Human rights trauma and the mental health of West Papuan refugees resettled in Australia

This article finds that West Papuan refugees resettled in Australia report a wide range of premigration potentially traumatic events (PTEs) including human rights violations as well as symptoms of PTSD and distress.Abstract Objectives: To document the extent and nature of human rights violations and other traumatic events reported by West Papuan refugees resettled in Australia and to assess trauma-related psychological disorders, distress and disability.Design and setting: Australian-based sample, mixed-methods design with 44 participants, conducted in Australia between October 2007 and November 2010 in communities in North Queensland and Melbourne.Participants: West Papuan refugees aged 18 years and over (88% response rate).Main outcome measures: Post-traumatic stress disorder (PTSD) symptoms (Harvard Trauma Questionnaire) and premigration potentially traumatic events (PTEs), psychological distress (Kessler Psychological Distress Scale [K10]), post-migration living difficulties, days out of role.Results: Of the 44 West Papuan refugees, 40 reported one or more PTE, including inability to access medical care for family (40), lack of food and water (39) and lack of access to medical treatment (38). The most frequent postmigration stressors were separation from and worries about family members remaining in West Papua (43) and being unable to return home in an emergency because of ongoing conflict (41). Twenty-six participants reached a lower threshold for PTSD symptoms of 2.0, and 13 reached the clinical threshold of 2.5. Fourteen reported severe psychological distress.Conclusions: West Papuan refugees resettled in Australia report a wide range of premigration PTEs including human rights violations, as well as symptoms of PTSD and distress. The data add to concerns about the state of human rights and mental health among West Papuans.Authored by Susan Rees, Derrick M Silove, Kuowei Tay and Moses Kareth

Domestic violence in refugee families in Australia : rethinking settlement policy and practice

It has been identified that immigrant and refugee women are particularly at risk in cases of domestic violence. This article reveals the qualitative research findings from a study into the significance of traumatic history, social and economic context, cultural differences and changed gender identities on the perceptions and experiences of domestic violence in refugee families. The study was undertaken with a sample of refugee men and women from Iraq, Ethiopia, Sudan, Serbia, Bosnia and Croatia. Compounding contextual factors concerning structurally based inequalities, culturally emerged challenges, social dissonance, psychological stress and patriarchal foundations are revealed. Informed by an intersectional framework that recognizes gender oppression as modified by intersections with other forms of inequality, the article argues the case for community-managed projects involving multi-level empowerment-based interventions to prevent domestic violence

Diet and deprivation in pregnancy : A rat model to investigate the effects of the maternal diet on the growth of the dam and its offspring.

This work was funded as a part of the Scottish Government Rural and Environment Science and Analytical Services (RESAS) Strategic Research Program. HD is the recipient of a grant from Newton-Katip Çelebi Fund of The Scientific and Technological Research Council of Türkiye (TÜBITAK)-British Council Cooperation and by awards from the AFZ Giles Scholarship fund.Peer reviewe

The impact of maternal prenatal and postnatal anxiety on children's emotional problems: a systematic review

Maternal mental health problems during pregnancy and the postnatal period are a major public health issue. Despite evidence that symptoms of both depression and anxiety are common during pregnancy and the postpartum, the impact of maternal anxiety on the child has received relatively less attention than the impact of maternal depression. Furthermore, the evidence base for the direct impact of maternal anxiety during pregnancy and the postpartum on children’s emotional outcomes lacks cohesion. The aim of this systematic review is to summarise the empirical evidence regarding the impact of maternal prenatal and postnatal anxiety on children’s emotional outcomes. Overall, both maternal prenatal and postnatal anxiety have a small adverse effect on child emotional outcomes. However, the evidence appears stronger for the negative impact of prenatal anxiety. Several methodological weaknesses make conclusions problematic and replication of findings is required to improve the identification of at-risk parents and children with appropriate opportunities for intervention and prevention

Adult separation anxiety in pregnancy: how common is it?

