bluuebunny/crossref_metadata_2025_split huggingface dataset:
Asylum seekers’ mental health in the Finnish Asylum Seekers Health and Wellbeing Survey (TERTTU)
Authors: Castaneda A E , Lilja E , Garoff F , Mustonen K L , Ahmed A , Skogberg N 
Published: November 2019

Abstract

Background
Asylum seekers have major health and well-being burdens, including mental health. However, there is a lack of population-based survey data on the health status and service needs of asylum seekers in Europe. The TERTTU-project was launched to fill these information gaps and to develop the current health examination protocol for assessing the health, well-being and need for health care services, including mental health, of newly arrived asylum seekers.

Methods
As part of the TERTTU-project, systematic, nationally representative data was collected in 2018 by conducting a health examination and a face-to-face interview survey in reception centers in Finland (n = 1087). The sample was drawn from the Finnish Immigration Services electronic asylum database. Mental health was assessed with the HSCL and PROTECT questionnaires (SDQ among the children), along with questions of potentially traumatic experiences.

Results
39% (95% CI 35,6-42,6) of the adults had current severe depressive and anxiety symptoms, 50% (95% CI 46,9-53,9) had an increased risk for PTSD, and 83% (95% CI 80,0-85,3) had experienced at least one potentially traumatic event before arriving to Finland. The most common psychosocial symptoms among 2-6 year-olds were behavioral symptoms (49%) and difficulties in peer relationships (37%). Difficulties in peer relationships were also common among 7-17 year-olds (49%), followed by challenges in the emotional domain (42%).

Conclusions
Potentially traumatic experiences and mental health problems are common among asylum seekers in Finland. Based on the survey-data, a national health examination protocol will be developed in 2019 to improve assessment and identification and to enable systematic health monitoring and evidence-based development of services for asylum seekers. A common health examination protocol will also unify practices across reception centers all over the country.

Key messages
Potentially traumatic experiences and mental health problems are common among asylum seekers in Finland. A national health examination protocol allows for the early identification of vulnerable groups and individuals.
Self Rated Health among Syrian refugees in Lebanon and Norway – a cross sectional study
Authors: Haj-Younes J , Strømme E M , Hasha W , Abildsnes E , Fadnes L T , Kumar B , Diaz E 
Published: November 2019

Abstract

Background
Refugees are often exposed to various stressors before, during and after migration that can cause adverse health effects. Prior research indicates that the health status of refugees is a significant factor in determining their success in resettlement. This study aims to assess self-rated health (SRH) and factors associated with SRH among Syrian refugees in Lebanon and Norway.

Methods
The study uses a cross-sectional design with data from a self-administered survey among 827 adult Syrian asylum seekers of whom 506 were recruited in Lebanon, and 321 in Norway. Inclusion criteria were subjects who self-identified as Syrian nationals above the age of 16. The survey was conducted in 2017 and 2018 in collaboration with International Organization of Migration in Lebanon and through mandatory educational activities in Norway. Data analysis was performed for the main outcome self-rated health (SRH), a validated health status indicator, which was dichotomized into “good” and “poor” SRH. Odds Ratios for poor SRH were estimated adjusting for age, gender and country of residence.

Results
A total of 827 of 972 (85%) who were invited answered the questionnaire. The mean age was 33 years and 74% were men. Factors associated with good SRH were being Kurdish (AOR: 0.48 (0.23 to 0.97)) compared to Arabic ethnicity, being married (AOR 0.54 (0.29 to 0.99)) compared to being single, migrating alone (AOR 0.59 (0.37 to 0.96)) compared to co-migration and having low health literacy level (AOR: 0.64 (0.42 to 0.93)). In contrast, poor SRH was significantly increased with long time in transit country/ies (AOR 1.49 (1.07 to 2.06)) and with older age (age 30-34 AOR 3.2, age 35-39 AOR 2.2, age 40 + AOR 2.6) compared to age group 16-24.

Conclusions
Older refugees and those who stay long time in transit are at great risk of reporting poor SRH. Some of the factors associated with better health, like Kurdish ethnicity, low health literacy or migrating alone, deserve further research.

Key messages
Age and long stay in transit is associated with poor SRH among Syrian refugees. Demographic background and migrant related factors should be taken into account when planning refugee resettlement and healthcare provision.
The factors affecting response rate in survey on well-being among people with foreign origin
Authors: Lilja E , Seppänen A , Kuusio H 
Published: November 2019

Abstract

Background
Previous population surveys among people with foreign background (PFB) in Finland have had successful response rates (62%-66%) when using mainly face-to-face interviews. A cross-sectional population survey (FinMONIK) explored more cost-efficient ways to collect the data on PFB.

