Cluster analysis of prolonged grief, posttraumatic stress, and depression symptoms in bereaved asylum seekers and refugees.

Background: Refugees and asylum seekers (ASRs) are frequently exposed to loss in addition to a variety of other stressors and often display high levels of various psychological symptoms.Objective: The study aimed to primarily determine clusters of prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and depression symptoms in bereaved ASRs and secondly identify predictors of cluster membership. Sociodemographic  - and flight-related variables were investigated in exploratory analyses.Method: ASRs in Germany (N = 92) with interpersonal loss exposure, i.e. at least one missing or deceased relative or friend, were assessed with interview-based questionnaires for PGD, PTSD, and depressive symptoms. We used k-means cluster analysis to distinguish symptom profiles and logistic regression analyses to identify predictors of cluster membership.Results: We found a three-cluster-solution. The PGD-cluster (30%) was characterised predominantly by PGD symptoms, while the PGD/PTSD-cluster (32%) had high PGD and PTSD and moderate depressive symptoms. The resilient cluster (38%) showed low symptoms overall. insecure residence status predicted membership in the PGD and PGD/PTSD clusters relative to the resilient cluster, whilst higher attachment anxiety predicted membership in the PGD/PTSD cluster relative to the other clusters. Explorative analysis revealed duration of stay as a significant predictor.Conclusion: Findings can extend the current knowledge about different symptom profiles among bereaved ASRs in Europe. Insights to attachment  - and migration-related variables distinguishing between these profiles offer starting points for interventions.

Bereaved asylum seekers and refugees in Germany can be grouped into three symptom clusters: (1) predominantly prolonged grief, (2) high prolonged grief, high posttraumatic stress, and moderate depressive symptoms, and (3) low symptom load.Attachment  ­ and migration-related variables (i.e. residence status, duration of stay, and attachment anxiety) distinguish between cluster membership.Results highlight the importance of attending to profiles and not only single categories of symptoms and attachment features in bereaved asylum seekers and refugees.

Seroprevalence status of vaccine-preventable diseases in migrants living in shelter centers in Barcelona, Spain.

INTRODUCTION: Almost 281 million people were living in a foreign country in 2022, and more than 100 million were displaced because of war conflicts and human right violations. Vaccination coverage of infectious diseases in migrants from some disadvantaged settings could be lower than reception countries populations, consequently seroprevalence studies and better access to vaccination could contribute to reducing these differences. METHODS: A descriptive retrospective cross-sectional study was conducted including migrants, living ≤5 years in the reception country and ≥16 years old, who requested a medical exam between January 1st, 2020 and January 31st, 2021. Seroprevalence assessment was performed, and vaccination was offered to those individuals without immunity to hepatitis B, hepatitis A, varicella, measles, mumps, and rubella. RESULTS: A total of 315 migrants were attended during the study period. Immunity protection at arrival was 252/296 (85.1%) for measles, 274/295 (92.9%) for rubella, 257/296 (86.8%) for mumps, 264/295 (89.5%) for varicella, 267/313 (85.3%) for hepatitis A, and 104/300 (34.6%) for hepatitis B. The final immunity protection after full vaccination schedules was 278/296 (93.9%) for measles, 287/295 (97.3%) for rubella, 274/296 (92.6%) for mumps, 276/295 (93.6%) for varicella, 280/313 (89.5%) for hepatitis A, and 139/300 (46.3%) for hepatitis B. CONCLUSIONS: The vaccination intervention has increased immunity rates for the studied diseases in the attended migrants in our center, however, such interventions should be maintained to reach local population immunization levels. Moreover, the collaboration between shelter and reference specialized health centers is fundamental to implement such vaccination programs.

Effect of trauma on asylum seekers and refugees receiving a WHO psychological intervention: a mediation model.

Background: Scalable psychological interventions such as the WHO's Self-Help Plus (SH+) have been developed for clinical and non-clinical populations in need of psychological support. SH+ has been successfully implemented to prevent common mental disorders among asylum seekers and refugees who are growing in number due to increasing levels of forced migration. These populations are often exposed to multiple, severe sources of traumatisation, and evidence of the effect of such events on treatment is insufficient, especially for non-clinical populations.Objective: We aim to study the effect of potentially traumatic experiences (PTEs) and the mediating role of symptoms of posttraumatic stress disorder (PTSD) on the improvement following SH+.Method: Participants allocated to SH+ who received at least three sessions (N = 345) were extracted from two large, randomised, European prevention trials involving asylum seekers and refugees. Measures of distress, depression, functional impairment, and post-traumatic stress symptoms were administered at baseline and 6 months post-intervention, together with measures of well-being and quality of life. Adjusted models were constructed to examine the effect of PTEs on post-intervention improvement. The possible mediating role of PTSD symptoms in this relationship was then tested.Results: Increasing numbers of PTEs decreased the beneficial effect of SH+ for all measures. This relationship was mediated by symptoms of PTSD when analysing measures of well-being and quality of life. However, this did not apply for measures of mental health problems.Conclusions: Exposure to PTEs may largely reduce benefits from SH+. PTSD symptomatology plays a specific, mediating role on psychological well-being and quality of life of participants who experienced PTE. Healthcare professionals and researchers should consider the role of PTEs and PTSD symptoms in the treatment of migrants and refugees and explore possible feasible add-on solutions for cases exposed to multiple PTEs.

Increasing numbers of potentially traumatic experiences can decrease the beneficial effect of a manualized group psychotherapeutic intervention in migrants and refugees across multiple countries.In absence of a full threshold diagnosis of post-traumatic stress disorder, post-traumatic stress symptoms still mediate the relation between potentially traumatic experiences and some outcome improvements at follow-up.While the moderating role of number of potentially traumatic experiences applies to all outcomes (depression symptoms, psychological distress, functional impairment, well-being, and quality of life), the mediating role of post-traumatic stress symptoms in this relation only applies to well-being and quality of life.

