Socioeconomic determinants of growth in a longitudinal study in Nepal.

Socioeconomic status (SES) is associated with childhood anthropometry, but little is known about how it is associated with tissue growth and body composition. To investigate this, we looked at components of SES at birth with growth in early and mid-childhood, and body composition in a longitudinal study in Nepal. The exposure variables (material assets, land ownership, and maternal education) were quantified from questionnaire data before birth. Anthropometry data at birth, 2.5 and 8.5 years, were normalized using WHO reference ranges and conditional growth calculated. Associations with child growth and body composition were explored using multiple regression analysis. Complete anthropometry data were available for 793 children. There was a positive association between SES and height-for-age and weight-for-age, and a reduction in odds of stunting and underweight for each increase in rank of SES variable. Associations tended to be significant when moving from the lower to the upper asset score, from none to secondary education, and no land to >30 dhur (~500 m2 ). The strongest associations were for maternal secondary education, showing an increase of 0.6-0.7 z scores in height-for-age and weight-for-age at 2.5 and 8.5 years and 0.3 kg/m2 in fat and lean mass compared to no education. There was a positive association with conditional growth in the highest asset score group and secondary maternal education, and generally no association with land ownership. Our results show that SES at birth is important for the growth of children, with a greater association with fat mass. The greatest influence was maternal secondary education

Growing up in transit. Personal development and resistance of migrant adolescents travelling through Mexico unaccompanied

Mexico is a major global migration corridor. The last decade has seen an increase in adolescents travelling unaccompanied from Guatemala, Honduras and El Salvador, mainly due to violence and natural disasters. This group of migrants is exposed to migration risks such as trafficking and exploitation, as well as multiple deportations and long waiting times without appropriate access to health and education services. These conditions have significant documented adverse impacts on health and mental health, but the impact on personal development has been less explored. Thus, this article aims to explore the impact of migration transit on identity and resilience of unaccompanied migrant youth, psychosocial mental health constructs that are important for wellbeing and personal development. Through 47 semi-structured interviews conducted with migrant youth and different migration workers in summer 2021 in two migrant shelters in Mexico City and Guadalajara, we found that possibilities for identity building for migrant youth were restricted in a context of curbed freedom. Violence and poverty led to loss of crucial formative years, pushing many to aspire only to work – regardless of the type of work. Resilience overlapped with resistance but was generally maintained with cultural narratives of goal achievement, faith and hope. Strong responsibility towards sending remittances to family made family one of the main goals of the migration journey. Workers highlighted how regional migration management, underlined by discriminatory policies which place profit and national security ideology before a recognition of common humanity, is a considerable barrier to funding services and advancing access to rights for youth. However, youth showed recognition of their own agency and humanity, which represents an important basis on which to build a counter-discriminatory vision and management of this migration. Results are reported according to COREQ guidelines

Impact of infectious disease epidemics on xenophobia: A systematic review

Background Globally, xenophobia towards out-groups is frequently increased in times of economic and political instability, such as in infectious disease outbreaks. This systematic review aims to: (1) assess the xenophobic attitudes and behaviors towards migrants during disease outbreaks; and (2) identify adverse health outcomes linked to xenophobia. Methods We searched nine scientific databases to identify studies measuring xenophobic tendencies towards international migrants during disease outbreaks and evaluated the resulting adverse health effects. Results Eighteen articles were included in the review. The findings were grouped into: (1) xenophobia-related outcomes, including social exclusion, out-group avoidance, support for exclusionary health policies, othering, and germ aversion; and (2) mental health problems, such as anxiety and fear. Depending on the disease outbreak, different migrant populations were negatively affected, particularly Asians, Africans, and Latino people. Factors such as perceived vulnerability to disease, disgust sensitivity, medical mistrust individualism, collectivism, disease salience, social representation of disease and beliefs in different origins of disease were associated with xenophobia. Conclusions Overall, migrants can be a vulnerable population frequently blamed for spreading disease, promoting irrational fear, worry and stigma in various forms, thus leading to health inequities worldwide. It is urgent that societies adopt effective support strategies to combat xenophobia and structural forms of discrimination against migrants

O STAJALIŠTIMA PREMA JEZIČNOJ DISKRIMINACIJI NA OSNOVI SPOLA: PODRUČJE RADA I ZAPOŠLJAVANJA

U članku se interpretiraju rezultati ankete provedene kako bi se provjerila stajališta o jeziku oglasa za zapošljavanje u hrvatskim javnim glasilima. Suprotno odredbama Zakona o ravnopravnosti spolova u oglasima za radna mjesta u načelu se rabi muški rod. Anketa pokazuje da se ova vrsta diskriminacije općenito doživljava tek kao jedan od oblika ženske diskriminacije, ali upućuje i na neke neočekivane zaključke

