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PubMedDate not supplied

Risk factors for lead poisoning among Cuban refugee children.

OBJECTIVES: This study was designed to explore whether parental activities such as repairing cars, welding, and rebuilding car batteries are risk factors for lead poisoning among Cuban refugee children in Miami-Dade County. METHODS: The authors performed a cross-sectional study of 479 children aged 12-83 months who had lived in Cuba during the six months prior to immigrating to the U.S. Lead levels were obtained, and parents provided information on demographics, home/neighborhood environment in Cuba prior to immigration, family/occupational factors prior to immigration, and child behavior factors. RESULTS: Of 479 children, 30 (6.3%) had elevated blood lead levels (EBLLs), defined as > or = 10 microg/dL, based on the Centers for Disease Control and Prevention action level. In multivariate analysis, racial/ethnic identification other than white, living in a home built after 1979, car repair in the home or yard, eating paint chips, and male sex were independently associated with EBLL. CONCLUSIONS: Risk factors for lead poisoning among immigrant children may differ from those among U.S.-born children. Screening of immigrant children who may have been exposed in their country of origin and education of immigrant parents about lead exposure hazards associated with activities such as car repair should be considered in the design of lead poisoning prevention and control programs.

Age Distribution↗
PubMed1989

[Armed conflict and trauma: a clinical study of Latin-American refugee children].

This exploratory research on psychic consequences of armed conflicts has been carried out in Montreal on 30 latin-americans, eight to 12 year-old refugees. The principal objective was to assert the importance of traumas intensity, accumulation and age of occurrence on the level and type of symptomatology (introversion-extroversion). Using two types of methodologies, clinical scales and in a more exploratory way, projective instruments to study the intra-psychic dynamic underlying the symptomatology observed. The children were classified according to trauma intensity and for this purpose, a trauma scale was defined with latin-american informants. ACHENBACH and DOMINIQUE clinical evaluation scales were applied to the measure of clinical symptomatology. These instruments were analysed as a function of the symptoms intensity and type. Among results, the accumulation and intensity of traumas were found to be in significant correlation with anxio-depressive symptoms, as reported by the children with interiorization symptoms in ACHENBACH. The predominance of interiorization is discussed. The analysis of the TAT, based on objective indicators, brought out a light frequency of violent themes in relations with the clinical symptomatology. This research indicates the relevance of projective instruments to the study of traumatic response.

Adaptation, Psychological↗
PubMed1995

Immigrant and refugee children in Canada.

In view of Canada's commitment to immigration, understanding the sources of successful adaptation by immigrant and refugee children is vital. This paper reviews the literature on the mental health of migrant children and suggests an agenda for future research.

Acculturation↗
PubMed2007

Community social support for Cuban refugees in Texas.

Social support has been linked to positive health outcomes for many populations across multiple health issues. The interactional approach defines social support as a complex, transactional process between the person and his or her social environment. Being part of a community enhances the likelihood of social bonding, leading to increased perceived support. In this study, the authors describe recently arrived adult Cuban refugees' perceptions of community-level support in Texas. Practical and emotional support needs included jobs and companionship away from everyday problems. The two major sources of practical support were resettlement agencies and other Cubans. The two major sources of emotional support were other Cubans and English-speaking friends. There were no local Cuban clubs or associations where Cubans could meet. Besides receiving support, many Cubans were also supporting other Cubans locally and in Cuba, and some experienced discrimination.

Acculturation↗
PubMed2004

Olfactory-triggered panic attacks among Khmer refugees: a contextual approach.

One hundred Khmer refugees attending a psychiatric clinic were surveyed to determine the prevalence of olfactory-triggered panic attacks as well as certain characteristics of the episodes, including trigger (i.e. type of odor), frequency, length, somatic symptoms, and the rate of associated flashbacks and catastrophic cognitions. Forty-five of the 100 patients had experienced an olfactory-triggered panic attack in the last month. Trauma associations and catastrophic cognitions (e.g. fears of a 'wind attack', 'weakness', and 'weak heart') were common during events of olfactory panic. Several case examples are presented. A multifactorial model of the generation of olfactory panic is adduced. The therapeutic implications of this model for the treatment of olfactory panic are discussed.

Adult↗
PubMed2006

Immigrants and refugees: the psychiatric perspective.

Psychiatric studies of immigrants have yielded contradictory findings regarding rates of mental illness. Current evidence suggests that rates of schizophrenia (and probably other disorders) among immigrant groups are low compared with native-born populations when sending and receiving countries are socially and culturally similar. The rates for immigrants are higher when sending and receiving countries are dissimilar, probably because of multiple social problems faced by immigrants in the receiving country. Refugees who flee their own country because of fears of violence or starvation often have had extremely traumatic experiences, which may result in PTSD and sometimes chronic impairment. Asylum seekers who arrive illegally to seek refuge in a foreign country also may have multiple traumas and experience further distress from their uncertain residency and legal status. Although much is known about the effects of migration, competent culturally sensitive services for migrants remain inadequate to meet the need.