A qualitative evaluation of the use of Problem Management Plus (PM+) among Arabic-speaking migrants with psychological distress in France - The APEX study.

ABSTRACTBackground: Feasibility studies with non-French speaking migrants in France are needed to inform appropriate adaptation of psychosocial intervention procedures.Objective: To test the WHO Problem Management Plus (PM+) intervention protocol for Arabic-speaking migrants in the Paris metropolitan region.Methods: Between 2019 and 2021 we recruited participants from three accommodation centres receiving asylum seekers or migrants experiencing social and economic difficulties. Participants experiencing psychological distress underwent five PM + sessions with trained helpers. Feasibility was evaluated through 15 interviews with 8 participants, 4 helpers, and 3 study supervisors. Interview topics covered PM + implementation in general and for each component. We also sought to understand problems with delivery and gathered suggestions for improvement. Data were analysed thematically using a deductive approach.Results: We found implementation of PM + to be feasible, with predominantly positive reactions from participants, helpers and study staff. All intervention components were considered beneficial, with breathing exercises considered easy to implement and often sustained. Selection of problems and strategies to address them were described as challenging to execute. Psychosocial support from and rapport with helpers and the use of the native language were considered key strengths of the programme. However, we observed the need for complementary or higher intensity psychological support in some cases. Findings also highlighted the importance of addressing distress among non-specialist helpers delivering PM + . Finally, local guidance to social resources were suggested to be added in the protocol.Conclusion: PM + was well-liked and feasible, with cultural adjustments and increased access to community resources for migrants needed.

The World Health Organization Problem Management Plus (PM+) intervention was found to be a feasible and acceptable intervention for Arabic-speaking migrants in the Paris metropolitan region, with participants reporting improved mental health outcomes and satisfaction with the programme.The features of psychosocial support from and rapport with non-specialist helpers delivering PM + and the use of the native language were considered key strengths of the programme.The study documented perceived benefits of expanding PM + in scope and length, suggests the need for additional mental health services for non-specialist helpers, and highlights the importance of considering cultural and linguistic factors when providing mental health services to asylum seekers or migrants experiencing social and economic difficulties.

Complex posttraumatic stress disorder in intergenerational trauma transmission among Eritrean asylum-seeking mother-child dyads.

Background: Traumatic stress among forcibly displaced people has a variety of adverse consequences beyond individual mental health, including implications for poor socioemotional developmental outcomes for their children post-displacement.Objective: This study explored the intergenerational transmission of maternal ICD-11 Complex Posttraumatic Stress Disorder (CPTSD) and depression among asylum-seeking mothers for their children's internalizing and externalizing difficulties.Method: Participants were 127 trauma-affected Eritrean mothers of preschool-aged children in Israel. The severity of child difficulties was compared between mothers with probable ICD-11 CPTSD (94.5% comorbid depression), ICD-11 PTSD (48.5% comorbid depression), unimorbid depression, and healthy mothers, using multivariate analyses of variance, while controlling for children's direct exposure to adverse life experiences.Results: Probable ICD-11 CPTSD and PTSD were present in 23.6% and 26.0% of mothers, respectively. Relative to maternal PTSD, CPTSD was significantly and strongly associated with elevated child internalizing symptoms (d = 2.44) and marginally significantly, although strongly, associated with child externalizing symptoms (d = 1.30). Post-hoc exploratory analyses documented that, relative to maternal PTSD and depression, CPTSD and depression comorbidity was marginally significantly but strongly associated with child internalizing (SMD = .67), but not externalizing symptoms (SMD = .35).Conclusions: Findings implicate maternal CPTSD and comorbid depression in child socio-emotional development and inform clinical assessment, prevention, and intervention to attenuate poor development among children in unstable post-displacement settings.

Trauma among forcibly displaced people has a variety of aversive multisystemic consequences, compromising the socioemotional development of non-exposed children.ICD-11 complex posttraumatic stress disorder (CPTSD) and comorbid depression may be functionally important to elevated risk for maternal intergenerational trauma transmission, even relative to ICD-11 posttraumatic stress disorder (PTSD).To effectively attenuate intergenerational transmission of trauma post-displacement, efforts and resources should be invested in maternal mental health care as well as socio-culturally adapted, trauma-sensitive parenting training.

Translation and validation of the Dari International Trauma Questionnaire (ITQ) in Afghan asylum seekers and refugees.

Background: The International Trauma Questionnaire (ITQ) is a standardized and validated measure aligned with the 11th version of the International Classification of Diseases (ICD-11) diagnostic criteria to assess post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD). It has been translated into 25 different languages, but is yet to be translated into Dari and validated for use in the Afghan population.Objective: This study aimed (1) to translate and culturally adapt the ITQ for use in Dari; (2) to assess the construct validity and composite reliability of ICD-11 PTSD and CPTSD using the Dari ITQ; and (3) to examine the concurrent, convergent, and discriminant validity of the Dari ITQ.Method: The Dari ITQ was validated through the completion of a set of standardized measures by 305 Afghan asylum seekers and refugees in Austria. Factorial analyses and psychometric properties of the Dari ITQ were assessed using confirmatory factor analysis (CFA), bivariate correlations, and multivariate regression.Results: Asylum seekers showed significantly higher levels of ICD-11 CPTSD symptomatology and probable diagnoses of ICD-11 PTSD, Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) PTSD, anxiety, depression, and psychological distress in comparison to refugees. CFA results supported the two-factor second-order model comprised of the PTSD and disturbances in self-organization (DSO) as the best fit to the data. The psychometric adequacy of this model in the Dari ITQ was evidenced by high factor loadings and excellent internal reliability. The Dari ITQ showed satisfactory concurrent, convergent, and discriminant validity.Conclusion: The current study supports the statistical validity and cultural sensitivity of the Dari ITQ in identifying symptoms of ICD-11 PTSD and CPTSD among Afghan asylum seekers and refugees.

