Primary care
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Circumstances forcing individuals and families to flee set the stage for disruptions in mental health and forge resilience. Individual characteristics and conditions premigration, perimigration, and postmigration influence health, mental health, care-seeking behavior, and stages of well-being and successful resettlement. ⋯ Integrated or collaborative care models are ideal for delivering optimum care for refugee and immigrant communities. Connecting primary and behavioral care promotes a team approach; provides comprehensive, whole-person care; and relies on participation of patients and families.
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This article describes hematologic, nutritional, allergic/asthmatic conditions, lead screening, and management of these among immigrants and refugees. Some of these conditions present more frequently or differently in the newcomer population. ⋯ Screening and treatment suggested in this article are based on current guidelines and are intended for primary care providers who are caring for refugee and immigrant patients, especially within a medical home. Special considerations include level of education, instruction, demonstration, and cultural humility.
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The domestic medical examination of newly arrived refugees is a comprehensive medical visit. It includes a review of the overseas medical examination and a thorough medical and immigration history. ⋯ It should also include vaccinations for age-appropriate vaccine-preventable diseases. The concept of preventive care should be introduced, and future visits should be scheduled for preventive care.