[Syndromic approach in migrant patients: Fever, diarrhea, anemia, eosinophilia and chronic cough]. / Abordaje sindrómico en el paciente inmigrante: fiebre, diarrea, anemia, eosinofilia y tos crónica.

Migrant patients share the same diseases as natives, but biological or environmental differences may lead to distinct prevalence and manifestations of certain syndromes. Some common conditions in Primary Care stand out, such as fever, diarrhea, anemia, eosinophilia, and chronic cough, where it is important to have a special consideration. Fever may indicate a serious imported illness, and malaria should always be ruled out. Diarrhea is generally of infectious origin, and in most cases, management is outpatient. Anemia may indicate malnutrition or malabsorption, while eosinophilia may indicate a parasitic infection. Lastly, chronic cough may be a sign of tuberculosis, especially in immigrants from endemic areas. Family medicine holds a privileged position for the comprehensive, culturally sensitive, and person-centered approach to these conditions.

El concepto del estrés de aculturación desde la mirada del inmigrante hispano en los Estados Unidos / The concept of acculturation stress from the perspective of the Hispanic immigrant in the United States

Objetivo principal: Clarificar el significado de estrés de aculturación del inmigrante hispano, además de conocer cada una de las dimensiones y características propias del concepto, con la finalidad de comprender mejor las necesidades de la persona inmigrante que vive en los Estados Unidos. Metodología: El análisis de concepto se hizo a través de los ocho pasos propuestos por Walker y Avant. Resultados principales: Se identificaron tres dimensiones del concepto estrés de aculturación: (1) estresores personales, (2) estresores del entorno y (3) estresores sociales. Como antecedentes del concepto se identificó el arrepentimiento, la culpa y negación. En general, las consecuencias se reflejan en la salud mental del inmigrante hispano. Además, se reconoció los instrumentos de medición que evalúan el estrés de aculturación. Conclusión principal: Se obtuvo una definición clara del concepto estrés de aculturación desde la perspectiva del inmigrante hispano, que ayudará a estimar la validez de constructo de las mediciones de este concepto. Las dimensiones reportadas con mayor frecuencia son consideradas en el inventario de estrés en hispanos, sin embargo, se recomienda analizar la validez de constructo del concepto. Sería importante considerar las consecuencias derivadas del estrés de aculturación en la prevención y tratamiento de la salud mental. (AU)

Objective: Clarify the meaning of acculturation stress for the Hispanic immigrant, in addition to knowing each of the dimensions and characteristics of the concept, in order to better understand the needs of the immigrant living in the United States. Methods: The concept analysis was done through the eight steps proposed by Walker and Avant. Results: Three dimensions of the acculturation stress concept were identified: (1) personal stressors, (2) environmental stressors and (3) social stressors. Repentance, guilt, and denial were identified as antecedents in the concept. In general, the consequences are reflected in the mental health of the Hispanic immigrant. In addition, the measurement instruments that assess acculturation stress were recognized. Conclusions: A clear definition of the acculturation stress concept was obtained, which will help to estimate the construct validity of the measurements of this concept. The most frequently reported dimensions are considered in the stress inventory in Hispanics; however, it is recommended to analyze the construct validity of the concept. It would be important to consider the consequences derived from acculturation stress in the prevention and treatment of mental health. (AU)

Transición saludable del inmigrante hispano: derivación de una teoría de rango medio / Healthy transition of hispanic immigrant: derivation from a middle-range theory

Objetivo principal: Proponer una teoría de rango medio de enfermería para dar explicación al fenómeno del estrés de aculturación que presenta el inmigrante hispano durante su transición en los Estados Unidos de América. Metodología: Se efectuó la metodología de derivación teórica de Jacqueline Fawcett. Resultados principales: La teoría pone de manifiesto los factores personales, sociales y del entorno que impiden la transición del inmigrante hispano en los Estados Unidos de América, además expone un conjunto de proposiciones para el logro de una transición saludable. Conclusión principal: La teoría de la transición saludable contribuye al diseño de intervenciones de enfermería en el proceso de cambio de una cultura, para el logro, adopción y dominio de estrategias personales, sociales y del entorno, que contribuyan en la obtención de una transición saludable en el país receptor. (AU)

Objective: To propose a middle-range nursing theory to explain the phenomenon of acculturation stress that the Hispanic immigrant presents during their transition to the United States of America. Methods: The theory derivation methodology of Jacqueline Fawcett was carried out. Results: The theory reveals the personal, social and environmental factors that impede the transition of the Hispanic immigrant in the United States of America. In addition, this theory exposes a set of propositions for the achievement of a healthy transition. Conclusions: The theory of healthy transition contributes to the design of nursing interventions in the process of changing a culture, for the achievement, adoption and mastery of personal, social and environmental strategies that contribute to obtaining a healthy transition in the host country. (AU)

Jóvenes inmigrantes en la ciudad de São Paulo: acciones político-culturales, vida cotidiana y resistencias / Jovens imigrantes na cidade de São Paulo: ações político-culturais, vida cotidiana, resistências / Immigrant youths in São Paulo City: political-cultural actions, everyday life, resistances

Resumo (analítico) Este artículo es derivado de una investigación más amplia enfocada en cuatro colectivos de jóvenes inmigrantes en la ciudad de São Paulo y sus acciones político-culturales en la metrópoli. Basado en metodologías cualitativas, la investigación se construyó bajo el supuesto de entender las dimensiones históricas, políticas, antropológicas y comunicacionales que cruzan sus vidas. Los resultados contribuyen para la identificación de prácticas elaboradas y tejidas en la cotidianidad de sus productores y sus luchas por existencia, resistencia y re-existencia: a) las formas en las cuales ellos transforman, a través de acciones político-culturales, territorios, espacios y lugares cotidianos, desplazando prejuicios; b) los nexos entre pertenencia, inclusión, integración y relaciones interculturales y trans-fronterizas; c) la contribución de los colectivos en el enfrentamiento de exclusiones y desigualdades en sus vidas cotidianas.

