525) measures. Due to preponderance of torture survivors analysis of group difference was not applicable. Health care workers should be aware of ADL...

HJ (Iran) and HT (Cameroon) - Reflections on a new test for sexuality-based asylum claims in Britain

NARCIS (Netherlands)

Wessels, J.M.

2012-01-01

The case HJ (Iran) and HT (Cameroon) v Secretary of State for the Home Department [2010] UKSC 31 was celebrated as a 'fundamental shift in asylum law'. In this decision, the UK Supreme Court rejects the 'reasonably tolerable test' that had been applied in the case of the gay men HJ, a 40-year-old

Will a Quota Plan for Asylum Seekers Plan Work —and Why Not?

DEFF Research Database (Denmark)

Seeberg, Peter

2015-01-01

The article describes the recent situation in the Mediterranean, where the number of asylum seekers arriving from countries south and east of the Mediterranean Sea is increasing significantly. The European Commission has suggested a plan, “A European Agenda on Migration”, which will redistribute...... later on lead to a common EU migra-tion policy, which are beyond national control and would make it difficult to avoid responsibilities for internal crisis situations emerging in other parts of the Middle East or North Africa in the future....

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.

Science.gov (United States)

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

Some Present-Day Asylum Seekers in the U.S.: Machismo and “Women on the Run”

Directory of Open Access Journals (Sweden)

Barbara Eisold

2016-08-01

Full Text Available Following a brief review of international asylum law (The Geneva Conventions, and the role of American mental health professionals in the asylum process, this paper attempts to understand the ways in which the often trauma-creating custom of machismo is transferred across generations in Central American families. Using as background the work of self psychologist Alan Roland (1989,1996, 2005, I have described families from these areas as so powerfully father-centric that children develop a sense of themselves based largely on their ability to sustain their father’s positive regard. In addition, without discussion, they present a positive image of him to the outside world, even when his behavior at home is brutal. To do otherwise would be humiliating. Having no place to reflect on these customs, often they are acted upon/acted out in the next generation. Note:We publish thi paper also tranlated in italian by Francesca Tessitore (Francesca Tessitore, Psychologist, PhD Student in Mind, Gender and Languages, her research fields are the processes of female immigration and motherhood at risk through a psychodynamic framework. francitessitore@gmail.com.

A preliminary qualitative investigation into the relationship between pre-, peri- and post-migration factors/experiences and the psychological well-being of adolescent male Afghani asylum seekers living in the UK.

OpenAIRE

Button, Rebecca

2013-01-01

This qualitative study explores the influence of pre-, peri- and post-migration experiences on the psychological well-being of adolescent male Afghani asylum seekers living in the UK. It aims to provide a preliminary investigation of these experiences using the participants’ own voice in order to contribute towards addressing a gap in the research field and guide ongoing outreach, social and clinical work with this population, both locally, and nationally. Eight adolescent Afghani asylum seek...

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

Science.gov (United States)

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.

Naturopathic physicians: holistic primary care and integrative medicine specialists.

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Litchy, Andrew P

2011-12-01

The use of Complimentary and Alternative Medicine (CAM) is increasing in the United States; there is a need for physician level practitioners who possess extensive training in both CAM and conventional medicine. Naturopathic physicians possess training that allows integration of modern scientific knowledge and the age-old wisdom of natural healing techniques. Naturopathic philosophy provides a framework to implement CAM in concert with conventional therapies. The naturopathic physician's expertise in both conventional medicine and CAM allows a practice style that provides excellent care through employing conventional and CAM modalities while utilizing modern research and evidence-based medicine.

Gender and offender status predicting treatment success in refugees and asylum seekers with PTSD

Directory of Open Access Journals (Sweden)

Håkon Stenmark

2014-01-01

Full Text Available Background: Current knowledge is limited regarding patient characteristics related to treatment outcome of posttraumatic stress disorders (PTSD in refugees and asylum seekers. Objective: Gender, torture status, offender status, level of anger, and level of depression were investigated for possible effects on the treatment outcome. Method: Patient characteristics were explored in 54 refugees and asylum seekers who had completed a treatment program for PTSD. Non-responders (10, those who had the same or higher levels of symptom severity after treatment, were compared with responders, those who had lower symptom severity after treatment (44. Symptom severity was measured by Clinician-Administered PTSD Scale. The non-responders and responders constituted the dichotomous, dependent variable. The independent variables were gender, torture status, offender status, level of anger, and level of depression. T-tests and Exact Unconditional Homogeneity/Independence Tests for 2X2 Tables were used to study the relationship to treatment outcome. Results: Being male and reporting to have been a violent offender were significantly more frequent characteristics among the non-responders compared to the responders. The levels of pretreatment anger, depression and torture status did not affect the treatment outcome. Conclusions: The study adds support to findings that females benefit more from treatment of PTSD than males and that violent offenders are difficult to treat within the standard treatment programs.

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

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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.

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

Science.gov (United States)

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

Respiratory diphtheria in an asylum seeker from Afghanistan arriving to Finland via Sweden, December 2015.

Science.gov (United States)

Sane, Jussi; Sorvari, Tiina; Widerström, Micael; Kauma, Heikki; Kaukoniemi, Ulla; Tarkka, Eveliina; Puumalainen, Taneli; Kuusi, Markku; Salminen, Mika; Lyytikäinen, Outi

2016-01-01

In December 2015, an asylum seeker originating from Afghanistan was diagnosed with respiratory diphtheria in Finland. He arrived in Finland from Sweden where he had already been clinically suspected and tested for diphtheria. Corynebacterium diphtheriae was confirmed in Sweden and shown to be genotypically and phenotypically toxigenic. The event highlights the importance of early case detection, rapid communication within the country and internationally as well as preparedness plans of diphtheria antitoxin availability.

Physician choice making and characteristics associated with using physician-rating websites: cross-sectional study.

Science.gov (United States)

Emmert, Martin; Meier, Florian; Pisch, Frank; Sander, Uwe

2013-08-28

Over the past decade, physician-rating websites have been gaining attention in scientific literature and in the media. However, little knowledge is available about the awareness and the impact of using such sites on health care professionals. It also remains unclear what key predictors are associated with the knowledge and the use of physician-rating websites. To estimate the current level of awareness and use of physician-rating websites in Germany and to determine their impact on physician choice making and the key predictors which are associated with the knowledge and the use of physician-rating websites. This study was designed as a cross-sectional survey. An online panel was consulted in January 2013. A questionnaire was developed containing 28 questions; a pretest was carried out to assess the comprehension of the questionnaire. Several sociodemographic (eg, age, gender, health insurance status, Internet use) and 2 health-related independent variables (ie, health status and health care utilization) were included. Data were analyzed using descriptive statistics, chi-square tests, and t tests. Binary multivariate logistic regression models were performed for elaborating the characteristics of physician-rating website users. Results from the logistic regression are presented for both the observed and weighted sample. In total, 1505 respondents (mean age 43.73 years, SD 14.39; 857/1505, 57.25% female) completed our survey. Of all respondents, 32.09% (483/1505) heard of physician-rating websites and 25.32% (381/1505) already had used a website when searching for a physician. Furthermore, 11.03% (166/1505) had already posted a rating on a physician-rating website. Approximately 65.35% (249/381) consulted a particular physician based on the ratings shown on the websites; in contrast, 52.23% (199/381) had not consulted a particular physician because of the publicly reported ratings. Significantly higher likelihoods for being aware of the websites could be

"But my doctor recommended pot": medical marijuana and the patient-physician relationship.

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Nussbaum, Abraham M; Boyer, Jonathan A; Kondrad, Elin C

2011-11-01

As the use of medical marijuana expands, it is important to consider its implications for the patient-physician relationship. In Colorado, a small cohort of physicians is recommending marijuana, with 15 physicians registering 49% of all medical marijuana patients and a single physician registering 10% of all patients. Together, they have registered more than 2% of the state to use medical marijuana in the last three years. We are concerned that this dramatic expansion is occurring in a setting rife with conflicts of interest despite insufficient scientific knowledge about marijuana. This system diminishes the patient-physician relationship to the recommendation of a single substance while unburdening physicians of their usual responsibilities to the welfare of their patients.

[Advanced online search techniques and dedicated search engines for physicians].

Science.gov (United States)

Nahum, Yoav

2008-02-01

In recent years search engines have become an essential tool in the work of physicians. This article will review advanced search techniques from the world of information specialists, as well as some advanced search engine operators that may help physicians improve their online search capabilities, and maximize the yield of their searches. This article also reviews popular dedicated scientific and biomedical literature search engines.

Interviewing asylum seekers : A vignette study on the questions asked to assess credibility of claims about origin and persecution

NARCIS (Netherlands)

van Veldhuizen, Tanja S.; Horselenberg, Robert; Landström, Sara; Granhag, Pär Anders; van Koppen, Peter J.

2017-01-01

The aim of the current vignette study is to map the style, type, and themes of questions that are asked when assessing the credibility of asylum seekers' claims. Sixty-five officials from the Swedish Migration Agency (Migrationsverket), were asked to respond to one out of four different vignettes

Interference with the patient-physician relationship

Directory of Open Access Journals (Sweden)

Robbins RA

2012-11-01

Full Text Available No abstract available. Article truncated at 150 words. “Life is like a boomerang. Our thoughts, deeds and words return to us sooner or later, with astounding accuracy.”-Brant M. Bright, former project leader with IBM A recent sounding board in the New England Journal of Medicine discussed legislative interference with the patient-physician relationship (1. The authors, the executive staff leadership of the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American College of Physicians, and the American College of Surgeons believe that legislators should abide by principles that put patients’ best interests first. Critical to achieving this goal is respect for the importance of scientific evidence, patient autonomy, and the patient-physician relationship. According to the authors, lawmakers are increasingly intruding into the realm of medical practice, often to satisfy political agendas without regard to established, evidence-based guidelines for care. The article goes on to cite examples including: The Florida ….

'Colour-Evasiveness' and Racism without Race: The Disablement of Asylum-Seeking Children at The Edge of Fortress Europe

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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…

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.

Science.gov (United States)

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.

The Importance of Resources and Security in the Socio-Economic Integration of Refugees. A Study on the Impact of Length of Stay in Asylum Accommodation and Residence Status on Socio-Economic Integration for the Four Largest Refugee Groups in the Netherlands

NARCIS (Netherlands)

L. Bakker (Linda); J.M. Dagevos (Jaco); G.B.M. Engbersen (Godfried)

2013-01-01

textabstractIn many European countries, including the Netherlands, refugees stay in asylum accommodation pending a decision on their asylum request. While it seems evident that the lack of resources and insecurity about the future experienced during this stay will impact refugees' subsequent ability

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

Science.gov (United States)

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…

Refugees and Asylum Seekers in the UK: The Challenges of Accessing Education and Employment. NIACE Briefing Sheet 91

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National Institute of Adult Continuing Education, 2009

2009-01-01

This briefing paper endeavours to highlight the challenges facing refugees and asylum seekers in the United Kingdom in accessing education, training and employment. It does not claim to cover all the issues but is intended as a starting point for providers of adult learning and/or advice. It initially sets out the facts about definitions and…

The physician expert witness and the U.S. Supreme court--an epidemiologic approach.

Science.gov (United States)

Norton, Martin L

2002-01-01

It is a fact of life that the physician is occasionally called upon to provide Expert Witness evidence. This is clearly distinct from evidence of a participatory nature where the physician is a party to the act by virtue of the doctor-patient relationship. The purpose of this presentation is to alert the physician to new criteria, imposed by the court, for acceptance of Expert Testimony. Prior to March 23, 1999, expert witness testimony fell into three categories, Scientific, technical, and other specialized knowledge. Scientific knowledge included the conclusions that could be subjected to analysis of a statistical nature, or could be validated by methodology such as epidemiologic criteria. Technical knowledge was based on factors such as mechanical or stress analysis utilized in engineering. Other "specialized knowledge" could be based on experiential data and information not necessarily subject to epidemiologic or other scientific analysis. Therefore, the physician presented his reasoning often based on years of professional practice and publication in journals of clinical practice. On March 23rd 1999, the Supreme Court of the United States changed the criteria for all categories stating that there is "no relevant distinction between 'scientific' knowledge' and 'technical' or 'other specialized knowledge' in Federal Rule of Evidence 702. This momentous decision [Kumho Tire Co. v. Carmichael, (97-1709), 131 F.3d 1433) reversed.] referred back to a previous case [Daubert v. Merrell Dow Pharmaceuticals Inc., 509 US. 579,589], which established four criteria based on methods of analysis for t he courts, and was now extended for all expert evidence. Thus the area of expert witness evidence was changed by this momentous act placing the judge as arbiter of all expert evidence, including that of the physician. This paper will offer a brief review and an analysis of the significance of this for the professional involved in the legal system as an expert witness.

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

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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.

An integrated healthcare service for asylum seekers and refugees in the South-Eastern Region of Melbourne: Monash Health Refugee Health and Wellbeing.

Science.gov (United States)

McBride, Jacquie; Block, Andrew; Russo, Alana

2017-09-01

Asylum seekers and refugees generally have poorer health than the broader Australian population. However, these groups experience a range of barriers to accessing universal health services. Generalist and specialist refugee health services have been established in Australia to improve the health of humanitarian migrant groups. This article describes a refugee health service established in a high-settlement region of Melbourne, Australia, and explores clients' experiences with the service. Client feedback was captured through interviews (n=18) and surveys (n=159). Participants reported high levels of satisfaction with the service, and highlighted the value in having trusting relationships with staff, access to bicultural workers, onsite interpreting services and integrated care. The findings indicate that it is possible to engage asylum seekers and refugees through healthcare delivery that is responsive to the unique needs of this priority population.

Patient-physician alliance: from Hippocrates to Post-Genomic Era. Commentary.

Science.gov (United States)

Pulciani, Simonetta; Taruscio, Domenica

2017-01-01

Patients need clinical competence, appropriate diagnosis and therapies in overcoming their disease. Yet this is insufficient. The illness experience tends to frighten people and the resulting emotional aspects could become relevant factors in coping with a sickness and disability. Hippocrates was the first to urge physicians to look beyond the physical features of diseases and to consider the patient as a unique psychosomatic entity. Additionally, the scientist spurred physicians to make the patient an active participant in combating the disease. According to Hippocrates, "the Medical Art has three actors: the physician, the patients and the disease. The physician and the patient must be allied against the disease in order to fight it". In the "Post-Genomic Era", an effective therapeutic approach merits a patient-physician participation, based on scientific understandings and human considerations. These recommendations are even more urgent for Rare Diseases.

A guide for writing in the scientific forum.

Science.gov (United States)

Kotsis, Sandra V; Chung, Kevin C

2010-11-01

When considering the importance of scientific writing in disseminating new discoveries and ideas, it is quite remarkable that few physicians have received any formal instruction in this essential process. This article focuses on the fundamental principles of scientific writing that also include a "style and grace" component. The art of good scientific writing is to convey scientific materials in a clear and interesting way, while avoiding incomprehensible sentences that only serve to disguise marginal contents within the article. The goal of this article is to encourage authors and readers to critically examine the art of scientific writing to overcome the barrier to effective communication.

Creating Posters for Effective Scientific Communication.

Science.gov (United States)

Bavdekar, Sandeep B; Vyas, Shruti; Anand, Varun

2017-08-01

A scientific poster is a summary of one's research that is presented in a visually engaging manner. Posters are presented as a means of short and quick scientific communications at conferences and scientific meetings. Presenting posters has advantages for the presenters and for conference attendees and organizers. It also plays a part in dissemination of research findings and furthering science. An effective poster is the one that focuses on a single message and conveys it through a concise and artistically attractive manner. This communication intends to provide tips on creating an effective poster to young scientists. © Journal of the Association of Physicians of India 2011.

[From the asylums to the community: the reform process of National Colony "Dr. Manuel A. Montes de Oca"].

Science.gov (United States)

Rossetto, Jorge

2009-01-01

Since 2004, a profound transformation of the asylum care model, characterized by overcrowding, lack of discharge and absence of rehabilitation programs, and social reinsertion, has been developed at National Colony "Dr. Manuel A. Montes de Oca". During this period, a plan that contemplates several programs and projects aimed at restoring the rights of institutionalized people with mental disabilities and promoting opportunities for social inclusion has been implemented.

Sexual Maltreatment of Unaccompanied Asylum-Seeking Minors from the Horn of Africa: A Mixed Method Study Focusing on Vulnerability and Prevention

Science.gov (United States)

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…

A REVIEW OF ASYLUM SEEKERS AND REFUGEES IN ITALY: WHERE IS THE PSYCHOLOGICAL RESEARCH GOING?

Directory of Open Access Journals (Sweden)

Francesca Tessitore

2017-08-01

Full Text Available According to the United Nations High Commissioner for Refugees (UNHCR, nowadays, 65,3 million individuals have been forcibly displaced worldwide. In Europe, Italy is one of the countries with the highest number of asylum seeker arrivals per year and the emergency nature of the present-day migratory flows are increasingly involving researchers and clinicians to come up with and develop new models of research and interventions. This article aims to conduct a review of the Italian psychological research in the field of forced migration in order to systematise the Italian studies, to compare the Italian situation with the international one and to define limits, resources and future directions of current Italian research. A literature review in the databases Scopus, PubMed and Web of Knowledge for documents published from 2012 to 2017 was conducted. From the analysis, twelve articles emerged principally following two main trajectories of investigation: a clinical and mental health-related trajectory and a psychosocial and community-based one. Compared with the wider international field of research, a general underdevelopment of Italian research emerged. Research into protective factors with regard to the development of psychopathological outcomes and on interventions is highly recommended. Results highlighted support for future research on the theme of asylum seekers and refugees. Some cause for reflection as regards levels of criticality, the direction of future research and specific links between research and Italian social policies were given.

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

Science.gov (United States)

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Failure to appear at an interview before an... WITHHOLDING OF REMOVAL Asylum and Withholding of Removal § 208.10 Failure to appear at an interview before an... scheduled interview without prior authorization may result in dismissal of the application or waiver of the...

Hepatitis A among refugees, asylum seekers and migrants living in hosting facilities, Greece, April to December 2016

Science.gov (United States)

Mellou, Kassiani; Chrisostomou, Anthi; Sideroglou, Theologia; Georgakopoulou, Theano; Kyritsi, Maria; Hadjichristodoulou, Christos; Tsiodras, Sotirios

2017-01-01

An increased number of hepatitis A cases among refugees, asylum seekers and migrants residing in hosting facilities in Greece were recorded between April and December 2016. In total, 177 laboratory-confirmed symptomatic cases were reported; of these, 149 (84%) occurred in hosting camps mostly among Syrian children under 15 years. All cases reported symptom onset after their entry into the country. Public health interventions focused on hygiene measures and vaccination. PMID:28181904

Trends in twitter use by physicians at the american society of clinical oncology annual meeting, 2010 and 2011.

Science.gov (United States)

Chaudhry, Aafia; Glodé, L Michael; Gillman, Matt; Miller, Robert S

2012-05-01

Social media channels such as Twitter are gaining increasing acceptance as mechanisms for instantaneous scientific dialogue. Professional medical societies such as ASCO are using social media to expand the reach of scientific communications at and around their scientific meetings. This article examines the how Twitter use by oncologists expanded at the ASCO Annual Meetings from 2010 to 2011. In both years, tweets that were specifically generated by physicians and that incorporated the official meeting hashtag were harvested from the public domain, and a discourse analysis was performed by three independent raters. Follow-up surveys were conducted to assess physician attitudes toward Twitter and its potential role in clinical practice. A combined total of 12,644 tweets were analyzed for 2010 and 2011. Although the number of physicians authoring tweets was small (14 in 2010, 34 in 2011), this group generated nearly 29% of the total meeting dialogue examined in this analysis in 2010 and 23% in 2011. Physicians used Twitter for reporting clinical news from scientific sessions, for discussions of treatment issues, for promotion, and to provide social commentary. The tangible impact of Twitter discussions on clinical practice remains unclear. Despite the 140-character limit, Twitter was successfully used by physicians at the 2010 and 2011 ASCO Annual Meetings to engage in clinical discussions, whether or not an author was on site as a live attendee. Twitter usage grew significantly from 2010 to 2011. Professional societies should monitor these phenomena to enhance annual meeting attendee user experience.

Critical appraisal of scientific articles: part 1 of a series on evaluation of scientific publications.

Science.gov (United States)

du Prel, Jean-Baptist; Röhrig, Bernd; Blettner, Maria

2009-02-01

In the era of evidence-based medicine, one of the most important skills a physician needs is the ability to analyze scientific literature critically. This is necessary to keep medical knowledge up to date and to ensure optimal patient care. The aim of this paper is to present an accessible introduction into critical appraisal of scientific articles. Using a selection of international literature, the reader is introduced to the principles of critical reading of scientific articles in medicine. For the sake of conciseness, detailed description of statistical methods is omitted. Widely accepted principles for critically appraising scientific articles are outlined. Basic knowledge of study design, structuring of an article, the role of different sections, of statistical presentations as well as sources of error and limitation are presented. The reader does not require extensive methodological knowledge. As far as necessary for critical appraisal of scientific articles, differences in research areas like epidemiology, clinical, and basic research are outlined. Further useful references are presented. Basic methodological knowledge is required to select and interpret scientific articles correctly.

