Search

ABSTRACT: The Multidimensional Loss Scale (MLS) represents the first instrument designed specifically to index Experience of Loss Events and Loss Distress across multiple domains (cultural, social, material, and intrapersonal) relevant to refugee settlement. Recently settled Burmese adult refugees (N = 70) completed a questionnaire battery, including MLS items. Analyses explored MLS internal consistency, convergent and divergent validity, and factor structure. Cronbach alphas indicated satisfactory internal consistency for Experience of Loss Events (0.85) and Loss Distress (0.92), reflecting a unitary construct of multidimensional loss. Loss Distress did not correlate with depression or anxiety symptoms and correlated moderately with interpersonal grief and trauma symptoms, supporting divergent and convergent validity. Factor analysis provided preliminary support for a five-factor model: Loss of Symbolic Self, Loss of Interdependence, Loss of Home, Interpersonal Loss, and Loss of Intrapersonal Integrity. Received well by participants, the new scale shows promise for application in future research and practice. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic profoundly impacted the work of professionals who support people with intellectual disabilities. This study aimed to explore the experiences of outreach support staff supporting people with mild intellectual disabilities in the Netherlands during different phases of the pandemic between March 2020 and May 2021. Overall, seven outreach support staff from three intellectual disability services participated in this qualitative study. Using semi-structured interviews, participants were interviewed on three occasions between December 2020 and May 2021. A thematic analytical framework was used to analyze the interviews. Four overarching themes could be distinguished based on the data: (1) balancing between one's professional and personal life; (2) vaccination as both a stress reducer and a source of agitation; (3) service users: vulnerable versus resilient; and (4) contact with colleagues and service users. These themes provided valuable insights into the experiences of outreach support staff during different phases of the pandemic, both in the enduring impact of the pandemic and its measures on support staff, as well as in terms of how the pandemic and its preventive measures impacted their profession.

Social connections are foundational to the human condition and are inherently disrupted when people are forcibly displaced from their home countries. At a time of record high global forced migration, there is value in better understanding how refugee-background individuals engage theirsocial supports or ties in resettlement contexts. A mixed methods research design aimed to understand the complexities of how 104 refugee-background women experienced their social networks in the first few months of resettlement in Australia. One of the research activities involved participants completing a survey with both quantitative and qualitative components. The quantitative analyses identified the impact of post-migration living difficulties that represented social stressors (worry about family, loneliness and boredom, feeling isolated, and racial discrimination) on the women's mental health outcomes in the months following resettlement. The qualitative data highlighted the complexities of social relationships serving as both stressors and sources of support, and the importance of recognizing extended families and supports around the globe. The findings point to the need for nuanced accounts of the social contexts surrounding refugee resettlement as important influences able to promote trauma-informed and gender sensitive practices to support mental health and well-being in new settings.

The mental health of women has been largely neglected in the refugee literature, notwithstanding the specific gender-related issues that confront women seeking asylum. Furthermore, a specific category of women, deemed to be women-at-risk, face particular challenges in their journey and resettlement process. This longitudinal study investigated psychological distress in refugee women-at-risk one year after resettlement in Australia. Follow-up survey of 83 women-at-risk (mean age = 33.41 years; SD  = 11.93) assessed: trauma events and symptoms; loss events and loss distress; level of post-migration problems; anxiety, depression, and somatic symptoms; and absence of trust in community members. Participants demonstrated no symptom change since initial assessment ( p  > .05). Substantial proportions of women reported traumatization (39%), PTSD (20%), anxiety (32%), and depression (39%) above clinical cut-offs, and high levels of somatization and loss distress. Post-migration problems, trauma events, and region of birth were associated with all symptoms, with post-migration problems the strongest predictor. Absence of trust in community members was associated with trauma, depression, and somatic symptoms. Initial trauma and somatic symptoms were associated with follow-up traumatic and somatic symptoms. Loss and trauma events were associated with loss distress. Findings underline the role of post-migration problems on psychological distress and the need to consider women's psychological wellbeing in the context of their trauma and loss history, potential impacts of ethnicity, and complex socio-cultural dynamics underpinning issues of trust within communities. Effective service delivery requires that practitioners screen for and address psychological distress in women-at-risk at least up to 18 months after resettlement.