Resumen (analítico) O artigo é decorrente de uma investigação mais ampla, focada em quatro coletivos juvenis de imigrantes na cidade de São Paulo e suas ações político-culturais na cena metropolitana. Baseada em metodologia qualitativa, a pesquisa foi construída sob o pressuposto da compreensão de dimensões históricas, políticas, antropológicas e comunicacionais que atravessam as vidas imigrantes. Os resultados do estudo contribuem para o mapeamento das práticas tecidas nas vidas cotidianas de seus produtores e suas lutas por existências, re-sistências e re-existências: a) as formas pelas quais jovens imigrantes de coletivos urbanos transformam, por meio de ações político-culturais, territórios, espaços e lugares cotidianos, deslocando preconceitos; b) os nexos entre pertença, inclusão, integração e relações interculturais e transfronteiriças; c) a contribuição dos coletivos no enfrentamento das exclusões e desigualdades em suas vidas cotidianas.

Abstract (analytical) This article results from a broader investigation focused on four immigrant youth collectives in São Paulo city, and their political-cultural actions in metropolitan scenarios. Using qualitative methodologies, the research was focused on understanding historical, political, anthropological and communication dimensions that take part in their lives. The results contribute to the mapping of these actions, and also addresses their struggles for belonging, inclusion and integration as ways of existing, resisting and re-existing, such as: a) the ways in which immigrant young people from urban groups trans-form everyday territories, spaces and places; b) the links between belonging, inclusion, integration, interculturality and cross-border relationships, marked by their experiences between two contexts; c) the contribution of collectives to facing exclusions and inequalities in their daily lives.

Competencia Cultural de profesionales sanitarios en la atención a inmigrantes a la luz del modelo de Terry Cross / Cultural competence of health professionals in immigrant care, in the light to the Terry Cross model

Objetivo principal: resignificar, a partir de la experiencia de atención a pacientes inmigrantes desarrollada por un grupo de profesionales sanitarios, los niveles de Competencia Cultural del Modelo de Terry Cross a fin de reorientar sus descripciones hacia el ámbito sanitario. Asimismo, se propuso determinar el nivel en que se encuentran dichos profesionales. Metodología: Diseño cualitativo con estudio de caso instrumental. Recogida de datos mediante entrevistas semiestructuradas. Resultados principales: Se establecieron tres niveles de Competencia Cultural que permitieron conforman el Modelo Confrontación, Resistencia y Apertura Cultural (CRAC) específico para profesionales sanitarios. Dichos niveles concuerdan con Incapacidad, Ceguera y Pre-competencia cultural del Modelo de Cross. El nivel alcanzado fue Pre-competencia cultural. Conclusión principal: El nivel en que se encuentran los profesionales sanitarios entrevistados, según el Modelo CRAC, evidencia los desafíos pendientes para proporcionar cuidados en perspectiva cultural. La solución podría comenzar abordando los vacíos formativos en el área. (AU)

Objective: To re-signify the levels of cultural competence of the Terry Cross model based on the experience received by healthcare professionals over the years of service on the care of immigrant patients, with the objective of redirecting the descriptions concerning the health field. Besides, a determination of the level at which these professionals are placed was proposed. Methods: Qualitative design with an instrumental case study. Data collection through semi-structured interviews. Results: Three levels of Cultural Competence were stablished, and constitute the Confrontation, Resistance, and Cultural Openness Model (CRAC) specific for health professionals. These levels coincide with the Incapacity, Blindness, and Cultural Pre-competence of the Cross Model. The level achieved was Pre-cultural competence. Conclusions: The level of the interviewed health professionals, according to the CRAC Model, shows the unresolved challenges to provide care from a cultural perspective. The solution could start by addressing training gaps in the area. (AU)

Health status and infectious diseases in male unaccompanied immigrant minors from Africa in Spain.

INTRODUCTION: The aim was to examine the health status and infectious diseases in a cohort of unaccompanied immigrant minors (UIMs) from Africa in Spain, and to detect if there are differences according to the geographical area of origin. METHODS: Cross-sectional study in 622 African male UIMs at the time of admission to residential care in Aragon (Spain) during 2005-2019. A physical, nutritional and laboratory examination was performed following sanitary guidelines. RESULTS: The mean age of the African UIMs was 16.1 years (SD 1.7; range 13-17). 88.9% were from Maghreb (mean age 15.9 years; SD 1.5) and 14.1% from Western Sub-Saharan (mean age 16.8 years; SD 1). We found that the prevalence of caries, iron deficiency and dermatological problems was significantly higher (p<.05) among Maghrebian, and the prevalence of past and present hepatitis B virus (HBV) infection, intestinal parasitosis, eosinophilia (p<.00001) and latent tuberculosis (p=.0034) was significantly higher in those of Sub-Saharan origin. CONCLUSION: The most relevant finding was the high prevalence of present HBV infection (14.8%) among Sub-Saharan adolescents. This finding highlights the importance of recommending targeted screening, preventive vaccination programs, and integration into local health care systems that allow for long-term treatment and follow-up as a way to prevent the transmission of HBV infection.

Health status and infectious diseases in male unaccompanied immigrant minors from Africa in Spain / Estado de salud y enfermedades infecciosas de menores inmigrantes no acompañados varones procedentes de África en España

Introduction: The aim was to examine the health status and infectious diseases in a cohort of unaccompanied immigrant minors (UIMs) from Africa in Spain, and to detect if there are differences according to the geographical area of origin. Methods: Cross-sectional study in 622 African male UIMs at the time of admission to residential care in Aragon (Spain) during 2005-2019. A physical, nutritional and laboratory examination was performed following sanitary guidelines. Results: The mean age of the African UIMs was 16.1 years (SD 1.7; range 13-17). 88.9% were from Maghreb (mean age 15.9 years; SD 1.5) and 14.1% from Western Sub-Saharan (mean age 16.8 years; SD 1). We found that the prevalence of caries, iron deficiency and dermatological problems was significantly higher (p<.05) among Maghrebian, and the prevalence of past and present hepatitis B virus (HBV) infection, intestinal parasitosis, eosinophilia (p<.00001) and latent tuberculosis (p=.0034) was significantly higher in those of Sub-Saharan origin. Conclusion: The most relevant finding was the high prevalence of present HBV infection (14.8%) among Sub-Saharan adolescents. This finding highlights the importance of recommending targeted screening, preventive vaccination programs, and integration into local health care systems that allow for long-term treatment and follow-up as a way to prevent the transmission of HBV infection.(AU)

