Mental health and societal challenges among forced migrants of diverse sexual orientations, gender identities and gender expressions: health professionals' descriptions and interpretations.

The aim of this study was to explore health professionals' descriptions and interpretations of post-migration mental health and societal challenges among forced migrants with diverse sexual orientations, gender identities and gender expressions. Participants representing seven professions were recruited by a combination of convenience, purposive and snowball sampling. Data were collected through focus groups and individual interviews, analysed with systematic text condensation in a collaborative process involving researchers, clinicians and migrants with lived experiences. Participants described a challenging trajectory for migrants, as migrants venture through an uncertain and demanding journey impacting their mental health. Needing to deal with legal requirements, stressful circumstances and normative expectations during the asylum process were highlighted as major challenges, along with exposure to discrimination, violence, abuse and lack of psychosocial safety. Participants described significant psychological distress among migrants, including loneliness and shame. Challenges were also recognised related to exploring, accepting and expressing sexuality and gender. Loneliness and shame are major challenges in need of further attention in research, which could be addressed through the development and evaluation of actions, programmes and interventions to provide peer support.

Alcohol use among adult recent Latino/a immigrants: the role of stress, forced migration, and adherence to traditional gender roles.

Background: Previous research conducted among Latino/a immigrants has shown the underlying effect that exposure to stress after immigrating to the U.S. (i.e. health access, racial/ethnic discrimination, and language barriers) has on alcohol use patterns. However, given the demographic shifts in recent immigrants, understanding the influence of stress before (i.e. poverty, healthcare, and educational opportunities) and after immigration on their alcohol use (i.e. alcohol consumption and drinking behaviors in the past 12 months) in the context of migration and traditional gender roles is warranted.Objectives: To examine the (a) cumulative effects of pre- to post-immigration stress, (b) respective moderating effects of traditional gender roles, and (c) forced migration on alcohol use for men and women.Methods: Hierarchical multiple regression and moderation analyses were conducted on a cross-sectional sample of 529 (N = 268 men, N = 261 women) adult (18-34 years) from recent Latino/a immigrants in South Florida.Results: Gender had a statistically significant difference on alcohol use, (F 527) = 18.68, p < .001, with men (p = 4.36 ± SE =.22) reporting higher alcohol use than women (p = 3.08 ± SE =.20). Post-immigration stress (ß = .12, p = .03) but not pre-migration stress had a statistically significant association with alcohol use. There is no interaction effect by traditional gender roles and forced migration on the associations between pre- to post-immigration stress and alcohol use.Conclusion: Results suggest that post-immigration stress may be a reasonable intervention target to mitigate alcohol use among recent Latino/a immigrants, particularly among men.

"I Didn't Expect to Be So Caught Up in It": a Qualitative Study of Experiences of Medical Students' Volunteering for Ukrainian Refugees.

OBJECTIVE: Russia's invasion of Ukraine in February 2022 triggered a huge wave of migration, with thousands of refugees arriving at Prague's Central Station. With no medical service available, medical students started to volunteer and were running an infirmary available around the clock. The research aimed to explore medical students' professional experiences, emotionally challenging situations, and coping strategies in this demanding setting. METHODS: The authors used a qualitative analysis of semi-structured in-depth interviews with 19 participants recruited through purposive sampling. Interviews took place between April and May 2022. Data were recorded, transcribed, and processed by using thematic qualitative analysis. RESULTS: The research identified five emotionally challenging situations: caring for traumatized refugees, refusal of treatment, disruption of everyday life, independent decision-making, and complexity of voluntary work. Students adopted both adaptive and maladaptive coping strategies for dealing with stress and trauma. Almost half the students reported signs of secondary traumatization and moral distress; however, no one asked for psychological help. CONCLUSIONS: Medical school curricula should cover trauma-informed approaches, healthy coping strategies, and destigmatization of psychological problems.

Trans-border Mobility and Security in the Sahel: Exploring the Dynamics of Forced Migration and Population Displacements in Burkina Faso and Mali.

