Pain in Refugee and Migrant Populations
This systematic review aims to collect data about pain prevalence and treatment outcomes among displaced people, including asylum-seekers or migrants.
People in Refugee and Pain
Chronic pain is a common problem among refugees and displaced people. One study found that 66% of refugees are affected by chronic pain.1 However, very few studies on chronic painful conditions include refugees and other displaced persons such as migrants as subjects. Moreover, most multidisciplinary pain management studies are done in Western countries, and issues are usually from Western populations.
The potential study population is enormous: According to the United Nations Refugee Agency, UNHCR, at the end of 2021, persecutions, violence, conflicts, or events that severely disrupted public order resulted in the forcible displacements of more than 89 million people around the world.
To evaluate the effectiveness of multidisciplinary, culturally-adapted intervention programs over time, we need large-scale, well-designed studies. Michael Boutros MD, an associate professor of Anesthesiology and medical director of Pain Services at the Keck School of Medicine at the University of Southern California, said we don’t have it. We have some cohort studies and a few randomized control studies but nothing that would help from a significant perspective.
Because pain medicine is increasingly inter- and multidisciplinary in its treatment of chronic pain, it is essential to assess how effective these modalities are in treating chronic pain in immigrants and refugees.
Pain Prevalence among Asylum-Seekers and Refugees
Monash University, Melbourne, Australia, and Deakin University, Burwood, Australia, set out to analyze the available studies. The systematic review of the effective interventions for chronic pain in the refugee and the immigrant population was published in May in the journal Patient Education and Counseling.
The review included studies from Ovid (MEDLINE, Epub Ahead of Print and EMBASE, and PsychINFO), Scopus, Scopus, and CINAHL. All the selected studies were published in English, including patients older than 18. Chronic pain due to cancer was not included. The final analysis revealed that 21 papers, 13 cohort studies, and eight RCTs met the inclusion criteria. The majority of studies were multidisciplinary or psychological interventions. However, some articles focused on education, exercise therapy, or culturally appropriate information (e.g., medication and self-care education).
Only three studies focused on refugees, asylum-seekers, or survivors of torture. The rest were mainly about migrants. The most common types of chronic pain reported were back, shoulder, and widespread, indistinct pain. Three studies were conducted with participants suffering from fibromyalgia, while one included women with chronic pelvic problems. The pain suffered by refugees, asylum seekers, and those from countries subject to torture was generally more severe than the pain suffered by migrants. Women reported lower pain tolerance, more baseline symptoms, depression, anxiety, and more PTSD than men.
Sixty-two per cent of the studies included used a multidisciplinary approach for managing chronic pain. This typically involved consultations or cross-referrals among different medical specialties, physiotherapists and social workers, occupational therapy, psychologists, and therapists. The studies used bilingual interpreters, cultural support, and translated material. Two of the studies also involved bilingual healthcare teams.
Multidisciplinary approaches have the best outcomes.
While 80% of studies showed improvement in chronic pain symptoms, such as intensity, disability, and frequency, the results did not last long. Multidisciplinary care and/or exercise were the only methods that showed long-term positive effects.
One study found that yoga class participants from diverse ethnicities reported lower analgesic and opiate usage (13% versus 73%) and more significant improvement (73% versus 27%) compared to usual care.
However, the overall impact of these interventions was not their effectiveness but rather the lack of interventions that address the cultural influence on pain. Although pain is often conceptualized and expressed differently in different cultures, the best way to tailor treatment to each individual remains inconsistent. This applies even to stable populations with low resources in the US.
The study authors still wrote that “our review showed that multidisciplinary chronic pain treatments can be effective in managing both pain intensity and physical function in refugee and immigrant populations.” However, they added, “Without longer follow-up periods, it is difficult to determine the long-term effectiveness of these interventions.”
It is a formidable challenge. Dr. Bottros said that the United States does not clearly understand proper pain management. He noted that some still don’t fully understand the multidisciplinary approach to pain management and what it should look like. “If there is a barrier to our treatment of citizens in our country, how can we expect refugees to be treated?”
Drug and Alcohol Rehab in Texas
Drug and alcohol addictions can have a significant impact on a person’s life, causing physical, emotional, and mental health problems. Fortunately, Texas has a number of rehabilitation centers that can help people struggling with addiction recover and rebuild their lives. This article discusses what it takes to recover from drug and alcohol rehab in Texas and highlights some of the best drug rehab centers in the state.
What is Drug and Alcohol Rehab?
Drug and alcohol rehabilitation is a treatment program that helps individuals struggling with drug addiction overcome their dependence on drugs or alcohol. Rehabilitation centers typically offer a variety of services, including drug rehabilitation, individual and group therapy, and medication-assisted therapy (MAT). The goals of rehabilitation are to help individuals sober up, develop coping skills to sustain long-term recovery, and improve overall health and well-being.
Types of drug and alcohol rehabilitation
There are several types of drug and alcohol rehabilitation programs:
- Inpatient Rehabilitation – Also called inpatient rehabilitation, inpatient rehabilitation is a type of treatment in which individuals stay in a rehabilitation center for an extended period of time (usually 30 to 90 days). Inpatient rehabilitation provides a structured and supportive environment that allows individuals to focus on their recovery without interruptions.
