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Panuganti PL, Al-Hariri L, Toll E, Goldman RE. Refugee Resettlement: Case Studies of Two Syrian Women in Rhode Island. R I Med J (2013) 2021; 104:43-46. [PMID: 34582516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND Key elements of social integration of refugees overlap with the social determinants of health. Limited research exists about Syrian refugees' resettlement in Rhode Island (RI). METHODS Case study life history method: Two Syrian women in RI were interviewed and observed longitudinally. Content analysis cycles led to emerging topics. Key informant interviews informed the question guide. RESULTS Several themes emerged: (1) Interpreters, community health workers (CHWs), and patient navigators help access healthcare; (2) Education about healthcare maintenance is important; (3) Anti-refugee bias has compromised safety and psychosocial wellness; (4) Although hard work is prioritized, high hopes for education and employment conflict with reality; and (5) Syrian women have unique experiences during resettlement. CONCLUSIONS RI leaders can address resettlement challenges through investment in CHW programs, peer-led health initiatives, English language education, interpreter services, psychosocial support, migrant rights education, social opportunities, and job training and matching.
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Affiliation(s)
| | | | - Elizabeth Toll
- Departments of Pediatrics and Medicine, Warren Alpert Medical School, Providence, RI
| | - Roberta E Goldman
- Department of Family Medicine, Warren Alpert Medical School, Providence, RI
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Panuganti PL, Hinkle SN, Rawal S, Grunnet LG, Lin Y, Liu A, Thuesen ACB, Ley SH, Olesen SF, Zhang C. Lactation Duration and Long-Term Thyroid Function: A Study among Women with Gestational Diabetes. Nutrients 2018; 10:nu10070938. [PMID: 30037073 PMCID: PMC6073731 DOI: 10.3390/nu10070938] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 07/09/2018] [Accepted: 07/17/2018] [Indexed: 12/20/2022] Open
Abstract
Lactation is associated with reduced postpartum weight retention and a lower risk of several cardiometabolic disorders in population-based studies. We examined the association between lactation and long-term thyroid function among women with history of gestational diabetes mellitus (GDM), a high-risk population for subsequent metabolic complications. The study included 550 women who developed GDM in the Danish National Birth Cohort (1996–2002) and followed-up in the Diabetes & Women’s Health Study (2012–2014). We assessed adjusted associations between cumulative lactation duration and concentrations of thyroid stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4) measured at follow-up. Women with longer cumulative lactation duration tended to have higher fT3 levels (adjusted β and 95% confidence interval (CI) for ≥12 months vs. none: 0.19 (0.03–0.36); p-trend = 0.05). When restricted to women with a single lifetime pregnancy to control for parity (n = 70), women who lactated for >6 months (vs. none) had higher fT3 levels (0.46 pmol/L (0.12–0.80); p-trend = 0.02) and a higher fT3:fT4 ratio (0.61 (0.17–1.05); p-trend = 0.007). Our findings suggested that a longer duration of lactation may be related to greater serum fT3 levels and fT3:fT4 ratio 9–16 years postpartum among Danish women with a history of GDM. The association was particularly pronounced among women who only had one lifetime pregnancy.
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Affiliation(s)
- Pranati L Panuganti
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20817, USA.
- The Warren Alpert Medical School of Brown University, Providence, RI 02903, USA.
| | - Stefanie N Hinkle
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20817, USA.
| | - Shristi Rawal
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20817, USA.
- Department of Nutritional Sciences, School of Health Professions, Rutgers University, Newark, NJ 07107, USA.
| | - Louise G Grunnet
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, DK-2300 Copenhagen, Denmark.
- Department of Endocrinology, Rigshospitalet University Hospital, DK-2200 Copenhagen, Denmark.
- The Danish Diabetes Academy, DK-5000 Odense, Denmark.
| | - Yuan Lin
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20817, USA.
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN 46202, USA.
| | - Aiyi Liu
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20817, USA.
| | - Anne C B Thuesen
- Department of Endocrinology, Rigshospitalet University Hospital, DK-2200 Copenhagen, Denmark.
| | - Sylvia H Ley
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA.
- Channing Division of Network Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA 02115, USA.
| | - Sjurdur F Olesen
- Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institut, DK-2300 Copenhagen, Denmark.
| | - Cuilin Zhang
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20817, USA.
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