Burkina Faso and Mali have been grappling with multiple security threats including jihadist challenge, military coup d'état, violent extremism, and poor governance. These complex security problems have escalated into national conflicts, state failure, internal displacements, and forced migration. This paper examined the changing patterns of the drivers and enablers of these security threats and how these forces feed into the protracted challenges of forced migration and population displacements. Using qualitative methods and documentary evidence, the paper found that poor governance, lack of state-building measures, and socio-economic exclusion of local populations contributed to the worsening crises of forced migration and population displacements in Burkina-Faso and Mali. The paper emphasised the human security perspectives hinged on good governance principles through effective leadership in Burkina-Faso and Mali particularly in the areas of industrialization, employment creation, reduction of poverty, and provision of adequate security for the people.

Forced Migration and the Childbearing of Women and Men: A Disruption of the Tempo and Quantum of Fertility?

It is well known that migrant fertility is associated with age at migration, but little is known about this relationship for forced migrants. We study an example of displacement in which the entire population of Finnish Karelia was forced to move elsewhere in Finland in the 1940s. This displacement was unique because of its size and scale, because we have data on almost the whole population of both men and women who moved, and because of the similarity between origin and destination. These aspects enable us to investigate the disruptive impact of forced migration, net of other factors such as adaptation and selection. For all ages at migration from one to 20, female forced migrants had lower levels of completed fertility than similar women born in present-day Finland, which suggests a permanent impact of migration. However, women born in the same year as the initial forced migration showed no difference, which may indicate the presence of a counterbalancing fertility-increasing effect, as observed elsewhere for people born during a humanitarian crisis. There is less evidence of an impact for men, which suggests a gendered impact of forced migration-and its timing-on fertility. Results are similar after controlling for social and spatial mobility, indicating that there may be no major trade-off between reproduction and these forms of mobility.

Facilitating the prosocial development of Rohingya refugee children.

Prosociality is essential for the success of human societies. Children's prosocial development is found to increase in contexts that foster collaboration or emotion perspective taking and is negatively affected by exposure to extreme psychosocial trauma and adversity. Based on these findings, we assessed the effect of collaboration and emotion perspective taking on three types of prosocial behavior-helping, sharing, and comforting-in Rohingya children living in a refugee settlement in India (N = 122; age range = 4-11 years). Half of the children were born in Myanmar (i.e., experienced forced migration from genocide), and half were born in the refugee settlement after their families left Myanmar. We also included a small sample of Rohingya Canadian children (N = 20; age range = 3-12 years) as a within-culture comparison of overall levels of prosocial responding, which were higher in this group relative to children in a refugee settlement. We assigned children in the refugee settlement to one of three conditions-Collaboration, Emotion Perspective Taking (intervention conditions), or Drawing (control condition)-and assessed the three types of prosocial responding following the intervention. Prosocial responding was highest after Collaboration for children born in the refugee settlement and was highest after Emotion Perspective Taking for children born in Myanmar. Overall, these findings point to the potential prosocial benefit in refugee contexts for intervention programs that are responsive to children's lived experience.

Working with interpreters when working with forced migrants in mental health.

