Promoting the health of refugee women: a scoping literature review incorporating the social ecological model

The health of refugee women after settlement in a new country, can be adversely or positively affected by individual, interpersonal, community, and organizational factors. While much of the previous literature highlights these factors individually, there is a lack of comprehensive synthesis regarding how the factors interact to influence the health of refugee women. We conducted a thematic analysis in our literature review to elucidate how providers can work with refugee women to prevent adverse health outcomes and intervene at multiple levels to improve their health outcomes after resettlement. We reviewed peer-reviewed literature from 2009 to 2019 from Google Scholar, JSTOR, Global Health, PubMed, CINAHL, Sociological Abstracts, and Social Service Abstracts, and also used citation chaining, to identify relevant information pertaining to refugee women’s health. The key terms used for our literature review were, health care, violence, social support, and mental health. In total, we included 52 articles, 3 books, and 8 other sources. We found that refugee women are vulnerable to violence during migration and typically have high rates of post-traumatic stress disorder. There were also concerns of secondary victimization by providers after resettlement. We also found that social support is an important factor for reducing isolation, and improving access to health care, as well as improving mental health outcomes. However, social support was often difficult to maintain, and was moderated by factors such as English language fluency. Health care was influenced by health literacy, cultural difference, communication concerns, and access issues. The findings suggest that at the individual and interpersonal levels there is a need to address language barriers, improve provider-patient communication, and provide appropriate medical and mental health screenings. At the organizational level, interorganizational communication and awareness are vital. At the community level, providers can work with community leaders, to educate, create dialogue and collaboration, to help facilitate understanding and bolster community social support. Improved communication and knowledge about the unique needs and concerns of refugee women through an integrated, multi-system approach is necessary to improve their health outcomes

Local and systemic effect of transfection-reagent formulated DNA vectors on equine melanoma

Background Equine melanoma has a high incidence in grey horses. Xenogenic DNA vaccination may represent a promising therapeutic approach against equine melanoma as it successfully induced an immunological response in other species suffering from melanoma and in healthy horses. In a clinical study, twenty- seven, grey, melanoma-bearing, horses were assigned to three groups (n = 9) and vaccinated on days 1, 22, and 78 with DNA vectors encoding for equine (eq) IL-12 and IL-18 alone or in combination with either human glycoprotein (hgp) 100 or human tyrosinase (htyr). Horses were vaccinated intramuscularly, and one selected melanoma was locally treated by intradermal peritumoral injection. Prior to each injection and on day 120, the sizes of up to nine melanoma lesions per horse were measured by caliper and ultrasound. Specific serum antibodies against hgp100 and htyr were measured using cell based flow- cytometric assays. An Analysis of Variance (ANOVA) for repeated measurements was performed to identify statistically significant influences on the relative tumor volume. For post-hoc testing a Tukey-Kramer Multiple-Comparison Test was performed to compare the relative volumes on the different examination days. An ANOVA for repeated measurements was performed to analyse changes in body temperature over time. A one-way ANOVA was used to evaluate differences in body temperature between the groups. A p–value < 0.05 was considered significant for all statistical tests applied. Results In all groups, the relative tumor volume decreased significantly to 79.1 ± 26.91% by day 120 (p < 0.0001, Tukey-Kramer Multiple-Comparison Test). Affiliation to treatment group, local treatment and examination modality had no significant influence on the results (ANOVA for repeated measurements). Neither a cellular nor a humoral immune response directed against htyr or hgp100 was detected. Horses had an increased body temperature on the day after vaccination. Conclusions This is the first clinical report on a systemic effect against equine melanoma following treatment with DNA vectors encoding eqIL12 and eqIL18 and formulated with a transfection reagent. Addition of DNA vectors encoding hgp100 respectively htyr did not potentiate this effect

A Meta-analysis of Gene Expression Signatures of Blood Pressure and Hypertension

Genome-wide association studies (GWAS) have uncovered numerous genetic variants (SNPs) that are associated with blood pressure (BP). Genetic variants may lead to BP changes by acting on intermediate molecular phenotypes such as coded protein sequence or gene expression, which in turn affect BP variability. Therefore, characterizing genes whose expression is associated with BP may reveal cellular processes involved in BP regulation and uncover how transcripts mediate genetic and environmental effects on BP variability. A meta-analysis of results from six studies of global gene expression profiles of BP and hypertension in whole blood was performed in 7017 individuals who were not receiving antihypertensive drug treatment. We identified 34 genes that were differentially expressed in relation to BP (Bonferroni-corrected p&lt;0.05). Among these genes, FOS and PTGS2 have been previously reported to be involved in BP-related processes; the others are novel. The top BP signature genes in aggregate explain 5%–9% of inter-individual variance in BP. Of note, rs3184504 in SH2B3, which was also reported in GWAS to be associated with BP, was found to be a trans regulator of the expression of 6 of the transcripts we found to be associated with BP (FOS, MYADM, PP1R15A, TAGAP, S100A10, and FGBP2). Gene set enrichment analysis suggested that the BP-related global gene expression changes include genes involved in inflammatory response and apoptosis pathways. Our study provides new insights into molecular mechanisms underlying BP regulation, and suggests novel transcriptomic markers for the treatment and prevention of hypertension

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

A Community-engaged Narrative Inquiry Photovoice Project Examining the Health-Impacting Experiences of Older Adult Russian and Spanish-Speaking Immigrants in Southeastern Wisconsin, United States.