Introducción: El objetivo fue estudiar el estado de salud y las enfermedades infecciosas de una cohorte de menores inmigrantes no acompañados (MENA) procedentes de África en España, y detectar si existen diferencias según la zona geográfica de origen. Métodos: Estudio transversal en 622 MENA varones africanos en el momento de su admisión en la atención residencial en Aragón (España) entre 2005 y 2019. Se realizó un examen físico, nutricional y analítico de laboratorio siguiendo las directrices sanitarias. Resultados: La edad media de los MENA africanos era de 16,1 años (DE 1,7, intervalo 13-17). El 88,9 % procedía del Magreb (edad media 15,9 años; DE 1,5) y el 14,1 % de la zona subsahariana occidental (edad media 16,8 años; DE 1). Se constató que la prevalencia de caries, ferropenia y problemas dermatológicos era significativamente mayor (p < 0,05) entre los magrebíes, y que la prevalencia de infección pasada y presente por el virus de la hepatitis B (VHB), parasitosis intestinal, eosinofilia (p < 0,00001) y tuberculosis latente (p = 0,0034) era significativamente mayor entre los sujetos de origen subsahariano. Conclusión: El dato más relevante fue la alta prevalencia de infección actual por el VHB (14,8 %) entre los adolescentes subsaharianos. Este hallazgo pone de relieve la importancia de recomendar cribados selectivos, programas de vacunación preventiva e integración en los sistemas locales de atención sanitaria que permitan un tratamiento y seguimiento a largo plazo como manera de prevenir la transmisión de la infección por el VHB.(AU)

Emotional Reactions and Coping of Mexican Mixed-Status Immigrant Families in Anticipation of the 2016 Presidential Election.

The present study illuminates the emotions of mixed-status families as they anticipated the 2016 Presidential election. From a 6-year longitudinal case study of four Mexican immigrant families, we present interviews from May of 2016, prior to the presidential primaries, and from November of 2016, the day before or the day of the presidential election. Using a multiple case study method (Stake, 2006, Multiple case study analysis. Guilford Press, New York; Yin, 2014, Case study research: Design and methods (5th ed.). Sage, Los Angeles, CA), our primary goal was to describe how immigrant Mexican adults and their preadolescent and adolescent children (or grandchildren) personally and collectively reacted emotionally to the events leading up to the 2016 presidential election, and how they managed and coped with their emotions. Our secondary goal was to explain how their emotional reactions changed over time and were influenced by age and immigration status. Initially, participants expressed concern and fear about the anti-immigration rhetoric by the conservative political movement, but largely felt reassured that such rhetoric would not prevail. In the days immediately preceding the election, a notable change seemed apparent among all participants, regardless of immigration status. They expressed having intense emotions ranging from fear and angst to disbelief, anger, and denial, which they attempted to manage through external (e.g., community involvement, activism, solidarity) and internal (e.g., family communication, cognitive strategies) actions. Older adolescents had a better understanding of the implications of the election for their family than younger adolescents did. We provide recommendations for family practice and policy aimed to support and advocate on behalf of immigrant families.

El presente estudio explica las emociones de las familias cuyos miembros tienen distinta situación migratoria mientras esperaban la elección presidencial de 2016. De un caso práctico longitudinal de seis años de cuatro familias de inmigrantes mexicanos, presentamos entrevistas de mayo de 2016, antes de las primarias presidenciales, y de noviembre de 2016, el día antes o el día de la elección presidencial. Utilizando un método de casos prácticos múltiples (Stake, 2006; Yin, 2014), nuestro objetivo principal fue describir cómo los adultos inmigrantes mexicanos y sus hijos preadolescentes y adolescentes (o nietos) reaccionaron personal y colectivamente a los acontecimientos previos a la elección presidencial de 2016, y cómo manejaron y afrontaron sus emociones. Nuestro objetivo secundario fue explicar cómo sus reacciones emocionales cambiaron con el tiempo y estuvieron influenciadas por la edad y la situación inmigratoria. Inicialmente, los participantes expresaron preocupación y miedo acerca de la retórica contra los inmigrantes por parte del movimiento político conservador, pero en su gran mayoría estaban convencidos de que dicha retórica no prevalecería. Los días inmediatamente anteriores a la elección, se hizo evidente un cambio notable entre todos los participantes, independientemente de la situación de inmigración. Ellos dijeron tener emociones intensas, desde miedo y angustia hasta incredulidad, ira y rechazo, que intentaron manejar mediante medidas externas (p. ej.: participación en la comunidad, activismo, solidaridad) e internas (p. ej.: comunicación familiar, estrategias cognitivas). Los adolescentes mayores tuvieron una mejor comprensión de las implicancias de la elección para su familia que los adolescentes más jóvenes. Ofrecemos recomendaciones para la práctica familiar orientadas a apoyar y a abogar por las familias inmigrantes.

A Randomized Clinical Trial Testing a Parenting Intervention Among Afghan and Rohingya Refugees in Malaysia.

Refugee families experience uncertainty and stress when residing in countries of first asylum, such as Malaysia, and may benefit from supportive parenting interventions. In the greater Kuala Lumpur, Malaysia area we piloted an eight-week parenting program with 79 Rohingya and Afghan mothers in nine separate groups. Participants were randomized to an intervention group or a waitlist control group and those in each arm completed a 3-month follow-up assessment. Program content addressed positive discipline, strengthening family relationships, adapting to a new environment, and improving health and emotional well-being. Measures assessed included child intensity and parenting self-efficacy from the Child Adjustment and Parent Efficacy Scale; positive parenting, inconsistent discipline, and poor supervision from the Alabama Parenting Questionnaire-Short Form; family intimacy and family conflict from the Family Functioning Scale, and emotional well-being from the Refugee Health Screening-15. Participating in the intervention led to beneficial changes in child intensity, parenting self-efficacy, family intimacy, family conflict, and emotional distress for the treatment group, and all changes except for emotional distress were maintained over time. However, the intervention did not lead to changes in positive parenting, inconsistent discipline, or poor supervision in the treatment group. Findings point to the potential benefits of parenting programs for refugee communities in transitory settings and contribute to the limited body of literature examining such programs.

