Κυριακή 8 Σεπτεμβρίου 2019

The Prevalence of Mental Illness and Substance Abuse Among Rural Latino Adults with Multiple Adverse Childhood Experiences in California
The original version of this article unfortunately published without acknowledgement section. The complete funding information is given below.

From Dehydration to Fractures: Medical Issues Faced by People Crossing the United States: Mexico Border

Abstract

To quantify the number of Border Crossers seen at our hospitals, broken down by diagnoses and age. We used our electronic medical record to identify the number of patients in custody of the United States Border Patrol who were seen at Banner-University: South and University Campuses during the calendar year 2016. 734 patients were identified, and the electronic medical record was used to identify the primary diagnosis and age for each one. We then manually categorized them into groups of common diagnoses. We also compared the number of border crosser emergency department (ED) visits to overall ED visits. Of 734 patients, 77% were male, 60% were between 16 and 40 years of age, and 18% were under age 18 years. They made up 1.3% of ED visits to South Campus, but less than 0.1% to University Campus. The top categories were musculoskeletal trauma (n = 235, 32%), and dehydration and rhabdomyolysis (n = 95, 13%). The age range of border crossers brought to our EDs varies widely, as do their primary diagnoses, although trends can be seen. They make up a 1.3% of overall emergency department visits at South Campus hospital.

Health Realization Community Coping Intervention for Somali Refugee Women

Abstract

Health Realization (HR) is a strengths-based stress and coping intervention used to promote the use of internal and external coping resources. Our three-arm comparison group trial examined the effects of a culturally adapted Somali HR intervention on coping and mental health outcomes in 65 Somali refugee women post-resettlement. Subjects participated one of three conditions: HR intervention, nutrition attention-control, and evaluation-control. The HR intervention significantly affected multiple dimensions of coping: WAYS-distancing (p = 0.038), seeking social support (p = 0.042), positive reappraisal (p = 0.001); and Refugee Appraisal and Coping Experience Scale-Internal subscale (p = 0.045). The HR intervention also demonstrated improvement in depression symptom ratings (p = 0.079). We discuss findings from the pilot, challenges encountered conducting a three-arm comparison group trial, and implications for further research involving the HR intervention with culturally diverse refugee communities.

Health and Healthcare Needs of Koreans in San Francisco Bay Area: The Korean Needs Assessment (KoNA) Project

Abstract

Korean Americans (KA) face a significant burden of health disparities. However, limited data are available on their health needs. This health needs assessment includes a community-based sample of 342 KA from the San Francisco Bay Area. The assessment investigated participants’ sociodemographic characteristics, health status, and their healthcare needs. Nearly half of the survey participants rated their health as fair or poor, > 30% did not have a usual place for healthcare, and chronic conditions were prevalent. Limited English Proficiency (LEP) was significantly associated with low self-rated health and having no usual source of care, after adjusting for other sociodemographic factors. Older, LEP KA faced the highest health and health care burden. In addition, females were less likely to be physically active. Males were more likely to smoke. The findings provide guidance in identifying major KA health needs and supports local programming and policy development for KA.

The Prevalence of Mental Illness and Substance Abuse Among Rural Latino Adults with Multiple Adverse Childhood Experiences in California

Abstract

Adverse childhood experiences (ACEs) have been found to increase health and mental health risks in adulthood. Previous ACE studies tend to have small samples of Latinos; however, as Latinos are projected to be the largest minority group in the United States, it is important to examine how ACEs are associated with self-reported mental distress and alcohol and/or substance abuse among Latino populations. An ACEs survey was conducted in a predominantly Latino town; the sample included 195 individuals (18 or older), and the majority (92%) identified as Latino. Logistic regression showed that respondents with three or more ACEs, compared to those with no ACEs, were three times more likely to report more days of mental distress and eight times more likely to have alcohol and/or substance abuse problems. Further studies are needed to understand the association between ACEs and behavioral health using culturally and linguistically competent mental health screening tools.

Syndemic Factors and Resiliency Among Latina Immigrant Indirect Sex Workers in an Emergent Immigrant City

Abstract

Female sex workers (FSW) constitute a highly vulnerable population challenged by numerous co-existing, or syndemic, risk factors. FSW also display resilience to these, and some evidence suggests that resilience may be associated with protective factors that improve health outcomes. We conducted in-depth interviews with indirect sex workers (n = 11) and their clients (n = 18). Interviews were coded utilizing an iterative, modified constant comparison method to identify emergent themes. We identified five syndemic risk factors (difficulty finding work due to undocumented status, shame and mental health hardship, lack of social support, alcohol use, and violence) and five resilient factors (rationalizing sex work, identifying as a “decent” woman, fulfilling immigrant goals, reducing alcohol consumption, and creating rules to reduce risk of violence and HIV/STIs). Understanding the syndemic risk factors and resiliency developed by FSW is important to develop tailored, strength-based interventions for HIV/STIs and other risks.