The present study, the first to examine adult separation anxiety (ASA) in the context of pregnancy, found that ASA is a common yet unrecognized condition. Women attending an antenatal clinic were evaluated for the presence of ASA. A quarter of the women reached an established symptom threshold for ASA, with significantly more primigravida women (P = 0.003) identified as having the problem. There were no significant differences in the sociodemographic characteristics between those with and without ASA. Around one-third acknowledged that ASA was causing significant impairment in day-to-day functioning, suggesting the clinical importance of the pattern. Further research is indicated to explore this clinical entity and its impact on maternal and infant psychosocial wellbeing

ReCell® spray-on skin system for treating skin loss, scarring and depigmentation after burn injury: a NICE medical technology guidance

The gold standard treatment for deep burns is an autologous skin graft; in larger burns this may be meshed to increase the area covered. However, long-term aesthetic and functional outcomes of graft scars may be poor. ReCell® is a medical device that processes skin samples in the operating theatre into a cell suspension to be sprayed or dripped onto a wound. It is claimed to improve healing and scar appearance. This device was evaluated by the National Institute for Health and Care Excellence (NICE) Medical Technologies Evaluation Programme. Two groups were defined: ReCell compared to conventional dressings in shallower burns, and meshed grafts plus ReCell compared to meshed grafts alone in larger deeper burns. The manufacturer’s clinical evidence submission included three papers and eight conference abstracts. The External Assessment Centre (EAC) excluded two of these and added seven abstracts. In general, the evidence did not fit the defined groups, but suggested that ReCell was clinically comparable to skin grafts for partial thickness burns; however, ReCell is not used in this way in the UK. The manufacturer submitted an economic model in which ReCell treatment of partial thickness burns reduced the requirement for later skin grafts. This indicated that ReCell alone was cost saving in comparison to conventional dressings. The EAC indicated that this model was clinically inappropriate, but data were not available to populate a new model. NICE Medical Technologies Guidance 21 recommended that additional research was needed to address the uncertainties regarding the potential benefits of ReCell

Standardising the collection of patient-reported experience measures to facilitate benchmarking and drive service improvement

Patient experience teams in NHS Wales’ Health Boards and Trusts are working across the country to collect patient experience feedback from members of the public who access health care services. Although this work is advanced in many areas, there is currently no way of benchmarking across organisations, reducing opportunities for shared learning. We aimed to work with patients and colleagues across Wales to agree a set of universal Patient Reported Experience Measures (PREMs) questions. Working with patient experience teams, patient groups and Welsh Government, the NHS Wales Patient Reported Outcome Measures (PROMs), Patient Reported Experience Measures (PREMs) and Effectiveness Programme team has agreed a national set of PREMs questions for use across Wales. This process led on from previous work and included patient focus groups, patient experience leads and clinical input. Patients using secondary care services in Wales will be invited to complete the agreed PREMs survey along with patient outcome measures, via an electronic platform. This will provide a consistent method of data collection which will allow us to benchmark across hospitals and organisations in NHS Wales, identifying areas of good practice, as well as areas where patients report poorer experiences. This will allow local patient experience teams to target more in-depth experience gathering initiatives and carry out appropriate improvement programmes, making better use of resources. Identifying and sharing good practice will allow NHS Wales to advance patient experience, while triangulation with patient and clinical outcomes will drive the Prudent Healthcare agenda

ICME Observations During the Ulysses Fast Latitude Scan

Between November 2000 and October 2001 the Ulysses spacecraft performed a fast traversal of the heliospheric latitudes between 80°S and 80°N, a period close to the activity maximum of the current solar cycle. This paper provides an overview of the Ulysses observations of the transient solar wind structures associated with coronal mass ejections (ICMEs) during this period. Compared to the previous Ulysses fast latitude scan near solar minimum in 1995, many more ICME related signatures were observed in the present data set. Events were encountered spread over the full latitude range between 80°S and 80°N. Those at high northern latitudes, where fast solar wind from a northern polar coronal hole had become re‐established, were of the over‐expanding type first identified in Ulysses data at mid‐latitudes near solar minimum. The signatures of these events and their latitude dependence are discussed and some ongoing and possible future studies with this data set are described. © 2003 American Institute of PhysicsPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/87651/2/715_1.pd