I never thought I'd become a climate refugee.After moving my family from drought and wildfire-stricken California to the so-called“climate haven”of Asheville,NC,I thought we were safe.But just two months after s...I never thought I'd become a climate refugee.After moving my family from drought and wildfire-stricken California to the so-called“climate haven”of Asheville,NC,I thought we were safe.But just two months after settling into our lovely and wooded community with mild weather,we had to flee.展开更多
This study explores the impact of a host community’s level of cultural diversity on the integration ability and mental health of Syrian refugees resettling into two U.S.States:California and Idaho.This paper addresse...This study explores the impact of a host community’s level of cultural diversity on the integration ability and mental health of Syrian refugees resettling into two U.S.States:California and Idaho.This paper addresses the need for effective integration strategies,mainly due to their impact on mental health,given the current pressing conflicts in the Middle East and the global refugee crisis.This paper uses a comparative analysis of existing literature to examine how refugees hosted in more culturally diverse communities,such as California,experience better means of integration and thus have improved mental health than those hosted in culturally homogenous communities,such as Idaho.Additionally,the study concluded that refugees who can assimilate into a community experience fewer mental health issues.The findings provide valuable insight and information for policymakers seeking to improve refugee integration through nuanced strategies.The study suggests further primary research to discover additional impacts of a community’s cultural diversity on refugees’integration ability.展开更多
This study explores the lived experiences of Sudanese women residing in Clarkston Georgia,USA who fled war and conflict in Sudan and sought refuge in Egypt.This qualitative research illustrates the main challenges tha...This study explores the lived experiences of Sudanese women residing in Clarkston Georgia,USA who fled war and conflict in Sudan and sought refuge in Egypt.This qualitative research illustrates the main challenges that these women experienced in Egypt,such as racial discrimination,gender-based violence,economic hardship,police brutality,and legal protection gaps.Their being female,belonging to the black African race,and displacement status added to their vulnerabilities,which further isolated them from the Egyptian society.Semi-structured in-depth interviews and discussions in focus groups with 20 Sudanese refugee women who were resettled in Clarkston,Georgia,exposed the psychological residues that their struggles took in Egypt and elicited deep psychological trauma.However,now resettled in the U.S.,many women felt security,and came upon access to resources,avenues for education and work-undoing their lives with dignity.The study,therefore,calls for legal protection at the international level,gender-sensitive refugee policies,and deeper global cooperation that can guarantee protection and rights for refugee women.Guided by theories of feminism and human rights,this research provides important lessons in systemic reforms of mechanisms for the protection of refugees to meet special needs of refugee women worldwide.展开更多
Predator–prey interactions are fundamental to understanding ecosystem stability and biodiversity.In this study,we propose and analyze a stochastic predator–prey model that incorporates two critical ecological factor...Predator–prey interactions are fundamental to understanding ecosystem stability and biodiversity.In this study,we propose and analyze a stochastic predator–prey model that incorporates two critical ecological factors:prey refuge and harvesting.The model also integrates disease transmission within the predator population,adding an important layer of realism.Using rigorous mathematical techniques,we demonstrate the existence and uniqueness of a global positive solution,thereby confirming the model's biological feasibility.We further derive sufficient conditions for two key ecological scenarios:stochastic permanence,which ensures the sustained co-existence of prey and predators over time,and extinction,where one or both populations decline to zero.The interplay between prey refuge and harvesting is thoroughly examined to understand their combined impact on population dynamics.All theoretical results are validated by detailed numerical simulations,highlighting the applicability of the model to real-world ecological systems.From the simulation results,we observed that with an adequate level of prey refuge and predator harvesting,the susceptible predator and prey coexist with extensive oscillations,while the infected predator population was moving towards extinction.In addition,we have investigated the effect of disease transmission on system dynamics.Our results show that,as the transmission rate of disease increases,the susceptible predator approaches extinction,whereas,on the other hand,when it declines,the susceptible predator shows robust oscillations while the infected approaches extinction.In both cases,the prey population demonstrates robust stability due to the prey refuge.Our findings show that the management of harvesting and the prey refuge can be effective ecological tactics for disease control and species protection under stochastic environmental effects.展开更多
Background:The German Military Medical Service contributed to the medical screening of unaccompanied minor refugees(UMRs)coming to Germany in 2014 and 2015.In this study,a broad range of diagnostic procedures was appl...Background:The German Military Medical Service contributed to the medical screening of unaccompanied minor refugees(UMRs)coming to Germany in 2014 and 2015.In this study,a broad range of diagnostic procedures was applied to identify microorganisms with clinical or public health significance.Previously,those tests had only been used to screen soldiers returning from tropical deployments.This instance is the first time the approach has been studied in a humanitarian context.Methods:The offered screenings included blood cell counts,hepatitis B serology and microscopy of the stool to look for protozoa and worm eggs as well as PCR from stool samples targeting pathogenic bacteria,protozoa and helminths.If individuals refused certain assessments,their decision to do so was accepted.A total of 219 apparently healthy male UMRs coming from Afghanistan,Egypt,Somalia,Eritrea,Syria,Ghana,Guinea,Iran,Algeria,Iraq,Benin,Gambia,Libya,Morocco,Pakistan,and Palestine were assessed.All UMRs who were examined at the study department were included in the assessment.Results:We detected decreasing frequencies of pathogens that included diarrhoea-associated bacteria[Campylobacter(C.)jejuni,enteropathogenic Escherichia(E.)coli(EPEC),enterotoxic E.coli(ETEC),enteroaggregative E.coli(EAEC),enteroinvasive E.coli(EIEC)/Shigella spp.),Giardia(G.)duodenalis,helminths(comprising Schistosoma spp.,Hymenolepis(H.)nana,Strongyloides(S.)stercoralis]as well as hepatitis B virus.Pathogenic microorganisms dominated the samples by far.While G.duodenalis was detected in 11.4%of the assessed UMRs,the incidence of newly identified cases in the German population was 4.5 cases per 100,000 inhabitants.Conclusion:We conclude that the applied in-house PCR screening systems,which have proven to be useful for screening military returnees from tropical deployments,can also be used for health assessment of immigrants from the respective sites.Apparently healthy UMRs may be enterically colonized with a broad variety of pathogenic and apathogenic microorganisms.Increased colonization rates,as shown for G.duodenalis,can pose a hygiene problem in centralized homes for asylum seekers.展开更多
