Refugee health nursing.

Refugees are a common feature in Africa and Uganda is no exception. However, Uganda does not have the resources to provide health care to all its own citizens, let alone to refugees. Refugee health services are therefore usually set up and provided separately by international organizations such as the United Nations High Commissioner for Refugees (UNHCR). However, such services often end up being the only available or reliable services in a particular location for both host and refugee populations. Yet the host populations are often denied access to these services because, in theory, other services are being provided by their government. The case study in the West Nile region of Uganda describes how host and refugee services were integrated in an attempt to address the concerns of inequity of access to care for host populations, when reasonably good health services were available to nearby refugee populations. The paper identifies and discusses the challenges encountered and those remaining.

Refugee aid is seldom a topic of American political conversations despite rising global refugee populations (American Immigration Council, 2020). Refugees who have fled or been forced out of their native country seek asylum, or protection from persecution, in a host country (U.S. Citizenship and Immigration Services, 2015). Thus, an asylum country is one in which refugees can live without fear of persecution or deportation to their native country, while they apply for permanent residence or resettlement (U.S. Citizenship and Immigration Services, 2015). Many Middle Eastern nations including Syria, Libya, Yemen, and Palestine are currently experiencing war and subsequently, hundreds of thousands of individuals from these nations have been forced to seek asylum elsewhere (International Institute for Strategic Studies, 2022). Adjusting to asylum countries may affect mental health, which is an individual’s state of psychological wellness (Centers for Disease Control and Prevention, 2023; United Nations High Commissioner for Refugees, 2022). Thus, this paper will examine how relocation to an asylum country impacts the mental health of Middle Eastern refugees.

Publication of research is a goal of research capacity building initiatives. We reviewed the publications generated by practitioner researchers involved with the Primary and Community Health Research Unit (PCHRU), within the Division of Community Health in South Western Sydney Local Health District (SWSLHD), between 2011 and 2014. Publications were categorised using the Higher Education Research Data Collection Specifications. Published outputs included five refereed articles, one refereed full conference paper and 25 non-published conference presentations. A further 11 refereed articles in draft form were located. The majority of publications were considered 'not published' and not widely discoverable. Evidence for expected timeframes for project completion, including support for publication of research, is needed.

To determine hepatitis C virus (HCV) treatment rates among those newly diagnosed with the virus in the South Western Sydney Local Health District (SWSLHD) in NSW, Australia. Cross-sectional study of patients newly diagnosed with HCV in SWSLHD, based on local Public Health Unit notification data from the second half of 2017. A total of 200 consecutive notifications were enrolled in the study. Either the ordering clinician was interviewed, and/or data linkage with local hospital records performed, to determine rates of antiviral treatment in this cohort. Outcomes measured included the proportion of patients: started on antiviral treatment; referred to specialists for consideration of treatment; HCV ribonucleic acid (RNA) negative; and lost to follow-up. Descriptive analysis of factors contributing to those lost to follow-up was performed where available. The follow-up outcome of 93% of patients was traced. General Practitioners (GPs) diagnosed a similar number (102) of new HCV cases to those diagnosed by specialists (94). After detecting a patient as HCV antibody positive and confirming active infection, GPs preferred to refer patients to specialists (53%), rather than further evaluate and treat patients themselves (5%). The remainder of cases from the GP-detected group were lost to follow-up (26%), or HCV RNA negative (16%). Among the speciliast-detected patients, 41% were treated, 18% were lost to follow-up, 20% were RNA negative and the remainder were not treated for reasons including a concurrent diagnosis of hepatocellular carcinoma, or death. The most common reason patients were not started on antiviral treatment was loss to follow-up. We found that less than half (47%) of people in South Western Sydney newly diagnosed with HCV, in whom treatment was indicated, received antiviral medication in the 12 months following diagnosis.This figure excludes the 25% cases referred from general practice to specialists, in whom the treatment status is unknown. Approximately one in five newly diagnosed patients (22%) were lost to follow-up and 18% were RNA negative, indicating they had no active HCV infection.

