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Stöger R, Choi M, Begum K, Leeman G, Emes RD, Melamed P, Bentley GR. Childhood environment influences epigenetic age and methylation concordance of a CpG clock locus in British-Bangladeshi migrants. Epigenetics 2023; 18:2153511. [PMID: 36495138 PMCID: PMC9980690 DOI: 10.1080/15592294.2022.2153511] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Migration from one location to another often comes with a change in environmental conditions. Here, we analysed features of DNA methylation in young, adult British-Bangladeshi women who experienced different environments during their childhoods: a) migrants, who grew up in Bangladesh with exposure to comparatively higher pathogen loads and poorer health care, and b) second-generation British-Bangladeshis, born to Bangladeshi parents, who grew up in the UK. We used buccal DNA to estimate DNA methylation-based age (DNAm age) from 14 migrants and 11 second-generation migrants, aged 18-35 years. 'AgeAccel,' a measure of DNAm age, independent of chronological age, showed that the group of women who spent their childhood in Bangladesh had higher AgeAccel (P = 0.028), compared to their UK peers. Since epigenetic clocks have been proposed to be associated with maintenance processes of epigenetic systems, we evaluated the preference for concordant DNA methylation at the luteinizing hormone/choriogonadotropin receptor (LHCGR/LHR) locus, which harbours one of the CpGs contributing to Horvath's epigenetic clock. Measurements on both strands of individual, double-stranded DNA molecules indicate higher stability of DNA methylation states at this LHCGR/LHR locus in samples of women who grew up in Bangladesh. Together, our two independent analytical approaches imply that childhood environments may induce subtle changes that are detectable long after exposure occurred, which might reflect altered activity of the epigenetic maintenance system or a difference in the proportion of cell types in buccal tissue. This exploratory work supports our earlier findings that adverse childhood environments lead to phenotypic life history trade-offs.
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Affiliation(s)
- Reinhard Stöger
- School of Biosciences, University of Nottingham, Nottingham, UK
| | - Minseung Choi
- School of Medicine, Stanford University, Stanford, CA, USA
| | | | - Gregory Leeman
- School of Biosciences, University of Nottingham, Nottingham, UK
| | - Richard D Emes
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, UK.,Advanced Data Analysis Centre, University of Nottingham, Nottingham, UK
| | - Philippa Melamed
- Faculty of Biology, Technion-Israel Institute of Technology, Haifa, Israel
| | - Gillian R Bentley
- Department of Anthropology, Durham University, Durham, UK.,Wolfson Research Institute for Health and Wellbeing, Durham University, Durham, UK
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Bueno López C, Gómez Moreno G, Palloni A. Empirical evidence of predictive adaptive response in humans: systematic review and meta-analysis of migrant populations. J Dev Orig Health Dis 2023; 14:728-745. [PMID: 38196328 DOI: 10.1017/s2040174423000429] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Meta-analysis is used to test a variant of a Developmental Origins of Adult Health and Disease (DOHaD)'s conjecture known as predictive adaptive response (PAR). According to it, individuals who are exposed to mismatches between adverse or constrained in utero conditions, on the one hand, and postnatal obesogenic environments, on the other, are at higher risk of developing adult chronic conditions, including obesity, type 2 diabetes (T2D), hypertension and cardiovascular disease. We argue that migrant populations from low and middle to high-income countries offer a unique opportunity to test the conjecture. A database was constructed from an exhaustive literature search of peer-reviewed papers published prior to May 2021 contained in PUBMED and SCOPUS using keywords related to migrants, DOHaD, and associated health outcomes. Random effects meta-regression models were estimated to assess the magnitude of effects associated with migrant groups on the prevalence rate of T2D and hypertension in adults and overweight/obesity in adults and children. Overall, we used 38 distinct studies and 78 estimates of diabetes, 59 estimates of hypertension, 102 estimates of overweight/obesity in adults, and 23 estimates of overweight/obesity in children. Our results show that adult migrants experience higher prevalence of T2D than populations at destination (PR 1.48; 95% CI 1.35-1.65) and origin (PR 1.80; 95% CI 1.40-2.34). Similarly, there is a significant excess of obesity prevalence in children migrants (PR 1.22; 95% CI 1.04-1.43) but not among adult migrants (PR 0.89; 95% CI 0.80-1.01). Although the total effect of migrant status on prevalence of hypertension is centered on zero, some migrant groups show increased risks. Finally, the size of estimated effects varies significantly by migrant groups according to place of destination. Despite limitations inherent to all meta-analyses and admitting that some of our findings may be accounted for alternative explanations, the present study shows empirical evidence consistent with selected PAR-like conjectures.
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Affiliation(s)
- Clara Bueno López
- Department of Population, Institute of Economy, Geography and Demography, Spanish National Research Council, Madrid, Spain
| | - Guillermo Gómez Moreno
- Department of Population, Institute of Economy, Geography and Demography, Spanish National Research Council, Madrid, Spain
| | - Alberto Palloni
- Department of Population, Institute of Economy, Geography and Demography, Spanish National Research Council, Madrid, Spain
- Center for Demography of Health and Aging (CDHA), University of Wisconsin-Madison, Madison, WI, USA
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Andersen AMJ, Jervelund SS, Maindal HT, Hempler NF. Acquisition, application, and distribution of health literacy from culturally sensitive type 2 diabetes education among Arabic-Speaking migrants in Denmark: A longitudinal qualitative analysis. Scand J Caring Sci 2023. [PMID: 38031875 DOI: 10.1111/scs.13228] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 10/06/2023] [Accepted: 11/05/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Effective self-management of type 2 diabetes requires adequate health literacy (HL) and a supportive network. Diabetes self-management education and support programmes play a crucial role in improving these factors. However, limited research exists on how such programmes can support health literacy among migrants and facilitate the dissemination of knowledge within their social networks. AIM This study aimed to investigate the perspectives of Arabic-speaking informants with a migrant background in relation to how their type 2 diabetes-related health literacy was acquired, applied and distributed within social networks through participation in a culturally sensitive diabetes self-management education and support (DSMES) programme. METHODS Semi-structured interviews were conducted with 12 informants during the programme and three to 7 months later, from September 2019 to May 2020. Abductive analysis was applied using HL and distributed health literacy (DHL) theory as frameworks. RESULTS The analysis generated three themes: (1) sources of health information and the development of health literacy; (2) changes towards active self-management; and (3) distributed health literacy. Prior to programme participation, informants faced challenges in navigating conflicting information from family, friends and social media. After participating in the programme, they reported improvements in HL, particularly in knowledge acquisition. Many became more actively engaged in decision-making and exhibited improved health behaviours, such as dietary choices. Nonetheless, some informants continued to struggle with choosing appropriate prevention and treatment strategies. Notably, certain informants acted as HL mediators, sharing their newly acquired knowledge within their social networks in Denmark and abroad. CONCLUSION Culturally sensitive diabetes self-management education programmes have the potential to enhance HL among migrants, leading to the distribution of relevant diabetes knowledge within their social networks. Future studies should explore how members of migrants' social networks perceive their supportive role in type 2 diabetes management. Programmes can benefit from emphasising critical HL and exploring how participant-informants effectively communicate diabetes-related knowledge within their networks to address misinformation and conflicting information.
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Affiliation(s)
- Anne Mette Juul Andersen
- Health Promotion Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
- Department of Public Health, Section for Health Services Research, University of Copenhagen, Copenhagen K, Denmark
| | - Signe Smith Jervelund
- Department of Public Health, Section for Health Services Research, University of Copenhagen, Copenhagen K, Denmark
| | - Helle Terkildsen Maindal
- Health Promotion Research, Steno Diabetes Center Copenhagen, Herlev, Denmark
- Department of Public Health, Aarhus University, Aarhus C, Denmark
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Changizi N, Afshar NE, Farahani Z, Shariat M, Hejazi S, Jahromy LH, Ghasabe SR, Radpooyan L. Improving the health status of Afghan mothers living in the Islamic Republic of Iran. East Mediterr Health J 2023; 26:861-869. [PMID: 38279881 DOI: 10.26719/emhj.23.116] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 06/01/2023] [Indexed: 01/29/2024]
Abstract
Background The healthcare system of the Islamic Republic of Iran provides special maternal health care services for mothers, regardless of their nationality. Aim This study, supported by the United Nations Population Fund, was conducted to review available data associated with health indicators of Afghan mothers living in Islamic Republic of Iran. Methods This descriptive study used data from the electronic registration system of the Maternal Health Office of the Ministry of Health and Medical Education on characteristics, morbidity and mortality among Afghan mothers in the Islamic Republic of Iran from 2017 to 2019. The data were analysed using SPSS version 23.0. Based on the results, we propose interventions to improve health services for vulnerable Afghan mothers. Results There were 168 488 deliveries over the 3 years of the study (2017-2019). Deliveries by Afghan women increased from 3.4% in 2017 to 5.2% in 2019, and more than 70% of these Afghan women were vulnerable. Ten percent of deliveries among Afghan mothers were performed by traditional birth attendants. The rate of caesarean section among Afghan mothers was 30%. Maternal mortality ratio among the Afghan mothers was 43 per 100 000 for the 3 years. Conclusion Afghan mothers in the Islamic Republic of Iran use primary health care services provided for mothers in the country. However, healthcare delivery to these mothers is inadequate, although considered better than the care provided to Afghan mothers living in Afghanistan. We recommend targeted interventions to improve the health status of Afghan women living in the Islamic Republic of Iran.
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Affiliation(s)
- Nasrin Changizi
- Maternal, Fetal and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
- Maternal Health Department, Population, Family, and School Health Office, Vice Chancellery for Health, Iran Ministry of Health and Medical Education, Tehran, Islamic Republic of Iran
| | - Nezhat Emami Afshar
- Maternal Health Department, Population, Family, and School Health Office, Vice Chancellery for Health, Iran Ministry of Health and Medical Education, Tehran, Islamic Republic of Iran
| | - Zahra Farahani
- Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Mamak Shariat
- Breastfeeding Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Saeideh Hejazi
- Maternal Health Department, Population, Family, and School Health Office, Vice Chancellery for Health, Iran Ministry of Health and Medical Education, Tehran, Islamic Republic of Iran
| | - Leila Hadipour Jahromy
- Maternal Health Department, Population, Family, and School Health Office, Vice Chancellery for Health, Iran Ministry of Health and Medical Education, Tehran, Islamic Republic of Iran
| | - Susan Rahimi Ghasabe
- Maternal Health Department, Population, Family, and School Health Office, Vice Chancellery for Health, Iran Ministry of Health and Medical Education, Tehran, Islamic Republic of Iran
| | - Laleh Radpooyan
- Maternal Health Department, Population, Family, and School Health Office, Vice Chancellery for Health, Iran Ministry of Health and Medical Education, Tehran, Islamic Republic of Iran
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Fiore V, Manca V, De Vito A, Colpani A, Maida I, Madeddu G, Babudieri S. Quick diagnostic approach for HIV/STDs among migrants: results from a monocentric Italian cohort. J Infect Dev Ctries 2023; 17:1621-1625. [PMID: 38064407 DOI: 10.3855/jidc.18317] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 05/31/2023] [Indexed: 12/18/2023] Open
Abstract
INTRODUCTION Migration has a direct influence on sexual health. Differences both in sexual networks and the risk of sexually transmitted diseases (STDs) between racial or ethnic minorities and the native population have been described in the literature. METHODOLOGY We collected data on medical history, physical examination, and human immunodeficiency virus (HIV)/STDs tests. Screenings were proposed basing on Centers for Disease Control (CDC) 2018 guidelines on STDs. Patients underwent peer-to-peer counselling before screening. RESULTS We included data of 391 patients (both outpatients and migrants living in facility centers). The median age was 30 (range 24-38) years, and the majority were male (198/391; 50.6%). Among them, 389 (99.4%) were counselled, and 371 (94.8%) accepted the screening. We found 155 (41.7%) HBsAg/Anti-HBc positive tests, 4 (1%) HIV positive screenings, 1 (0.2%) hepatitis C virus (HCV) infection, 47 (12%) genital/perianal warts, 29 (2.3%) cases of syphilis, and 13 (3.3%) molluscum contagiosum. CONCLUSIONS Migrants have high-risk sexual behavior. Despite this, they may have a low perception of risk and healthcare needs. An approach based on quick tests was demonstrated to be useful in increasing the screening acceptance. However, the retainment in care was low, as in previous studies. Access to HIV/STDs screening and treatment should be implemented. The development of specific retainment in care pathways is still needed to reduce the lack of follow-up.
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Affiliation(s)
- Vito Fiore
- Unit of Infectious and Tropical Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Valentina Manca
- Unit of Infectious and Tropical Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Andrea De Vito
- Unit of Infectious and Tropical Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Agnese Colpani
- Unit of Infectious and Tropical Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Ivana Maida
- Unit of Infectious and Tropical Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Giordano Madeddu
- Unit of Infectious and Tropical Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - Sergio Babudieri
- Unit of Infectious and Tropical Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
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Brown C, Roucoux G, Rousset-Torrente O, Ali S, Yombo-Kokule L, Chaplin J, Chassany O, Duracinsky M. Fostering Patient-Clinician Communication to Promote Rapid HIV, Hepatitis B Virus, and Hepatitis C Virus Diagnostic Testing: Conceptual Development of a Multilingual App. JMIR Form Res 2023; 7:e49251. [PMID: 37971810 PMCID: PMC10690526 DOI: 10.2196/49251] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Migrants are disproportionately affected by HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV). Clinicians, at times, fail to offer rapid diagnostic testing (RDT) for these viruses when a language barrier exists in the patient-clinician relationship, therefore creating missed testing opportunities. Although their effectiveness has been demonstrated elsewhere, conventional, in-person interpreters are costly and underused in practice. Furthermore, clinicians often call upon ad hoc interpreters, which introduces complexities in the clinical relationship. Digital solutions exist to diminish the burden of language barriers; however, the challenges of developing a multilingual and multicultural app have yet to be documented with respect to RDT in the nonfrancophone migrant population in France. OBJECTIVE Our goal was to design a multilingual app to overcome language barriers, health literacy barriers, and fears related to being tested to promote RDT of HIV, HBV, and HCV in the nonfrancophone migrant population in France. METHODS A combination of qualitative methods, agile development, and user-centered design was used. We conducted 2 focus groups (FGs) with 12 participants, including physicians, nurses, and social workers conducting RDT, as well as 1 modified Delphi survey with 68 participants including physicians and nurses. FGs explored the content (risk factors and medical history), functions (cultural adaptation and instant translation), and interface ergonomics (graphics and font) needed in the app. The Delphi presented 95 content items that the researchers sought to include in the app. RESULTS Using FGs to inform the Delphi survey, we scientifically determined the app's content consisting of 95 items using expert consensus, developed a mock-up, and conducted initial user testing. We created an app that contains both migrant and clinician interfaces and includes a sociodemographic, risk assessment, health literacy, and testing barrier questionnaires available in 11 languages. Educational content is related to HIV, HBV, and HCV, along with the ability to understand whether the migrant agrees to be tested. CONCLUSIONS This study allowed us to conceptualize a multilingual app that aims to increase the acceptance of RDT for HIV, HBV, and HCV. The specific features of the Assistant intelligent au dépistage des allophones app were designed to overcome the testing barriers in the nonfrancophone migrant population. The next phase will be an implementation study, as we intend to validate our app.