OBJECTIVE: United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) provides primary health care services including care for diabetes and hypertension, with limited resources under diffic...OBJECTIVE: United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) provides primary health care services including care for diabetes and hypertension, with limited resources under difficult circumstances in Gaza, West Bank, Jordan, Lebanon and Syria. A total of 114,911 people with diabetes were registered with UNRWA health centres in 2011. The aim of this cross-sectional observational study was to assess the quality of diabetes care in the UNRWA primary health care centres. METHOD: The study population consisted of 1600 people with diabetes attending the 32 largest UNRWA health centres and treated there for at least one year. Between April and Sept. 2012 data from medical records, including results of clinical examinations and laboratory tests performed during the last one year, current management including self-care education and evidence of diabetes complications were collected and recorded in a previously validated data collection form (DCF). Patients were interviewed and clinically examined on the day of the audit and blood collected for HbA1c testing which was done at a central lab using High-performance liquid chromatography (HPLC) method (HLC®-723G8 Tosoh Corporation, Japan). Data was transferred from paper records into a computer and analysed with Epi-info 2000. RESULTS: Type 1 diabetes was present in 4.3% and type 2 diabetes in 95.7%. Co-morbid hypertension was present in 68.5%;90.3% were either obese (64.0%) or overweight (26.3%). Clinical management of diabetes was largely in line with UNRWA’s technical instructions (TI) for diabetes. Records for 2 hour postprandial glucose (2 h PPG), serum cholesterol, serum creatinine, and urine protein analysis were available in 94.7%, 96.4%, 91.4% and 87.5%, cases, respectively. Records of annual fundoscopic eye examination were available in 47.3% cases but foot examinations were less well documented. Most patients (95.6%) were on anti-diabetic drugs—68.2% oral anti diabetic drugs (OAD) only, 14.4% combination of OAD and insulin, and 12.9% insulin only. While 44.8% patients had 2 h PPG ≤ 180 mg/dl, only 28.2% had HbA1c ≤ 7%;55.5% and 28.2% had BP ≤ 140/90 and ≤130/80 mm of Hg respectively. Serum cholesterol ≥ 200 mg/dl, serum creatinine ≥ 1.2 mg/dl and macro albuminuria were noted in 39.8%, 6.4% and 10.3% cases respectively. Peripheral neuropathy (52.6%), foot infections (17%), diabetic retinopathy (11%) and myocardial infarction (9.6%) were the most common long term complications. One or more episodes of hypoglycaemia were reported by 25% cases in total and in 48% of those using insulin. 17.7% and 22.6% cases received no or ≥4 self-care education sessions respectively. CONCLUSION: The study confirmed that UNRWA doctors and nurses follow TI for diabetes and hypertension fairly well. Financial constraints and the consequent effects on UNRWA TI and policies related to diabetes care were important constraints. Key challenges identified were: reliance on 2 h PPG to measure control;non-availability of routine HbA1c testing, self-monitoring of blood glucose (SMBG) and statins within the UNRWA system;and high levels of obesity in the community. Addressing these will further strengthen UNRWA health system’s efforts of providing services for diabetes and hypertension at the primary care level. Given that most developing countries either have no or only rudimentary services for diabetes and hypertension at the primary care level, UNRWA’s efforts can serve as an inspiration to others.展开更多
Objective:To investigate and compare the demographic characteristics,clinical findings,and laboratory results of pulmonary tuberculosis(PTB)and extrapulmonary tuberculosis(EPTB)patients,among Turkish citizens,and fore...Objective:To investigate and compare the demographic characteristics,clinical findings,and laboratory results of pulmonary tuberculosis(PTB)and extrapulmonary tuberculosis(EPTB)patients,among Turkish citizens,and foreign nationals.Methods:This study included patients aged 18 and over,both Turkish citizens and foreign nationals,diagnosed with PTB or EPTB between 2016 and 2022.All patients were divided into PTB and EPTB group,and demographic characteristics,clinical findings,and laboratory results were compared.Patients with both PTB and EPTB were not included in the comparison.Multivariate logistic regression analysis was conducted to identify potential risk factors for PTB.Results:Among the 261 TB cases included,46 patients(17.6%)had PTB,and 188(72%)had EPTB.The percentage of female patients was significantly higher(P=0.003)in EPTB compared to PTB group.While the prevalence of diabetes mellitus(P=0.002),hypertension(P=0.017),coronary obstructive pulmonary disease(P=0.001),congestive heart failure(P=0.005),coronary artery disease(P=0.001)and immunosuppressive medication use(P=0.017)were significantly higher in PTB patients than in EPTB patients.Multivariate logistical analysis reveals that male(OR 2.6,95%CI 1.3-5.5,P=0.009),diabetes mellitus(OR 2.7,95%CI 1.2-6.1,P=0.015),and asthma(OR 6.3,95%CI 1.2-33.9,P=0.032)were associated with an increased risk of PTB.Social security coverage(P<0.001)and regular employment status(P<0.001)were found to be lower and the presence of multidrug resistance(P=0.002),isoniazid resistance(P=0.012),and rifampin resistance(P=0.012)were found to be significantly higher in foreign-national TB patients comparing with Turkiye citizens.Conclusions:Patients with PTB need to be evaluated for comorbidities and PTB should be investigated in men,in patients with diabetes mellitus or asthma if there are clinical findings suspicious for TB.TB screening for foreign nationals upon entry into the country is essential for TB control and elimination.展开更多
AIM: To assess the prevalence of hepatitis B and C serological markers in a population of refugees living in Athens.METHODS: One hundred and thirty refugees (81 males and 49 females, mean age ±SD: 31.7±8 yea...AIM: To assess the prevalence of hepatitis B and C serological markers in a population of refugees living in Athens.METHODS: One hundred and thirty refugees (81 males and 49 females, mean age ±SD: 31.7±8 years) were included in the study. The hepatitis B virus surface antigen (HBsAg),the hepatitis B virus core antibody (anti-HBc) and the hepatitis C virus antibody (anti-HCV) were detected using a third-generation immunoassay.RESULTS: Twenty individuals (15.4%) were HBsAg positive and 69 (53.1%) were anti-HBc positive. The prevalence of HBsAg and anti-HBc was higher among refugees from Albania and Asia (statistical significant difference, P＜0.008 and P＜0.001 respectively). The prevalence of these markers was found irrelevant to age or sex. Anti-HCV was detected in the serum of 3 individuals (2.3 %). No differences among age, sex or ethnicity regarding anti-HCV prevalence were found.CONCLUSION: It can be concluded that refugees living in Athens are an immigrant population characterized by a high incidence of HBV infection. The prevalence of HBV markers is higher among refugees from Albania and Asia. It is therefore believed that the adherence to general precautions and the initiation of HBV vaccination programs will be necessary in the future, especially in these communities.Although the prevalence of HCV infection seems to be relatively low, extended epidemiological surveys are needed to provide valid results.展开更多
Objective:To determine the prevalence of blinding trachoma among refugees in South Western Ethiopia.Methods:A cross-sectional outreach clinic based descriptive study was conducted on 1054 refugees in Southwest Ethiopi...Objective:To determine the prevalence of blinding trachoma among refugees in South Western Ethiopia.Methods:A cross-sectional outreach clinic based descriptive study was conducted on 1054 refugees in Southwest Ethiopia.A basic eyelid and cornea examination for signs of trachoma was done by using 2.5× binocular magnifying loupe.The findings were classified by using the World Health Digitization simplified trachoma grading system and data were analyzed by using SPSS version 16.0.Results:A total of 1054 refugee patients were examined for trachoma.179(16.98%) of them had clinical signs of trachoma.About 6(3.35%) patients had active trachoma with trachomatous trichiasis(TT),47(26.26%) patients had TT only and the rest 126(70.39%)patients had TT with trachomatous corneal opacity.All of the trachoma patients had blinding trachoma(TT with or without trachomatous corneal opacity),and about 60.89% of them had visual impairment.Blinding trachoma was significantly more common among females.patients in age group of 16-59 years,married patients,illiterates and Fugnido camp settlers(P<0.05).Conclusions:There is a very high burden of blinding trachoma among refugees.Urgent surgical intervention is needed to prevent blindness and low vision in the study subjects,and targeted regular outreach-based eye care service should be commenced.展开更多