Las familias refugiadas sienten incertidumbre y estrés cuando viven en países de primer asilo, como Malasia, por eso, pueden beneficiarse de intervenciones de apoyo para la crianza. En el área metropolitana de Kuala Lumpur, en la zona de Malasia, hicimos una prueba piloto de un programa de ocho semanas sobre la crianza de los niños con 79 madres afganas y rohinyás en nueve grupos distintos. Se asignó aleatoriamente a los participantes a un grupo de intervención o a un grupo de referencia en lista de espera, y las personas de cada división completaron una evaluación de seguimiento a los tres meses. El contenido del programa abordó la disciplina positiva, el fortalecimiento de las relaciones familiares, la adaptación a un entorno nuevo y la mejora del bienestar emocional y de la salud. Los criterios evaluados fueron la intensidad de los niños y la autoeficacia de los padres de la Escala de Adaptación de los Niños y Eficacia de los Padres (Child Adjustment and Parent Efficacy Scale); la crianza positiva; la disciplina inconstante y la mala supervisión del Cuestionario Breve de Alabama sobre la Crianza (Alabama Parenting Questionnaire-Short Form); la intimidad familiar y el conflicto familiar de la Escala de Funcionamiento Familiar (Family Functioning Scale), y el bienestar emocional de la Evaluación de Salud de los Refugiados-15 (Refugee Health Screening-15). La participación en la intervención condujo a cambios beneficiosos en la intensidad de los niños, la autoeficacia en la crianza, la intimidad familiar, el conflicto familiar y el distrés emocional para el grupo de tratamiento, y todos los cambios, salvo el distrés emocional, se mantuvieron con el tiempo. Sin embargo, la intervención no condujo a cambios en la crianza positiva, ni en la disciplina inconstante, ni en la mala supervisión en el grupo de tratamiento. Los resultados señalan los posibles beneficios de los programas de crianza para las comunidades de refugiados en entornos transitorios y contribuyen al escaso corpus de publicaciones que analizan dichos programas.

A Phenomenological Study of Immigrant Parents of Adolescents with Delinquent Behavior in Israel.

Scarce qualitative literature has focused on understanding the perspective of parents of adolescents involved in crime, and no prior literature has examined how the status of being a parent of an adolescent who is involved in delinquency intersects with being an immigrant parent. The current phenomenological study examined, through the eyes of immigrant parents, how they comprehend their children's involvement in delinquent behavior. This study examined in-depth semistructured interviews conducted with fourteen immigrant parents (10 mothers and 4 fathers) from the former Soviet Union in Israel of children treated in rehabilitation facilities for delinquent youth. Data analysis revealed a gradual decline in children's behavior ascribed to the developmental stage of adolescence, the pressures of immigration, and cultural conflict. These three factors are interwoven together to create a fabric within which they see their children turning to crime. Parents' gradual loss of control is balanced by attempts to idealize the parent-child relationship and to minimize the severity of the offenses committed. They describe various differing and even contradictory experiences of themselves as parents and their struggles to piece together incohesive, alternating experiences of themselves as parents. Despite the critical role they can play in their children's rehabilitation, as well as the distress that they themselves experience, parents of children involved in delinquent behavior have often been ignored in research. Acknowledging parents' perspectives and experiences can allow development of appropriate therapeutic strategies to support them and maximize their abilities to support their children.

Existe escasa bibliografía cualitativa centrada en comprender la perspectiva de los padres de adolescentes implicados en la delincuencia, y no existe bibliografía anterior que haya analizado cómo la situación de ser padre de un adolescente que está implicado en la delincuencia se conjuga con ser padre inmigrante. El presente estudio fenomenológico analizó, desde la óptica de padres inmigrantes, cómo ellos entienden la participación de sus hijos en conductas delictivas. Para ello, analizó entrevistas semiestructuradas detalladas realizadas con catorce padres inmigrantes (10 madres y 4 padres) de la antigua Unión Soviética en Israel de niños tratados en centros de rehabilitación para jóvenes delincuentes. Los análisis de datos revelaron una reducción gradual de la conducta de los niños atribuida a la etapa del desarrollo de la adolescencia, las presiones de la inmigración y el conflicto cultural. Estos tres factores se entrelazan para crear un tejido dentro del cual ellos ven a sus hijos recurriendo a la delincuencia. La pérdida de control gradual de los padres está equilibrada por intentos de idealizar la relación entre padres e hijos y de disminuir la gravedad de los delitos cometidos. Ellos describen varias experiencias diversas e incluso contradictorias de sí mismos como padres y sus luchas para armar experiencias incoherentes y alternadas de sí mismos como padres. A pesar del papel fundamental que pueden desempeñar en la rehabilitación de sus hijos, así como del distrés que ellos mismos sufren, los padres de niños implicados en conductas delictivas han sido ignorados con frecuencia en las investigaciones. El reconocimiento de las experiencias y los puntos de vista de los padres puede permitir el desarrollo de estrategias terapéuticas adecuadas que los apoyen y maximizar sus habilidades para que ayuden a sus hijos.

Trauma, immigration, and sexual health among Latina women: Implications for maternal-child well-being and reproductive justice.

Latina immigrant women are vulnerable to traumatic stress and sexual health disparities. Without autonomy over their reproductive health and related decision-making, reproductive justice is elusive. We analyzed behavioral health data from 175 Latina immigrant participants (M age = 35; range = 18-64) of the International Latino Research Partnership (ILRP) study. We used descriptive and inferential statistics to compare immigrant mothers of minor children to those without, regarding their psychological and reproductive health, and correlates of past exposure to sexual trauma. Over one third (38%) of ILRP participants had minor children, and 58% had citizenship in their host country. The rate for sexual assault was 30 and 61%, respectively, for physical assault; these rates were similarly high for women with and without minor children. Women who reported sexual assault scored significantly higher for depression, posttraumatic stress disorder, and substance-abuse screens. Odds of experiencing sexual assault was highest for women who experienced physical assault (odds ratio = 10.74), and for those from the Northern Triangle (odds ratio = 8.41). Subgroups of Latina migrant mothers are vulnerable to traumatic stress and related sexual and mental health risks. Given these findings, we frame the implications in a reproductive justice framework and consider consequences for caregiver-child well-being.