8 CFR 240.68 - Failure to appear at an interview before an asylum officer or failure to follow requirements for...

Science.gov (United States)

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Failure to appear at an interview before an... Removal Under Section 203 of Pub. L. 105-100 § 240.68 Failure to appear at an interview before an asylum... interview without prior authorization may result in dismissal of the application or waiver of the right to...

Behavior Modification: A Patient and Physician's Perspective.

Science.gov (United States)

Swanson, Elizabeth; Primack, Craig

2017-03-01

This article, co-authored by a patient affected by obesity and an obesity medicine specialist, discusses the patient's experience of living with the disease and using many different weight loss approaches until finding a lifestyle program that was appropriate for her metabolism. The physician discusses the scientific basis of insulin resistance, and why the chosen lifestyle program worked so well for this individual.

Assessing the Relationship between Community Education, Political Efficacy and Electoral Participation: A Case Study of the Asylum Seeking Community in Cork

Science.gov (United States)

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.…

[Labour, silence and order: visualizing modern psychiatry--strategies for legitimizing Swiss asylum psychiatry in the context of occupational therapy in the interwar period].

Science.gov (United States)

Germann, Urs

2006-01-01

In the 1930s Swiss psychiatrists were engaged in a singular public campaign to promote a new image of their profession. The result of this campaign was a series of booklets about psychiatric institutions. These asylum-monographs, as they were called, encompassed a large number of photographic illustrations, most of which showed patients at work. Taking the visual omnipresence of patients' work in the asylum-monographs as a starting point, this contribution examines the status of occupational therapy in psychiatric discourse and practice in Switzerland at the beginning of the 1930s. The first part of the contribution describes and outlines the development of patients' work in several psychiatric institutions after World War I. Then it turns to the discussion about the introduction of a new and more active form of occupational therapy ("aktivere Therapie") in this period. The second part of the contribution analyzes the meanings of therapeutic work in psychiatric discourse. It shows that the enthusiasm occupational therapy produced among Swiss psychiatrists was mainly due to its ability to change the visual appearance of the asylums. Furthermore it points to several traits of Eugen Bleuler's concept of schizophrenia, especially the assumption of different ranks of primary and secondary symptoms and the notion of autism, which were both crucial to the contemporary understanding and handling of occupational therapy. Finally, it argues that a medical interpretation of patients' work, which identified therapy with working discipline, was a necessary precondition for the omnipresence of patients' work in Swiss psychiatry's public campaign in the 1930s.

Geographical distribution of torture: An epidemiological study of torture reported by asylum applicants examined at the Department of Forensic Medicine, University of Copenhagen

DEFF Research Database (Denmark)

Busch, Johannes Rødbro; Hansen, Steen Holger; Hougen, Hans Petter

2015-01-01

Using reports from 154 examinations of alleged torture victims among asylum applicants to Denmark conducted by the Department of Forensic Medicine, Univer- sity of Copenhagen, between 2001 and 2013, we have categorized the victims into four geographical regions, as well as according to the conflict...

Romulus’ adytum or asylum? A New Exegetical proposal for De lingua Latina 5, 8

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Federica Lazzerini

2017-05-01

Molto si è discusso sui quattro livelli progressivi secondo i quali Varrone struttura l’etimologia in ling. 5, 8; a ogni livello è associato un diverso tipo di analisi e si applica a una diversa categoria di parole. Una formulazione criptica ed ellittica, in un passo che nel manoscritto del testo è quasi certamente corrotto, avvolgono il quarto livello in una nube di incertezza e ambiguità. Se alcuni filologi hanno difeso il mantenimento del tradito Quartus, ubi est aditus et initia regis (“Il quarto livello è dove è l’ingresso e le origini del re”, la maggior parte delle interpretazioni moderne opta piuttosto per l’emendazione di aditus in adytum (“santuario” e legge il passo come un riferimento a vari tipi di culti misterici, collocando il quarto livello etimologico in un quadro di esoterismo. Nel presente contributo, si avanza la proposta che nel passo in questione non vi sia alcuna allusione ai misteri, ma un riferimento all’episodio storico-leggendario della fondazione, da parte di Romolo, di un “santuario” sul Campidoglio, destinato all’accoglienza di supplici provenienti da ogni popolo ed estrazione sociale. Questa istituzione portò alla formazione del primo nucleo abitativo di Roma e anche, di conseguenza, del sostrato vernacolare alle origini della lingua latina; come tale, tale episodio converge con gli interessi e le idee di Varrone. L’ipotesi che il quartus gradus etymologiae alluda al santuario di Romolo può essere difesa o dando una nuova interpretazione al termine adytum, o proponendo un’emendazione testuale (aditus > asylum, che produca il testo Quartus, ubi est asylum et initia regis.

[Dangerous liaisons--physicians and pharmaceutical sales representatives].

Science.gov (United States)

Granja, Mónica

2005-01-01

Interactions between physicians and detailers (even when legitimate ones) raise scientific and ethical questions. In Portugal little thinking and discussion has been done on the subject and the blames for bribery have monopolized the media. This work intended to review what has been said in medical literature about these interactions. How do physicians see themselves when interacting with pharmaceutical companies and their representatives? Do these companies in fact change their prescriptive behaviour, and, if so, how do they change it? How can physicians interact with detailers and still keep their best practice? A Medline research, from 1966 till 2002, was performed using the key-words as follows. A database similar to Medline but concerning medical journals published in Portugal, Index das Revistas Médicas Portuguesas, was also researched from 1992 to 2002. Pharmaceutical companies are profit bound and they allot promoting activities, and detailing in particular, huge amounts of money. Most physicians hold firmly to the belief that they are able to resist and not be influenced by drug companies promotion activities. Nevertheless, all previous works on literature tell us the opposite. Market research also indicates that detailers effectively promote drug sales. Various works also suggest that the information detailers provide to physicians may be largely incorrect, even comparing it to the written information provided by the pharmaceutical companies they work for. The frequency at which portuguese physicians (especially family physicians) contact with pharmaceutical sales representatives is higher than the frequency reported in countries where the available studies come from (namely, Canada and the United States of America). This may put portuguese physicians at a higher risk, making it imperative that work and wide debate are initiated among the class.

Taking care of patients--does it matter whether the physician is a woman?

OpenAIRE

Arnold, R M; Martin, S C; Parker, R M

1988-01-01

Researchers have recently begun to compare male and female physicians' attitudes toward patients, medical knowledge, and practice styles. Although women start medical school with more "humanistic views," the conservative effect of medical socialization on both male and female students attenuates these differences. While some studies suggested that men are more scientifically knowledgeable, recent studies showed no significant differences in physicians' medical knowledge. Male and female physi...

Physician leadership development at Cleveland Clinic: a brief review.

Science.gov (United States)

Christensen, Terri; Stoller, James K

2016-06-01

We aim to describe the rationale for and spectrum of leadership development programs, highlighting experience at a large healthcare institution (Cleveland Clinic, Cleveland, Ohio, USA). Developing leaders is a universal priority to sustain organizational success. In health care, significant challenges of ensuring quality and access and making care affordable are widely shared internationally and demand effective physician leadership. Yet, leadership competencies differ from clinical and scientific competencies and features of selecting and training physicians-who have been called "heroic lone healers" -often conspire against physicians being effective leaders or followers. Thus, developing leadership competencies in physicians is critical.Leadership development programs have been signature features of successful organizations and various Australian organizations offer such training (e.g. The Australian Leadership Foundation and the University of South Australia), but relatively few health care organizations have adopted the practice of offering such training, both in Australia and elsewhere. As a United States example of one such integrated program, the Cleveland Clinic, a large, closed-staff physician-led group practice in Cleveland, Ohio has offered physician leadership training for over 15 years. This paper describes the rationale, structure, and some of the observed impacts associated with this program. © The Royal Australian and New Zealand College of Psychiatrists 2016.

Medicolegal reports in asylum applications: a framework for addressing the practical and ethical challenges.

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Pitman, Alexandra

2010-03-01

The clinical care of asylum-seekers may bring clinicians in contact with the immigration authorities. A request for a medicolegal report usually requires the responsible clinician to state their opinion on the risks involved in returning an applicant to their country of origin, taking into account their current condition, the treatments available in that country, and the risks involved in travel. This review draws on clinical experience and a review of the literature to describe the work involved in preparing a medical report requested by immigration authorities. Although the starting point chosen is the psychiatric report, the principles described apply to the preparation of immigration reports in any medical discipline.

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

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Taylor, Keith

2009-10-01

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.

Social competence of physicians and medical students – a preliminary report

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Bożena Mroczek

2016-09-01

Full Text Available Background . Efficient functioning at work and in the environment depends on social and emotional competence, understood as complex skills that determine the effectiveness of behaviors in various professional and social situations. Objectives. The aim of this study was to determine the social competence of physicians and medical students with regard to the sociodemographic contributors which shape social competence. Material and methods . The study was conducted in 2015 and 2016 and it involved 90 physicians, including 25 GPs (27.8% and 53 medical students of PMU in Szczecin. The median age of the physicians and the students was 32 and 25, respectively. The Social Competencies Questionnaire (SC Q by Anna Matczak and a self-developed survey questionnaire were employed. Results. The ability of physicians to achieve medium and high levels of social competence increases by 8.5% with every year of seniority. Membership in scientific societies increases the odds of a high level of social competence fivefold in the ES scale and fourfold in the A scale. Physicians involved in the education of medical students were less likely to obtain medium and high scores (5 stens in the A scale. An increase in seniority in the last workplace is accompanied by a 0.93 times lower probability of obtaining a high competence score in the A scale. Similarly, third cycle degree studies increase the odds of achieving high competence level by 7.48 times in the A scale. Conclusions . Low levels of competence can be expected from physicians with less seniority, not belonging to scientific societies, not involved in students’ education, working in only one place, and not participating in third cycle degree studies. This group should be provided with social competence training.

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

Science.gov (United States)

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.

The Characteristics of Patients with Intellectual Disabilities Held in Forensic Asylums in Norway: 1915–1987

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Erik Søndenaa

2018-02-01

Full Text Available A significant number of patients with intellectual disability (ID were admitted to forensic mental health asylums during the period 1915–1987. Many of these patients stayed for more than a decade, because of previous offending behaviour. We investigated the daily lives of 262 patients with an ID using casebooks. Two of the patients were studied more in detail. The available documents describe most of these patients as sociable, well-behaved and socially engaged although they missed having contacts outside the hospital. Long-stay patients were studied more in detail.

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

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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.

Human lead exposure in a late 19th century mental asylum population

Energy Technology Data Exchange (ETDEWEB)

Bower, Nathan W. [Department of Chemistry, Colorado College, Colorado Springs, CO 80903-3294 (United States)]. E-mail: nbower@coloradocollege.edu; McCants, Sarah A. [Department of Chemistry, Colorado College, Colorado Springs, CO 80903-3294 (United States); Custodio, Joseph M. [Department of Chemistry, Colorado College, Colorado Springs, CO 80903-3294 (United States); Ketterer, Michael E. [Departments of Chemistry and Biochemistry, Northern Arizona University, Flagstaff, AZ 86011-5698 (United States); Getty, Stephen R. [Biological Sciences Curriculum Study, Colorado Springs, CO 80918 (United States); Hoffman, J. Michael [Department of Anthropology, Colorado College, Colorado Springs, CO 8090-3294 (United States)

2007-01-01

Lead isotope ratios and lead (Pb) levels were analyzed in 33 individuals from a forgotten cemetery at the Colorado Mental Health Institute at Pueblo, Colorado dating to 1879-1899. Isotopic ratios from healing bone fractures, cortical bone, and tooth dentine provide information about sources of Pb exposures over a range of time that illuminates individual's life histories and migration patterns. Historical records and Pb production data from the 19th century were used to create a database for interpreting Pb exposures for these African, Hispanic and European Americans. The analysis of these individuals suggests that Pb exposure noticeably impacted the mental health of 5-10% of the asylum patients in this frontier population, a high number by standards today, and that differences exist in the three ancestral groups' exposure histories.

Human lead exposure in a late 19th century mental asylum population

International Nuclear Information System (INIS)

Bower, Nathan W.; McCants, Sarah A.; Custodio, Joseph M.; Ketterer, Michael E.; Getty, Stephen R.; Hoffman, J. Michael

2007-01-01

Lead isotope ratios and lead (Pb) levels were analyzed in 33 individuals from a forgotten cemetery at the Colorado Mental Health Institute at Pueblo, Colorado dating to 1879-1899. Isotopic ratios from healing bone fractures, cortical bone, and tooth dentine provide information about sources of Pb exposures over a range of time that illuminates individual's life histories and migration patterns. Historical records and Pb production data from the 19th century were used to create a database for interpreting Pb exposures for these African, Hispanic and European Americans. The analysis of these individuals suggests that Pb exposure noticeably impacted the mental health of 5-10% of the asylum patients in this frontier population, a high number by standards today, and that differences exist in the three ancestral groups' exposure histories

Development of physician leadership competencies: perceptions of physician leaders, physician educators and medical students.

Science.gov (United States)

McKenna, Mindi K; Gartland, Myles P; Pugno, Perry A

2004-01-01

Research regarding the development of healthcare leadership competencies is widely available. However, minimal research has been published regarding the development of physician leadership competencies, despite growing recognition in recent years of the important need for effective physician leadership. Usingdata from an electronically distributed, self-administered survey, the authors examined the perceptions held by 110 physician leaders, physician educators, and medical students regarding the extent to which nine competencies are important for effective physician leadership, ten activities are indicative of physician leadership, and seven methods are effective for the development of physician leadership competencies. Results indicated that "interpersonal and communication skills" and "professional ethics and social responsibility" are perceived as the most important competencies for effective physician leadership. Furthermore, respondents believe "influencing peers to adopt new approaches in medicine" and "administrative responsibility in a healthcare organization" are the activities most indicative of effective physician leadership. Finally, respondents perceive"coaching or mentoring from an experienced leader" and "on-job experience (e.g., a management position)" as the most effective methods for developing physician leadership competencies. The implications of these findings for the education and development of physician leaders are discussed.

Communication between physicians and cancer patients about complementary and alternative medicine: exploring patients' perspectives.

Science.gov (United States)

Tasaki, Katsuya; Maskarinec, Gertraud; Shumay, Dianne M; Tatsumura, Yvonne; Kakai, Hisako

2002-01-01

The aim of this paper is to identify barriers to communication between physicians and cancer patients regarding complementary and alternative medicine (CAM) by exploring the perspectives of patients. In face of the recent popularity of CAM use among cancer patients, the lack of communication is a serious problem. A number of CAM therapies may interfere with conventional treatments and thus impact patients' well-being and chances of survival. In addition, lack of communication is problematic in the health care context because the development of openness and trust between health care providers and clients is contingent upon effective interpersonal communication. We conducted semi-structured interviews with 143 cancer patients to explore their experiences with CAM use. Using a qualitative research method, we examined interview data from 93 CAM users who provided sufficient information about communication issues. As a result, three themes emerged describing barriers to unsuccessful communication as perceived from the patient's point of view: physicians' indifference or opposition toward CAM use, physicians' emphasis on scientific evidence, and patients' anticipation of a negative response from their physician. Increasing education about CAM and regular assessment of CAM use may help physicians to be more aware of their patients' CAM use. As a result, physicians may provide patients with information on risks and benefits of CAM use and refer patients to other services that may address unmet needs. Given a difference in epistemiologic beliefs about cancer and its treatment, the challenge is to find a common ground for an open discussion in which physicians consider that scientific evidence is not all that counts in the life of an individual facing a serious disease. Copyright 2002 John Wiley & Sons, Ltd.

Asylum, Immigration Restrictions and Exploitation: Hyper-precarity as a lens for understanding and tackling forced labour

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Hannah Lewis

2015-09-01

Full Text Available The topic of forced labour is receiving a growing amount of political and policy attention across the globe. This paper makes two clear contributions to emerging debates. First, we focus on a group who are seldom explicitly considered in forced labour debates: forced migrants who interact with the asylum system. We build an argument of the production of susceptibility to forced labour through the United Kingdom’s (UK asylum system, discussing the roles of compromised socio-legal status resulting from restrictive immigration policy, neoliberal labour market characteristics and migrants’ own trajectories. Second, we argue that forced labour needs to be understood as part of, and an outcome of, widespread normalised precarious work. Precarity is a concept used to describe the rise of insecure, casualised and sub-contracted work and is useful in explaining labour market processes that are conducive to the production of forced labour. Using precarity as a lens to examine forced labour encourages the recognition of extreme forms of exploitation as part of a wider picture of systematic exploitation of migrants in the labour market. To understand the reasons why forced migrants might be drawn into severe labour exploitation in the UK, we introduce the concept of hyper-precarity to explain how multidimensional insecurities contribute to forced labour experiences, particularly among forced migrants in the global north. Viewing forced labour as connected to precarity also suggests that avenues and tools for tackling severe labour exploitation need to form part of the wider struggle for migrant labour rights.

Female genital cutting: an evidence-based approach to clinical management for the primary care physician.

Science.gov (United States)

Hearst, Adelaide A; Molnar, Alexandra M

2013-06-01

The United States has more than 1.5 million immigrants from countries in Africa and the Middle East where female genital cutting (FGC) is known to occur. Often, FGC occurs in infancy and childhood in the countries where it is practiced, but patients of any age can present with complications. Lack of understanding of this common problem can potentially alienate and lower quality of care for this patient population. We provide an introduction to the practice of FGC and practice guidelines for the primary care physician. We reviewed original research, population-based studies, and legal research from PubMed, Scopus, CINAHL plus, PsycINFO, and Legal Trac. The terms searched included female genital cutting, female genital circumcision, and female genital mutilation alone and with the term complications or health consequences; no limit on date published. Legal databases were searched using the above terms, as well as international law and immigration law. Editorials and review articles were excluded. This review discusses the different types of FGC, important cultural considerations for physicians caring for patients with FGC, the common early and late medical complications and their management, and psychosocial issues associated with FGC. Current laws pertaining to FGC are briefly reviewed, as well as implications for patients seeking asylum status in the United States because of FGC. Finally, the article presents evidence-based, culturally sensitive approaches to discussions of FGC with girls and women for whom this is an issue. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

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

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Clerkin Pauline

2011-05-01

Full Text Available Abstract 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.

The Impact of Direct Provision Accommodation for Asylum Seekers on Organisation and Delivery of Local Primary Care and Social Care Services: A Case Study

LENUS (Irish Health Repository)

Pieper, Hans-Olaf

2011-05-15

Abstract 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.

Contested spacing: International non-profit organizations and the mobility of asylum seekers

DEFF Research Database (Denmark)

Albu, Oana Brindusa

The importance of examining space from an organizational standpoint is timely, not the least because the use of this concept has critical and often unintended social, and political effects (Mengis, Nicolini & Gorli, 2016). The global refugee crisis following the post-2015 Syrian conflict is perhaps...... one indicative situation of the highly contested ways in which international non-profit organizations (INGOs) create spaces for their organizational activities (e.g., build informal settlements to provide emergency aid), and thus affect how individuals (e.g., asylum seekers) get re-settled, confined...... to, or even restricted from living in such spaces. These matters are relevant since in the contexts where both the opportunities to move freely and being at peace are challenged, space is not only a neutral structure in which such contested organizing takes place (Mengis et al., 2016). Rather...

Physician-industry relations. Part 1: individual physicians.

Science.gov (United States)

Coyle, Susan L

2002-03-05

This is part 1 of a 2-part paper on ethics and physician-industry relationships. Part 1 offers advice to individual physicians; part 2 gives recommendations to medical education providers and medical professional societies. Physicians and industry have a shared interest in advancing medical knowledge. Nonetheless, the primary ethic of the physician is to promote the patient's best interests, while the primary ethic of industry is to promote profitability. Although partnerships between physicians and industry can result in impressive medical advances, they also create opportunities for bias and can result in unfavorable public perceptions. Many physicians and physicians-in-training think they are impervious to commercial influence. However, recent studies show that accepting industry hospitality and gifts, even drug samples, can compromise judgment about medical information and subsequent decisions about patient care. It is up to the physician to judge whether a gift is acceptable. A very general guideline is that it is ethical to accept modest gifts that advance medical practice. It is clearly unethical to accept gifts or services that obligate the physician to reciprocate. Conflicts of interest can arise from other financial ties between physicians and industry, whether to outside companies or self-owned businesses. Such ties include honorariums for speaking or writing about a company's product, payment for participating in clinic-based research, and referrals to medical resources. All of these relationships have the potential to influence a physician's attitudes and practices. This paper explores the ethical quandaries involved and offers guidelines for ethical business relationships.

[The psychiatric revolution in Quebec, 1950-1962. From asylum to community psychiatry and the open door].

