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Building healthy communities with immigrants and refugees.

Immigration fueled by large population shifts across international borders will be an ongoing phenomenon throughout the world for the foreseeable future. Forces raising concern for the development of healthy immigrant communities in the United States are the scapegoating of immigrants as the cause of many of the problems of society, a growing lack of tolerance for diversity, and the need for rapid acculturation. A construct of what constitutes healthy communities for immigrants is discussed. The construct is built around the concepts of convergent stereotyping, solidarity, and agency. To help build healthy communities, transcultural nurses must assist other nurses and health care providers to function from a transcultural posture to develop culture competence, reconceptualize how immigrants are viewed, avoid reductionism of the immigrant experience into a psycho-emotional phenomenon, and actualize human development as part of community development.

Community Health Nursing↗
PubMed2003

'Hit by the wind' and temperature-shift panic among Vietnamese refugees.

Surveying 60 Vietnamese patients with either current or past post-traumatic stress disorder, this article aims to phenomenologically characterize the syndrome of 'hit by the wind' in a multidimensional manner. This includes determining the patient conceptualization of the disorder, profiling 'hit by the wind' episodes suffered by patients in the previous month, and presenting case vignettes. Eighteen of the 60 patients (30%) suffered at least one episode of 'hit by the wind' in the last month; all 18 patients had at least one episode of 'hit by the wind' in the last month that met panic attack criteria. For the 18 patients, 33 episodes of'hit by the wind' that met panic attack criteria were experienced in the previous month. For these 33 episodes, the most frequently reported DSM-IV panic attack symptoms were chills (100%; 33/33) and dizziness (88%; 29/33). Flashbacks played a role in the 'hit by the wind' episodes for 5 of the 18 patients (28%). In the discussion, a model of how the syndrome of 'hit by the wind' generates panic is adduced; also, possible Chinese origins of the disorder are discussed.

Adult↗
PubMed2003

Delayed visual maturation in Karen refugee infants.

Thirty-eight babies born to Karen mothers living in camps for displaced persons in north-western Thailand have delayed visual maturation (DVM type 1) that recovers within 6 months. Vitamin A concentrations were deficient in 16% of breast-milk samples from lactating mothers and vitamin B(1) concentrations were deficient in 60% of plasma samples. Infantile beriberi was common in this population. The levels of fatty acids in plasma and milk in Karen women were excellent at birth and in the postpartum period. The degree of deficiencies in these vitamins and the concentration of essential fatty acids in cord blood and maternal breast-milk did not correlate significantly with visual impairment in the infants. DVM might be caused by nutritional deficiency or toxic effects during critical periods of gestation that lead to delayed cortical myelination or structural defects which impinge on parietal cortex function.

Adolescent↗
PubMed2005

Cost-effectiveness of tuberculosis control strategies among immigrants and refugees.

Today, in Western Europe, Canada and the USA, more than half of all new active tuberculosis (TB) cases occur among foreign-born migrants. This article examines the impact of migration from high TB-incidence to low TB-incidence countries, and compares the cost-effectiveness of different TB control strategies. A Medline search was conducted to identify relevant English language publications prior to December 2003. Additional articles were identified from the reference lists from these publications. Despite the high proportion of active cases in low-incidence countries attributable to foreign-born residents, the public health impact is relatively low. Current chest radiograph screening programmes have little impact and are not cost-effective. Screening with sputum culture would improve cost-effectiveness marginally. Treatment of latent infection detected through screening with tuberculin skin testing or chest radiographs may require coercive measures to maximise impact and cost-effectiveness. In contrast, contact tracing, particularly within ethnic communities, appears to be more cost-efficient and less intrusive. In low-incidence countries, screening of migrants at entry has little overall impact and is not a very cost-effective tuberculosis control strategy. More effective alternatives include contact tracing delivered through primary care and increased investment in global tuberculosis control.

Cost-Benefit Analysis↗
PubMed1991

Cultural themes in health-care decision making among Cambodian refugee women.

The Cambodians are adapting to the American ways while still holding firmly to their culture. Such cultural identity provides security and a sense of equilibrium. With the Cambodian patient, providing culturally sensitive nursing care centers on supporting the concept of equilibrium. In this endeavor, the nurse plays multiple roles advocate, culture broker, educator, and friend.

California↗