Workplace violence (WPV) by patients and visitors is a hazard in many emergency departments (ED), with serious consequences for both staff and patients. Patients with a migratory background seem to be prone to being involved in WPV. We therefore reviewed all reports of ED staff who experienced WPV over a 4-year period (2013–2016). We analyzed data on the reasons for the incident, the time of day, the manner of violence, the consequences, and the migratory background of the aggressor. In total, 83 cases of WPV were reported over a four-year period. The average age of the violent person was 33.1 years; in 35 cases (42.0%), aggressors were younger than 30 years old, 53 (63.8%) were male, 49 (59%) were of Swiss nationality, and 35–40% had a migratory background. The odds ratio of people originating from a low- to middle-income country versus those originating from a high-income country was 1.8. Furthermore, 45.8% of the patients arrived by ambulance (n = 38) and 19 patients (22.9%) were self-presenting. Most cases (92.8%) involved verbal aggression, but in more than half of the cases, physical assault (56.6%) was also reported. In addition, 43 (51.8%) of the events occurred during the night. Results also showed that 42 (50.6%) of patients who were involved in WPV were under the influence of alcohol and 29 (34.9%) suffered from psychiatric disorders. Security personnel and police were involved in 53 (63.9%) and 47 (56.6%) cases, respectively. Twenty patients (24.1%) were sedated and 16 (19.3%) were restrained. In 18 cases (21.7%), the psychiatrist ordered compulsory hospitalization in a psychiatric institution. Taken together, WPV is a relatively common event in our ED and persons with a migratory background are involved more often relative to their frequency of ED visits.

We investigated whether immigrants from Southeast Europe (SE) and Swiss patients have different reasons for visiting the emergency department (ED). Our retrospective data analysis for the years 2013–2017 describes the pattern of ED consultations for immigrants from SE living in Switzerland (Canton Bern), in comparison with Swiss nationals, with a focus on type of referral and reason for admission. A total of 153,320 Swiss citizens and 12,852 immigrants from SE were included in the study. The mean age was 51.30 (SD = 21.13) years for the Swiss patients and 39.70 (SD = 15.87) years for the SE patients. For some countries of origin (Albania, Bosnia and Herzegovina, and Turkey), there were highly statistically significant differences in sex distribution, with a predominance of males. SE immigrants had a greater proportion of patients in the lower triage level (level 3: SE: 67.3% vs. Swiss: 56.0%) and a greater proportion of patients in the high triage level than the Swiss population (level 1: SE: 3.4% vs. Swiss: 8.8%). SE patients of working age (16–65 years) were six times more often admitted by ambulance than older (≥65 years) SE patients, whereas this ratio was similar in the Swiss population. In both groups, the fast track service was primarily used for patients of working age (<65) and more than three times more often in the SE than the Swiss group (SE: 39.1%, Swiss: 12.6%). We identified some indications for access to primary care in emergency departments for immigrants and highlighted the need for attention to the role of organizational characteristics of primary health care in Switzerland. We highlighted the need for professional support to improve the quality of healthcare for immigrants. In the future, we will need more primary care services and general practitioners with a migrant background.

International migration, particularly to Europe, has increased in the last few decades, making research on aspects of this phenomenon, including numbers, challenges, and successes, particularly vital [...]

Background The ultra-Orthodox Jewish (UOJ) community is a primarily low socio-economic, culturally insular minority sub-sect in Israel. Compared with the general population, UOJ women report higher rates of diabetes and overweight, lower physical activity rates, and have lower breast cancer survival rates. Research in this sub-sect is limited. Identifying the facilitators and barriers to health behavior engagement would facilitate public health intervention design in this population. Methods This study describes UOJ women’s barriers and facilitators to engagement in targeted health behaviors (i.e. health nutrition, physical activity), identified through mixed methods analysis. Qualitative and quantitative analyses of interviews (N = 5), focus groups (5, including 35 women), and questionnaires (N = 239) identified barriers to engaging in preventive health behaviors and intervention preferences. Results Most of the barriers identified (financial and time limitations, personal preferences, lack of education/awareness, and family-related obstacles) are similar to those reported by women from the general population. Cultural aspects such as women’s role in the home, religious restrictions, and modesty were also identified as barriers to health behavior engagement, comparable to women from other insular communities. Conclusions Utilizing a mixed methods approach in identifying barriers and facilitators informed intervention development and improved cultural tailoring, potentially serving as a model for intervention design with additional UOJ communities as well as other difficult to access, low socio-economic, culturally insular populations. Key messages This is the first study identifying facilitators and barriers to UOJ women’s health behavior engagement. Findings can inform intervention design in difficult to access, culturally insular populations.