What are the experiences and psychosocial needs of female survivors of domestic violence in Afghanistan? A qualitative interview study in three Afghan provinces

Objectives This study aimed to qualitatively explore (1) the experiences of female survivors of domestic abuse and mental health problems in Afghanistan; (2) how female survivors of violence and abuse, male members of the community and service providers perceive and respond to mental health and domestic violence in Afghanistan and (3) the provision of mental health services for female survivors of violence and abuse in Afghanistan, including the barriers and challenges faced around accessing mental health services.Design Qualitative interviews and framework thematic analysis.Setting Kabul, Bamyan and Nangarhar in Afghanistan.Participants 60 female survivors of domestic abuse, 60 male community members and 30 service providers who work with female survivors of domestic abuse.Results Experiences of multiple and compounding traumatic experiences of violence, armed conflict, and complex and competing psychosocial concerns were common among the female survivor participants. All female survivor participants reported experiencing negative mental health outcomes in relation to their experiences of violence and abuse, which were further precipitated by widespread social stigma and gender norms. Support and service provision for female survivors was deemed by participants to be insufficient in comparison to the amount of people who need to access them.Conclusions There are many risks and barriers women face to disclosing their experiences of violence and mental health problems which restrict women’s access to psychological support. Culturally relevant services and trauma-informed interventions are necessary to respond to these issues. Service providers should be trained to effectively recognise and respond to survivors’ mental health needs.Data sharing not applicable as no datasets generated and/or analysed for this study

Mental health prevalence, healthcare use and access between 2018 and 2022 in Sri Lanka: an analysis of survey data

Background Sri Lanka has suffered four decades of violent conflict, a tsunami, terrorist attacks and an economic crisis, with unknown mental health consequences. People living with mental health difficulties may experience individual, interpersonal, social or structural barriers to help-seeking. These may include stigma, lack of knowledge, denial, fear of societal repercussions, language, acceptability/appropriateness of care, lack of family support, availability of medication, lack of transport and financial barriers. It is possible that several of these factors may have manifested during the challenging time period for Sri Lankans at which this study took place. Methods Using a sample of 4030 respondents from two waves of a nationally representative survey, this study assessed the changes in the prevalence of mental health conditions, and subsequent changes in rates of healthcare usage and access, among adults in Sri Lanka between 2018 and 2022. This spanned a period of crisis and unrest, inclusive of the Easter Sunday attacks in 2019, anti-Muslim riots, the coronavirus disease 2019 pandemic and lockdown measures, as well as the current economic crisis that started in late 2021. Descriptive analyses were conducted to assess the demographic and socioeconomic characteristics of the cohort, and to quantify the prevalence of mental health difficulties within the cohort at each wave. Regression analyses examined the changes in prevalence of mental health difficulties over time. Cross-sectional descriptive analyses examined rates of healthcare use and access among those experiencing mental health difficulties, and regression analyses compared use and access for those experiencing different levels of mental health difficulties, adjusting for age, sex, education, socioeconomic status, ethnicity, religion, region and language. Results We found that 2.9% of Sri Lankans experienced high mental health difficulties during 2018–9 and 6.1% in 2021–2. There was a statistically significant increase in prevalence between 2018–9 and 2021–2 (β = 0.23, 95% confidence interval 0.20 to 0.26; p < 0.05). This rise was disproportionately higher amongst older adults, those in the lowest socioeconomic classes, and those not from a minority ethnic group. The gap between inpatient use for those living with the highest and lowest levels of mental health difficulties widened across the study period, though the outpatient use gap remained stable. Finally, while those with high mental health difficulties reported high levels of unmet need for health care, when compared to those with the lowest levels of mental health difficulty, the difference was not found to be significant, likely due to a restricted sample size. Future work and limitations It would be beneficial for future studies to investigate issues with measuring mental health, applicability and the cultural safety of mental health measures. Conclusions We explored mental health in Sri Lankans during critical time periods when the country experienced various traumatic events. The lessons learnt from how mental health and healthcare access and use were measured in this study allows us to strengthen methods for future studies, allowing for robust longitudinal analyses of healthcare use and access for those experiencing common mental health difficulties. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Global Health Research programme as award number 17/63/47. A plain language summary of this article is available on the NIHR Journals Library website https://doi.org/10.3310/HJWA5078