refugees

难民
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  • 文章类型: Journal Article
    阿富汗难民童工在被标记为难民时面临许多挑战。为了探索这些挑战,本研究是在德黑兰采用定性方法进行的。本定性研究是在2022年在德黑兰对25名阿富汗童工使用常规内容分析方法进行的。通过有目的和滚雪球抽样选择了童工,并在半深度访谈中进行了采访。数据是根据Granheim和Lundman的标准进行分析的,还有古巴和林肯,进一步丰富研究结果。共3类,13个子类别,从数据分析中提取了183个初始代码,包括:“心理挑战”(骚扰和虐待的历史,负面影响,高风险行为,和家庭脱离);“健康挑战”(身体问题,不合适的住宿,医疗/治疗问题,和健康威胁);和“社会挑战”(被忽视的童年,双重身份,教育的局限性,社会支持不足,社会孤立,和社会羞辱)。在个人层面,有可能满足童工的健康需求,并通过一定间隔的体检和举办防止骚扰培训讲习班,使他们意识到在街道上工作的危害,愤怒控制,预防高风险行为,预防传染病,如肝炎,增强自信心以改善健康。此外,阿富汗童工的工作可以通过在更合适的社区提供住宿,在社会和家庭层面进行干预,为童工提供健康保险,创造在学校学习的机会,防止辍学,和加强社会关系,以提高儿童的健康。
    Afghan refugees child labourers face many challenges as they are labelled as refugees. In an attempt to explore these challenges, the present study was conducted in Tehran with a qualitative approach. The present qualitative research was conducted using a conventional content analysis approach with 25 Afghan child labourers in 2022 in Tehran. Child labourers were selected through purposive and snowball sampling and interviewed in a semi-in-depth interview. The data were analysed based on Granheim and Lundman\'s criteria, as well as those of Guba and Lincoln, to further enrich the findings. A total of 3 categories, 13 sub-categories, and 183 initial codes were extracted from the data analysis, including: \"psychological challenges\" (history of harassment and abuse, negative effects, high-risk behaviours, and family detachment); \"health challenges\" (physical problems, inappropriate accommodation, medical/therapeutic problems, and health threats); and \"social challenges\" (neglected childhood, dual identity, educational limitations, inadequate social support, social isolation, and social humiliation). At the individual level, it is possible to meet the child labourers\' health needs and make them aware of the hazards of working in the streets through physical examination at certain intervals and holding training workshops on harassment prevention, anger control, prevention of high-risk behaviours, prevention of infectious diseases such as hepatitis, and strengthening self-confidence to improve health. Also, the Afghan child labourers\' work could be intervened at the social and familial level by providing accommodation in more suitable neighbourhoods, providing health insurance for child labourers, creating the chances of studying in schools, preventing dropouts, and strengthening social relations in order to improve children\'s health.
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  • 文章类型: Journal Article
    本文采用社会经济和政治视角来阐明加剧叙利亚难民农业工人脆弱性及其在黎巴嫩接触农药的因素之间的相互作用。它为相互联系的社会提供了全面的理解,全球政治和经济因素,区域,国家和地方层面,以及它们如何增加叙利亚难民农业工人的脆弱性,特别是他们接触杀虫剂。全球因素凸显了从殖民主义到国家控制经济再到新自由主义政策的转变。这些变化优先考虑了大型农业计划和跨国公司的利益,而牺牲了中小型农业。因此,农药需求增加,再加上全球南方国家监管薄弱,农业投资减少。本文解释了中东和北非地区气候变化和冲突的动态相互作用如何对农业部门和粮食生产产生负面影响,这导致农药使用的潜力增加。在国家和地方层面,黎巴嫩的社会,政治和经济政策导致农业部门的削弱,农药的过度使用,以及叙利亚难民农业工人的脆弱性和接触杀虫剂的加剧。文章建议研究人员,政策制定者,和从业者采用政治-经济-社会视角来分析和解决黎巴嫩和其他国家的移民和难民工人面临的全面动态状况,并促进全球农业部门的平等。
    This article adopts a socio-economic and political lens to elucidate the interplay of factors that heighten the vulnerability of Syrian refugee agricultural workers and their exposure to pesticides in Lebanon. It provides a comprehensive understanding for the interconnected social, political and economic factors at the global, regional, national and local levels and how they increase the vulnerability of Syrian refugee agricultural workers, particularly their exposure to pesticides. The global factors highlight the shifts from colonialism to state-controlled economies to neoliberal policies. These changes have prioritized the interests of large agricultural schemes and multinationals at the expense of small and medium-sized agriculture. Consequently, there has been a boost in pesticides demand, coupled with weak regulations and less investment in agriculture in the countries of the Global South. The article explains how the dynamic interaction of climate change and conflicts in the Middle East and North Africa region has negatively impacted the agriculture sector and food production, which led to an increased potential for pesticide use. At the national and local levels, Lebanon\'s social, political and economic policies have resulted in the weakening of the agricultural sector, the overuse of pesticides, and the intensification of the Syrian refugee agricultural workers\' vulnerability and exposure to pesticides. The article recommends that researchers, policymakers, and practitioners adopt a political-economic-social lens to analyze and address the full dynamic situation facing migrant and refugee workers in Lebanon and other countries and promote equity in the agricultural sector globally.
