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Article
Publication date: 16 March 2015

Maureen Mayhew, Karen J. Grant, Lorena Mota, Setareh Rouhani, Michael C. Klein and Arminée Kazanjian

The purpose of this paper is to describe the patient level characteristics of government-assisted refugees (GARs) who had acquired family doctors after leaving specialized…

Abstract

Purpose

The purpose of this paper is to describe the patient level characteristics of government-assisted refugees (GARs) who had acquired family doctors after leaving specialized refugee clinics (RC).

Design/methodology/approach

A cross-sectional telephone survey of GARs households, three to six years after arrival to British Columbia, that used logistic regression to identify GAR characteristics associated with having a family doctor compared to having no family doctor or remaining at a RC.

Findings

Contact rate was 52 percent. Of 177 interviewed GARs who spoke 24 languages, only 61 percent had secured a family doctor. Only 57 percent were educated; 46 percent spoke English and 40 percent worked consistently. Central Asian or African origin was associated with having a family doctor (OR 10.6 (95 percent CI 3.1-36.8) for RC; OR 10.3 (95 percent CI 2.2-47.8) for no family doctor). Other significant characteristics in the comparison with GARs at a RC included English proficiency (OR 15.6 (95 percent CI 4.3-56.9)), and female sex (OR 4.0 (95 percent CI 1.4-1.1)). When compared to those with no family doctor, additional significant characteristics included Health Authority A compared to B (OR 8.9, 95 percent CI 1.4-55.6) and having recently visited a doctor (OR 7.7 (95 percent CI 1.9-30.7)).

Research limitations/implications

The results of this study are limited to a specific environment and the low contact rate may have resulted in bias.

Originality/value

This study described characteristics of GARs who had successfully transitioned to a family doctor and those who had not. This population is rarely captured in studies because they are difficult to contact, ethnically diverse and not proficient in English.

Details

International Journal of Migration, Health and Social Care, vol. 11 no. 1
Type: Research Article
ISSN: 1747-9894

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Article
Publication date: 15 June 2015

Lorena Mota, Maureen Mayhew, Karen J. Grant, Ricardo Batista and Kevin Pottie

International migrants frequently struggle to obtain access to local primary care practices. The purpose of this paper is to explore factors associated with rejecting and…

Abstract

Purpose

International migrants frequently struggle to obtain access to local primary care practices. The purpose of this paper is to explore factors associated with rejecting and accepting migrant patients into Canadian primary care practices.

Design/methodology/approach

Mixed methods study. Using a modified Delphi consensus approach among a network of experts on migrant health, the authors identified and prioritized factors related to rejecting and accepting migrants into primary care practices. From ten semi-structured interviews with the less-migrant-care experienced practitioners, the authors used qualitative description to further examine nuances of these factors.

Findings

Consensus was reached on practitioner-level factors associated with a reluctance of practitioners to accept migrants − communication challenges, high-hassle factor, limited availability of clinicians, fear of financial loss, lack of awareness of migrant groups, and limited migrant health knowledge – and on factors associated with accepting migrants − feeling useful, migrant health education, third party support, learning about other cultures, experience working overseas, and enjoying the challenge of treating diseases from around the world. Interviews supported use of interpreters, community resources, alternative payment methods, and migrant health education as strategies to overcome the identified challenges.

Research limitations/implications

This Delphi network represented the views of practitioners who had substantive experience in providing care for migrants. Interviews with less-experienced practitioners were used to mitigate this bias.

Originality/value

This study identifies the facilitators and challenges of migrants’ access to primary care from the perspective of primary care practitioners, work that complements research from patients’ perspectives. Strategies to address these findings are discussed.

Details

International Journal of Migration, Health and Social Care, vol. 11 no. 2
Type: Research Article
ISSN: 1747-9894

Keywords

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Article
Publication date: 16 March 2015

Karen J. Grant, Maureen Mayhew, Lorena Mota, Michael C. Klein and Arminée Kazanjian

– The purpose of this paper is to explore refugees’ experiences of the barriers and facilitators involved in finding a regular family doctor.

Abstract

Purpose

The purpose of this paper is to explore refugees’ experiences of the barriers and facilitators involved in finding a regular family doctor.

Design/methodology/approach

Hermeneutic phenomenology was used to produce an integrated description sensitive to the lifeworlds of refugees who came from multiple cultural perspectives. Participants consisted of refugees from Iran, Afghanistan, Myanmar, Vietnam, and Latin America who arrived in Canada between 2005 and 2007. Texts for analysis came from first language focus group discussions and interviews with the interpreters for those groups.