Science.gov (United States)

Duprey, Catherine

2011-01-01

Psychiatry opens to the world at a time when the very basis of psychiatric practice, namely the asylum, is called into question. Studies appear in Quebec and Canadian journals concurrent to the introduction of new formulas for care, such as the delivery of psychiatric services in general hospitals and clinics, that allow patients to be treated outside the walls of psychiatric hospitals. In addition, postwar psychiatry takes an optimistic view toward the future of children with impairments through the creation of specialized schools and workshops. From the mid-20th century onward, the thinking in psychiatry centres on the open door.

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

Science.gov (United States)

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.

Unaccompanied & Denied: Regional Legal Framework for Unaccompanied Minors Asylum Seekers (UMAS

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Rohaida Nordin

2015-12-01

Full Text Available Unaccompanied minor asylum seekers are vulnerable and thus, provided special international law protections. However, in reality, they are being mistreated as illegal immigrants and on thereceiving end of ethnic violence, discrimination, restrictions in enjoyment of their rights duly recognised by international human rights law. This article identifies legislative, policy and supportmechanisms which encompass the minimum UMAS guardianship standards at international law and which are evidence-based from best practice models for the provision of guardians for UMASinternationally. It presents situation of UMAS in relation to human rights violations with emphasis on the legal framework and practices in Australia and five ASEAN State Members. This article also highlights the various stands taken by various countries providing better legal framework and practices regarding the terms for protection and enforcement of human rights for UMAS. Finally, this article provides recommendations for Australia and ASEAN Member States to adopt in order to realise the international human rights of UMAS with respect to guardianship.

Representation of Refugees, Asylum-Seekers and Refugee Affairs In Hungarian Dailies

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Lilla VICSEK

2008-11-01

Full Text Available How does the press in Hungary write about refugees, asylum-seekers and refugee affairs? We sought to answer this question. Articles appearing in 2005 and 2006 in two leading national Hungarian dailies were examined with quantitative content analysis. The results show that the articles analyzed often treat refugee affairs as an “official” political matter. The high proportion of legislation and political positions conveys the image that refugee affairs are a state or intergovernmental matter, an “official”, legal, political issue rather than for example a humanitarian question. Most of the articles published in both papers write about problems and conflicts in connection with refugee affairs. The negative media image has different significance for different topics. We argue that the question of refugee affairs is a topic where the image shown by the media is of great relevance: the media can be a more important source of information on this subject than personal contacts.

Differences in the prevalence of hospitalizations and utilization of emergency outpatient services for ambulatory care sensitive conditions between asylum-seeking children and children of the general population: a cross-sectional medical records study (2015

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Célina Lichtl

2017-11-01

Full Text Available Abstract Background Hospitalizations for ambulatory care sensitive (ACS conditions are established indicators for the availability and quality of ambulatory care. We aimed to assess the differences between asylum-seeking children and children of the general population in a German city with respect to (i the prevalence of ACS hospitalizations, and (ii the utilization of emergency outpatient services for ACS conditions. Methods Using anonymous account data, all children admitted to the University Hospital Heidelberg in 2015 were included in our study. A unique cost unit distinguished asylum seekers residing in a nearby reception center (exposed from the children of the general population. We adapted international lists of ACS conditions and calculated the prevalence of ACS hospitalizations and the utilization of emergency outpatient services for ACS conditions, attributable fractions among the exposed (Afe and the population attributable fraction among total admissions (PAF for each outcome. Differences in the prevalence of each outcome between exposed and controls were analyzed in logistic regression models adjusted for sex, age group and quarterly admission. Results Of the 32,015 admissions in 2015, 19.9% (6287 were from inpatient and 80.1% (25,638 from outpatient care. In inpatient care, 9.8% (622 of all admissions were hospitalizations for ACS conditions. The Afe of ACS hospitalizations was 46.57%, the PAF was 1.12%. Emergency service use for ACS conditions could be identified in 8.3% (3088 of all admissions (Afe: 79.57%, PAF: 5.08%. The odds ratio (OR of asylum-seeking children being hospitalized for ACS conditions in comparison to the control group was 1.81 [95% confidence interval, CI: 1.02; 3.2]. The OR of the asylumseeking population compared to the general population for the utilization of emergency service use for ACS conditions was 4.93 [95% CI: 4.11; 5.91]. Conclusions Asylum-seeking children had significantly higher odds of ACS

Translation through argumentation in medical research and physician-citizenship.

Science.gov (United States)

Mitchell, Gordon R; McTigue, Kathleen M

2012-06-01

While many "benchtop-to-bedside" research pathways have been developed in "Type I" translational medicine, vehicles to facilitate "Type II" and "Type III" translation that convert scientific data into clinical and community interventions designed to improve the health of human populations remain elusive. Further, while a high percentage of physicians endorse the principle of citizen leadership, many have difficulty practicing it. This discrepancy has been attributed, in part, to lack of training and preparation for public advocacy, time limitation, and institutional resistance. As translational medicine and physician-citizenship implicate social, political, economic and cultural factors, both enterprises require "integrative" research strategies that blend insights from multiple fields of study, as well as rhetorical acumen in adapting messages to reach multiple audiences. This article considers how argumentation theory's epistemological flexibility, audience attentiveness, and heuristic qualities, combined with concepts from classical rhetoric, such as rhetorical invention, the synecdoche, and ethos, yield tools to facilitate translational medicine and enable physician-citizenship.

Divine service, music, sport, and recreation as medicinal in Australian asylums 1860s-1945.

Science.gov (United States)

MacKinnon, Dolly

2009-01-01

Australian asylum records (circa 1860 to circa 1945) demonstrate that medical staff went to great lengths to provide recreation to suitable patients. This article examines how the demarcation of Australian institutional spaces along gender divisions was also mirrored by the gender-specific recreational activities provided in purpose-built facilities. Using Australian examples I demonstrate how the main forms of recreation-that is divine service, music and dance, and sport-were justified to governments on medical grounds. Some designated recreational spaces even offered select female and male patients the opportunity to mix under medical supervision. Recreation was therapeutic because of its psychological, physical, social, and moral benefits, and government authorities funded the construction of costly chapels, recreation halls, and sports grounds expressly for this medical purpose.

[Philosophers, physicists and physicians in defense of the unity of the scientific method].

Science.gov (United States)

Antiseri, D

1998-01-01

The falsifiability of scientific knowledge is an acquired result of contemporary philosophy of science and yet there is not a universal consensus upon the idea of the unity of scientific method. Albeit there are differences in techniques of testing (methodics) hypotheses in the vast field of research, the author, following the critical rationalism of Karl Popper, favors the perspective of the unity of method in natural as well in social and philological sciences.

Seeking asylum in Denmark: Refugee children's mental health and exposure to violence

DEFF Research Database (Denmark)

Montgomery, Edith; Foldspang, Anders

2005-01-01

Aims: The aim of this study was to compare profiles of present mental health and previous exposure to violence among refugee children from the Middle East, whose asylum seeking families either did or did not obtain permission to stay in Denmark. Methods: Shortly after arrival in Denmark......, the parents of 311 Middle-Eastern children answered a structured interview on their children’s exposure to organized violence and their mental health. The families were followed-up as concerns receipt of a residence permit. Results: At arrival in Denmark, the children’s patterns of previous exposure...... to violence and present mental health was generally similar irrespective of the family getting a residence permit, as was the case for 90 families (60.4%) with 190 children (61.1%). In both groups an overwhelming majority, eight to nine out of 10 children, had been exposed to conditions of war and had stayed...

The Phoenix Physician: defining a pathway toward leadership in patient-centered care.

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Good, Robert G; Bulger, John B; Hasty, Robert T; Hubbard, Kevin P; Schwartz, Elliott R; Sutton, John R; Troutman, Monte E; Nelinson, Donald S

2012-08-01

Health care delivery has evolved in reaction to scientific and technological discoveries, emergent patient needs, and market forces. A current focus on patient-centered care has pointed to the need for the reallocation of resources to improve access to and delivery of efficient, cost-effective, quality care. In response to this need, primary care physicians will find themselves in a new role as team leader. The American College of Osteopathic Internists has developed the Phoenix Physician, a training program that will prepare primary care residents and practicing physicians for the changes in health care delivery and provide them with skills such as understanding the contributions of all team members (including an empowered and educated patient), evaluating and treating patients, and applying performance metrics and information technology to measure and improve patient care and satisfaction. Through the program, physicians will also develop personal leadership and communication skills.

Survey of Knowledge, Attittudes and Practices about Antibiotic Use in Colombian Physicians

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Jorge Cortes

2018-04-01

Full Text Available We applied a voluntary survey about knowledge, attittudes and practices about antibiotic prescription at three scientific meetings of the Asociacion Colombiana de Infectología, on February 2008. The survey was anonimous and individual. The results were analyzed using Excel 2007 and STATA 2000. We analyzed 96 surveys, 29 from general practitioners and 67 medical specialists. Physicians had wrong knowledge about antibiotic use between 29,2% and 67,42%. Most physicians (97.4% considered the antibiotics have to be sold only under medical prescription. Many physicians recognized having limited knowledge about antibiotic dosing interval and security. 60% physicians disagreed with the application of guidelines from other countries in our enviroment and 76% physician consider the infectious disease experts contribute to clinical management of patients. Physicians reported having support from an infectious disease expert on 72%, and had strategies to restrict the use of some antibiotics, likecontact isolation when multi-resistant organisms had been suspected. There were not differences between answers according to years of experience. Several physcians reported conservative practices and rational antibiotic use with limited knowledge about antibiotic pharmacokinetics and pharmacodynamics.

[Habitus, capital and fields: the search for an acting head of the Hamburg Asylum Friedrichsberg in 1897].

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Sammet, Kai

2005-01-01

In 1897 Hamburg was in search of an Oberarzt for the asylum Friedrichsberg who should function as the acting head of the head Wilhelm Reye (1833-1912). This search was part of the intended reformation of the outmoded psychiatric care in Hamburg. During this application procedure the Hamburg Physikus John Wahncau examined all possible candidates and applicants. The article explores the election process by using some sociological categories developed by Pierre Bourdieu (habitus, capital, field). The author argues that not only meritocratic attributes led to the choice of one candidate, but also his functional "fitting" into the field in Hamburg.

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

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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 (Pviolence (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.

Physician practice management companies: should physicians be scared?

Science.gov (United States)

Scott-Rotter, A E; Brown, J A

1999-01-01

Physician practice management companies (PPMCs) manage nonclinical aspects of physician care and control physician groups by buying practice assets. Until recently, PPMCs were a favorite of Wall Street. Suddenly, in early 1998, the collapse of the MedPartners-PhyCor merger led to the rapid fall of most PPMC stock, thereby increasing wariness of physicians to sell to or invest in PPMCs. This article explores not only the broken promises made by and false assumptions about PPMCs, but also suggests criteria that physicians should use and questions would-be PPMC members should ask before joining. Criteria include: demonstrated expertise, a company philosophy that promotes professional autonomy, financial stability, freedom from litigation, and satisfied physicians already in the PPMC. The authors recommend that physicians seek out relatively small, single-specialty PPMCs, which hold the best promise of generating profits and permitting professional control over clinical decisions.

Dietary Supplements in American Children: Scientific vs Marketing Justifications.

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Grivetti, Louis E.

2002-01-01

The American public receives conflicting messages from dietitians, nutritionists, physicians, and manufacturers regarding food supplements. Consumers commonly distrust scientists and justify supplement use based upon word of mouth and friendship patterns. Scientific-based education regarding supplement use is vital in the present atmosphere where consumer misinformation is rampant.

Resident physicians in Mexico: tradition or humiliation

Directory of Open Access Journals (Sweden)

Donovan Casas Patiño

2013-08-01

Full Text Available Mexico has a great history and tradition in relation to the training of resident physicians, but what we find behind this process?, Power relations implied and not implied, unnoticed or ignored for convenience by the academic and health institutions, with the aggravation of forgetting its commitment to the training of men and women "professionals" and limited to meet another indicator of "human resources for health." The resident physician in academic and scientific training is immersed in this dehumanized maelstrom and ends up becoming a character for the domain of knowledge as power, forgetting that his act and its rationale lies in the principle of "primum non nocere" to that we would add: nor your person, nor your fellowman, much less whom you have the moral, ethical and civic responsibility to convey some of your knowledge and your experience, that is, part of your essence”.

The relationship between physician humility, physician-patient communication, and patient health.

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Ruberton, Peter M; Huynh, Ho P; Miller, Tricia A; Kruse, Elliott; Chancellor, Joseph; Lyubomirsky, Sonja

2016-07-01

Cultural portrayals of physicians suggest an unclear and even contradictory role for humility in the physician-patient relationship. Despite the social importance of humility, however, little empirical research has linked humility in physicians with patient outcomes or the characteristics of the doctor-patient visit. The present study investigated the relationship between physician humility, physician-patient communication, and patients' perceptions of their health during a planned medical visit. Primary care physician-patient interactions (297 patients across 100 physicians) were rated for the physician's humility and the effectiveness of the physician-patient communication. Additionally, patients reported their overall health and physicians and patients reported their satisfaction with the interaction. Within-physician fluctuations in physician humility and self-reported patient health positively predicted one another, and mean-level differences in physician humility predicted effective physician-patient communication, even when controlling for the patient's and physician's satisfaction with the visit and the physician's frustration with the patient. The results suggest that humble, rather than paternalistic or arrogant, physicians are most effective at working with their patients. Interventions to improve physician humility may promote better communication between health care providers and patients, and, in turn, better patient outcomes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Public health ethics: asylum seekers and the case for political action.

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McNeill, Paul M

2003-10-01

This paper is a case study in public health ethics. It considers whether there is a basis in ethics for political action by health professionals and their associations in response to inhumane treatment. The issue arises from Australia's treatment of asylum seekers and the charge that this treatment has been both immoral and inhumane. This judgement raises several questions of broader significance in bioethics and of significance to the emerging field of public health ethics. These questions relate to the role of health professionals in response to inhumane treatment of people in their charge; to the discipline of public health in light of a growing recognition of its ethical basis; and the role of public health and bioethical associations in response to ethical issues arising in a political context. It is argued that, in serious cases of humanitarian and human rights abuses affecting health and well-being, there is a case for political action by health professionals, academic and professional institutions, and associations of public health and ethics.

Physician Order Entry Clerical Support Improves Physician Satisfaction and Productivity.

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Contratto, Erin; Romp, Katherine; Estrada, Carlos A; Agne, April; Willett, Lisa L

2017-05-01

To examine the impact of clerical support personnel for physician order entry on physician satisfaction, productivity, timeliness with electronic health record (EHR) documentation, and physician attitudes. All seven part-time physicians at an academic general internal medicine practice were included in this quasi-experimental (single group, pre- and postintervention) mixed-methods study. One full-time clerical support staff member was trained and hired to enter physician orders in the EHR and conduct previsit planning. Physician satisfaction, productivity, timeliness with EHR documentation, and physician attitudes toward the intervention were measured. Four months after the intervention, physicians reported improvements in overall quality of life (good quality, 71%-100%), personal balance (43%-71%), and burnout (weekly, 43%-14%; callousness, 14%-0%). Matched for quarter, productivity increased: work relative value unit (wRVU) per session increased by 20.5% (before, April-June 2014; after, April-June 2015; range -9.2% to 27.5%). Physicians reported feeling more supported, more focused on patient care, and less stressed and fatigued after the intervention. This study supports the use of physician order entry clerical personnel as a simple, cost-effective intervention to improve the work lives of primary care physicians.

[Chance meeting of psychiatry and art on the "dissecting table"].

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Perenyei, Monika

2015-01-01

This paper shows one of many aspects of the history of the Hungarian psychiatry between the two world wars. The data were collected from the "Hungarian Museum of Mind" opened for the public in 1931. It focuses on the collecting policy and the research topics of Hungarian psychiatrists working in the asylums in those days. In 2007 Lipotmezo (the Hungarian Psychiatric and Neurological Institution the biggest Hungarian asylum since its foundations in 1868) was closed. Its art collection was rescued by the Hungarian Academy of Science. From 2007 this collection has been named The Psychiatric Art Collection of the HAS, maintained by The Research Centre for the Humanities of the Hungarian Academy of Science. The artistic objects and documents are properly stored and available for research. Two art historians are in charge of curating the exhibitions and leading the research on the psychiatric art in the context of history, psychiatric history and contemporary culture. This work follows the well established practice of the eighties and nineties when the art historian Edit Plesznivy expert in this subject listed the pieces of this historical collection, and through the context of outsider art and art therapy she channeled it into the field of art institutions. Leaving the hospital environment and having been introduced to the academic world the research is looking toward the collection has been changed and new perspectives have been opened. Beside the art works of the patients living as inmates in mental hospitals, the collecting work and therapeutic practices of the mental physicians became a significant research topic also. Arpad Selig as an assistant physician at the Mental and Neurological Clinic in Lipotmezo started to collect the patients' works of art in the first decade of twentieth century. During the 1920s he was appointed the director of Angyalfold Asylum found in 1883. Selig died in 1929 and the Museum of Mind named after its enthusiastic founder Selig was

[Asylum Law and Mental Health: An Interdisciplinary Analysis of the Coaction of Medical and Legal Aspects].

Science.gov (United States)

Hanewald, Bernd; Gieseking, Janina; Vogelbusch, Oliver; Markus, Inessa; Gallhofer, Bernd; Knipper, Michael

2016-04-01

Interdisciplinary analysis of the consequences of laws and legal practice for mental health conditions of asylum seekers and psychiatric care. Based on the case study of a Kurdish woman with complex trauma-related psychiatric disorder, who had been in psychiatric hospital care for 25 months, the legal and medical facts are exposed, followed by a discussion referring to theoretical approaches from medical anthropology. Immigration laws and legal practice can have harmful consequences, which can be interpreted as "structural violence". In case of traumatized refugees, the coaction of legal and medical aspects has to be acknowledged seriously by the medical, legal and political parts involved. © Georg Thieme Verlag KG Stuttgart · New York.

Sex differences in physician salary in U.S. public medical schools

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Jena, Anupam B.; Olenski, Andrew R.; Blumenthal, Daniel M.

2017-01-01

Importance Limited evidence exists on salary differences between male and female academic physicians, largely due to difficulty obtaining data on salary and factors influencing salary. Existing studies have been limited by reliance on survey-based approaches to measuring sex differences in earnings, lack of contemporary data, small sample sizes, or limited geographic representation. Objective To analyze sex differences in earnings among U.S. academic physicians. Design, setting, and participants Freedom of Information laws mandate release of salary information of public university employees in several states. In 12 states with salary information published online, we extracted salary data on 10,241 academic physicians at 24 public medical schools. We linked this data to a unique physician database with detailed information on sex, age, years of experience, faculty rank, specialty, scientific authorship, NIH funding, clinical trial participation, and Medicare reimbursements (proxy for clinical revenue). We estimated sex differences in salary adjusting for these factors. Exposure Physician sex Main outcome measures Annual salary Results Female physicians had lower unadjusted salaries than male physicians ($206,641 vs. $257,957; difference $51,315; 95% CI $46,330–$56,301). Sex differences persisted after multivariable adjustment ($227,782 vs. $247,661; difference $19,878; 95% CI $15,261–$24,495). Sex differences in salary varied across specialties, institutions, and faculty ranks. Female full and associate professors had comparable adjusted salaries to those of male associate and assistant professors, respectively. Conclusions and relevance Among physicians with faculty appointments at 24 U.S. public medical schools, significant sex differences in salary exist even after accounting for age, experience, specialty, faculty rank, and measures of research productivity and clinical revenue. PMID:27400435

Asylum Seekers Crisis in Europe 2015: Debating Spaces of Fear and Security in Latvia

Directory of Open Access Journals (Sweden)

Lulle Aija

2015-12-01

Full Text Available In this paper we analyse emerging discourses of fear on the one hand and safety and security on the other. In the context of rupture - sudden, unprecedented asylum flows as well as the historical context of the fear and experience of losing the state’s freedom, we pose the following research question: Where do insecurities and fear come from and how are spaces of security and safety carved out through public discourses? We argue that, instead of singling out political discourses in Eastern European as filled with hatred towards other ethnicities and races or an inability to show solidarity with human suffering, we have to open up a far more deep reaching debate on the interplay of fear and the willingness to create safer, more secure futures. We illustrate this with examples from media debates in Latvia, in late 2015.

Physicians' perceptions of medical representative visits in Yemen: a qualitative study.