This study provides the first translation and validation of the ITQ in Dari with an Afghan refugee population in Austria.The two-factor second-order model was supported as the best fit to the data.Additional support for the composite reliability, and concurrent, convergent, and discriminant validity was provided, suggesting the statistical validity and cultural sensitivity of the Dari ITQ in identifying symptoms of ICD-11 PTSD and CPTSD among Afghan asylum seekers and refugees.

[Profile and indicators of long-stay establishments for older adults in Chile]. / Perfil e indicadores de los establecimientos de larga estancia para adulto mayor en Chile.

BACKGROUND AND OBJECTIVE: In this article we sought to characterize the Long Stay Establishments for the Elderly in Chile, besides presenting the services offered in the public and private. MATERIAL AND METHODS: It is a quantitative, cross-sectional descriptive study, with secondary information source. We analyze all establishments in the country registered with the National Service of the Elderly. As of November 2015, a total of 724 establishments were registered and distributed in 169 neighborhoods throughout the country in which 16,985 adults aged 60 and over were institutionalized. RESULTS: Most of the establishments (65.9% [n=246/724]) are private, 47.5% of them (n=344/724) are located in the metropolitan region of Santiago. Of the residents' health, only 26.5% are considered functional brave, 28.3% are physically handicapped and 8.8% are mentally handicapped. Most establishments offer manual activities, physical exercises, memory classes, cultural classes and recreational or touristic tours. Proportionally of the activities offered were mostly private ones. CONCLUSIONS: In Chile, most of the establishments are private, located in the metropolitan region where there is the largest supply deficit of this type of service, with an occupancy rate of 90.7%, with 72.4% women and almost half 47.7% with some physical or psychic dependence.

Welcome, how are you doing? - towards a systematic mental health screening and crisis management for newly arriving refugees.

Background: Compared to the general German population, refugees in Germany are a high-risk group for trauma spectrum disorders. Currently, many barriers exist for the implementation of a screen-and-treat approach for mental disorders as part of the routine health care provision during the early stage of the immigration process.Objective: The aim of the present study was to develop and test a systematic screening approach to identify individual refugees in need of mental health care during the initial immigration phase.Method: 167 newly arrived refugees underwent a screening interview with the Refugee Health Screener (RHS) carried out by Intercultural Therapy Assistants (ITAs). The ITAs were super-vised by psychologists at a reception centre in Bielefeld, Germany. A subsample of 48 persons partici-pated in clinical validation interviews.Results: Findings demonstrated the need for and feasibility of a systematic screening during the initial immigration phase. However, established cut-off values of the RHS had to be adapted and the screening procedure had to be adjusted due to the needs of a significant number of refugees in severe psychological crises.Conclusion: A systematic screening that is applied shortly after arrival facilitates the early identification of refugees at risk of developing mental disorders and may be helpful to prevent chronic symptom development and an aggravation of psychological crises.

A systematic complementary screening procedure during the initial immigration phase was found to be useful for the identification of refugees in need of mental health care.The procedure could be implemented both safely and efficiently in conjunction with the initial medical check-up for recently arrived refugees.Responding to the needs of the refugees immediately following their arrival in Germany, we adjusted the cut-off of the screening instrument and suggest to explicitly include a detection procedure for severe psychological crises.

Perfil e indicadores de los establecimientos de larga estancia para adulto mayor en Chile / Profile and indicators of long-stay establishments for older adults in Chile

Antecedentes y objetivo: En este artículo sé buscó caracterizar los establecimientos de larga estancia para adultos mayores (ELEAM) de Chile, además de presentar los servicios ofrecidos en lo público y en lo privado. Material y métodos: Se trata de un estudio cuantitativo, transversal descriptivo, a través de fuente de información secundaria. Analizamos todos los ELEAM del país registrados en el Servicio Nacional del Adulto Mayor (SENAMA). Hasta noviembre de 2015 un total de 724 ELEAM estaban registrados y distribuidos en 169 comunas alrededor del país, en los cuales estaban institucionalizados 16.985 adultos con edad a partir de los 60años. Resultados: La mayoría de los ELEAM (65,9% [n=344/724]) son privados. Entre ellos, el 47,5% (n=246/724) están localizados en la región metropolitana de Santiago. De la salud de los residentes, apenas el 26,5% son considerados autosuficientes funcionales, el 28,3% son deficientes físicos y el 8,8%, deficientes psíquicos. La mayoría de los establecimientos ofrecen actividades manuales, ejercicios físicos, clases de memoria, clases culturales y paseos recreativos o turísticos. Proporcionalmente, la mayoría de las actividades ofrecidas eran privadas. Conclusiones: En Chile la mayor parte de los establecimientos son de carácter privado, ubicados en la región metropolitana, donde se encuentra un mayor déficit de oferta de este servicio, con una tasa de ocupación del 90,7%, siendo el 72,4% mujeres, y casi la mitad (47,7%) con alguna dependencia física o psíquica. (AU)