Introduction and Objective: The 2025 ADA standards recognize early pregnancy dysglycemia is associated with worse outcomes, and recommend detection with either fasting glucose (FG) or A1C. This study compared different early glycemic screening strategies for overt diabetes (ODIP) and GDM prediction. Methods: Pregnant women with GDM risk factors enrolled in a multicenter early GDM RCT had a 75g OGTT and A1C <20 wks using ADA ODIP and GDM criteria. Repeat OGTT occurred at 24-28 wks if untreated (normal OGTT and randomized 50% early GDM). Area under the receiver operator curve (AUROC) with 95%CI was used for ODIP and late GDM prediction. The proportion of late OGTTs avoided included those with an A1C or FG <90% sensitivity thresholds or reaching the ADA early screening thresholds (A1C≥5.9%; FG≥110 mg/dL). Results: Among 3515 women, mean age was 31±5 yrs, BMI 29.9±7.4 kg/m2, OGTT gestation 16±3 wks, 40.6% were European. A1C and FG had similar AUROCs for ODIP and similar, but lower, AUROCs for GDM. The ADA-recommended A1C and FG thresholds were<50% sensitive for ODIP and <5% sensitive for GDM. An early FG threshold of 92 mg/dL was <70% sensitive for ODIP and persistent GDM. An early A1C threshold of 4.8% or FG of 76 mg/dL (@90% sensitivity for GDM) could avoid 22.7% of 24-28 week OGTTs (Table 1). Conclusion: The 2025 ADA recommended early pregnancy A1C and FG thresholds are insensitive tests for detecting women with ODIP and later pregnancy GDM. Disclosure D. Simmons: Research Support; Novo Nordisk, AMSL. Other Relationship; Abbott, Abbott, Boehringer-Ingelheim. Speaker's Bureau; Ascensia Diabetes Care. C.J. Nolan: None. J. Immanuel: None. H. Teede: None. J.R. Flack: None. V.W.M. Wong: None. E. Hibbert: None. M. McLean: Advisory Panel; Recordati Rare Diseases. A. Kautzky-Willer: None. J. Harreiter: None. H.E. Backman: None. E.J. Gianatti: None. A. Sweeting: None. V. Mohan: Speaker's Bureau; Novo Nordisk. Advisory Panel; Abbott. Research Support; Servier Laboratories. Speaker's Bureau; USV Private Limited, Sanofi, Medtronic, Eli Lilly and Company. W. Hague: None. Funding NHMRC (grants 1104231 and 2009326); Region ?rebro Research Committee Dnr OLL-970566, OLL-942177; Medical Scientific Fund of the Mayor of Vienna, project 15205; South Western Sydney Local Health District Academic Unit grant 2016; Western Sydney University Ainsworth Trust grant 2019

What Matters 2 Adults (WM2A)-a wellbeing measure that is culturally grounded in the values and preferences of Aboriginal and Torres Strait Islander people-is being trialed in cancer services across NSW, Australia; we present the experience of the South Western Sydney Local Health District, Cancer Services, as a case study. WM2A is implemented by an Aboriginal Health Worker who uses it to identify and holistically support the wellbeing needs of patients undergoing cancer treatment. Outcomes from the measure are used to deliver culturally responsive patient-and family-centered cancer care.Early results suggest the combined effects of the measure and a dedicated Aboriginal Health Worker are improving outcomes for Aboriginal and Torres Strait Islander patients.

Oxaliplatin-induced neuropathic pain limits treatment compliance. However, the variability of neuropathic pain symptoms in each cycle for individual patients and the impacts on treatment compliance remain untested. Data from 322 adult patients who received oxaliplatin-based chemotherapy were extracted based on pattern of chemotherapy, adverse events, and patient survival. Cox regression and survival analyses were employed. Seventy-eight percent of patients developed neuropathic pain that oscillated between a complete absence and presence on a cycle-by-cycle basis. Consequently, the presence of neuropathy in one cycle did not predict the incidence of neuropathy in subsequent cycles. This implies that neuropathic pain need not be a sufficient criterion to reduce, delay, or cease chemotherapy. In the case of multiple system adverse events during combined drug treatment, the responsible cause for dose reduction was not identified. Cox regression analysis revealed that middle age (61–78 years old, P=0.003) and oxaliplatin cumulative dose <850 mg/m2 (P=0.002) were associated with patient mortality. Completion of chemotherapy (8 cycles) and cumulative dose >850 mg/m2 of oxaliplatin prolonged the median survival time by 8 and 5 months, respectively. As oxaliplatin-induced neuropathic pain fluctuates across cycles in a manner that varies from patient-to-patient, current assumptions on the predictive nature of the emergence of neuropathy (and its impact on treatment compliance) need to be reconsidered. Detailed patient-by-patient analysis of adverse events should be applied to future studies in order to determine the efficacy of current treatments (and future interventions) and whether neuropathic pain should be retained as a criterion to vary the treatment. Additionally, when two or more system toxicities occurred in cases of combined drug treatment, the causes for drug reduction should be separately recorded.