281 million people were recorded as having migrated across national borders by the United Nations in 2021, this equates to approximately 3.6 percent of the world's population. Forced migrants/refugees account for 12 per cent of all international migrants. A percentage of these people will not speak the language of their new country fluently. If they are to access and utilize mental health services, they will require access to an interpreter. This paper provides guidance on working with interpreters in health settings when the work is either face to face or on-line. These guidelines are based on those written by the authors for the British Psychological Society. Working effectively with interpreters should be a skill in the repertoire of every clinician. This is to ensure that equal opportunities are upheld and that certain groups (including forced migrants) are not denied access to mental health services. Interpreters may also assist with teaching clinicians about diverse cultural views surrounding mental health and well-being. They may also advise on idioms of distress, cultural meanings and expression of emotional problems across cultures, explanatory health models and contextual factors which may help extend the repertoire of clinicians. The guidelines cover key recommendations for practice, booking and finding an interpreter, preparation before the consultation/meeting, practical considerations, preparation with the interpreter, during the meeting/consultation, issues to address after the meeting, written translations, psychometric testing, working by telephone or online and other issues to consider when working with an interpreter. These are reproduced below (with the permission of the BPS) in a shortened and updated form.Key recommendations for practiceUndertake a language needs analysis of the population covered by your service or Trust and consider how you will best meet needs.If you have not undertaken training in working with interpreters, undertake a training course. If you are working with an interpreter unexpectedly and training is not feasible, read these or other relevant guidelines and allocate time to consider the issues or discuss them with a more experienced colleague.Check that the interpreter is qualified and appropriate for the consultation/meeting and speaks the service user's first language.Allocate 10-15 minutes in advance of the session to brief the interpreter about the purpose of the meeting and to enable them to inform you about any cultural issues which may have bearing on the session.Be mindful of issues of confidentiality and trust when working with someone from a small language community as the service user may be anxious about being identifiable and mistrustful of an interpreter's professionalism. This has particular relevance when working with forced migrants.State clearly that you alone hold clinical responsibility for the meeting.Commit to a collaborative working relationship based on trust and mutual respect.Match if appropriate for gender, age or religion, avoid using relatives and never use a child.Create an atmosphere where each member of the triad feels able to ask for clarification if anything is unclear and be respectful to your interpreter, they are an important member of the team who makes your work possible.Be aware of the well-being of your interpreter and mindful of the risk of vicarious traumatization. Consider what support they will be offered, and if they are subcontracted from an external agency, be aware that there is often little support provided by their employer.At the end of the session always allocate 10-15 minutes to debrief the interpreter about the session and offer support and supervision as appropriate.Extreme caution should be exercised when considering the use of translated assessment measures as languages and concepts are not interchangeable and results may therefore not be valid or meaningful.All written translations used should have been back translated to ensure they are fit for purpose.Commissioners of health services need to ensure that there are clear pathways to support for all members of their local community including those who do not speak the majority language.

Impact of war and forced displacement on children's mental health-multilevel, needs-oriented, and trauma-informed approaches.

The infliction of war and military aggression upon children must be considered a violation of their basic human rights and can have a persistent impact on their physical and mental health and well-being, with long-term consequences for their development. Given the recent events in Ukraine with millions on the flight, this scoping policy editorial aims to help guide mental health support for young victims of war through an overview of the direct and indirect burden of war on child mental health. We highlight multilevel, need-oriented, and trauma-informed approaches to regaining and sustaining outer and inner security after exposure to the trauma of war. The impact of war on children is tremendous and pervasive, with multiple implications, including immediate stress-responses, increased risk for specific mental disorders, distress from forced separation from parents, and fear for personal and family's safety. Thus, the experiences that children have to endure during and as consequence of war are in harsh contrast to their developmental needs and their right to grow up in a physically and emotionally safe and predictable environment. Mental health and psychosocial interventions for war-affected children should be multileveled, specifically targeted towards the child's needs, trauma-informed, and strength- and resilience-oriented. Immediate supportive interventions should focus on providing basic physical and emotional resources and care to children to help them regain both external safety and inner security. Screening and assessment of the child's mental health burden and resources are indicated to inform targeted interventions. A growing body of research demonstrates the efficacy and effectiveness of evidence-based interventions, from lower-threshold and short-term group-based interventions to individualized evidence-based psychotherapy. Obviously, supporting children also entails enabling and supporting parents in the care for their children, as well as providing post-migration infrastructures and social environments that foster mental health. Health systems in Europe should undertake a concerted effort to meet the increased mental health needs of refugee children directly exposed and traumatized by the recent war in Ukraine as well as to those indirectly affected by these events. The current crisis necessitates political action and collective engagement, together with guidelines by mental health professionals on how to reduce harm in children either directly or indirectly exposed to war and its consequences.

[Context of the emigration of Jewish neurologists (1933-1939)]. / Rahmenbedingungen der Emigration jüdischer Neurologinnen und Neurologen (1933­1939).