Acculturation↗
PubMed1998

Political violence, family stress and mental health of refugee children in exile.

The mental health of 63 refugee children, with a mean age of 5.9 years, from Chile and the Middle East, were studied during the first 18 months of exile in Stockholm, Sweden. 46% of the children were rated as having poor mental health five months after resettlement in symptom interviews with parents based on the structured questionnaire developed by Cederblad, and 44% thirteen months later. Political violence in the home country and stress in the family sphere in exile were identified as the major determinants of poor mental health in this context.

Acculturation↗
PubMed2004

Psychological trauma and evidence for enhanced vulnerability for posttraumatic stress disorder through previous trauma among West Nile refugees.

BACKGROUND: Political instability and the civil war in Southern Sudan have resulted in numerous atrocities, mass violence, and forced migration for vast parts of the civilian population in the West Nile region. High exposure to traumatic experiences has been particularly prominent in the Ugandan and Sudanese of the West Nile Region, representing an indication of the psychological strain posed by years of armed conflict. METHODS: In this study the impact of traumatic events on the prevalence and severity of posttraumatic stress disorder (PTSD) in a random sample of 3.339 Ugandan nationals, Sudanese nationals, and Sudanese refugees (1.831 households) of the West Nile region is assessed. RESULTS: Results show a positive correlation between the number of traumatic events and the number of endorsed PTSD symptoms. Of the 58 respondents who experienced the greatest number of traumatizing experiences, all reported symptoms which met the DSM-IV criteria for PTSD. CONCLUSIONS: There is a clear dose-effect relationship between traumatic exposure and PTSD in the studied populations with high levels of traumatic events. In this context, it is probable that any individual could develop PTSD regardless of other risk-factors once the trauma load reaches a certain threshold.

Adolescent↗
PubMed1980

Mental illness among Polish and Russian refugees in Bradford.

An epidemiological study of first admission to psychiatric hospitals in Bradford revealed that foreign-born people had substantially higher illness rates than native born. Comparing the major World War II refugee groups it was found that morbidity was higher among Poles than Ukrainians. It is suggested that the difference can be partly explained by the lower social cohesion of the former. The resulting marginal identity is insufficient protection against the normal crises and losses of later life.

Adolescent↗
PubMedDate not supplied

The Haitian refugee: concerns for health care providers.

This paper reports an exploratory study of the situation of Haitian refugees in the U.S., based on extensive interviews and conversations with health care providers around the state of Florida. The study raises issues that are applicable to other disadvantaged subcultures, and illustrates the need for further, more rigorous fact-finding and attention by health care providers. Suggestions for social workers working in cross-cultural settings are also discussed.

Acculturation↗
PubMed2006

Iraqi Gulf War veteran refugees in the U.S.: PTSD and physical symptoms.

Veterans of the Gulf War present various symptoms and maladies. Reports by governmental and private entities have yielded mixed results and have been fraught with criticisms of biased research design. The vast majority of these studies have focused on U.S. veterans, with a much smaller number focusing upon British veterans. Very few have examined Iraqi Gulf War veterans. Our study involves administering a health issues questionnaire to a sample of Iraqi Gulf War veteran refugees in the U.S. Results indicate relationships between Post-Traumatic Stress Disorder (PTSD) scores and health outcome measures of chronic fatigue, fibromyalgia, functional status, quality of life, and health care utilization in terms of frequency and level of intensity. Implications for further inquiry are presented.

Gulf War↗
PubMed2003

Tuberculosis among Tibetan refugee claimants in Toronto: 1998 to 2000.

BACKGROUND AND OBJECTIVES: Between 1998 and 2000, approximately 525 Tibetan people previously living in the United States claimed refugee status in Canada, many of whom were referred to our centers for completion of tuberculosis (TB) screening. We reviewed TB-related outcomes in this cohort, to compare our experience with previously published work, and to assess follow-up after a stay in a low-incidence region. METHODS: We performed a retrospective study of all patients of Tibetan origin assessed at our centers (St. Michael's Hospital and West Park Healthcare Centre, both in Toronto) for completion of TB screening, referred because of abnormal chest radiographic findings or positive tuberculin skin test (TST) result. We compared rates of active and drug-resistant TB in our cohort with local and national rates, as well as those previously published in similar groups. RESULTS: One hundred eighty-nine individuals were referred to us for assessment, and 181 records were available for review. The mean duration of stay in Canada prior to presentation was 2.6 months, after having spent a mean of 11 months in the United States. Thirty-two percent of patients gave a history of previous TB, and 97% were TST positive. Culture-positive TB was diagnosed in 24 patients (13%, 4,571 per 100,000), 12 patients had at least one drug resistance (50% of cases), and 4 patients were resistant to at least isoniazid and rifampin (multidrug resistant, 17% of cases). INTERPRETATION: People from highly TB endemic areas retain a very high risk of active TB and drug resistance, despite an intervening period in a low-prevalence country. It is important to maintain a high degree of suspicion for TB in all people from high-incidence areas. Treatment of all cases of latent TB infection or ongoing medical surveillance is likely justified in this population.

