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Background and Objectives: The aim of the study was to estimate prevalence rates of pathological gambling and problem gambling among veterans receiving VA care, since several studies have suggested that VA patients may be at increased risk to these conditions., Sample: consisted of 1,999 veterans randomly selected from VA centers and community clinics in the Albuquerque and Minneapolis catchment areas. Women and younger veterans were oversampled, due to anticipated low rates in these two groups., Results: revealed that the lifetime prevalence rate of pathological gambling weighted for current VA patients was 2.0%, twice the general adult population rate. Current 1-year weighted prevalence of pathological gambling was .9%, with an additional .2% having continued problem gambling and .9% recovered. Lifetime weighted problem gambling rate was 8.8%. Altogether, 10.7% had lifetime pathological gambling or problem gambling. Women had higher rates of pathological gambling, but similar rates of problem gambling compared to men. The greater prevalence of pathological gambling for younger veterans aged 20-29 (1.3%) compared to veterans aged 30-39 (.8%) was unusual and warrants further investigation., Conclusions and Scientific Significance: Veterans in VA care have higher rates of gambling problems than the general adult population. Female and young veterans have rates higher than those observed in other surveys of women and young adults., (Copyright © American Academy of Addiction Psychiatry.)

Objective: This study assessed whether a simple, readily implemented four-symptom somatic screen would be able to effectively identify current posttraumatic stress symptoms in victimized populations., Methods: The sample consisted of 622 Somali community-dwelling refugees who fled widespread violence and trauma occurring in East Africa during 1990-1992. Data were collected during 2000-2003 and included demographic characteristics, number of types of torture and nontorture trauma experienced earlier in Africa, and current self-rated posttraumatic stress symptoms, as measured by the Posttraumatic Stress Disorder Checklist (PCL). The sample was also assessed with the HADStress screen, which was developed for this study, to determine whether the screen was effective in detecting current posttraumatic stress symptoms. The HADStress screen assessed for the presence of four somatic symptoms: Headaches, Appetite change, Dizziness, and Sleep problems. All items were given equal weight. Possible scores on the screen range from 0 to 4, with higher scores indicating more somatic symptoms., Results: Univariate analysis showed that persons who experienced more types of trauma (both torture and nontorture trauma) and persons who had higher PCL scores (indicating more current posttraumatic stress symptoms) had significantly higher HADStress scores. Negative binomial regression analysis showed that PCL scores were the most effective variable in predicting HADStress scores. On the Tukey-B post hoc analysis, a HADStress score of 0 or 1 was associated with a mean PCL score of less than 30, a score of 2 was associated with a mean PCL score of 40.28, and a score of 4 was associated with a mean PCL score of 51.07 (suggesting that over 50% of this group would have active posttraumatic stress disorder)., Conclusions: A score of 2 or higher on the HADStress scale among refugees warrants additional evaluation for posttraumatic stress symptoms in clinical settings. For communitywide efforts at early recognition and treatment, a cutoff score of 4 may be more practical and cost-effective.

Purpose was to assess whether a 4-symptom somatic screen, shown to correlate with current post-traumatic stress symptoms in 1 refugee group, could function as a screening instrument in another group of refugees. Sample consisted of 512 community-dwelling refugees from Ethiopia. Data collection included demography, types of torture and nontorture trauma experienced a decade earlier in Africa, and current posttraumatic stress symptoms. Somatic symptoms included headaches (H), appetite change (A), dizziness and faintness (D), and sleep problems (S), added with equal weighting into the HADStress Screen, ranging from 0 to 4. Results showed that age, gender, torture, and other trauma experiences from a decade ago, and current posttraumatic stress symptoms predicted current somatic symptoms on univariate analyses. On a negative binomial regression model, current posttraumatic stress symptoms, male gender, and number of torture types predicted a high HADStress score. Post hoc tests supported cut-off levels at 3 and at 4 symptoms. Conclusion is that the HADStress Screen can serve as an efficient, nonthreatening screen for posttraumatic stress symptoms among refugees.

Aim: This paper reports a study identifying the demographic characteristics, self-reported trauma and torture prevalence, and association of trauma experience and health and social problems among Somali and Oromo women refugees., Background: Nearly all refugees have experienced losses, and many have suffered multiple traumatic experiences, including torture. Their vulnerability to isolation is exacerbated by poverty, grief, and lack of education, literacy, and skills in the language of the receiving country., Method: Using data from a cross-sectional population-based survey, conducted from July 1999 to September 2001, with 1134 Somali and Oromo refugees living in the United States of America, a sub-sample of female participants with clearly identified parenting status (n = 458) were analysed. Measures included demographics, history of trauma and torture, scales for physical, psychological, and social problems, and a post-traumatic stress symptom checklist., Findings: Results indicated high overall trauma and torture exposure, and associated physical, social and psychological problems. Women with large families reported statistically significantly higher counts of reported trauma (mean 30, P < 0.001) and torture (mean 3, P < 0.001), and more associated problems (P < 0.001) than the other two groups. Women who reported higher levels of trauma and torture were also older (P < 0.001), had more family responsibilities, had less formal education (P < 0.001) and were less likely to speak English (P < 0.001)., Conclusion: These findings suggest a need for nurses, and especially public health nurses who work with refugee and immigrant populations in the community, to develop a more comprehensive understanding of the range of refugee women's experiences and the continuum of needs post-migration, particularly among older women with large family responsibilities. Nurses, with their holistic framework, are ideally suited to partner with refugee women to expand their health agenda beyond the biomedical model to promote healing and reconnection with families and communities.

Objectives: This cross-sectional, community-based, epidemiological study characterized Somali and Ethiopian (Oromo) refugees in Minnesota to determine torture prevalence and associated problems., Methods: A comprehensive questionnaire was developed, then administered by trained ethnic interviewers to a nonprobability sample of 1134. Measures assessed torture techniques; traumatic events; and social, physical, and psychological problems, including posttraumatic stress symptoms., Results: Torture prevalence ranged from 25% to 69% by ethnicity and gender, higher than usually reported. Unexpectedly, women were tortured as often as men. Torture survivors had more health problems, including posttraumatic stress., Conclusions: This study highlights the need to recognize torture in African refugees, especially women, identify indicators of posttraumatic stress in torture survivors, and provide additional resources to care for tortured refugees.

Understanding the sociocultural context of prenatal care underuse by an immigrant population can suggest programmatic changes that result in more effective health care delivery. Ethnographic survey interviews of female Hmong clinic patients conducted in 1987/88 revealed that they objected to biomedical procedures and to being attended by several doctors; the women also reported poor communication with staff as a problem. Clinic reforms implemented in 1989/90 included hiring a nurse-midwife, reducing the number of pelvic examinations, expanding hours of operation, creating a direct telephone line to Hmong interpreters, and producing a Hmong-language prenatal health care education videotape. Women interviewed in 1993 reported a more positive clinic experience.

Laotian Hmong refugees in the Twin Cities of Minneapolis and St. Paul, Minnesota, cultivate many plants and employ them as a first line of defense against illness and disease. Thirty-seven medicinal plants have been identified, phytochemical components catalogued through literature research, and potential pharmacological activities correlated with Hmong medicinal uses. Using western biomedical criteria of efficacy, 92% of the medicinal plants being cultivated were found to be potentially efficacious. The frequent use of these plants in diet (81%) suggests that they have served to mediate against illness and disease states in the cultural and natural environment in which the practices evolved. A listing of 37 plants with Hmong names, uses and potentially active constituents is provided.