Background: Research indicates that Posttraumatic stress disorder(PTSD) has an extensive impact on family relationships. Nevertheless, there is a dearth of empirically supported interventions addressing family functio...Background: Research indicates that Posttraumatic stress disorder(PTSD) has an extensive impact on family relationships. Nevertheless, there is a dearth of empirically supported interventions addressing family functioning and PTSD. In the Netherlands, it is considered good clinical practice to offer multi-family therapy(MFT) to veteran and refugee families. MFT for traumatized families aims to address the dysfunctional family patterns that have evolved to address the consequences with trauma.Methods: The aim of this study is to generate a common framework for the practical impact and active ingredients of MFT in families confronted with trauma. The Delphi method was used to study the expert opinion of 11 therapists in Dutch expert trauma institutes.Results: The results indicate that MFT is a promising treatment for families dealing with the consequences of trauma. According to experts, positive outcomes include an increased understanding between family members,particularly visible in the de-escalation of conflicts within the family, and improved parenting. One explanation for the effectiveness of MFT with these target groups is its defining feature of therapy with several families.Conclusions: The findings support the importance of considering family relationships and the family context in interventions for traumatized individuals.展开更多
Objective: According to a theoretical approach, events that elicit stress after arrival in the reception country, i.e., post-migration stress, have a negative impact on health-related quality of life among newly-arriv...Objective: According to a theoretical approach, events that elicit stress after arrival in the reception country, i.e., post-migration stress, have a negative impact on health-related quality of life among newly-arrived refugees. With the aim of paying attention to such symptoms, a revised culturally-tailored clinical health promotion model developed at Harvard Program in Refugee Trauma was used for invited groups of new-coming adult refugees in a town south of the Swedish capital. Methods: A coordinator administered the five-weekly sessions, 2 hours/week, with a professional interpreter. It covered major topics from Western and Arabic worldviews: 1) introduction;2) health care: organisation and access to;3) exercises;4) stress management and coping, 5) medical doctor-patient communication. Each topic was led by a nurse, a physiotherapist, a psychologist and a physician with experience of encounters with this target group in health care. Data cover results from 70 participants attending six groups;39 participants with pre-course findings and, post-course and six-month follow-ups. There were no significant differences in background factors between the participants and the drop-outs. Results: Participants’ perceptions of their health, measured by EQ-5D, changed positively over time, above all immediately after the course, with no significant differences between the two follow-ups. In the follow-ups, female participants perceived their health as significantly worse than males. Qualitative data at the six-month follow-up assessed the course as useful but expressed a wish to continue a similar course with a focus on post- migration stress. Conclusion: The results sup- port earlier findings. A course, administered to a small group in a dialogue setting, has value for the participants’ empowerment and perception of health. It is recommended that reception be more adapted to coping of post-migration stress of new-coming refugees. Practical Implications: The results have implications for education in clinical health promotion, intercultural communication and inter-professional collaboration in refugee reception.展开更多
There is a worldwide increase in the rate of caesarean sections. With recent migration patterns and the influx of refugees into high-income countries, migrants and refugees are also subjected to the increase in caesar...There is a worldwide increase in the rate of caesarean sections. With recent migration patterns and the influx of refugees into high-income countries, migrants and refugees are also subjected to the increase in caesarean section rates. This article explores known information about the obstetrical experiences of refugee and displaced women. Pregnancy care varies depending on the location of the displaced women. Obstetrical care in refugee centers in Greece is examined as an example of the overall challenges facing European countries as they juggle the influx of refugees. Challenges to obstetrical care include physician shortage and the ongoing economic crisis in Greece. Refugees are some of the world’s most vulnerable populations and overall their obstetrical outcomes are worse than women of the host communities. Providers in refugee centers must be supported and educated in best obstetrical practices including labor management and a judicious use of caesarean deliveries. Increased outreach and training of maternal health worker can improve reproductive healthcare for refugees in non-camp environments.展开更多
Objectives:To assess the outcomes of the intensive care of Syrian refugees under temporary protection (SRUTP). Methods: The sample of the study was composed of 110 SRUTP patients who were treated at a tertiary intensi...Objectives:To assess the outcomes of the intensive care of Syrian refugees under temporary protection (SRUTP). Methods: The sample of the study was composed of 110 SRUTP patients who were treated at a tertiary intensive care unit (ICU) between 2013 and 2019 in Istanbul, Turkey. Baseline information and clinical data of the patients were collected by scanning the hospital's electronic database and clinical decision support system. Results:The mean length of ICU stay was 97.6 (36.3-187.8) h. Among the patients, 71 (64.5%) had comorbid diseases, and ICU mortality was 40%. The median cost of health care for each patient was 2144 (1060-4471) USD, and the total health care cost of all patients was 534012USD. Conclusions: Use of vasoactive drug, hemodialysis application, and low Glasgow Coma Scale scores are independent risk factors of the mortality. More researches are needed to clearly reveal the health and cost consequences of war.展开更多
The major impacts of climate change play a substantial role in triggering human migration, especially in the coastal areas. The individual or combined effects of climate change are likely to trigger mass human movemen...The major impacts of climate change play a substantial role in triggering human migration, especially in the coastal areas. The individual or combined effects of climate change are likely to trigger mass human movement both within and across international borders. People rarely move for a single reason;the motivation to migrate is complex of many factors. The main goal of this article is to identify the factors related to the decision to migrate taken by refugees in the coastal area. To assess this objective we employ exploratory factor analysis and structural equation modeling (SEM) and find that different factors influence refugees’ migration decision differently. From the findings, it is seen that loss of shelter, extreme events, decreasing soil fertility and food shortage, variability in temperature patterns and exhaustion of natural resources are the most important environmental factors that affect the decision to migrate of climate refugees. Low income, increasing price, decreasing purchasing power are the most important economic factors that influence migration decision. No social factors have significant effect on migration decision while safety as a political factor has a moderate influence on refugees’ decision to migrate. Finally, this article provides some recommendations for recognition of and protection for migrants forced to move to safer places due to certain direct impacts of climate change, notwithstanding the existence of multi-causality.展开更多
Za’atari camp is the largest refugee camp in Jordan. It was first established in 2012 to host Syrian refugees. Currently the camp hosts more than 81,000 refugees, with no proper sanitary system which might pose a maj...Za’atari camp is the largest refugee camp in Jordan. It was first established in 2012 to host Syrian refugees. Currently the camp hosts more than 81,000 refugees, with no proper sanitary system which might pose a major threat to surface resources in the area. An investigation was done at Za’atari refugees’ camp to find the impact of refugees settling on surface and groundwater quality. Surface water quality of surface runoff generated from thirty rain fall events were collected during the winter season of 2013/2014 from the major Wadi that passes through the camp and small ponds within the camp after the rainfall event. The collected samples were analyzed for acidity (pH), the electrical connectivity (EC), total dissolved solids (TDS), nutrients (NO3<sup style='margin-left:-7px;'>- and PO4<sup style='margin-left:-7px;'>3-) and selected heavy metals (Mn, Cd, Zn, Pb and Ni) in addition to biological oxygen demand (BOD5), chemical oxygen demand (COD) and intestinal worms (Total Coliform, E. cali). The results showed that there are significant variations in the EC as well as with TDS between the sites due to fluctuating amounts of water used for different activities within the camp as it was highest in the center of the camp where most of the refugees settle decreasing away from the center. The pH values were within the specifications of the World Health Organization and the Jordanian Standards. For nutrients, nitrate concentration was low with high phosphate ions which are most probably from detergents origin.展开更多
