The politics of immigrant and refugee health in the United States

2019 ◽  
pp. 245-259
Author(s):  
Michael Grodin ◽  
Sondra Crosby ◽  
George Annas
Keyword(s):  
Cultural Sensitivity ◽  
Medical Model ◽  
The United States ◽  
Lessons Learned ◽  
System Level ◽  
Complex Treatment ◽  
Structural Barriers ◽  
Health And Human Rights ◽  
Immigrant And Refugee ◽  
Immigrant And Refugee Health

Over 25 years of experience from the field have resulted in important lessons learned concerning how to best approach the multifaceted, complex treatment of immigrants and refugees. Continuing this work, it is important to educate medical communities about tried-and-true best practices and cultural sensitivity, as well as the integration of culturally-related practices in different clinical contexts. The medical model is inadequate to address the systematic challenges inherent in caring for displaced and traumatized populations. Beyond the clinical realm, systems are needed to advocate on behalf of immigrant and refugee communities using policy and law instruments; system-level intervention is the most effective way to address structural barriers to the highest possible standard of health and human rights.

The COVID-19 Challenges and Opportunities for Immigrant Career Development

2021 ◽  
pp. 172-196
Author(s):  
Lizette Solis-Cortes ◽  
Falu Rami
Keyword(s):  
Career Development ◽  
Service Providers ◽  
The United States ◽  
Structural Barriers ◽  
Executive Orders ◽  
Challenges And Opportunities ◽  
Development Paths ◽  
Immigrant And Refugee ◽  
The Impact ◽  
To Receive

This chapter focuses on the impact of the COVID-19 pandemic, it's disproportionate impact on immigrants' careers and employment opportunities, and the dire need to address inequitable career development opportunities. COVID-19 has also highlighted the anti-immigrant sentiment and structural barriers that impact immigrant career experiences and outcomes. A second interrelated obstacle to immigrant career development paths are recent executive orders signed by Donald Trump in the United States against immigrants and refugees as well as global anti-immigrant and refugee policies such as Brexit and the Citizenship Amendment Act. Immigrant workers require advocacy, protection, and avenues to receive continued support during and post-pandemic. Resources for immigrant employers and employees including international resources, avenues for advocacy, and recommendations to service providers are discussed.

In Different Tongues: Making Room for Cultural Differences in the Negotiated Rulemaking Process

2002 ◽  
Vol 7 (2) ◽  
pp. 209-233
Author(s):  
◽  
Keyword(s):  
Environmental Protection Agency ◽  
Cultural Sensitivity ◽  
The United States ◽  
Federal Agencies ◽  
Lessons Learned ◽  
Theory And Practice ◽  
Cultural Recognition ◽  
Negotiated Rulemaking ◽  
Indian Nations ◽  
The U.S

AbstractThis article explores the ethical impact of cultural recognition within the regulatory negotiation (reg-neg) process as it is currently being used by federal agencies in the United States. The authors use a blend of theory and practice to explore the ethical necessity, feasibility, and practicality of including cultural guidelines within the reg-neg process. Using the findings from extensive prior research on negotiated rulemaking at the U.S. Environmental Protection Agency (EPA) as a foundation, we illustrate the lessons learned from years of regulatory negotiations conducted by the pioneer of reg-neg. We then show how these lessons have been brought under an umbrella of ``cultural recognition'' within the consensus-based regulatory negotiation being used to improve relations between American Indian nations and the U.S. government. We discuss the ethical and practical implications of incorporating cultural sensitivity into the reg-neg process.

scholarly journals Increasing Social Work Students’ Participation in Macro Specializations

2021 ◽  
Vol 20 (3) ◽  
pp. 709-724
Author(s):  
Dawn Apgar
Keyword(s):  
Social Work ◽  
Social Work Students ◽  
Clinical Work ◽  
The United States ◽  
System Level ◽  
Structural Barriers ◽  
Master Of Social Work ◽  
Black African ◽  
Attitudinal Barriers ◽  
Macro Practice

Much effort has been made to increase the number of social work students in macro practice specializations in graduate school. Despite the development of pedagogical techniques which have shown to increase interest in and appreciation for macro practice, the proportion of macro students has stayed low and stable over time. Using survey data collected from 474 Master of Social Work students and graduates, this exploratory study identified both structural and attitudinal barriers which impede specialization in macro practice. Data reveals that despite exposure to these methods, those whose original motivation to enter the profession was based on a desire to do clinical work are unlikely to concentrate on macro practice. Structural barriers such as the lack of availability of macro programs also prevented increased specialization in macro practice. Social workers who are Black/African American are more likely to concentrate in macro practice, perhaps due to a recognition of the need for systems change in the United States to promote equal opportunities and rights for those who have historically been marginalized. Findings indicate that current efforts to increase the number of graduates with macro specializations may not be effective. Treatment of macro methods as a specialization, rather than integral to social work education, should be revisited if the profession wants to ensure enough graduates are able to make system-level changes to rectify current societal inequities.