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  • 文章类型: Journal Article
    面临被迫离开祖国的移民青年有紧急的心理健康负担,使他们面临更高的自杀风险。因此,儿科服务提供者在对该人群的护理中纳入自杀筛查和评估至关重要.移民家庭寻求安全,但是,在许多情况下,在移民旅程和东道国社区中遇到不良事件和社会心理不平等。创伤等因素,适应应激,和交叉性影响移民的自杀风险。总结性创伤事件导致移民青年的心理健康负担和自杀结局恶化。文化适应压力会导致东道国的社会边缘化,进一步增加了现有的心理健康负担。最后,交叉性包含复杂的社会文化影响,塑造了流动青年文化认同的发展,影响了自杀风险。通过研究这些因素,作者通过儿科临床实践中的循证工具,提出了在移民青年自杀风险筛查和评估中的文化考虑因素.获得精神卫生服务的障碍,污名,还解决了东道国社区对医疗保健系统的不信任。作者提出了通过创伤知情护理在该人群中进行早期自杀筛查和预防的建议,积极倡导,文化敏感性。
    Migrant youth who face forced displacement from their home countries have an emergent mental health burden, placing them at increased suicide risk. As such, it is crucial for pediatric providers to include suicide screening and assessment in their care for this population. Migrant families seek safety but, in many cases, encounter adverse events and psychosocial inequities in the migration journey and in the host community. Factors such as trauma, acculturative stress, and intersectionality influence suicide risk in migrants. Summative traumatic events contribute to the mental health load and worsen suicidal outcomes in migrant youth. Acculturative stress can lead to social marginalization in the host country, further adding to the existing mental health burden. Finally, intersectionality encompasses complex sociocultural influences, which shape the development of cultural identity in migrant youth and influence suicide risk. By examining these factors, the author advances cultural considerations in screening and assessment for suicide risk in migrant youth through evidence-based tools in pediatric clinical practice. Barriers to access to mental health services, stigma, and distrust of the health care system within the host community are also addressed. The author establishes recommendations for early suicide screening and prevention within this population through trauma-informed care, active advocacy, and cultural sensitivity.
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  • 文章类型: Journal Article
    目标:尽管美国外国出生人口有所增加,移民和难民健康(IRH)方面的医学教育机会仍然有限。我们总结了已发布的IRH课程的发现,并提供了将IRH纳入儿科住院医师计划的建议。
    方法:我们对描述设计的文章进行了文献综述,实施,或评估美国本科和研究生医学学员的IRH课程。
    结果:文献综述确定了来自21个机构的36篇文章,描述了37个独特的课程。三个课程包括儿科住院医师计划。通常教授的主题包括文化谦逊,解释器使用,和移民身份是健康的社会决定因素。连续性诊所存在以移民为重点的培训经验,难民或寻求庇护者诊所,和专门的选修/轮换。课程最常被描述为独立的选修课/轮换。
    结论:IRH课程提供了发展临床护理技能的机会,倡导,以及与移民人口的社区伙伴关系。儿科住院医师计划应将IRH课程与现有的学习重点保持一致,支持和聘请具有IRH专业知识的教师,并与具有专业知识的社区组织合作。课程还可以考虑如何最好地支持对专注于移民人口的职业感兴趣的学习者。需要进一步的工作来建立能力和经过验证的工具,以衡量IRH课程的受训者满意度和临床能力。
    OBJECTIVE: Despite increases in the US foreign-born population, medical education opportunities in immigrant and refugee health (IRH) remain limited. We summarize findings for published IRH curricula and offer recommendations for integrating IRH into pediatric residency programs.