Background and objective: In this article we sought to characterize the Long Stay Establishments for the Elderly in Chile, besides presenting the services offered in the public and private. Material and methods: It is a quantitative, cross-sectional descriptive study, with secondary information source. We analyze all establishments in the country registered with the National Service of the Elderly. As of November 2015, a total of 724 establishments were registered and distributed in 169 neighborhoods throughout the country in which 16,985 adults aged 60 and over were institutionalized. Results: Most of the establishments (65.9% [n=246/724]) are private, 47.5% of them (n=344/724) are located in the metropolitan region of Santiago. Of the residents’ health, only 26.5% are considered functional brave, 28.3% are physically handicapped and 8.8% are mentally handicapped. Most establishments offer manual activities, physical exercises, memory classes, cultural classes and recreational or touristic tours. Proportionally of the activities offered were mostly private ones. Conclusions: In Chile, most of the establishments are private, located in the metropolitan region where there is the largest supply deficit of this type of service, with an occupancy rate of 90.7%, with 72.4% women and almost half 47.7% with some physical or psychic dependence. (AU)

Nursing students' experiences and perspectives on institutional care for elderly in totally dependent persons / Experiencias y perspectivas de estudiantes de enfermería sobre cuidado geriátrico institucionalizado en personas con dependencia total

ABSTRACT Objective: To learn the perspectives of nursing students on geriatric care provided in a public home for the aged. Method: Qualitative study - grounded theory. Nineteen students who performed social service at a home for the aged between 2020 and 2021 in the state of San Luis Potosí, Mexico, were interviewed based on the criteria of theoretical saturation. The analysis was based on Strauss and Corbin's proposal and was triangulated with the field diary records. Results: the central emerging category was "Non-humanistic care", the organization and implementation of care obey more to administrative issues and protocols developed from the biomedical medicalizing paradigm. Conclusion: the perspectives dehumanize care, there is no recognition of people's autonomy, and the nursing staff shows weaknesses in psychosocial competences to relate to this population.

RESUMEN Objetivo: conocer las perspectivas de estudiantes de enfermería, sobre el cuidado geriátrico que se brinda dentro de un asilo público. Método: estudio cualitativo-teoría fundamentada. Se entrevistó con base en el criterio de saturación teórica a 19 estudiantes que realizaban servicio social en el asilo entre 2020 y 2021 en el estado de San Luis Potosí, México. El análisis se hizo desde la propuesta de Strauss y Corbin, y se trianguló con los registros en diario de campo. Resultados: la categoría central emergente fue "El cuidado no humanístico", la organización e implementación de los cuidados obedecen más a cuestiones administrativas y protocolos desarrollados desde el paradigma biomédico medicalizante. Conclusión: las perspectivas deshumanizan el cuidado, no hay reconocimiento de la autonomía de las personas y el personal de enfermería muestra debilidades en competencias psicosociales para relacionarse con esta población.

Violências relatadas por solicitantes de refúgio atendidos na Cáritas Arquidiocesana do Rio de Janeiro de 2010 a 2017 / Violence reported by asylum seekers assisted by the Archdiocesan Caritas of Rio de Janeiro from 2010 to 2017 / Violencias relatadas por solicitantes de asilo asistidos por la Cáritas Arquidiocesana de Río de Janeiro desde 2010 hasta 2017

Resumo Estima-se que no mundo, atualmente, haja 89,3 milhões de pessoas em deslocamentos forçados, incluindo 27,1 milhões de refugiados. Entre as razões para essas migrações forçadas estão a tortura e outras formas de violência, embora a prevalência de violências antes e durante a migração ainda seja pouco conhecida. O objetivo deste estudo é analisar a prevalência e alguns fatores associados às violências relatadas por solicitantes de refúgio no Rio de Janeiro. Foram coletados dados preenchidos nos formulários de solicitação de refúgio do Comitê Nacional para Refugiados de 2010 a 2017 e em entrevistas adicionais conduzidas na Cáritas Arquiocesana-RJ. Foram incluídos 1.546 solicitantes de refúgio com idade mediana de 30 anos (faixa 15-72 anos), dos quais 65% eram homens. Um terço informou ter sofrido violência antes de chegar ao Brasil, com chances de violência relatada entre 20 e 40 vezes maiores entre migrantes oriundos de Paquistão, Congo, Colômbia, República Democrática do Congo e Guiné. Violência física/tortura, ameaça e violência psicológica foram as mais frequentes (relatadas por 10%, 7% e 6% da população estudada, respectivamente). Entre as mulheres, a violência sexual foi a modalidade mais frequente (9%). Conclui-se que a história de violência entre os solicitantes de refúgio no Brasil é frequente, em particular para alguns grupos nacionais, aspecto a ser considerado no acolhimento e na prestação de serviços a essa população em situação de extrema vulnerabilidade.

Abstract Currently, the world has 89.3 million forcibly displaced people, including 27.1 million refugees. Among the reasons for displacement are torture and other forms of violence, but the real prevalence of violence before and during migration is poorly reported. The aim of this study is to analyze the prevalence of reported violence among asylum seekers in Rio de Janeiro and its associated factors. We collected secondary data from individuals who filled out the National Committee for Refugees' asylum application forms from 2010 to 2017 and responded to the social interview at Cáritas-RJ. We included 1,546 asylum seekers with a mean age of 30 (range 15-72), 65% of whom were men. One third reported experiencing violence before arriving in Brazil. Chances of experiencing violence were 20 to 40 times higher among refugees arriving from Pakistan, Congo, Colombia, the Democratic Republic of Congo and Guinea. Physical violence/torture and psychological threats were the most frequent forms (10%, 7% and 6% of the population, respectively). Among women, sexual violence was the most frequent form of violence (9% of women). We conclude that asylum seekers in Brazil frequently suffered violence before their arrival, particularly some groups. This needs to be addressed when providing services to this extremely vulnerable population.

