“They Kill People Over Nothing”: An Exploratory Study of Latina Immigrant Trauma

Abstract

This article presents findings from an exploratory, mixed methods study to: (1) Ascertain whether Latina immigrant clients of a healthcare clinic for uninsured patients suffer a higher rate of PTSD compared to the citizen population at large and (2) Explore whether factors unique to immigrants, such as surviving human smuggling, would predict PTSD. Two validated instruments were deployed with clients who agreed to be screened (n?=?62). Ten percent of U.S. women are expected to develop PTSD in a lifetime, a total tripled by immigrant women in this study. Women who scored high on the PTSD CheckList for Civilians (PCL-C) reported victimization from sexual assault, robberies and loss of friend/family member to violence, though no single assault predicted PTSD. Qualitative data, however, revealed that violence in countries of origin influenced decisions to immigrate. Among the avenues for future research identified by this study are (1) exploration of methods for linking Latina immigrants to mental health services, (2) determining the effects of smuggling violence on immigrants, and (3) Evaluate additive effects of multiple traumas.     

More than a piece of paper?: Personal education plans and ‘looked after’ children in England

This paper reports on research into personal education plans (PEPs) for ‘looked after’ children (children in care) in one large county local authority in England. PEPs were introduced by guidance from the Department for Education and Employment and Department of Health in 2000. The fieldwork for this research began two years after this guidance was published. The research findings show that although social services staff and teachers are critical of specific aspects of PEPs, they have helped to raise the profile of the educational needs of looked after children in the local authority studied. They have provided a forum for social work and education professionals to meet in the interests of particular children. Key problems relate to practical issues: ensuring social workers and teachers feel able to fulfil their expected roles in relation to the education of looked after children; making the system focus on meeting the needs of children as well as practitioners; difficulty in meeting specified timescales; more meaningful, constructive and sensitive involvement of children in the process of producing and reviewing PEPs. The broader issue, however, is about the ability to plan the education of looked after children. Additional barriers to planning were particularly apparent in residential care and specifically within secure accommodation.     

The Precautionary Principle in Context: U.S. and E.U. Scientists' Prescriptions for Policy in the Face of Uncertainty*

Objective. Our objective is to explain how scientists interpret less‐than‐certain scientific findings to inform policymakers' choices on controversial science policy issues. We focus on two particularly difficult policy cases concerning global climate change and low‐dose radiation protection. Methods. Our method is to analyze data from a unique multination survey of scientists to analyze the ways their views about what is scientifically correct are translated into judgments about appropriate policy. The surveys asked scientists, randomly drawn from U.S. and E.U. subscribers to the journal Science, to indicate the “most likely” relationships between greenhouse gas emissions and average global temperatures and between radiation dose and incidence of cancer in humans. Follow‐up questions asked for their judgments about appropriate policy targets for reductions in greenhouse gas emission and safety standards for radiation exposure. The data permit analysis of the relationships between scientific certainty and policy judgments in these two cases. Results. Our results shed light on when and how scientists reach precautionary policy conclusions, demonstrating that scientists' application of precaution is dependent on context. In the case of radiation protection, greater certainty is associated with less precaution. But with respect climate change, we found the opposite relationship. Conclusions. We conclude with a discussion of the implications for the role of scientists, and scientific advice, in the policy process.     

Student assistance program: a new approach for student success in addressing behavioral health and life events

College health centers, whether large or small, often find it challenging to provide counseling and supportive services for all students (including remotely located students) 24 hours a day, 7 days a week. Student assistance programs (SAPs) are services provided to students through a contractual arrangement to the university or college as a part of student services. The goal is to address psychosocial concerns that may interfere with academic performance within the realm of short-term counseling. These services range from traditional behavioral health concerns about stress and depressive reactions to how to find child care with foreign-speaking services. In this article, the authors describe a method to provide such short-term counseling to a 2,200-student health-science campus. They present data from 1 year of service as well as the benefits and limitations.     

Adjustment to disability

This article will focus on the biopsychosocial challenges encountered when an individual is disabled at an early age as well as when an individual acquires a disability later in life. Two case examples will focus on the adaptations/life choices that are necessary to adequately meet psycho/social/developmental needs and enhance individual self esteem. The case of Rita, a woman who lost her hearing at age two, highlights the importance of integrating a biopsychosocial approach to understand the multiple challenges and adaptations of individuals who are disabled at an early age. Laureen, a woman who acquired a spinal cord injury during her late teen years, described her struggles as a young adult adapting to a physical disability. Both cases highlight the importance of integrating an ecological/systems framework focusing on a biopsychosocial perspective, emphasizing the interrelationship between biological, psychological, social, technological, cultural and political factors.     

Methodologic challenges of e-health research

In this article, research-based strategies used in a web-based study to assess the impact of participation in cancer-related mailing lists on cancer survivors and caregivers are highlighted. The paper presents alternative methods of measuring response rates in Internet surveys. Response rate estimation, based on American Association for Public Opinion Research guidelines, ranged between 15% and 24.9% for the study. Several strategies were implemented to increase survey participation and reduce item nonresponse. Few participants opted for a telephone survey as an alternative to a web-administered design (mixed-mode administration). Using time-stamp data to diagnose places in the questionnaire where respondents prematurely exited or broke off survey participation, we were able to decrease premature break offs. A lottery was also implemented to increase response rates. The experience of obtaining institutional review board approval for the lottery is also described. Preliminary data indicate slight increases in response rates subsequent to implementing the lottery.