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Al-Areefi, Mahmoud Abdullah; Hassali, Mohamed Azmi; Ibrahim, Mohamed Izham b Mohamed

2013-08-20

The pharmaceutical industry invests heavily in promotion, and it uses a variety of promotional strategies to influence physicians' prescribing decisions. Within this context, medical representatives (MRs) are the key personnel employed in promoting their products. One significant consequence of the interactions between physicians and medical representatives is a conflict of interests which may contribute to the over prescribing of medications and thus negative effects on patients' health and economics. There is limited detailed information published on the reasons why physicians interact with pharmaceutical representatives. This study aims to qualitatively explore physicians' attitudes about interactions with medical representatives and their reasons for accepting the medical representatives' visits. In-depth interviews were used to gain a better understanding of physicians' perceptions of medical representative visits. A total of 32 physicians from both private and public hospitals were interviewed. The recordings of the interviews were transcribed verbatim and subject to thematic analysis using a framework analysis approach. The present qualitative study found that the majority of the physicians had positive interactions with medical representatives. The physicians' main reasons stated for allowing medical representatives' visits are the social contacts and mutual benefits they will gain from these representatives. They also emphasized that the meeting with representatives provides educational and scientific benefits. A few physicians stated that the main reasons behind refusing the meeting with medical representatives were lack of conviction about the product and obligation to prescribe medicine from the representative company. Most of the physicians believed that they were under marketing pressure to prescribe certain medicines. Although physicians are aware that the medical representatives could influence their prescribing decision, they welcome

Physicians' perceptions of physician-nurse interactions and information needs in China.

Science.gov (United States)

Wen, Dong; Guan, Pengcheng; Zhang, Xingting; Lei, Jianbo

2018-01-01

Good communication between physicians and nurses is important for the understanding of disease status and treatment feedback; however, certain issues in Chinese hospitals could lead to suboptimal physician-nurse communication in clinical work. Convenience sampling was used to recruit participants. Questionnaires were sent to clinical physicians in three top tertiary Grade-A teaching hospitals in China and six hundred and seventeen physicians participated in the survey. (1) Common physician-nurse interactions were shift-change reports and provisional reports when needed, and interactions expected by physicians included face-to-face reports and communication via a phone or mobile device. (2) Most respondents believed that the need for information in physician-nurse interactions was high, information was moderately accurate and timely, and feedback regarding interaction time and satisfaction indicated that they were only average and required improvement. (3) Information needs in physician-nurse interactions differed significantly according to hospital category, role, workplace, and educational background (p < .05). There was a considerable need for information within physician-nurse interactions, and the level of satisfaction with the information obtained was average; requirements for the improvement of communication differed between physicians and nurses because of differences in their characteristics. Currently, the use of information technology in physician-nurse communication was less common but was highly expected by physicians.

Personal values of exemplary family physicians: implications for professional satisfaction in family medicine.

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Eliason, B C; Schubot, D B

1995-09-01

Personal social values have been identified as important determinants of generalists' specialty choice. However, the personal values or "guiding principles" of generalist physicians have not been identified scientifically. To establish a benchmark, we measured the personal values of exemplary family physicians because they serve as role models for current and future physicians. We also explored the relationship between personal values and practice satisfaction. We obtained a list of 330 family physicians nominated for the American Academy of Family Physicians' (AAFP) Family Doctor of the Year award for the years 1988 through 1993. We asked them to complete the Schwartz Values Questionnaire, a 56-item instrument for measuring personal values. They also answered three questions concerning practice satisfaction. The return rate was 83%. The physicians' mean age was 63 years. They had been in practice an average of 34 years, 93% were male, and 52% practiced in rural areas. Honesty was rated as the most important of the 56 values, and social power as the least important. Of the 10 value types (groups of common values), the responding physicians rated "Benevolence" as most important and "Power" as least important. Practice satisfaction correlated positively with the Benevolence value type (r = .21, P = .001) and negatively with the Power value type (r = -.15, P = .023). Of the 10 value types, Benevolence was rated the most important and Power the least important by exemplary family physicians, and both value types also correlated, positively and negatively, respectively, with their practice satisfaction. These results have implications for the selection, training, and career satisfaction of generalist physicians.

Physicians under the influence: social psychology and industry marketing strategies.

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Sah, Sunita; Fugh-Berman, Adriane

2013-01-01

Pharmaceutical and medical device companies apply social psychology to influence physicians' prescribing behavior and decision making. Physicians fail to recognize their vulnerability to commercial influences due to self-serving bias, rationalization, and cognitive dissonance. Professionalism offers little protection; even the most conscious and genuine commitment to ethical behavior cannot eliminate unintentional, subconscious bias. Six principles of influence - reciprocation, commitment, social proof, liking, authority, and scarcity - are key to the industry's routine marketing strategies, which rely on the illusion that the industry is a generous avuncular partner to physicians. In order to resist industry influence, physicians must accept that they are vulnerable to subconscious bias and have both the motivation and means to resist industry influence. A culture in which accepting industry gifts engenders shame rather than gratitude will reduce conflicts of interest. If greater academic prestige accrues to distant rather than close relationships with industry, then a new social norm may emerge that promotes patient care and scientific integrity. In addition to educating faculty and students about the social psychology underlying sophisticated but potentially manipulative marketing and about how to resist it, academic medical institutions should develop strong organizational policies to counteract the medical profession's improper dependence on industry. © 2013 American Society of Law, Medicine & Ethics, Inc.

Scientific visualization and radiology

International Nuclear Information System (INIS)

Lawrance, D.P.; Hoyer, C.E.; Wrestler, F.A.; Kuhn, M.J.; Moore, W.D.; Anderson, D.R.

1989-01-01

Scientific visualization is the visual presentation of numerical data. The National Center for Supercomputing Applications (NCSA) has developed methods for visualizing computerbased simulations of digital imaging data. The applicability of these various tools for unique and potentially medical beneficial display of MR images is investigated. Raw data are obtained from MR images of the brain, neck, spine, and brachial plexus obtained on a 1.5-T imager with multiple pulse sequences. A supercomputer and other mainframe resources run a variety of graphic and imaging programs using this data. An interdisciplinary team of imaging scientists, computer graphic programmers, an physicians works together to achieve useful information

Social media: physicians-to-physicians education and communication.

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Fehring, Keith A; De Martino, Ivan; McLawhorn, Alexander S; Sculco, Peter K

2017-06-01

Physician to physician communication is essential for the transfer of ideas, surgical experience, and education. Social networks and online video educational contents have grown exponentially in recent years changing the interaction among physicians. Social media platforms can improve physician-to-physician communication mostly through video education and social networking. There are several online video platforms for orthopedic surgery with educational content on diagnosis, treatment, outcomes, and surgical technique. Social networking instead is mostly centered on sharing of data, discussion of confidential topics, and job seeking. Quality of educational contents and data confidentiality represent the major drawbacks of these platforms. Orthopedic surgeons must be aware that the quality of the videos should be better controlled and regulated to avoid inaccurate information that may have a significant impact especially on trainees that are more prone to use this type of resources. Sharing of data and discussion of confidential topics should be extremely secure according the HIPAA regulations in order to protect patients' confidentiality.

Physician self-referral and physician-owned specialty facilities.

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Casalino, Lawrence P

2008-06-01

Physician self-referral ranges from suggesting a follow-up appointment, to sending a patient to a facility in which the doctor has an ownership interest or financial relationship. Physician referral to facilities in which the physicians have an ownership interest is becoming increasingly common and not always medically appropriate. This Synthesis reviews the evidence on physician self-referral arrangements, their effect on costs and utilization, and their effect on general hospitals. Key findings include: the rise in self-referral is sparked by financial, regulatory and clinical incentives, including patient convenience and doctors trying to preserve their income in the changing health care landscape. Strong evidence suggests self-referral leads to increased usage of health care services; but there is insufficient evidence to determine whether this increased usage reflects doctors meeting an unmet need or ordering clinically inappropriate care. The more significant a physician's financial interest in a facility, the more likely the doctor is to refer patients there. Arrangements through which doctors receive fees for patient referrals to third-party centers, such as "pay-per-click," time-share, and leasing arrangements, do not seem to offer benefits beyond increasing physician income. So far, the profit margins of general hospitals have not been harmed by the rise in doctor-owned facilities.

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

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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.

Measuring the health impact of human rights violations related to Australian asylum policies and practices: a mixed methods study.

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Johnston, Vanessa; Allotey, Pascale; Mulholland, Kim; Markovic, Milica

2009-02-03

Human rights violations have adverse consequences for health. However, to date, there remains little empirical evidence documenting this association, beyond the obvious physical and psychological effects of torture. The primary aim of this study was to investigate whether Australian asylum policies and practices, which arguably violate human rights, are associated with adverse health outcomes. We designed a mixed methods study to address the study aim. A cross-sectional survey was conducted with 71 Iraqi Temporary Protection Visa (TPV) refugees and 60 Iraqi Permanent Humanitarian Visa (PHV) refugees, residing in Melbourne, Australia. Prior to a recent policy amendment, TPV refugees were only given temporary residency status and had restricted access to a range of government funded benefits and services that permanent refugees are automatically entitled to. The quantitative results were triangulated with semi-structured interviews with TPV refugees and service providers. The main outcome measures were self-reported physical and psychological health. Standardised self-report instruments, validated in an Arabic population, were used to measure health and wellbeing outcomes. Forty-six percent of TPV refugees compared with 25% of PHV refugees reported symptoms consistent with a diagnosis of clinical depression (p = 0.003). After controlling for the effects of age, gender and marital status, TPV status made a statistically significant contribution to psychological distress (B = 0.5, 95% CI 0.3 to 0.71, p basic human rights, culminated in a strong sense of injustice. Government asylum policies and practices violating human rights norms are associated with demonstrable psychological health impacts. This link between policy, rights violations and health outcomes offers a framework for addressing the impact of socio-political structures on health.

Lab Coats or Trench Coats? Detective Sleuthing as an Alternative to Scientifically Based Research in Indigenous Educational Communities

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Kaomea, Julie

2013-01-01

Amidst late 19th-century efforts to emphasize modern medicine's transition to a more scientific approach, physicians seeking to represent themselves as scientists began wearing white laboratory coats. Today educational researchers are likewise urged to don metaphorical white coats as scientifically based research is held up as the cure-all for our…

How do physicians discuss e-health with patients? the relationship of physicians' e-health beliefs to physician mediation styles.

Science.gov (United States)

Fujioka, Yuki; Stewart, Erin

2013-01-01

A survey of 104 physicians examined the role of physicians' evaluation of the quality of e-health and beliefs about the influence of patients' use of e-health in how physicians discuss e-health materials with patients. Physicians' lower (poor) evaluation of the quality of e-health content predicted more negative mediation (counter-reinforcement of e-health content). Perceived benefits of patients' e-health use predicted more positive (endorsement of e-health content). Physician's perceived concerns (negative influence) regarding patients' e-health use were not a significant predictor for their mediation styles. Results, challenging the utility of restrictive mediation, suggested reconceptualizing it as redirective mediation in a medical interaction. The study suggested that patient-generated e-health-related inquiries invite physician mediation in medical consultations. Findings and implications are discussed in light of the literature of physician-patient interaction, incorporating the theory of parental mediation of media into a medical context.

History and Outcomes of 50 Years of Physician-Scientist Training in Medical Scientist Training Programs.

Science.gov (United States)

Harding, Clifford V; Akabas, Myles H; Andersen, Olaf S

2017-10-01

Physician-scientists are needed to continue the great pace of recent biomedical research and translate scientific findings to clinical applications. MD-PhD programs represent one approach to train physician-scientists. MD-PhD training started in the 1950s and expanded greatly with the Medical Scientist Training Program (MSTP), launched in 1964 by the National Institute of General Medical Sciences (NIGMS) at the National Institutes of Health. MD-PhD training has been influenced by substantial changes in medical education, science, and clinical fields since its inception. In 2014, NIGMS held a 50th Anniversary MSTP Symposium highlighting the program and assessing its outcomes. In 2016, there were over 90 active MD-PhD programs in the United States, of which 45 were MSTP supported, with a total of 988 trainee slots. Over 10,000 students have received MSTP support since 1964. The authors present data for the demographic characteristics and outcomes for 9,683 MSTP trainees from 1975-2014. The integration of MD and PhD training has allowed trainees to develop a rigorous foundation in research in concert with clinical training. MSTP graduates have had relative success in obtaining research grants and have become prominent leaders in many biomedical research fields. Many challenges remain, however, including the need to maintain rigorous scientific components in evolving medical curricula, to enhance research-oriented residency and fellowship opportunities in a widening scope of fields targeted by MSTP graduates, to achieve greater racial diversity and gender balance in the physician-scientist workforce, and to sustain subsequent research activities of physician-scientists.

42 CFR 415.172 - Physician fee schedule payment for services of teaching physicians.

Science.gov (United States)

2010-10-01

... teaching physicians. 415.172 Section 415.172 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.172 Physician fee schedule payment for services of teaching physicians. (a...

Does the physician's emotional intelligence matter? Impacts of the physician's emotional intelligence on the trust, patient-physician relationship, and satisfaction.

Science.gov (United States)

Weng, Hui-Ching

2008-01-01

Much of the literature pertinent to management indicates that service providers with high emotional intelligence (EI) receive higher customer satisfaction scores. Previous studies offer limited evidence regarding the impact of physician's EI on patient-physician relationship. Using a multilevel and multisource data approach, the current study aimed to build a model that demonstrated the impact of a physician's EI on the patient's trust and the patient-physician relationship. The survey sample included 983 outpatients and 39 physicians representing 11 specialties. Results of path analyses demonstrated that the ratio of patient's follow-up visits (p impact of patient's trust on patient's satisfaction was mediated by the patient-physician relationship at a significant level (p relationship had a significantly positive effect on patient's satisfaction (p relationship; however, mutual trust and professional respect between nurses and physicians play a critical role in reinforcing the patient-physician relationship to effect improvements in the provision of patient-centered care.

["What do physicians really read?" Medical journals and pharma-marketing between 1900 and the late 1970s].

Science.gov (United States)

Thoms, Ulrike

2014-01-01

Scientific Journals are widely used sources in the history science. First and foremost they are analyzed under the aspect of professionalization and the development of scientific topics. However, the impact of the increasing number of advertisements on the journals has been almost systematically excluded from historical analysis. The paper analyses the relations between pharma marketing and medical journals. However, the emphasis here is not so much on the development of print advertisements. Instead the paper uses sources, which were produced in the process of marketing to access the history of the medical scientific journal, its change and its reception by physicians.

Louse-borne relapsing fever among East African refugees in Europe.

Science.gov (United States)

Antinori, Spinello; Mediannikov, Oleg; Corbellino, Mario; Raoult, Didier

2016-01-01

Louse-borne relapsing fever a neglected and forgotten disease by western physicians has recently re-emerged among East African migrants seeking asylum in Europe. We review here the cases observed so far together with a critical reappraisal of several issues regarding clinical presentation, diagnosis and treatment. Copyright © 2016 Elsevier Ltd. All rights reserved.

Refugee, Asylum, and Related Legislation in the US Congress: 2013–2016

Directory of Open Access Journals (Sweden)

Tara Magner

2016-11-01

Full Text Available Members of Congress have introduced numerous pieces of legislation in recent years related to refugees, asylum seekers, and other populations of migrants seeking protection in the United States. These bills were drafted in reaction to dramatic events within the United States, at its borders, and around the world. For example, roughly 400,000 children traveling alone and mothers with children have arrived at the southern US border since 2013, many seeking protection from organized crime, gang violence, and threats of human trafficking. Similarly, more than a million refugees from the Middle East, North Africa, and Asia sought to reach safety on the European continent in 2015 alone. Terrorist attacks fueled attempts to curtail the US commitment to offer protection to those fleeing persecution, even when those attacks had no connection to refugees or only tenuous links. And yet existing US law has been left virtually unchanged throughout this tumultuous period. This article describes the significant attempts to enact legislation related to refugees and international migrants since 2013 and examines the reasons why those attempts have not succeeded. It also describes American attitudes toward refugees and assesses whether those attitudes affected the fate of legislation.

First and foremost, physicians: the clinical versus leadership identities of physician leaders.

Science.gov (United States)

Quinn, Joann Farrell; Perelli, Sheri

2016-06-20

Purpose - Physicians are commonly promoted into administrative and managerial roles in US hospitals on the basis of clinical expertise and often lack the skills, training or inclination to lead. Several studies have sought to identify factors associated with effective physician leadership, yet we know little about how physician leaders themselves construe their roles. The paper aims to discuss these issues. Design/methodology/approach - Phenomenological interviews were performed with 25 physicians at three organizational levels with physicians affiliated or employed by four hospitals within one health care organization in the USA between August and September 2010. A rigorous comparative methodology of data collection and analysis was employed, including the construction of analytic codes for the data and its categorization based on emergent ideas and themes that are not preconceived and logically deduced hypotheses, which is characteristic of grounded theory. Findings - These interviews reveal differences in how part- vs full-time physician leaders understand and value leadership roles vs clinical roles, claim leadership status, and identify as physician leaders on individual, relational and organizational basis. Research limitations/implications - Although the physicians in the sample were affiliated with four community hospitals, all of them were part of a single not-for-profit health care system in one geographical locale. Practical implications - These findings may be of interest to hospital administrators and boards seeking deeper commitment and higher performance from physician leaders, as well as assist physicians in transitioning into a leadership role. Social implications - This work points to a broader and more fundamental need - a modified mindset about the nature and value of physician leadership. Originality/value - This study is unique in the exploration of the nature of physician leadership from the perspective of the physician on an individual, peer

Extracurricular scientific production among medical students has increased in the past decade

DEFF Research Database (Denmark)

Bech Andersen, Sofie; Østergaard, Lauge; Fosbøl, Philip Loldrup

2015-01-01

Introduction: Undergraduate research among medical students is essential in the education of future physicians and scientists. This study aimed to evaluate the scientific yield of extracurricular undergraduate research among medical students. Methods: Medical students at the University of Copenha...... in cardiology (14.1%). Car - diology was also associated with the greatest scientific yield with a median number of 0.8 publications per year after the students concluded their undergraduate research period. Three or more years after concluding their undergraduate research, 32.8% of the students had continued...... specialty and also the specialty with the greatest scientific yield. A third of the undergraduate re - search students continued doing research in the context of a PhD programme....

Physician Compare

Data.gov (United States)

U.S. Department of Health & Human Services — Physician Compare, which meets Affordable Care Act of 2010 requirements, helps you search for and select physicians and other healthcare professionals enrolled in...

Physician participation in clinical research and trials: issues and approaches

Directory of Open Access Journals (Sweden)

Sami F Shaban

2011-03-01

research culture’. This article examines the barriers to and benefits of physician participation in clinical research as well as interventions needed to increase their participation, including the specific role of undergraduate medical education. The main challenge is the unwillingness of many physicians and patients to participate in clinical trials. Barriers to participation include lack of time, lack of resources, trial-specific issues, communication difficulties, conflicts between the role of clinician and scientist, inadequate research experience and training for physicians, lack of rewards and recognition for physicians, and sometimes a scientifically uninteresting research question, among others. Strategies to encourage physician participation in clinical research include financial and nonfinancial incentives, adequate training, research questions that are in line with physician interests and have clear potential to improve patient care, and regular feedback. Finally, encouraging research culture and fostering the development of inquiry and research-based learning among medical students is now a high priority in order to develop more and better clinician-researchers.Keywords: physician, clinical research, clinical trial, medical education

Edward Gantt (1742-1837): US senate chaplain and first White House physician to Thomas Jefferson.

Science.gov (United States)

Cavanagh, Harrison Dwight

2017-08-01

In his long and eventful life, Edward Gantt (1742-1837) made important contributions to the newly independent American Republic, as well as to the development of scientific evidence-based American medicine. Unfortunately, his achievements have gone unrecognized and unreported in mainstream historical publications. Specifically, his service as the first designated White House doctor, and personal physician to President Thomas Jefferson from 1801 to 1809 has not been reported. The purpose of this paper is to document the biographical and scientific details of his extraordinary life and notable contributions.

U.K. physicians' attitudes toward active voluntary euthanasia and physician-assisted suicide.

Science.gov (United States)

Dickinson, George E; Lancaster, Carol J; Clark, David; Ahmedzai, Sam H; Noble, William

2002-01-01

A comparison of the views of geriatric medicine physicians and intensive care physicians in the United Kingdom on the topics of active voluntary euthanasia and physician-assisted suicide revealed rather different attitudes. Eighty percent of geriatricians, but only 52% of intensive care physicians, considered active voluntary euthanasia as never justified ethically. Gender and age did not play a major part in attitudinal differences of the respondents. If the variability of attitudes of these two medical specialties are anywhere near illustrative of other physicians in the United Kingdom, it would be difficult to formulate and implement laws and policies concerning euthanasia and assisted suicide. In addition, ample safeguards would be required to receive support from physicians regarding legalization.

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

Science.gov (United States)

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.

Physician heal thyself

African Journals Online (AJOL)

Compared to overweight or obese physicians, normal‑weight physicians were significantly more likely to discuss weight loss with their obese patients, according to a study among. 500 primary care physicians, undertaken by researchers at the Johns Hopkins Bloomberg School of Public Health.[4]. A recent, highly accessed ...

Iranian Physicians' Perspectives Regarding Nurse-Physician Professional Communication: Implications for Nurses.