This study aimed to investigate the help-seeking behaviours among children and young people (CYP) from culturally and linguistically diverse (CALD) backgrounds for mental health (MH) needs in a multicultural Australian population. We analysed the electronic medical records (eMR) of 8135 MH-related emergency department (ED) encounters of CYP aged up to 18 years across six public hospitals in the South Western Sydney Local Health District, Australia, from January 2016 to April 2022. Urgency of MH care was grouped into high priority (triage categories 1 and 2, needing to have treatment within 10 minutes) and low-to-moderate (triage categories 3-5, needing to have treatment within 30-120 minutes) presentations. Multilevel logistic regression models adjusted for key covariates and patient level clustering examined the relationship between CALD status and urgency of MH care. We also assessed the combined effects of gender and CALD status, as well as CALD status and residential area socioeconomic status, on urgent ED care. About 8.3% of all MH-related ED presentations during the 6-year period were classified as high priority. The odds of high-priority MH ED care were 2.03-fold higher for CALD CYPs compared to non-CALD CYPs (adjusted odds ratio (AOR): 2.03, 95% confidence interval [CI] = [1.46-2.82]). Furthermore, an added increase in the odds of seeking urgent MH care for CYPs who belong to multiple risk groups was observed among CALD male CYPs (AOR: 2.96, 95% CI = [1.81-4.85]) and those living in disadvantaged areas (AOR: 2.36, 95% CI = [1.59-3.49]). The findings of this study highlight the need for culturally appropriate services aimed at prevention and early intervention targeted at CYP from CALD backgrounds to avoid crisis presentations.

Background Inflammatory Bowel Disease (IBD) is experiencing compounding prevalence with Australian prevalence expected to grow by 258% by 20301. Digital technologies hold promise for improving care quality and accessibility by virtue of scalability. Patient-facing mobile applications can be implemented across different stages including diagnosis, monitoring, facilitation of treatment, and research. These tools can empower patients, enhance engagement, and reduce care navigation stress Despite a number of IBD apps being described in literature or available to consumers, very few are accessible locally, whilst existing solutions offer limited functionality and fall short in supporting meaningful clinical use. Methods Two independent reviewers conducted a systematic search of the Australia/New Zealand Apple App Store and Android Play Store. The following search terms were included “colitis”, “ulcerative colitis”, “IBD”, “inflammatory bowel disease”, and “Crohn’s”. Apps were included if the title/description referenced IBD, excluding those focused on other gastrointestinal conditions. Non-English apps, and those limited or locked to a specific institution were also excluded. Results Within both stores, 49 apps were identified and 16 met the inclusion criteria. Most were free (14/16), though three required paid subscriptions. Only four apps reported medical professional input. Symptom tracking was the most common feature (10/16), followed by dietary logging (9/16). Fewer apps included medication management (5/16), educational content (4/16), or administrative tools (2/16). Symptom-tracking functionality was heteregenous, with only four incorporating validated measures such as SCCAI or HBI. Two apps included AI-based flare prediction. Dietary tools ranged from basic logging to AI-driven analysis. Four apps offered educational content covering topics such as lifestyle and wellbeing, medication, and disease-related information. Sources varied, with two providing expert-curated or medically reviewed material, while others were unsourced or AI-generated content. Additional features includ ed remote calprotectin testing, administrative tools and community support forums. Overall, functionality was fragmented across different apps, with nearly half (43.7%) of apps including one of the above categories, and the majority (62.5%) incorporated two or fewer feature categories. Conclusion The growing burden of IBD and its associated costs remain a challenge within current health system constraints. Digital technology holds promise in augmenting clinical care, yet most existing IBD apps offer narrow feature sets, lack health system integration, and are not personalised to individuals, thus limiting their usefulness in clinical settings. Reference: 1. Crohn’s Colitis Australia. State of the Nation in Inflammatory Bowel Disease in Australia: Final Report. February, 2025. Accessed May 1, 2025. https://crohnsandcolitis.org.au/wp-content/uploads/2025/05/CCA_State-of-the-Nation-in-IBD-1.pdf Conflict of interest: Dr. Chan, Patrick: No conflicts of interest. Wu, Rodger: No conflicts of interest. Andrews, Jane Mary: The work I will present was funded via CCCure. CCCure’s funding sources include grants for research and payments for data reports from Pharma including AbbVie, J&amp;J, Takeda, Celltrion, Falk, Ferring, BMS, Janssen, Pfizer, Sandoz Connor, Susan Jane: Grant: This project is supported by a grant from The Leona M. and Harry B. Helmsley Charitable Trust. Research Support: Abbvie, Agency for Clinical Innovation, Amgen, BMS, Chiesi, Celltrion, DrFalk, Ferring, Janssen, Medical Research Future Fund, Pfizer, South Western Sydney Local Health District, Sydney Partnership for Health, Research and Enterprise, Takeda and The Leona M and Harry B Helmsley Charitable Trust Ad Boards: Abbvie, Amgen, BMS, Celltrion, Eli Lilly, Ferring, GSK, Janssen, Organon, Pfizer, Takeda Speaker Fees: Abbvie, Cornerstones Health, Dr Falk, Ferring, Janssen, Pfizer, Sandoz, Sydney IBD School, Takeda Educational Support: DrFalk, Sandoz, Takeda