This article focuses on the historical context of the emigration of "Jewish" doctors during the "Third Reich". The approximately 9000 Jewish physicians, who were still able to emigrate, represented 17% of the German medical profession in 1933. Around three quarters of them left the German Reich by 1939, mainly for the USA, Palestine and Great Britain. Initially, Jewish organizations fueled hopes of a temporary exile; however, in the wake of the events of 1938 ("Anschluss" of Austria, failure of the Evian Conference, establishment of the Central Office for Jewish Emigration headed by Adolf Eichmann in Vienna, maximization of economic plundering etc.) emigration via the intermediate step of forced emigration had turned into a life-saving flight. Scientists could appeal to special aid organizations for support. Among the best known are the Emergency Community of German Scientists Abroad initiated in Zurich, the Academic Assistance Council founded in England, from which originated the Society for the Protection of Science and Learning as well as the Emergency Committee in Aid of Displaced German Scholars created in New York. Their help was often subject to criteria, such as publication performance, scientific reputation and age. Promising researchers who were awarded a scholarship before 1933 could rely on a commitment from the Rockefeller Foundation. The historical analysis of options and motivations but also of restrictions and impediments affecting the decision-making process to emigrate, provides the basis for a retrospective approach to individual hardships and fates.

[" no reservations against the dismissals": the expulsion of neuroscientists from Berlin]. / " keinerlei Bedenken gegen die Entlassungen": die Vertreibung von Neurowissenschaftlerinnen und Neurowissenschaftlern aus Berlin.

Before 1933 Berlin was considered a center of clinical neurology and neuroscientific research in the German Reich. Using a group biographical approach and drawing upon scattered secondary literature as well as upon various archival documents, this article provides an overview of 12 less well-known physicians and researchers who were forced into exile during the nationalsocialist (NS) era, primarily for racist reasons. Among those affected by NS persecution were Franz Kramer and Fredy Quadfasel (Charité), Ernst Haase, Carl Felix List, and Lipman Halpern (Moabit Hospital), Paul Schuster (Hufeland Hospital), and Clemens Ernst Benda (Augusta Hospital). Others who were forced to emigrate were Franz Josef Kallmann (Herzberge Sanatorium), Max Bielschowsky, and Hans Löwenbach (Kaiser Wilhelm Institute for Brain Research), Otto Maas (Berlin-Buch Clinic), and Kurt Löwenstein (Lankwitz). A total of 6 neurological departments at municipal hospitals were run by (in NS terminology) "non-Aryans" in 1933. With their expulsion, the existence of neurological treatment and training centers outside the university ended and did not resume until the 1960s.

["Impossible to be part of this system any longer": the expulsion of neuroscientists from Frankfurt am Main (1933-1939)]. / "Impossible to be part of this system any longer": die Vertreibung von Neurowissenschaftlerinnen und Neurowissenschaftlern aus Frankfurt am Main (1933­1939).

In the 1920s, the situation of neuropsychiatry in Frankfurt was characterized by the rivalry between two institutions (Edinger Institute and University Neurology Clinic), two subdisciplines (neurology and psychiatry), and the physicians Kurt Goldstein (1878-1965) and Karl Kleist (1879-1960). After the National Socialists' assumption of power, university neuropsychiatric institutions in Frankfurt showed the highest number of dismissed university teachers and personnel in the German Reich. In neurology and psychiatry alone the university lost almost 50% of the personnel. Among those persecuted on racist grounds was Leo Alexander (1905-1985), who carried out genetic studies before 1933, prepared the "Alexander Reports" on behalf of the Allies after the Second World War, and was one of the prosecution counselors in the Nuremberg Doctors' Trial. His colleague Walther Riese (1890-1976) fled via France also to the USA and dedicated himself to the historical and ethical principles of neurology. Alice Rosenstein (1898-1991) was the first woman to specialize in neuroradiology and neurosurgery. In contrast to her male colleagues who were also dismissed in 1933, she committed herself to psychiatry after her arrival in North America and belonged to the early campaigners for the rights of homosexuals. Ernst (1905-1965) and Berta (1906-1995) Scharrer finally left Germany because of the prevailing political climate in the country. They excelled as co-founders of neuroendocrinology and neuroimmunology on the other side of the Atlantic.

[" without a visible sign of protest or at least solidarity from colleagues": the expulsion of neuroscientists from Hamburg]. / " ohne ein sichtbares Zeichen des Protestes oder wenigstens der Solidarität der Kollegen": die Vertreibung von Neurowissenschaftlern aus Hamburg.