The Impact of Provision of Professional Language Interpretation on Length of Stay and Readmission Rates in an Acute Care Hospital Setting

Abstract

The provision of professional interpreting services (PIS) in the hospital setting can decrease clinically significant communication errors and improve clinical outcomes. The aim of this study was to investigate the differences in length of stay (LOS) and 30 day readmission rates associated with provision of PIS in the Emergency Department (ED) and inpatient wards. A retrospective audit at a tertiary referral adult hospital in Brisbane, Australia, identified all admissions of patients requiring an interpreter. Patients provided an interpreter in the Emergency Department had a mean (age-adjusted) LOS 22.4 h less than patients not provided an interpreter in ED (95% CI 10.9–33.9). For patients provided with an interpreter on the ward the mean LOS was longer, (IRR 2.2, 1.8–2.3, p < 0.0001). There was no association between interpreter provision in either ED or the inpatient ward and readmission rate. Provision of PIS in the Emergency Department to those patients who require it can significantly reduce hospital LOS.

Heterogeneity in Tobacco-Use Behaviors Among U.S. Blacks per Global Region of Origin

Abstract

Heterogeneity in tobacco-use behaviors among U.S. blacks by global region of origin and age at immigration was examined. Self-identified black participants from the 2006–2015 Tobacco Use Supplement to the Current Population Survey were included (n = 47,857). Countries of origin were classified by global regions (U.S., Africa, Europe, West Indies). Multivariable logistic regression models, adjusted for sociodemographic characteristics, were used to examine the association of global region of origin and age at immigration with tobacco-use behaviors. Prevalence of current cigarette smoking among U.S. blacks varied significantly by global region of origin (U.S.-born = 17.4%, Europe-born = 17.7%, Africa-born = 4.7%, West-Indies-born = 4.9%; p < 0.01). Furthermore, foreign-born blacks were less likely than U.S.-born blacks to smoke menthol flavored cigarettes (p < 0.05). Participants who immigrated to the U.S. at ≥ 13 years old were less likely than U.S.-born blacks to start regular smoking as minor (p < 0.05). Tobacco-use behaviors differ by global region of origin and age at immigration in the U.S. black population.

Food Insecurity and the Double Burden of Malnutrition of Indigenous Refugee Épera Siapidara

Abstract

The goal of this paper is to assess food and nutritional security status of an indigenous population who migrated from Colombia to Ecuador. We collected data about the perception of food insecurity, anthropometric and food intake (n = 104). An analysis multivariate (Generalized Linear Model) we used to know the adequacy to the Dietary Reference Intake (DRI). All the households were food insecure, stunting affected 45.1% of children and adolescents and the 60% were overweight or obese women. Significant differences were observed by gender for energy, lipid, carbohydrate, fiber, and iron (p < 0.001). No age group meets the DRI for fiber, calcium and potassium (except in children 24–59 months) and iron. There was a deficiency in vitamins A, D, folic acid and thiamine. The Epera Siapidara people in Ecuador experience acute food insecurity and a double burden of malnutrition, which may seriously affect their health and general progress.

Trauma, Post-Migration Stress, and Mental Health: A Comparative Analysis of Refugees and Immigrants in the United States

Abstract

Numerous studies describe mental health effects of pre-migration trauma and post-resettlement stress among refugees, yet less research examines these associations with non-refugee immigrants. Additionally, few studies assess the prevalence and impact of traumatic experiences after settlement in a new country. Using a U.S.-based representative sample of Asian (n = 1637) and Latino (n = 1620) refugees and immigrants, we investigated how traumatic events prior to and after migration, and post-migration stressors, are associated with mental illness and distress. Pre-migration trauma posed risk across a broad range of psychological outcomes for Asian refugees and Latino immigrants. Deleterious effects of post-migration trauma were notable for both groups of refugees and immigrants. Discrimination, acculturative stress, and family conflict increased risk for disorder and distress across groups in complex ways. Findings highlight the importance of examining trauma and stress at pre- and post-migration phases across migrant populations, including those not labeled as refugees.

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