- Outpatient Rehabilitation – Outpatient rehabilitation allows an individual to receive treatment in their home. Outpatient programs usually involve attending therapy sessions and conferences several times a week. Outpatient rehabilitation is ideal for people with mild to moderate poisoning or who are unable to work or attend school.
- Partial Hospitalization Program (PHP) – PHP is a rehabilitation service that provides intensive care while an individual lives at home. A PHP program typically consists of attending therapy sessions and conferences for a few hours each day, five days a week.
- Intensive Outpatient Program (IOP) – An IOP is a rehabilitation service that provides intensive care while allowing an individual to live at home. An IOP plan usually involves attending therapy sessions and conferences several times a week for several hours each day.
Best Drug and Alcohol Rehab Centers in Texas
- La Hacienda Treatment Center – La Hacienda Treatment Center is a residential rehabilitation center located in Hunter, Texas. The center offers a variety of services including drug rehabilitation, individual and group therapy, and MAT. La Hacienda has a highly trained team of addiction specialists who provide individualized treatment for each patient.
- The Right Step – The Right Step is a statewide network of outpatient and inpatient rehabilitation centers. The center offers a range of services including drug rehabilitation, individual and group therapy, and aftercare support. The Right Step has a comprehensive approach to drug addiction treatment that covers physical, emotional and spiritual recovery.
- Burning Tree – Burning Tree is a residential rehabilitation center located in Kaufman, Texas. This center specializes in helping individuals with chronic relapsing problems achieve long-term recovery. Burning Tree offers a highly structured and supportive environment, including individual therapy, group therapy, and 12-step sessions.
- Summer Sky Healing Center – Summer Sky Healing Center is a residential rehabilitation center located in Stephenville, Texas. The center offers a variety of services including drug rehabilitation, individual and group therapy, and aftercare support. Summer Sky has a highly trained team of addiction specialists who provide individualized treatment for each patient.
- Cenikor Foundation – The Cenikor Foundation is a non-profit organization that provides a range of services including inpatient and outpatient rehabilitation, drug rehabilitation and aftercare support. Located in Texas and Louisiana, these centers provide evidence-based treatment that addresses the physical, emotional, and spiritual aspects of addiction.
In conclusion, drug and alcohol rehabilitation centers in Texas offer a variety of services to help individuals struggling with addiction overcome dependence and achieve long-term recovery. At Texas’ premier rehabilitation centers, individuals can receive personalized treatment and support to rebuild their lives.
The Unexpected Impact of Breast Cancer: Dealing with the Psychological Aftermath
When diagnosed with breast cancer, patients experience a wide range of psychological challenges. During this time, it is important for health care providers to be sensitive and compassionate to the patient’s needs.
Psychologists can help breast cancer survivors overcome the emotional and mental impact of their diagnosis. In addition, they can use their knowledge of mind-body interactions to improve physical recovery.
Depression is a common comorbidity among breast cancer patients, which may result in a decreased quality of life and affect treatment outcomes. It is important to provide proper assessment and treatment for depression at the time of BC diagnosis, during the treatment journey, and monitoring after treatment completion.
Licensed psychologists and other mental health professionals can help women cope with the physical, emotional, and medical changes associated with breast cancer and medical treatments that can be distressing. They can also help women learn to control stress, anxiety, and depression so they are less likely to experience symptoms of these disorders in the future.
Depression is a serious mental illness that can affect a person’s ability to work, sleep, think and feel. It can also cause hallucinations (seeing or hearing things that are not there) and delusions (false beliefs that are not shared by others).
Despite advances in early detection and treatment, breast cancer remains a stressful experience. This stress can cause a number of psychological issues including depression and anxiety.
Anxiety is a common problem that many people experience at some point in their lives. It can be chronic and cause trouble with work, relationships, and daily activities.
Risk factors for anxiety include personality traits, a history of mental health problems, and other medical conditions. These can include heart, lung, or thyroid diseases that can trigger feelings of anxiety.
Life events that can raise your anxiety include trauma, loss, and a severe illness or health condition. Substance abuse can also make you more prone to anxiety.
Anxiety disorders can be treated with medication and psychotherapy. These treatments can help you learn to recognize and change thoughts that are making you anxious. They can also teach you ways to cope with stressful situations. The goal of these treatments is to restore calm so you can feel more in control of your life.
Post-traumatic stress disorder (PTSD)
After a traumatic event, it’s normal to experience stress symptoms for a while. These may include anxiety, irritability and trouble sleeping. However, for some people these symptoms continue longer than a few months and can develop into PTSD (post-traumatic stress disorder).
Women are more likely to have PTSD after experiencing trauma like military combat or sexual assault than men. This is because women often have a more intense reaction to certain types of trauma than men.
PTSD is caused by a traumatic event and can happen to anyone, at any age. But it can also be caused by things you do or say after the traumatic event, for example when you think about what happened or if you find it hard to relax.