In Hamburg, the National Socialists' racially motivated exclusion principally hit neurologists from two institutions: the Eppendorf Neurological Clinic (director until 1934 Max Nonne) and the Psychiatric and Neurological Clinic of Friedrichsberg State Hospital (director Wilhelm Weygandt). The chief physician of the neurological department of Barmbek Hospital, Heinrich Embden (1871-1941), who had been trained by Nonne, emigrated to Brazil, whereas Friedrich Wohlwill (1881-1958), another Nonne pupil who had been a pathologist at St Georg since 1924, lived for many years in Lisbon, before he found a new scientific home at the Harvard Medical School. The cerebrospinal fluid researcher Victor Kafka (1881-1955), a Freemason and intermittent member of the Communist Party, was briefly in so-called protective custody (Schutzhaft) in Fuhlsbüttel then fled via Norway to Sweden. Hermann Josephy (1887-1960) and Walter R. Kirschbaum (1894-1982), both imprisoned in the Sachsenhausen concentration camp after the November pogroms in 1938, could successfully continue their professional careers in Chicago. Richard Loewenberg (1898-1954) first opted to continue his career in China, then changed his mind and also went to the USA after the Japanese invasion. With the exception of the latter all were full members of the Society of German Neurologists. The broad scope of their research work clearly illustrates that in addition to clinical core competence, former neurologists could intensively follow scientific interests in the neighboring disciplines of pathology, serology, and psychiatry.

["There are no worthy life opportunities from a human, professional or scientific viewpoint": expelled neurologists outside the centers of German-speaking neuroscience]. / "Weder menschlich noch beruflich, noch wissenschaftlich würdige Lebensmöglichkeiten": vertriebene Neurologen außerhalb der Zentren der deutschsprachigen Neurowissenschaft.

The persecution and expulsion of German-speaking neurologists were not limited to research centers, such as Berlin, Vienna, Frankfurt am Main and Hamburg. The exclusion from science, teaching and clinical care also occurred at other (university) sites. The different aspects and implementation of the exclusion are presented here exemplified by 10 physicians involved in neuroscience. These ranged from forced internal emigration (Georg Stertz/Kiel), racially motivated removal from office (Max Isserlin and Karl Neubürger/both Munich, Ernst Grünthal/Würzburg, Gabriel Steiner/Heidelberg, Rudolf Altschul and Francis Schiller/both Prague) to publicly staged denunciation and humiliation (Otto Löwenstein/Bonn). Furthermore, without being directly persecuted themselves, individual physicians reacted to the poisoned political and academic climate in that they either sooner or later left their homeland (Eduard Heinrich Krapf/Cologne, Hartwig Kuhlenbeck/Jena). The results and conclusions summarized in this article for university clinics and institutes represent only a narrow section of the neurological scene in 1933-1939; however, they emphasize how necessary an expansion of the historical research perspective is on the fate of neurologists at communal hospitals, in field practices and other professional areas.

[Persecution, expulsion and extermination of German-speaking neurologists during the NS era: attempt at an assessment]. / Verfolgung, Vertreibung und Vernichtung deutschsprachiger Neurologinnen und Neurologen während der NS-Zeit: Versuch einer Bewertung.

Some 90 years after the beginning of the Nazi regime, the German Neurological Society (DGN) commissioned an investigation into the extent to which persecution, expulsion and extermination during the "Third Reich" also affected neurologists. In total, the biographies of 61 mostly Jewish physicians and scientists, of whom more than 70% were members of the neurological association of the time, could be analyzed. Most of them emigrated, a few remained in Germany or Austria despite persecution, and nine died in the Holocaust or by suicide. The racistically motivated expulsion affected all age groups, especially those who were 30-60 years old in "middle" positions. In close connection with Nazi legislation, three waves of emigration can be distinguished (1933-1934, 1935-1937, 1938-1939) and the clearly preferred destination country was the USA (64.7%). Younger age, knowledge of a universal language, reliable family and academic connections as well as internationally recognized publications, could make it easier to start a career in the country of exile. It was not uncommon for those who were involved in neurological fields before emigration to turn to basic science or psychiatry afterwards. The general "brain-drain"/"brain gain" hypothesis must be expanded by analyses on the biographical microlevel in order to illustrate the difficulties emigrants encountered when trying to start a new career and to publicize a sometimes unsuccessful acculturation. Not a single neurologist returned to Germany and, as far as can be assessed, any compensation, if at all was low. The critical assessment of the racistically motivated persecution between 1933 and 1945 can today be an occasion for the DGN and its members to reflect on collegiality as a value as well as to become more aware of structurally related discrimination and injustice and to counteract it in a timely manner.