The aim of Health Alliances is to work collaboratively to improve coordination and effectiveness of health services in the community to support healthier neighbourhoods. Our Fairfield City Health Alliance (FCHA) consists of three key partners representing all levels of Government: South Western Sydney Local Health District (SWSLHD), South Western Sydney Primary Health Network (SWSPHN) and Fairfield City Council (FCC). Fairfield City is one of the most culturally diverse cities in Australia; over 50% of residents were born overseas in a non-English speaking country. Nearly 70% of residents speak a language other than English at home and about 20% report difficulty speaking English. The migration history and the economic profile of the Fairfield LGA have resulted in a range of health issues and needs which are not evident in other areas of Sydney or NSW. In Fairfield, health is further complicated by social determinants of health such as income, housing affordability, education levels and social inclusion. The SEIFA index for Fairfield City (856) makes it the most disadvantaged in metropolitan Sydney and the fourth most disadvantaged in NSW. FCHA aims to get the whole community to work together to improve health services in Fairfield. The community remain at the centre of the Alliance approach; they are engaged in designing, planning and evaluating local health initiatives. Shared health priorities are established through needs assessment and extensive stakeholder consultation. The FCHA priority areas are: •Health literacy in vulnerable refugees and migrants and disadvantaged Culturally and Linguistically Diverse (CALD) population groups •Wellbeing, with a particular focus on the health and social impact of gambling •General Practice quality improvement Key partners utilise shared knowledge and expertise to develop local health priorities. Working collaboratively in a holistic approach presents strengths and opportunities to solve the complexities and large scope of our health system. Each partner brings unique strengths to the Alliance. The collaboration between partners from a range of primary care and non-government organisations has enabled the Health Alliance to leverage health knowledge, expertise and relationships to develop innovative ways to connect local health services and improve the health of the local community. In recent years, the local council has transformed themselves beyond a focus on ‘roads, rates and rubbish’ to deliver broad social, environmental and community wellbeing objectives. The implementation of place-based projects such as the diabetes Bilingual Community Education (BCE) program, the implementation and evaluation of a gambling harm screening tool, the mental health literacy BCE program and the antimicrobial research project have all demonstrated extensive health outcomes with improvements in diabetes self- management, increased knowledge of mental health literacy, improvements in lifestyle choices and behaviours resulting in overall improvements to wellbeing. The level of integration and collaboration across the three levels of government, non-government agencies and the community has largely reduced the fragmented approach and has enhanced a well-co-ordinated and holistic approach in addressing health issues in a local context.