scholarly journals Embedded Mental Health in the United States Marine Corps

2020 ◽  
Vol 185 (9-10) ◽  
pp. e1499-e1505
Author(s):  
Katherine E Pierce ◽  
David Broderick ◽  
Scott Johnston ◽  
Kathryn J Holloway
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Medical Model ◽  
Health Resources ◽  
Marine Corps ◽  
The United States ◽  
Lessons Learned ◽  
United States Marine Corps ◽  
The Rich ◽  
Health Assets

Abstract Introduction Despite the rich history and progression of mental health assets and their utilization within the Marine Corps, the implementation of these assets has been varied and inconsistent. This article strives to take the lessons learned from the past and improve on them. The goal is to develop a consistent program focused on resiliency and retention, and propose an integrated organized structure across all the Marine Expeditionary Forces (MEF). Means and Methods Review of the literature, current practices, and future recommendations. Results This article demonstrates that continuing to utilize mental health resources at the Regimental level with a focus on community mental health principles rather than the medical model allows for proximity to members and leadership of their primary command, immediate access to them as their Special Staff Officer, the ability to set the expectation of recovery, resiliency, and readiness, and the capability to implement simple principles of nonmedical recuperation and advisement. Conclusions Improving on the organizational structure of mental health in the Marine Corps by placing a mental health Special Staff Officer at the MEF level and focusing on the principles of community mental health will shift the focus back to the primary and secondary prevention care efforts across all levels of the Marine Corps and provide clinical and leadership oversight as it relates to the philosophy, role, and implementation of organic mental health Officers.

scholarly journals (P2-55) The Role of Nursing in International Disasters: Lessons Learned

2011 ◽  
Vol 26 (S1) ◽  
pp. s153-s154
Author(s):  
S.M. Burke ◽  
S. Briggs
Keyword(s):  
Cultural Sensitivity ◽  
Disaster Response ◽  
Massachusetts General Hospital ◽  
The United States ◽  
Lessons Learned ◽  
Field Hospital ◽  
Mortality And Morbidity ◽  
Primary Specialty ◽  
Us Government ◽  
Complex Disasters

A disaster may result from a serious or sudden catastrophic event that has the potential for massive loss of infrastructure and significant mortality and morbidity. Disasters may be caused by natural or man-made events. With either type, the forces of the event overwhelm the first responders and health organizations in the stricken community and outside assistance is required. Developing countries have the highest burden with limited available resources. Today's complex disasters have increased the need for mobile medical/surgical response teams to provide disaster care. The United States (US) Government created the International Medical Surgical Response Teams (IMSuRT), which, on short notice, deploy a multidisciplinary team of doctors, nurses, and other health professionals to disasters around the world. IMSuRT has a rapidly deployable, fully equipped field hospital. Historically, Massachusetts General Hospital (MGH) in Boston, Massachusetts, US, has played a significant role in responding to humanitarian efforts both within the US and internationally. The MGH nurses play key roles in several response teams, including IMSuRT. Disaster nursing has many unique challenges. Nurses practice daily under controlled situations and become expert in one specialty; however, in the disaster setting this is not possible. Disaster nursing requires a fundamental change in the care of patients. During disasters, nurses work in areas that are not their primary specialty. Disaster nurses must be prepared in the essentials of disaster response- this requires planning, preparation, and training with multiple simulation drills focusing on patient scenarios, equipment utilization, teamwork, triage, decontamination, and scene safety. We must be creative, adaptable, and flexible to the needs of the disaster. Most importantly, cultural sensitivity, and communication are important factors in the delivery of disaster care.

Characteristics of Physician Relocation Following Hurricane Katrina

2009 ◽  
Vol 95 (1) ◽  
pp. 6-12
Author(s):  
Kusuma Madamala ◽  
Claudia R. Campbell ◽  
Edbert B. Hsu ◽  
Yu-Hsiang Hsieh ◽  
James James
Keyword(s):  
Hurricane Katrina ◽  
Gulf Coast ◽  
General Medicine ◽  
The United States ◽  
Lessons Learned ◽  
Bivariate Analysis ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Factors Associated ◽  
The Impact