Refugee women-at-risk represent a distinct and vulnerable refugee population. We investigated the psychometric properties of the Multidimensional Loss Scale (MLS) with 104 women-at-risk, recently-arrived in Australia. Cross-sectional survey included: the MLS (indexing loss events and loss distress); Harvard Trauma Questionnaire (Indexing Trauma Events and Trauma Symptoms), and; Hopkins Symptom Checklist-37 (indexing anxiety, depression, and somatization symptoms). Exploratory factor analyses of MLS loss distress revealed a six-factor model (loss of symbolic self; loss of home; loss of interdependence; loss of past aspirations; interpersonal loss, and; loss of intrapersonal integrity). Cronbach alphas indicated satisfactory internal consistency for loss events (0.83) and distress (0.88). Correlations supported convergent validity of loss distress with trauma symptoms (r = 0.41) and divergent validity with anxiety (r = 0.09), Depression (r = 0.29), and somatic (r = 0.24) symptoms. Findings support MLS use in assessment of loss and associated distress with refugee women-at-risk.

Background: Despite increasing numbers of refugee women-at-risk being resettled and their potential vulnerability, there exists no empirical research into the psychiatric health of this unique subgroup with which to guide policy and practice. This research aimed to investigate psychiatric symptom status of a sample of refugee women-at-risk recently resettled in Australia, as well as factors contributing to symptoms of trauma, anxiety, depression, and somatization. The level of psychiatric symptomatology is compared to reference groups of women from Sudan and Burma, who entered Australia under the Humanitarian Entry Programme, and who did not meet criteria as women-at-risk., Methods: This is a cross-sectional survey of 104 refugee women-at-risk across several ethnic groups including a demographic questionnaire, the Harvard Trauma Questionnaire, Post-migration Living Difficulties Checklist, and Hopkins Symptom Checklist to assess individual factors, traumatic experiences, post-migration problems, and symptoms of trauma, anxiety, depression, and somatization. A series of multiple hierarchical regression analyses examined factors predicting psychiatric symptoms., Results: Substantial proportions of participants reported psychiatric distress in symptomatic ranges, including for traumatization (41%), post-traumatic stress disorder (20%), anxiety (29%), and depression (41%), as well as significant symptoms of somatization (41%). These findings are significantly higher than those derived from reference groups of women from Sudan or Burma, resettled in the same area and utilizing a similar methodology. Higher numbers of trauma events and post-migration living difficulties predicted higher trauma, depression, and somatic (but not anxiety) symptoms. Having children predicted higher trauma, anxiety, and somatic symptoms. Greater English fluency predicted higher anxiety symptoms. Region of birth predicted anxiety and depression symptoms. Age predicted trauma and anxiety symptoms., Conclusions: Findings suggest that recently arrived refugee women-at-risk are at high risk of psychiatric disorders. The results indicate a need for comprehensive psychiatric assessment to identify women in need of treatment very early after resettlement, with implications for medical practice, service delivery, and policy programs.

In the early 1900s, the abnormal toxicity test (ATT) was developed as an auxiliary means to ensure safe and consistent antiserum production. Today, the ATT is utilized as a quality control (QC) release test according to pharmacopoeial or other regulatory requirements. The study design has not been changed since around 1940. The evidence of abnormal toxicity testing as a prediction for harmful batches is highly questionable and lacks a scientific rationale. Numerous reviews of historical ATT results have revealed that no reliable conclusions can be drawn from this QC measure. Modern pharmaceutical manufacturers have thorough control of the manufacturing process and comply with good manufacturing practice rules. Contaminants are appropriately controlled by complying with the validated manufacturing processes and strict QC batch release confirming batch-to-batch consistency. Recognizing that product safety, efficacy, and stability can be ensured with strict QC measures, nowadays most regulatory authorities do not require the ATT for most product classes. In line with the replacement, reduction, and refinement (3Rs) initiative, the test requirement has been deleted from approximately 80 monographs of the European Pharmacopoeia and for the majority of product classes in the United States. For these reasons, it is recommended that the ATT should be consistently omitted world-wide and be removed from pharmacopoeias and other regulatory requirements., (© 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.)

