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Public Health ; 121(1): 34-44, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17182071


OBJECTIVE: From August 1999 to July 2001, asylum seekers who had come to Switzerland from Kosovo were repatriated. The present study aimed to assess the relationship between living conditions during asylum in Switzerland and health status among returnees. STUDY DESIGN: Cross-sectional survey of 319 ethnic Albanian families in Kosovo, selected from a list of 12900 heads of households who had received repatriation aid. METHODS: Consenting household members aged 16 years or more who had received asylum in Switzerland were interviewed during the autumn of 2001. Questions explored living conditions during asylum, present socio-economic conditions (World Bank Kosovo Poverty Assessment Survey), subjective physical and mental health [Medical Outcomes Study 36-item Short Form Health Survey (SF-36)], traumatic events (Harvard Trauma Questionnaire) and symptoms of post-traumatic stress disorder (PTSD; Mini International Neuropsychiatric Interview). RESULTS: Ninety-four per cent of selected households were located. Among the 580 participants, 25.5% suffered from PTSD and 65% lived in extreme poverty. Subjective health scores, measured by SF-36, were low, particularly for those affected by PTSD. Among living conditions in the host country, duration of stay longer than 26 weeks was associated with lower mental health scores, particularly among people with PTSD. CONCLUSIONS: Two years after the conflict, returnees had low health scores. The association between duration of stay and lower mental health scores may reflect the stress of adapting to asylum or the consequence of compulsory repatriation. This study has implications for the emerging healthcare system in Kosovo and for policies of asylum in host countries.

Nível de Saúde , Inquéritos Epidemiológicos , Acontecimentos que Mudam a Vida , Refugiados/psicologia , Meio Social , Transtornos de Estresse Pós-Traumáticos/etnologia , Guerra , Adolescente , Adulto , Idoso , Albânia/etnologia , Atitude Frente a Saúde/etnologia , Estudos Transversais , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Refugiados/estatística & dados numéricos , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Suíça/epidemiologia , Fatores de Tempo , Iugoslávia/etnologia
J Trauma Stress ; 19(1): 57-67, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16568462


Studies conducted in high-income countries have demonstrated that posttraumatic stress symptoms are positively correlated with increased use of general health services; however, comparative data are lacking in postwar settings. This survey was conducted in Kosovo after the end of the conflict; 996 people, age 16 or older, were interviewed. Older age, lower education level, worse physical health, and current diagnosis of posttraumatic stress disorder (PTSD) were associated with higher use of any health services. After adjusting for gender, age, place of residence, type of education, poverty, refugee status, and subjective physical health, PTSD remained associated with an increased use of most health care services. Our results underline the importance of taking into account PTSD when restoring health services in postwar countries.

Serviços de Saúde/estatística & dados numéricos , Nível de Saúde , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/terapia , Guerra , Adolescente , Adulto , Fatores Etários , Escolaridade , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , População Rural/estatística & dados numéricos , Fatores Socioeconômicos , Transtornos de Estresse Pós-Traumáticos/psicologia , Inquéritos e Questionários , Iugoslávia/epidemiologia
J Nerv Ment Dis ; 192(10): 664-71, 2004 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-15457109


During the period from 1998 to 1999, more than 1 million civilians from the province of Kosovo in the Balkans were displaced as a consequence of organized violence and war. The aim of the present study was to determine the prevalence of posttraumatic stress disorder (PTSD) in a sample of the Albanian Kosovar population more than 2 years after the end of the conflict and to assess the effect of exposure to war-related events. A total of 340 households were randomly selected among 12,900 families returned from a country of asylum (Switzerland). All adults in each household were invited to participate (N = 996). The following instruments were used: the Albanian translations of the PTSD section of the Mini International Neuropsychiatric Interview and of the Medical Outcomes Study 36-Item Short Form, and a list of traumatic events adapted from the Harvard Trauma Questionnaire. The overall prevalence of PTSD was 23.5%. A strong cumulative effect of trauma was observed, with odds ratios for PTSD rising steeply with the number of events to which people were exposed. After taking into account traumatic events, multivariable analysis indicated that female gender, older age, and having left Kosovo during the conflict were significantly associated with higher frequency of PTSD, whereas significant heterogeneity among municipalities was observed. Stratified analysis for people who stayed and left the province during the war suggested that different patterns of trauma may be relevant in the two subsamples, with forced separation and isolation strongly associated with PTSD in people who stayed in Kosovo. PTSD diagnosis was also significantly associated with lower scores on all dimensions of the Medical Outcomes Study 36-Item Short Form and lower economic status. The results suggest that responding to medium-term and long-term mental health consequences of conflict is a necessary task for the global rehabilitation of health care systems in a war devastated country.

Grupos Étnicos/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/etnologia , Adolescente , Adulto , Fatores Etários , Idoso , Albânia/etnologia , Assistência à Saúde/organização & administração , Grupos Étnicos/estatística & dados numéricos , Feminino , Nível de Saúde , Humanos , Acontecimentos que Mudam a Vida , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Escalas de Graduação Psiquiátrica , Refugiados/psicologia , Refugiados/estatística & dados numéricos , Fatores Sexuais , Fatores Socioeconômicos , Inquéritos e Questionários , Violência/psicologia , Guerra , Iugoslávia/etnologia
Vaccine ; 21(5-6): 393-8, 2003 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-12531637


Switzerland has lagged behind other industrialized countries in increasing vaccination coverage against flu in the elderly population. The information campaign "United against Flu", started in Geneva in 1993, gradually extended to other French and Italian speaking cantons in Switzerland and indirectly affected German-speaking cantons. Activities developed include the production of TV spots, press conferences, information forwarded to health professionals, an Internet site and information material such as leaflets and posters to risk groups. The campaign is evaluated by repeated surveys that measure vaccination coverage as well as network of informants, knowledge and perceptions in the geriatric population. Vaccination coverage of the geriatric population in Geneva canton has increased from 29% in 1991 to 59% in the year 2000.

Idoso , Promoção da Saúde/métodos , Vacinas contra Influenza , Vacinação/estatística & dados numéricos , Idoso de 80 Anos ou mais , Comunicação , Coleta de Dados , Feminino , Humanos , Disseminação de Informação , Internet , Masculino , Inquéritos e Questionários , Suíça
In. Enarson, Elaine, ed; Hearn Morrow, Betty, ed. The gendered terrain of disaster : Through women's eyes. s.l, International Hurricane Center. Laboratory for Social and Behavioral Research, 1998. p.207-11.
Monografia em Inglês | Desastres | ID: des-12900
s.l ; s.n; s.f. 15 p. Tab, mapas.(Disasters, 12, 3).
Artigo em Inglês | Desastres | ID: des-205