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Affiliation(s)
- Carter Brown
- Épidémiologie Clinique et Évaluation Économique appliquées aux Populations Vulnérables (UMR-S 1123), Université Paris Cité, Paris, France
| | - Guillaume Roucoux
- Épidémiologie Clinique et Évaluation Économique appliquées aux Populations Vulnérables (UMR-S 1123), Université Paris Cité, Paris, France
- Unité de Recherche Clinique en Economie de la Santé, General Administration of Public Assistance of Paris, Hôpital Hôtel-Dieu, Paris, France
| | - Olivia Rousset-Torrente
- Unité de Recherche Clinique en Economie de la Santé, General Administration of Public Assistance of Paris, Hôpital Hôtel-Dieu, Paris, France
| | - Saleh Ali
- Épidémiologie Clinique et Évaluation Économique appliquées aux Populations Vulnérables (UMR-S 1123), Université Paris Cité, Paris, France
| | - Lisa Yombo-Kokule
- Épidémiologie Clinique et Évaluation Économique appliquées aux Populations Vulnérables (UMR-S 1123), Université Paris Cité, Paris, France
| | - John Chaplin
- Institute of Health and Care Sciences, University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
| | - Olivier Chassany
- Épidémiologie Clinique et Évaluation Économique appliquées aux Populations Vulnérables (UMR-S 1123), Université Paris Cité, Paris, France
- Unité de Recherche Clinique en Economie de la Santé, General Administration of Public Assistance of Paris, Hôpital Hôtel-Dieu, Paris, France
| | - Martin Duracinsky
- Épidémiologie Clinique et Évaluation Économique appliquées aux Populations Vulnérables (UMR-S 1123), Université Paris Cité, Paris, France
- Unité de Recherche Clinique en Economie de la Santé, General Administration of Public Assistance of Paris, Hôpital Hôtel-Dieu, Paris, France
- Service de Médecine Interne et d'Immunologie Clinique, Hôpital Bicêtre, General Administration of Public Assistance of Paris, Le Kremlin,-Bicêtre, France
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Koumantakis E, Comoretto RI, Dalmasso P, Bersia M, Lemma P, Lazzeri G, Nardone P, Vieno A, Galeotti T, Berchialla P, Charrier L. Risk Behaviors among Migrant Adolescents in Italy. Children (Basel) 2023; 10:1816. [PMID: 38002907 PMCID: PMC10670227 DOI: 10.3390/children10111816] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/27/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023]
Abstract
Adolescence is a critical period for engaging in health risk behaviors. Migrant adolescents may face unique challenges due to acculturation stress. This study aims to monitor substance use and problem gambling among migrant adolescents living in Italy. Data from the 2017/18 Health Behavior in School-Aged Children survey in Italy were analyzed. The 18,794 participants included 15-year-olds, categorized as native or migrants, with ethnic backgrounds from Western, Eastern European, or non-Western/non-European countries. Girls had higher smoking rates, while boys exhibited higher prevalence of alcohol-related risk behaviors, cannabis use, and gambling. Boys from Eastern European countries displayed a greater risk of drunkenness (OR: 1.58, 95% CI: 1.06-2.37), particularly in the first generation, while those from Western countries showed a higher risk of multiple substance use (OR: 1.44, 95% CI: 1.05-1.96). Girls from Eastern European and non-Western/non-European countries had a lower risk of alcohol consumption (OR: 0.50, 95% CI: 0.29-0.85; OR: 0.55, 95% CI: 0.33-0.91, respectively). Finally, boys, especially those from Eastern European and non-Western/non-European countries, had a significantly higher risk of problem gambling (OR: 1.83, 95% CI: 1.04-3.22; OR: 2.10, 95% CI: 1.29-3.42, respectively). This disparity was more pronounced in the first generation, possibly due to acculturation challenges and socio-economic factors. Risk behaviors in adolescents are influenced by complex interplays of gender, cultural factors, and migration generation. Preventive strategies should consider these factors to effectively address substance use and gambling in this heterogeneous population.
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Affiliation(s)
- Emanuele Koumantakis
- Department of Public Health and Pediatrics, University of Torino, 10126 Torino, Italy
- Post Graduate School of Medical Statistics, University of Torino, 10126 Torino, Italy
| | | | - Paola Dalmasso
- Department of Public Health and Pediatrics, University of Torino, 10126 Torino, Italy
| | - Michela Bersia
- Department of Public Health and Pediatrics, University of Torino, 10126 Torino, Italy
- Post Graduate School of Medical Statistics, University of Torino, 10126 Torino, Italy
| | - Patrizia Lemma
- Department of Public Health and Pediatrics, University of Torino, 10126 Torino, Italy
| | - Giacomo Lazzeri
- Department of Molecular and Developmental Medicine, University of Siena, 53100 Siena, Italy
| | - Paola Nardone
- National Centre for Disease Prevention and Health Promotion, Istituto Superiore di Sanità (National Institute of Health), 00161 Rome, Italy
| | - Alessio Vieno
- Department of Developmental Psychology and Socialisation, University of Padova, 35131 Padova, Italy
| | - Tommaso Galeotti
- Department of Developmental Psychology and Socialisation, University of Padova, 35131 Padova, Italy
| | - Paola Berchialla
- Department of Clinical and Biological Sciences, University of Torino, 10043 Orbassano, Italy
| | - Lorena Charrier
- Department of Public Health and Pediatrics, University of Torino, 10126 Torino, Italy
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Istiko SN, Remata S, Ndayizeye A, Moreno MEV, Kirunda V, Hollingdrake O, Osborne R, Hou JZ, Abell B, Mullens AB, Gu Z, Debattista J, Vujcich D, Lobo R, Parma G, Howard C, Durham J. Developing critical HIV health literacy: insights from interviews with priority migrant communities in Queensland, Australia. Cult Health Sex 2023:1-16. [PMID: 37950430 DOI: 10.1080/13691058.2023.2265960] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 09/28/2023] [Indexed: 11/12/2023]
Abstract
In Australia, surveillance data establish that there are higher rates of late HIV diagnoses among heterosexual migrants from Sub-Saharan Africa and new HIV diagnoses among gay and bisexual men (GBM) from Southeast and Northeast Asia and Latin America. Together, these groups are identified as priority migrant communities in current efforts to eliminate HIV transmissions. HIV health literacy is recognised as a key means of improving access to services and health outcomes. This qualitative paper explores critical HIV health literacy among priority migrant communities in Queensland, Australia. To foreground community voices, peer researchers from priority migrant communities participated in the project design, data collection and analysis, with 20 interviews completed. The findings demonstrate how participants' engagement with HIV health information and services is highly relational and situated within the framework of sexual health and wellbeing. Participants strategically selected where to seek information and who they trusted to help them appraise this information. They further demonstrated reflective capacities in identifying the contextual barriers that inhibit the development of their HIV health literacy. The findings highlight the need for HIV health promotion strategies that embrace a sex positive approach, promote cultural change, and involve collaboration with general practitioners (GPs).
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Affiliation(s)
- Satrio Nindyo Istiko
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Faculty of Medicine, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Simeon Remata
- Queensland Positive People, Brisbane, Queensland, Australia
- ACON, Sydney, New South Wales, Australia
| | - Aimable Ndayizeye
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Miguel Eduardo Valencia Moreno
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Vanessa Kirunda
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Olivia Hollingdrake
- School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Richard Osborne
- Department of Health and Medical Sciences, School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Jenny Zhengye Hou
- Faculty of Creative Industries, Education, and Social Justice, School of Communication/Digital Media Research Centre, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Bridget Abell
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Amy B Mullens
- Centre for Health Research, School of Psychology and Wellbeing, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Zhihong Gu
- Ethnic Communities Council of Queensland, Brisbane, Queensland, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital and Health Service, Herston, Queensland, Australia
| | - Daniel Vujcich
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Roanna Lobo
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Gianna Parma
- True Relationships & Reproductive Health, Brisbane, Queensland, Australia
| | - Chris Howard
- Queensland Positive People, Brisbane, Queensland, Australia
| | - Jo Durham
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
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Yameogo AR, Délétroz C, Sasseville M, Amil S, Da SMAR, Bodenmann P, Gagnon MP. Effectiveness of Interventions to Improve Digital Health Literacy in Forced Migrant Populations: Protocol for a Mixed Methods Systematic Review. JMIR Res Protoc 2023; 12:e50798. [PMID: 37917139 PMCID: PMC10654904 DOI: 10.2196/50798] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Digital health literacy is considered a health determinant that can influence improved health and well-being, health equity, and the reduction of social health inequalities. Therefore, it serves as an asset for individuals to promote their health. However, low digital health literacy is a major problem among forced migrant populations. They do not always have the capacity and skills to access digital health resources and use them appropriately. To our knowledge, no studies are currently available to examine effective interventions for improving digital health literacy among forced migrant populations. OBJECTIVE This paper presents the protocol for a systematic review that aims to assess the effectiveness of digital health literacy interventions among forced migrant populations. With this review, our objectives are as follows: (1) identify interventions designed to improve digital health literacy among forced migrant populations, including interventions aimed at creating enabling conditions or environments that cater to the needs and expectations of forced migrants limited by low levels of digital health literacy, with the goal of facilitating their access to and use of eHealth resources; (2) define the categories and describe the characteristics of these interventions, which are designed to enhance the abilities of forced migrants or adapt digital health services to meet the needs and expectations of forced migrant populations. METHODS A mixed methods systematic review will be conducted according to the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) checklist. The research will be conducted in an iterative process among the different authors. With the help of a medical information specialist, a specific search strategy will be formulated for the 6 most relevant databases (ie, MEDLINE, Embase, CINAHL, Web of Science, Academic Search Premier, PsycINFO, and the Google Scholar search engine). A literature search covering studies published between 2000 and 2022 has already been conducted. Two reviewers then proceeded, individually and independently, to conduct a double selection of titles, abstracts, and then full texts. Data extraction will be conducted by a reviewer and validated by a senior researcher. We will use the narrative synthesis method (ie, structured narrative summaries of key themes) to present a comprehensive picture of effective digital health literacy interventions among forced migrant populations and the success factors of these interventions. RESULTS The search strategy and literature search were completed in December 2022. A total of 1232 articles were identified. The first selection was completed in July 2023. The second selection is still in progress. The publication of the systematic review is scheduled for December 2023. CONCLUSIONS This mixed methods systematic review will provide comprehensive knowledge on effective interventions for digital literacy among forced migrant populations. The evidence generated will further inform stakeholders and aid decision makers in promoting equitable access to and use of digital health resources for forced migrant populations and the general population in host countries. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/50798.
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Affiliation(s)
- Achille Roghemrazangba Yameogo
- Faculté des Sciences Infirmières, Université Laval, Québec, QC, Canada
- VITAM - Centre de Recherche en Santé Durable, Quebec, QC, Canada
| | - Carole Délétroz
- Faculté des Sciences Infirmières, Université Laval, Québec, QC, Canada
- School of Health Sciences, University of Applied Sciences and Arts Western Switzerland, Avenue de Beaumont 21, 1011, Lausanne, Switzerland
| | - Maxime Sasseville
- Faculté des Sciences Infirmières, Université Laval, Québec, QC, Canada
- VITAM - Centre de Recherche en Santé Durable, Quebec, QC, Canada
| | - Samira Amil
- VITAM - Centre de Recherche en Santé Durable, Quebec, QC, Canada
| | - Sié Mathieu Aymar Romaric Da
- Faculté des Sciences Infirmières, Université Laval, Québec, QC, Canada
- VITAM - Centre de Recherche en Santé Durable, Quebec, QC, Canada
| | - Patrick Bodenmann
- Department of Vulnerabilities and Social Medicine, Unisanté, Lausanne, Switzerland
- Faculty of Biology and Medicine, Vice-Dean Teaching and Diversity, University of Lausanne, Lausanne, Switzerland
| | - Marie-Pierre Gagnon
- Faculté des Sciences Infirmières, Université Laval, Québec, QC, Canada
- VITAM - Centre de Recherche en Santé Durable, Quebec, QC, Canada
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Wang Q, Dowsey MM, Woodward-Kron R, O'Brien P, Hawke L, Bunzli S. Physical activity amongst culturally and linguistically diverse communities in Australia: a scoping review. Ethn Health 2023; 28:1195-1220. [PMID: 37271830 DOI: 10.1080/13557858.2023.2219874] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 05/25/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Australia's overseas-born population continues to grow. This population is disproportionately affected by chronic, non-communicable diseases. Physical activity is the cornerstone of all chronic disease management. Engaging people from culturally and linguistically diverse (CALD) backgrounds in physical activity is an important public health objective. The purpose of this scoping review was to examine the factors that shape physical activity participation among people from CALD backgrounds in Australia. METHODS This scoping review followed Arksey and O'Malley's framework. Medline, Embase and CINAHL were searched with key words relating to 'physical activity', 'CALD' and 'Australia' in July 2021 and again in February 2022 for qualitative studies published in English since 2000. Exclusion criteria were: participants < 18 years old, studies specifically focusing on populations with health issues, pregnant or postpartum states. Methodological quality of included studies was evaluated using the Critical Appraisal Skills Programme with the purpose of informing future research. Data extracted from each study were analysed thematically and results were interpreted using Acculturation theory. RESULTS Of the 1130 studies, 17 met the inclusion criteria. Findings from each study were captured in three themes: Perceptions of physical activity; Acceptability and Appropriateness; and Access. Following migration, a decrease in physical activity, especially leisure-time activity, was reported. Common factors influencing physical activity engagement included perceptions of physical activity and wellbeing; language, financial and environmental barriers; as well as social, cultural, and religious considerations. CONCLUSION This review identified several factors which may interact and contribute to the decline in self-reported physical activity upon migration. Findings from this review may be used to inform future health promotion initiatives targeting people from CALD backgrounds. Future research may benefit from devising a shared definition of physical activity and studying different CALD communities over time.
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Affiliation(s)
- Qiwei Wang
- Melbourne Medical School, The University of Melbourne, Melbourne, Australia
| | - Michelle M Dowsey
- Department of Surgery, St Vincent's Hospital, The University of Melbourne, Melbourne, Australia
| | - Robyn Woodward-Kron
- Department of Medical Education, The University of Melbourne, Melbourne, Australia
| | - Penny O'Brien
- Department of Surgery, St Vincent's Hospital, The University of Melbourne, Melbourne, Australia
| | - Lyndon Hawke
- Department of Surgery, St Vincent's Hospital, The University of Melbourne, Melbourne, Australia
| | - Samantha Bunzli
- Department of Surgery, St Vincent's Hospital, The University of Melbourne, Melbourne, Australia
- School of Health Sciences and Social Work, Griffith University, Queensland, Australia
- Physiotherapy Department, Royal Brisbane and Women's Hospital, Queensland, Australia
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Reyes-Urueña J, Marrone G, Noori T, Kuchukhidze G, Martsynovska V, Hetman L, Basenko A, Bivol S, van der Werf MJ, Pharris A. HIV diagnoses among people born in Ukraine reported by EU/EEA countries in 2022: impact on regional HIV trends and implications for healthcare planning. Euro Surveill 2023; 28:2300642. [PMID: 38037726 PMCID: PMC10690861 DOI: 10.2807/1560-7917.es.2023.28.48.2300642] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 11/30/2023] [Indexed: 12/02/2023] Open
Abstract
Following Russia's invasion in 2022, over 4.1 million Ukrainians sought refuge in the EU/EEA. We assessed how this impacted HIV case reporting by EU/EEA countries. Ukrainian refugees constituted 10.2% (n = 2,338) of all 2022 HIV diagnoses, a 10-fold increase from 2021. Of these, 9.3% (n = 217) were new diagnoses, 58.5% (n = 1,368) were previously identified; 32.2% had unknown status. Displacement of Ukrainians has partly contributed to increasing HIV diagnoses in EU/EEA countries in 2022, highlighting the importance of prevention, testing and care.
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Affiliation(s)
| | - Gaetano Marrone
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Teymur Noori
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Giorgi Kuchukhidze
- World Health Organization, Regional Office for Europe (WHO/Europe), Copenhagen, Denmark
| | - Violetta Martsynovska
- HIV Diagnosis and Treatment Programs of Public Health Center, Ministry of Health of Ukraine, Kyiv, Ukraine
| | - Larysa Hetman
- HIV Diagnosis and Treatment Programs of Public Health Center, Ministry of Health of Ukraine, Kyiv, Ukraine
| | - Anton Basenko
- International Network of People Who Use Drugs (INPUD), European AIDS Treatment Group (EATG), Kyiv, Ukraine
- Alliance for Public Health (APH), Ukraine Cabinet of Ministers' National Council on HIV/TB (CCM Ukraine), Kyiv, Ukraine
| | - Stela Bivol
- World Health Organization, Regional Office for Europe (WHO/Europe), Copenhagen, Denmark
| | | | - Anastasia Pharris
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
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Xiao L, Gordon S, Ahmad M. Experiences of family caregivers of people with dementia from a Muslim migrant background in high-income countries: a systematic review and meta-synthesis. Aging Ment Health 2023; 27:2319-2328. [PMID: 37300492 DOI: 10.1080/13607863.2023.2222078] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 03/08/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND The cultural and religious beliefs and values of family caregivers of people with dementia have a profound impact on the use of dementia care services in high-income countries. Yet, little is known about how caregivers of people with dementia from a Muslim migrant background in high-income countries perceive their caregiving journey. AIM To synthesise findings from rigorous qualitative studies on the experiences of family caregivers of people with dementia from a Muslim migrant background in high-income countries. METHODS Meta-ethnography of qualitative studies was applied to address the aim. Five databases including MEDLINE, CINHAL, PsycINFO, Web of Science and Scopus were searched. Inclusion criteria were qualitative or mixed study design studies on family caregivers of people with dementia from a Muslim migrant background in a home care setting in high-income countries. Studies were excluded if they used a quantitative research design, were not written in English and were not original studies. FINDINGS In total 17 articles met the inclusion criteria and were included in the study. Meta-synthesis of the data revealed three themes from the life course intersectionality perspective: caregiving as both positive and negative experiences; factors affecting caregivers' experiences; and coping strategies used by caregivers. CONCLUSION Caregivers of people with dementia from a Muslim migrant background living in high-income countries have both positive and negative caregiving experiences. However, dementia care services were not tailored to address their care needs and expectations arising from their religious and cultural beliefs.