Objective: To understand, based on the life narratives of refugee women, food and nutritional security. Method: Qualitative, descriptive, exploratory study, Narratives of life method, by Daniel Bertaux. Conducted with...Objective: To understand, based on the life narratives of refugee women, food and nutritional security. Method: Qualitative, descriptive, exploratory study, Narratives of life method, by Daniel Bertaux. Conducted with 11 participants, refugee women residing in the state of Rio de Janeiro, Brazil. Results: The meanings and feelings evidenced in the life narratives of refugee women expressed the insecurities and weaknesses with food in the resettlement. Final Considerations: Given the meanings and feelings regarding food in the refuge, it is expected that the present study will contribute to the elaboration of new action plans and intersectoral public policies of agile action to meet the demands of the refugee population, in the attempt to mitigate starvation, poverty, social differences and the compromised health status of the refugee population.展开更多
There are over thirty million refugees globally with severe experiences of trauma.Art therapy intervention allows for nonverbal expression and could alleviate mental health symptomatology among refugees.The present re...There are over thirty million refugees globally with severe experiences of trauma.Art therapy intervention allows for nonverbal expression and could alleviate mental health symptomatology among refugees.The present review’s aim was to integrate and summarize the previous research which examined the effects of visual arts on alleviating psychological conditions of refugees.However,due to the paucity of studies which solely used visual arts,we included studies that used visual arts alongside other modalities as part of an expressive arts therapy intervention.The present review synthesizes studies that examined the effect of art therapy on mental health issues of refugees from January 2000 to March 2021.Seven studies(child and adolescent sample,N=5 and adult sample,N=2)with a total of 298 refugee participants(n=298)met our inclusion criteria.The participants were from the Middle East and North Africa(MENA),Southeast Asia,and Europe.We found three commonly reported mental health disorders,namely Post Traumatic Stress Disorder(PTSD),anxiety,and Major Depression Disorder.The research highlights how art therapy interventions could be a great starting point to alleviate symptomatology among refu-gees.Four additional benefits of art therapy which were commonly reported across the seven studies emerged from this review:working with traumatic experience/loss,rebuilding social connection and trust,nonverbal com-munication and self-expression of loss and trauma,and retelling stories.Art therapy interventions could be used as a starting point in the healing process of traumatized refugees to encourage verbal articulation of their feelings and reduce mental health symptoms.Despite these promisingfindings,due to a dearth of robust methodologies,further research is required to assess the long-term effectiveness of art therapy.展开更多
Introduction: Refugees in urban areas often face acculturation challenges, stigma, and stereotypes that impact their mental well-being. The aim of the present study was to examine the prevalence of stigma and its asso...Introduction: Refugees in urban areas often face acculturation challenges, stigma, and stereotypes that impact their mental well-being. The aim of the present study was to examine the prevalence of stigma and its association with depressive symptoms among urban refugees living in Mbarara city, southwestern Uganda. Methods: This cross-sectional study used snowball sampling and interviewed 343 refugees residing in Mbarara city, southwestern Uganda. The Discrimination and Stigma Scale was used to assess stigma, whereas the Patient Health Questionnaire (PHQ-9) was used to screen for depression symptoms severity. Linear regression models determined the associations between stigma and depression symptoms severity. Data were collected between June 2019 and March 2020. Findings: Of the 343 participants, 198 were males and 145 were females;their mean age was 28.8 years (SD = 11.0). Most of the participants (95.3%) had attained formal education. Our findings show that 84% (n = 288) of the participants had symptoms of stigma. Stigma had a statistically significant positive association with depressive symptoms severity (b = 0.11;95% CI, 0.08 to 0.15). Age had statistically significant positive association with depression symptoms severity (b = 0.08;95% CI, 0.02 to 0.14). Education level had a statistically significant negative association with depressive symptoms severity (b = -0.53;95% CI, -0.97 to -0.09). Conclusions: Urban refugees experience high levels of both stigma and depression. Interventions aimed at reducing stigma could subsequently reduce depression among refugees living in urban areas.展开更多
Uganda has significantly continued to receive a large number of refugees in the region and this is positively correlated with its proportional increase in peace and stability. The presence of favorable climatic condit...Uganda has significantly continued to receive a large number of refugees in the region and this is positively correlated with its proportional increase in peace and stability. The presence of favorable climatic conditions enhances agricultural productivity and this has triggered redirecting refugees into agricultural production as the major source of livelihood. However, in Ugandan setting, it has not yet been clearly established how agriculture has practically enhanced the livelihoods of the refugees. The study therefore aimed at identifying the agricultural activities practiced by refugees living in Nakivale refugee settlement, identifying the challenges faced by refugees involved in agriculture and their possible solutions as well as examining the contribution of agriculture towards livelihoods of refugees in Nakivale Refugee settlement. The study utilized a case-study approach to analyze the contribution of agriculture in the enhancement of livelihoods in the context of a single settlement and a sample size of 80 respondents was chosen using simple random sampling and an interview guide was used to collect primary data from the respondents. It was revealed from the study that crop production is the main agricultural activity practiced by refugees living in Nakivale refugee settlement in a bid to improve on their food security and household incomes. The study further revealed that climate change, diseases/parasites and diseases, limited land and low prices for the produce are the most serious challenges facing refugees’ farmers. It is concluded that food security in Nakivale refugee settlement is rather influenced by agricultural production and the associated dynamics that ultimately determine the well-being of the refugee communities. It is important to appreciate that any variation in factors of production, weather and produce prices will determine livelihood status of the community for such a specific period of time. It’s recommended that farmers should adopt climate smart farming to mitigate effects of climate change, supporting farmers with agricultural credit and other agricultural inputs like fertilizers, pesticides, farming tools, land, farmers training, improved seeds which are high yielding and quick maturing, market linkages for improved productivity and production.展开更多
文摘I never thought I'd become a climate refugee.After moving my family from drought and wildfire-stricken California to the so-called“climate haven”of Asheville,NC,I thought we were safe.But just two months after settling into our lovely and wooded community with mild weather,we had to flee.