Resumen Actualmente, hay en el mundo 89,3 millones de personas desplazadas por la fuerza, incluidos 27,1 millones de refugiados. Entre las razones de desplazamiento forzado están la tortura y otras formas de violencia, pero la prevalencia real de la violencia antes y durante la migración ha sido poco estudiada. El objetivo de este estudio es analizar la prevalencia de violencia reportada entre los solicitantes de asilo en Río de Janeiro y los factores asociados a esta. Recolectamos datos secundarios de personas que completaron los formularios de solicitud de asilo del Comité Nacional para Refugiados desde 2010 hasta 2017 y de entrevistas adicionales en Cáritas RJ. Incluimos a 1546 solicitantes de asilo con una edad media de 30 (15-72) años, de los cuales 65 % eran hombres. Un tercio informó haber experimentado violencia antes de llegar a Brasil, con posibilidades de violencia de entre 20 a 40 veces mayores para entre migrantes oriundos de Pakistán, Congo, Colombia, República Democrática del Congo y Guinea. Violencia/tortura física, amenazas y violencia psicológica son las formas más frecuentes (10 %, 7 % y 6 % respectivamente) relatadas. Entre las mujeres, la más frecuente fue la violencia sexual (9 % de los relatos). Concluimos que la historia de violencia entre los solicitantes de asilo en Brasil es frecuente, sobre todo en algunos grupos nacionales en particular, aspecto que se debe considerar al prestarle servicios a esta población extremadamente vulnerada.

Asociación entre la condición oral y sistémica con la calidad de vida en salud bucal de adultos mayores institucionalizados en Recoleta. Estudio piloto / Association between oral and systemic condition and oral health-related quality of life of older people in Recoleta. Pilot study

Objetivo: Evaluar la asociación entre la condición oral y sistémica con la calidad de vida relacionada a salud bucal de adultos mayores institucionalizados en un hogar en Recoleta, Santiago. Material y método: En el presente estudio piloto de corte transversal, se realizó un examen intraoral y se aplicó la encuesta OHIP-7Sp a adultos mayores internados en la residencia Mi Hogar. Además, se revisaron las fichas médicas de los participantes para el registro de sus enfermedades y fármacos. Los datos fueron analizados a través del test t, test de Mann-Whitney y regresión logística considerando un valor p < a 0.05 como estadísticamente significativo. Resultados: 20 adultos mayores cumplieron los criterios de inclusión, 11 hombres y 9 mujeres, con un rango de edad entre 65 y 88 años. Se encontró asociación clínica entre la condición oral (p=0.06), salud general (p=0.2) y calidad de vida asociada a salud bucal en los adultos mayores. Conclusión: La condición oral, salud general y calidad de vida asociada a salud bucal de los adultos mayores se consideró deficiente. Se requieren estudios posteriores con una mayor muestra para lograr establecer una significancia estadística de las variables y así, proponer intervenciones para mejorar las condiciones de salud de los adultos mayores institucionalizados.

Aim: To evaluate the association between the oral and systemic condition and the oral health-related quality of life of institutionalized older people in a retirement home in Recoleta, Santiago. Material and method: In the present pilot, non-experimental, cross-sectional and descriptive study, an oral examination was performed, alongside with the OHIP-7Sp survey to the individuals that meets the inclusion criteria. In addition, the medical history of the participants was reviewed to record the diseases under treatment and the drugs in use. Results: 20 individuals met the inclusion criteria, 11 men and 9 women with ages ranging between 65 and 88 years. There was a clinical association between oral condition, general health and oral health-related quality of life related to oral health in the oelder people of thefrom the residence retirement home of in Recoleta. A statistical significance was not established. Conclusion: The oral condition, general health and quality of life related to oral health was were deficient. Subsequent studies with a larger sample are required to establish a statistically significant relationship of between the variables in order to propose different solutions.

Envelhecimento e poética de atenção às formas de vida / Aging and poetics of attention to life forms / Envejecimiento y poética de atención a las formas de vida

Este artigo discute a possibilidade de uma poética de cuidado e atenção às formas de vida em uma instituição de longa permanência para idosos. O texto ancora-se em uma etnografia que ocorreu em um abrigo para idosos, realizada por meio de observação participante, entrevistas e acompanhamento da vida cotidiana. Durante o trabalho de campo, uma das atividades centrais era um Círculo de Leitura promovido pela instituição. Ao acompanhar essas atividades, a literatura provocava os afetos e memórias dos participantes e constituiu uma forma de cuidado e produção de saúde. Nesse contexto, ler e rememorar também era produzir saúde. Procurando analisar as vivências no Círculo de Leitura, o texto indaga o que pode a literatura e quais experiências provocam. A busca é por entender como a literatura afeta os idosos.(AU)

This article discusses the potential of poetics of care in a long-term care facility for older persons. The text is anchored in an ethnography conducted in a care home using participant observation, interviews, and accompanying day-to-day life in the home. One the central activities during field work were reading circles organized by the home. It was observed that the literature triggered affects and memories among the participants and constituted a form of care and production of health. Within this context, reading and reminiscing also produce health. Analyzing the experiences of the reading circles, the text explores the potential of literature and the experiences provoked by reading, seeking to understand how it affected the residents.(AU)

El objetivo de este artículo es discutir la posibilidad de una poética de cuidado y atención a las formas de vida en una institución de larga permanencia para ancianos. El texto está anclado en una etnografía que ocurrió en un asilo para ancianos, realizada por medio de observación participante, entrevistas y acompañamiento de la vida cotidiana. Durante el trabajo de campo, una de las actividades centrales era un círculo de lectura promovido por la institución. Al acompañar esas actividades, la literatura provocaba los afectos y memorias de los participantes y se constituyó como forma de cuidado y producción de salud. En ese contexto, leer y rememorar también era producir salud. Buscando analizar las vivencias en el círculo de lectura, el texto indaga lo que puede la literatura y cuáles son las experiencias que provoca. La búsqueda es entender de qué forma la literatura afectaba a los ancianos.(AU)