    METHODS: We performed a literature review of articles describing the design, implementation, or assessment of IRH curricula for US-based undergraduate and graduate medical trainees.
    RESULTS: The literature review identified 36 articles from 21 institutions describing 37 unique curricula. Three curricula included pediatric residency programs. Commonly taught topics included cultural humility, interpreter use, and immigration status as a social determinant of health. Immigrant-focused training experiences existed at continuity clinics, clinics for refugees or asylum seekers, and dedicated electives/rotations. Curricula were most frequently described as stand-alone electives/rotations.
    CONCLUSIONS: IRH curricula provide opportunities to develop skills in clinical care, advocacy, and community partnerships with immigrant populations. Pediatric residency programs should align the IRH curriculum with existing learning priorities, support and hire faculty with expertise in IRH, and partner with community organizations with expertise. Programs can also consider how to best support learners interested in careers focusing on immigrant populations. Further work is needed to establish competencies and validated tools measuring trainee satisfaction and clinical competency for IRH curricula.
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  • 文章类型: Journal Article
    背景:自2011年叙利亚内战开始以来,据报道,到2023年,图尔基耶受临时保护的官方难民人数为3,522,036。大多数生活在难民营外的叙利亚人在获得医疗中心和社会机会方面的条件较差,与住在营地的人相比。Sanliurfa省在图尔基耶拥有第三多的叙利亚人(370,291)。没有关于弓形虫血清阳性率的数据(T。gondii),风疹(擦),或巨细胞病毒(CMV)在Sanliurfa的叙利亚难民中。我们的目的是调查弓形虫的血清阳性率,rub,生活在Sanliurfa省的育龄(15-49岁)的叙利亚女性难民中的CMV感染。
    方法:在Sanliurfa的不同地区进行了横断面研究。采用概率抽样方法共抽取460户。一名年龄在15至49岁之间的已婚叙利亚女性难民,在每个家庭中被选中,导致410名叙利亚女性难民的样本量。弓形虫的血清阳性,CMV,并使用酶免疫测定法分析血液样本中的IgM和IgG(雅培建筑师,伊利诺伊州,美国)。
    结果:弓形虫的血清阳性率,CMV,风疹IgM和IgG分别为4.4%和59.8%;3.9%;和99%;和1.9%,99.5%,分别。
    结论:应实施弓形虫筛查计划,CMV,并为叙利亚难民提供感染。血清阴性的妇女应接种疫苗,以预防弓形虫病和CMV感染的传播和预防途径。
    BACKGROUND: Since the Syrian Civil War began in 2011, the official number of refugees under temporary protection in Turkiye is reported to be 3,522,036 in 2023. Most of the Syrians living outside the refugee camps have worse conditions in terms of access to healthcare centers and social opportunities, compared to those living in camps. The Sanliurfa province hosts the third highest number of Syrians (370,291) in Turkiye. There are no data about the seroprevalence of Toxoplasma gondii (T. gondii), rubella (rub), or cytomegalovirus (CMV) among Syrian refugees in Sanliurfa. We aimed to investigate the seroprevalence of T. gondii, rub, and CMV infections among female Syrian refugees of reproductive age (15-49 years) living in Sanliurfa province.
    METHODS: A cross-sectional study was conducted in different districts of Sanliurfa. A total of 460 households were selected using the probability sampling method. One married female Syrian refugee aged between 15 and 49 years, was chosen in each household, leading to a sample size of 410 female Syrian refugees. The seropositivity of T. gondii, CMV, and rub IgM and IgG in blood samples were analyzed using enzyme immunoassays (Abbott Architect, Illinois, USA).
    RESULTS: The seropositivity rates of T. gondii, CMV, and rubella IgM and IgG were 4.4% and 59.8%; 3.9%; and 99%; and 1.9%, and 99.5%, respectively.