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Affiliation(s)
- Lily Xiao
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Sue Gordon
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Mahjabeen Ahmad
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
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O’Donoghue B, Roche E, Lyne J, Renwick L, Clarke M. Outcomes 1 year after a first episode of psychosis in migrants to the Republic of Ireland. Int J Soc Psychiatry 2023; 69:1617-1625. [PMID: 37211684 PMCID: PMC10657506 DOI: 10.1177/00207640231174360] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND Migration is a robust risk factor for developing a psychotic disorder, yet there is a paucity of research on the outcomes of migrants who develop a psychotic disorder. Identifying sub-groups within FEP cohorts who have a poorer outcome, could assist in the development and delivery of more targeted interventions. AIMS There is a paucity of research on the outcomes of migrants who develop a psychotic disorder. This study aimed to evaluate a broad range of outcomes for those with a FEP who migrated to the Republic of Ireland, including: (i) symptomatic; (ii) functional; (iii) hospitalisation and (iv) engagement with psychosocial services. METHODS All individuals with a FEP aged 18 to 65 who presented between 01.02.2006 and 01.07.2014 were included. Structured and validated instruments were used to measure positive, negative, depressive symptoms and insight. RESULTS Of the 573 individuals with a FEP, 22.3% were first-generation migrants and 63.4% (n = 363) were followed up at 1 year. At this time, 72.4% of migrants were in remission of positive psychotic symptoms compared to 78.5% of the Irish born (OR = 0.84, 95% CI [0.50-1.41], p = .51). In relation to negative symptoms, 60.5% of migrants were in remission compared to 67.2% of the Irish born (OR = 0.75, 95% CI [0.44-1.27], p = .283). There was no difference in the severity of positive, negative or depressive symptoms between groups and there was a trend for the Irish born to have better insight (p = .056). The functional outcomes were similar across groups. One third of migrants were admitted to hospital compared to 28.7% of the Irish born (OR = 1.24, 95% CI [0.73-2.13], p = .426). Just over half of both groups attended CBT and 46.2% of caregivers for migrants attended the psychoeducation programme, compared to 39.7% for the Irish born (OR = 1.30, 95% CI [0.79-2.16], p = .306). CONCLUSIONS These findings demonstrate that migrants have broadly similar outcomes to the native-born populations, however there is still considerable scope for the outcomes for all individuals affected by psychotic disorders to be improved.
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Affiliation(s)
- Brian O’Donoghue
- Department of Psychiatry, University College Dublin, Ireland
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Centre for Youth Mental Health, University of Melbourne, Parkville VIC, Australia
| | - Eric Roche
- Cluain Mhuire Mental Health Services, Newtownpark Avenue, Blackrock, Co. Dublin, Ireland
| | - John Lyne
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Wicklow Mental Health Services, Newcastle Hospital, Greystones, Co. Wicklow, Ireland
| | - Laoise Renwick
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Mary Clarke
- Department of Psychiatry, University College Dublin, Ireland
- DETECT Early Intervention for Psychosis Service, Blackrock, Co. Dublin, Ireland
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Yakubu K, Campain A, Abimbola S, Bouckley T, Peiris D, Joshi R, Shanthosh J. Promoting equitable health workforce distribution through improved migration governance: A mixed methods study of African health professionals' perceptions in Australia. Int J Health Plann Manage 2023; 38:1789-1815. [PMID: 37674361 DOI: 10.1002/hpm.3704] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 07/19/2023] [Accepted: 08/21/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND This study examined skilled health worker (SHW) migration governance in African countries and Australia, with an emphasis on areas of influence for achieving an equitable global health workforce distribution. METHODS We used a mixed-methods research design with African SHW migrants in Australia. An institutional and rights-based framing of governance guided thematic analysis of the interviews, which was mapped to survey findings from a Bayesian Exploratory Factor Analysis. RESULTS The findings imply that Australian state actors enforce laws that attract SHW migrants and promote safe clinical practice, but do not adequately address their integration concerns or role in health system strengthening. Non-state actors in Australia make donations to African health institutions but rarely promote health workforce equity. African state actors respond to increased SHW migration trends by increasing health worker training and limiting migration, but they lack a comprehensive governance framework for involving citizens and engaging foreign governments. There is limited evidence of a shared community definition of SHW migration governance in many African countries. CONCLUSION When stakeholders in both sending and receiving countries recognise the indivisibility of the rights at stake (for example, SHW rights as migrants and the right to health), support for an equity-focused SHW migration governance system may increase. Promoting these rights can result in policies that enhance health system strengthening in destination and source countries. Similarly, growing adoption of these rights in sending countries should help inspire a coordinated plan for strengthening health system and SHW migration governance.
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Affiliation(s)
- Kenneth Yakubu
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, New South Wales, Sydney, Australia
| | - Anna Campain
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, New South Wales, Sydney, Australia
| | - Seye Abimbola
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Tristan Bouckley
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, New South Wales, Sydney, Australia
| | - David Peiris
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, New South Wales, Sydney, Australia
| | - Rohina Joshi
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, New South Wales, Sydney, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, New South Wales, Sydney, Australia
- The George Institute for Global Health India, New Delhi, India
| | - Janani Shanthosh
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, New South Wales, Sydney, Australia
- Australian Human Rights Institute, Faculty of Law and Justice, University of New South Wales, Sydney, New South Wales, Australia
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Losev Y, Rubinstein M, Nissan I, Haviv P, Barsky Y, Volinsky M, Bar-Giora G, Zouher T, Hamawi M, Valenci GZ, Kutikov I, Shwartz HK, Dveyrin Z, Chemtob D, Rorman E. Genomic, phenotypic and demographic characterization of Mycobacterium tuberculosis in Israel in 2021. Front Cell Infect Microbiol 2023; 13:1196904. [PMID: 37928179 PMCID: PMC10622789 DOI: 10.3389/fcimb.2023.1196904] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
According to World Health Organization WHO, Tuberculosis (TB) is the second cause of death from infectious disease worldwide. During 2021, 10.6 million people were infected with TB, and 1.6 million people died. TB is caused by pathogens belonging to the Mycobacterium tuberculosis complex (MTBC), mainly by Mycobacterium tuberculosis (M.tb). Members of this complex are acid-fast bacilli, which can cause intrapulmonary and extra pulmonary TB, and can be divided into various lineages, based on genomic markers. The main public health threat comes from drug resistant M.tb strains, which are responsible for about 25% of TB death and treatment failure worldwide. Treating drug resistant TB patients significantly raises the costs of TB treatment. This study provides an overview of the demographic and drug susceptibility characteristics of newly diagnosed TB patients in Israel in 2021. The State of Israel has a very low level of TB endemicity and is at a pre-elimination phase. Notably, only 11.7% of the newly diagnosed TB patients were born in Israel. In this report, of the 154 new laboratory-confirmed TB patients, 66.7% had pulmonary TB, while 16% had extrapulmonary TB. Males accounted for 52% of the patients, with the most prevalent age group being 21-40. Most patients were citizens of Israel (53.9%), while 37.7% had no Israeli citizenship. Among non-citizens, there was a predominance of males and patients aged 21-40. The susceptibility profile showed a high resistance rate to streptomycin (18.2%) and to a lower extent to isoniazid (13.6%), pyrazinamide (8.4%), rifampicin (7.8%), and ethambutol (3.2%). Only 2 cases of XDR-TB and 10 MDR-TB strains were detected in Israel in 2021, with both XDR strains and 5 out of 10 MDR strains belonging to the Beijing lineage. Most of Beijing isolates were resistant to at least one tested drug. Genomic sequencing of 134 out of 156 strains and bioinformatics analysis using the MTBseq program and WHO mutation catalogue shows a good match with only 9 discrepancies between phenotypic and genotypic susceptibility profiles in first line drugs. The most common lineage is Delhi-Cas (23%) followed by the Beijing lineage (17%). Most patients from the Delhi-Cas lineage were born in Africa, while patients with Beijing isolates were born in different countries. Minimum spanning tree analysis identified 15 clusters. The study highlights the need for ongoing surveillance of TB using molecular and phenotypic tools to further decreasing the spreading level of the disease and develop effective treatment strategies.
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Affiliation(s)
- Yelena Losev
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Mor Rubinstein
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Israel Nissan
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Paz Haviv
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Yohi Barsky
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Martha Volinsky
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Gefen Bar-Giora
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Tamara Zouher
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Mazal Hamawi
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Gal Zizelski Valenci
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Ina Kutikov
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Hasia Kaidar Shwartz
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Zeev Dveyrin
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
| | - Daniel Chemtob
- Department of Tuberculosis (TB) and AIDS and National TB Program Manager, Ministry of Health, Jerusalem, Israel
- Hebrew University-Hadassah Faculty of Medicine, School of Public Health and Community Medicine, Jerusalem, Israel
| | - Efrat Rorman
- National Public Health Laboratory, Public Health Directorate, Ministry of Health, Tel Aviv, Israel
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Brun-Rambaud G, Alcouffe L, Tareau MA, Adenis A, Vignier N. Access to health care for migrants in French Guiana in 2022: a qualitative study of health care system actors. Front Public Health 2023; 11:1185341. [PMID: 37920590 PMCID: PMC10619762 DOI: 10.3389/fpubh.2023.1185341] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 09/22/2023] [Indexed: 11/04/2023] Open
Abstract
Background Access to health care is a major public health issue. The social determinants of health have a role in accessing health care and in meeting the health needs of populations. With 281 million international migrants around the world, population movements are another major issue. Migrants are particularly exposed to precariousness during their migratory journey and after their settlement. These vulnerabilities may have deleterious effects on their health status and on their social conditions. In French Guiana, 36% of the population is of foreign origin. The objective of this study is to explore the barriers and the facilitators to accessing health care for migrants in French Guiana in 2022, from the perspective of health care professionals, social workers and local NGO actors. Methods This research is an exploratory qualitative study based on the experiential knowledge of health care professionals, social workers and local NGO actors in French Guiana. 25 semi-structured interviews were conducted with these professionals and actors between April and June 2022, using an interview guide to explore their practices, representations and beliefs of access to health care and accompaniment of migrants in their patient journey. The interviews were transcribed and analyzed using the thematic analysis method. Results A total of 25 health care professionals, social workers and local NGO actors were included in the study. Participants highlighted that migrants are exposed to many factors hindering their access to health care in French Guiana (administrative complexity, language barriers, financial barriers, mobility issues, etc.). With the situations of great precariousness and the inadequacies of the public authorities, associative support (social, health and legal accompaniment process provided by NGOs and associations) has an important role in providing close support to migrants. Moreover, health mediation supports migrants in their social and health care journey to lead them toward empowerment. Health mediators contribute to promote a better understanding between professionals and migrants. Conclusion In French Guiana, associative support and health mediation promote access to health care and social accompaniment for migrants. This article highlights the issues surrounding access to health care, associative support and health mediation in the Guianese context, which is marked by significant socio-cultural diversity and precariousness. Considering the benefits of associative support and health mediation, as well as social inequalities in health, is essential for health care professionals, social workers, local NGO actors, associations, public health authorities and political decision-makers to initiate concrete and suitable actions in favor of access to health care and social support for migrants in French Guiana.
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Affiliation(s)
- Gabriel Brun-Rambaud
- Centre d'Investigation Clinique Antilles Guyane, Inserm CIC 1424, COREVIH Guyane, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Leslie Alcouffe
- Centre d'Investigation Clinique Antilles Guyane, Inserm CIC 1424, COREVIH Guyane, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Marc-Alexandre Tareau
- Centre d'Investigation Clinique Antilles Guyane, Inserm CIC 1424, COREVIH Guyane, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Antoine Adenis
- Centre d'Investigation Clinique Antilles Guyane, Inserm CIC 1424, COREVIH Guyane, Centre Hospitalier de Cayenne, Cayenne, French Guiana
| | - Nicolas Vignier
- Centre d'Investigation Clinique Antilles Guyane, Inserm CIC 1424, COREVIH Guyane, Centre Hospitalier de Cayenne, Cayenne, French Guiana
- Hôpital Jean Verdier, AP-HP, UFR SMBH, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Avicenne, Université Sorbonne Paris Nord, Bobigny, France
- IAME, Inserm UMR 1137, Université Sorbonne Paris Nord, Université Paris Cité, Paris, France
- Institut Convergences et Migrations, Health and Policy Departments, Aubervilliers, France
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García-Taibo O, Martín-López IM, Baena-Morales S, Rodríguez-Fernández JE. The Impact of Service-Learning on the Prosocial and Professional Competencies in Undergraduate Physical Education Students and Its Effect on Fitness in Recipients. Int J Environ Res Public Health 2023; 20:6918. [PMID: 37887656 PMCID: PMC10606541 DOI: 10.3390/ijerph20206918] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 10/07/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023]
Abstract
Education is a key component of the student's transformation towards the creation of a more sustainable future. Among the methodological adaptations in teaching-learning processes, Service-Learning (SL) stands out as a meaningful academic experience to respond to social needs by developing committed citizens to transform society. The aim of the present study was to analyze the impact of this SL program on prosocial competence and satisfaction levels in university students, enhance physical fitness and analyze the reflections of the recipients. Moreover, the reflections on SL of the students and the migrants were analyzed. A mixed-methods design was performed. Forty-five students of Physical Activity and Sport Sciences provided a service to a migrant group that consisted of physical fitness training. The instruments implemented were the Prosocial and Civic Competence, the Impact of Service-Learning During Initial Training of Physical Activity and Sports and the reflective diary. The recipients participated in a physical fitness assessment and in a group discussion. The results show that SL in PAH contributes to pedagogical, communication, wellbeing and intercultural competences and also improves their prosocial and civic attitudes. Moreover, the recipients could enhance their physical fitness and their social interaction.
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Affiliation(s)
- Olalla García-Taibo
- Department of Physical Activity and Sport Sciences, CESAG, Comillas Pontifical University, 07013 Palma de Mallorca, Spain;
| | - Isabel María Martín-López
- Department of Physical Activity and Sport Sciences, CESAG, Comillas Pontifical University, 07013 Palma de Mallorca, Spain;
| | - Salvador Baena-Morales
- Department of General Didactics and Specific Didactics, Faculty of Education, University of Alicante, 03009 Alicante, Spain;
| | - José Eugenio Rodríguez-Fernández
- Department of Applied Didactics, Faculty of Education Sciences, University of Santiago de Compostela, 15782 Santiago de Compostela, Spain;
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Crawshaw AF, Kitoko LM, Nkembi SL, Lutumba LM, Hickey C, Deal A, Carter J, Knights F, Vandrevala T, Forster AS, Hargreaves S. Co-designing a theory-informed, multicomponent intervention to increase vaccine uptake with Congolese migrants: A qualitative, community-based participatory research study (LISOLO MALAMU). Health Expect 2023; 27:e13884. [PMID: 37831054 PMCID: PMC10726157 DOI: 10.1111/hex.13884] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/11/2023] [Accepted: 09/22/2023] [Indexed: 10/14/2023] Open
Abstract
INTRODUCTION Disparities in the uptake of routine and COVID-19 vaccinations have been observed in migrant populations, and attributed to issues of mistrust, access and low vaccine confidence. Participatory research approaches and behaviour change theory hold the potential for developing tailored vaccination interventions that address these complex barriers in partnership with communities and should be explored further. METHODS This study used a theory-informed, community-based participatory research approach to co-design a culturally tailored behaviour change intervention aimed at increasing COVID-19 vaccine uptake among Congolese migrants in London, United Kingdom (2021-2022). It was designed and led by a community-academic partnership in response to unmet needs in the Congolese community as the COVID-19 pandemic started. Barriers and facilitators to COVID-19 vaccination, information and communication preferences, and intervention suggestions were explored through qualitative in-depth interviews with Congolese migrants, thematically analysed, and mapped to the theoretical domains framework (TDF) and the capability, opportunity, motivation, behaviour model to identify target behaviours and strategies to include in interventions. Interventions were co-designed and tailored in workshops involving Congolese migrants. RESULTS Thirty-two Congolese adult migrants (24 (75%) women, mean 14.3 (SD: 7.5) years in the United Kingdom, mean age 52.6 (SD: 11.0) years) took part in in-depth interviews and 16 (same sample) took part in co-design workshops. Fourteen barriers and 10 facilitators to COVID-19 vaccination were identified; most barrier data related to four TDF domains (beliefs about consequences; emotion; social influences and environmental context and resources), and the behavioural diagnosis concluded interventions should target improving psychological capability, reflective and automatic motivations and social opportunities. Strategies included culturally tailored behaviour change techniques based on education, persuasion, modelling, enablement and environmental restructuring, which resulted in a co-designed intervention comprising community-led workshops, plays and posters. Findings and interventions were disseminated through a community celebration event. CONCLUSIONS Our study demonstrates how behavioural theory can be applied to co-designing tailored interventions with underserved migrant communities through a participatory research paradigm to address a range of health issues and inequalities. Future research should build on this empowering approach, with the goal of developing more sensitive vaccination services and interventions which respond to migrant communities' unique cultural needs and realities. PATIENT OR PUBLIC CONTRIBUTION Patient and public involvement (PPI) were embedded in the participatory study design and approach, with community members co-producing all stages of the study and co-authoring this paper. An independent PPI board (St George's Migrant Health Research Group Patient and Public Involvement Advisory Board) comprising five adult migrants with lived experience of accessing healthcare in the United Kingdom were also consulted at significant points over the course of the study.