ABSTRACT Introduction: On Aug. 29, 2005, Hurricane Katrina made landfall along the Gulf Coast of the United States, resulting in the evacuation of more than 1.5 million people, including nearly 6000 physicians. This article examines the relocation patterns of physicians following the storm, determines the impact that the disaster had on their lives and practices, and identifies lessons learned. Methods: An Internet-based survey was conducted among licensed physicians reporting addresses within Federal Emergency Management Agency-designated disaster zones in Louisiana and Mississippi. Descriptive data analysis was used to describe respondent characteristics. Multivariate logistic regression was performed to identify the factors associated with physician nonreturn to original practice. For those remaining relocated out of state, bivariate analysis with x2 or Fisher exact test was used to determine factors associated with plans to return to original practice. Results: A total of 312 eligible responses were collected. Among disaster zone respondents, 85.6 percent lived in Louisiana and 14.4 percent resided in Mississippi before the hurricane struck. By spring 2006, 75.6 percent (n = 236) of the respondents had returned to their original homes, whereas 24.4 percent (n = 76) remained displaced. Factors associated with nonreturn to original employment included family or general medicine practice (OR 0.42, 95 percent CI 0.17–1.04; P = .059) and severe or complete damage to the workplace (OR 0.24, 95 percent CI 0.13–0.42; P < .001). Conclusions: A sizeable proportion of physicians remain displaced after Hurricane Katrina, along with a lasting decrease in the number of physicians serving in the areas affected by the disaster. Programs designed to address identified physician needs in the aftermath of the storm may give confidence to displaced physicians to return.

Winning the Argument and Moving the Fight: The Legacy of a Grassroots Humanitarian

Public Voices ◽  
2016 ◽  
Vol 14 (1) ◽  
pp. 115
Author(s):  
Mary Coleman
Keyword(s):  
Higher Education ◽  
United States ◽  
Winning Strategy ◽  
Supreme Court Decision ◽  
The United States ◽  
Colleges And Universities ◽  
Lessons Learned ◽  
The Political ◽  
Political Actors ◽  
Trade Offs

The author of this article argues that the two-decades-long litigation struggle was necessary to push the political actors in Mississippi into a more virtuous than vicious legal/political negotiation. The second and related argument, however, is that neither the 1992 United States Supreme Court decision in Fordice nor the negotiation provided an adequate riposte to plaintiffs’ claims. The author shows that their chief counsel for the first phase of the litigation wanted equality of opportunity for historically black colleges and universities (HBCUs), as did the plaintiffs. In the course of explicating the role of a legal grass-roots humanitarian, Coleman suggests lessons learned and trade-offs from that case/negotiation, describing the tradeoffs as part of the political vestiges of legal racism in black public higher education and the need to move HBCUs to a higher level of opportunity at a critical juncture in the life of tuition-dependent colleges and universities in the United States. Throughout the essay the following questions pose themselves: In thinking about the Road to Fordice and to political settlement, would the Justice Department lawyers and the plaintiffs’ lawyers connect at the point of their shared strength? Would the timing of the settlement benefit the plaintiffs and/or the State? Could plaintiffs’ lawyers hold together for the length of the case and move each piece of the case forward in a winning strategy? Who were plaintiffs’ opponents and what was their strategy? With these questions in mind, the author offers an analysis of how the campaign— political/legal arguments and political/legal remedies to remove the vestiges of de jure segregation in higher education—unfolded in Mississippi, with special emphasis on the initiating lawyer in Ayers v. Waller and Fordice, Isaiah Madison

Recruiting Immigrant and Refugee Arab American Mother–Father–Infant Triads Resettling in the United States: A Feasibility Study

2020 ◽  
Vol 52 (2) ◽  
pp. 139-148
Author(s):  
Dalia Khalil ◽  
Carmen Giurgescu ◽  
Dawn P. Misra ◽  
Thomas Templin ◽  
Arash Javanbakht
Keyword(s):  
Depressive Symptoms ◽  
Telomere Length ◽  
Feasibility Study ◽  
The United States ◽  
Buccal Swab ◽  
Study Protocols ◽  
Hair Samples ◽  
Stigma Of Mental Illness ◽  
Conducting Research ◽  
Immigrant And Refugee

Background Recent Iraqi and Syrian immigrant families are exposed to stress, anxiety, and depressive symptoms due to civil war. Recruitment challenges specific to conducting research within this population include the lack of knowledge about research, stigma of mental illness, and mistrust. Purposes Among immigrant Iraqi and Syrian families: (1) evaluate the approach to recruitment and retention; and (2) evaluate the acceptability of the study procedures. Methods This feasibility study was conducted based on the work of Orsmond and Cohn. It is focused on the evaluation of recruitment capability and resulting sample characteristics and evaluation of acceptability and suitability of the study procedures. Mother–father–infant triads were recruited from a community center. Parents completed questionnaires about stress and depressive symptoms. Buccal swab samples were obtained from the triads to measure telomere length, and infant hair samples were obtained to measure cortisol level. Telomere length and hair cortisol were utilized as measures of chronic stress. Results Ten mother–father–infant triads were enrolled out of 11 approached. Challenges faced this study included inability to reach families by telephone and the effect of cultural norms where the husband’s permission was needed before proceeding, resulting in a slow pace of recruitment. The study strategy and procedures appeared to be feasible as all of the families who participated completed all study protocols. Conclusion This study provides feasibility data to inform the launching of a larger study to examine the associations of family stress with infant stress and development. These findings from Iraqi and Syrian families may be generalizable to studies seeking to recruit these and other immigrant and refugee population families.