文摘This study explores the impact of a host community’s level of cultural diversity on the integration ability and mental health of Syrian refugees resettling into two U.S.States:California and Idaho.This paper addresses the need for effective integration strategies,mainly due to their impact on mental health,given the current pressing conflicts in the Middle East and the global refugee crisis.This paper uses a comparative analysis of existing literature to examine how refugees hosted in more culturally diverse communities,such as California,experience better means of integration and thus have improved mental health than those hosted in culturally homogenous communities,such as Idaho.Additionally,the study concluded that refugees who can assimilate into a community experience fewer mental health issues.The findings provide valuable insight and information for policymakers seeking to improve refugee integration through nuanced strategies.The study suggests further primary research to discover additional impacts of a community’s cultural diversity on refugees’integration ability.
文摘This study explores the lived experiences of Sudanese women residing in Clarkston Georgia,USA who fled war and conflict in Sudan and sought refuge in Egypt.This qualitative research illustrates the main challenges that these women experienced in Egypt,such as racial discrimination,gender-based violence,economic hardship,police brutality,and legal protection gaps.Their being female,belonging to the black African race,and displacement status added to their vulnerabilities,which further isolated them from the Egyptian society.Semi-structured in-depth interviews and discussions in focus groups with 20 Sudanese refugee women who were resettled in Clarkston,Georgia,exposed the psychological residues that their struggles took in Egypt and elicited deep psychological trauma.However,now resettled in the U.S.,many women felt security,and came upon access to resources,avenues for education and work-undoing their lives with dignity.The study,therefore,calls for legal protection at the international level,gender-sensitive refugee policies,and deeper global cooperation that can guarantee protection and rights for refugee women.Guided by theories of feminism and human rights,this research provides important lessons in systemic reforms of mechanisms for the protection of refugees to meet special needs of refugee women worldwide.
基金supported by the National Natural Science Foundation of China(Grant No.32271554)the Guangdong Basic and Applied Basic Research Foundation(Grant No.2023A1515011501)。
文摘Predator–prey interactions are fundamental to understanding ecosystem stability and biodiversity.In this study,we propose and analyze a stochastic predator–prey model that incorporates two critical ecological factors:prey refuge and harvesting.The model also integrates disease transmission within the predator population,adding an important layer of realism.Using rigorous mathematical techniques,we demonstrate the existence and uniqueness of a global positive solution,thereby confirming the model's biological feasibility.We further derive sufficient conditions for two key ecological scenarios:stochastic permanence,which ensures the sustained co-existence of prey and predators over time,and extinction,where one or both populations decline to zero.The interplay between prey refuge and harvesting is thoroughly examined to understand their combined impact on population dynamics.All theoretical results are validated by detailed numerical simulations,highlighting the applicability of the model to real-world ecological systems.From the simulation results,we observed that with an adequate level of prey refuge and predator harvesting,the susceptible predator and prey coexist with extensive oscillations,while the infected predator population was moving towards extinction.In addition,we have investigated the effect of disease transmission on system dynamics.Our results show that,as the transmission rate of disease increases,the susceptible predator approaches extinction,whereas,on the other hand,when it declines,the susceptible predator shows robust oscillations while the infected approaches extinction.In both cases,the prey population demonstrates robust stability due to the prey refuge.Our findings show that the management of harvesting and the prey refuge can be effective ecological tactics for disease control and species protection under stochastic environmental effects.
文摘Background:The German Military Medical Service contributed to the medical screening of unaccompanied minor refugees(UMRs)coming to Germany in 2014 and 2015.In this study,a broad range of diagnostic procedures was applied to identify microorganisms with clinical or public health significance.Previously,those tests had only been used to screen soldiers returning from tropical deployments.This instance is the first time the approach has been studied in a humanitarian context.Methods:The offered screenings included blood cell counts,hepatitis B serology and microscopy of the stool to look for protozoa and worm eggs as well as PCR from stool samples targeting pathogenic bacteria,protozoa and helminths.If individuals refused certain assessments,their decision to do so was accepted.A total of 219 apparently healthy male UMRs coming from Afghanistan,Egypt,Somalia,Eritrea,Syria,Ghana,Guinea,Iran,Algeria,Iraq,Benin,Gambia,Libya,Morocco,Pakistan,and Palestine were assessed.All UMRs who were examined at the study department were included in the assessment.Results:We detected decreasing frequencies of pathogens that included diarrhoea-associated bacteria[Campylobacter(C.)jejuni,enteropathogenic Escherichia(E.)coli(EPEC),enterotoxic E.coli(ETEC),enteroaggregative E.coli(EAEC),enteroinvasive E.coli(EIEC)/Shigella spp.),Giardia(G.)duodenalis,helminths(comprising Schistosoma spp.,Hymenolepis(H.)nana,Strongyloides(S.)stercoralis]as well as hepatitis B virus.Pathogenic microorganisms dominated the samples by far.While G.duodenalis was detected in 11.4%of the assessed UMRs,the incidence of newly identified cases in the German population was 4.5 cases per 100,000 inhabitants.Conclusion:We conclude that the applied in-house PCR screening systems,which have proven to be useful for screening military returnees from tropical deployments,can also be used for health assessment of immigrants from the respective sites.Apparently healthy UMRs may be enterically colonized with a broad variety of pathogenic and apathogenic microorganisms.Increased colonization rates,as shown for G.duodenalis,can pose a hygiene problem in centralized homes for asylum seekers.