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Affiliation(s)
- Alison F. Crawshaw
- The Migrant Health Research Group, Institute for Infection and ImmunitySt George's University of LondonLondonUK
| | | | | | | | | | - Anna Deal
- The Migrant Health Research Group, Institute for Infection and ImmunitySt George's University of LondonLondonUK
- Faculty of Public Health and Policy, London School of Hygiene and Tropical MedicineLondonUK
| | - Jessica Carter
- The Migrant Health Research Group, Institute for Infection and ImmunitySt George's University of LondonLondonUK
| | - Felicity Knights
- The Migrant Health Research Group, Institute for Infection and ImmunitySt George's University of LondonLondonUK
| | - Tushna Vandrevala
- Centre for Applied Health and Social Care Research, Faculty of Health, Science, Social Care and EducationKingston University LondonLondonUK
| | | | - Sally Hargreaves
- The Migrant Health Research Group, Institute for Infection and ImmunitySt George's University of LondonLondonUK
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Lyons N, Bhagwandeen B. Examining healthcare needs and decisions to seek health services among Venezuelan migrants living in Trinidad and Tobago using Andersen's Behavioral Model. Front Public Health 2023; 11:1212825. [PMID: 37900018 PMCID: PMC10600439 DOI: 10.3389/fpubh.2023.1212825] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/29/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Beginning in 2016, Trinidad and Tobago experienced increasing flows of migrants and refugees from Venezuela. Through a Government Registration Exercise in 2019, followed by a Re-registration Exercise in 2020, migrants and refugees benefitted from access to publicly available primary care and emergency medical services. By applying Andersen's Behavioral Model for Health Service Use, our study examined the non-communicable disease care needs of migrants, and factors influencing their decision to seek public and private health services. Method Between September and December 2020, a health questionnaire was administered via telephone to n = 250 migrants from Venezuela. Descriptive statistics summarized the constructs of Andersen's Behavioral Model. The model comprised of predisposing factors including migrants' social characteristics; enabling factors namely monthly earnings, education level and most trusted source of information on medical needs; need for care factors such as migrants self-reported health status, presence of non-communicable health conditions and having visited a doctor in the past 12 months; and the outcome variables which were migrants' decisions to seek public and private health services. Pearson χ2 tests, odds ratios and multivariable logistic regression with backward elimination examined the factors influencing a migrant's decision to seek health services. Results Overall, 66.8% of migrants reported they would seek public health services, while 22.4% indicated they would seek private health services. Predisposing factors namely length of time residing in Trinidad and Tobago (p = 0.031) and living with family/friends (p = 0.049); the enabling factor of receiving information from publicly available sources (p = 0.037); and the need for care factor of visiting a doctor for a physical health problem (p = 0.010) were significant correlates of their decision to seek care in the public sector. Predisposing factors namely living with family/friends (p = 0.020) and the enabling factor of having difficulty accessing healthcare services (p = 0.045) were significant correlates of their decision to seek care from private providers. Discussion Our findings demonstrated the positive association between social networks and a migrant's decision to use public and private health services, thus underscoring the importance of family and friends in facilitating health service use, promoting proper health practices and preventing diseases. Overall, the use of Andersen's Behavioral Model aided in identifying the factors associated with the use of health services by Venezuelan migrants in Trinidad and Tobago. However, further studies are needed to better understand their need for ongoing care, to inform policy, and to plan targeted health interventions for addressing the gaps in health service access, barriers and use.
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Affiliation(s)
- Nyla Lyons
- Medical Research Foundation of Trinidad and Tobago, Port of Spain, Trinidad and Tobago
| | - Brendon Bhagwandeen
- School of Mathematical and Computer Sciences, Heriot-Watt University Malaysia, Putrajaya, Malaysia
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Pham PN, Johnston LG, Keegan K, Wei C, Vinck P. Innovative Strategies for Remotely Sampling Hard-to-Reach Populations: Assessing Phone Versus Internet Respondent-Driven Sampling Approaches Among Venezuelan Refugees and Migrants in Colombia. Am J Epidemiol 2023; 192:1613-1623. [PMID: 37194729 PMCID: PMC10558185 DOI: 10.1093/aje/kwad116] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 11/10/2022] [Accepted: 05/10/2023] [Indexed: 05/18/2023] Open
Abstract
It is challenging to quantitatively measure the health vulnerability and risk factors of refugees and migrants residing outside of formal settlement settings. For hard-to-reach populations without available sampling frames, researchers have increasingly turned to novel sampling and statistical methods, like respondent-driven sampling (RDS). "Standard" RDS is typically conducted face-to-face at fixed sites. However, during the coronavirus disease 2019 (COVID-19) pandemic, face-to-face survey methods and recruitment approaches posed high potential risk of virus transmission and infection, making remote RDS approaches optimal. In this paper, we explore the feasibility of implementing telephone and Internet RDS strategies to assess challenges faced by Venezuelan refugees and migrants in the city of Bogotá, Colombia's capital, and the department of Norte de Santander, the main Venezuelan-Colombian border crossing site. We describe RDS assumptions, survey design, formative research, and the implementation of both strategies and present diagnostics for determining whether assumptions are met. Phone-based recruitment strategies in both locations and the Internet strategy in Bogotá achieved their calculated sample size; however, the Internet strategy in Norte de Santander did not. Most RDS assumptions were sufficiently met at sites where sample sizes were reached. These surveys provide valuable lessons for implementing innovative remote strategies with which to study hard-to-reach populations such as refugees and migrants.
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Affiliation(s)
- Phuong N Pham
- Correspondence to Dr. Phuong N. Pham, Department of Emergency Medicine, Harvard Medical School, Harvard University, 14 Story Street, 2nd Floor, Cambridge, MA 02139 (e-mail: )
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Guidi CF, Berti F. Labor exploitation in the Italian agricultural sector: the case of vulnerable migrants in Tuscany. Front Sociol 2023; 8:1234873. [PMID: 37860274 PMCID: PMC10582926 DOI: 10.3389/fsoc.2023.1234873] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/11/2023] [Indexed: 10/21/2023]
Abstract
Labor exploitation of agricultural migrant workers is a well-documented phenomenon by investigations and field research in several Italian regions, both in the North and the South. Despite the agri-food excellencies of the "Made in Italy" brand being a source of pride for Italian entrepreneurship, including the viticulture sector, evidence shows that many of these products are the result of different levels of illegal recruitment and labor exploitation. In this article, the authors analyze the impact of recent waves of vulnerable migrants entering the Italian labor market and present the results of a qualitative field research, conducted in Tuscany between 2021 and 2022. Through 60 interviews with exploited migrant workers and 40 interviews with relevant stakeholders, the authors focus on the recruitment process of vulnerable migrants into the agriculture sector and the labor conditions granted to them regardless of their particular migratory status. The article concludes with the analysis of the peculiarities of the Tuscan case study, characterized by the presence of a legal system of labor exploitation.
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Affiliation(s)
- Caterina Francesca Guidi
- Laboratorio sulle Diseguaglianze, Department of Social, Political and Cognitive Sciences (DISPOC), University of Siena, Siena, Italy
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Cetrez ÖA, Kaynak S. Editorial: Migrants' psychosocial health: cultural and religious resources through resilience and coping. Front Sociol 2023; 8:1286892. [PMID: 37904906 PMCID: PMC10613468 DOI: 10.3389/fsoc.2023.1286892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 09/11/2023] [Indexed: 11/01/2023]
Affiliation(s)
- Önver Andreas Cetrez
- Faculty of Theology, Psychology of Religion, Uppsala University, Uppsala, Sweden
| | - Selcan Kaynak
- Department of Political Science and International Relations, Koç University, Istanbul, Türkiye
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Vasiliu A, Köhler N, Altpeter E, Ægisdóttir TR, Amerali M, de Oñate WA, Bakos Á, D'Amato S, Cirillo DM, van Crevel R, Davidaviciene E, Demuth I, Domínguez J, Duarte R, Günther G, Guthmann JP, Hatzianastasiou S, Holm LH, Herrador Z, Hribar U, Huberty C, Ibraim E, Jackson S, Jensenius M, Josefsdottir KS, Koch A, Korzeniewska-Kosela M, Kuksa L, Kunst H, Lienhardt C, Mahler B, Makek MJ, Muylle I, Normark J, Pace-Asciak A, Petrović G, Pieridou D, Russo G, Rzhepishevska O, Salzer HJF, Marques MS, Schmid D, Solovic I, Sukholytka M, Svetina P, Tyufekchieva M, Vasankari T, Viiklepp P, Villand K, Wallenfels J, Wesolowski S, Mandalakas AM, Martinez L, Zenner D, Lange C. Tuberculosis incidence in foreign-born people residing in European countries in 2020. Euro Surveill 2023; 28:2300051. [PMID: 37855907 PMCID: PMC10588305 DOI: 10.2807/1560-7917.es.2023.28.42.2300051] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/12/2023] [Indexed: 10/20/2023] Open
Abstract
BackgroundEuropean-specific policies for tuberculosis (TB) elimination require identification of key populations that benefit from TB screening.AimWe aimed to identify groups of foreign-born individuals residing in European countries that benefit most from targeted TB prevention screening.MethodsThe Tuberculosis Network European Trials group collected, by cross-sectional survey, numbers of foreign-born TB patients residing in European Union (EU) countries, Iceland, Norway, Switzerland and the United Kingdom (UK) in 2020 from the 10 highest ranked countries of origin in terms of TB cases in each country of residence. Tuberculosis incidence rates (IRs) in countries of residence were compared with countries of origin.ResultsData on 9,116 foreign-born TB patients in 30 countries of residence were collected. Main countries of origin were Eritrea, India, Pakistan, Morocco, Romania and Somalia. Tuberculosis IRs were highest in patients of Eritrean and Somali origin in Greece and Malta (both > 1,000/100,000) and lowest among Ukrainian patients in Poland (3.6/100,000). They were mainly lower in countries of residence than countries of origin. However, IRs among Eritreans and Somalis in Greece and Malta were five times higher than in Eritrea and Somalia. Similarly, IRs among Eritreans in Germany, the Netherlands and the UK were four times higher than in Eritrea.ConclusionsCountry of origin TB IR is an insufficient indicator when targeting foreign-born populations for active case finding or TB prevention policies in the countries covered here. Elimination strategies should be informed by regularly collected country-specific data to address rapidly changing epidemiology and associated risks.
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Affiliation(s)
- Anca Vasiliu
- Baylor College of Medicine, Department of Pediatrics, Global and Immigrant Health, Global Tuberculosis Program, Houston, Texas, United States
| | - Niklas Köhler
- Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany
- German Center for Infection Research (DZIF), TTU-TB, Borstel, Germany
- Respiratory Medicine & International Health, University of Lübeck, Lübeck, Germany
| | - Ekkehardt Altpeter
- Swiss Federal Office of Public Health, Division of Communicable Diseases, Bern, Switzerland
| | - Tinna Rán Ægisdóttir
- The National University Hospital of Iceland, Pharmaceutical Services, Reykjavik, Iceland
| | - Marina Amerali
- Tuberculosis Control Office, Department of Respiratory Infections, Directorate for Epidemiological Surveillance & Intervention, National Public Health Organization (NPHO), Athens, Greece
| | - Wouter Arrazola de Oñate
- Belgian Lung and Tuberculosis Association, Brussels, Belgium
- Flemish Association of Respiratory Health and TB Control, Leuven, Belgium
| | - Ágnes Bakos
- Koranyi National Institute for Pulmonology, Budapest, Hungary
| | - Stefania D'Amato
- Prevention of Communicable Diseases and International Prophylaxis, General Direction of Health Prevention, Ministry of Health of Italy, Rome, Italy
| | - Daniela Maria Cirillo
- Emerging Bacterial Pathogens Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Reinout van Crevel
- Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, the Netherlands
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Edita Davidaviciene
- Vilnius University hospital Santaros Klinikos, Department of Tuberculosis State information system, Vilnius, Lithuania
| | | | - Jose Domínguez
- Institut d'Investigació Germans Trias i Pujol; Universitat Autònoma de Barcelona; CIBER Enfermedades Respiratorias; INNOVA4TB consortium Badalona, Barcelona, Spain
| | - Raquel Duarte
- ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto
- ISPUP - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
- Centro Hospitalar de Vila Nova de Gaia/Espinho, Porto, Portugal
| | - Gunar Günther
- Department of Pulmonary Medicine and Allergology, Inselspital, Bern University Hospital, University of Bern, Switzerland
- Department of Medical Sciences, School of Medicine, University of Namibia, Windhoek, Namibia
| | - Jean-Paul Guthmann
- Division of Infectious Diseases, Santé publique France, Saint-Maurice, France
| | - Sophia Hatzianastasiou
- Tuberculosis Control Office, Department of Respiratory Infections, Directorate for Epidemiological Surveillance & Intervention, National Public Health Organization (NPHO), Athens, Greece
| | - Louise Hedevang Holm
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
| | - Zaida Herrador
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Urška Hribar
- Tuberculosis Register of the Republic of Slovenia, University Clinic Golnik, Golnik, Slovenia
| | | | - Elmira Ibraim
- Marius Nasta Institute of Pulmonology, Bucharest, Romania
| | - Sarah Jackson
- Infectious Diseases; Health Service Executive Health Protection Surveillance Centre, Dublin, Ireland
| | - Mogens Jensenius
- Department of Infectious Diseases, Oslo University Hospital, Ullevaal, Norway
| | | | - Anders Koch
- Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Copenhagen, Denmark
- Department of Infectious Diseases, Rigshospitalet University Hospital, Copenhagen, Denmark
| | - Maria Korzeniewska-Kosela
- Department of Tuberculosis Epidemiology and Surveillance, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
| | - Liga Kuksa
- Riga East University Hospital, TB and Lung Disease Clinic, Riga, Latvia
| | - Heinke Kunst
- Blizard Institute, The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Christian Lienhardt
- Unité Unité Mixte Internationale 233 IRD - U1175 INSERM - Université de Montpellier, Institut de Recherche pour le Développement (IRD), Montpellier, France
- Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Beatrice Mahler
- Marius Nasta Institute of Pulmonology, Bucharest, Romania
- Department Cardio-thoracic, Pneumophtisiology II, University of Medicine and Pharmacy "Carol Davila" Bucharest, Romania
| | - Mateja Janković Makek
- University of Zagreb, School of Medicine Zagreb, Croatia
- University Hospital Centre Zagreb, Department for Lung diseases, Zagreb, Croatia
| | - Inge Muylle
- Division of Pneumology, Onze-Lieve-Vrouw Ziekenhuis (OLV) Aalst, Aalst, Belgium
| | - Johan Normark
- Department of Clinical Microbiology, Umeå University, Sweden
- Wallenberg Centre for Molecular Medicine, Umeå University, Sweden
| | - Analita Pace-Asciak
- Infectious Disease Prevention and Control Unit, Health Promotion and Disease Prevention Directorate, Superintendence of Public Health, Ministry for Health of Malta, La Valetta, Malta
| | - Goranka Petrović
- Respiratory Diseases and Travel Medicine Department with Vaccination Unit, Infectious Diseases Epidemiology ServiceDepartment, Croatian Institute of Public Health, Zagreb, Croatia
| | - Despo Pieridou
- Cyprus National Reference Laboratory for Mycobacteria, Microbiology Department, Nicosia General Hospital, Nicosia, Cyprus
| | - Giulia Russo
- Emerging Bacterial Pathogens Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Olena Rzhepishevska
- Department of Chemistry, Department of Clinical Microbiology, Umeå University, Sweden
| | - Helmut J F Salzer
- Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine 4- Pneumology, Kepler University Hospital, Linz, Austria
- Faculty of Medicine, Johannes-Kepler-University, Linz, Austria and Ignaz Semmelweis Institut, Interuniversity Institute for Infection Resarch, Vienna, Austria
| | | | - Daniela Schmid
- Unit for Infectious Diseases Diagnostics and Infectious Diseases Epidemiology, Centre for Pathophysiology, Infectious Diseases and Immunology, Medical University of Vienna, Vienna, Austria
| | - Ivan Solovic
- National Institute for TB, Lung Diseases and Thoracic Surgery, Vysne Hagy, Slovakia
- Catholic University Ruzomberok, Ruzomberok, Slovakia
| | - Mariya Sukholytka
- First Faculty of Medicine and Faculty Thomayer Hospital Prague, Czechia
| | - Petra Svetina
- National TB Program and Tuberculosis Registry of Republic of Slovenia, University Clinic of Respiratory and Allergic Diseases Golnik, Golnik, Slovenia
| | - Mariya Tyufekchieva
- Health Promotion and Prevention Unit, Directorate Public Health Protection and Health Control, Ministry of Health of Bulgaria, Sofia, Bulgaria
| | - Tuula Vasankari
- University of Turku, Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, Turku, Finland
- Finnish Lung Health Association (Filha ry), Helsinki, Finland
| | - Piret Viiklepp
- Estonian Tuberculosis Register, Dept. of Registries, National Institute for Health Development, Tallinn, Estonia
| | - Kersti Villand
- Estonian Tuberculosis Register, Dept. of Registries, National Institute for Health Development, Tallinn, Estonia
| | - Jiri Wallenfels
- National TB Surveillance Unit, University Hospital Bulovka, Prague, Czechia
| | - Stefan Wesolowski
- Department of Tuberculosis Epidemiology and Surveillance, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
| | - Anna-Maria Mandalakas
- Baylor College of Medicine, Department of Pediatrics, Global and Immigrant Health, Global Tuberculosis Program, Houston, Texas, United States
- Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany
| | - Leonardo Martinez
- Boston University, School of Public Health, Department of Epidemiology, Boston, Massachusetts, United States
| | - Dominik Zenner
- Global Public Health Unit, Wolfson Institute of Population Health Barts
- The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Christoph Lange
- Baylor College of Medicine, Department of Pediatrics, Global and Immigrant Health, Global Tuberculosis Program, Houston, Texas, United States
- Division of Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany
- German Center for Infection Research (DZIF), TTU-TB, Borstel, Germany
- Respiratory Medicine & International Health, University of Lübeck, Lübeck, Germany
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D'Andrea G, Lal J, Tosato S, Gayer-Anderson C, Jongsma HE, Stilo SA, van der Ven E, Quattrone D, Velthorst E, Berardi D, Rossi Menezes P, Arango C, Parellada M, Lasalvia A, La Cascia C, Ferraro L, La Barbera D, Sideli L, Bobes J, Bernardo M, Sanjuán J, Santos JL, Arrojo M, Del-Ben CM, Tripoli G, Llorca PM, de Haan L, Selten JP, Tortelli A, Szöke A, Muratori R, Rutten BP, van Os J, Jones PB, Kirkbride JB, Murray RM, di Forti M, Tarricone I, Morgan C. Child maltreatment, migration and risk of first-episode psychosis: results from the multinational EU-GEI study. Psychol Med 2023; 53:6150-6160. [PMID: 36305570 PMCID: PMC10520604 DOI: 10.1017/s003329172200335x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 09/29/2022] [Accepted: 10/06/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Child maltreatment (CM) and migrant status are independently associated with psychosis. We examined prevalence of CM by migrant status and tested whether migrant status moderated the association between CM and first-episode psychosis (FEP). We further explored whether differences in CM exposure contributed to variations in the incidence rates of FEP by migrant status. METHODS We included FEP patients aged 18-64 years in 14 European sites and recruited controls representative of the local populations. Migrant status was operationalized according to generation (first/further) and region of origin (Western/non-Western countries). The reference population was composed by individuals of host country's ethnicity. CM was assessed with Childhood Trauma Questionnaire. Prevalence ratios of CM were estimated using Poisson regression. We examined the moderation effect of migrant status on the odds of FEP by CM fitting adjusted logistic regressions with interaction terms. Finally, we calculated the population attributable fractions (PAFs) for CM by migrant status. RESULTS We examined 849 FEP cases and 1142 controls. CM prevalence was higher among migrants, their descendants and migrants of non-Western heritage. Migrant status, classified by generation (likelihood test ratio:χ2 = 11.3, p = 0.004) or by region of origin (likelihood test ratio:χ2 = 11.4, p = 0.003), attenuated the association between CM and FEP. PAFs for CM were higher among all migrant groups compared with the reference populations. CONCLUSIONS The higher exposure to CM, despite a smaller effect on the odds of FEP, accounted for a greater proportion of incident FEP cases among migrants. Policies aimed at reducing CM should consider the increased vulnerability of specific subpopulations.