Science.gov (United States)

Esmaeilpour-Bandboni, Mohammad; Vaismoradi, Mojtaba; Salsali, Mahvash; Snelgrove, Sherrill; Sheldon, Lisa Kennedy

2017-08-01

Nurse-physician professional communication affects the effectiveness and performance of the health care team and the quality of care delivered to the patient. This study aimed to explore the perspectives and experiences of physicians on nurse-physician professional communication in an urban area of Iran. Semistructured interviews were conducted with 15 physicians selected using a purposive sampling method. Physicians from different medical specialties were chosen from 4 teaching hospitals in an urban area of Iran. The data were analyzed with content analysis and themes developed. Three themes developed during data analysis: "seeking the formal methods of communication to ensure patient care," "nurses' professional attributes for professional communication," and "patients' health conditions as the mediators of professional communication." Nurses need to be informed of the perspectives and experiences of physicians on professional communication. Our findings can improve nurses' understandings of professional communication that could inform the development of educational and training programs for nurses and physicians. There is a need to incorporate communication courses during degree education and design interprofessional training regarding communication in clinical settings to improve teamwork and patient care. Open discussions between nurses and physicians, training sessions about how to improve their knowledge about barriers to and facilitators of effective professional communication, and key terms and phrases commonly used in patient care are suggested.

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

Science.gov (United States)

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.

Opinions of Primary Care Family Physicians About Family Medicine Speciality Training Program

Directory of Open Access Journals (Sweden)

Hamit Sirri Keten

2014-04-01

Material and Method: A total of 170 family physicians working in Kahramanmaras were included in the study. After obtaining informed consent a questionnaire comprising questions regarding socio-demographic properties, conveying contracted family physicians as family medicine specialists and organization of the training program was applied to participants. Results: Among physicians participating in the study 130 (76.5% were male and 40 (23.5% were female, with a mean age of 40.7±7.1 (min = 26 years, max = 64 years. The mean duration of professional experience of physicians was 15.3±7.0 (min = 2 years, max = 40 years years. Of all, 91 (53.5% participants had already read the decree on family medicine specialist training program for contracted family physicians. A hundred and fifteen (67.6% family physicians supported that Family Medicine Specialty program should be taken part-time without interrupting routine medical tasks. Only 51 (30.0% participants stated the requirement of an entrance examination (TUS for family medicine specialty training. Conclusion: Family medicine specialty training program towards family physicians should be considered in the light of scientific criteria. In family medicine, an area exhibited a holistic approach to the patient; specialty training should be through residency training instead of an education program. For this purpose, family medicine departments in medical faculties should play an active role in this process. Additionally further rotations in needed branches should be implemented with a revision of area should be performed. In medicine practical training is of high importance and distant or part-time education is not appropriate, and specialist training shall be planned in accordance with the medical specialty training regulations. [Cukurova Med J 2014; 39(2.000: 298-304

An intervention to increase patients' trust in their physicians. Stanford Trust Study Physician Group.

Science.gov (United States)

Thom, D H; Bloch, D A; Segal, E S

1999-02-01

To investigate the effect of a one-day workshop in which physicians were taught trust-building behaviors on their patients' levels of trust and on outcomes of care. In 1994, the study recruited 20 community-based family physicians and enrolled 412 consecutive adult patients from those physicians' practices. Ten of the physicians (the intervention group) were randomly assigned to receive a one-day training course in building and maintaining patients' trust. Outcomes were patients' trust in their physicians, patients' and physicians' satisfaction with the office visit, continuity in the patient-physician relationship, patients' adherence to their treatment plans, and the numbers of diagnostic tests and referrals. Physicians and patients in the intervention and control groups were similar in demographic and other data. There was no significant difference in any outcome. Although their overall ratings were not statistically significantly different, the patients of physicians in the intervention group reported more positive physician behaviors than did the patients of physicians in the control group. The trust-building workshop had no measurable effect on patients' trust or on outcomes hypothesized to be related to trust.

Physician Appraisals: Key Challenges

Directory of Open Access Journals (Sweden)

Klich Jacek

2017-06-01

Full Text Available The main purpose of the article is to identify key criteria being used for physician appraisals and to find how communication skills of physicians are valued in those appraisals. ScienceDirect and EBSCOhost databases were used for this search. The results show that a physician appraisal is underestimated both theoretically and empirically. The particular gap exists with respect to the communication skills of physicians, which are rarely present in medical training syllabi and physician assessments. The article contributes to the theoretical discourse on physician appraisals and points out at the inconsistency between the high status of physicians as a key hospital resource on the one hand and, on the other hand, at inadequate and poorly researched assessment of their performance with a special emphasis on communication skills. The article may inspire health managers to develop and implement up-to-date assessment forms for physicians and good managerial practices in this respect in hospitals and other health care units.

Physicians and euthanasia: a Canadian print-media discourse analysis of physician perspectives.

Science.gov (United States)

Wright, David Kenneth; Fishman, Jennifer R; Karsoho, Hadi; Sandham, Sarah; Macdonald, Mary Ellen

2015-01-01

Recent events in Canada have mobilized public debate concerning the controversial issue of euthanasia. Physicians represent an essential stakeholder group with respect to the ethics and practice of euthanasia. Further, their opinions can hold sway with the public, and their public views about this issue may further reflect back upon the medical profession itself. We conducted a discourse analysis of print media on physicians' perspectives about end-of-life care. Print media, in English and French, that appeared in Canadian newspapers from 2008 to 2012 were retrieved through a systematic database search. We analyzed the content of 285 articles either authored by a physician or directly referencing a physician's perspective. We identified 3 predominant discourses about physicians' public views toward euthanasia: 1) contentions about integrating euthanasia within the basic mission of medicine, 2) assertions about whether euthanasia can be distinguished from other end-of-life medical practices and 3) palliative care advocacy. Our data showed that although some medical professional bodies appear to be supportive in the media of a movement toward the legalization of euthanasia, individual physicians are represented as mostly opposed. Professional physician organizations and the few physicians who have engaged with the media are de facto representing physicians in public contemporary debates on medical aid in dying, in general, and euthanasia, in particular. It is vital for physicians to be aware of this public debate, how they are being portrayed within it and its potential effects on impending changes to provincial and national policies.

Communication skills training for physicians performing work disability assessments increases knowledge and self-efficacy: results of a randomised controlled trial.

Science.gov (United States)

van Rijssen, Jolanda; Schellart, Antonius J M; Anema, Johannes R; van der Beek, Allard J

2015-07-21

It was assessed whether a post-graduate communication skills training course would increase physicians' competence and knowledge with regard to communication during work disability assessment interviews, and would change the determinants of their communication behaviour. A randomised controlled trial was performed. At baseline and at follow-up, 42 physicians completed questionnaires. The primary outcome measures were competence and knowledge about communication. The secondary outcome measures were 21 self-reported determinants of communication behaviour. One-way analyses of variance and covariance were performed. There was no significant difference between the intervention and control groups in overall competence, but there was for the introduction phase (intervention: mean = 7.0, SD 2.7; control: mean = 4.8, SD 2.7; p = 0.014). Knowledge about communication was significantly higher (p = 0.001) in the intervention group (mean = 79.6, SD 9.2) than in the control group (mean = 70.9, SD 6.7), especially concerning the information-gathering phase of the interview (intervention: mean = 80.0, SD 10.2; control: mean = 69.4, SD 8.9; p = 0.001). The intervention group scored significantly better on 7 of the 21 self-reported determinants (secondary outcomes), including self-efficacy, intentions, skills and knowledge. The communication skills training course may improve some aspects of physician communication, but not all. Because physicians were unanimously positive about the course, further development is warranted. Implications for Rehabilitation Even though optimal communication is essential in face-to-face assessment interviews for determining entitlement to work disability benefits, and there is a lot at stake for the claimants, this issue has scarcely been addressed in scientific research. A tailor-made two-day communication skills training course, based on scientific research, increases physicians' knowledge about communication

Family physician perceptions of working with LGBTQ patients: physician training needs.

Science.gov (United States)

Beagan, Brenda; Fredericks, Erin; Bryson, Mary

2015-01-01

Medical students and physicians report feeling under-prepared for working with patients who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ). Understanding physician perceptions of this area of practice may aid in developing improved education. In-depth interviews with 24 general practice physicians in Halifax and Vancouver, Canada, were used to explore whether, when and how the gender identity and sexual orientation of LGBTQ women were relevant to good care. Inductive thematic analysis was conducted using ATLAS.ti data analysis software. Three major themes emerged: 1) Some physicians perceived that sexual/gender identity makes little or no difference; treating every patient as an individual while avoiding labels optimises care for everyone. 2) Some physicians perceived sexual/gender identity matters primarily for the provision of holistic care, and in order to address the effects of discrimination. 3) Some physicians perceived that sexual/gender identity both matters and does not matter, as they strove to balance the implications of social group membership with recognition of individual differences. Physicians may be ignoring important aspects of social group memberships that affect health and health care. The authors hold that individual and socio-cultural differences are both important to the provision of quality health care. Distinct from stereotypes, generalisations about social group differences can provide valuable starting points, raising useful lines of inquiry. Emphasizing this distinction in medical education may help change physician approaches to the care of LGBTQ women.

Family physician perceptions of working with LGBTQ patients: physician training needs

Directory of Open Access Journals (Sweden)

Brenda Beagan

2015-04-01

Full Text Available Background: Medical students and physicians report feeling under-prepared for working with patients who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ. Understanding physician perceptions of this area of practice may aid in developing improved education. Method: In-depth interviews with 24 general practice physicians in Halifax and Vancouver, Canada, were used to explore whether, when and how the gender identity and sexual orientation of LGBTQ women were relevant to good care. Inductive thematic analysis was conducted using ATLAS.ti data analysis software. Results: Three major themes emerged: 1 Some physicians perceived that sexual/gender identity makes little or no difference; treating every patient as an individual while avoiding labels optimises care for everyone. 2 Some physicians perceived sexual/gender identity matters primarily for the provision of holistic care, and in order to address the effects of discrimination. 3 Some physicians perceived that sexual/gender identity both matters and does not matter, as they strove to balance the implications of social group membership with recognition of individual differences. Conclusions: Physicians may be ignoring important aspects of social group memberships that affect health and health care. The authors hold that individual and socio-cultural differences are both important to the provision of quality health care. Distinct from stereotypes, generalisations about social group differences can provide valuable starting points, raising useful lines of inquiry. Emphasizing this distinction in medical education may help change physician approaches to the care of LGBTQ women.

Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians.

Science.gov (United States)

Eyal, Nir; Cancedda, Corrado; Kyamanywa, Patrick; Hurst, Samia A

2015-12-30

Responding to critical shortages of physicians, most sub-Saharan countries have scaled up training of non-physician clinicians (NPCs), resulting in a gradual but decisive shift to NPCs as the cornerstone of healthcare delivery. This development should unfold in parallel with strategic rethinking about the role of physicians and with innovations in physician education and in-service training. In important ways, a growing number of NPCs only renders physicians more necessary - for example, as specialized healthcare providers and as leaders, managers, mentors, and public health administrators. Physicians in sub-Saharan Africa ought to be trained in all of these capacities. This evolution in the role of physicians may also help address known challenges to the successful integration of NPCs in the health system. © 2016 by Kerman University of Medical Sciences.

[Significance of the doctorate in scientific medical education].

Science.gov (United States)

Frosch, Matthias

2018-02-01

According to European and German law, the medical education of physicians must take place in a scientific degree program at a university or under the supervision of a university. To keep up the ideal of a scientific degree program, various organizations and associations, such as the German Research Foundation, the German Council of Science and Humanities and the German Medical Faculty Association, see the need for an even stronger anchoring of academic learning content in the course of study. Traditionally, a scientific project, which is carried out during the studies, provides the basis for the Doctor of Medicine (Dr. med.) after graduation, although the research projects as a basis for medical degrees are currently not obligatory parts of the curricula. The number of medical students performing such research projects is significantly decreasing, thus they are missing major skills for working in science. To counteract these developments, faculties of medicine are currently developing model curricula including deepened scientific education. Despite these efforts, the German Association of Faculties of Medicine argues that the performance of research projects leading to the doctoral degree is most suitable for obtaining expertise in scientific work. According to recommendations by the German Council of Science on the requirements for quality assurance of graduation doctoral degree programs have been introduced. This and further measures, like MD/PhD programs or research-based additional study programs serving the scientific qualification of medical students, are the subject of this article.

Associations Between Physician Empathy, Physician Characteristics, and Standardized Measures of Patient Experience.

Science.gov (United States)

Chaitoff, Alexander; Sun, Bob; Windover, Amy; Bokar, Daniel; Featherall, Joseph; Rothberg, Michael B; Misra-Hebert, Anita D

2017-10-01

To identify correlates of physician empathy and determine whether physician empathy is related to standardized measures of patient experience. Demographic, professional, and empathy data were collected during 2013-2015 from Cleveland Clinic Health System physicians prior to participation in mandatory communication skills training. Empathy was assessed using the Jefferson Scale of Empathy. Data were also collected for seven measures (six provider communication items and overall provider rating) from the visit-specific and 12-month Consumer Assessment of Healthcare Providers and Systems Clinician and Group (CG-CAHPS) surveys. Associations between empathy and provider characteristics were assessed by linear regression, ANOVA, or a nonparametric equivalent. Significant predictors were included in a multivariable linear regression model. Correlations between empathy and CG-CAHPS scores were assessed using Spearman rank correlation coefficients. In bivariable analysis (n = 847 physicians), female sex (P empathy scores. In multivariable analysis, female sex (P empathy scores. Of the seven CG-CAHPS measures, scores on five for the 583 physicians with visit-specific data and on three for the 277 physicians with 12-month data were positively correlated with empathy. Specialty and sex were independently associated with physician empathy. Empathy was correlated with higher scores on multiple CG-CAHPS items, suggesting improving physician empathy might play a role in improving patient experience.

Scientific events of the Turner Scientific And Research Institute for children’s orthopedics as a form of continuous medical education for pediatric traumatologists

Directory of Open Access Journals (Sweden)

Karina S. Solovyova

2017-03-01

Full Text Available The experience of the Turner Scientific and Research Institute for Children's Orthopedics in educational activities for improvement of the professional knowledge of pediatric physicians was represented. The target audience of the continuous medical education include traumatologists, pediatric surgeons, and doctors of related specialties of Russia that are involved in diagnosis, treatment, and rehabilitation of children with injuries, congenital and acquired diseases of the musculoskeletal system. Since 1986, the Institute has organized 28 all-Russian scientific and practical conferences on topical issues of traumatology and orthopedics of pediatric age in 22 different cities across the country. In the interest of the institute, the school of pediatric orthopedists is constantly working for district orthopedists of children's polyclinics of St. Petersburg, and regular monothematic seminars are performed with the participation of leading Russian experts and visiting lecturers from abroad. These scientific and practical activities improve the professional skills of doctors and help them improve the provision of specialized care to children.

Systematic review on physician's knowledge about radiation doses and radiation risks of computed tomography

International Nuclear Information System (INIS)

Krille, Lucian; Hammer, Gael P.; Merzenich, Hiltrud; Zeeb, Hajo

2010-01-01

Background: The frequent use of computed tomography is a major cause of the increasing medical radiation exposure of the general population. Consequently, dose reduction and radiation protection is a topic of scientific and public concern. Aim: We evaluated the available literature on physicians' knowledge regarding radiation dosages and risks due to computed tomography. Methods: A systematic review in accordance with the Cochrane and PRISMA statements was performed using eight databases. 3091 references were found. Only primary studies assessing physicians' knowledge about computed tomography were included. Results: 14 relevant articles were identified, all focussing on dose estimations for CT. Overall, the surveys showed moderate to low knowledge among physicians concerning radiation doses and the involved health risks. However, the surveys varied considerably in conduct and quality. For some countries, more than one survey was available. There was no general trend in knowledge in any country except a slight improvement of knowledge on health risks and radiation doses in two consecutive local German surveys. Conclusions: Knowledge gaps concerning radiation doses and associated health risks among physicians are evident from published research. However, knowledge on radiation doses cannot be interpreted as reliable indicator for good medical practice.

[Use of information sources by recently graduated physicians of Lima].

Science.gov (United States)

Mejia, Christian R; Caceres, Onice J; Vera, Claudia A; Nizama-Vía, Ayar; Curioso, Walter H; Mayta-Tristán, Percy

2014-01-01

In order to determine the use of information sources by recently graduated physicians of Lima, Peru in 2011, a survey was conducted among graduated physicians at seven universities. They were asked about the use of search engines in the health area during their year of medical internship [last year of medical school]. Regular use was defined as the source being used once a week or daily. For 490 respondents, regularly used information sources were SciELO, accessed by 173 (36.4%); PubMed 165 (34.4%); HINARI 117 (25.5%); UpToDate 98 (22.3%); Cochrane Library 94 (20.6%); LILACS 91 (19.8%); a hospital institutional library 70 (15.0%); LIPECS 39 (8.7%); and Peru BVS 42 (9.3%). Only a minority regularly accessed information sources related to health. It is necessary to improve capacity in the efficient use of various resources of scientific information in a continuous way and that reaches students and health professionals.

Job satisfaction among obstetrician-gynecologists: a comparison between private practice physicians and academic physicians.

Science.gov (United States)

Bell, Darrel J; Bringman, Jay; Bush, Andrew; Phillips, Owen P

2006-11-01

Physician job satisfaction has been the subject of much research. However, no studies have been conducted comparing academic and private practice physician satisfaction in obstetrics and gynecology. This study was undertaken to measure satisfaction levels for academic and private practice obstetrician-gynecologists and compare different aspects of their practice that contributed to their satisfaction. A survey was mailed to randomly selected obstetrician-gynecologists in Memphis, TN; Birmingham, AL; Little Rock, AR; and Jackson, MS. Physicians were asked to respond to questions concerning demographics and career satisfaction. They were also asked to assess the contribution of 13 different aspects of their practice in contributing to their job selection and satisfaction using a Likert scale. A score of 1 meant the physician completely disagreed with a statement regarding a factor's contribution or was completely dissatisfied; a score of 5 meant the physician completely agreed with a factor's contribution or was completely satisfied. Simple descriptive statistics, as well as the 2-sample t test, were used. Likert scale values were assumed to be interval measurements. Of the 297 questionnaires mailed, 129 (43%) physicians responded. Ninety-five (74%) respondents rated their overall satisfaction as 4 or 5. No significant difference was found between academic and private physicians when comparing overall job satisfaction (P = .25). When compared to private practice physicians, the aspects most likely contributing to overall job satisfaction for academic physicians were the ability to teach, conduct research, and practice variety (P = .0001, P = .0001, and P = .007, respectively). When compared with academic physicians, the aspects most likely contributing to job satisfaction for private practice physicians were autonomy, physician-patient relationship, and insurance reimbursement (P = .0058, P = .0001, and P = .0098, respectively). When choosing a practice setting

[On the evolution of scientific thought].

Science.gov (United States)

de Micheli, Alfredo; Iturralde Torres, Pedro

2015-01-01

The Nominalists of the XIV century, precursors of modern science, thought that science's object was not the general, vague and indeterminate but the particular, which is real and can be known directly. About the middle of the XVII Century the bases of the modern science became established thanks to a revolution fomented essentially by Galileo, Bacon and Descartes. During the XVIII Century, parallel to the development of the great current of English Empiricism, a movement of scientific renewal also arose in continental Europe following the discipline of the Dutch Physicians and of Boerhaave. In the XIX Century, Claude Bernard dominated the scientific medicine but his rigorous determinism impeded him from taking into account the immense and unforeseeable field of the random. Nowadays, we approach natural science and medicine, from particular groups of facts; that is, from the responses of Nature to specific questions, but not from the general laws. Furthermore, in recent epistemology, the concept that experimental data are not pure facts, but rather, facts interpreted within a hermeneutical context has been established. Finally a general tendency to retrieve philosophical questions concerning the understanding of essence and existence can frequently be seen in scientific inquiry. In the light of the evolution of medical thought, it is possible to establish the position of scientific medicine within the movement of ideas dominating in our time. Copyright © 2014 Instituto Nacional de Cardiología Ignacio Chávez. Published by Masson Doyma México S.A. All rights reserved.

Bringing physician nutrition specialists into the mainstream: rationale for the Intersociety Professional Nutrition Education Consortium.

Science.gov (United States)

1998-10-01

Given the prevalence of nutritionally related chronic diseases in American society, the training of physicians should include a focus on the relations of diet to disease. Yet, despite scientific data, public interest, US government reports, society studies, and congressional mandates, the teaching of nutrition in medical schools and residency programs remains inadequate. The authority whom patients most wish to consult for information on health-their physician-thus remains insufficiently informed about the role of diet in the prevention and treatment of disease. New efforts must be initiated to train nutrition-literate physicians. The principal obstacle to nutrition literacy among physicians is the paucity of physician nutrition specialists (PNSs) on medical school faculties who can effectively advocate for change in medical school and residency curricula and who can serve as role models for incorporating nutrition into patient care. To encourage nutrition societies to unite in addressing these issues, the Intersociety Professional Nutrition Education Consortium was founded in 1997. The Consortium aims to establish educational standards for fellowship training and a unified mechanism for posttraining certification of PNSs, and to develop a long-term plan to increase the pool of PNSs and surmount obstacles that currently impede the incorporation of nutrition education into the curricula of medical schools and primary-care residency programs.