Trasfondo: Las mujeres latinas inmigrantes son vulnerables al estrés traumático y a las disparidades de salud sexual. Sin autonomía sobre su salud reproductiva y las decisiones que se deben tomar al respecto, la justicia reproductiva es difícil de alcanzar. Métodos: Analizamos información sobre las actitudes con respecto a la salud de parte de 175 inmigrantes latinas participantes (edad promedio 35; entre 18 y 64) del estudio de Investigación Conjunta Internacional de Asuntos Latinos (ILRP). Usamos estadísticas descriptivas y deductivas para comparar las madres inmigrantes de niños menores con aquellas sin ellos, sin tomar en cuenta su salud sicológica y reproductiva, y correlacionar el haber estado expuestas a trauma sexual en el pasado. Resultados: Más de un tercio (38%) de las participantes del grupo de ILRP tenían niños menores, y 58% tenían ciudadanía en el país donde residían. El promedio en cuanto a la agresión sexual fue de 30% y 61% en el caso de agresión física; estos promedios fueron similarmente altos tanto para mujeres con niños pequeños como mujeres sin niños pequeños. Las mujeres que reportaron agresión sexual tuvieron puntajes significativamente más altos en el caso de depresión, trastorno por estrés postraumático (PTSD) y exámenes de detección de abuso de sustancias. Las posibilidades de experimentar agresión sexual fue lo más alto para mujeres que experimentaron agresión física (OR = 10.74), y para aquellas del Triángulo del Norte (OR = 8.41). Conclusiones: Los subgrupos de madres latinas inmigrantes son vulnerables al estrés traumático y los relacionados riesgos de salud sexual y mental. Dados estos resultados, colocamos las implicaciones dentro de un marco de trabajo de justicia reproductiva y consideramos las consecuencias para el bienestar de quien le presta cuidados al niño.

Contexte Les femmes immigrées latinas sont vulnérables au stress traumatique et aux disparités de santé sexuelle. Sans autonomie quant à leur santé reproductive et les décisions qui y sont liées, leur justice reproductive est insaisissable. Méthodes Nous avons analysé des données de santé comportementale de 175 participantes immigrées (moyenne d'âge 35 ans; éventail de 18 à 64 ans) de l'étude du partenariat de recherche international International Latino Research Partnership (ILRP). Nous avons utilisé des statistiques descriptives et déductives pour comparer les mères immigrées d'enfants mineurs à celles sans enfants, pour ce qui concerne leur santé psychologique et reproductive, ainsi que les corrélats d'exposition à un trauma sexuel dans le passé. Résultats Plus d'un tiers (38%) des participantes ILRP avaient des enfants mineurs et 58% détenaient la citoyenneté dans leur pays d'accueil. Le taux de violences sexuelles était de 30% et de 61% pour les aggressions physiques. Ces taux étaient aussi élevés chez les femmes avec ou sans enfants mineurs. Les femmes ayant déclaré des violences sexuelles ont fait état de scores bien plus élevés pour la dépression, le TSPT et la toxicomanie. Les probabilités de faire face à des violences sexuelles étaient les plus élevées chez les femmes ayant vécu une aggression physique (OR = 10,74), et pour celles du Triangle du Nord de l'Amérique centrale (OR = 8,41). Conclusions Des sous-groupes de mères migrantes latinas sont vulnérables au stress traumatique et à des risques de santé mentale qui y sont liés. Au vu de ces résultats, nous encadrons les implications dans une structure de justice de reproduction et considérons les conséquences pour le bien-être mère-enfant.

A questão do estrangeiro na contemporaneidade: uma leitura a partir de Zygmunt Bauman / The foreigners question in contemporaneity: a reading from Zygmunt Bauman / La cuestión del extranjero en la contemporaneidad: una lectura a partir de Zygmunt Bauman

Vive-se um momento global em que pessoas estão sendo forçadas a sair de seus países, preponderantemente por considerarem que estes não oferecerem condições de vida e proteção, dirigindo-se para outras localidades em busca de refúgio. A partir destes movimentos internacionais levantam-se a necessidade de construir modos de convivência. O presente trabalho pretende analisar a problemática do contexto atual de migrações internacionais e a questão do estrangeiro a partir da obra do sociólogo polonês Zygmunt Bauman. Nesta análise, é realizada uma discussão acerca da questão do estrangeiro amparada ao conceito de identidade. Considerando a alteridade como uma dimensão que se faz presente na relação com o outro, por fim entendemos a necessidade de desenvolver um olhar que inclua o reconhecimento do outro em sua singularidade. Ao mesmo tempo, compreendemos a importância de desenvolver uma nova política vinculada à construção de espaços físicos e simbólicos que viabilizem a vivência na diferença. (AU)

We live in a global moment when people are being forced to leave their countries, mainly because they consider that they do not offer living conditions and protection, going to other places in search of refuge. From these international movements it is possible to observe the need to construct ways of coexistence. The present work intends to analyze the problematic of the current context of international migrations and the issue of the foreigner from the ideas of polish sociologist Zygmunt Bauman. For this analysis the issue of the foreigner supported by the concept of identity. Considering the otherness that is present in the relationship with the other, finally we understand the importance of the recognition of the other in its singularity. At the same time, we understand the need to develop a new policy linked to construction of physical and symbolic spaces that make possible the experience of difference. (AU)

Se vive un momento global en que las personas están siendo forzadas a salir de sus países, principalmente por considerar que éstos no ofrecen condiciones de vida y protección, dirigiéndose a otras localidades en busca de refugio. A partir de estos movimientos internacionales se plantea la necesidad de construir modos de convivencia. El presente trabajo pretende analizar la problemática del contexto actual de las migraciones internacionales y la cuestión del extranjero a partir de la obra del sociólogo polaco Zygmunt Bauman. Para este análisis se plantea la cuestión del extranjero amparado al concepto de identidad. Considerando la alteridad que se hace presente en la relación con el otro, por fin entendemos la necesidad del reconocimiento del otro en su singularidad. Al mismo tiempo, se entiende que es necesario desarrollar una política vinculada a la construcción de espacios físicos y simbólicos que viabilizen la vivencia en la diferencia. (AU)