Antitubercular Agents↗
PubMed1985

Multiple puncture skin test and mantoux test in Southeast Asian refugees.

Skin test reactions to PPD applied by Mantoux techniques were compared with reactions to tuberculin tine test (PPD-tine); tuberculin, old tine test (OT tine); Aplitest; and Mono-Vacc, tuberculin, old (Mono-Vacc) in newly arrived refugees from Cambodia and Laos. The reaction to Mantoux test was accepted as the "true reading" and compared to the reaction size to one of the multiple puncture tests (MPT). A 2 X 2 table was constructed and sensitivity, specificity, false negative, and false positive rates computed over a broad range of cut-off points for MPT. The MPTs were very sensitive (100 percent to 78 percent) but lacked specificity (78 percent to 18 percent) when a cut-off of 1 mm was used. Predictably, as the cut-off is moved to larger reactions, sensitivity decreases and specificity increases. The relationship between the two is emphasized in a receiver-operator characteristics analysis. The MPTs are not intended for diagnostic use. Reaction to the MPT should be interpreted with the same careful consideration that clinicians use to interpret reactions to the Mantoux test.

Asia, Southeastern↗
PubMed1999

Health culture and the clinical encounter: Vietnamese refugees' responses to preventive drug treatment of inactive tuberculosis.

A majority of Vietnamese refugees entering the United States test positive for inactive tuberculosis (TB). In asymptomatic conditions like inactive TB, it is often difficult to obtain compliance with medical treatment. The clinical encounter has been analyzed as a form of symbolic action between doctor and patient critical to patient trust and compliance. However, it is equally, if not more, important to understand the health culture of patients, that is, the broader sociocultural context of the patient within which his or her illness is interpreted and understood. In this article I look at health culture elements that influence compliance and noncompliance by Vietnamese American clients with courses of preventive drug therapy for inactive TB. Key factors in compliance are: (1) cultural interpretations of the therapy's side effects as "hot"; (2) the role of family members and peers; and (3) community perceptions of the drug treatment. Culturally incongruent elements of the clinical encounter and the funding of community-based organizations for health education also are examined.

Adult↗
PubMed1994

Culture, stress and substance use in Cambodian refugee women.

Initial data were generated on the use of alcohol and other drugs by Cambodian refugee women and their families (N = 120) in two sites: Massachusetts and California. Information on frequency and situations surrounding use, and culturally specific use, was elicited. In those families where alcohol was perceived as a problem, the majority of problem drinkers were husbands. About 45% of the East Coast women, however, said they used alcohol for nervousness, stress, headaches, insomnia and pain. In addition, about 15% of the East Coast women reported that a family member used street drugs and was having dependency problems. While use of alcohol or street drugs was not perceived as problematic on the West Coast, over 58% reported using prescription drugs for self-treatment of illnesses other than those targeted by the prescription. When prescription drugs were misused by women, it was most frequently to get an altered state, or "street drug effect". Numerous stressors influence Cambodian women during the pressures of acculturation to the U.S. lifestyle. Some may turn to self-medication in the form of alcohol, prescription sleeping pills, or other drugs. A better understanding of how and why these women make coping choices is needed.

Acculturation↗
PubMed1982

Cambodian disaster relief: refugee camp medical care.

The lack of available data impedes the efficient delivery of health care in disaster situations. We present organizational information and patient data based on review of 924 consecutive admissions seen during our three-month experience as refugee camp pediatricians at Khao-I-Dang Holding Center for Kampucheans in Thailand. Most patients had severe and multiple common diseases, with pneumonia, diarrhea, measles, and meningitis having the highest incidence. To optimize care, the gathering and distribution of epidemiologic data, the development of laboratory facilities and treatment protocols, standardization of supplies, and the initiation of programs for disease prevention must be stressed.

Adolescent↗
PubMed1982

Pregnancy outcomes of Indochinese refugees, Santa Clara County, California.

Birth certificates and a sample of hospital obstetric records for Indochinese refugees in Santa Clara County, CA, 1979-1980, were reviewed. Among 542 live births, the overall median birthweight of 3175 gm and 5.7 per cent rate of low birthweight were favorable; it is our impression that the more recent arrivals, especially Cambodians and Laotians, present at greater risk, lacking prenatal care, and have more infants of low birth rate and more pregnancy complications.

Adolescent↗
PubMed1983

Indochinese refugee fertility rates and pregnancy risk factors, Oregon.

Matching 471 Oregon birth certificates with official Indochinese arrival lists reveals a fertility rate of 126.7, 1.8 times the US rate of 68.5. Greater maternal and infant risk rates were noted, particularly for Hmong. Data indicate improvements in obtaining prenatal care and in reducing the number of low birth weight infants for refugees who have resided in the US three or more months: however, the improvements appear to be reversed after 12 months of US residency.

Adolescent↗