Movimento feminista e antimanicomial: uma análise das lutas por direitos em uma sociedade capitalista-patriarcal / Feminist and anti-asylum movement: an analysis of fights for rights in capitalist-patriarchal society / Movimiento feminista y movimiento contra el asilo: un análisis de la lucha por los derechos en una sociedad capitalista-patriarcal

O presente artigo tem como objetivo traçar um paralelo entre o movimento feminista e o movimento antimanicomial procurando pontos de convergência e divergência entre ambos, a fim de verificar suas possíveis articulações. Para isso, por meio de revisão bibliográfica, busca-se contextualizar os movimentos sociais e realizar a análise histórica de ambos, afim de esclarecer suas motivações, formas de atuação na luta por direitos e atendimento de demandas dos sujeitos envolvidos com pretensões de alcançar transformações sociais. Dessa forma, o material discute as confluências e divergências entre o movimento feminista e antimanicomial, na tentativa de ampliar e construir o debate acadêmico acerca do assunto, que se transforma diariamente, de modo democrático e dialético. À guisa de conclusão, considera-se a necessidade de constituir novas formas de pensar sobre nossa condição histórica, com intuito de que isso possibilite a criação de estratégias de reinvenção e recriação constante de coletivos de luta e que promovam movimentos de resistências aos poderes instituídos que submetem mulheres e sujeitos em sofrimento psíquico, com objetivos de constituir mudanças e responsabilização social para que os absurdos tolerados por parcela considerável da sociedade não se reproduzam.(AU)

The present study aims to draw a parallel between the feminist and the anti-asylum movements looking for convergence and divergence points between both, in order to verify their possible articulations. To do so, through bibliographic review, it seeks to contextualize the social movements and carry out the historical analysis of both, in order to clarify their motivations, ways of acting in the fight for rights and meeting the demands of the subjects involved with the pretensions of achieving social transformations. This way, this paper discusses the confluences and divergences between the feminist and anti-asylum movement, in an attempt to broaden and build the academic debate on the subject, which changes daily, in a democratic and dialectical way. By way of conclusion, it is considered the need to constitute new ways of thinking about our historical condition, in order to allow the creation of strategies of constant reinvention recreation of fight collectives and that it promotes resistance movements against instituted powers which subject women and individuals in psychological distress, with the goal to constitute changes and social responsability so that the absurdities tolerated by a considerable part of society are not reproduced.(AU)

El presente estudio tiene como objetivo comprender las posibles conexiones entre el movimiento feminista y el movimiento contra el asilo buscando puntos de convergencia y divergencia entre ambos, con el fin de verificar sus posibles articulaciones. Para esto, a través de la revisión bibliográfica, se busca contextualizar los movimientos sociales y realizar el análisis histórico de ambos para aclarar sus motivaciones, formas de actuar en la lucha por los derechos y atender las demandas de los sujetos involucrados con las pretensiones de logrando transformaciones sociales. De esta manera, este trabajo discute las confluencias y divergencias entre el feminismo y el movimiento contra el asilo, en un intento por ampliar el debate académico sobre el tema, que cambia a diario, de manera democrática y dialéctica. En conclusión, consideramos la necesidad de establecer nuevas formas de pensar sobre nuestra condición histórica, con la intención de posibilidad de creación de estrategias de reinvención y recreación constante de la lucha colectiva y que promueva movimientos de resistencia a los poderes establecidos que someten a las mujeres y individuos en malestar psicológico, con fines constitutivos de cambios y responsabilidad social para que no se reproduzcan los absurdos tolerados por una parte considerable de la sociedad.(AU)

La laborterapia, entre el tratamiento de la locura, la crisis institucional y la legitimación profesional en el Open Door de Oliva. Córdoba, Argentina, 1914-1940 / Labor therapy, between the treatment of madness, institutional crisis and professional legitimation in the Open Door of Oliva. Córdoba, Argentina, 1914-1940 / A terapia do trabalho, entre o tratamento da loucura, a crise institucional e a legitimação profissional na Open Door de Oliva. Córdoba, Argentina, 1914-1940

RESUMEN A principios del siglo XX, la laborterapia fue la modalidad terapéutica más extendida para el tratamiento de la locura dentro de las instituciones Open-Door argentinas. En el caso del Asilo-Colonia de Alienados de Oliva la historiografía reveló que su implementación constituyó el eje de funcionamiento institucional desempeñando un papel clave en el sostenimiento económico del establecimiento y en el disciplinamiento de los/as pacientes. Sin embargo, en los años 30, el equipo de psiquiatras de Oliva sostuvo una agenda de intercambios teóricos con distintos colegas que permiten complejizar aquella visión asociada a la ausencia de criterios científicos. En el marco del proceso de profesionalización disciplinar los alienistas buscaron nuevos referentes teóricos para reconceptualizar la técnica. El presente trabajo analiza los fundamentos de la aplicación de la terapéutica entre 1914-1940, en vinculación a los procesos de legitimación profesional de los años 30. Se abordan las publicaciones científicas de los psiquiatras del establecimiento profundizando en los diálogos sostenidos con un colega brasileño, los cuales, sin negar lógicas de poder, permiten aseverar que los fundamentos de la aplicación del tratamiento, excedieron cuestiones disciplinarias y económicas.