Objective: To establish, in the context of the revised European Pharmacovigilance Directive and based on physicians' perspectives, how Summaries of Product Characteristics (SmPCs) could be more user friendly and better support physicians' interactions with patients, thereby improving patients' own understanding of their medicines., Design: Qualitative focus group discussions (step 1), development of an alternative SmPC (step 2) and an online quantitative survey (step 3) comparing the alternative SmPC to the currently approved version., Setting: Office-based physicians (n=218) from all federal states of Germany., Participants: 218 German physicians participated, with an equal representation of office-based general practitioners and specialists. For step 1 (n=18), physicians were recruited who frequently consulted SmPCs., Outcome Measures: Planned and performed: Mayring's qualitative content analysis of focus group discussions (step 1), rating on a five-point Likert scale of preference of current versus alternative SmPCs (step 3)., Results: Physicians confirmed the importance of SmPCs as a comprehensive source of medicinal product information, but were moderately satisfied with the current SmPCs, utilised it infrequently and were more likely to engage additional sources of information. The alternative SmPC was consistently preferred. It differed in the way information for particular patient groups was presented, included additional sections (synopsis, checklist for patient information) and used a tabular format. Physicians indicated that SmPCs should be available with search and hyperlink functions, as well as be automatically updated and integrated in available practice software or similar solutions., Conclusions: This research contributes to the development of an official, reliable medicinal product information system meeting the needs of a modern information society while providing the reliability of an officially authorised source. In the context of health literacy, SmPCs should be established as the primary information source for healthcare professionals to ensure compliant and safe utilisation of medicinal products.

Objective: The present study seeks to examine the impact of therapeutic interventions for people from refugee backgrounds within a naturalistic setting., Methods: Sixty-two refugees from Burma were assessed soon after arriving in Australia. All participants received standard interventions provided by a resettlement organisation which included therapeutic interventions, assessment, social assistance, and referrals where appropriate. At the completion of service provision a follow-up assessment was conducted., Results: Over the course of the intervention, participants experienced a significant decrease in symptoms of post-traumatic stress disorder, anxiety, depression and somatisation. Pre-intervention symptoms predicted symptoms post-intervention for post-traumatic stress, anxiety and somatisation. Post-migration living difficulties, the number of traumas experienced, and the number of contacts with the service agency were unrelated to all mental health outcomes., Conclusions: In the first Australian study of its kind, reductions in mental health symptoms post-intervention were significantly linked to pre-intervention symptomatology and the number of therapy sessions predicted post-intervention symptoms of post-traumatic stress. Future studies need to include larger samples and control groups to verify findings.

Objective: This study documents the mental health status of people from Burmese refugee backgrounds recently arrived in Australia, then examines the contributions of gender, pre-migration and post-migration factors in predicting mental health., Method: Structured interviews, including a demographic questionnaire, the Harvard Trauma Questionnaire, the Post-migration Living Difficulties Checklist and Hopkins Symptom Checklist assessed pre-migration trauma, post-migration living difficulties, depression, anxiety, somatization and traumatization symptoms in a sample of 70 adults across five Burmese ethnic groups., Results: Substantial proportions of participants reported psychological distress in symptomatic ranges including: post-traumatic stress disorder (9%), anxiety (20%) and depression (36%), as well as significant symptoms of somatization (37%). Participants reported multiple and severe pre-migration traumas. Post-migration living difficulties of greatest concern included communication problems and worry about family not in Australia. Gender did not predict mental health. Level of exposure to traumatic events and post-migration living difficulties each made unique and relatively equal contributions to traumatization symptoms. Post-migration living difficulties made unique contributions to depression, anxiety and somatization symptoms., Conclusions: While exposure to traumatic events impacted on participants' mental well-being, post-migration living difficulties had greater salience in predicting mental health outcomes of people from Burmese refugee backgrounds. Reported rates of post-traumatic stress disorder symptoms were consistent with a large review of adults across seven western countries. High levels of somatization point to a nuanced expression of distress. Findings have implications for service provision in terms of implementing appropriate interventions to effectively meet the needs of this newly arrived group in Australia.

Five low-dose applications of a commercial coal tar preparation on a small scalp skin region resulted in an induction of aryl hydrocarbon hydroxylase (AHH) activity in freshly isolated human hair follicles. Large but reproducible interindividual differences in AHH-inducibility could be detected. The method offers the opportunity to measure AHH-inducibility, which has been correlated to the risk of developing chemical-induced cancer, in vivo in normal epithelium, a cell-type highly relevant for chemical carcinogenesis. Smoking habits did not have any effect on AHH-activity in freshly isolated hair follicles. Therefore the method potentially permits the identification of persons with high and low genetically determined AHH-inducibility.