La fotointervención como instrumento de reflexión sobre la violencia de género e inmigración / The photo intervention as an instrument of reflection of gender violence and immigration / A fotointervenção como instrumento de reflexão sobre a violência de gênero e imigração

Este artículo trata de la técnica de fotointervención como herramienta de análisis. Se presentan la definición y los procedimientos de este instrumento y se describen los resultados de una experiencia de aplicación con una mujer inmigrante. El objetivo de la experiencia fue facilitar a la mujer inmigrante la reflexión sobre su experiencia migratoria y su situación de violencia de género en la pareja a partir de las siguientes cuestiones: qué significa ser mujer inmigrante, qué significa la violencia, y qué significa salir de la violencia. Los hallazgos de este ejercicio señalaron que la utilización de la fotointervención como instrumento de reflexión facilitó a la participante la construcción de significados sobre su historia como mujer inmigrante que ha padecido violencia de género en la pareja. La oportunidad de rescatar su historia, a través de las fotos y del relato que realiza facilita que ella reconozca sus estrategias de afrontamiento ante las condiciones de adversidad a las que ha sido expuesta. Ello permite el verse no como víctima, sino como resistente y resiliente ante situaciones de dominio y opresión.(AU)

This article describes technique of photo intervention as a tool for analysis. It presents the definition and the procedures of this instrument and it describes the application of this instrument with one immigrant woman. From questions about the meaning of being immigrant women, the significance of violence and getting out of violence, the main objective was to promote reflection about migratory experience and gender violence in couples. The results of the experience showed that the use of photo intervention is an instrument of reflection and enabled the participant to build meanings concerning to their history as an immigrant woman that suffered gender violence in couples. We can come to the conclusion that the opportunity to rescue her history through the pictures and her report helps her to see her coping strategies toward the adversities conditions. It allows to see her not as victims, but as resilient to oppression and dominion situations.(AU)

Este artigo aborda a técnica da fotointervenção como ferramenta de análise. A definição e os procedimentos deste instrumento são apresentados e posteriormente os resultados da experiência de aplicação desta técnica com uma mulher imigrante. O objetivo da experiência foi facilitar que ela refletisse sobre a sua experiência migratória e a sua situação de violência de gênero no relacionamento com seu parceiro a partir das seguintes questões: o que significa ser mulher imigrante, o que significa a violência, e o que significa sair da relação abusiva. Os resultados indicam que o uso da fotointervenção como instrumento de reflexão facilitou com que a participante construisse significados sobre a sua história como mulher imigrante que sofreu violência de gênero no relacionamento íntimo. A oportunidade de resgatar a sua história, através das fotos e do seu relato, facilita com que ela perceba suas estratégias de enfrentamento diante de condições de adversidade, as quais foi exposta. Isso favorece que ela se reconheça não como vítima, mas como resistente e resiliente a situações de domínio e opressão.(AU)

La fotointervención como instrumento de reflexión sobre la violencia de género e inmigración / The photo intervention as an instrument of reflection of gender violence and immigration / A fotointervenção como instrumento de reflexão sobre a violência de gênero e imigração

Este artículo trata de la técnica de fotointervención como herramienta de análisis. Se presentan la definición y los procedimientos de este instrumento y se describen los resultados de una experiencia de aplicación con una mujer inmigrante. El objetivo de la experiencia fue facilitar a la mujer inmigrante la reflexión sobre su experiencia migratoria y su situación de violencia de género en la pareja a partir de las siguientes cuestiones: qué significa ser mujer inmigrante, qué significa la violencia, y qué significa salir de la violencia. Los hallazgos de este ejercicio señalaron que la utilización de la fotointervención como instrumento de reflexión facilitó a la participante la construcción de significados sobre su historia como mujer inmigrante que ha padecido violencia de género en la pareja. La oportunidad de rescatar su historia, a través de las fotos y del relato que realiza facilita que ella reconozca sus estrategias de afrontamiento ante las condiciones de adversidad a las que ha sido expuesta. Ello permite el verse no como víctima, sino como resistente y resiliente ante situaciones de dominio y opresión.

This article describes technique of photo intervention as a tool for analysis. It presents the definition and the procedures of this instrument and it describes the application of this instrument with one immigrant woman. From questions about the meaning of being immigrant women, the significance of violence and getting out of violence, the main objective was to promote reflection about migratory experience and gender violence in couples. The results of the experience showed that the use of photo intervention is an instrument of reflection and enabled the participant to build meanings concerning to their history as an immigrant woman that suffered gender violence in couples. We can come to the conclusion that the opportunity to rescue her history through the pictures and her report helps her to see her coping strategies toward the adversities conditions. It allows to see her not as victims, but as resilient to oppression and dominion situations.

Este artigo aborda a técnica da fotointervenção como ferramenta de análise. A definição e os procedimentos deste instrumento são apresentados e posteriormente os resultados da experiência de aplicação desta técnica com uma mulher imigrante. O objetivo da experiência foi facilitar que ela refletisse sobre a sua experiência migratória e a sua situação de violência de gênero no relacionamento com seu parceiro a partir das seguintes questões: o que significa ser mulher imigrante, o que significa a violência, e o que significa sair da relação abusiva. Os resultados indicam que o uso da fotointervenção como instrumento de reflexão facilitou com que a participante construisse significados sobre a sua história como mulher imigrante que sofreu violência de gênero no relacionamento íntimo. A oportunidade de resgatar a sua história, através das fotos e do seu relato, facilita com que ela perceba suas estratégias de enfrentamento diante de condições de adversidade, as quais foi exposta. Isso favorece que ela se reconheça não como vítima, mas como resistente e resiliente a situações de domínio e opressão.

Health status and disease burden of unaccompanied asylum-seeking adolescents in Bielefeld, Germany: cross-sectional pilot study.