Physician-patient communication in HIV disease: the importance of patient, physician, and visit characteristics.

Science.gov (United States)

Wilson, I B; Kaplan, S

2000-12-15

Although previous work that considered a variety of chronic conditions has shown that higher quality physician-patient communication care is related to better health outcomes, the quality of physician-patient communication itself for patients with HIV disease has not been well studied. To determine the relationship of patient, visit, physician, and physician practice characteristics to two measures of physician-patient communication for patients with HIV disease. Cross-sectional survey of physicians and patients. Cohort study enrolling patients from throughout eastern Massachusetts. 264 patients with HIV disease and their their primary HIV physicians (n = 69). Two measures of physician-patient communication were used, a five-item general communication measure (Cronbach's alpha = 0.93), and a four-item HIV-specific communication measure that included items about alcohol, drug use, and sexual behaviors (Cronbach's alpha = 0.92). The mean age of patients was 39. 5 years, 24% patients were women, 31.1% were nonwhite, and 52% indicated same-sex contact as their principal HIV risk factor. The mean age of physicians was 39.1 years, 33.3% were female, 39.7% were specialists, and 25.0% self-identified as gay, lesbian, or bisexual. In multivariable models relating patient and visit characteristics to general communication, longer reported visit length (pbetter communication. The interaction of patient gender and visit length was also significant (p =.02); longer visit length was more strongly associated with better general communication for male than female patients. In similar models relating patient and visit characteristics to HIV-specific communication, longer visit length (p better communication. In multivariable models relating physician and practice characteristics to general communication no variables were significant. However, both female physician gender (p =.002) and gay/lesbian/bisexual sexual preference (p =.003) were significantly associated with better HIV

Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety.

Science.gov (United States)

Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian

2011-01-01

Long working hours and sleep deprivation have been a facet of physician training in the US since the advent of the modern residency system. However, the scientific evidence linking fatigue with deficits in human performance, accidents and errors in industries from aeronautics to medicine, nuclear power, and transportation has mounted over the last 40 years. This evidence has also spawned regulations to help ensure public safety across safety-sensitive industries, with the notable exception of medicine. In late 2007, at the behest of the US Congress, the Institute of Medicine embarked on a year-long examination of the scientific evidence linking resident physician sleep deprivation with clinical performance deficits and medical errors. The Institute of Medicine's report, entitled "Resident duty hours: Enhancing sleep, supervision and safety", published in January 2009, recommended new limits on resident physician work hours and workload, increased supervision, a heightened focus on resident physician safety, training in structured handovers and quality improvement, more rigorous external oversight of work hours and other aspects of residency training, and the identification of expanded funding sources necessary to implement the recommended reforms successfully and protect the public and resident physicians themselves from preventable harm. Given that resident physicians comprise almost a quarter of all physicians who work in hospitals, and that taxpayers, through Medicare and Medicaid, fund graduate medical education, the public has a deep investment in physician training. Patients expect to receive safe, high-quality care in the nation's teaching hospitals. Because it is their safety that is at issue, their voices should be central in policy decisions affecting patient safety. It is likewise important to integrate the perspectives of resident physicians, policy makers, and other constituencies in designing new policies. However, since its release, discussion of the

Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians

Directory of Open Access Journals (Sweden)

Nir Eyal

2016-03-01

Full Text Available Responding to critical shortages of physicians, most sub-Saharan countries have scaled up training of nonphysician clinicians (NPCs, resulting in a gradual but decisive shift to NPCs as the cornerstone of healthcare delivery. This development should unfold in parallel with strategic rethinking about the role of physicians and with innovations in physician education and in-service training. In important ways, a growing number of NPCs only renders physicians more necessary – for example, as specialized healthcare providers and as leaders, managers, mentors, and public health administrators. Physicians in sub-Saharan Africa ought to be trained in all of these capacities. This evolution in the role of physicians may also help address known challenges to the successful integration of NPCs in the health system.

Burnout among physicians

OpenAIRE

Romani, Maya; Ashkar, Khalil

2014-01-01

Burnout is a common syndrome seen in healthcare workers, particularly physicians who are exposed to a high level of stress at work; it includes emotional exhaustion, depersonalization, and low personal accomplishment. Burnout among physicians has garnered significant attention because of the negative impact it renders on patient care and medical personnel. Physicians who had high burnout levels reportedly committed more medical errors. Stress management programs that range from relaxation to ...

Competencies for first year residents - physicians' views from medical schools with different undergraduate curricula.

Science.gov (United States)

Fürstenberg, Sophie; Schick, Kristina; Deppermann, Jana; Prediger, Sarah; Berberat, Pascal O; Kadmon, Martina; Harendza, Sigrid

2017-09-07

Frameworks like the CanMEDS model depicting professional roles and specific professional activities provide guidelines for postgraduate education. When medical graduates start their residency, they should possess certain competencies related to communication, management and professionalism while other competencies will be refined during postgraduate training. Our study aimed to evaluate the relevance of different competencies for a first year resident required for entrustment decision from the perspective of physicians from medical faculties with different undergraduate medical curricula. Nine hundred fifty-two surgeons and internists from three medical schools with different undergraduate medical curricula were invited to rank 25 competencies according to their relevance for first year residents. The rankings were compared between universities, specialties, physicians' positions, and gender. Two hundred two physicians participated, 76 from Hamburg University, 44 from Oldenburg University, and 82 from Technical University Munich. No significant differences were found regarding the top 10 competencies relevant for first year residents between the universities. 'Responsibility' was the competency with the highest rank overall. Internists ranked 'Structure, work planning and priorities' higher while surgeons ranked 'Verbal communication with colleagues and supervisors' higher. Consultants evaluated 'Active listening to patients' more important than department directors and residents. Female physicians ranked 'Verbal communication with colleagues and supervisors' and 'Structure, work planning and priorities' significantly higher while male physicians ranked 'Scientifically and empirically grounded method of working' significantly higher. Physicians from universities with different undergraduate curricula principally agreed on the competencies relevant for first year residents. Some differences between physicians from different positions, specialties, and gender were

Effectiveness of a Unique Support Group for Physicians in a Physician Health Program.

Science.gov (United States)

Sanchez, Luis T; Candilis, Philip J; Arnstein, Fredrick; Eaton, Judith; Barnes Blood, Diana; Chinman, Gary A; Bresnahan, Linda R

2016-01-01

State Physician Health Programs (PHPs) assess, support, and monitor physicians with mental, behavioral, medical, and substance abuse problems. Since their formation in the 1970s, PHPs have offered support groups following the 12-step model for recovery from substance use disorders (SUDs). However, few programs have developed support groups for physicians without SUDs. This study at the Massachusetts PHP (Physician Health Services Inc.) represents the first effort to survey physician attitudes concerning a unique support group that goes beyond classic addiction models. The group was initiated because of the observation that physicians with problems other than SUDs did not fit easily into the 12-step framework. It was hypothesized that such a group would be effective in helping participants control workplace stress, improve professional and personal relationships, and manage medical and psychiatric difficulties. With a response rate of 43% (85 respondents), the survey identified a strong overall impact of the Physician Health Services Inc. support group, identifying positive effects in all areas of personal and professional life: family and friends, wellness, professional relationships, and career. Respondents identified the role of the facilitator as particularly important, underscoring the facilitator's capacity to welcome participants, manage interactions, set limits, and maintain a supportive emotional tone. The implications for physician health extend from supporting a broader application of this model to using a skilled facilitator to manage groups intended to reduce the stress and burnout of present-day medical practice. The results encourage PHPs, hospitals, medical practices, and physician groups to consider implementing facilitated support groups as an additional tool for maintaining physician health.

Physician wages across specialties: informing the physician reimbursement debate.

Science.gov (United States)

Leigh, J Paul; Tancredi, Daniel; Jerant, Anthony; Kravitz, Richard L

2010-10-25

Disparities in remuneration between primary care and other physician specialties may impede health care reform by undermining the sustainability of a primary care workforce. Previous studies have compared annual incomes across specialties unadjusted for work hours. Wage (earnings-per-hour) comparisons could better inform the physician payment debate. In a cross-sectional analysis of data from 6381 physicians providing patient care in the 2004-2005 Community Tracking Study (adjusted response rate, 53%), we compared wages across broad and narrow categories of physician specialties. Tobit and linear regressions were run. Four broad specialty categories (primary care, surgery, internal medicine and pediatric subspecialties, and other) and 41 specific specialties were analyzed together with demographic, geographic, and market variables. In adjusted analyses on broad categories, wages for surgery, internal medicine and pediatric subspecialties, and other specialties were 48%, 36%, and 45% higher, respectively, than for primary care specialties. In adjusted analyses for 41 specific specialties, wages were significantly lower for the following than for the reference group of general surgery (wage near median, $85.98): internal medicine and pediatrics combined (-$24.36), internal medicine (-$24.27), family medicine (-$23.70), and other pediatric subspecialties (-$23.44). Wage rankings were largely impervious to adjustment for control variables, including age, race, sex, and region. Wages varied substantially across physician specialties and were lowest for primary care specialties. The primary care wage gap was likely conservative owing to exclusion of radiologists, anesthesiologists, and pathologists. In light of low and declining medical student interest in primary care, these findings suggest the need for payment reform aimed at increasing incomes or reducing work hours for primary care physicians.

Urology and the scientific method in ancient Egypt.

Science.gov (United States)

Gordetsky, Jennifer; O'Brien, Jeanne

2009-03-01

To examine the practice of urology in ancient Egypt using various sources, including the Edwin Smith and Ebers Papyri. The sources of knowledge of ancient Egyptian medicine include medical papyri, paleopathology, art, and hieroglyphic carvings. A brief overview of the medical system in ancient Egypt was completed, in addition to an examination of the training and specialization of the physician in the ancient world. Urologic diseases treated in ancient Egypt and some of the first documented urologic surgeries are presented. Finally, we studied the role of the physician-priest and the intertwined use of religion and magic in ancient Egyptian medicine. The same medical conditions urologists treat in the office today were methodically documented thousands of years ago. Medical papyri show evidence that the ancient Egyptians practiced medicine using a scientific method based on the clinical observation of disease. This has been exemplified by the Edwin Smith Surgical Papyrus, a collection of surgical cases that gives a diagnosis, treatment, and prognosis for each ailment, and the discovery of medical specialization in ancient Egypt, giving us perhaps the world's first urologists. Intertwined with the scientific method was also the rich mysticism and religion of ancient Egypt, which were integral components of the healing process. We present an overview of the practice of urology in ancient Egypt, in terms of both pharmacologic and surgical intervention, as well as with a look into the religion of medicine practiced at that time.

Sleep and recovery in physicians on night call: a longitudinal field study

Directory of Open Access Journals (Sweden)

Malmberg Birgitta

2010-08-01

Full Text Available Abstract Background It is well known that physicians' night-call duty may cause impaired performance and adverse effects on subjective health, but there is limited knowledge about effects on sleep duration and recovery time. In recent years occupational stress and impaired well-being among anaesthesiologists have been frequently reported for in the scientific literature. Given their main focus on handling patients with life-threatening conditions, when on call, one might expect sleep and recovery to be negatively affected by work, especially in this specialist group. The aim of the present study was to examine whether a 16-hour night-call schedule allowed for sufficient recovery in anaesthesiologists compared with other physician specialists handling less life-threatening conditions, when on call. Methods Sleep, monitored by actigraphy and Karolinska Sleep Diary/Sleepiness Scale on one night after daytime work, one night call, the following first and second nights post-call, and a Saturday night, was compared between 15 anaesthesiologists and 17 paediatricians and ear, nose, and throat surgeons. Results Recovery patterns over the days after night call did not differ between groups, but between days. Mean night sleep for all physicians was 3 hours when on call, 7 h both nights post-call and Saturday, and 6 h after daytime work (p Conclusions Despite considerable sleep loss during work on night call, and unexpectedly short sleep after ordinary day work, the physicians' self-reports indicate full recovery after two nights' sleep. We conclude that these 16-hour night duties were compatible with a short-term recovery in both physician groups, but the limited sleep duration in general still implies a long-term health concern. These results may contribute to the establishment of safe working hours for night-call duty in physicians and other health-care workers.

Economic Crisis and Portuguese National Health Service Physicians: Findings from a Descriptive Study of Their Perceptions and Reactions from Health Care Units in the Greater Lisbon Area

OpenAIRE

Inês Rego; Giuliano Russo; Luzia Gonçalves; Julian Perelman; Pedro Pita Barros

2017-01-01

Introduction: In Europe, scant scientific evidence exists on the impact of economic crisis on physicians. This study aims at understanding the adjustments made by public sector physicians to the changing conditions, and their perceptions on the market for medical services in the Lisbon metropolitan area. Material and Methods: A random sample of 484 physicians from São José Hospital and health center groups in Cascais and Amadora, to explore their perceptions of the economic crisis, and the...

Relationships of multitasking, physicians' strain, and performance: an observational study in ward physicians.

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Weigl, Matthias; Müller, Andreas; Sevdalis, Nick; Angerer, Peter

2013-03-01

Simultaneous task performance ("multitasking") is common in hospital physicians' work and is implicated as a major determinant for enhanced strain and detrimental performance. The aim was to determine the impact of multitasking by hospital physicians on their self reported strain and performance. A prospective observational time-and-motion study in a Community Hospital was conducted. Twenty-seven hospital physicians (surgical and internal specialties) were observed in 40 full-shift observations. Observed physicians reported twice on their self-monitored strain and performance during the observation time. Associations of observed multitasking events and subsequent strain and performance appraisals were calculated. About 21% of the working time physicians were engaged in simultaneous activities. The average time spent in multitasking activities correlated significantly with subsequently reported strain (r = 0.27, P = 0.018). The number of instances of multitasking activities correlated with self-monitored performance to a marginally significant level (r = 0.19, P = 0.098). Physicians who engage in multitasking activities tend to self-report better performance but at the cost of enhanced psychophysical strain. Hence, physicians do not perceive their own multitasking activities as a source for deficient performance, for example, medical errors. Readjustment of workload, improved organization of work for hospital physicians, and training programs to improve physicians' skills in dealing with multiple clinical demands, prioritization, and efficient task allocation may be useful avenues to explore to reduce the potentially negative impact of simultaneous task performance in clinical settings.

Physicians and Physician Trainees Rarely Identify or Address Overweight/Obesity in Hospitalized Children.

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King, Marta A; Nkoy, Flory L; Maloney, Christopher G; Mihalopoulos, Nicole L

2015-10-01

To determine how frequently physicians identify and address overweight/obesity in hospitalized children and to compare physician documentation across training level (medical student, intern, resident, attending). We conducted a retrospective chart review. Using an administrative database, Centers for Disease Control and Prevention body mass index calculator, and random sampling technique, we identified a study population of 300 children aged 2-18 years with overweight/obesity hospitalized on the general medical service of a tertiary care pediatric hospital. We reviewed admission, progress, and discharge notes to determine how frequently physicians and physician trainees identified (documented in history, physical exam, or assessment) and addressed (documented in hospital or discharge plan) overweight/obesity. Physicians and physician trainees identified overweight/obesity in 8.3% (n = 25) and addressed it in 4% (n = 12) of 300 hospitalized children with overweight/obesity. Interns were most likely to document overweight/obesity in history (8.3% of the 266 patients they followed). Attendings were most likely to document overweight/obesity in physical examination (8.3%), assessment (4%), and plan (4%) of the 300 patients they followed. Medical students were least likely to document overweight/obesity including it in the assessment (0.4%) and plan (0.4%) of the 244 hospitalized children with overweight/obesity they followed. Physicians and physician trainees rarely identify or address overweight/obesity in hospitalized children. This represents a missed opportunity for both patient care and physician trainee education. Copyright © 2015 Elsevier Inc. All rights reserved.

Medical record automation at the Los Alamos Scientific Laboratory

International Nuclear Information System (INIS)

Hogle, G.O.; Grier, R.S.

1979-01-01

With the increase in population at the Los Alamos Scientific Laboratory and the growing concern over employee health, especially concerning the effects of the work environment, the Occupational Medicine Group decided to automate its medical record keeping system to meet these growing demands. With this computer system came not only the ability for long-term study of the work environment verses employee health, but other benefits such as more comprehensive records, increased legibility, reduced physician time, and better records management

Studying physician effects on patient outcomes: physician interactional style and performance on quality of care indicators.

Science.gov (United States)

Franks, Peter; Jerant, Anthony F; Fiscella, Kevin; Shields, Cleveland G; Tancredi, Daniel J; Epstein, Ronald M

2006-01-01

Many prior studies which suggest a relationship between physician interactional style and patient outcomes may have been confounded by relying solely on patient reports, examining very few patients per physician, or not demonstrating evidence of a physician effect on the outcomes. We examined whether physician interactional style, measured both by patient report and objective encounter ratings, is related to performance on quality of care indicators. We also tested for the presence of physician effects on the performance indicators. Using data on 100 US primary care physician (PCP) claims data on 1,21,606 of their managed care patients, survey data on 4746 of their visiting patients, and audiotaped encounters of 2 standardized patients with each physician, we examined the relationships between claims-based quality of care indicators and both survey-derived patient perceptions of their physicians and objective ratings of interactional style in the audiotaped standardized patient encounters. Multi-level models examined whether physician effects (variance components) on care indicators were mediated by patient perceptions or objective ratings of interactional style. We found significant physician effects associated with glycohemoglobin and cholesterol testing. There was also a clinically significant association between better patient perceptions of their physicians and more glycohemoglobin testing. Multi-level analyses revealed, however, that the physician effect on glycohemoglobin testing was not mediated by patient perceived physician interaction style. In conclusion, similar to prior studies, we found evidence of an apparent relationship between patient perceptions of their physician and patient outcomes. However, the apparent relationships found in this study between patient perceptions of their physicians and patient care processes do not reflect physician style, but presumably reflect unmeasured patient confounding. Multi-level modeling may contribute to better

Pharmaceutical industry gifts to physicians: patient beliefs and trust in physicians and the health care system.

Science.gov (United States)

Grande, David; Shea, Judy A; Armstrong, Katrina

2012-03-01

Pharmaceutical industry gifts to physicians are common and influence physician behavior. Little is known about patient beliefs about the prevalence of these gifts and how these beliefs may influence trust in physicians and the health care system. To measure patient perceptions about the prevalence of industry gifts and their relationship to trust in doctors and the health care system. Cross sectional random digit dial telephone survey. African-American and White adults in 40 large metropolitan areas. Respondents' beliefs about whether their physician and physicians in general receive industry gifts, physician trust, and health care system distrust. Overall, 55% of respondents believe their physician receives gifts, and 34% believe almost all doctors receive gifts. Respondents of higher socioeconomic status (income, education) and younger age were more likely to believe their physician receives gifts. In multivariate analyses, those that believe their personal physician receives gifts were more likely to report low physician trust (OR 2.26, 95% CI 1.56-3.30) and high health care system distrust (OR 2.03, 95% CI 1.49-2.77). Similarly, those that believe almost all doctors accept gifts were more likely to report low physician trust (OR 1.69, 95% CI 1.25-2.29) and high health care system distrust (OR 2.57, 95% CI 1.82-3.62). Patients perceive physician-industry gift relationships as common. Patients that believe gift relationships exist report lower levels of physician trust and higher rates of health care system distrust. Greater efforts to limit industry-physician gifts could have positive effects beyond reducing influences on physician behavior.

Preventive health services implemented by family physicians in Portugal—a cross-sectional study based on two clinical scenarios

Science.gov (United States)

Martins, Carlos; Azevedo, Luís Filipe; Santos, Cristina; Sá, Luísa; Santos, Paulo; Couto, Maria; Pereira, Altamiro; Hespanhol, Alberto

2014-01-01

Objectives To assess whether Portuguese family physicians perform preventive health services in accordance with scientific evidence, based on the recommendations of the United States Preventive Services Task Force (USPSTF). Design Cross-sectional study. Setting Primary healthcare, Portuguese National Health Service. Participants 255 Portuguese family physicians selected by a stratified cluster sampling design were invited to participate in a computer-assisted telephone survey. Outcomes Prevalence of compliance with USPSTF recommendations for screening, given a male and female clinical scenario and a set of proposed medical interventions, including frequency of the intervention and performance in their own daily practice. Results A response rate of 95.7% was obtained (n=244). 98–100% of family physicians answered according to the USPSTF recommendations in most interventions. In the male scenario, the lowest concordance was observed in the evaluation of prostate-specific antigen with 37% of family physicians answering according to the USPSTF recommendations. In the female scenario, the lowest concordance was for cholesterol testing with 2% of family physicians complying. Family physicians younger than 50 years had significantly better compliance scores than older ones (mean 77% vs 72%; p<0.001). Conclusions We found a high degree of agreement with USPSTF recommendations among Portuguese family physicians. However, we also found results suggesting excessive use of some medical interventions, raising concerns related to possible harm associated with overdiagnosis and overtreatment. PMID:24861550

Perceptions of trust in physician-managers.