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Affiliation(s)
- Giuseppe D'Andrea
- Department of Medical and Surgical Sciences, Bologna Transcultural Psychosomatic Team (BoTPT), University of Bologna, Bologna, Italy
- Community Mental Health Center of Sassuolo, Department of Mental Health and Drug Abuse, AUSL Modena, Modena, Italy
| | - Jatin Lal
- Department of Medical and Surgical Sciences, Bologna Transcultural Psychosomatic Team (BoTPT), University of Bologna, Bologna, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Charlotte Gayer-Anderson
- ESRC Center for Society and Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Hannah E Jongsma
- Centre for Transcultural Psychiatry 'Veldzicht', Balkbrug, The Netherlands
- University Centre for Psychiatry, University Medical Centre Groningen, Groningen, The Netherlands
| | - Simona A Stilo
- Department of Mental Health and Addiction Services, ASP Crotone, Crotone, Italy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Els van der Ven
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Eva Velthorst
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Domenico Berardi
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Section of Psychiatry, University of Bologna, Bologna, Italy
| | - Paulo Rossi Menezes
- University Hospital, Section of Epidemiology, University of São Paulo, São Paulo, Brazil
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
| | - Laura Ferraro
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
| | - Daniele La Barbera
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
| | - Lucia Sideli
- Department of Human Science, LUMSA University, Rome, Italy
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, ISPA, Ineuropa, CIBERSAM, Oviedo, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Department of Medicine, Neuroscience Institute, Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental, Valencia, Spain
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital "Virgen de la Luz", Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago, Spain
| | - Cristina Marta Del-Ben
- Neuroscience and Behavior Department, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Piazza delle Cliniche, 290127 Palermo, Italy
| | | | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | - Jean-Paul Selten
- School for Mental Health and Neuroscience, University of Maastricht, Maastricht, The Netherlands
| | | | - Andrei Szöke
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, Fondation Fondamental, F-94010 Créteil, France
| | - Roberto Muratori
- Department of Mental Health and Pathological Addiction, Local Health Authority, Bologna, Italy
| | - Bart P Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | | | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Marta di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
| | - Ilaria Tarricone
- Department of Medical and Surgical Sciences, Bologna Transcultural Psychosomatic Team (BoTPT), University of Bologna, Bologna, Italy
- Department of Mental Health and Pathological Addiction, Local Health Authority, Bologna, Italy
| | - Craig Morgan
- ESRC Center for Society and Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
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Lee YG, Alessi EJ, Lynn M, Starks TJ, Robles G. Everyday Discrimination and HIV Testing Among Partnered Latino/x Sexual Minority Men in the United States: A Stratified Analysis by Birth Location. AIDS Educ Prev 2023; 35:376-389. [PMID: 37843904 DOI: 10.1521/aeap.2023.35.5.376] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
We examined the association between everyday discrimination and HIV testing patterns-current (≤ 6 months), recent (7-12 months), and delayed (> 12 months or never tested)-among partnered Latino/x sexual minority men (SMM). Multinomial regression analyses revealed that in the full sample (N = 484) experiencing discrimination based on sexual orientation and race/ethnicity attributions concurrently (vs. no discrimination) was associated with higher odds of delayed (vs. current) HIV testing (AOR = 2.6, 95% CI [1.0, 6.7]). Similarly, in the subset of Latino/x SMM born outside the mainland U.S. (n = 209), experiencing concurrent sexual orientation- and race/ethnicity-based discrimination (vs. no discrimination) was associated with higher odds of recent (AOR = 12.4, 95% CI [1.3, 115.7]) and delayed HIV testing (AOR = 7.3, 95% CI [1.6, 33.0]), compared with current testing. Findings suggest that addressing discrimination may improve HIV testing uptake among partnered Latino/x SMM, particularly those born outside the U.S.
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Affiliation(s)
- Yong Gun Lee
- School of Social Work, Rutgers University, New Brunswick, New Jersey
| | - Edward J Alessi
- School of Social Work, Rutgers University, New Brunswick, New Jersey
| | - Matthew Lynn
- School of Social Work, Rutgers University, New Brunswick, New Jersey
| | - Tyrel J Starks
- Department of Psychology, Hunter College of the City University of New York, New York, New York
| | - Gabriel Robles
- School of Social Work, Rutgers University, New Brunswick, New Jersey
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76
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Nanakali SS, Hassan O, Silva L, Al‐Oraibi A, Chaloner J, Gogoi M, Qureshi I, Sahare P, Pareek M, Chattopadhyay K, Nellums LB. Migrants' living conditions, perceived health needs and implications for the use of antibiotics and antimicrobial resistance in the United Kingdom: A qualitative study. Health Sci Rep 2023; 6:e1655. [PMID: 37885468 PMCID: PMC10599099 DOI: 10.1002/hsr2.1655] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/05/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023] Open
Abstract
Background and Aims Antimicrobial resistance (AMR) is among the top public health concerns around the globe. Migrants, especially forced migrants, could be at higher risk of acquiring and transmitting AMR during their journeys or in host countries. There is limited understanding regarding migrants' living conditions and the wider factors contributing to their risk of acquiring infections, and behaviors around antimicrobial use, and AMR development. In this study, we aimed to explore transit experiences, living conditions, and antibiotic use of migrants living in the United Kingdom. Methods We conducted semistructured qualitative interviews with 27 participants and identified five themes regarding migrants' journey and their living conditions during transit and after arriving in the United Kingdom, their access to water, sanitation and hygiene (WASH), and their use of antibiotics. Results Migrants, particularly forced migrants, experienced unfavorable living conditions, poor access to WASH, and challenges in accessing healthcare, which further contributed to health conditions like urinary and skin problems. Isolation and difficulty in accessing healthcare played significant roles in migrants' perceived need for storing and using antibiotics as a safety net. Conclusion The findings highlight the need for coordinated and multilevel interventions to address these challenges and contribute toward tackling AMR and improving the health of this population group.
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Affiliation(s)
- Shajwan S. Nanakali
- Lifespan and Population Health Academic Unit, School of Medicine, Nottingham City HospitalUniversity of NottinghamNottinghamUK
| | - Osama Hassan
- Lifespan and Population Health Academic Unit, School of Medicine, Nottingham City HospitalUniversity of NottinghamNottinghamUK
| | - Luisa Silva
- Lifespan and Population Health Academic Unit, School of Medicine, Nottingham City HospitalUniversity of NottinghamNottinghamUK
| | - Amani Al‐Oraibi
- Lifespan and Population Health Academic Unit, School of Medicine, Nottingham City HospitalUniversity of NottinghamNottinghamUK
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
| | - Jonathan Chaloner
- Lifespan and Population Health Academic Unit, School of Medicine, Nottingham City HospitalUniversity of NottinghamNottinghamUK
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
| | - Mayuri Gogoi
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
| | - Irtiza Qureshi
- Lifespan and Population Health Academic Unit, School of Medicine, Nottingham City HospitalUniversity of NottinghamNottinghamUK
| | - Pankhuri Sahare
- Lifespan and Population Health Academic Unit, School of Medicine, Nottingham City HospitalUniversity of NottinghamNottinghamUK
| | - Manish Pareek
- Department of Respiratory SciencesUniversity of LeicesterLeicesterUK
| | - Kaushik Chattopadhyay
- Lifespan and Population Health Academic Unit, School of Medicine, Nottingham City HospitalUniversity of NottinghamNottinghamUK
| | - Laura B. Nellums
- Lifespan and Population Health Academic Unit, School of Medicine, Nottingham City HospitalUniversity of NottinghamNottinghamUK
- College of Population HealthUniversity of New MexicoAlbuquerqueNew MexicoUSA
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Zysset AE, Schwärzler P, Dratva J. Seeking Health in a Digital World: Exploring Immigrant Parents' Quest for Child Health Information-A Scoping Review. Int J Environ Res Public Health 2023; 20:6804. [PMID: 37835074 PMCID: PMC10572919 DOI: 10.3390/ijerph20196804] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/10/2023] [Accepted: 09/16/2023] [Indexed: 10/15/2023]
Abstract
During pregnancy and early parenthood, parents' strong interest in pediatric health information presents a valuable opportunity to positively impact long-term health-seeking behavior and overall child health. In line with the increasing prevalence of digital transformation, a scoping review was conducted to explore two key aspects: (1) information seeking and use of digital health information among immigrant parents, and (2) associated reasons and factors. The literature search covered the period until July 2022, using Web of Science, MEDLINE, and CINAHL Complete databases. Out of 625 articles, 12 were included, comprising six qualitative, five quantitative studies, and one review. The majority of studies focused on immigrants in North America, primarily from Latin America and Asia. The studies varied in topics and methodologies, making it challenging to draw general conclusions. Nevertheless, while most immigrant parents rely on digital information on child health, they often prefer human sources such as family, friends, or healthcare providers. Trustworthiness and accessibility emerged as critical criteria for health resources. Two focus group discussions, derived from the results of the review, confirmed these findings for migrant mothers in Switzerland.
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Affiliation(s)
- Annina E. Zysset
- Departement of Health, Institute of Public Health, ZHAW Zürich University of Applied Sciences, 8401 Winterthur, Switzerland; (A.E.Z.); (P.S.)
| | - Patricia Schwärzler
- Departement of Health, Institute of Public Health, ZHAW Zürich University of Applied Sciences, 8401 Winterthur, Switzerland; (A.E.Z.); (P.S.)
| | - Julia Dratva
- Departement of Health, Institute of Public Health, ZHAW Zürich University of Applied Sciences, 8401 Winterthur, Switzerland; (A.E.Z.); (P.S.)
- Medical Faculty, University of Basel, 4056 Basel, Switzerland
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78
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Ponce J, Beltrán-Sánchez H. US migration history and depressive symptoms among older mexican adults. Salud Publica Mex 2023; 65:485-492. [PMID: 38060917 PMCID: PMC10751990 DOI: 10.21149/14742] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/04/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE To explore the association between US migration, chronic conditions (diabetes, stroke, heart attack, cancer, and hypertension), and mental health (depressive symptoms, and depression). MATERIALS AND METHODS We assessed average changes in depressive symptom scores as well as depression over time and their link with migration experience controlling for health and sociodemographic factors among older Mexican adults (50+) using 2012, 2015, and 2018 waves of the Mexican Health and Aging Study (MHAS). RESULTS Non-migrants had higher average depressive symptom scores and prevalence of depression (5+ score) in 2012 and 2015, but there was no significant difference in either measure in 2018 or on changes over time. CONCLUSION Although there were no significant differences in average depressive symptoms and depression over time by migration history, this study highlights some differences in 2012 and 2015. Comparing groups across migration histories allowed the researchers to examine how life course differences impact mental health outcomes.
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Affiliation(s)
- Julián Ponce
- Fielding School of Public Health, University of California. Los Angeles, United States..
| | - Hiram Beltrán-Sánchez
- Fielding School of Public Health, University of California. Los Angeles, United States..
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79
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Vange SS, Nielsen MR, Michaëlis C, Smith Jervelund S. Interpreter services for im migrants in European healthcare systems: a systematic review of access barriers and facilitators. Scand J Public Health 2023:14034948231179279. [PMID: 37698073 DOI: 10.1177/14034948231179279] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
BACKGROUND Language barriers have been identified as a key access barrier to healthcare services for immigrants. The aim of this study was twofold: to investigate immigrants' and healthcare professionals' experiences with barriers and facilitators of interpreter services, and to examine the influence of barriers to interpreter services on the quality of care from immigrant and healthcare professional perspectives. METHODS We searched PubMed, Embase, The Cochrane Library, Scopus, SocINDEX and PsycINFO, resulting in 1425 studies. A total of 21 original quantitative, qualitative and mixed methods studies published between 1996 and 2021 were assessed as eligible for inclusion. RESULTS Identified barriers included: lack of immediately available interpreter services, cost, lack of knowledge about availability, and attitude towards interpreter services. Facilitators included: a high number of interpreters in the requested language, awareness among healthcare professionals and patients of the patient's rights to interpreters, and a positive attitude towards use of interpreter services. Regarding quality of care, language barriers created safety risks for the patients, made patients feel unsafe, or delayed patient contact with the healthcare system. CONCLUSION Immigrant patients and healthcare professionals experience barriers in using interpreter services due to restrictive policies regarding user fees and limitations to entitlement to interpreters, a limited number of qualified interpreters and lack of knowledge. Medical encounters with unaddressed language barriers can put patients at risk and reduce quality of care for immigrants, which calls for strengthening formal and informal access to interpreters.