[The exclusion of "non-Aryan" scientists: universities, clinics and professional organizations]. / Der Ausschluss "nichtarischer" Wissenschaftler: Universitäten, Kliniken, Standesorganisationen.

With the implementation of the Law for the Restoration of the Professional Civil Service (1933), including the Third Implementation Decree (1934), the Regulation for Obtaining a Teaching License (1934) and the Law for the Dismissal and Transfer of University Teachers (1935), the National Socialist (NS) government created legislative instruments to ban university staff (from lecturers to full professors) labelled as Jewish or considered politically unwanted from teaching and research. Whereas around 20% of the staff at the universities were affected by these measures after 1933, at various medical faculties the figures reached 30-40% and at neurological departments and institutes sometimes up to 90%. Student Nazi activists played a significant role in expelling faculty members from office. As beneficiaries of the expulsions, young doctors often improved their career prospects and established professors remained silent out of political conviction, opportunism or fear. A (self) coordination (Gleichschaltung) with immediate or gradual exclusion of "non-Aryan" members and boards is documented for numerous medical organizations and associations (e.g. Deutscher Ärztevereinsbund, Hartmannbund, German Medical Women's Association, Association of Statutory Health Insurance Physicians) as well as for scientific academies (e.g. Leopoldina) and research societies (Kaiser Wilhelm Institutes, German Research Foundation). The NS-loyal Society of German Neurologists and Psychiatrists, which had been founded in 1935, tolerated "Jewish" members until 1938. As a whole, the picture that emerged from everyday medical (and neurological) practice is one of drastic changes that massively affected not only the lives of many doctors but also the moral standards in terms of patient care, teaching, research and collegiality.

Mobile agency and relational webs in women's narratives of international study.

Internationalisation and forced migration are rarely thought about as related phenomena in higher education (HE) literature. Internationalisation is associated with movement, choice and brand recognition, and used in international rankings methodologies as a proxy for quality. Forced migration is associated not only with movement, but also with lack of choice, containment, or 'stuckness'. Some scholars have called for a rethinking of 'the international' through attention to students as mobile agents, and international study as situated within broader mobile lives. Our study responded to these calls through exploring the educational biographies of 37 international and refugee-background women students based in two universities: 21 in New Zealand and 16 in Bangladesh. Ten of the women were from refugee or refugee-like backgrounds, while the remainder were international students. The women's accounts revealed the complex ways in which circumstances shaped their educational journeys similarly and differently. One woman represented mobility in relation to autonomy and choice; but most emphasised relational webs as shaping their access to and experiences of international study, and post-study aspirations. In this paper, we draw on selected narratives to illustrate the range of ways in which family and/or community members appeared in women's accounts of their education journeys: as a source of (1) sustenance and support; (2) inspiration and motivation; and (3) obligation, and sometimes regulation. We conclude by suggesting that attention to the affective and embodied entanglements that shape students' international study journeys might inform new ways of thinking about both 'the international' and higher education more broadly.

Sensitivity-driven simulation development: a case study in forced migration.

This paper presents an approach named sensitivity-driven simulation development (SDSD), where the use of sensitivity analysis (SA) guides the focus of further simulation development and refinement efforts, avoiding direct calibration to validation data. SA identifies assumptions that are particularly pivotal to the validation result, and in response model ruleset refinement resolves those assumptions in greater detail, balancing the sensitivity more evenly across the different assumptions and parameters. We implement and demonstrate our approach to refine agent-based models of forcibly displaced people in neighbouring countries. Over 70.8 million people are forcibly displaced worldwide, of which 26 million are refugees fleeing from armed conflicts, violence, natural disaster or famine. Predicting forced migration movements is important today, as it can help governments and NGOs to effectively assist vulnerable migrants and efficiently allocate humanitarian resources. We use an initial SA iteration to steer the simulation development process and identify several pivotal parameters. We then show that we are able to reduce the relative sensitivity of these parameters in a secondary SA iteration by approximately 54% on average. This article is part of the theme issue 'Reliability and reproducibility in computational science: implementing verification, validation and uncertainty quantification in silico'.