PTSD is a long-lasting mental health condition that can be treated with talking therapy and medication. Medication such as venlafaxine and selective serotonin reuptake inhibitors (SSRIs) can help reduce some of the core symptoms, including nightmares and irritability.
Grief is a common emotional response to loss. It is often experienced after the death of someone, but grief can also be experienced when a person loses their relationship, job, pet, health, way of life or treasured possessions.
People may have a hard time dealing with their feelings, and they often feel confused or overwhelmed. These feelings may last for weeks, months or even years.
Researchers have developed a model of grief that is based on 5 stages: denial, anger, bargaining, depression and acceptance. While many people do move through these stages, it is important to remember that everyone’s experiences of grief are different.
Some women who have been diagnosed with cancer feel sad, upset or angry about their condition. It is a natural reaction to the changes that the disease has caused in their lives, and it can be very difficult to manage.
Breastfeeding and Milk Production: Understanding the Relationship and Increasing Supply
Breastfeeding is an incredible experience that offers numerous benefits for both the mother and the baby. Not only does it provide optimal nutrition for infants, but it also promotes bonding and offers health benefits for mothers. However, one of the mothers’ most common concerns is whether they produce enough milk for their babies. This article will explore the relationship between breastfeeding and milk production and provide tips on increasing your milk supply.
Understanding the Relationship between Breastfeeding and Milk Production
Breast milk is produced in response to demand. Therefore, the more a baby feeds, the more milk the mother produces. This is because the baby’s suckling stimulates the release of prolactin, a hormone that signals the body to produce more milk. Additionally, the more milk removed from the breast, the more the body produces. This means that frequent and effective feedings are crucial for maintaining milk production.
Factors That Affect Milk Production
While demand is the primary factor influencing milk production, other factors can also affect it. These include:
A poor latch can make it difficult for the baby to extract milk effectively from the breast, which can lead to decreased milk production. It can also cause nipple pain and discomfort for the mother. To ensure a proper latch, make sure your baby’s mouth is wide open, their lips are flanged outwards, and their chin is pressed into the breast.
Infrequent feedings signal the body that less milk is needed, decreasing milk production. In the early weeks, newborns may need to feed as often as 8-12 times per day, and as they grow, the frequency may decrease to 6-8 times per day.
Supplementation with Formula
Supplementing with formula can reduce the demand for breast milk, which can result in decreased milk production. If supplementation is necessary, it’s important to work with a healthcare professional to develop a plan that supports both breastfeeding and the baby’s nutritional needs.
Dehydration can affect milk production, as breast milk is mostly made up of water. To ensure adequate hydration, drink water and other fluids throughout the day, and try to limit your caffeine and alcohol intake.
Stress can interfere with the release of hormones that are involved in milk production. Therefore, taking care of yourself and managing stress through self-care, relaxation techniques, and seeking support when needed is important.
Tips for Increasing Milk Production
Breastfeed on Demand
Breastfeeding on demand, or whenever your baby shows signs of hunger, can help increase milk production. Trust your baby’s cues and feed them whenever they need to.
Switch Sides during Feedings
Switching sides during feedings can help ensure that both breasts are being stimulated and producing milk. It can also help prevent sore nipples and clogged milk ducts. Aim to switch sides every 10-15 minutes during each feeding.
Massage Your Breasts
Gently massaging your breasts before and during feedings can help stimulate milk production. For example, use your fingers to massage in a circular motion toward the nipple. You can also use a warm compress or shower before feedings to help increase blood flow to the breasts.
Breastfeeding can be challenging, especially in the early weeks. Seek support from a lactation consultant, a breastfeeding support group, or a trusted friend or family member with breastfeeding experience. They can offer tips and encouragement to help you through any challenges.
Stress can negatively affect milk production, so stay calm and relaxed while breastfeeding. Take deep breaths and focus on your baby’s cues and the bond you
are forming through breastfeeding. Remember that breastfeeding is a learning experience for you and your baby, and establishing a good milk supply takes time and practice.
Galactagogues are substances that are believed to help increase milk production. Some examples include fenugreek, blessed thistle, and fennel. However, it’s important to seek help from a healthcare professional before taking supplements or herbal remedies, as they may not be safe or effective for everyone.
Pumping can help increase milk production by providing additional stimulation to the breasts. It can also help you build up a supply of breast milk for times when you’re unable to breastfeed directly. Aim to pump after feedings, and gradually increase the length of your pumping sessions over time.
Take Care of Yourself
Taking care of yourself is crucial for maintaining a good milk supply. Ensure you eat a well-balanced diet, get enough rest, and stay hydrated. In addition, consider taking a prenatal vitamin or a supplement that contains iron and other nutrients that support milk production.
Breastfeeding is a beautiful and natural process providing numerous benefits for mothers and babies. While concerns about milk supply are common, it’s important to remember that milk production is a dynamic process influenced by many factors. Following these tips and seeking support can increase your milk supply and help you enjoy a positive and fulfilling breastfeeding experience.
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