OBJECTIVE: This exploratory pilot study aimed to investigate the physical and mental disease burden of unaccompanied asylum-seeking adolescents arriving in Bielefeld, a medium-size city in Germany. METHODS: A cross-sectional survey with purposive sampling of 102 unaccompanied asylum-seeking adolescents aged 12-18 years was performed. Information on general health status, selected infectious and non-communicable diseases, iron deficiency anaemia and mental illness was collected during routine check-up medical examinations upon arrival in Bielefeld, Germany. The data were analysed using descriptive statistics. RESULTS: The analysis revealed a complex disease burden with a high prevalence of infections (58.8%), mental illness (13.7%) and iron deficiency anaemia (17.6%) and a very low prevalence of non-communicable diseases (<2.0%). One in five of the refugees were infected with parasites. Whilst sub-Saharan Africans showed the highest prevalence of infections (86.7%), including highest prevalences of parasites (46.7%), West Asians had the highest prevalence of mental disorders (20.0%). Overall, the disease burden in females was higher. CONCLUSION: A thorough medical and psychological screening after arrival is highly recommended to reduce the individual disease burden and the risk of infection for others. This promotes good physical and mental health, which is needed for successful integration into the receiving society. Barriers to health service access for unaccompanied asylum-seeking adolescents need to be lowered to allow need-specific health care and prevention.

[Population screening strategies in recent immigrant to Spain]. / Estrategias de cribado en población inmigrante recién llegada a España.

The definition of terms that delimites the content of this paper are initially displayed. Subsequently, the main sources of information about the disease screening in immigrants and the entities considered susceptible of screening are showed. In a later section we review the diagnostic methodology used, separately considering the history, physical examination, the usual complementary tests and specific studies of both infectious and noninfectious diseases. Finally, with the limitations of the data available a proposal of a protocol for screening of diseases in recent immigrant is performed.

Inmigración y salud mental infanto-juvenil: análisis de los artículos publicados en revistas nacionales de psicología durante el periodo 2003-2013 / Immigration and infant-juvenile mental health: an analysis of articles published in national psychology journals during the 2003-2013

El presente artículo tiene por objetivo describir el estado actual de las publicaciones en revistas de Psicología a nivel nacional respecto del tema migratorio, particularmente de la salud mental en población infanto-juvenil inmigrante. Para ello se revisaron 1.094 artículos publicados en seis revistas de Psicología en Chile durante el periodo 2003-2013. Se encontraron 26 artículos referidos a temas migratorios, los que posteriormente fueron clasificados según: tipo de investigación, proyecto asociado, apoyo institucional, nivel de análisis, población objetivo, y contexto del estudio. Los resultados indican una baja tasa de publicación en temas migratorios, y la inexistencia de artículos sobre inmigración y salud mental infanto-juvenil. Finalmente, se enfatiza en la necesidad de publicaciones en Psicología que aborden la temática, contemplando dimensiones socioculturales en sus análisis...

This paper aims to describe the current state of the national publications in journals of Psychology respect to the subject of immigration, particularly mental health in infant-juvenile immigrant population. In order to do so, 1.094 articles published in six journals of Psychology in Chile during the period 2003-2013 were reviewed. Twenty-six articles on immigration were found, which were subsequently classified by: type of research, associated project, institutional support, level of analysis, targeted population, and context of study. The results indicate a low rate of publication on the subject of immigration issues, and the lack of articles on immigration and infant-juvenile mental health. Finally, it is emphasized the need for publications in Psychology to address immigration, considering socio-cultural dimensions in their analysis...

Evaluation and revision of questionnaires for use among low-literacy immigrant Latinos / Avaliação e revisão de questionários para uso entre imigrantes latinos com baixos níveis de alfabetização / Evaluación y revisión de cuestionarios para uso en inmigrantes Latinos con bajo grado de alfabetización

As more Spanish speaking immigrants participate in and become the focus of research studies, questions arise about the appropriateness of existing research tools. Questionnaires have often been adapted from English language instruments and tested among college-educated Hispanic-Americans. Little has been written regarding the testing and evaluation of research tools among less educated Latino immigrants. The purpose of this study was to evaluate and revise a battery of Spanish-language questionnaires for an intervention among immigrant Hispanic women. A three-step process was used to evaluate, adapt and test Spanish versions of the Self-Efficacy and Exercise Habits Survey, an abbreviated version of the Hispanic Stress Inventory-Immigrant version and the Latina Values Scale. The revised tools demonstrated acceptable validity and reliability. The adaptations improved the readability of the tools, resulting in a higher response rate, less missing data and fewer extreme responses. Psychometric limitations to the adaptation of Likert scales are discussed.

À medida que número maior de imigrantes de língua espanhola participa de pesquisas, surgem questões relacionadas à adequação de instrumentos já existentes. Questionários, em versões inglesas, são frequentemente adaptados e testados com americanos de origem hispânica com nível superior. Pouco tem sido escrito sobre testes e avaliação desses instrumentos de pesquisa entre imigrantes com níveis mais baixos de escolaridade. O objetivo deste estudo foi avaliar e revisar uma bateria de questionários para intervenção com mulheres imigrantes hispânicas. Utilizou-se um processo de três etapas para avaliar, adaptar e testar as versões espanholas dos instrumentos Self-Efficacy and Exercise Habits Survey, versão abreviada para imigrantes do Hispanic Stress Inventory e o Latina Values Scale. Os instrumentos revisados demonstraram validade e confiabilidade aceitáveis. As adaptações melhoraram a compreensão dos instrumentos, aumentando a taxa de respostas e reduzindo dados omissos e respostas extremas. Limitações psicométricas da adaptação de escalas do tipo Likert também são abordadas.