I would like to express my gratitude to diverse individuals and organizations who contributed to this study, particularly those who participated in interviews, focus group discussions, and other research methods utilized to gather the data that form the basis of this report. I am especially thankful to the staff of the various UN agencies operating in South Sudan, including the United Nations Mission in Sudan (UNMISS), International Organization for Migration (IOM), the United Nations High Commissioner for Refugees (UNHCR), the United Nations Development Programme (UNDP) and the United Nations Children’s Fund (UNICEF) for their guidance. Special mention is due to Laura Nistri, Tracking and Monitoring Coordinator from IOM Juba, who generously made herself available to answer my many return and reintegration questions, both in person at IOM headquarters in Juba and by email upon my return at the University of Tennessee’s Center for the Study of Youth and Political Conflict, where I am currently based.

We approached this chapter by providing frameworks for understanding the migration process, posttraumatic stress disorder (PTSD), and mental health and wellbeing of migrants with special focus on migrants of African origin. The Migration Theory of Boswell (Addressing the causes of migratory and refugee movements: The role of the European Union (Working Paper No. 73). United Nations High Commissioner for Refugees, Geneva. https://www.unhcr.org/3e19ac624.pdf, 2002) was critiqued and principally utilized to explain the root and proximate causes, enabling conditions and sustaining factors of migration with backgrounds in the existing macro, meso and micro theories of migration. The existing theoretical postulations used in explaining the PTSD, wellbeing and mental health of migrants include the Trauma-based Medical Model, Chronic Traumatic Stress Model, Hobfoll’s Conservation of Resources, Stress-coping Framework, Lazarus and Folkman’s Stress Model, Boski’s Theory of Disharmony, Acculturative Theory, Cultural Syndromes, and Attachment Theory. These theories were categorized according to how they accounted for the mental health and wellbeing of both forced and economic migrants during the pre-migration, mid-migration and the post-migration periods. These categorizations may be useful to experts in the management of mental health problems based on each stage of the migration process and motives for migration.

This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of Anthropology. Please check back later for the full article. Refugees are understood as forcefully displaced people who flee conflict in their country of origin in search of safety in another country. Their international legal status is defined by the United Nations 1951 Refugee Convention complemented by the 1967 Protocol. To be recognized as a refugee, an individual must fulfill three conditions: fear of being persecuted for reasons of race, religion, nationality, membership in a particular social group, or political opinion; having crossed an international border and being outside his or her country of nationality; and having lost the protection of the country of origin. The United Nations High Commissioner for Refugees (UNHCR) has a mandate to provide protection and humanitarian assistance to some 20 million refugees, according to 2016 figures, and to promote the three solutions to their problem: voluntary repatriation in the country of origin; integration into the first country of asylum; resettlement in a third country. The more than 5 million Palestinian refugees fall under another set of texts and are supported by a separate agency, the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA). This body of international legal texts and practices has triggered the emergence of a whole set of studies in the social sciences. This new and distinctive field of research was further institutionalized when the Refugee Studies Centre was established in 1982 at the University of Oxford and when the Journal of Refugee Studies was launched a few years later. Anthropologists have played a significant role in these developments. Many have worked closely with humanitarian organizations assisting refugees on the ground, while many others have critically addressed the conceptual background of the notion, with its supposed state-centric and sedentarist bias, according to which solutions are found when movements stop. Refugees represent a practical and theoretical challenge for anthropology. Indeed, the figure of the refugee has been analyzed as a categorical anomaly that disrupts the functionalist idea that societies form coherent sets anchored in discrete territories. Is the refugee a distinct social type with specific protection needs, or does it result from a bureaucratic label that comes with potentially alienating consequences? Some authors insist that refugee studies have imported uncritically the legal and humanitarian terminology of governments as well as international and nongovernmental organizations. Some others consider that theory and practice should inform each other. This debate may call into question any sharp distinction between applied and fundamental research. Refugees are a field of study for anthropologists, but they also represent an opportunity for jobs. If there is little doubt that anthropology might inform the way refugees are assisted, a fundamental question is also how engagement with humanitarian action and post-conflict reconstruction will affect anthropological practice as well as theory. While 85 percent of the world’s forcefully displaced people are in developing countries, the so-called European refugee crisis of 2015 has attracted much attention. Among the many topics addressed in the first decades of the 21st century, let us mention the social meaning of the legal notions of asylum and refuge; refugees living in camps and so called self-settled refugees in urban centers; return; strategies developed by the people labeled as refugees and their capacity to respond to the situation they face; the long-term process of cultural adjustment; and memory of the country of origin and feeling of belonging.