Science.gov (United States)

Cregård, Anna; Eriksson, Nomie

2015-01-01

The purpose of this paper is to explore the dual role of physician-managers through an examination of perceptions of trust and distrust in physician-managers. The healthcare sector needs physicians to lead. Physicians in part-time managerial positions who continue their medical practice are called part-time physician-managers. This paper explores this dual role through an examination of perceptions of trust and distrust in physician-managers. The study takes a qualitative research approach in which interviews and focus group discussions with physician-managers and nurse-managers provide the empirical data. An analytical model, with the three elements of ability, benevolence and integrity, was used in the analysis of trust and distrust in physician-managers. The respondents (physician-managers and nurse-managers) perceived both an increase and a decrease in physicians' trust in the physician-managers. Because elements of distrust were more numerous and more severe than elements of trust, the physician-managers received negative perceptions of their role. This paper's findings are based on perceptions of perceptions. The physicians were not interviewed on their trust and distrust of physician-managers. The healthcare sector must pay attention to the diverse expectations of the physician-manager role that is based on both managerial and medical logics. Hospital management should provide proper support to physician-managers in their dual role to ensure their willingness to continue to assume managerial responsibilities. The paper takes an original approach in its research into the dual role of physician-managers who work under two conflicting logics: the medical logic and the managerial logic. The focus on perceived trust and distrust in physician-managers is a new perspective on this complicated role.

Mental health concerns among Canadian physicians: results from the 2007-2008 Canadian Physician Health Study.

Science.gov (United States)

Compton, Michael T; Frank, Erica

2011-01-01

In light of prior reports on the prevalence of stress, depression, and other mental health problems among physicians in training and practice, we examined the mental health concerns of Canadian physicians using data from the 2007-2008 Canadian Physician Health Study. Among 3213 respondents, 5 variables (depressive symptoms during the past year, anhedonia in the past year, mental health concerns making it difficult to handle one's workload in the past month, problems with work-life balance, and poor awareness of resources for mental health problems) were examined in relation to sex, specialty, practice type (solo practice vs group or other practice settings), and practice setting (inner city, urban/suburban, or rural/small town/remote). Nearly one quarter of physicians reported a 2-week period of depressed mood, and depression was more common among female physicians and general practitioners/family physicians. Anhedonia was reported by one fifth; anesthesiologists were most likely to report anhedonia, followed by general practitioners/family physicians. More than one quarter reported mental health concerns making it difficult to handle their workload, which was more common among female physicians and general practitioners/family physicians and psychiatrists. Nearly one quarter reported poor work-life balance. Lack of familiarity with mental health resources was problematic, which was more prominent among female physicians and specialists outside of general practice/family medicine or psychiatry. Mental health concerns are relatively common among Canadian physicians. Training programs and programmatic/policy enhancements should redouble efforts to address depression and other mental health concerns among physicians for the benefit of the workforce and patients served by Canadian physicians. Copyright © 2011 Elsevier Inc. All rights reserved.

Measuring the health impact of human rights violations related to Australian asylum policies and practices: a mixed methods study

Directory of Open Access Journals (Sweden)

Mulholland Kim

2009-02-01

Full Text Available Abstract Background Human rights violations have adverse consequences for health. However, to date, there remains little empirical evidence documenting this association, beyond the obvious physical and psychological effects of torture. The primary aim of this study was to investigate whether Australian asylum policies and practices, which arguably violate human rights, are associated with adverse health outcomes. Methods We designed a mixed methods study to address the study aim. A cross-sectional survey was conducted with 71 Iraqi Temporary Protection Visa (TPV refugees and 60 Iraqi Permanent Humanitarian Visa (PHV refugees, residing in Melbourne, Australia. Prior to a recent policy amendment, TPV refugees were only given temporary residency status and had restricted access to a range of government funded benefits and services that permanent refugees are automatically entitled to. The quantitative results were triangulated with semi-structured interviews with TPV refugees and service providers. The main outcome measures were self-reported physical and psychological health. Standardised self-report instruments, validated in an Arabic population, were used to measure health and wellbeing outcomes. Results Forty-six percent of TPV refugees compared with 25% of PHV refugees reported symptoms consistent with a diagnosis of clinical depression (p = 0.003. After controlling for the effects of age, gender and marital status, TPV status made a statistically significant contribution to psychological distress (B = 0.5, 95% CI 0.3 to 0.71, p ≤ 0.001 amongst Iraqi refugees. Qualitative data revealed that TPV refugees generally felt socially isolated and lacking in control over their life circumstances, because of their experiences in detention and on a temporary visa. This sense of powerlessness and, for some, an implicit awareness they were being denied basic human rights, culminated in a strong sense of injustice. Conclusion Government asylum policies

[Physicians in the Swedish-German Association 1937-1945, who and why?].

Science.gov (United States)

Hansson, Nils M G; Nilsson, Peter M

2007-01-01

The national association Sweden-Germany (In Swedish: Riksföreningen Sverige-Tyskland; RST) was founded in 1937. The headquarters were located in Lund, in southern Sweden. The proclamation for the association gathered more than 400 signatures, among them 40 physicians. The purpose of the RST was to evaluate and eventually support the arguments of contemporary Nazi Germany, mainly in positive words, and to cultivate the ideological homogeneity within Sweden. During its historical boom period 1938-1943, RST had about 5600 members, of which nearly 200 were physicians. As a peak RST activity the summer summit meeting in Jönköping August, 1941, the members gathered and listened to lectures and proclamations mixed with music in a beautiful environment. The association published a periodical paper, in which members published articles on various themes related to German culture and politics, as well as commentaries on war changes. This essay discusses the RST-memberships of Swedish physicians. Reasons relevant for joining RST may be due to scientific contacts in Germany, or because of German relatives and close friends, if not political agreement with the German Nazi government. Some members chose to leave the association in disappointment after the German military attacks on neighbouring countries of Sweden in April 1940 (Denmark and Norway), although the association grew significantly from 1941-1943. The lesson to be learned from RST is that a leading academic profession, such as the Swedish physicians, participated with many prominent members in a friendship organistaion with the once victorious, but later defeated Germany during the turbulent years just before and during the Second World War. Further research efforts will focus on individual biographies and careers of some of these physicians, ranging from common country-side general practitioners to one Nobel laureate.

Emotional and psychological effects of physician-assisted suicide and euthanasia on participating physicians.

Science.gov (United States)

Stevens, Kenneth R

2006-01-01

This is a review and evaluation of medical and public literature regarding the reported emotional and psychological effects of participation in physician-assisted suicide (PAS) and euthanasia on the involved physicians. Articles in medical journals, legislative investigations and the public press were obtained and reviewed to determine what has been reported regarding the effects on physicians who have been personally involved in PAS and euthanasia. The physician is centrally involved in PAS and euthanasia, and the emotional and psychological effects on the participating physician can be substantial. The shift away from the fundamental values of medicine to heal and promote human wholeness can have significant effects on many participating physicians. Doctors describe being profoundly adversely affected, being shocked by the suddenness of the death, being caught up in the patient's drive for assisted suicide, having a sense of powerlessness, and feeling isolated. There is evidence of pressure on and intimidation of doctors by some patients to assist in suicide. The effect of countertransference in the doctor-patient relationship may influence physician involvement in PAS and euthanasia. Many doctors who have participated in euthanasia and/or PAS are adversely affected emotionally and psychologically by their experiences.

Physicians' strikes and the competing bases of physicians' moral obligations.

Science.gov (United States)

MacDougall, D Robert

2013-09-01

Many authors have addressed the morality of physicians' strikes on the assumption that medical practice is morally different from other kinds of occupations. This article analyzes three prominent theoretical accounts that attempt to ground such special moral obligations for physicians--practice-based accounts, utilitarian accounts, and social contract accounts--and assesses their applicability to the problem of the morality of strikes. After critiquing these views, it offers a fourth view grounding special moral obligations in voluntary commitments, and explains why this is a preferable basis for understanding physicians' moral obligations in general and especially as pertaining to strikes.

Marketing Masked Depression: Physicians, Pharmaceutical Firms, and the Redefinition of Mood Disorders in the 1960s and 1970s.

Science.gov (United States)

Gerber, Lucie; Gaudillière, Jean-Paul

2016-01-01

This article investigates the redefinition of depression that took place in the early 1970s. Well before the introduction of the third edition of the Diagnostic and Statistical Manual of Mental Disorders, this rather rare and severe psychiatric disorder hitherto treated in asylums was transformed into a widespread mild mood disorder to be handled by general practitioners. Basing itself on the archives of the Swiss firm Ciba-Geigy, the article investigates the role of the pharmaceutical industry in organizing this shift, with particular attention paid to research and scientific marketing. By analyzing the interplay between the firm, elite psychiatrists specializing in the study of depression, and general practitioners, the article argues that the collective construction of the market for first-generation antidepressants triggered two realignments: first, it bracketed etiological issues with multiple classifications in favor of a unified symptom-oriented approach to diagnosis and treatment; second, it radically weakened the differentiation between antidepressants, neuroleptics, and tranquilizers. The specific construction of masked depression shows how, in the German-speaking context, issues of ambulatory care such as recognition, classification, and treatment of atypical or mild forms of depression were reshaped to meet commercial as well as professional needs.

Team physicians in college athletics.

Science.gov (United States)

Steiner, Mark E; Quigley, D Bradford; Wang, Frank; Balint, Christopher R; Boland, Arthur L

2005-10-01

There has been little documentation of what constitutes the clinical work of intercollegiate team physicians. Team physicians could be recruited based on the needs of athletes. A multidisciplinary team of physicians is necessary to treat college athletes. Most physician evaluations are for musculoskeletal injuries treated nonoperatively. Descriptive epidemiology study. For a 2-year period, a database was created that recorded information on team physician encounters with intercollegiate athletes at a major university. Data on imaging studies, hospitalizations, and surgeries were also recorded. The diagnoses for physician encounters with all undergraduates through the university's health service were also recorded. More initial athlete evaluations were for musculoskeletal diagnoses (73%) than for general medical diagnoses (27%) (P respiratory infections and dermatologic disorders, or multiple visits for concussions. Football accounted for 22% of all physician encounters, more than any other sport (P athletes did not require a greater number of physician encounters than did the general undergraduate pool of students on a per capita basis. Intercollegiate team physicians primarily treat musculoskeletal injuries that do not require surgery. General medical care is often single evaluations of common conditions and repeat evaluations for concussions.

Physician buy-in for EMRs.

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Yackanicz, Lori; Kerr, Richard; Levick, Donald

2010-01-01

Implementing an EMR in an ambulatory practice requires intense workflow analysis, introduction of new technologies and significant cultural change for the physicians and physician champion. This paper will relate the experience at Lehigh Valley Health Network in the implementation of an ambulatory EMR and with the physician champions that were selected to assist the effort. The choice of a physician champion involves political considerations, variation in leadership and communication styles, and a cornucopia of personalities. Physician leadership has been shown to be a critical success factor for any successful technology implementation. An effective physician champion can help develop and promote a clear vision of an improved future, enlist the support of the physicians and staff, drive the process changes needs and manage the cultural change required. The experience with various types of physician champions will be discussed, including, the "reluctant leader", the "techie leader", the "whiny leader", and the "mature leader". Experiences with each type have resulted in a valuable, "lessons learned" summary. LVHN is a tertiary academic community medical center consisting of 950 beds and over 450 employed physicians. LVHN has been named to the Health and Hospital Network's 100 Top Wired and 25 Most Wireless Hospitals.

Physicians' Job Satisfaction.

African Journals Online (AJOL)

AmL

doctors and retention of the existing doctors, in addition to the ... an employee's well-being Examples of job resources are job ..... increase physician job satisfaction for ensuring the .... both pay and benefits physicians at private hospitals.

Agreement between physicians and non-physician clinicians in starting antiretroviral therapy in rural Uganda

Directory of Open Access Journals (Sweden)

Vasan Ashwin

2009-08-01

Full Text Available Abstract Background The scarcity of physicians in sub-Saharan Africa – particularly in rural clinics staffed only by non-physician health workers – is constraining access to HIV treatment, as only they are legally allowed to start antiretroviral therapy in the HIV-positive patient. Here we present a pilot study from Uganda assessing agreement between non-physician clinicians (nurses and clinical officers and physicians in their decisions as to whether to start therapy. Methods We conducted the study at 12 government antiretroviral therapy sites in three regions of Uganda, all of which had staff trained in delivery of antiretroviral therapy using the WHO Integrated Management of Adult and Adolescent Illness guidelines for chronic HIV care. We collected seven key variables to measure patient assessment and the decision as to whether to start antiretroviral therapy, the primary variable of interest being the Final Antiretroviral Therapy Recommendation. Patients saw either a clinical officer or nurse first, and then were screened identically by a blinded physician during the same clinic visit. We measured inter-rater agreement between the decisions of the non-physician health workers and physicians in the antiretroviral therapy assessment variables using simple and weighted Kappa analysis. Results Two hundred fifty-four patients were seen by a nurse and physician, while 267 were seen by a clinical officer and physician. The majority (> 50% in each arm of the study were in World Health Organization Clinical Stages I and II and therefore not currently eligible for antiretroviral therapy according to national antiretroviral therapy guidelines. Nurses and clinical officers both showed moderate to almost perfect agreement with physicians in their Final Antiretroviral Therapy Recommendation (unweighted κ = 0.59 and κ = 0.91, respectively. Agreement was also substantial for nurses versus physicians for assigning World Health Organization Clinical

Box-ticking and Olympic high jumping - Physicians' perceptions and acceptance of national physician validation systems.

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Sehlbach, Carolin; Govaerts, Marjan J B; Mitchell, Sharon; Rohde, Gernot G U; Smeenk, Frank W J M; Driessen, Erik W

2018-05-24

National physician validation systems aim to ensure lifelong learning through periodic appraisals of physicians' competence. Their effectiveness is determined by physicians' acceptance of and commitment to the system. This study, therefore, sought to explore physicians' perceptions and self-reported acceptance of validation across three different physician validation systems in Europe. Using a constructivist grounded-theory approach, we conducted semi-structured interviews with 32 respiratory specialists from three countries with markedly different validation systems: Germany, which has a mandatory, credit-based system oriented to continuing professional development; Denmark, with mandatory annual dialogs and ensuing, non-compulsory activities; and the UK, with a mandatory, portfolio-based revalidation system. We analyzed interview data with a view to identifying factors influencing physicians' perceptions and acceptance. Factors that influenced acceptance were the assessment's authenticity and alignment of its requirements with clinical practice, physicians' beliefs about learning, perceived autonomy, and organizational support. Users' acceptance levels determine any system's effectiveness. To support lifelong learning effectively, national physician validation systems must be carefully designed and integrated into daily practice. Involving physicians in their design may render systems more authentic and improve alignment between individual ambitions and the systems' goals, thereby promoting acceptance.

Erving Goffman's asylums and institutional culture in the mid-twentieth-century United States.

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Gambino, Matthew

2013-01-01

Sociologist Erving Goffman based his seminal work Asylums (1961) on a year of field research at St. Elizabeths Hospital in Washington, DC. Goffman described the mental hospital as a "total institution," in which regimentation dominated every aspect of daily life and patients were denied even the most basic means of self-expression; rather than promote recovery, such conditions produced the sorts of disordered behavior for which men and women were ostensibly admitted. A closer look at the changes transforming St. Elizabeths around the time of Goffman's research reveals a far richer portrait of institutional culture. Group therapy, psychodrama, art and dance therapy, patient newspapers, and patient self-government-each of which debuted at the hospital in the 1940s and 1950s-provided novel opportunities for men and women to make themselves heard and to take their fate into their own hands. While these initiatives did not reach all of the patients at St. Elizabeths, surviving documentation suggests that those who participated found their involvement rewarding and empowering. Goffman explicitly set out to describe "the social world of the hospital inmate." His failure to appreciate fully the capacities of his subjects, however, appears to have led him to underestimate the importance of these developments.

Operating room teamwork among physicians and nurses: teamwork in the eye of the beholder.

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Makary, Martin A; Sexton, J Bryan; Freischlag, Julie A; Holzmueller, Christine G; Millman, E Anne; Rowen, Lisa; Pronovost, Peter J

2006-05-01

Teamwork is an important component of patient safety. In fact, communication errors are the most common cause of sentinel events and wrong-site operations in the US. Although efforts to improve patient safety through improving teamwork are growing, there is no validated tool to scientifically measure teamwork in the surgical setting. Operating room personnel in 60 hospitals were surveyed using the Safety Attitudes Questionnaire. Surgeons, anesthesiologists, certified registered nurse anesthetists, and operating room nurses rated their own peers and each other using a 5-point Likert scale (1 = very low, 5 = very high). Overall response rate was 77.1% (2,135 of 2,769). Ratings of teamwork differed substantially by operating room caregiver type, with the greatest differences in ratings shown by physicians: surgeons (F[4, 2058] = 41.73, p teamwork exist in the operating room, with physicians rating the teamwork of others as good, but at the same time, nurses perceive teamwork as mediocre. Given the importance of communication and collaboration in patient safety, health care organizations should measure teamwork using a scientifically valid method. The Safety Attitudes Questionnaire can be used to measure teamwork, identify disconnects between or within disciplines, and evaluate interventions aimed at improving patient safety.

Ethical principles for physician rating sites.

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Strech, Daniel

2011-12-06

During the last 5 years, an ethical debate has emerged, often in public media, about the potential positive and negative effects of physician rating sites and whether physician rating sites created by insurance companies or government agencies are ethical in their current states. Due to the lack of direct evidence of physician rating sites' effects on physicians' performance, patient outcomes, or the public's trust in health care, most contributions refer to normative arguments, hypothetical effects, or indirect evidence. This paper aims, first, to structure the ethical debate about the basic concept of physician rating sites: allowing patients to rate, comment, and discuss physicians' performance, online and visible to everyone. Thus, it provides a more thorough and transparent starting point for further discussion and decision making on physician rating sites: what should physicians and health policy decision makers take into account when discussing the basic concept of physician rating sites and its possible implications on the physician-patient relationship? Second, it discusses where and how the preexisting evidence from the partly related field of public reporting of physician performance can serve as an indicator for specific needs of evaluative research in the field of physician rating sites. This paper defines the ethical principles of patient welfare, patient autonomy, physician welfare, and social justice in the context of physician rating sites. It also outlines basic conditions for a fair decision-making process concerning the implementation and regulation of physician rating sites, namely, transparency, justification, participation, minimization of conflicts of interest, and openness for revision. Besides other issues described in this paper, one trade-off presents a special challenge and will play an important role when deciding about more- or less-restrictive physician rating sites regulations: the potential psychological and financial harms for

Nurse-physician communication - An integrated review.

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Tan, Tit-Chai; Zhou, Huaqiong; Kelly, Michelle

2017-12-01

To present a comprehensive review of current evidence on the factors which impact on nurse-physician communication and interventions developed to improve nurse-physician communication. The challenges in nurse-physician communication persist since the term 'nurse-doctor game' was first used in 1967, leading to poor patient outcomes such as treatment delays and potential patient harm. Inconsistent evidence was found on the factors and interventions which foster or impair effective nurse-physician communication. An integrative review was conducted following a five-stage process: problem identification, literature search, data evaluation, data analysis and presentation. Five electronic databases were searched from 2005 to April 2016 using key search terms: "improve*," "nurse-physician," "nurse," "physician" and "communication" in five electronic databases including the Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PubMed, Science Direct and Scopus. A total of 22 studies were included in the review. Four themes emerged from the data synthesis, namely communication styles; factors that facilitate nurse-physician communication; barriers to effective nurse-physician communication; and interventions to improve nurse-physician communication. This integrative review suggests that nurse-physician communication still remains ineffective. Current interventions only address information needs of nurses and physicians in limited situations and specific settings but cannot adequately address the interprofessional communication skills that are lacking in practice. The disparate views of nurses and physicians on communication due to differing training backgrounds confound the effectiveness of current interventions or strategies. Cross-training and interprofessional educational from undergraduate to postgraduate programmes will better align the training of nurses and physicians to communicate effectively. Further research is needed to determine the

La relación médico-paciente, la medicina científica y las terapias alternativas Physician-patient relationship, scientific medicine and alternative therapies

Directory of Open Access Journals (Sweden)

J. a. Franco

2003-04-01

(p<0.00001, self-medication (p<0.0002, pain and concern during over 6 months due to disease or disability (p<0.00001, lack of confidence in scientific medicine (p<0.00001, the belief that «spiritual problems» (p<0.00001, «mental conditions» (p<0.003, and «emotional conditions» (p<0.00001, popular beliefs, particularly daño & envidia (p<0.00001, and mal de ojo (p<0.001 have triggered the disease. One third of the patients attended the hospital while undergoing an alternative therapy that may pose an interference or interaction hazard. Emphasis is placed on the importance of medical education to assess physician-patient relationship and the ability to convey trust in medical procedures and treatments, and scientific consulting for other practices.

The physician leader as logotherapist.

