Resilience and well-being among children of migrant parents in South-East Asia

There has been little systematic empirical research on the well-being of children in transnational households in South-East Asia—a major sending region for contract migrants. This study uses survey data collected in 2008 from children aged 9, 10 and 11 and their caregivers in Indonesia, the Philippines, and Vietnam (N=1,498). Results indicate that while children of migrant parents, especially migrant mothers, are less likely to be happy compared to children in non-migrant households, greater resilience in child well-being is associated with longer durations of maternal absence. There is no evidence for a direct parental migration effect on school enjoyment and performance. The analyses highlight the sensitivity of results to the dimension of child well-being measured and who makes the assessment.Publisher PDFPeer reviewe

Locating the place and meaning of physical activity in the lives of young people from low-income, lone-parent families

Background: In the United Kingdom (UK), it is predicted that economic cuts and a subsequent increase in child poverty will affect those already on the lowest incomes and, in particular, those living in lone-parent families. As a result, the informal pedagogic encounters within the family that contribute to the development of physical activity-related values, beliefs and dispositions from a very early age will be affected. Therefore, it is vital that we gain an understanding of the place and meaning of physical activity in the lives of young people, as well as the informal pedagogic practices and the socio-cultural forces that influence individual agency. Purpose: Based on Bourdieu's key concepts, this paper explores the interplay of structural conditions and personal agency with regard to physical activity in the lives of young people from low-income, lone-parent families. Methods: This study reports on the voices of 24 participants (aged 11–14) from low-income, lone-parent families in the West Midlands, UK. These participants were engaged in paired, semi-structured interviews to explore issues of personal agency by listening to how they reported on their present lives, past experiences and future possibilities with regard to physical activity. All corresponding interview data were analysed using analytical induction. Findings: This paper suggests that young people exhibited diminished desires to engage in activity due to structural constraints of time, parents' work commitments and a lack of transport that resulted in engagement in sedentary alternatives. Informal pedagogic practices within these families were restricted due to the associated structural conditions of living in a lone-parent family. As such, young people's choice to not seek out physical activities when at home reflected a ‘taste for necessity’ resulting from a lack of cultural and economic capital, placing restrictions on physical activity opportunities that stemmed from their family doxa. Conclusions: To succeed in fostering dispositions and opportunities to participate in physical activity, we must engage with young people from low-income, lone-parent families from an early age. Certainly though, further consideration of the informal pedagogic practices within, and the demands on, lone-parent families is required when designing any intervention or policy that seeks to enhance their current circumstances and provide opportunities for engagement in a variety of contexts

Utilisation of sexual health services by female sex workers in Nepal

Background The Nepal Demographic Health Survey (NDHS) in 2006 showed that more than half (56%) of the women with sexually transmitted infections (STIs), including HIV, in Nepal sought sexual health services. There is no such data for female sex workers (FSWs) and the limited studies on this group suggest they do not even use routine health services. This study explores FSWs use of sexual health services and the factors associated with their use and non-use of services. Methods This study aimed to explore the factors associated with utilisation of sexual health services by FSWs in the Kathmandu Valley of Nepal, and it used a mixed-method approach consisting of an interviewer administered questionnaire-based survey and in-depth interviews. Results The questionnaire survey, completed with 425 FSWs, showed that 90% FSWs self-reported sickness, and (30.8%) reported symptoms of STIs. A quarter (25%) of those reporting STIs had never visited any health facilities especially for sexual health services preferring to use non-governmental clinics (72%), private clinics (50%), hospital (27%) and health centres (13%). Multiple regression analysis showed that separated, married and street- based FSWs were more likely to seek health services from the clinics or hospitals. In- depth interviews with 15 FSWs revealed that FSWs perceived that personal, structural and socio-cultural barriers, such as inappropriate clinic opening hours, discrimination, the judgemental attitude of the service providers, lack of confidentiality, fear of public exposure, and higher fees for the services as barriers to their access and utilisation of sexual health services. Conclusion FSWs have limited access to information and to health services, and operate under personal, structural and socio-cultural constraints. The ‘education’ to change individual behaviour, health worker and community perceptions, as well as the training of the health workers, is necessary

Urinary ATP as an indicator of infection and inflammation of the urinary tract in patients with lower urinary tract symptoms

BACKGROUND: Adenosine-5'-triphosphate (ATP) is a neurotransmitter and inflammatory cytokine implicated in the pathophysiology of lower urinary tract disease. ATP additionally reflects microbial biomass thus has potential as a surrogate marker of urinary tract infection (UTI). The optimum clinical sampling method for ATP urinalysis has not been established. We tested the potential of urinary ATP in the assessment of lower urinary tract symptoms, infection and inflammation, and validated sampling methods for clinical practice. METHODS: A prospective, blinded, cross-sectional observational study of adult patients presenting with lower urinary tract symptoms (LUTS) and asymptomatic controls, was conducted between October 2009 and October 2012. Urinary ATP was assayed by a luciferin-luciferase method, pyuria counted by microscopy of fresh unspun urine and symptoms assessed using validated questionnaires. The sample collection, storage and processing methods were also validated. RESULTS: 75 controls and 340 patients with LUTS were grouped as without pyuria (n = 100), pyuria 1-9 wbc ?l(-1) (n = 120) and pyuria ?10 wbc ?l(-1) (n = 120). Urinary ATP was higher in association with female gender, voiding symptoms, pyuria greater than 10 wbc ?l(-1) and negative MSU culture. ROC curve analysis showed no evidence of diagnostic test potential. The urinary ATP signal decayed with storage at 23°C but was prevented by immediate freezing at ??-20°C, without boric acid preservative and without the need to centrifuge urine prior to freezing. CONCLUSIONS: Urinary ATP may have a role as a research tool but is unconvincing as a surrogate, clinical diagnostic marker