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Affiliation(s)
- Sif Sofie Vange
- Faculty of Health and Medical Sciences, Department of Public Health, Section for Health Services Research, University of Copenhagen, Copenhagen, Denmark
| | - Maj Rørdam Nielsen
- Faculty of Law, Centre for Private Governance, University of Copenhagen, Copenhagen, Denmark
| | - Camilla Michaëlis
- Faculty of Health and Medical Sciences, Department of Public Health, Section for Health Services Research, University of Copenhagen, Copenhagen, Denmark
| | - Signe Smith Jervelund
- Faculty of Health and Medical Sciences, Department of Public Health, Section for Health Services Research, University of Copenhagen, Copenhagen, Denmark
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80
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Grossi AA, Puoti F, Maggiore U, Cardillo M. Refusal Rates to Organ Donation in Intensive Care Units Among Immigrant Populations in Italy. Transpl Int 2023; 36:11674. [PMID: 37745641 PMCID: PMC10513101 DOI: 10.3389/ti.2023.11674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/14/2023] [Indexed: 09/26/2023]
Affiliation(s)
- Alessandra Agnese Grossi
- Center for Clinical Ethics, Department of Biotechnologies and Life Sciences, University of Insubria, Varese, Italy
- Department of Human Sciences, Innovation and Territory, University of Insubria, Como, Italy
| | - Francesca Puoti
- Italian National Transplant Center (CNT), Istituto Superiore di Sanità, Rome, Italy
| | - Umberto Maggiore
- Nephrology Unit, Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Massimo Cardillo
- Italian National Transplant Center (CNT), Istituto Superiore di Sanità, Rome, Italy
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Deal A, Crawshaw AF, Carter J, Knights F, Iwami M, Darwish M, Hossain R, Immordino P, Kaojaroen K, Severoni S, Hargreaves S. Defining drivers of under-immunization and vaccine hesitancy in refugee and migrant populations. J Travel Med 2023; 30:taad084. [PMID: 37335192 PMCID: PMC10481413 DOI: 10.1093/jtm/taad084] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/15/2023] [Accepted: 05/29/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND/OBJECTIVE Some refugee and migrant populations globally showed lower uptake of COVID-19 vaccines and are also considered to be an under-immunized group for routine vaccinations. These communities may experience a range of barriers to vaccination systems, yet there is a need to better explore drivers of under-immunization and vaccine hesitancy in these mobile groups. METHODS We did a global rapid review to explore drivers of under-immunization and vaccine hesitancy to define strategies to strengthen both COVID-19 and routine vaccination uptake, searching MEDLINE, Embase, Global Health PsycINFO and grey literature. Qualitative data were analysed thematically to identify drivers of under-immunization and vaccine hesitancy, and then categorized using the 'Increasing Vaccination Model'. RESULTS Sixty-three papers were included, reporting data on diverse population groups, including refugees, asylum seekers, labour migrants and undocumented migrants in 22 countries. Drivers of under-immunization and vaccine hesitancy pertaining to a wide range of vaccines were covered, including COVID-19 (n = 27), human papillomavirus (13), measles or Measles-mumps-rubella (MMR) (3), influenza (3), tetanus (1) and vaccination in general. We found a range of factors driving under-immunization and hesitancy in refugee and migrant groups, including unique awareness and access factors that need to be better considered in policy and service delivery. Acceptability of vaccination was often deeply rooted in social and historical context and influenced by personal risk perception. CONCLUSIONS These findings hold direct relevance to current efforts to ensure high levels of global coverage for a range of vaccines and to ensure that marginalized refugee and migrant populations are included in the national vaccination plans of low-, middle- and high-income countries. We found a stark lack of research from low- and middle-income and humanitarian contexts on vaccination in mobile groups. This needs to be urgently rectified if we are to design and deliver effective programmes that ensure high coverage for COVID-19 and routine vaccinations.
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Affiliation(s)
- Anna Deal
- The Migrant Health Research Group, Institute for Infection and Immunity, St George’s, University of London, London, UK
- Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Alison F Crawshaw
- The Migrant Health Research Group, Institute for Infection and Immunity, St George’s, University of London, London, UK
| | - Jessica Carter
- The Migrant Health Research Group, Institute for Infection and Immunity, St George’s, University of London, London, UK
| | - Felicity Knights
- The Migrant Health Research Group, Institute for Infection and Immunity, St George’s, University of London, London, UK
| | - Michiyo Iwami
- The Migrant Health Research Group, Institute for Infection and Immunity, St George’s, University of London, London, UK
| | - Mohammad Darwish
- The Health and Migration Programme, World Health Organization, Geneva, Switzerland
| | - Rifat Hossain
- The Health and Migration Programme, World Health Organization, Geneva, Switzerland
| | - Palmira Immordino
- The Health and Migration Programme, World Health Organization, Geneva, Switzerland
| | - Kanokporn Kaojaroen
- The Health and Migration Programme, World Health Organization, Geneva, Switzerland
| | - Santino Severoni
- The Health and Migration Programme, World Health Organization, Geneva, Switzerland
| | - Sally Hargreaves
- The Migrant Health Research Group, Institute for Infection and Immunity, St George’s, University of London, London, UK
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Dawson-Hahn E, Fredkove W, Karim S, Mohamed F, Abudiab S, de Acosta D, Ebengho S, Garcia Y, Hoffman S, Keaveney M, Mann E, Thomas C, Yu K, Yun K. Perspectives of public health organizations partnering with refugee, immigrant, and migrant communities for comprehensive COVID-19 case investigation and contact tracing. Front Public Health 2023; 11:1218306. [PMID: 37732101 PMCID: PMC10508845 DOI: 10.3389/fpubh.2023.1218306] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 08/17/2023] [Indexed: 09/22/2023] Open
Abstract
Objectives To understand public health organizations' experiences providing comprehensive COVID-19 case investigation and contact tracing, and related promising practices with refugee, immigrant and migrant communities. Methods We interviewed public health professionals (September 2020 to February 2021) from local and state health departments using a geographically stratified, purposive sampling approach. A multidisciplinary team at the National Resource Center for Refugees, Immigrants and Migrants (NRC-RIM) conducted a thematic analysis of the data. Results Six themes were identified: understanding community and public health context, cultivating relationships, ensuring linguistic and cultural concordance, communicating intentionally, evolving response, and implementing equity. The interconnection of themes and promising practices is explored. Conclusion As public health continues to learn from and build upon COVID-19 response experiences, the thematic findings and potential promising practices identified in this project may foster proactive, community-engaged solutions for public health, and other organizations working and partnering with refugee, immigrant, and migrant communities. Implementing these findings with COVID-19 into current and future public health crisis responses may improve public health, collaborations with refugee, immigrant, and migrant communities, and staff wellbeing.
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Affiliation(s)
- Elizabeth Dawson-Hahn
- Department of Pediatrics, University of Washington, Seattle, WA, United States
- National Resource Center for Refugees, Immigrants and Migrants (NRC-RIM), University of Minnesota, Minneapolis, MN, United States
| | - Windy Fredkove
- National Resource Center for Refugees, Immigrants and Migrants (NRC-RIM), University of Minnesota, Minneapolis, MN, United States
- School of Nursing, University of Minnesota, Minneapolis, MN, United States
| | - Sayyeda Karim
- National Resource Center for Refugees, Immigrants and Migrants (NRC-RIM), University of Minnesota, Minneapolis, MN, United States
| | | | - Seja Abudiab
- Department of Pediatrics, University of Washington, Seattle, WA, United States
| | - Diego de Acosta
- National Resource Center for Refugees, Immigrants and Migrants (NRC-RIM), University of Minnesota, Minneapolis, MN, United States
| | - Sabrina Ebengho
- Department of Pediatrics, University of Washington, Seattle, WA, United States
| | - Yesenia Garcia
- Seattle Children’s Research Division, Seattle, WA, United States
| | - Sarah Hoffman
- National Resource Center for Refugees, Immigrants and Migrants (NRC-RIM), University of Minnesota, Minneapolis, MN, United States
- School of Nursing, University of Minnesota, Minneapolis, MN, United States
| | - Megan Keaveney
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Erin Mann
- National Resource Center for Refugees, Immigrants and Migrants (NRC-RIM), University of Minnesota, Minneapolis, MN, United States
| | - Christine Thomas
- National Resource Center for Refugees, Immigrants and Migrants (NRC-RIM), University of Minnesota, Minneapolis, MN, United States
- Department of Medicine, University of Minnesota, Minneapolis, MN, United States
| | - Kimberly Yu
- National Resource Center for Refugees, Immigrants and Migrants (NRC-RIM), University of Minnesota, Minneapolis, MN, United States
| | - Katherine Yun
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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Sarkeala T, Lamminmäki M, Nygård M, Njor SH, Virtanen A, Leivonen A, Hirvonen E, Toikkanen S, Campbell S, Stefansdóttir H, Ursin G, Heinävaara S. Cervical, liver and stomach cancer incidence and mortality in non-Western immigrant women: a retrospective cohort study from four Nordic countries. Acta Oncol 2023; 62:977-987. [PMID: 37594889 DOI: 10.1080/0284186x.2023.2245557] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 07/20/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND Cervical, liver and stomach cancers are the most common infection-associated malignancies and the leading cause of morbidity in non-Western regions. We compared the incidence and mortality of these cancers between non-Western immigrant and non-immigrant Nordic female populations. We also analysed the effect of age at immigration, duration of residence and education on cancer burden. MATERIAL AND METHODS Study population consisted of women residents in Denmark, Finland, Iceland and Norway in 1973-2020. Non-Western women contributed 3.1% of the total 260 million person-years at risk. All women were followed from their 20th birthday, or from the date of immigration if after, until the date of their first primary cancer diagnosis, death, emigration, or the end of the country-specific study period. All data were adjusted for 10-year age groups and calendar periods, and immigrant data was further broken down by region of birth, age at immigration and education level. Country-specific estimates were produced by multivariable Poisson regression and pooled in Finland with a random effects model. RESULTS Altogether, there were 60 982 cases of cervical, liver and stomach cancer in the study population, causing 36 582 deaths. The immigrant women had significantly higher liver (rate ratio [RR] 1.78, 95% confidence interval (CI) 1.03-3.06) and stomach cancer incidence (RR 1.68, CI 1.29-2.18), and stomach cancer mortality (RR 1.49, CI 1.17-1.92) than non-immigrant women. In the immigrant population, high education was related to lower incidence and mortality of studied cancers. The rate ratio of cervical cancer decreased with duration of residence and increased with rising age at immigration. CONCLUSION Due to the increased incidence and mortality of infection-related cancers and changes in cancer patterns by age at immigration and duration of residence, attention should be paid to targeted health care services for immigrants. Special efforts should be given to women who have spent their youth in high-risk areas.
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Affiliation(s)
| | | | - Mari Nygård
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Sisse Helle Njor
- University Research Clinic for Cancer Screening, Randers Regional Hospital, Randers, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Anni Virtanen
- Finnish Cancer Registry, Helsinki, Finland
- Department of Pathology, University of Helsinki, Helsinki, Finland
| | - Aku Leivonen
- Finnish Cancer Registry, Helsinki, Finland
- Data and Analytics Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | | | | | | | - Giske Ursin
- Cancer Registry of Norway, Oslo, Norway
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Sirpa Heinävaara
- Finnish Cancer Registry, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
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84
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Hermes Soares G, Jamieson L, Kumar S, Mejia G. Oral health profile of Australian children from different immigrant backgrounds. Community Dent Health 2023; 40:162-169. [PMID: 37162282 DOI: 10.1922/cdh_00268soares08] [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] [Received: 11/29/2022] [Accepted: 02/26/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVES To profile the oral health of Australian children from different immigrant backgrounds. METHOD Cross-sectional data for Australian children were obtained from the 2012-14 National Child Oral Health Study (NCOHS). Three categories of immigrant status were created based on parents' country of birth and language (non-immigrant, non-visible immigrant, and visible immigrant). Descriptive analyses reported weighted estimates for experience of dental caries, self-rated oral health, and dental services utilisation separately for children aged 5-9 years and 10-14 years. RESULTS The sample comprised 10,610 children aged 5-9 years (3,605 from immigrant backgrounds), and 8,741 children aged 10-14 years (3,074 from immigrant backgrounds). Children from non-visible immigrant backgrounds presented worse dental service utilisation and poorer self-rated oral health than children from non-immigrant and visible immigrant families. Greater inequalities in dental caries experience were observed in the 5-9-year-olds. Untreated caries was substantially higher among visible immigrant children aged 5-9 years (38.8%, 95% CI: 35.5-42.3) than non-immigrant (24.9%, 95% CI: 23.4-26.6) and non-visible immigrant children (21.0%, 95% CI: 17.7-24.7). CONCLUSIONS Australian children from immigrant families constitute a highly heterogeneous group with substantial discrepancies in oral health outcomes.
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Affiliation(s)
- G Hermes Soares
- Australian Research Centre for population Oral Health, the University of Adelaide, Australia
| | - L Jamieson
- Australian Research Centre for population Oral Health, the University of Adelaide, Australia
| | - S Kumar
- Allied Health and Human Performance, University of South Australia, Australia
| | - G Mejia
- Australian Research Centre for population Oral Health, the University of Adelaide, Australia
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Grossi AA, Puoti F, Masiero L, Troni A, Cianchi T, Maggiore U, Cardillo M. Inequities in Organ Donation and Transplantation Among Immigrant Populations in Italy: A Narrative Review of Evidence, Gaps in Research and Potential Areas for Intervention. Transpl Int 2023; 36:11216. [PMID: 37636900 PMCID: PMC10450150 DOI: 10.3389/ti.2023.11216] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 07/19/2023] [Indexed: 08/29/2023]
Abstract
Immigrants from outside Europe have increased over the past two decades, especially in Southern European countries including Italy. This influx coincided with an increased number of immigrants with end-stage organ diseases. In this narrative review, we reviewed evidence of the gaps between native-born and immigrant populations in the Organ Donation and Transplantation (ODT) process in Italy. Consistent with prior studies, despite the availability of a publicly funded health system with universal healthcare coverage, non-European-born individuals living in Italy are less likely to receive living donor kidney transplantation and more likely to have inferior long-term kidney graft function compared with EU-born and Eastern European-born individuals. While these patients are increasingly represented among transplant recipients (especially kidney and liver transplants), refusal rates for organ donation are higher in some ethnic groups compared with native-born and other foreign-born referents, with the potential downstream effects of prolonged waiting times and inferior transplant outcomes. In the process, we identified gaps in relevant research and biases in existing studies. Given the Italian National Transplant Center's (CNT) commitment to fighting inequities in ODT, we illustrated actions taken by CNT to tackle inequities in ODT among immigrant communities in Italy.
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Affiliation(s)
- Alessandra Agnese Grossi
- Center for Clinical Ethics, Department of Biotechnologies and Life Sciences, University of Insubria, Varese, Italy
- Department of Human Sciences, Innovation and Territory, University of Insubria, Como, Italy
| | - Francesca Puoti
- Italian National Transplant Center (CNT), Istituto Superiore di Sanità, Rome, Italy
| | - Lucia Masiero
- Italian National Transplant Center (CNT), Istituto Superiore di Sanità, Rome, Italy
| | - Alessia Troni
- Italian National Transplant Center (CNT), Istituto Superiore di Sanità, Rome, Italy
| | - Tiziana Cianchi
- Italian National Transplant Center (CNT), Istituto Superiore di Sanità, Rome, Italy
| | - Umberto Maggiore
- Nephrology Unit, Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Massimo Cardillo
- Italian National Transplant Center (CNT), Istituto Superiore di Sanità, Rome, Italy
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Mosnier E, Artigas F, Richard E, Hoyer M, Michels D, Vandentorren S, Girard G, Nagot N, Regnault H, Mosnier M, Inegbeze G, Roux P, Spire B, Eldin C. Effectiveness of a Community Empowerment Intervention to Improve Access to Pre-exposure Prophylaxis in Migrant Women Sex Workers: Protocol for a Mixed Methods Implementation Study. JMIR Res Protoc 2023; 12:e42844. [PMID: 37540547 PMCID: PMC10439469 DOI: 10.2196/42844] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 03/24/2023] [Accepted: 04/03/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND The World Health Organization recommends pre-exposure prophylaxis (PrEP) for all populations at substantial risk of HIV infection. However, at-risk women very rarely use PrEP in France-this represents a critical issue among migrant women sex workers (MWSWs). Previous studies on PrEP use among women sex workers or migrants focused on individual or social determinants of motivation. However, operational studies in real-word settings using a holistic population approach to maximize PrEP adherence among MWSWs are lacking. OBJECTIVE FASSETS (ie, "Favoriser l'Accès à la Santé Sexuelle des Travailleuses du Sexe"; English: "facilitate the access to Sexual Health in women sex workers") is a participative, multilevel, mixed methods study aiming to improve global knowledge of and access to sexual health care and PrEP among MWSWs through targeted empowerment strategies. METHODS This study comprises several phases: (1) phase 1: an initial qualitative study combining semistructured interviews, informal interviews, and participative observations will be performed among MWSWs, local community nongovernmental organizations, and institutions providing sexual reproductive health services to identify the determinants of PrEP access among MWSWs and for respondent-driven sampling (RDS); (2) phase 2: the size of the hidden MWSW population is estimated in Marseille through capture-recapture (the RDS survey will serve as "recapture"); (3) phase 3: a longitudinal cohort will be formed through RDS to represent the MWSW population with a goal of 150 inclusions-this cohort will be followed up for 12 months, and sequential questionnaires exploring medical history; knowledge of sexual health, HIV, and sexually transmitted infections; migration route; and current living conditions will be administered at inclusion (month 0) and months 3, 6, and 12 to measure the following interventional phase's outcomes; and (4) phase 4: an interventional study with community empowerment actions about sexual health and PrEP will be conducted with community health workers; standardized questionnaires and semistructured interviews, observations, and focus groups will highlight MWSWs' experiences with empowerment resources, concerns about sexual health, and especially PrEP use or uptake, and we will evaluate whether and how community-adapted empowerment actions conducted by community health workers are effective in increasing access to sexual health, prevention and screening of sexually transmitted infections, and PrEP knowledge and access among MWSWs. RESULTS Recruitment commenced on March 1, 2022. We estimate the follow-up period to end on September 30, 2023. CONCLUSIONS This multiphase study will provide robust evidence about the magnitude of the MWSW population in Marseille (the second largest town in France) and their current conditions of living, access to and knowledge of sexual health, and PrEP access. Using a mixed methods analysis, we will investigate whether individual and collective community health empowerment approaches can facilitate access to PrEP and its initiation, use, and adherence in this vulnerable population. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/42844.