Methods
The data collection was conducted in Finland between May 2018 and January 2019. The random sample consisted of 12 877 (after removing over-coverage) 18-64-year-olds stratified by region. First, a letter containing a link to the online survey with 18 different language options was sent to the participants. After two reminders, the questionnaire was sent twice on paper to the non-respondents. Finally, supplementary phone interviews were carried out by multi-lingual interviewers. All the participants were able to enter in a draw to win gift cards.

Results
The response rate (RR) for the online survey was 34%. RR was highest for those who had lived in Finland 5 years or less (43%) and lowest among the divorced (23%) and Estonians (27%). The paper questionnaire was mostly preferred by older age groups, increasing the RR of 40-64 year-olds from 31% to 48%. Telephone interviews increased the RR by five percent points, thus making the final RR for the survey 53%. Persons born in the EU and North-America responded the most frequently (58%) whereas RR was lowest amongst the Sub-Saharan African origin migrants (47%). RR was particularly low (42%) for those who had moved to Finland at ages 0-6.

Conclusions
In surveys conducted amongst PFB, relatively good response rates can be obtained by using alternate methods for gathering data instead of costly and time-consuming face-to-face interview. Age and marital status seemed to affect the preference of survey format. The overall RR varied by country of origin.

Key messages
A good response rate can be obtained without face-to-face interviews in migrant population surveys. Migrant population surveys can be conducted more efficiently by combining a variety of methods.
Bridging Generations: Sharing stories from the past with the future
Authors: Brisbois M , Silva H , Soares R , Cabral L , Canasta H , Feno A , Santos A 
Published: November 2019

Abstract

Background
As the immigration population continues to grow; little is known about this phenomenon from the immigrants’ perspective. In recent years, nurses have embraced narrative inquiry to better understand the human experience. When relaying their stories, vulnerable groups legitimize their behavior, share their emotional experiences, and amplify their voices that may have otherwise remained silent.

Objective
Eight elderly Portuguese women who immigrated to the United States (US) were interviewed about their experience of immigration by nursing students from Portugal and U.S., as part of a student exchange. The objective of this project was to better understand the impact of immigration through narrative inquiry.

Results
On average, the women lived in the US for approximately fifty years; immigrating in their early twenties. Most women arrived alone or accompanied by spouse and/or children. Their first memories were related to snow, and solitude of being in a new country. The participants attended classes to obtain documents or learn English. All worked in the textile industry; their greatest accomplishment was buying their own house. Challenges faced were related to language and difficult jobs. Overall, they had no regrets except in leaving family members behind. Their message to the students was that love and family are most important in the world. Students were able to realize emigration and immigration from their respective countries.

Conclusions
Rich descriptions provided an in-depth understanding of the details of the women’s experience. Student nurses gained valuable skills and knowledge to understand the impact of immigration among Portuguese women using narrative inquiry.

Key messages
The use of narrative inquiry proved to be a valuable method to interview Portuguese immigrant women. Every immigrant has a unique narrative to share that allowed for nursing student’s appreciation of the experience across generations.
Health-Related Quality of Life in resettled refugee youth
Authors: Dangmann C , Andersen P A , Fjeld-Solberg Ø , Steffenak A K , Høye S 
Published: November 2019

Abstract

Aim
Millions have fled from the Civil unrest in Syria and half of these are children and youth. Although they are a population with elevated risk for health problems due to adverse pre-migratory and post-migratory experiences, few studies have explored their Health-Related Quality of Life (HRQoL). This is considered a fundamental construct in public health and might provide complementary descriptions of their health and wellbeing after resettling in a new country.

Methods
A cross-sectional survey of 160 Syrian youth aged 13-24 years recently resettled in Norway, was carried out in 23 schools. Using KIDSCREEN-27, results from five dimensions of HRQoL (physical and psychological wellbeing, parental relations, school environment and friends) was compared to norm populations and analysed with associated sociodemographic factors and war related adverse events.

Results
Preliminary results indicate that for most participants the overall HRQoL was good, but lower in the dimensions for physical and psychological wellbeing and friends than in norm populations. Satisfaction with parental relations and the school environment was high and the main contributors to a positive HRQoL in the participants. Age and number of reported Stressful Events had the greatest impact of all the the included variables, but all correlations were small to moderate and therefore accounted for little of the total variance.

Conclusions
The findings suggest that HRQoL is a relevant and non-invasive measure for refugee youth. Interventions focussing on general psychological wellbeing and networks could be beneficial for the group, and need to be explored. These interventions could potentially be based in schools or in family work, to benefit from these being seemingly safe environments for the majority of the group.