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Washburn, E R

1998-01-01

Today's physicians feel helpless and angry about changing conditions in the medical landscape. This is due, in large part, to our postmodernist world view and the influence of corporations on medical practice. The life and work of existentialist psychiatrist Viktor Frankl is proposed as a role model for physicians to take back control of their profession. Physician leaders are in the best position to bring the teachings and insight of Frankl's logotherapy to rank-and-file physicians in all practice settings, as well as into the board rooms of large medical corporations. This article considers the spiritual and moral troubles of American medicine, Frankl's answer to that affliction, and the implications of logotherapy for physician organizations and leadership. Physician executives are challenged to take up this task.

The differing perspectives of workers and occupational medicine physicians on the ethical, legal and social issues of genetic testing in the workplace.

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Brandt-Rauf, Sherry I; Brandt-Rauf, Elka; Gershon, Robyn; Brandt-Rauf, Paul W

2011-01-01

Genetic testing in the workplace holds the promise of improving worker health but also raises ethical, legal, and social issues. In considering such testing, it is critical to understand the perspectives of workers, who are most directly affected by it, and occupational health professionals, who are often directly involved in its implementation. Therefore, a series of focus groups of unionized workers (n=25) and occupational medicine physicians (n=23) was conducted. The results demonstrated strikingly different perspectives of workers and physicians in several key areas, including the goals and appropriateness of genetic testing, and methods to minimize its risks. In general, workers were guided by a profound mistrust of the employer, physician, and government, while physicians were guided primarily by scientific and medical concerns, and, in many cases, by the business concerns distrusted by the workers.

Analysis of 4999 online physician ratings indicates that most patients give physicians a favorable rating.

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Kadry, Bassam; Chu, Larry F; Kadry, Bayan; Gammas, Danya; Macario, Alex

2011-11-16

Many online physician-rating sites provide patients with information about physicians and allow patients to rate physicians. Understanding what information is available is important given that patients may use this information to choose a physician. The goals of this study were to (1) determine the most frequently visited physician-rating websites with user-generated content, (2) evaluate the available information on these websites, and (3) analyze 4999 individual online ratings of physicians. On October 1, 2010, using Google Trends we identified the 10 most frequently visited online physician-rating sites with user-generated content. We then studied each site to evaluate the available information (eg, board certification, years in practice), the types of rating scales (eg, 1-5, 1-4, 1-100), and dimensions of care (eg, recommend to a friend, waiting room time) used to rate physicians. We analyzed data from 4999 selected physician ratings without identifiers to assess how physicians are rated online. The 10 most commonly visited websites with user-generated content were HealthGrades.com, Vitals.com, Yelp.com, YP.com, RevolutionHealth.com, RateMD.com, Angieslist.com, Checkbook.org, Kudzu.com, and ZocDoc.com. A total of 35 different dimensions of care were rated by patients in the websites, with a median of 4.5 (mean 4.9, SD 2.8, range 1-9) questions per site. Depending on the scale used for each physician-rating website, the average rating was 77 out of 100 for sites using a 100-point scale (SD 11, median 76, range 33-100), 3.84 out of 5 (77%) for sites using a 5-point scale (SD 0.98, median 4, range 1-5), and 3.1 out of 4 (78%) for sites using a 4-point scale (SD 0.72, median 3, range 1-4). The percentage of reviews rated ≥75 on a 100-point scale was 61.5% (246/400), ≥4 on a 5-point scale was 57.74% (2078/3599), and ≥3 on a 4-point scale was 74.0% (740/1000). The patient's single overall rating of the physician correlated with the other dimensions of care that

Physicians and euthanasia: a Canadian print-media discourse analysis of physician perspectives

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Wright, David Kenneth; Karsoho, Hadi; Sandham, Sarah; Macdonald, Mary Ellen

2015-01-01

Background Recent events in Canada have mobilized public debate concerning the controversial issue of euthanasia. Physicians represent an essential stakeholder group with respect to the ethics and practice of euthanasia. Further, their opinions can hold sway with the public, and their public views about this issue may further reflect back upon the medical profession itself. Methods We conducted a discourse analysis of print media on physicians’ perspectives about end-of-life care. Print media, in English and French, that appeared in Canadian newspapers from 2008 to 2012 were retrieved through a systematic database search. We analyzed the content of 285 articles either authored by a physician or directly referencing a physician’s perspective. Results We identified 3 predominant discourses about physicians’ public views toward euthanasia: 1) contentions about integrating euthanasia within the basic mission of medicine, 2) assertions about whether euthanasia can be distinguished from other end-of-life medical practices and 3) palliative care advocacy. Interpretation Our data showed that although some medical professional bodies appear to be supportive in the media of a movement toward the legalization of euthanasia, individual physicians are represented as mostly opposed. Professional physician organizations and the few physicians who have engaged with the media are de facto representing physicians in public contemporary debates on medical aid in dying, in general, and euthanasia, in particular. It is vital for physicians to be aware of this public debate, how they are being portrayed within it and its potential effects on impending changes to provincial and national policies. PMID:26389090

The Validity of Online Patient Ratings of Physicians: Analysis of Physician Peer Reviews and Patient Ratings.

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McGrath, Robert J; Priestley, Jennifer Lewis; Zhou, Yiyun; Culligan, Patrick J

2018-04-09

Information from ratings sites are increasingly informing patient decisions related to health care and the selection of physicians. The current study sought to determine the validity of online patient ratings of physicians through comparison with physician peer review. We extracted 223,715 reviews of 41,104 physicians from 10 of the largest cities in the United States, including 1142 physicians listed as "America's Top Doctors" through physician peer review. Differences in mean online patient ratings were tested for physicians who were listed and those who were not. Overall, no differences were found between the online patient ratings based upon physician peer review status. However, statistical differences were found for four specialties (family medicine, allergists, internal medicine, and pediatrics), with online patient ratings significantly higher for those physicians listed as a peer-reviewed "Top Doctor" versus those who were not. The results of this large-scale study indicate that while online patient ratings are consistent with physician peer review for four nonsurgical, primarily in-office specializations, patient ratings were not consistent with physician peer review for specializations like anesthesiology. This result indicates that the validity of patient ratings varies by medical specialization. ©Robert J McGrath, Jennifer Lewis Priestley, Yiyun Zhou, Patrick J Culligan. Originally published in the Interactive Journal of Medical Research (http://www.i-jmr.org/), 09.04.2018.

The Influence of Physician Communication Style on Overweight Patients’ Perceptions of Length of Encounter and Physician Being Rushed

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Gulbrandsen, Pål; Østbye, Truls; Lyna, Pauline; Dolor, Rowena J.; Tulsky, James A.; Alexander, Stewart C.; Pollak, Kathryn I.

2012-01-01

BACKGROUND AND OBJECTIVES Little is known about how patients and physicians perceive time and the extent to which they perceive the physician being rushed during encounters. One aim of this paper is to examine whether patient and physician characteristics and physician communication influence patient perception of the duration of the encounter and their perception of physicians being rushed. Another aim is to examine the relationship between patient and physician perceptions of physicians feeling rushed. METHODS We audiorecorded 461 encounters of overweight or obese patients with 40 primary care physicians and included 320 encounters in which weight was discussed. We calculated time spent with physician and coded all communication about weight using the Motivational Interview Treatment Integrity scale (MITI). Patients completed post-visit questionnaires in which they reported the estimated duration of the encounter and how rushed they thought the physician was during the encounter. Physicians reported how rushed they felt. RESULTS Patients estimated encounters to be longer than they actually were by an average of 2.6 minutes (SD=11.0). When physicians used reflective statements when discussing weight, patients estimated the encounter to be shorter than when physicians did not use reflective statements (1.17 versus 4.56 minutes more than actual duration). Whites perceived the encounter as shorter than African Americans (1.45 versus 4.28 minutes more than actual duration). Physicians felt rushed in 66% of visits; however, most patients did not perceive this. Internists were perceived to be more rushed than family physicians. CONCLUSIONS There is wide variation in patients’ ability to estimate the length of time they spend with their physician. Some physician and patient characteristics were related to patient perceptions of the length of the encounter. Reflective statements might lead patients to perceive encounters as shorter. Physicians, especially family

Should physicians have facial piercings?

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Newman, Alison W; Wright, Seth W; Wrenn, Keith D; Bernard, Aline

2005-03-01

The objective of this study was to assess attitudes of patrons and medical school faculty about physicians with nontraditional facial piercings. We also examined whether a piercing affected the perceived competency and trustworthiness of physicians. Survey. Teaching hospital in the southeastern United States. Emergency department patrons and medical school faculty physicians. First, patrons were shown photographs of models with a nontraditional piercing and asked about the appropriateness for a physician or medical student. In the second phase, patrons blinded to the purpose of the study were shown identical photographs of physician models with or without piercings and asked about competency and trustworthiness. The third phase was an assessment of attitudes of faculty regarding piercings. Nose and lip piercings were felt to be appropriate for a physician by 24% and 22% of patrons, respectively. Perceived competency and trustworthiness of models with these types of piercings were also negatively affected. An earring in a male was felt to be appropriate by 35% of patrons, but an earring on male models did not negatively affect perceived competency or trustworthiness. Nose and eyebrow piercings were felt to be appropriate by only 7% and 5% of faculty physicians and working with a physician or student with a nose or eyebrow piercing would bother 58% and 59% of faculty, respectively. An ear piercing in a male was felt to be appropriate by 20% of faculty, and 25% stated it would bother them to work with a male physician or student with an ear piercing. Many patrons and physicians feel that some types of nontraditional piercings are inappropriate attire for physicians, and some piercings negatively affect perceived competency and trustworthiness. Health care providers should understand that attire may affect a patient's opinion about their abilities and possibly erode confidence in them as a clinician.

Comparing selection criteria of residency directors and physicians' employers.

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Villanueva, A M; Kaye, D; Abdelhak, S S; Morahan, P S

1995-04-01

In 1993, the Medical College of Pennsylvania (MCP), mindful of the rapidly changing environments of health care delivery, created three surveys to gather information from outside the school that would help the faculty plan how the curriculum and advising system could better prepare students and residents for the demands of twenty-first-century medicine. The first survey focused on the MCP seniors graduating that year and asked about their perceptions of their medical education and their specialty and residency choices. The second survey, directed to 40 medical residency program directors in family medicine, internal medicine, pediatrics, and surgery, sought to identify the characteristics of applicants that these directors valued when selecting entrants to their programs. The third survey, of 30 employers of physicians representing four practice environments (private practice, hospitals/other health systems, academic medical centers, and health maintenance organizations), sought information on hiring and recruitment practices and the skills, competencies, and attitudes these employers valued most when hiring recently graduated physicians. The responses showed several differences and/or misperceptions among the views held by the three groups surveyed and suggest that medical educators have not adapted as rapidly as have employers to changes in the health care environment. Academic health centers must broaden their missions and make changes in their own institutional cultures, both to maintain their own viability and to train physicians who have the balance between scientific and technical competency and essential personal characteristics (such as empathy) that the next century's practice will probably demand.

Total expenditures per patient in hospital-owned and physician-owned physician organizations in California.

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Robinson, James C; Miller, Kelly

Hospitals are rapidly acquiring medical groups and physician practices. This consolidation may foster cooperation and thereby reduce expenditures, but also may lead to higher expenditures through greater use of hospital-based ambulatory services and through greater hospital pricing leverage against health insurers. To determine whether total expenditures per patient were higher in physician organizations (integrated medical groups and independent practice associations) owned by local hospitals or multihospital systems compared with groups owned by participating physicians. Data were obtained on total expenditures for the care provided to 4.5 million patients treated by integrated medical groups and independent practice associations in California between 2009 and 2012. The patients were covered by commercial health maintenance organization (HMO) insurance and the data did not include patients covered by commercial preferred provider organization (PPO) insurance, Medicare, or Medicaid. Total expenditures per patient annually, measured in terms of what insurers paid to the physician organizations for professional services, to hospitals for inpatient and outpatient procedures, to clinical laboratories for diagnostic tests, and to pharmaceutical manufacturers for drugs and biologics. Annual expenditures per patient were compared after adjusting for patient illness burden, geographic input costs, and organizational characteristics. Of the 158 organizations, 118 physician organizations (75%) were physician-owned and provided care for 3,065,551 patients, 19 organizations (12%) were owned by local hospitals and provided care for 728,608 patients, and 21 organizations (13%) were owned by multihospital systems and provided care for 693,254 patients. In 2012, physician-owned physician organizations had mean expenditures of $3066 per patient (95% CI, $2892 to $3240), hospital-owned physician organizations had mean expenditures of $4312 per patient (95% CI, $3768 to $4857), and

HMO penetration and physicians' earnings.

Science.gov (United States)

Hadley, J; Mitchell, J M

1999-11-01

The goal of this study is to estimate whether cross-sectional variations in enrollment in health maintenance organizations (HMOs) affected physicians' earnings and hourly income in 1990. Using data from a nationally representative sample of 4,577 younger physicians (penetration is endogenous and used the instrumental variables approach to obtain unbiased estimates. HMO penetration had a negative and statistically significant impact on physicians earnings in 1990. A doubling of the average level of HMO penetration in the market is estimated to reduce annual earnings by 7% to 10.7%, and hourly earnings by approximately 6% to 9%. It appears that HMOs were successful in reducing physicians' annual and per hour earnings in 1990, presumably through a combination of fewer visits and lower payment rates for people covered by HMOs. Although these results cannot be generalized to all physicians, the experience of a younger cohort of physicians may still be a good indicator of the future effects of HMOs because younger physicians may be more susceptible to market forces than older and more established physicians. Moreover, these results may be somewhat conservative because they reflect market behavior in 1990, several years before the rapid growth and more aggressive market behavior of HMOs in recent years.

Study of relation of continuing medical education to quality of family physicians' care.

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Dunn, E V; Bass, M J; Williams, J I; Borgiel, A E; MacDonald, P; Spasoff, R A

1988-10-01

A random sample of 120 physicians in Ontario was studied to assess quality of care in primary care and test an hypothesis that quality of care was related to continuing medical education (CME) activities. The quality-of-care scores were obtained by an in-office audit of a random selection of charts. The scores were global scores for charting, prevention, the use of 13 classes of drugs, and care of a two-year period for 182 different diagnoses. There were no relationships between global quality-of-care scores based on these randomly chosen charts and either the type or quantity of the physicians' CME activities. These activities were reading journals, attending rounds, attending scientific conferences, having informal consultations, using audio and video cassettes, and engaging in self-assessment. The implications of these findings are significant for future research in CME and for planners of present CME programs.

Ozone therapy in dentistry. A brief review for physicians.

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Domb, William C

2014-10-31

The 21(st) century dental practice is quite dynamic. New treatment protocols and new materials are being developed at a rapid pace. Ozone dental therapy falls into the category of new treatment protocols in dentistry, yet ozone is not new at all. Ozone therapy is already a major treatment modality in Europe, South America and a number of other countries. What is provided here will not be an exhaustive scientific treatise so much as a brief general introduction into what dentists are now doing with ozone therapies and the numerous oral/systemic links that make this subject so important for physicians so that, ultimately, they may serve their patients more effectively and productively.

The sum of us: considerations on physician-industry relationships.

Science.gov (United States)

Flores Rebollar, Armando

2017-05-26

This essay describes critically the physician-industry relationships and how the latter influences economically in the realization of continuing medical education (CME), industry expenses in sponsoring the academic events of medical societies, travel costs and enrollment, payment for consultants and speakers. It also refers to the movements that have been created in the academic world to counteract this influence, such as No Free Lunch (Spanish version “NoGracias”) and PharmFree. And the struggles between major scientific medical journals, with editorials and among editorialists on the concept of conflicts of interest. All this seen through the existence of an academic institution in Mexico and the exemplary life of one of its members.

DESTINY-S: attitudes of physicians toward disability and treatment in malignant MCA infarction.

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Neugebauer, Hermann; Creutzfeldt, Claire J; Hemphill, J Claude; Heuschmann, Peter U; Jüttler, Eric

2014-08-01

Decompressive hemicraniectomy (DHC) reduces mortality and improves outcome after malignant middle cerebral artery (MCA) infarction but leaves a high number of survivors severely disabled. Attitudes among physicians toward the degree of disability that is considered acceptable and the impact of aphasia may play a major role in treatment decisions. DESTINY-S is a multicenter, international, cross-sectional survey among 1,860 physicians potentially involved in the treatment of malignant MCA infarction. Questions concerned the grade of disability, the hemisphere of the stroke, and the preferred treatment for malignant MCA infarction. mRS scores of 3 or better were considered acceptable by the majority of respondents (79.3%). Only few considered a mRS score of 5 still acceptable (5.8%). A mRS score of 4 was considered acceptable by 38.0%. Involved hemisphere (dominant vs. non-dominant) was considered a major clinical symptom influencing treatment decisions in 47.7% of respondents, also reflected by significantly different rates for DHC as preferred treatment in dominant versus non-dominant hemispheric infarction (46.9 vs. 72.9%). Significant differences in acceptable disability and treatment decisions were found among geographic regions, medical specialties, and respondents with different work experiences. Little consensus exists among physicians regarding acceptable outcome and therapeutic management after malignant MCA infarction, and physician's recommendations do not correlate with available evidence. We advocate for a decision-making process that balances scientific evidence, patient preference, and clinical expertise.

Family physicians' attitude and interest toward participation in urban family physician program and related factors

Directory of Open Access Journals (Sweden)

Masoumeh Sadeghi

2016-01-01

Full Text Available Introduction: Every family physician has a key role in achieving the goals of the family physician program (FPP. Low satisfaction of physicians in certain areas of Iran and their low maintenance level in the program is quite challenging. The aims of the present study were; (1 to assess the attitude of rural/rural-urban family physicians about FPP and (2 to investigate their interest toward participation in urban FPP and (3 to explore the influencing factors. Methods: This cross-sectional study was performed on 137 family physicians who were working in rural/rural-urban FPP in Mashhad University of Medical Sciences (Iran. A self-designed valid and reliable questionnaire including demographic data and thirty questions on the participants' attitudes toward the FPP in Likert scale were used. Data were analyzed by multiple logistic regression models using SPSS software. Results: 49.3% of physicians were interested in continuing their cooperation in the urban-FPP. The mean total attitude score was 62.18 out of 100. The highest agreement and positive attitude of physicians were related to achievements of the program goals dimension. Multiple analyses showed that gender (odds ratio [OR] =5.5; male vs. female and employment status (OR = 16.7 and 10.9 for permanent employment and by contract compared to legal obligation, respectively were significantly associated with physicians' willingness toward participation in the urban-FPP. Conclusion: About half of the studied physicians were interested toward participation in the urban-FPP; Male physicians more than females and permanent employees more than others were willing and interested to participate in the urban-FPP.

[What medical students want - evaluation of medical recruitment ads by future physicians].

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Renkawitz, T; Schuster, T; Benditz, A; Craiovan, B; Grifka, J; Lechler, P

2013-10-01

Three-quarters of all hospitals in Germany are now struggling to fill open positions for doctors. The medical job ad is a vital tool for human resources marketing and an important image factor. The present study examines the importance of information and offers in medical recruitment ads on application decisions by medical students. A total of 184 future physicians from clinical semesters participated voluntarily in an anonymous cross-sectional survey. Using a standardised questionnaire, the importance of 49 -individual items extracted from medical recruitment ads were rated with the help of a 4-point Likert Scale. Finally, the study participants prioritised their reasons for an application as a physician. Primary influence on the application decision on medical recruitment ads by medical students had offers/information in relation to education and training aspects and work-life balance. Payment rates for physicians and work load played an important role for the application motivation. Additional earnings for, e. g., emergency calls, providing of medical expertise and assistance with housing, relocation and reimbursement of interview expenses were less crucial. In prioritising key reasons for selecting a prospective employer "regular working hours," an "individual training concept" and an "attractive work-life balance" scored the highest priority. The "opportunity for scientific work" was assigned only a small significance. High importance for the application decision by future physicians on medical recruitment ads is placed on jobs with an opportunity for personal development and aspects that contribute to work-life balance. © Georg Thieme Verlag KG Stuttgart · New York.

Patient-physician communication regarding electronic cigarettes.

Science.gov (United States)

Steinberg, Michael B; Giovenco, Daniel P; Delnevo, Cristine D

2015-01-01

Smokers are likely asking their physicians about the safety of e-cigarettes and their potential role as a cessation tool; however, the research literature on this communication is scant. A pilot study of physicians in the United States was conducted to investigate physician-patient communication regarding e-cigarettes. A total of 158 physicians were recruited from a direct marketing e-mail list and completed a short, web-based survey between January and April 2014. The survey addressed demographics, physician specialty, patient-provider e-cigarette communication, and attitudes towards tobacco harm reduction. Nearly two-thirds (65%) of physicians reported being asked about e-cigarettes by their patients, and almost a third (30%) reported that they have recommended e-cigarettes as a smoking cessation tool. Male physicians were significantly more likely to endorse a harm reduction approach. Physician communication about e-cigarettes may shape patients' perceptions about the products. More research is needed to explore the type of information that physicians share with their patients regarding e-cigarettes and harm reduction.