    CONCLUSIONS: A screening program should be implemented for T. gondii, CMV, and rub infections for Syrian refugees. Seronegative women should be vaccinated against rub and educated about the transmission and preventive routes of toxoplasmosis and CMV infection.
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  • 文章类型: Journal Article
    共有7,307名乌克兰难民移居安特卫普,比利时,在研究期间(2022年4月1日至2022年12月31日)。市政府建立了三个护理中心,这些人被引入比利时初级保健系统,创建了一个医疗文件,并提供了急性/预防性/慢性护理。本社区案例研究分析了护理的组织和内容,并反思了其对主流医疗保健系统的意义。
    这是一项观察性研究,使用常规电子病历数据来测量护理的摄取。对于200名受试者的样本,进行了回顾性图表审查.
    在三个参与护理中心之一拥有医疗档案的所有难民都包括在内。
    对于观察性研究,达到2,261名患者(潜在用户的30%),并对6450名接触者进行了研究。护士(包括助产士)在所有咨询的6450次(76%)中进行了4929次,而全科医生(全科医生)在6,450人中有1,521人(24%)。在护士咨询中,955(19%)随后是另一位护士咨询,866(18%)随后是全科医生咨询。在结构化案例审查中,大多数接触者与严重问题有关(1074人中有609人,占57%)。遇到和诊断的最普遍原因是典型的初级保健问题。护士能够独立管理一半的病例(327,55%),将37%(217)的病例转介给全科医生,并咨询了全科医生(现场,通过电话,或专用应用程序)适用于8%(48)的病例。全科医生主要是处方药,转诊给医学专家,并建议使用非处方药,虽然护士更经常建议非处方药(主要是扑热息痛,喷鼻剂,和抗炎药),提供非医疗建议,或订购实验室测试。
    在第一阶段,医疗护理点主要提供典型的急性初级保健,对护士有重要作用。护理点没有充分解决慢性病和心理健康问题。这些结果将为决策者提供有关在大量涌入时使用初级保健中心治疗新到达的患者的信息。护士优先模式似乎可行且有效,但是需要评估护理的安全性和质量。一旦危机的急性阶段消失,关于全面性的问题,连续性,移民护理的整合仍然重要。
    UNASSIGNED: A total of 7,307 Ukrainian refugees moved to Antwerp, Belgium, during the study period (01 April 2022 to 31 December 2022). The city\'s administration set up three care centers where these people were introduced to the Belgian primary care system, a medical file was created, and acute/preventive/chronic care was delivered. This community case study analyzes the organization and contents of care and reflects upon its meaning for the mainstream healthcare system.
    UNASSIGNED: This is an observational study using routine electronic medical record data to measure the uptake of care. For a sample of 200 subjects, a retrospective chart review was conducted.
    UNASSIGNED: All refugees with a medical file at one of the three participating care centers were included.
    UNASSIGNED: For the observational study, 2,261 patients were reached (30% of the potential users), and 6,450 contacts were studied. The nurses (including midwives) conducted 4,929 out of 6,450 (76%) of all consultations, while the general practitioners (GPs) conducted 1,521 out of 6,450 (24%). Of the nurse consultations, 955 (19%) were followed by another nurse consultation and 866 (18%) by a GP consultation. In the structured case reviews, most contacts were concerned with acute problems (609 out of 1,074, 57%). The most prevalent reasons for encounters and diagnoses were typical primary care issues. The nurses were able to manage half of the cases independently (327, 55%), referred 37% (217) of cases to the GP, and consulted a GP (live, by telephone, or a dedicated app) for 8% (48) of cases. GPs mostly prescribed drugs, referred to a medical specialist, and advised over-the-counter drugs, while nurses more often advised over-the-counter drugs (mostly paracetamol, nose sprays, and anti-inflammatory drugs), provided non-medical advice, or ordered laboratory tests.
    UNASSIGNED: The medical care points delivered mostly typical acute primary care in this first phase, with a key role for nurses. The care points did not sufficiently take up chronic diseases and mental health problems. These results will inform policymakers on the use of primary care centers for newly arriving patients in times of a large influx. A nurse-first model seems feasible and efficient, but evaluation of safety and quality of care is needed. Once the acute phase of this crisis fades away, questions about the comprehensiveness, continuity, and integration of care for migrants remain relevant.
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