Key messages
Health Related Quality of life in young Syrian refugees was good, but lower in the dimensions for friends and psychological wellbeing than for norm populations. Satisfaction with parental relations and school environment was high among the Syrian youth and the main areas that contribute to a positive Health Related Quality of Life.
The influence of culturalisation on GP consultations and in research on GP care
Authors: Stern A , Razum O 
Published: November 2019

Abstract

Background
General practitioners (GPs) have a gatekeeping function in the healthcare system. Research shows that patients of Turkish origin in Germany manage to access specialist care less often than non-immigrant patients. Underlying could be problems related to interactions with the GP. Focusing on interaction instead of individual patients’ characteristics might help identifying underappreciated barriers in health care.

Methods
We conducted a scoping review to identify research on interaction-related aspects of GP consultations of people of Turkish origin. Goffman’s interactional theory was used for operationalisation. Analysis focused on the process of consultation from the perspectives of patients, GPs, and interpreters. Additionally, noticeable issues in researchers’ perspectives on migrants’ utilization of health care were identified.

Results
Patients of Turkish origin expect similar professional performances from their GPs as patients without a migration background. If informal interpreters take part, misinformation might remain unrecognised. Frequently, GPs experience insecurity, which sometimes results in lower empathy and prejudice-based, unprofessional reactions or misdiagnoses. Researchers’ interpretations refer partly to unfounded explanations such as a homogeneous Turkish culture or somatization tendencies of Turkish patients.

Conclusions
Difficulties in GP care of patients of Turkish origin, and access barriers to specialist care, arise less from culture-bound performances of these patients as from culturalising expectations and performances of GPs. Researchers often show similar expectations and interpretations. Such culturalising interpretations should be avoided in future research.

Key messages
Difficulties in GP care of patients of Turkish origin, and access barriers to specialist care, arise less from culture-bound performances of these patients as from culturalising expectations of GPs. Future research should avoid culturalising interpretations.
Characteristics of specialist consultations regarding immigrant patients at a large Swedish hospital
Authors: Svärd V , Sernbo E , Nilsson M 
Published: November 2019

Abstract

Background
After an increased number of asylum-seeking patients, the Karolinska University Hospital in 2016 introduced a one-year-project with five asylum social workers (ASW). This study analyzes the characteristics of patients, issues and performed tasks.

Methods
The data consists of five months anonymized case documentation of ASWs direct patient contacts and documented telephone consultations with staff. Descriptive statistics and qualitative content analysis were made.

Results
Of direct patient contacts, 56% were with asylum seekers, 7% undocumented, 7% EU citizens and 30% had various forms of migration status. Tasks consisted of 39% external cooperation, 15% writing certificates, 20% applying for e.g. social assistance for patients’ basic needs.
Analysis of telephone consultations with staff showed that 24% concerned patients with unclear migration status, 17% undocumented, 14% asylum seekers, followed by various forms of migration status. The issues related to patient rights (17%), housing and discharge problems (17%), subsidized health care (11%), costs for care (10%), social assistance (8%) and national registration and establishment (8%). Performed tasks by ASWs were legal advice (19%), referral for further management (19%), advice about cooperation with e.g. the Swedish Migration Board (14%), costs for health and social care (13%), social support (11%), health care administration (10%), application for visa or passport (8%) and the right to subsidized health care (7%).

Conclusions
ASWs performed tasks concerning cooperation and advisement regarding care-planning and legal concerns, helping both patients and staff. Staff were often insecure about immigrant patient’s legal status and right to health and social care. To optimize support to staff regarding asylum-seeking patients, it is recommended to use a broader definition of migration status to include unclear cases.

Key messages
The hospital staff were often insecure about immigrant patient’s legal status and consultation should thus address various forms of migration status among patients. The hospital staff needed consultation regarding legislations, discharge, housing, social assistance and costs for and right to health and social care.
Health system resilience – a conceptual and empirical review of health system literature
Authors: Wahedi K , Biddle L , Bozorgmehr K 
Published: November 2019

Abstract

Background
The concept of health system resilience has gained popularity in the global health discourse, featuring in UN policies, academic articles and conferences. The term is commonly used to refer to the ability of health systems to respond to challenges. However, there has been no comprehensive overview of how the concept is understood and assessed in health systems research (HSR).

Methods
We conducted a conceptual and empirical review in 3 databases using systematic methods. Quantitative and narrative synthesis was used to trace the introduction of the concept to HSR, identify relevant definitions and examine its use in research.

Results
From 4063 references, we identified 96 articles concerned with health system resilience from 2007 - 2017, with a recent increase in literature (45% of studies published since 2016). Many articles take a general perspective; others focus on specific HSR building blocks (e.g. 28% on service delivery) or a particular type of crisis, such as climate change (12.5%) or natural disasters (10.4%). While the concept was developed from the ecological sciences, its meaning has been adapted in HSR, with a shift towards people-centred and process-oriented definitions. We identify three frameworks operationalising resilience: the “attributes” framework by Kruk et al. (2017), the “everyday resilience” framework by Barasa et al. (2017) and the “complex adaptive systems” framework by Blanchet et al. (2017). However, we find a mismatch between these frameworks and how the concept is assessed in 13 quantitative and 8 qualitative empirical studies.