ABSTRACT At the beginning of the 20th century, labor therapy was the most widespread therapeutic modality for the treatment of madness within Argentine Open-Door institutions. In the case of the Asilo-Colonia de Alienados de Oliva, historiography revealed that its implementation constituted the axis of institutional functioning, playing a key role in the economic sustainability of the establishment and in the discipline of the patients. However, in the 1930's, the team of psychiatrists from Oliva held an agenda of theoretical exchanges with different colleagues that allowed them to make complex that vision that lacked scientific criteria. Within the framework of the process of disciplinary professionalization, the especialists sought new theoretical references to reconceptualize the technique. The present work analyzes the foundations of the application of therapeutics between 1914-1940, in connection with the processes of professional legitimization of the 1930s. The scientific publications of the establishment's psychiatrists are addressed, deepening the dialogues held with a Brazilian colleague, which, without denying power logics, allow asserting that the foundations of the application of the treatment exceeded disciplinary and economic issues.

RESUMO No início do século XX, a terapia do trabalho era a modalidade terapêutica mais difundida para o tratamento da loucura dentro das instituições Open-Door argentinas. No caso da Asilo-Colonia de Alienados de Oliva, a historiografia revelou que sua implementação constituiu o eixo do funcionamento institucional, desempenhando um papel fundamental no apoio econômico do estabelecimento e na disciplina dos pacientes. Entretanto, na década de 1930, a equipe de psiquiatras de Oliva realizou uma agenda de trocas teóricas com diferentes colegas que lhes permitiu complexificar aquela visão que carecia de critérios científicos. No âmbito do processo de profissionalização disciplinar, os psiquiatras buscaram novas referências teóricas para reconceptualizar a técnica. O presente trabalho analisa os fundamentos da aplicação da terapêutica entre 1914-1940, em conexão com os processos de legitimação profissional dos anos 30. São abordadas as publicações científicas dos psiquiatras do estabelecimento, aprofundando os diálogos realizados com um colega brasileiro, que, sem negar a lógica do poder, permitem afirmar que os fundamentos da aplicação do tratamento superaram as questões disciplinares e econômicas.

Maltrato al adulto mayor institucionalizado - una revisión sistemática / Institutionalized maltreatment to the elderly adult - a systematic review

Resumen Introducción: El maltrato al adulto mayor va en incremento y se identifica de distintas formas. Objetivo: Conocer el panorama del maltrato al adulto mayor institucionalizado y a partir de una revisión sistemática de literatura, identificar causas, tipos, principales características y signos diagnósticos de violencia a esta población, en instituciones prestadoras de servicio de salud o alojamiento para ellos. Metodología: Revisión de literatura internacional en español e inglés sobre el maltrato del adulto mayor en diferentes instituciones, en las bases de datos: Scielo, Medgraphic literatura biomédica, Redalyc, Science direct, Pubmed, Scopus, Dialnet, Base y Redib, bajo la metodología PRISMA. Resultados: Se revisaron 301 referencias que muestran incidencia del maltrato al adulto mayor institucionalizado, características y consecuencias, esto permitió hacer un balance de las causas, tipos, signos y síntomas del maltrato que frecuentemente se presentan. Conclusión: El maltrato en ancianos es un problema de salud pública y social que deja graves consecuencias en la calidad de vida del adulto mayor y representa un reto para la atención en salud.

Abstract Introduction: Elder abuse is increasing and it is identified in different ways. Objective: To learn about the panorama of institutionalized elder mistreatment from a systematic literature review, identify causes, types, main characteristics, and diagnostic signs of violence in this population, in institutions which provides health services or housing for them. Methodology: Review of international literature in English and Spanish on elder abuse in different institutions in the following data bases: Scielo, Medgraphic biomedical literature, Redalyc, Science direct, Pubmed, Scopus, Dialnet, Base and Redib, under the PRISMA methodology. Results: A review of 301 references show the incidence of institutionalized elder abuse, characteristics, and consequences. This permitted a balance of the causes, types, signs, and symptoms of mistreatment that frequently occur. Conclusion: Elder abuse is a public and social health problem that has serious consequences on the quality of life of the elderly and represents a challenge for health care.

A Phenomenological Study on the Experience of Syrian Asylum-Seekers and Refugees in the United States.

Violence in Syria has displaced an unprecedented number of people from their homes. While couple/family therapy (C/MFT) scholars have explored migration experiences, particularly among refugees, there is still limited research using a bioecological framework. This exploratory study examined the experiences of Syrian asylum-seekers and refugees living in the United States using a qualitative phenomenological approach. Twelve Syrians (n = 8 men, n = 4 women) between 20 and 52 years of age (M = 35.8, SD = 10.7) were interviewed about their experiences across three stages of resettlement: (1) pre-resettlement, (2) resettlement/migration, and (3) post-resettlement. Findings suggest that the effects of conflict-induced displacement and resettlement permeate across multiple ecologies. These range from the individual and his or her interpersonal relationships to their larger community and society. C/MFTs should account for contextual factors while becoming familiar with the sociopolitical impact of displacement and resettlement in their clinical work with this population.

La violencia en Siria ha desplazado a un número de personas sin precedentes de sus hogares. Si bien los especialistas en terapia de pareja, conyugal y familiar han analizado las experiencias de migración; particularmente entre los refugiados, aun hay escasas investigaciones que usan un marco bioecológico. Este estudio exploratorio analizó las experiencias de los solicitantes de asilo y los refugiados sirios que viven en Estados Unidos utilizando un enfoque fenomenológico cualitativo. Se entrevistó a doce sirios (n = 8 hombres, n = 4 mujeres) de entre 20 y 52 años (M = 35.8, SD = 10.7) con respecto a sus experiencias en tres etapas del reasentamiento: (1) prereasentamiento, (2) reasentamiento/migración, y (3) posreasentamiento. Los resultados sugieren que los efectos del desplazamiento inducido por el conflicto, junto con el reasentamiento, penetran en las ecologías. Estos pueden variar desde la persona y sus relaciones interpersonales hasta su comunidad y sociedad más amplias. Por lo tanto, la terapia de pareja, conyugal y familiar debería justificar los factores contextuales y a la vez familiarizarse con el efecto sociopolítico del desplazamiento y el reasentamiento en su trabajo clínico con esta población.

