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1.
J Forensic Leg Med ; 96: 102526, 2023 May.
Article in English | MEDLINE | ID: mdl-37126952

ABSTRACT

The rapidly growing population of asylum seekers in the United States often seeks asylum following persecution and severe traumatic events. Asylum evaluations play an influential role in the process by objectively documenting human rights abuses. The purpose of this study was to describe the prevalence of major depressive disorder (MDD) and anxiety disorders among asylum seekers and analyze differences in the severity of disease by time and sub-group. Data was collected from a retrospective review of medical affidavits written from 2017 to 2020 following asylum evaluations in South Florida. Decision trees were utilized to make diagnoses for each individual's current mental health status in the U.S. and retrospectively for while in their home country. These diagnoses were recorded according to the Global Burden of Disease study criteria and utilizing validated mental health screeners. The prevalence of MDD was found to significantly decrease from 75.8% in patients' home countries to 46.7% in the U.S. Similarly, prevalence of anxiety disorders significantly fell from 85.8% to 64.2%. Gender and being a victim of sexual assault were significantly associated with severity of MDD and anxiety disorders. This reduction in the burden of mental health disease after relocation to the United States demonstrate the benefit of asylum not only as a human right, but also as a mental health intervention. Through their connection with higher application success rates and referrals to follow-up care, physician-performed asylum evaluations can thus be linked to improved health outcomes.


Subject(s)
Depressive Disorder, Major , Refugees , Stress Disorders, Post-Traumatic , Humans , United States , Depressive Disorder, Major/epidemiology , Stress Disorders, Post-Traumatic/diagnosis , Florida/epidemiology , Refugees/psychology , Prevalence , Retrospective Studies , Anxiety Disorders/epidemiology
2.
Article in English | MEDLINE | ID: mdl-36612579

ABSTRACT

BACKGROUND: Firefighters are exposed to a unique set of carcinogens through their work environment that predispose them to several cancers, yet there is limited research related to cancer survivorship amongst this occupational group. METHODS: A mixed-method approach was used to assess cancer survivorship amongst firefighters. Four focus groups and one in-depth interview were conducted with 29 active and retired firefighters who have been diagnosed with cancer to understand the experiences and challenges associated with cancer survivorship in the fire service and desired resources. Qualitative data were analyzed using Nvivo software. All participants completed the Functional Assessment of Cancer Therapy-General (FACT-G) survey to assess their quality of life. RESULTS: The primary themes that emerged from the focus groups included managing health and well-being changes, navigating support systems in place, and accessing new resources. FACT-G scores (mean ± standard deviation) of the firefighter cancer survivor sample demonstrate relatively lower levels of emotional well-being (19.26 ± 4.67) and higher quality of life in the physical well-being (23.67 ± 5.08), social well-being (23.38 ± 4.16), and functional well-being (22.6 ± 4.966) domains. CONCLUSIONS: Firefighters requested curated resources, such as support groups and department training resources, supporting the need for more cancer survivorship resources specific to firefighters.


Subject(s)
Cancer Survivors , Firefighters , Neoplasms , Humans , Quality of Life , Focus Groups , Neoplasms/epidemiology
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