Findings

The principal themes that emerged from the experience of barriers were “futility,” “dependence,” and “relevance.” Themes related to the experience of facilitators were “inclusion,” “congruence,” and “benefit to family.” These themes provide key messages about sources of patient decisions to seek or not seek care, not comply, attend irregularly, and not disclose symptoms, which can be used by doctors and other health providers to enhance care planning.

Practical implications

The factors that facilitate refugees’ access to a regular family doctor have implications for the development of culturally appropriate healthcare information, policies that support adequate interpreter services, and cultural sensitivity training for physicians.

Originality/value

Previous research documents barriers such as lack of language access, differences in health beliefs, and lack of knowledge about western healthcare systems. However, little is known about how refugees experience these barriers, nor how they overcome them. This study contributes a rich and deeper understanding of how refugees experience these barriers and elucidates factors that facilitate their process of obtaining a regular family doctor.

Details

International Journal of Migration, Health and Social Care, vol. 11 no. 1
Type: Research Article
ISSN: 1747-9894

Keywords

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Article
Publication date: 30 November 2012

David V. Power and Rebekah J. Pratt

This paper's aim is to describe the health experiences of a recently arrived group of refugees, the Karen from Burma, in an American midwestern city.

Abstract

Purpose

This paper's aim is to describe the health experiences of a recently arrived group of refugees, the Karen from Burma, in an American midwestern city.

Design/methodology/approach

Four focus groups were conducted in their native language with 40 Karen refugees: one group of ten Sgaw Karen speaking men and one of women, one of East Pwo Karen speaking men and one of women. The focus groups and two additional individual interviews were coded using NVivo‐9.

Findings

The findings emphasize the significant communication barriers experienced by the Karen. The data provide rich insights into the struggles being experienced by these new Americans in their own words and highlight some of their differences from previous Asian refugees.

Research limitations/implications

These data are derived from focus groups with refugees in one city in the USA with few available demographic details. Their experiences and observations may not apply to other Burmese refugee groups in other cities and countries.

Practical implications

The data emphasize the complexity of language of this group of Burmese refugees which acts as a significant barrier to accessing health care. Poor or improper interpretation has increased obstacles. Data indicate that many struggle with simple health care tasks that are likely taken for granted by most providers. There appears to be more alcohol and tobacco usage amongst both genders than in other recently arrived Asian groups.

Originality/value

This is original research, which supplements a prior chart review and overview paper by the first author and supplements the otherwise scant literature on this group outside Asia.

Details

International Journal of Migration, Health and Social Care, vol. 8 no. 4
Type: Research Article
ISSN: 1747-9894

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Book part
Publication date: 28 June 1991

Karen Horny

Abstract

Details

Library Technical Services: Operations and Management
Type: Book
ISBN: 978-1-84950-795-0

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Article
Publication date: 11 June 2018

Jennifer J. Esala, Leora Hudak, Alyce Eaton and Maria Vukovich

The purpose of this paper is to explore the “active ingredients” of integrated behavioral health care (IBHC) from the perspective of Karen refugee participants in an IBHC…

Abstract

Purpose

The purpose of this paper is to explore the “active ingredients” of integrated behavioral health care (IBHC) from the perspective of Karen refugee participants in an IBHC intervention.

Design/methodology/approach

This paper is based on in-depth, semi-structured interviews with participants (n=40) who have received an IBHC intervention for one year. These qualitative data are supplemented by descriptive quantitative data from those same participants.

Findings

This research suggested that IBHC increased awareness and access to behavioral health services, and that IBHC may be especially amenable to treating complex health conditions. The research also found that IBHC provided a point of regular contact for patients who had limited time with their primary care providers, which helped to enhance access to and engagement with health care.

Practical implications

IBHC has the potential to meet the complex needs of Karen resettled refugees living in an urban setting in the USA.

Originality/value

IBHC is a promising approach to help meet the mental health needs of refugees in the USA. There are, however, gaps in knowledge about the “active ingredients” of IBHC. This paper helps fill these gaps by studying how IBHC works from the perspective of a group of Karen refugees; these are critical perspectives, missing in the literature, which must be heard in order to better address the complex conditions and needs of resettled refugees.