文摘OBJECTIVE: United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) provides primary health care services including care for diabetes and hypertension, with limited resources under difficult circumstances in Gaza, West Bank, Jordan, Lebanon and Syria. A total of 114,911 people with diabetes were registered with UNRWA health centres in 2011. The aim of this cross-sectional observational study was to assess the quality of diabetes care in the UNRWA primary health care centres. METHOD: The study population consisted of 1600 people with diabetes attending the 32 largest UNRWA health centres and treated there for at least one year. Between April and Sept. 2012 data from medical records, including results of clinical examinations and laboratory tests performed during the last one year, current management including self-care education and evidence of diabetes complications were collected and recorded in a previously validated data collection form (DCF). Patients were interviewed and clinically examined on the day of the audit and blood collected for HbA1c testing which was done at a central lab using High-performance liquid chromatography (HPLC) method (HLC®-723G8 Tosoh Corporation, Japan). Data was transferred from paper records into a computer and analysed with Epi-info 2000. RESULTS: Type 1 diabetes was present in 4.3% and type 2 diabetes in 95.7%. Co-morbid hypertension was present in 68.5%;90.3% were either obese (64.0%) or overweight (26.3%). Clinical management of diabetes was largely in line with UNRWA’s technical instructions (TI) for diabetes. Records for 2 hour postprandial glucose (2 h PPG), serum cholesterol, serum creatinine, and urine protein analysis were available in 94.7%, 96.4%, 91.4% and 87.5%, cases, respectively. Records of annual fundoscopic eye examination were available in 47.3% cases but foot examinations were less well documented. Most patients (95.6%) were on anti-diabetic drugs—68.2% oral anti diabetic drugs (OAD) only, 14.4% combination of OAD and insulin, and 12.9% insulin only. While 44.8% patients had 2 h PPG ≤ 180 mg/dl, only 28.2% had HbA1c ≤ 7%;55.5% and 28.2% had BP ≤ 140/90 and ≤130/80 mm of Hg respectively. Serum cholesterol ≥ 200 mg/dl, serum creatinine ≥ 1.2 mg/dl and macro albuminuria were noted in 39.8%, 6.4% and 10.3% cases respectively. Peripheral neuropathy (52.6%), foot infections (17%), diabetic retinopathy (11%) and myocardial infarction (9.6%) were the most common long term complications. One or more episodes of hypoglycaemia were reported by 25% cases in total and in 48% of those using insulin. 17.7% and 22.6% cases received no or ≥4 self-care education sessions respectively. CONCLUSION: The study confirmed that UNRWA doctors and nurses follow TI for diabetes and hypertension fairly well. Financial constraints and the consequent effects on UNRWA TI and policies related to diabetes care were important constraints. Key challenges identified were: reliance on 2 h PPG to measure control;non-availability of routine HbA1c testing, self-monitoring of blood glucose (SMBG) and statins within the UNRWA system;and high levels of obesity in the community. Addressing these will further strengthen UNRWA health system’s efforts of providing services for diabetes and hypertension at the primary care level. Given that most developing countries either have no or only rudimentary services for diabetes and hypertension at the primary care level, UNRWA’s efforts can serve as an inspiration to others.
文摘Objective:To investigate and compare the demographic characteristics,clinical findings,and laboratory results of pulmonary tuberculosis(PTB)and extrapulmonary tuberculosis(EPTB)patients,among Turkish citizens,and foreign nationals.Methods:This study included patients aged 18 and over,both Turkish citizens and foreign nationals,diagnosed with PTB or EPTB between 2016 and 2022.All patients were divided into PTB and EPTB group,and demographic characteristics,clinical findings,and laboratory results were compared.Patients with both PTB and EPTB were not included in the comparison.Multivariate logistic regression analysis was conducted to identify potential risk factors for PTB.Results:Among the 261 TB cases included,46 patients(17.6%)had PTB,and 188(72%)had EPTB.The percentage of female patients was significantly higher(P=0.003)in EPTB compared to PTB group.While the prevalence of diabetes mellitus(P=0.002),hypertension(P=0.017),coronary obstructive pulmonary disease(P=0.001),congestive heart failure(P=0.005),coronary artery disease(P=0.001)and immunosuppressive medication use(P=0.017)were significantly higher in PTB patients than in EPTB patients.Multivariate logistical analysis reveals that male(OR 2.6,95%CI 1.3-5.5,P=0.009),diabetes mellitus(OR 2.7,95%CI 1.2-6.1,P=0.015),and asthma(OR 6.3,95%CI 1.2-33.9,P=0.032)were associated with an increased risk of PTB.Social security coverage(P<0.001)and regular employment status(P<0.001)were found to be lower and the presence of multidrug resistance(P=0.002),isoniazid resistance(P=0.012),and rifampin resistance(P=0.012)were found to be significantly higher in foreign-national TB patients comparing with Turkiye citizens.Conclusions:Patients with PTB need to be evaluated for comorbidities and PTB should be investigated in men,in patients with diabetes mellitus or asthma if there are clinical findings suspicious for TB.TB screening for foreign nationals upon entry into the country is essential for TB control and elimination.
文摘AIM: To assess the prevalence of hepatitis B and C serological markers in a population of refugees living in Athens.METHODS: One hundred and thirty refugees (81 males and 49 females, mean age ±SD: 31.7±8 years) were included in the study. The hepatitis B virus surface antigen (HBsAg),the hepatitis B virus core antibody (anti-HBc) and the hepatitis C virus antibody (anti-HCV) were detected using a third-generation immunoassay.RESULTS: Twenty individuals (15.4%) were HBsAg positive and 69 (53.1%) were anti-HBc positive. The prevalence of HBsAg and anti-HBc was higher among refugees from Albania and Asia (statistical significant difference, P＜0.008 and P＜0.001 respectively). The prevalence of these markers was found irrelevant to age or sex. Anti-HCV was detected in the serum of 3 individuals (2.3 %). No differences among age, sex or ethnicity regarding anti-HCV prevalence were found.CONCLUSION: It can be concluded that refugees living in Athens are an immigrant population characterized by a high incidence of HBV infection. The prevalence of HBV markers is higher among refugees from Albania and Asia. It is therefore believed that the adherence to general precautions and the initiation of HBV vaccination programs will be necessary in the future, especially in these communities.Although the prevalence of HCV infection seems to be relatively low, extended epidemiological surveys are needed to provide valid results.