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Affiliation(s)
- Emilie Mosnier
- Aix Marseille University, Inserm, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Institute of Public Health ISSPAM, Marseille, France
- University of Health and Science, ANRS | MIE site, Phnom Penh, Cambodia
| | | | - Elodie Richard
- Université de Bordeaux; Laboratoire Bordeaux Population Health (BPH), Inserm U1219, Bordeaux, France
- Fnasat-GV, Paris, France
| | - Maxime Hoyer
- Aix Marseille University, Inserm, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Institute of Public Health ISSPAM, Marseille, France
| | - David Michels
- Laboratoire de recherche Communautaire, Coalition PLUS, AIDES NGO, Pantin, France
| | - Stephanie Vandentorren
- Université de Bordeaux; Laboratoire Bordeaux Population Health (BPH), Inserm U1219, Bordeaux, France
- Santé publique France, Saint Maurice, France
| | - Gabriel Girard
- Aix Marseille University, Inserm, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Institute of Public Health ISSPAM, Marseille, France
| | - Nicolas Nagot
- Pathogenesis and Control of Chronic & Emerging Infections, University of Montpellier, Inserm, Etablissement Français du Sang, University of Antilles-Guyane, Montpellier, France
| | - Hippolyte Regnault
- Aix Marseille University, Inserm, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Institute of Public Health ISSPAM, Marseille, France
| | | | | | - Perrine Roux
- Aix Marseille University, Inserm, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Institute of Public Health ISSPAM, Marseille, France
| | - Bruno Spire
- Aix Marseille University, Inserm, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM), Aix Marseille Institute of Public Health ISSPAM, Marseille, France
| | - Carole Eldin
- Unité des Virus Émergents (UVE) Aix-Marseille Univ-IRD 190-Inserm 1207-IHU Méditerranée Infection), Marseille, France
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Öcek ZA, Geise M, Volkmann AM, Basili A, Klünder V, Coenen M. Strengthening the social resilience of people living at the intersection of precariousness and migration during pandemics: action recommendations developed in Munich, Germany. Front Public Health 2023; 11:1201215. [PMID: 37601211 PMCID: PMC10433162 DOI: 10.3389/fpubh.2023.1201215] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/19/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction An EU-funded project in five countries examined vulnerability mechanisms during the COVID-19 pandemic. The research team in Germany concentrated on people living at the intersection of migration and precariousness. The study aimed first to provide an understanding of how migrants living in precarious conditions in Munich had been affected by the pandemic, both from their own and from experts' perspectives. The second aim was to develop action recommendations to reduce structural vulnerabilities and increase resilience with a view towards improved pandemic preparedness. Methods The study followed a two-phase process. The first was a qualitative study based on interviews with 25 migrants and 13 experts. In the second, researchers developed action recommendations based on the vulnerability/ resilience factors that had been generated in the first phase. Three consecutive meetings with stakeholders (expert panel, focus group discussion with two migrant organization, meeting with the Munich Migration Council) were then held to further strengthen the draft recommendations. Results Content analysis revealed twelve vulnerability and eight resilience factors in three domains (COVID-19 prevention; human rights, living and housing environment; social support). Migrants had limited access to COVID-19 prevention measures; living conditions made outbreaks inevitable; uncertainty about legal status, employment, and housing, as well as stigma and discrimination, exacerbated their precariousness; social support had decreased; and resilience mechanisms had failed. The initial draft of recommendations contained 24 proposed actions. The meetings added recommendations such as enhancing psychosocial support, preventing ghettoization, improving social housing, preventing the interruption of language education in times of crisis, severe penalties for media stigmatisation and proactive truth-telling. The final list included 30 actions. Conclusion In Munich, the COVID-19 pandemic exacerbated vulnerability mechanisms commonly associated with being a migrant. The recommendations developed here speak to those vulnerabilities but need to be refined further to be more actionable and comprehensive. Nonetheless, the recommendations and the processes that led to them highlight the importance of migrant-inclusive approaches and empowerment in increasing migrants' resilience to future crises.
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Affiliation(s)
- Zeliha Asli Öcek
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Chair for Public Health and Health Services Research, Medical Faculty, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
- Rachel Carson Centre for Environment and Society, LMU Munich, Munich, Germany
| | - Mandy Geise
- Netherlands Institute for Health Services Research, Utrecht, Netherlands
| | | | - Acelya Basili
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Chair for Public Health and Health Services Research, Medical Faculty, LMU Munich, Munich, Germany
| | - Vera Klünder
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Chair for Public Health and Health Services Research, Medical Faculty, LMU Munich, Munich, Germany
| | - Michaela Coenen
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Chair for Public Health and Health Services Research, Medical Faculty, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
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88
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Beltrami M, Grande R, Giacomelli A, Sabaini F, Biondo L, Longo M, Grosso S, Oreni L, Fadelli S, Galimberti L, Ridolfo AL, Antinori S. Chagas disease prevalence among migrants from El Salvador in Milan: a cross- sectional study of an often-overlooked population. Infect Dis (Lond) 2023; 55:559-566. [PMID: 37317783 DOI: 10.1080/23744235.2023.2222817] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/02/2023] [Accepted: 06/03/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Chagas disease (CD) is considered to be highly endemic in El Salvador, where its prevalence is estimated to be 1.3-3.7%. Although more than 40,000 migrants from El Salvador are currently living in Europe (particularly in Spain and Italy), there are few data regarding the prevalence of CD in this population. The aim of this study was to evaluate the prevalence of CD among Salvadorans living in Italy. METHODS A cross-sectional serological survey of CD among Salvadorans living in the metropolitan area of Milan was carried out between October 2017 and December 2019. The participants' blood samples were tested for Trypanosoma cruzi antibodies using two different serological assays. The collected demographic data included their biological sex, province of origin, the type of housing in their country of origin, and family history of CD. RESULTS Of the 384 subjects who voluntarily participated in the study, five (1.3%, most coming from La Paz) were positive to both serological assays and therefore conclusively diagnosed as having CD. Five other subjects had discrepant serological results but were not positive to a third assay. Three of the five subjects with a diagnosis of CD completed medical staging, one of whom had chronic disease (digestive and cardiac involvement). CONCLUSIONS The prevalence of CD among Salvadorans living in Milan is similar to that estimated by the WHO in 2010. Although they are often overlooked in CD surveys, Salvadoran migrants should be included in CD control programs in countries in which the disease is not endemic.
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Affiliation(s)
- Martina Beltrami
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | | | - Andrea Giacomelli
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Federico Sabaini
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Lidia Biondo
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Margherita Longo
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Silvia Grosso
- Clinical Microbiology, Virology and Bioemergency Diagnostics, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Letizia Oreni
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy
| | | | - Laura Galimberti
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Anna Lisa Ridolfo
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
| | - Spinello Antinori
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Italy
- III Division of Infectious Diseases, ASST Fatebenefratelli Sacco, Luigi Sacco Hospital, Milan, Italy
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89
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Svanholm S, Carlerby H, Viitasara E. Politicians' views on societal responsibility and possibility to promote newly arrived migrants' health in Sweden. Health Promot Int 2023; 38:daab199. [PMID: 34897484 PMCID: PMC10439525 DOI: 10.1093/heapro/daab199] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Newly arrived migrants in Sweden risk facing ill health. Politicians at the local and regional levels are involved in many decisions regarding the social determinants of health. The aim of this study was to explore politicians' views on different societal actors' responsibility and possibility to promote newly arrived migrants' health. Data were collected through online questionnaires completed by 667 politicians from municipality and regional councils in northern Sweden. Bivariate analysis was performed using the Wilcoxon signed-rank test. Multivariate analyses were performed using cluster analysis and binary logistic regression analysis. The results show that politicians generally rate societal actors' responsibility and possibility to promote the general population's health higher than newly arrived migrants' health. Moreover, they consider societal actors' responsibility to be greater than their possibility to promote health. Factors significantly contributing to politicians' high ratings of societal responsibility and possibility are attitude (odds ratio [OR] = 2.156, 95% confidence interval [CI]: 1.306-3.558), specific knowledge of newly arrived migrants' health status (OR = 1.528, 95% CI: 1.005-2.323), personal interest in public health (OR = 2.452, 95% CI: 1.460-4.119), being a municipality politician (OR = 1.659, 95% CI: 1.031-2.670) and being female (OR = 1.934, 95% CI: 1.333-2.806). This study shows that politicians generally rate societal responsibility and possibility to promote newly arrived migrants' health rather high. Personal characteristics are important for politicians' high or low ratings of responsibility and possibility, suggesting insufficient structural support for politicians in health promotion.
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Affiliation(s)
- Sara Svanholm
- Department of Health Sciences, Mid Sweden University, Homgatan 10, 851 70 Sweden
| | - Heidi Carlerby
- Department of Health Sciences, Mid Sweden University, Homgatan 10, 851 70 Sweden
| | - Eija Viitasara
- Department of Health Sciences, Mid Sweden University, Homgatan 10, 851 70 Sweden
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90
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Grossi AA, Randhawa G, Jansen NE, Paredes-Zapata D. Taking a "Care Pathway/Whole Systems" Approach to Equality Diversity Inclusion (EDI) in Organ Donation and Transplantation in Relation to the Needs of "Ethnic/Racial/Migrant" Minority Communities: A Statement and a Call for Action. Transpl Int 2023; 36:11310. [PMID: 37600748 PMCID: PMC10437067 DOI: 10.3389/ti.2023.11310] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 07/13/2023] [Indexed: 08/22/2023]
Abstract
International evidence shows variation in organ donation and transplantation (ODT) based upon a range of patient characteristics. What is less well understood is the impact of patient "ethnicity/race/immigration background," as these terms are defined and intended differently across countries. We also know that these characteristics do not operate in isolation but intersect with a range of factors. In this paper, we propose a framework that seeks to clarify the definition of the key terms "ethnicity/race/migrant" and to review how these communities are operationalized across European studies about inequities in ODT. Further, patients and the public wish to see Equality Diversity Inclusion (EDI) approaches in their everyday lives, not just in relation to ODT. We propose a 'care pathway/whole-systems' approach to ODT encompassing culturally competent public health interventions for a) the prevention and management of chronic diseases, b) improvements in public engagement for the promotion of the culture of ODT and enhancements in end-of-life care, through to c) enhanced likelihood of successful transplant among migrant/ethnic minority communities. Our framework recognizes that if we truly wish to take an EDI approach to ODT, we need to adopt a more social, human and holistic approach to examining questions around patient ethnicity.
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Affiliation(s)
- Alessandra Agnese Grossi
- Center for Clinical Ethics, Department of Biotechnologies and Life Sciences, University of Insubria, Varese, Italy
- Department of Human Sciences, Innovation and Territory, University of Insubria, Como, Italy
| | - Gurch Randhawa
- Institute for Health Research, University of Bedfordshire, Luton, United Kingdom
| | | | - David Paredes-Zapata
- Donation and Transplant Coordination Section, Hospital Clínic, Barcelona, Spain
- Surgical Department, University of Barcelona, Barcelona, Spain
- Donation and Transplantation Institute Foundation, Barcelona, Spain
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91
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Xavier SM, Barbosa S, Correia AF, Dindo V, Sequeira M, Maia T, Goes AR. Images that speak: A Portuguese Photovoice study on the psychosocial experience of a migrant population from Cape Verde after a first episode of psychosis. Transcult Psychiatry 2023:13634615231187252. [PMID: 37519012 DOI: 10.1177/13634615231187252] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Several migrant populations have been identified worldwide as high-risk groups for psychosis because of their experience of social adversity. Recent evidence suggests that the local contexts in which these populations live should be addressed in their complexity to take into account individual and larger societal environmental aspects. This study aimed to assess the lived experiences of a group of migrant Cape Verdean patients, who had been recently hospitalized for a first episode of psychosis in a mental health service on the outskirts of Lisbon, Portugal. The study used Photovoice, a qualitative participatory research method in which people's experiences are documented through photography. Six individuals were recruited, and five weekly sessions were conducted to collect data that were analyzed thematically. Emergent themes addressed two main categories of well-being and illness. Participant concepts of well-being were rooted in a definition of freedom encompassing cultural expression, conveyed by familiar environments and supporting communities. Cultural differences may be experienced as important obstacles for well-being and can be associated with feelings of oppression and guilt. Participants' accounts focused on positive aspects of life despite illness and on personal concepts of recovery. The study findings contribute to knowledge of the dynamics of migrants' social experience and underscore the importance of socially and culturally informed mental healthcare institutions.
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Affiliation(s)
| | | | | | - Vera Dindo
- Hospital Professor Doutor Fernando Fonseca
- Sahlgrenska University Hospital
| | - Márcia Sequeira
- Hospital Professor Doutor Fernando Fonseca
- Hunter New England Health District
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Fiore V, Manca V, Colpani A, De Vito A, Maida I, Madeddu G, Babudieri S. Facing HCV as a Major Public Healthcare Threat in Italy: Epidemiology and Micro-Elimination Pathways among Underserved Populations. Healthcare (Basel) 2023; 11:2109. [PMID: 37510549 PMCID: PMC10379370 DOI: 10.3390/healthcare11142109] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/18/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023] Open
Abstract
Underserved populations have a wide heterogeneity on healthcare provision and use. They also represent the key populations according to WHO 2030 goals for HCV micro-elimination. Our review evaluated the available literature on HCV diagnosis, staging, and treatment among underserved populations, such as incarcerated people, patients with psychiatric disorders, and migrants. A narrative review of literature was performed using key electronic databases (Scopus, Pubmed-MEDLINE) and search engines (Google Scholar). Peer-reviewed publications, grey literature on HCV, and recent models proposed for micro-elimination in underserved populations were included. An insight into the COVID-19 pandemic and its influence on HCV micro-elimination pathways will be also provided. Regarding prison settings, a progressive reduction in HCV epidemiology among incarcerated people in the last years was found (one-third of the level it had been before). People suffering from psychiatric disorders have a high anti-HCV prevalence, but there is a lack of data on active infections. A bidirectional relationship between HCV and psychiatric disorders was found. Migrants showed a very inconsistent assessment of HCV. Furthermore, available studies recorded data from populations with high heterogeneity of anti-HCV prevalence, Therefore, the reported results need caution in their evaluation.
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Affiliation(s)
- Vito Fiore
- Unit of Infectious and Tropical Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Valentina Manca
- Unit of Infectious and Tropical Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Agnese Colpani
- Unit of Infectious and Tropical Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Andrea De Vito
- Unit of Infectious and Tropical Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Ivana Maida
- Unit of Infectious and Tropical Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Giordano Madeddu
- Unit of Infectious and Tropical Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Sergio Babudieri
- Unit of Infectious and Tropical Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
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93
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MacKinnon MJ, Picchio CA, Nomah DK, Segura AR, van Selm L, Fernández E, Buti M, Lens S, Forns X, Rodriguez-Tajes S, Pamplona J, Lopez C, Rodriguez-Frías F, Lazarus JV. Chronic conditions and multimorbidity among West African migrants in greater Barcelona, Spain. Front Public Health 2023; 11:1142672. [PMID: 37538267 PMCID: PMC10394694 DOI: 10.3389/fpubh.2023.1142672] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 06/23/2023] [Indexed: 08/05/2023] Open
Abstract
Objectives This study aimed to report the prevalence and identify potential risk factors of chronic conditions among West African migrants living in the greater Barcelona area, Spain, and explore the relationship between years of residence in Spain and chronic disease burden. Methods This cross-sectional study included 436 adult African migrants who participated in a community-based hepatitis B virus (HBV) screening and vaccination program (HBV-COMSAVA) in the greater Barcelona area from 21 November 2020 to 22 January 2022. Data were analyzed using standard descriptive statistics and bivariable and multivariable logistic regression. Results HBV, non-communicable diseases (NCDs) and metabolic risk factors, and multimorbidity prevalence were 9.17, 20.87, and 4.13%, respectively. Being male or having been previously tested for HBV were associated with higher odds of HBV positivity. Associated risk factors for NCDs and metabolic risk factors included living in Spain for >5 years, being female, and being aged ≥50 years. Conclusion The high prevalence of chronic conditions in migrant populations supports a need for early detection strategies and tailored public health interventions that aim to reduce the disease burden imposed on migrants and on health systems in host countries.