Pursuing concordance: moving away from paternalism

In the second of two articles exploring the value and application of concordance across nursing practice the discussion is aimed at clinical settings and patient groups where concordance may have been viewed as impractical. The author harnesses Cribb and Entwhistle's broader conception of shared decision making and the notion of decision-making capacity as a continuum to argue that concordance can be pursued effectively in challenging settings such as childcare practice, mental health and the care of older people. As in the first paper (McKinnon, 2013) the discussion is not limited to medicines management but remains engaged with all aspects of nursing practice. Legal and ethical frameworks, social participation theory and research across healthcare practice are sourced to argue for concordant approaches in the care of patients who may at times have compromised decision-making capacity. Ideas of direct and indirect concordance are explored. © 2014 MA Healthcare Ltd

Rapid emergence of multidrug resistant, H58-lineage Salmonella typhi in Blantyre, Malawi.

INTRODUCTION: Between 1998 and 2010, S. Typhi was an uncommon cause of bloodstream infection (BSI) in Blantyre, Malawi and it was usually susceptible to first-line antimicrobial therapy. In 2011 an increase in a multidrug resistant (MDR) strain was detected through routine bacteriological surveillance conducted at Queen Elizabeth Central Hospital (QECH). METHODS: Longitudinal trends in culture-confirmed Typhoid admissions at QECH were described between 1998-2014. A retrospective review of patient cases notes was conducted, focusing on clinical presentation, prevalence of HIV and case-fatality. Isolates of S. Typhi were sequenced and the phylogeny of Typhoid in Blantyre was reconstructed and placed in a global context. RESULTS: Between 1998-2010, there were a mean of 14 microbiological diagnoses of Typhoid/year at QECH, of which 6.8% were MDR. This increased to 67 in 2011 and 782 in 2014 at which time 97% were MDR. The disease predominantly affected children and young adults (median age 11 [IQR 6-21] in 2014). The prevalence of HIV in adult patients was 16.7% [8/48], similar to that of the general population (17.8%). Overall, the case fatality rate was 2.5% (3/94). Complications included anaemia, myocarditis, pneumonia and intestinal perforation. 112 isolates were sequenced and the phylogeny demonstrated the introduction and clonal expansion of the H58 lineage of S. Typhi. CONCLUSIONS: Since 2011, there has been a rapid increase in the incidence of multidrug resistant, H58-lineage Typhoid in Blantyre. This is one of a number of reports of the re-emergence of Typhoid in Southern and Eastern Africa. There is an urgent need to understand the reservoirs and transmission of disease and how to arrest this regional increase

Learning to live together: a challenge for schools located in contexts of social vulnerability

Currently, there are many educational centres that demonstrate the need to promote initiatives to improve coexistence at school at the international level, especially in those located in contexts of social vulnerability. A socio-educational programme has been developed, applied and evaluated at a Singular Education Action Centre (Centro de Acción Educativa Singular - C.A.E.S) in the city of Valencia (Spain). To ascertain the programme's impact and possible generalization to other contexts, a quasi-experimental pretest-posttest design with a control group was used. Information was collected from 297 students and 54 teachers based on questionnaires assessing coexistence at school. The results obtained demonstrate the satisfactory functioning of the programme. The faculty and students from the experimental group affirm the importance of continuing to work in this direction to invest in creating a democratic school that firmly believes in coexistence and participation. Areas for improvement include the need to incorporate actions to increase family participation and develop strategies to facilitate the implementation of a more comprehensive programme

Ambient Air Quality of Nashik City 2017 (Maharashtra, India)

Ambient air quality of Nasik city was monitored during the year 2017. Criteria pollutants selected for the monitoring was, sulphur dioxide (SO2) & nitrogen dioxide (NO2) and PM10 (Particulate Matter having aerodynamic diameter less than or equal to 10 µm) for the period of January 2017 to December 2017. Sampling was done for successive periods of about 4 hours for sulphur dioxides (SO2), nitrogen dioxide (NO2) and 8 hours for Respirable suspended particulate matter (PM10) for 24 hours. For Air Quality Monitoring, four representative sites were selected i.e. Industrial-S1-I-VIP, Commercial- S2-R-RTO and Residential-S3-C-NMC and Industrial-S4-I-UB. High volume air sampler were used to measure the concentration of nitrogen dioxide (NO2), sulphur dioxides (SO2) and Respirable suspended particulate matter (PM10). The results reported pertain to an eight hour successive continuous air sampling exercise carried out at each of the four selected locations in Nasik city. The value of PM10 (Particles ≥ 10µ, PM 10µg/m3)  was  noted  to  be  crossing  the  permissible   limit   and  exceeded  the  National Ambient Air Quality Standard (NAAQS) at all locations. The concentration of SO2 and NO2 was within the National Ambient Air Quality Standard (NAAQS, National Ambient Air Quality Standers, November 18, 2009) at all the locations. Keywords: PM10, Ambient Air Quality (AQI), National Ambient Air Quality Standard (NAAQS), Pollutant, Urban air sampling, Transport emissions