文摘Objective:To determine the prevalence of blinding trachoma among refugees in South Western Ethiopia.Methods:A cross-sectional outreach clinic based descriptive study was conducted on 1054 refugees in Southwest Ethiopia.A basic eyelid and cornea examination for signs of trachoma was done by using 2.5× binocular magnifying loupe.The findings were classified by using the World Health Digitization simplified trachoma grading system and data were analyzed by using SPSS version 16.0.Results:A total of 1054 refugee patients were examined for trachoma.179(16.98%) of them had clinical signs of trachoma.About 6(3.35%) patients had active trachoma with trachomatous trichiasis(TT),47(26.26%) patients had TT only and the rest 126(70.39%)patients had TT with trachomatous corneal opacity.All of the trachoma patients had blinding trachoma(TT with or without trachomatous corneal opacity),and about 60.89% of them had visual impairment.Blinding trachoma was significantly more common among females.patients in age group of 16-59 years,married patients,illiterates and Fugnido camp settlers(P<0.05).Conclusions:There is a very high burden of blinding trachoma among refugees.Urgent surgical intervention is needed to prevent blindness and low vision in the study subjects,and targeted regular outreach-based eye care service should be commenced.
基金supported in part by a grant from de Bond van Nederlands Militaire Oorlogs-en dienstslachtoffers(BNMO)
文摘Background: Research indicates that Posttraumatic stress disorder(PTSD) has an extensive impact on family relationships. Nevertheless, there is a dearth of empirically supported interventions addressing family functioning and PTSD. In the Netherlands, it is considered good clinical practice to offer multi-family therapy(MFT) to veteran and refugee families. MFT for traumatized families aims to address the dysfunctional family patterns that have evolved to address the consequences with trauma.Methods: The aim of this study is to generate a common framework for the practical impact and active ingredients of MFT in families confronted with trauma. The Delphi method was used to study the expert opinion of 11 therapists in Dutch expert trauma institutes.Results: The results indicate that MFT is a promising treatment for families dealing with the consequences of trauma. According to experts, positive outcomes include an increased understanding between family members,particularly visible in the de-escalation of conflicts within the family, and improved parenting. One explanation for the effectiveness of MFT with these target groups is its defining feature of therapy with several families.Conclusions: The findings support the importance of considering family relationships and the family context in interventions for traumatized individuals.
文摘Objective: According to a theoretical approach, events that elicit stress after arrival in the reception country, i.e., post-migration stress, have a negative impact on health-related quality of life among newly-arrived refugees. With the aim of paying attention to such symptoms, a revised culturally-tailored clinical health promotion model developed at Harvard Program in Refugee Trauma was used for invited groups of new-coming adult refugees in a town south of the Swedish capital. Methods: A coordinator administered the five-weekly sessions, 2 hours/week, with a professional interpreter. It covered major topics from Western and Arabic worldviews: 1) introduction;2) health care: organisation and access to;3) exercises;4) stress management and coping, 5) medical doctor-patient communication. Each topic was led by a nurse, a physiotherapist, a psychologist and a physician with experience of encounters with this target group in health care. Data cover results from 70 participants attending six groups;39 participants with pre-course findings and, post-course and six-month follow-ups. There were no significant differences in background factors between the participants and the drop-outs. Results: Participants’ perceptions of their health, measured by EQ-5D, changed positively over time, above all immediately after the course, with no significant differences between the two follow-ups. In the follow-ups, female participants perceived their health as significantly worse than males. Qualitative data at the six-month follow-up assessed the course as useful but expressed a wish to continue a similar course with a focus on post- migration stress. Conclusion: The results sup- port earlier findings. A course, administered to a small group in a dialogue setting, has value for the participants’ empowerment and perception of health. It is recommended that reception be more adapted to coping of post-migration stress of new-coming refugees. Practical Implications: The results have implications for education in clinical health promotion, intercultural communication and inter-professional collaboration in refugee reception.
文摘There is a worldwide increase in the rate of caesarean sections. With recent migration patterns and the influx of refugees into high-income countries, migrants and refugees are also subjected to the increase in caesarean section rates. This article explores known information about the obstetrical experiences of refugee and displaced women. Pregnancy care varies depending on the location of the displaced women. Obstetrical care in refugee centers in Greece is examined as an example of the overall challenges facing European countries as they juggle the influx of refugees. Challenges to obstetrical care include physician shortage and the ongoing economic crisis in Greece. Refugees are some of the world’s most vulnerable populations and overall their obstetrical outcomes are worse than women of the host communities. Providers in refugee centers must be supported and educated in best obstetrical practices including labor management and a judicious use of caesarean deliveries. Increased outreach and training of maternal health worker can improve reproductive healthcare for refugees in non-camp environments.
文摘Objectives:To assess the outcomes of the intensive care of Syrian refugees under temporary protection (SRUTP). Methods: The sample of the study was composed of 110 SRUTP patients who were treated at a tertiary intensive care unit (ICU) between 2013 and 2019 in Istanbul, Turkey. Baseline information and clinical data of the patients were collected by scanning the hospital's electronic database and clinical decision support system. Results:The mean length of ICU stay was 97.6 (36.3-187.8) h. Among the patients, 71 (64.5%) had comorbid diseases, and ICU mortality was 40%. The median cost of health care for each patient was 2144 (1060-4471) USD, and the total health care cost of all patients was 534012USD. Conclusions: Use of vasoactive drug, hemodialysis application, and low Glasgow Coma Scale scores are independent risk factors of the mortality. More researches are needed to clearly reveal the health and cost consequences of war.
文摘The major impacts of climate change play a substantial role in triggering human migration, especially in the coastal areas. The individual or combined effects of climate change are likely to trigger mass human movement both within and across international borders. People rarely move for a single reason;the motivation to migrate is complex of many factors. The main goal of this article is to identify the factors related to the decision to migrate taken by refugees in the coastal area. To assess this objective we employ exploratory factor analysis and structural equation modeling (SEM) and find that different factors influence refugees’ migration decision differently. From the findings, it is seen that loss of shelter, extreme events, decreasing soil fertility and food shortage, variability in temperature patterns and exhaustion of natural resources are the most important environmental factors that affect the decision to migrate of climate refugees. Low income, increasing price, decreasing purchasing power are the most important economic factors that influence migration decision. No social factors have significant effect on migration decision while safety as a political factor has a moderate influence on refugees’ decision to migrate. Finally, this article provides some recommendations for recognition of and protection for migrants forced to move to safer places due to certain direct impacts of climate change, notwithstanding the existence of multi-causality.