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Affiliation(s)
- Marina J. MacKinnon
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Camila A. Picchio
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Daniel K. Nomah
- Department of Health, Center for Epidemiological Studies on Sexually Transmitted Infections and HIV/AIDS in Catalonia (CEEISCAT), Generalitat of Catalonia, Badalona, Spain
| | - Ariadna Rando Segura
- Liver Pathology Unit, Biochemistry and Microbiology Service, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Lena van Selm
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Emma Fernández
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Maria Buti
- CIBER Hepatic and Digestive Diseases (CIBERehd), Instituto Carlos III, Madrid, Spain
- Liver Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Sabela Lens
- CIBER Hepatic and Digestive Diseases (CIBERehd), Instituto Carlos III, Madrid, Spain
- Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Xavier Forns
- CIBER Hepatic and Digestive Diseases (CIBERehd), Instituto Carlos III, Madrid, Spain
- Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Sergio Rodriguez-Tajes
- CIBER Hepatic and Digestive Diseases (CIBERehd), Instituto Carlos III, Madrid, Spain
- Liver Unit, Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Javier Pamplona
- Department of Digestive Diseases, Hospital de Santa Caterina, Girona, Spain
| | - Carmen Lopez
- Department of Digestive Diseases, Hospital Trueta, Girona, Spain
| | - Francisco Rodriguez-Frías
- Liver Pathology Unit, Biochemistry and Microbiology Service, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Jeffrey V. Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
- City University of New York Graduate School of Public Health (CUNY SPH), New York, NY, United States
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Ribas-Pérez D, Sevillano Garcés D, Rodriguez Menacho D, Hernandez-Franch PV, Barbero Navarro I, Castaño Séiquer A. Cross-Sectional Study on Oral Health-Related Quality of Life Using OHIP-14 in Migrants Children in Melilla (Spain). Children (Basel) 2023; 10:1168. [PMID: 37508665 PMCID: PMC10377792 DOI: 10.3390/children10071168] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023]
Abstract
Quality of life is a parameter that not only evaluates clinical parameters, but also refers to the perception of the individual in his or her sociocultural context. It also refers to psychosocial aspects that have a very important impact on people's lives. Oral health-related quality of life (OHRQoL) must also be considered when assessing oral health in any population for which an oral health program is to be developed. On this premise, and taking into account the precarious situation of refugee children housed in the Temporary Center for Migrants (CETI) in Melilla (Spain), a study was conducted to assess the oral health and OHRQoL of the children housed in the aforementioned facility. For this purpose, the 120 children in care at the time of the study underwent a basic epidemiological examination according to the recommendations of the World Health Organization (WHO), and their OHRQoL was assessed using the specific OHIP-14 questionnaire. The results show a state of oral health with a high caries prevalence (95%), high DMFT, and dft indices for the studied population. The oral health-related quality of life perceived by these children shows that pain and psychological discomfort are the areas rated worst by them. Thus, it is concluded that it is important to implement specific oral health programs for this population, based on caries prevention and pain management, which must also take into account the psychological and sociocultural aspects that have accompanied their lives.
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Affiliation(s)
- David Ribas-Pérez
- Department of Stomatology, University of Seville, 41004 Sevilla, Spain
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95
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Chivinski J, Nathan K, Naeem F, Ekmekjian T, Libman MD, Barkati S. Intravenous Liposomal Amphotericin B Efficacy and Safety for Cutaneous and Mucosal Leishmaniasis: A Systematic Review and Meta-analysis. Open Forum Infect Dis 2023; 10:ofad348. [PMID: 37520422 PMCID: PMC10372713 DOI: 10.1093/ofid/ofad348] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/08/2023] [Indexed: 08/01/2023] Open
Abstract
Background Tegumentary leishmaniasis is often subject to limited funding, underpowered studies, and a paucity of high-quality interventional studies. Intravenous liposomal amphotericin B (L-AmB) has been increasingly used to treat cutaneous and mucosal leishmaniasis (CL and ML, respectively) despite the lack of well-conducted interventional studies. We conducted a systematic review to consolidate the descriptive evidence on the efficacy and safety of L-AmB in treating CL and ML. Methods Several online databases and the reference lists of included studies were searched to extract data from 132 studies comprising both case reports and case series. The population, intervention, comparison, outcome, and study design strategy and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used. Results Of 132 studies included, 92 were case reports and 40 were case series. Of the 92 cases, 65 (82.3%) were considered cured after receiving L-AmB as part of their treatment regimen. Twenty-one of the 92 (22.8%) cases reported adverse reactions to L-AmB. A pooled cure rate of 87.0% (95% CI, 79.0%-92.0%) was reported for the 38 case series that reported on treatment efficacy; 40.7% of the cases were associated with an adverse reaction. Conclusions Observational data on cure rates using L-AmB suggest efficacy between 80% and 90%, similar to rates reported for other antileishmanial drugs. The highest efficacy rates were observed when a single cycle of L-AmB was administered to patients with mild-moderate CL and ML. The limitations of this study include the heterogeneity observed among the included studies and the increased likelihood of publication bias associated with the inclusion of case reports and case series. This systematic review further illustrates the need for high-quality comparative trials of intravenous L-AmB for the treatment of tegumentary leishmaniasis.
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Affiliation(s)
| | | | - Faheel Naeem
- J.D. MacLean Centre for Tropical Diseases at McGill University, Montreal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Taline Ekmekjian
- Medical Libraries, McGill University Health Centre, Montreal, Quebec, Canada
| | - Michael D Libman
- Correspondence: Sapha Barkati, MD, MSc, FRCPC, DTM&H, CTropMed, J.D. MacLean Centre for Tropical Diseases at McGill University, 1001 Boulevard Decarie, Montreal, Quebec, Canada, H4A 3J1 (); or Michael Libman, MD, J.D. MacLean Centre for Tropical Diseases at McGill University, 1001 Boulevard Decarie, Montreal, Quebec, Canada, H4A 3J1 ()
| | - Sapha Barkati
- Correspondence: Sapha Barkati, MD, MSc, FRCPC, DTM&H, CTropMed, J.D. MacLean Centre for Tropical Diseases at McGill University, 1001 Boulevard Decarie, Montreal, Quebec, Canada, H4A 3J1 (); or Michael Libman, MD, J.D. MacLean Centre for Tropical Diseases at McGill University, 1001 Boulevard Decarie, Montreal, Quebec, Canada, H4A 3J1 ()
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96
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Blukacz A, Fuentes R, Cabieses B, Obach A, Domic C, Paredes C, Saavedra R, Rojas-Zegers J. Burns: Why give special attention to adolescents in Latin America and the Caribbean from a primary health prevention perspective? Medwave 2023; 23:e2679. [PMID: 37369128 DOI: 10.5867/medwave.2023.05.2679] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023] Open
Abstract
The existing evidence on burns in the underage population has focused mainly on children under ten years, leaving behind the age group defined as "adolescents" by the World Health Organization. However, adolescents present their own characteristics that differentiate them from their younger counterparts. These differences are relevant from a primary prevention perspective, focusing on preventing illness or injury. In this context, this article reflects on why adolescents need special attention in the primary prevention of burns in Latin America and the Caribbean. First, burn scenarios in adolescents are often linked to participation in risky activities due to pressure, social desirability, or low perception of the associated risks. Second, it is essential to emphasize that adolescents may experience social vulnerability, which entails a higher risk of suffering an intentional or unintentional burn. Third, the risk of burns in adolescents may be related to mental health and self-harm scenarios. These aspects need to be investigated through both quantitative and qualitative studies to design and implement primary prevention strategies relevant to this population group in the region.
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Affiliation(s)
- Alice Blukacz
- Centro de Salud Global Intercultural, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Rodrigo Fuentes
- Corporación de Ayuda al Niño Quemado COANIQUEM, Santiago, Chile
| | - Báltica Cabieses
- Centro de Salud Global Intercultural, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Alexandra Obach
- Centro de Salud Global Intercultural, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - Carmina Domic
- Corporación de Ayuda al Niño Quemado COANIQUEM, Santiago, Chile
| | - Carola Paredes
- Corporación de Ayuda al Niño Quemado COANIQUEM, Santiago, Chile
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97
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Kondili LA, Craxì A. Migrants and hepatitis: A tale of two worlds. J Viral Hepat 2023. [PMID: 37340805 DOI: 10.1111/jvh.13866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 06/10/2023] [Indexed: 06/22/2023]
Affiliation(s)
- Loreta A Kondili
- Center for Global Health, Istituto Superiore di Sanità, Rome, Italy
- UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | - Antonio Craxì
- PROMISE, School of Medicine, University of Palermo, Palermo, Italy
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98
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Benoni R, Sartorello A, Moretti F, Marchiori F, Accordini L, Postiglione C, Coffele V, Tardivo S. Disparities in access to COVID-19 vaccine in Verona, Italy: a cohort study using local health immunization data. Front Public Health 2023; 11:1167414. [PMID: 37397767 PMCID: PMC10310303 DOI: 10.3389/fpubh.2023.1167414] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/25/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Migrant populations worldwide were disproportionately impacted by the COVID-19 pandemic. Although substantial resources have been invested in scaling COVID-19 vaccination campaigns, globally vaccine rate and uptake remained low among migrants from across many countries. This study aimed to explore the country of birth as a factor influencing access to the COVID-19 vaccine. Methods This retrospective cohort study included adults vaccinated against SARS-CoV-2 receiving at least one dose in the Verona province between 27 December 2020 and 31 December 2021. Time-to-vaccination was estimated as the difference between the actual date of each person's first dose of COVID-19 vaccination and the date in which the local health authorities opened vaccination reservations for the corresponding age group. The birth country was classified based on both the World Health Organization regions and the World Bank country-level economic classification. Results were reported as the average marginal effect (AME) with corresponding 0.95 confidence intervals (CI). Results During the study period, 7,54,004 first doses were administered and 5,06,734 (F = 2,46,399, 48.6%) were included after applying the exclusion criteria, with a mean age of 51.2 years (SD 19.4). Migrants were 85,989 (17.0%, F = 40,277, 46.8%), with a mean age of 42.4 years (SD 13.3). The mean time-to-vaccination for the whole sample was 46.9 days (SD 45.9), 41.8 days (SD 43.5) in the Italian population, and 71.6 days (SD 49.1) in the migrant one (p < 0.001). The AME of the time-to-vaccination compared to the Italian population was higher by 27.6 [0.95 CI 25.4-29.8], 24.5 [0.95 CI 24.0-24.9], 30.5 [0.95 CI 30.1-31.0] and 7.3 [0.95 CI 6.2-8.3] days for migrants from low-, low-middle-, upper-middle- and high-income countries, respectively. Considering the WHO region, the AME of the time-to-vaccination compared to the Italian group was higher by 31.5 [0.95 CI 30.6-32.5], 31.1 [0.95 CI 30.6-31.5], and 29.2 [0.95 CI 28.5-29.9] days for migrants from African, European, and East-Mediterranean regions, respectively. Overall, time-to-vaccination decreased with increasing age (p < 0.001). Although both migrants and Italians mainly used hub centers (>90%), migrants also used pharmacies and local health units as alternative sites (2.9% and 1.5%, respectively), while Italians (3.3%) and migrants from the European region (4.2%) relied more on family doctors. Conclusion The birth country of migrants influenced access to COVID-19 vaccine both in terms of time-to-vaccination and vaccination points used, especially for the LIC migrant group. Public health authorities should take socio-cultural and economic factors into consideration for tailored communication to people from migrant communities and for planning a mass vaccination campaign.
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Affiliation(s)
- Roberto Benoni
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Anna Sartorello
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Francesca Moretti
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Francesco Marchiori
- Department of Prevention, Unità Locale Socio-Sanitaria (ULSS) 9, Verona, Italy
| | - Luciana Accordini
- Department of Prevention, Unità Locale Socio-Sanitaria (ULSS) 9, Verona, Italy
| | - Chiara Postiglione
- Department of Prevention, Unità Locale Socio-Sanitaria (ULSS) 9, Verona, Italy
| | - Viviana Coffele
- Department of Prevention, Unità Locale Socio-Sanitaria (ULSS) 9, Verona, Italy
| | - Stefano Tardivo
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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99
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Jansen D, Brenner M, Illy K, Dembiński Ł, del Torso S, Grossman Z, Valiulis A, De Guchtenaere A, Mazur A, Da Dalt L, Størdal K, Koletzko B, Hadjipanayis A. Leave no one behind: why WHO's regional office for Europe should prioritise children and adolescents in their program of work. A position statement from the European academy of paediatrics. Front Pediatr 2023; 11:1184870. [PMID: 37388289 PMCID: PMC10301733 DOI: 10.3389/fped.2023.1184870] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/25/2023] [Indexed: 07/01/2023] Open
Abstract
Children and adolescents are no longer a priority in the most recent European Programme of Work (EPW) 2020-2025 of the World Health Organization (WHO) Regional Office for Europe. In this position statement we provide arguments for why we think this population should be explicitly addressed in this important and influential document. We firstly emphasize the persistent health problems and inequalities in access to care for children and adolescents that are challenging to solve, and thus require a continuous focus. Secondly, we urge the WHO to prioritize children and adolescents in their EPW due to the new and emerging health problems related to global issues. Finally, we explain why permanent prioritization of children and adolescents is essential for the future of children and of society.
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Affiliation(s)
- Danielle Jansen
- Department of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Department of Sociology, University of Groningen, Groningen, Netherlands
- Accare, University Centre for Child and Adolescent Psychiatry, Groningen, Netherlands
| | - Maria Brenner
- School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
| | - Károly Illy
- Dutch PaediatricSociety, Utrecht, Netherlands
- Department of Pediatrics, Hospital Rivierenland, Tiel, Netherlands
- European Academy of Paediatrics (EAP), Brussels, Belgium
| | - Łukasz Dembiński
- European Academy of Paediatrics (EAP), Brussels, Belgium
- Department of Pediatric Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Stefano del Torso
- European Academy of Paediatrics (EAP), Brussels, Belgium
- ChidCare WorldWide CCWWItalia OdV, Padova, Italy
| | - Zachi Grossman
- European Academy of Paediatrics (EAP), Brussels, Belgium
- Department of Pediatrics, Maccabi Health Care Services Pediatrics, Tel Aviv, Israel
- Adelson School of Medicine, Ariel University, Ariel, Israel
| | - Arunas Valiulis
- European Academy of Paediatrics (EAP), Brussels, Belgium
- Clinic of Children’s Diseases, Institute of Clinical Medicine, Vilnius University Medical Faculty, Vilnius, Lithuania
| | - Ann De Guchtenaere
- European Academy of Paediatrics (EAP), Brussels, Belgium
- Department of Paediatrics, Ghent University, Ghent, Belgium
| | - Artur Mazur
- European Academy of Paediatrics (EAP), Brussels, Belgium
- Department Pediatrics, Pediatric Endocrinology and Diabetes, Medical College, University of Rzeszow, Rzeszow, Poland
| | - Liviana Da Dalt
- European Academy of Paediatrics (EAP), Brussels, Belgium
- Department of Women’s and Children’s Health, University Hospital of Padova, Padova, Italy
| | - Ketil Størdal
- European Academy of Paediatrics (EAP), Brussels, Belgium
- Department of Pediatric Research, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Berthold Koletzko
- European Academy of Paediatrics (EAP), Brussels, Belgium
- Department of Paediatrics, LMU—Ludwig-Maximilians-Universität Munich, Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children’s Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Adamos Hadjipanayis
- European Academy of Paediatrics (EAP), Brussels, Belgium
- Medical School, European University Cyprus, Nicosia, Cyprus
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100
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Collatuzzo G, Ferrante M, Ippolito A, Di Prima A, Colarossi C, Scarpulla S, Boffetta P, Sciacca S. Cancer in Migrants: A Population-Based Study in Italy. Cancers (Basel) 2023; 15:3103. [PMID: 37370713 DOI: 10.3390/cancers15123103] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/02/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Migrants are a vulnerable and neglected population. We aimed at investigating cancer proportionate rates in migrants in Sicily, Southern Italy. METHODS We extracted data on new cancer cases diagnosed between 2004 and 2019 from the Eastern Sicily cancer registry. We compared the adjusted proportionate morbidity ratio (PMR) for the most common cancer types among migrants and non-migrants. We fitted multivariate logistic regression models comparing one cancer to all other cancers to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for migration status. The analysis was stratified by region of origin. RESULTS Overall, 4726 new cancer cases occurred in migrants between 2004 and 2019, 63.5% of those among women and 224,211 in non-migrants, including 54.5% among men, with odds for migrants/non-migrants of 2.1%. Migrants had an increased proportion of cervical (PMR = 2.68, 95% CI = 2.29-3.10) and lung cancer (PMR = 1.20, 95% CI = 1.07-1.33). The highest OR in migrants was observed for cervical cancer (OR = 3.54, 95% CI = 2.99-4.20). Colorectal cancer was decreased among migrants (OR = 0.86, 95% CI = 0.77-0.96). CONCLUSIONS Migrants to Sicily have higher odds of cervical cancer and a decreased risk of colorectal cancer compared to non-migrants. Increased odds were also detected for lung cancer, in particular in women. Different cancer patterns could be observed based on the region of origin. HPV-related cancers need targeted attention in migrants living in Sicily.
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Affiliation(s)
- Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Margherita Ferrante
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, 95123 Catania, Italy
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, University of Catania, 95123 Catania, Italy
| | - Antonella Ippolito
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, University of Catania, 95123 Catania, Italy
| | - Alessia Di Prima
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, University of Catania, 95123 Catania, Italy
| | | | | | - Paolo Boffetta
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, University of Catania, 95123 Catania, Italy
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY 11794, USA
- Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA
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