Details

International Journal of Migration, Health and Social Care, vol. 14 no. 2
Type: Research Article
ISSN: 1747-9894

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Book part
Publication date: 8 August 2014

Karen Pierce, Ted D. Englebrecht and Wei-Chih Chiang

This study examines whether Revenue Procedure 2003-61 is an improvement over Revenue Procedure 2000-15, in the areas of taxpayers’ expectations for IRS equitable relief…

Abstract

This study examines whether Revenue Procedure 2003-61 is an improvement over Revenue Procedure 2000-15, in the areas of taxpayers’ expectations for IRS equitable relief decisions and gender-related in-group bias. The survey instrument includes a vignette adapted from a judicial decision. The results show that Rev. Proc. 2003-61 does improve upon Rev. Proc. 2000-15. Furthermore, taxpayers perceive different expectations of what the IRS should do and what the IRS would do in equitable relief decision making. Also, gender-related in-group biases are found to be present for both genders. Tax policy implications regarding equitable relief are discussed.

Details

Advances in Accounting Behavioral Research
Type: Book
ISBN: 978-1-78190-838-9

Keywords

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Book part
Publication date: 29 October 2020

Oren Ergas and Karen Ragoonaden

In this chapter, we contribute to the conceptualization of self by engaging in a self-study of teacher education practices in which we distilled our perspectives on…

Abstract

In this chapter, we contribute to the conceptualization of self by engaging in a self-study of teacher education practices in which we distilled our perspectives on incorporating mindfulness in teacher education. Mindfulness is currently incorporated in teacher learning and education mostly toward stress-reduction and well-being, yet its ancestries stress its role as a path toward self-knowledge. Working in teacher education departments set in Israel, on the one hand, and Canada, on the other, we describe the place of the practice in our personal lives and articulate how we view its contribution to teacher education. Specifically, we focus on how “self” features in our endeavors, by examining “who it is” in the teacher that we seek to evoke/invoke by the application of mindfulness? We engaged in dialogue and reflective writing, in which each of us served as the other's critical friend in an attempt to clarify our different views. Oren emerges with a view of mindfulness as invoking “self as moment-to-moment experience” and the “teleological self,” both crucial for teachers. These senses of self mobilize us away from sociopolitical identities toward human-to-human relationships and reground teachers in the values they view as core to their call to teach. Conversely, Karen stresses the practice as a primer for situating the self in the sociopolitical. It enables deeper engagement in critical pedagogy, invoking teachers' “fluid self” situated in open-mindedness. Here mindfulness becomes a practice of social justice that allows us to acknowledge marginalized voices. Highlighting these different approaches, we contribute to the understanding of the role of mindfulness in teacher education. In particular, we extend the practice's main positioning within teacher well-being to its role within the discourse of teacher identity.

Details

Exploring Self Toward Expanding Teaching, Teacher Education and Practitioner Research
Type: Book
ISBN: 978-1-83982-262-9

Keywords

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Article
Publication date: 15 November 2011

George K. Stylios

Examines the sixteenth published year of the ITCRR. Runs the whole gamut of textile innovation, research and testing, some of which investigates hitherto untouched…

Abstract

Examines the sixteenth published year of the ITCRR. Runs the whole gamut of textile innovation, research and testing, some of which investigates hitherto untouched aspects. Subjects discussed include cotton fabric processing, asbestos substitutes, textile adjuncts to cardiovascular surgery, wet textile processes, hand evaluation, nanotechnology, thermoplastic composites, robotic ironing, protective clothing (agricultural and industrial), ecological aspects of fibre properties – to name but a few! There would appear to be no limit to the future potential for textile applications.

Details

International Journal of Clothing Science and Technology, vol. 23 no. 6
Type: Research Article
ISSN: 0955-6222

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Article
Publication date: 1 March 2014

Judith Harris, Karen S. McKenzie and Randall Rentfro

Using tax abatements to spur economic development can be controversial. The potential benefits are stressed when abatements are granted, but subsequent reporting may be…

Abstract

Using tax abatements to spur economic development can be controversial. The potential benefits are stressed when abatements are granted, but subsequent reporting may be insufficient for citizens to hold governments accountable for actual results. We solicited perspectives on tax abatements from three user groups (citizens representing advocacy groups, county board members, and financial analysts) and county officials involved in financial reporting, budgeting, or property tax administration. Users and preparers expressed generally similar views about the need for reporting; however, some differences were evident in the degree of support for reporting specific information items and the format for making information available. We also found that much information desired by users is not available to them currently, and governments may need to create mechanisms to collect information.

Details

Journal of Public Budgeting, Accounting & Financial Management, vol. 26 no. 3
Type: Research Article
ISSN: 1096-3367

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