文摘Za’atari camp is the largest refugee camp in Jordan. It was first established in 2012 to host Syrian refugees. Currently the camp hosts more than 81,000 refugees, with no proper sanitary system which might pose a major threat to surface resources in the area. An investigation was done at Za’atari refugees’ camp to find the impact of refugees settling on surface and groundwater quality. Surface water quality of surface runoff generated from thirty rain fall events were collected during the winter season of 2013/2014 from the major Wadi that passes through the camp and small ponds within the camp after the rainfall event. The collected samples were analyzed for acidity (pH), the electrical connectivity (EC), total dissolved solids (TDS), nutrients (NO3<sup style='margin-left:-7px;'>- and PO4<sup style='margin-left:-7px;'>3-) and selected heavy metals (Mn, Cd, Zn, Pb and Ni) in addition to biological oxygen demand (BOD5), chemical oxygen demand (COD) and intestinal worms (Total Coliform, E. cali). The results showed that there are significant variations in the EC as well as with TDS between the sites due to fluctuating amounts of water used for different activities within the camp as it was highest in the center of the camp where most of the refugees settle decreasing away from the center. The pH values were within the specifications of the World Health Organization and the Jordanian Standards. For nutrients, nitrate concentration was low with high phosphate ions which are most probably from detergents origin.
文摘Objective: To understand, based on the life narratives of refugee women, food and nutritional security. Method: Qualitative, descriptive, exploratory study, Narratives of life method, by Daniel Bertaux. Conducted with 11 participants, refugee women residing in the state of Rio de Janeiro, Brazil. Results: The meanings and feelings evidenced in the life narratives of refugee women expressed the insecurities and weaknesses with food in the resettlement. Final Considerations: Given the meanings and feelings regarding food in the refuge, it is expected that the present study will contribute to the elaboration of new action plans and intersectoral public policies of agile action to meet the demands of the refugee population, in the attempt to mitigate starvation, poverty, social differences and the compromised health status of the refugee population.
文摘There are over thirty million refugees globally with severe experiences of trauma.Art therapy intervention allows for nonverbal expression and could alleviate mental health symptomatology among refugees.The present review’s aim was to integrate and summarize the previous research which examined the effects of visual arts on alleviating psychological conditions of refugees.However,due to the paucity of studies which solely used visual arts,we included studies that used visual arts alongside other modalities as part of an expressive arts therapy intervention.The present review synthesizes studies that examined the effect of art therapy on mental health issues of refugees from January 2000 to March 2021.Seven studies(child and adolescent sample,N=5 and adult sample,N=2)with a total of 298 refugee participants(n=298)met our inclusion criteria.The participants were from the Middle East and North Africa(MENA),Southeast Asia,and Europe.We found three commonly reported mental health disorders,namely Post Traumatic Stress Disorder(PTSD),anxiety,and Major Depression Disorder.The research highlights how art therapy interventions could be a great starting point to alleviate symptomatology among refu-gees.Four additional benefits of art therapy which were commonly reported across the seven studies emerged from this review:working with traumatic experience/loss,rebuilding social connection and trust,nonverbal com-munication and self-expression of loss and trauma,and retelling stories.Art therapy interventions could be used as a starting point in the healing process of traumatized refugees to encourage verbal articulation of their feelings and reduce mental health symptoms.Despite these promisingfindings,due to a dearth of robust methodologies,further research is required to assess the long-term effectiveness of art therapy.
文摘Introduction: Refugees in urban areas often face acculturation challenges, stigma, and stereotypes that impact their mental well-being. The aim of the present study was to examine the prevalence of stigma and its association with depressive symptoms among urban refugees living in Mbarara city, southwestern Uganda. Methods: This cross-sectional study used snowball sampling and interviewed 343 refugees residing in Mbarara city, southwestern Uganda. The Discrimination and Stigma Scale was used to assess stigma, whereas the Patient Health Questionnaire (PHQ-9) was used to screen for depression symptoms severity. Linear regression models determined the associations between stigma and depression symptoms severity. Data were collected between June 2019 and March 2020. Findings: Of the 343 participants, 198 were males and 145 were females;their mean age was 28.8 years (SD = 11.0). Most of the participants (95.3%) had attained formal education. Our findings show that 84% (n = 288) of the participants had symptoms of stigma. Stigma had a statistically significant positive association with depressive symptoms severity (b = 0.11;95% CI, 0.08 to 0.15). Age had statistically significant positive association with depression symptoms severity (b = 0.08;95% CI, 0.02 to 0.14). Education level had a statistically significant negative association with depressive symptoms severity (b = -0.53;95% CI, -0.97 to -0.09). Conclusions: Urban refugees experience high levels of both stigma and depression. Interventions aimed at reducing stigma could subsequently reduce depression among refugees living in urban areas.
文摘Uganda has significantly continued to receive a large number of refugees in the region and this is positively correlated with its proportional increase in peace and stability. The presence of favorable climatic conditions enhances agricultural productivity and this has triggered redirecting refugees into agricultural production as the major source of livelihood. However, in Ugandan setting, it has not yet been clearly established how agriculture has practically enhanced the livelihoods of the refugees. The study therefore aimed at identifying the agricultural activities practiced by refugees living in Nakivale refugee settlement, identifying the challenges faced by refugees involved in agriculture and their possible solutions as well as examining the contribution of agriculture towards livelihoods of refugees in Nakivale Refugee settlement. The study utilized a case-study approach to analyze the contribution of agriculture in the enhancement of livelihoods in the context of a single settlement and a sample size of 80 respondents was chosen using simple random sampling and an interview guide was used to collect primary data from the respondents. It was revealed from the study that crop production is the main agricultural activity practiced by refugees living in Nakivale refugee settlement in a bid to improve on their food security and household incomes. The study further revealed that climate change, diseases/parasites and diseases, limited land and low prices for the produce are the most serious challenges facing refugees’ farmers. It is concluded that food security in Nakivale refugee settlement is rather influenced by agricultural production and the associated dynamics that ultimately determine the well-being of the refugee communities. It is important to appreciate that any variation in factors of production, weather and produce prices will determine livelihood status of the community for such a specific period of time. It’s recommended that farmers should adopt climate smart farming to mitigate effects of climate change, supporting farmers with agricultural credit and other agricultural inputs like fertilizers, pesticides, farming tools, land, farmers training, improved seeds which are high yielding and quick maturing, market linkages for improved productivity and production.