How Are Forcibly Displaced People Affected by the COVID-19 Pandemic Outbreak? Evidence From Brazil.

Refugees tend to be a neglected population during health emergencies. This article studies how the COVID-19 pandemic outbreak in Brazil affected forcibly displaced people considering their intersectional multiple identities. I conducted 29 semistructured phenomenological interviews with refugees living in the states of São Paulo and Rio de Janeiro between March 27 and April 06, 2020. These states' governors closed nonessential services and schools. The results indicate that refugees face three challenges connected to this pandemic: (a) same challenges as Brazilians due to their labor vulnerability social identity, (b) challenges aggravated by the pandemic due to their identity of nonnationals including access to information and services, and (c) new challenges due to their social identity of forced displaced nonnationals including closing of migration services and borders and the feeling of "living the pandemic twice." This research contributes to the literature of intersectionality and asylum by understanding how refugees in the Global South are affected by pandemics and responses to them, considering their own lived experiences and multiple social identities.

Active and latent tuberculosis in refugees and asylum seekers: a systematic review and meta-analysis.

BACKGROUND: In 2018, there were 70.8 million refugees, asylum seekers and persons displaced by wars and conflicts worldwide. Many of these individuals face a high risk for tuberculosis in their country of origin, which may be accentuated by adverse conditions endured during their journey. We summarised the prevalence of active and latent tuberculosis infection in refugees and asylum seekers through a systematic literature review and meta-analyses by country of origin and host continent. METHODS: Articles published in Medline, EMBASE, Web of Science and LILACS from January 2000 to August 2017 were searched for, without language restriction. Two independent authors performed the study selection, data extraction and quality assessment. Random effect models were used to estimate average measures of active and latent tuberculosis prevalence. Sub-group meta-analyses were performed according to country of origin and host continent. RESULTS: Sixty-seven out of 767 identified articles were included, of which 16 entered the meta-analyses. Average prevalence of active and latent tuberculosis was 1331 per 100 thousand inhabitants [95% confidence interval (CI) = 542-2384] and 37% (95% CI = 23-52%), respectively, both with high level of heterogeneity (variation in estimative attributable to heterogeneity [I2] = 98.2 and 99.8%). Prevalence varied more according to countries of origin than host continent. Ninety-one per cent of studies reported routine screening of recently arrived immigrants in the host country; two-thirds confirmed tuberculosis bacteriologically. Many studies failed to provide relevant information. CONCLUSION: Tuberculosis is a major health problem among refugees and asylum seekers and should be given special attention in any host continent. To protect this vulnerable population, ensuring access to healthcare for early detection for prevention and treatment of the disease is essential.

Negotiating identity at the intersection of family legacy and present time life conditions: A qualitative exploration of central issues connected to identity and belonging in the lives of children of refugees.

INTRODUCTION: Most studies on refugee populations are organized around trauma-related issues and focus on explanations of pathological factors. Few studies are anchored in general developmental psychology with the aim of exploring normal age-specific developmental tasks and how the special circumstances associated with forced migration can influence that development. METHODS: Using an ecological and transactional understanding of developmental trajectories, this qualitative study explored issues connected to identity formation processes in an exile context based on interviews with 6 male and 10 female children of refugees (18-26 years) who have grown up in Norway. RESULTS: The findings show that family experiences of war and conflict intersect with experiences of marginalization in exile. The interaction of these experiences influences the development of individual identity in cumulative and complex ways. Many of the participants expressed feelings of isolation, disconnectedness, and a lack of belonging. Nevertheless, though the participants described growing up facing major challenges, they also searched for ways to reframe their difficult personal and family histories into meaningful experiences. CONCLUSIONS: In order to provide conditions and develop interventions that can support well-being and identity development, we need a better understanding of the different forces that influence the identity development of children of refugees. By foregrounding the participants' experiences, and perspectives, we gained insight into different ways in which participants negotiate identity issues in relation to often contradictory demands and messages from family and the wider social context.