&lt;p&gt;The International Organization for Migration (IOM) and the United Nations High Commissioner for Refugees (UNHCR) return crisis-affected populations as part of their humanitarian interventions under the assumption that return represents a solution to the initial displacement. This assumption raises the question of how IOM and UNHCR problematize crisis-affected populations, that is, conceptualize them as a policy problem through policy documents reflecting implicit rationalities of government. Based on Foucault’s concepts of discipline and biopolitics and Bacchi’s approach to critical discourse analysis, this working paper examines the disciplinary and biopolitical rationalities of two policy documents. First, the IOM Migration Crisis Operational Framework (MCOF) draws on disciplinary rationality to outline a process of successive immobilization and mobilization of crisis-affected populations during which IOM monitors, cares for, transports, and immobilizes individuals in their countries of origin. Second, the UNHCR Policy Framework builds on a biopolitical rationality to elicit spontaneous returns of populations by reshaping the milieu of return through constructing infrastructure and restoring social services. However, each policy document combines both disciplinary and biopolitical rationalities. The MCOF strives to durably immobilize returnees by reshaping their milieu through infrastructure construction and resolution of land and property issues. The Policy Framework seeks to achieve durable returns by securing the milieu of return by restoring the nation-state’s disciplinary institutions. This complementarity between disciplinary and biopolitical rationalities indicates that IOM and UNHCR expanded their role in return governance to shape the economic, social, security and, ultimately, political conditions in the countries of return. &lt;/p&gt;

Displaced persons are Refugees, cross borders under coercion by force, leave motherland and difficult to return safely to home of parents. Root word is ‘refuge’ from which ‘refugee’ is derived, it means hiding and shelter from danger. Pakistan is not signatory of Refugee Convention 1951 but member of the United Nations (UN). Afghan refugees are living in Pakistan for approximately four decades, the Government of Pakistan provides favorable treatment and atmosphere to Afghan Refugees in Pakistan. Resultantly, Pakistan has been suffering terrorism, political instability, and economic dropdown though after left of Unites States of America (USA) in 2021, many more Afghan Refugees are expected to migrate to Pakistan. International Community is required to work and ensure peace and stability in Afghanistan in order to ensure returning back of Afghan Refugees to their parent’s home safely and work for stability and peace of Afghanistan and the region so that they live there peacefully. According to Universal Declaration of Human Rights’ (UDHR) article 14: everybody has freedom and right to enjoy, seek asylum from persecution in other countries. Asylum right not invoked if (i) genuinely arising prosecutions from non-political crimes, or (ii) acts repugnant to principles and purposes of United Nations, and Convention Relating to Status of Refugee signed in 1951 under United Nations High Commissioner for Refugees (UNHCR). There are 145 signatories currently to Refugee Convention 1951 but Pakistan has not yet acceded to Refugee Convention 1951. According to Refugee Convention 1951 preamble: freedom under fundamental rights enjoyed by human beings under Charter of the UN and UDHR without discrimination. The UN has assured efforts to expand freedom under fundamental rights to refugees. Communitarian Critique research methodology is deployed to help understand issues of refugees. Qualitative methodology is used while conducting this research, an analytical and comparative methods to analyze and compare Government of Pakistan’s treatment of Afghan refugees in Pakistan approximately for 4 decades as compare to Syrian Refugees’ treatment by European Union (EU). The largest populated migrants refugee country of the world for 4 decades is Pakistan, approximately 5 million Afghan nationals migrated to Pakistan during Cold War and approximately around 1.3 million still living in Pakistan and they are not willing to go back to Afghanistan specially after withdrawal of USA in 2021. The International Community is required, requested, and suggested to wish, help, and endeavor to build up economies of Afghanistan and Pakistan and try to strengthen stability and peace so that remaining Afghan nationals who are living as refugees in Pakistan can go back to their motherland safely, happily, and live there peacefully.