"Nadie está preparado para escuchar lo que vi": atención de salud mental de refugiados y solicitantes de asilo en Chile / "No one seems ready to hear what I've seen": Mental health care for refugees and asylum seekers in Chile

RESUMEN El presente artículo analiza las necesidades de atención de salud mental de refugiados y solicitantes de asilo de origen latinoamericano en Chile, por medio de un estudio cualitativo descriptivo, realizado en 2018, desde la voz de las personas solicitantes de refugio y asilo (n=8), profesionales de salud que los atienden (n=4), y miembros de organismos e instituciones dedicados en la temática (n=2). Los hallazgos evidencian que las obligaciones asumidas por Chile, a través de la adhesión a tratados internacionales, no han logrado garantizar el ejercicio del derecho a la salud mental, entendida como parte del derecho universal de acceso a la salud. En lo particular, el artículo documenta la presencia tanto de barreras de acceso a la salud mental en migrantes solicitantes de refugio y asilo, como de factores de estrés posmigratorios que pueden acentuar el riesgo de estos grupos a sufrir trastornos emotivos. También se reporta la insuficiente instalación de capacidades de atención en los equipos de salud mental para abordar las consecuencias psíquicas de los episodios de violencia y persecución que están a la base de la migración forzada. Finalmente, el artículo discute la necesidad de estrechar la vinculación entre la salud mental -como derecho humano fundamental- y el derecho a la protección internacional.

ABSTRACT This article analyzes the results of a descriptive, qualitative study carried out in 2018 on the mental healthcare needs of Latin American refugees and asylum seekers in Chile, through the perspectives of refugees and asylum applicants (n=8), healthcare professionals responsible for delivery of care (n=4), and members of civil society organisations involved in this area (n=2). Our findings indicate that despite Chile's commitment to international treaties in this regard, little has been achieved in safeguarding the right to access to mental health care, understood as part of the universal right to health care access. This article documents barriers to mental health care access for migrants applying for asylum and refugee status. Post-migration stress factors may also increase the risk of emotional disorders within this group of people. Mental healthcare providers and teams are often not equipped with the tools to deal with the psychological consequences arising from the situations of violence and persecution associated with forced migration. Our study discusses the need to strengthen the link between mental health care - as a fundamental human right - and the right to international protection.

"De volta à cidade, sr. cidadão!" - reforma psiquiátrica e participação social: do isolamento institucional ao movimento antimanicomial / "De vuelta a la ciudad, el sr. ciudadano" - reforma psiquiátrica y participación social: del aislamiento institucional al movimiento antimanicomial / "Back to the city, Mr. citizen!" — psychiatric reform and social participation: from institutional isolation to the anti-asylum movement

Resumo O modelo manicomial produziu a exclusão da loucura da vida social, fundado no princípio do isolamento terapêutico, que gerou a institucionalização do louco e sua retirada da cidade e do direito à participação social, com a perda do direito à cidade e da condição de cidadania. Atualmente, a reforma psiquiátrica no Brasil é um dos mais importantes processos de crítica à psiquiatrização da loucura, promovendo uma desconstrução das formas de exclusão social da loucura e o debate na sociedade acerca dos direitos e da cidadania dos sujeitos em sofrimento mental e vulnerabilidade social. Diversas frentes inovadoras, de inclusão pelo trabalho, pela arte-cultura, pela militância política e de ocupação da cidade, têm configurado novas possibilidades de vida e expressão para os sujeitos, numa nova concepção sobre a loucura e a diferença, na qual os sujeitos da diversidade têm direito à cidade e à participação social.

Resumen El modelo de asilo produjo la exclusión de la locura de la vida social, fundado en el principio de aislamiento terapéutico, lo que llevó a la institucionalización de los locos y su retirada de la ciudad y la participación social, la pérdida del derecho a la ciudad y la ciudadanía. Actualmente, la reforma psiquiátrica en Brasil es uno de los procesos críticos más importantes para psiquiatrización de la locura, la promoción de una deconstrucción de las formas de exclusión social de la locura y el debate en la sociedad sobre la ciudadanía de las personas en la angustia mental y la vulnerabilidad. Varios frentes innovadores, la integración a través del trabajo, el arte, la cultura, el activismo político y la ocupación de la ciudad, han creado nuevas posibilidades de vida y expresión al sujeto, una nueva concepción de la locura y la diferencia en el cual los sujetos de la diversidad tienen derecho a la ciudad y la participación social.

Abstract The asylum model produced the exclusion of madness from social life, adopting the principle of therapeutic isolation, which led to the institutionalization of the person with mental suffering and their removal from the city and the social participation, subtracting from them the right to the city and the condition of citizenship. Currently, psychiatric reform in Brazil is one of the most important processes of criticizing the psychiatrisation of madness, promoting a deconstruction of the forms of social exclusion and the debate in society about the citizenship of the subjects in mental suffering and social vulnerability. Several innovative fronts, including work, art, culture, political activism and occupation of the city, have set new possibilities for life and expression for the people, in a new conception of madness and difference, in which the diversity of individuals have the right to the city and social participation.