scholarly journals The Global Limb Anatomic Staging System (GLASS) for CLTI: Improving Inter-Observer Agreement

2021 ◽  
Vol 10 (16) ◽  
pp. 3454
Author(s):  
Joep G. J. Wijnand ◽  
Devin Zarkowsky ◽  
Bian Wu ◽  
Steven T. W. van Haelst ◽  
Evert-Jan P. A. Vonken ◽  
...  
Keyword(s):  
Staging System ◽  
The United States ◽  
Lessons Learned ◽  
Observer Agreement ◽  
Lesion Length ◽  
Solid Base ◽  
Stepwise Approach ◽  
Additional Tool ◽  
Atherosclerotic Lesions ◽  
Stenosis Severity

Objective: The 2020 Global Vascular Guidelines aim at improving decision making in Chronic Limb-Threatening Ischemia (CLTI) by providing a framework for evidence-based revascularization. Herein, the Global Limb Anatomic Staging System (GLASS) serves to estimate the chance of success and patency of arterial pathway revascularization based on the extent and distribution of the atherosclerotic lesions. We report the preliminary feasibility results and observer variability of the GLASS. GLASS is a part of the new global guideline and posed as a promising additional tool for EBR strategies to predict the success of lower extremity arterial revascularization. This study reports on the consistency of GLASS scoring to maximize inter-observer agreement and facilitate its application. Methods: GLASS separately scores the femoropopliteal (FP) and infrapopliteal (IP) segment based on stenosis severity, lesion length and the extent of calcification within the target artery pathway (TAP). In our stepwise approach, we used two angiographic datasets. Each following step was based on the lessons learned from the previous step. The primary outcome was inter-observer agreement measured as Cohen’s Kappa, scored by two (step 1 + 2) and four (step 3) blinded and experienced observers, respectively. Steps 1 (n = 139) and 2 (n = 50) were executed within a dataset of a Dutch interventional RCT in CLTI. Step 3 (n = 100) was performed in randomly selected all-comer CLTI patients from two vascular centers in the United States. Results: In step 1, kappa values were 0.346 (FP) and 0.180 (IP). In step 2, applied in the same dataset, the use of other experienced observers and a provided TAP, resulted in similar low kappa values 0.406 (FP) and 0.089 (IP). Subsequently, in step 3, the formation of an altered stepwise approach using component scoring, such as separate scoring of calcification and adding a ruler to the images resulted in kappa values increasing to 0.796 (FP) and 0.730 (IP). Conclusion: This retrospective GLASS validation study revealed low inter-observer agreement for unconditioned scoring. A stepwise component scoring provides acceptable agreement and a solid base for further prospective validation studies to investigate how GLASS relates to treatment outcomes.

scholarly journals The COVID Army: Experiences from the Deployment of Non-Hospitalist Physician Volunteers during the 2020 COVID Pandemic

2021 ◽  
pp. 1-15
Author(s):  
Kevin Hauck ◽  
Katherine Hochman ◽  
Mark Pochapin ◽  
Sondra Zabar ◽  
Jeffrey A Wilhite ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Medical Center ◽  
The United States ◽  
Lessons Learned ◽  
Front Line ◽  
Clinical Leadership ◽  
Team Members ◽  
Medical Centers ◽  
Hospitalist Physician

Abstract Objective New York City was the epicenter of the outbreak of the 2020 COVID-19 pandemic in the United States. As a large, quaternary care medical center, NYU Langone Medical Center was one of many New York medical centers that experienced an unprecedented influx of patients during this time. Clinical leadership effectively identified, oriented, and rapidly deployed a “COVID Army”, consisting of non-hospitalist physicians, to meet the needs of this patient influx. We share feedback from our providers on our processes and offer specific recommendations for systems experiencing a similar influx in the current and future pandemics. Methods In order to assess the experiences and perceived readiness of these physicians (n=183), we distributed a 32-item survey between March and June of 2020. Thematic analyses and response rates were examined in order to develop results. Results Responses highlighted varying experiences and attitudes of our front-line physicians during an emerging pandemic. Thematic analyses revealed a series of lessons learned, including the need to: (1) provide orientations, (2) clarify roles/ workflow, (3) balance team workload, (4) keep teams updated on evolving policies, (5) make team members feel valued, and (6) ensure they have necessary tools available. Conclusions Lessons from our deployment and assessment are scalable at other institutions.

Sign in / Sign up

Export Citation Format

Share Document