Conclusions
The HSR literature has converged around a definition of resilience focusing on the system’s ability to mitigate ongoing challenges. Differences in emphasis remain, resulting in a variety of operational frameworks. The frameworks require further adaptation and testing in empirical studies to demonstrate the usefulness of “resilience” as an analytical category in HSR.

Key messages
There is a mismatch between conceptualisation and operationalisation of resilience in the HSR literature. Existing operational frameworks of resilience require further adaptation and testing in empirical studies to demonstrate the usefulness of “resilience” as an analytical category in HSR.
The meaningfulness of open data in Public Health and Healthcare
Authors: Pita Costa J , Fuart F , Cleland B , Wallace J , Staines A , Belar O , Bidaurrazaga J , Pääkkönen J , Epelde G , Poliwoda P 
Published: November 2019

Abstract

Background
The growing challenges and opportunities of Big Data for Public Health have revealed the potential to improve the efficiency and cost-effectiveness of public policy, for example through better targeting of resources with regard to General Practice (GP) prescribing. Open data has an important role due to its easy access and potential to complement proprietary data sources from, e.g., regional hospitals, and also itself be complemented with social data acquired by specialized approaches.

Methods
MIDAS pipeline of open source tools aiming integrating, analysing and visualising Open Data enabling health professionals and decision-makers to: (i) improve the usability of open data in combination with proprietary data through combining multiple visualisation tools in an integrated dashboard (ii) to explore the meaning of data in a global/local context based on new information using tone analysis and natural language techniques; and (iii) to have better informed decision-making based on evidence from trusted knowledge-bases. Specific data sources used have included information extracted from the biomedical database MEDLINE, worldwide news and government open data. Social media sources have also been used to gather information from the general public.

Results
Results include a strong correlation between antidepressant prescribing and economic deprivation, and a wide variation in how individual GP practices respond to demographic conditions. Automated anomaly detection based on the Local Outlier Probability has also been shown to be an easily understood and controllable approach to identifying prescribing outliers.

Conclusions
MIDAS demonstrates the significant value of open data from heterogeneous sources as basis decision-making in public health and healthcare, particularly when it is combined with proprietary or closed datasets. A key challenge in this regard is the ability to integrate and utilize data from diverse sources in a variety of formats and standards.

Key messages
MIDAS is exemplar on tackling the need for improved standards of open data, and new software architectures, tools and platforms addressing a complex ecosystem of heterogenous data sources and formats. MIDAS demonstrates the significant value of open data from heterogeneous sources as basis decision-making in public health and healthcare, particularly when combined with proprietary datasets.
StopBlues: a French e-health device to prevent suicide in the general population
Authors: Le Jeannic A , Gandré C , Vinet M A , Turmaine K , Roelandt J L , Giraudeau B , Alberti C , Chevreul K 
Published: November 2019

Abstract

Background
France is one of the Western European countries most affected by suicide, an epidemiological burden and high societal cost of several million euros/year. Several European projects have either implemented web-based interventions for care of mental disorders or recommended online actions which have demonstrated their effectiveness for suicide prevention.
The objective of the project was the construction of an application and website to prevent suicide in the general population, with its promotion being supported at the local authority level.

Methods
The detailed content of the devices and promotional tools available to local authorities was determined through literature reviews and expert groups (psychiatrists, local authorities’ workers and potential users).

Results
An application and website were constructed with two parts: a public interface with videos (psychological suffering, coping strategies and help available), an emergency button, a map with local resources and contact information (psychiatrists, psychologists, associations...), tips and videos to overcome a period of psychological suffering; and a private interface requiring registration giving access to self-assessment questionnaires and a safety plan to fill in case of crisis. 40 local authorities are involved in StopBlues promotion, with a referent each, responsible of contact with our team, and local organization of promotion.

Conclusions
Since 04-2018, StopBlues is available at www.stopblues.fr and can be downloaded on iOs and Android. Its promotion is part of a cluster randomized trial with 3 arms: a control group with no promotion, a group with promotion by local authorities, and a group with promotion by local authorities and general practitioner’s waiting room. As promotion could have different intensities depending on budgets and referent’s involvement, we decided to extend it for another year, with local authorities of group control receiving additional financial and organizational support.

Key messages
As the first e-health program for suicide primary prevention in the French general population, StopBlues’ main goal is to help people find solutions that suit them and direct them to the right help. Local authorities are a key level to promote primary health prevention programs.