En la medida en que un número mayor de inmigrantes de lengua española participa de investigaciones, surgen cuestiones relacionadas a la adecuación de instrumentos ya existentes. Cuestionarios, en versiones inglesas, son frecuentemente adaptados y comprobados con americanos de origen hispana con nivel superior. Poco ha sido escrito sobre pruebas y evaluación de esos instrumentos de investigación entre inmigrantes con grados más bajos de escolaridad. El objetivo de este estudio fue evaluar y revisar una batería de cuestionarios para intervención con mujeres inmigrantes hispanas. Se utilizó un proceso de tres etapas para evaluar, adaptar y comprobar las versiones españolas de los instrumentos Self-Efficacy and Exercise Habits Survey, versión abreviada para inmigrantes del Hispanic Stress Inventory y Latina Values Scale. Los instrumentos revisados demostraron validad y confiabilidad aceptables. Las adaptaciones mejoraron la comprensión de los instrumentos, aumentando la tasa de respuestas y reduciendo datos omisos y respuestas extremas. Las limitaciones psicométricas de la adaptación de escalas del tipo Likert también son abordadas.

Estudio de la relación entre consumo de drogas y migración a la frontera norte de México y Estados Unidos

resumen está disponible en el texto completo

Abstract: Since the beginning of the XX Century, migration has played an important role in the relations between Mexico and the United States. The main reasons behind most of these migration movements are to improve life conditions and already established social-familiar networks. It is estimated that approximately 390,000 Mexican people migrate each year to the United States. In 2002, Mexicans represented the biggest immigrant group, with 9.5 million people. Among the main elements that cause this migrating movement are: the increasing Mexican demographic population in prime working age, the insufficient creation of jobs, low salaries, as well as the high demand that exists for manpower in the United States, specially in the agricultural, industrial and service areas. There have been important changes in the migrating process, which modify usual behaviors, habits, values, attitudes and points of view by migrants, their families, their home town and their new environment. These changes can facilitate the development of some problems, at a public health level. Some such problems include stress, depression, risky sexual behavior, AIDS contagion, or increase in the abuse of alcohol and drugs. The Community Epidemiology Work Group and NIDA has reported that South and South East areas of the United States show a high cocaine, heroine, methamphetamine, and ecstasy abuse. Most such areas are located at the Mexican border, and this problem seems to affect both countries the same. Method. The study involved following transversal, ex post facto comparisons of migrant and no migrant users drugs. The main objectives included: a) To identifiy abuse levels of migrating drug users, and compare these results with those of Mexican resident drug abusers (non migrating); b) To identify abuse levels in migrating people before and after they moved into the United States and/ or Mexican border cities, and their degree of abuse upon returning to Mexico; c) To explore any relationships between migrating and increased drug consumption, such as heroine and methamphetamine. The participant selection procedure involved intentional, sampling by using pairs. Inclusion criteria included using ilegal drugs, being new patient in the Treatment area of Centros de Integración Juvenil (CIJ), and having migrated to any Mexican border cities and/or the United States in the last five years, and stayed for a period of three months or more. The CIJ operating units that participated in the study included those in Cancán, Celaya, Chihuahua, Ciudad Juárez, Colima, Guadalajara, Hermosillo, Laguna, La Paz, León, Los Mochis, Monterrey, Puebla, Zacatecas and Zamora. These units were selected because of their high number of patients who are methamphetamine or heroine abusers, as well as for including a considerable rate of migrating people to the United States. The groups included 92 drug abusers, of which 46 went to the mexican north border or to the United States cities, and 46 non migrants. Data was gathered through the application of a questionnaire. Main findings. Some of the results revealed that 97.8% of the participants were male, with an average age of 26 years old (SD=7.5), and 80% had studied elementary school or higher. 1. Characteristics of the migrating process. Drug abusers, who migrated to the northern Mexican border, mainly went to Baja California and Chihuahua states. The ones who went to the United Stated were living in California, Texas, Arizona and Illinois. Among the main reasons for migrating were personal development, getting a job or improving it. Migrants also stated that they were "seeking adventure", and, those who went to the United States, said that their purpose was to solve family problems, or to follow tradition. Most of them had planned to stay at their new home for just one season, although a majority stayed over one year. 2. Drug abuse. All participants had consumed alcohol and almost 90% of them had smoked tobacco at least once in their lives. The illegal substances consumed by both migrating and non migrating participants included, in decreasing frequency order: cocaine, marijuana, inhalants, methamphetamines and sedatives. Prevalence among the migrating abusers was higher. Non migrating abusers, also consumed tranquilizers, heroine and other opiates. On the other hand, migrating abusers, had consumed, at least once in a lifetime one or more of the following substances: ecstasy, crack, basuco, methamphetamine, amphetamines, LSD and PCP. Migrants showed a higher percentage of those who had used central nervous system inhibitors (except methamphetamine), and most of them had used a combination of drugs. Those migrating to the United States predominantly consumed drugs to stimulate the central nervous system or to produce hallucinations, and also used some other non specified substances. Drug preference perception. Both groups reported a preference towards marijuana and cocaine. However, migrating abusers showed an additional preference for methamphetamine use. Migrating abusers stated that the reason for consuming this drug was mainly seeking stimulation, just to feel active and euphoric. The ones who migrated to the United States mentioned that they consume methamphetamine because of labor reasons, such as to be more productive and alert. Drug abuse before, during and after migrating. Eighty percent of migrating abusers had already used drugs before leaving their home town. During the migrating process the drug abuse pattern changed by increasing the use of some other drugs. Migrating abusers mentioned that they had used cocaine at their home place, but that during the migrating process, its consumption was significantly higher. They also mentioned that they continued using cocaine when they came back home, although at a lower rate. There was no record of opiates' use such as morphine, darvon, nubain or methadone when these abusers were in their home town, before migrating. They started using these drugs when they arrived to the north of Mexico or to the United States, and they continued using them when they returned. Only some abusers had used methamphetamine, crack, heroine and PCP before migrating. However, when they arrived to their migrating place, the use of these drugs was highly increased although it was reduced considerably when they returned home. LSD was consumed only at the migrating places. The use of tranquilizers and mushrooms was slightly decreased during the migrating process, but it increased when abusers returned home. In the case of those who went to the border, heroine abuse increased, and it decreased as abusers returned home. Only some of them used methamphetamine and ecstasy at their migrating places. On the other hand, those migrating abusers that went to the United States increased their use of methamphetamine, ecstasy, cocaine, and crack, although it decreased when they returned home. Some migrating abusers started using heroin when they arrived to the border, and only continued consuming it when they came home.