The American College Health Association (ACHA) has declared international students a campus population disproportionately affected by the novel coronavirus (COVID-19) in the United States (US; ACHA, 2020). More than a million international students study at US colleges and universities -5.5% of all US college students (IIE, 2020) -and occupy a precarious space at the intersection of immigration policy and global education mobility. As a group of temporary migrants, international students play a unique and complex role and cannot simply be defined in contrast to local students (Maleku et al., 2021). They participate in multiple economic systems as
Despite the rapidly growing need to understand mental health challenges faced by refugee subpopulations, there is a dearth of literature exploring mental health conceptualization through the unique refugee lens. Guided by historical trauma theory, we gathered data using a two-phase explanatory sequential mixed-methods study (quantitative:
n
= 40; qualitative:
n
= 6) in a Midwestern U.S. region to understand mental health conceptualization from the Bhutanese refugee perspective by examining the cultural meaning and perception of mental health, describing experiences of mental health problems, and examining cultural protective factors and coping strategies. We argue that recognition of refugees’ conceptualization of mental health and identification of cultural protective factors is paramount to healing. Findings emphasize the need to understand historical and cultural perspectives in cross-cultural contexts for the development and implementation of culturally responsive services. Our study also contributes to emerging knowledge on methodological rigor in research among understudied, hard-to-reach, small populations.
Background The best outcomes for acute stroke treatment occur through rapid recognition and transfer of patients to hospitals with a hyperacute stroke unit (HASU). Pre-hospital ambulance paramedics are crucial to this process as first responders, but they have limited feedback on subsequent patient care and progress to improve their learning. Methods A dedicated stroke training course for paramedics was developed on a HASU that involved a standardised introductory educational briefing and subsequent participation in clinical activities with multidisciplinary HASU staff. On completion of the course, attendees completed a standardised semi-structured questionnaire about their learning and experience. All text was thematically analysed and themes were developed by iteratively recoding and regrouping the data. Results 30 paramedics attended the training course over a three-month period. All candidates reported that the course was useful to their learning and training with ‘real-world’ transferability; 93% stated that they benefited from observing clinicians performing assessments on patients and 73% commented that they gained a better understanding of care pathways and treatment. These two themes encompassed 48% of 160 free-text responses with the other responses being grouped into four further themes (improved patient/family communication, increased awareness of subtle signs of stroke, localisation of intracranial pathology, and improved ‘handover’). Discussion This single centre experience of HASU training for paramedics demonstrated a number of key educational themes embedded within the stroke care pathway. This process may be a useful additional educational resource to develop further paramedic training in the hyperacute arena.
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