In recent years, there has been a substantial increase in refugee and asylum-seeking adults, adolescents and children to high-income countries. Infectious diseases remain the most frequently identified medical diagnosis among U.S.-bound refugee children. Medical screening and immunization are key strategies to reduce the risk of infectious diseases in refugee, internationally adopted, and immigrant children. Notable infectious diseases affecting refugee and other newly arriving migrants include latent or active tuberculosis, human immunodeficiency virus type 1 (HIV), hepatitis B, hepatitis C, vaccine-preventable diseases, malaria, and other parasitic infections. The U.S. Centers for Disease Control and Prevention and the American Academy of Pediatrics have published guidelines for health assessment of newly arriving immigrant, refugee, and internationally adopted children. Although, data on the health risks and needs of refugee exists in some high-income countries, there is an urgent need to develop robust evidence-informed guidance on screening for infectious diseases and vaccination strategies on a broader scale to inform national policies. Innovative approaches to reach migrant communities in the host nations, address health and other complex barriers to improve access to high-quality integrated health services, and strong advocacy to mobilize resources to improve health, safety, and wellbeing for refugee children and their families are urgent priorities.

Infectious Diseases among Refugee Children.

Screening for posttraumatic stress disorder in young adult refugees from Syria and Iraq.

Background Approximately 18,000 Syrian refugees have resettled to the United States. Half of these refugees are children, whose age and refugee status jeopardize their abilities to attain quality healthcare. Information on Syrian refugees’ health in the U.S. is limited. This qualitative study sought to explore Syrian refugee parents’ beliefs, perspectives, and practices regarding their children’s health through in-depth interviews. Methods Eighteen Syrian refugee parents residing in Cincinnati, Ohio were interviewed in Arabic by bilingual researchers using semi-structured in-depth interviews. The interviews were recorded, transcribed, and translated. Three members of the research team independently coded each interview using an inductive thematic analysis approach. Results Analysis identified four salient themes: stressors preclude health seeking behaviors, parents perceive health barriers, parents are dissatisfied with the healthcare system, and parents use resilience behaviors to overcome barriers. Stressors included poor housing and neighborhoods, reliving traumatic experiences, depression and anxiety, and social isolation. Dissatisfaction included emergency room wait times, lack of testing and prescriptions. Health barriers included missed appointments and inadequate transportation, translation services, health literacy and care coordination. Parents reported resilience through faith, by seeking knowledge, use of natural remedies, and utilizing community resources. Conclusion This qualitative study provides information on the beliefs, practices, and behaviors of Syrian refugee parents related to health care utilization of pediatric refugees in the United States. Psychosocial and environmental stressors as well as perceived systemic health barriers, hinder health seeking behaviors in Syrian refugee parents. Culturally relevant care targeting perceived barriers and incorporating resilience behaviors may improve parental satisfaction and parental health seeking behaviors. Further study is needed to implement and evaluate interventions that target identified barriers.

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Beliefs, perceptions, and behaviors impacting healthcare utilization of Syrian refugee children

Exponential growth of the world's population combined with increased travel has dramatically increased the spread of infectious diseases. Although there has been significant focus on migration, the major contributors to the transmission of communicable diseases are travel and tourism not migration. Given that children represent up to 10% of international travellers, it is critical to the health of all age groups to ensure that tailored guidance for children is considered in public health policy and guidelines, and pandemic responses. To further support pandemic preparedness, public health systems need to strengthen ties with communities and health systems. In addition, travel and migration issues need to be included as core competencies in medical education. Ensuring that clinicians who care for children have knowledge of travel and migration health will foster a better health outcome in an increasingly mobile population at risk of emerging infectious diseases.Abbreviations CDC: Centers for Disease Control and Prevention; DGMQ: CDC Division of Global Migration and Quarantine; EID: emerging infectious diseases; EU: European Union; VFR: visiting friends and relatives; IOM: United Nations International Organization for Migration; LPR: lawful permanent resident; US: United States of America; WHO: World Health Organization.

Global mobility, travel and migration health: clinical and public health implications for children and families.

Affective infrastructure has become an unremarkable feature of geographical research. By examining how ‘affective infrastructure’ has been mobilised within geography and political theory, and charting its distinguishing features – whether as metaphor, analogy, or material-technical system – I suggest that Bosworth's explication presents an opportunity for thinking about the role and development of concepts more broadly. Using the Tyne Bridge as an example of affective infrastructure, I reflect on the mechanisms through which a concept appears and ask whether affective infrastructure's ‘power’ comes from its circulation as a term or shorthand. In clarifying its analytical utility, I ask what implications there might be for affective infrastructure's spaces of connotation, and what is at stake when a concept appears.

https://doi.org/10.1177/20438206231154347

Coming to terms with affective infrastructure

Clinical Tools Working at Home with Immigrants and Refugees.

Encountering Berlant part 1: Concepts otherwise

12032 Background: Medical Aid in Dying (MAID) allows patients (pts) with a terminal illness and less than 6 months prognosis to request a prescription that will end their life. MAID is controversial; opponents argue that negative psychological health underlies the choice, and that participation adversely effects pts and FMs. This is the first study to prospectively examine psychological health of pts and Family Members (FMs) who engaged in MAID and compare this to the psychological health of pts and FMs who did not utilize MAID. Methods: Pts and FMs were recruited prospectively from End-of-Life Washington (largest non-profit, public MAID advocacy/assistance organization in Washington State) from September 2022-January 2023 to a self-report, longitudinal study. Pts, FMs or the dyad were enrolled. Results of this study are compared to previously published results: *means (standard deviation, SD) taken from *Singer, et al. 2021; **Frikkel, et al. 2021; ^Robinson, et al. 2016 and ~Trevino, et al. 2013. + indicates no significant difference between MAID and non-MAID subjects at p > .05 level. Results: 16% (8/51) of eligible pts and 49% (20/41) of eligible FMs were recruited. 55% (n = 11) of FMs were spouses. There was no difference in sex and subjects were mostly white (pts 87.5%; FMs 95%) with college or higher degrees (pts 62.5%; FMs 85%). Most pts reported having cancer (n = 6 [75%]; neurologic condition, n = 1 [12.5%]; cirrhosis, n = 1 [12.5%]); most FMs also reported their pt had cancer (n = 17 [85%]; neurologic condition, n = 3 [15%]). There were no differences in psychological health between terminal cancer pts and FMs who engaged in MAID and advanced cancer pts & FMs who did not (see table). Conclusions: In this study, FMs and pts participating in MAID appear to have rates of negative psychological states that are in the low to moderate range. These rates appear similar to pts with advanced cancer and their FMs who are not engaging in MAID. Future research should study larger, heterogeneous populations earlier in the illness trajectory. [Table: see text]

Chloe Turner

Papers

Clinical Tools Working at Home with Immigrants and Refugees.

Encountering Berlant part 1: Concepts otherwise

Psychosocial health of patients engaging in medical aid in dying and their family members: A prospective descriptive analysis.

Leaking Across Time: Icy Lake and Kevin Aviance - Chloe Turner