Background: Among the nearly 10 million older adult immigrants in the United States, most come from Mexico and speak Spanish. Moreover, in addition to the hundreds of thousands of Russian-speaking immigrants from the Former Soviet Union already residing in the United States, the current war in Ukraine is fueling mass emigration of Ukrainian and Russian-speakers from Ukraine. Thus, in this study we sought to examine the health-impacting experiences of older adult Russian and Spanish-speaking immigrants in Southeastern Wisconsin. Design & Methods: This was a Community-Engaged Participatory Narrative Inquiry Photovoice Project and applied the Older Adult Immigrant Adapted Model for Health Promotion. Participants took or selected 10 photos, and then through an in-depth semi-structured interview we discussed the stories and experiences related to the photos, and how those experiences were related to their health. Moreover, given the multiple languages in this study, we created adapted cross-language research methods, which we followed in this study. These adapted cross-language methods were: (1) What and why? Considerations for Study Design, (2) When do we translate, and how many times? Question development, pilot testing, transcription, and translation, (3) Who? The role of the translator/interpreter during the research process, (4) Who again? Translator/interpreter credentials and positionality, (5) What are you really saying? Dynamic equivalence, (6) Do your ears deceive you? Reflexive reflective reflexivity, and (7) Triality, not just Duality, of the role of the Researcher. Data analysis was conducted in the languages of participants (Russian or Spanish). Data analysis was conducted by the research team to understand the metastory. Data analysis was an iterative process of listening and re-listening to interviews, as connected with the photos, assessing not only what was said, but how it was said. Results: The two overarching metastories were related to the environment and healthcare access. In this dissertation, the two sections of results are titled as follows: (1) “Your soul will rest in the fresh air” HealthInfluencing Experiences of Older Adult Russian and Spanish-Speaking Immigrants in Southeastern, Wisconsin, United States, and (2) “You Die or You Get Better” Conceptualizations of Health-Seeking Behavior and Health Care Encounters among Older Adult (Im)migrants in Wisconsin, the United States. These results demonstrate the importance of the environment as both facilitating and inhibiting the health of older adult Russian and Spanishspeaking immigrants. For example, social support, as well as access to parks and lakes positively affected participants physical and mental health, while limited access to health care negatively affected their physical and mental health. Significance: This study elucidated the experiences of older adult Russian and Spanish-speaking immigrants in Southeastern Wisconsin and explicates their own viewpoints through the use of their own photos. These findings underscore the importance of the built environment as it impacts health. They also underscore the importance of improved cross-cultural training for health care and public health professionals. Finally, these findings are novel and nuanced in that through the use of the Older Adult Adapted Model for Health Promotion the results illustrated the specific pathways that interact among older adult immigrants and thereby also illuminate potential areas for intervention

The changing dynamics of community care and support in rural Malawi : the impact on Women's health and wellbeing at end of life

In this critical ethnographic study, we examined women's end of life experiences in Malawi, one of the few countries in the world with a national palliative care policy. Specifically, we explored how women's and their caregivers' experiences were shaped by family and community care, and material needs. Interviews and observations with female clients of a non-governmental organization in rural Central Malawi, and with their caregivers, revealed that community-level support was both precarious and critical. We found three main themes: (1) I stay with them well, (2) we eat together, and (3) everyone is for themselves. The analysis illustrates the centrality of community care, social in/exclusion, and availability of stable food, shelter, medical, and caregiving resources on health and wellbeing at end of life. We provide recommendations to strengthen community care opportunities and women's resource bases.The University of Wisconsin-Milwaukee Center for Global Health Equity and Sustainable Peacebuilding Program.https://www.elsevier.com/locate/socscimed2023-04-01hj2022Agricultural Economics, Extension and Rural Developmen

A qualitative analysis of perceptions of and reactions to COVID-19

Objective: To understand communities\u27 perceptions, beliefs, and health-related behavior choices related to COVID-19 in order to guide public health nursing communication and interaction with patients and the community. Design: A qualitative study, guided by the Health Belief Model (HBM), strove to comprehend the perceptions and reactions to COVID-19 among Wisconsinites. Sample: Twenty-five diverse Wisconsin residents aged 18 or older. Measurements: Semi-structured interviews provided information about individuals\u27 attitudes, perceptions, and reactions to COVID-19. Interviews were audio-recorded, transcribed, and thematic analysis was conducted to identify themes. Results: We identified three major themes: (1) health care starts way before you ever enter the doors of a healthcare facility ; (2) to live in a society is to help each other ; and (3) mental health as impacted by COVID-19. Conclusions: This study demonstrated the need for greater public health support, as well as the role of Social Determinants of Health. Understanding perceptions and reactions to COVID-19 can help public health nurses understand and better respond to future pandemics