Are migrants during the periconception period less likely to be supplementing with folic acid: An Australian cohort study.

BACKGROUND: Folic acid (FA) supplementation before and in early pregnancy is known to improve outcomes such as reducing neural tube defects; however, little is known about groups in Australia at risk of low FA use. AIM: To determine whether differences exist in FA supplementation rates between Australian-born women and migrant women, with a secondary aim of examining the sociodemographic characteristics of women who are not supplementing with FA in early pregnancy. METHODS: A retrospective cohort study from January 2018-July 2022 in a high-migrant population in Western Sydney, Australia. Multivariate logistic regression analysis was conducted adjusting for confounders including place of birth, age, ethnicity, parity, history of diabetes, and type of conception. FINDINGS: There were 48,045 women who met inclusion criteria; 65% of whom were migrants. We identified that 39.4% of the study population did not report FA supplementation by early pregnancy. Women who were migrants were more likely to report FA usage than those born in Australia (aOR 1.24; 95%CI 1.17-1.31). Women least likely to report use of FA were women < 20 years of age (aOR 0.54; 95%CI 0.44-0.67) and multiparous women (aOR 0.84; 95%CI 0.82-0.86). Women with type 1 or type 2 diabetes were more likely to report FA use (aOR 1.66; 95%CI 1.11-2.48, aOR 1.30; 95%CI 1.05-1.61). CONCLUSION: A significant proportion of the population did not report FA supplementation before or during early pregnancy. To increase uptake of FA supplementation, clinicians and public health messaging should target at-risk groups.

The MEDITAGING study: protocol of a two-armed randomized controlled study to compare the effects of the mindfulness-based stress reduction program against a health promotion program in older migrants in Luxembourg.

BACKGROUND: Migration is a phenomenon worldwide, with older migrants, particularly those with fewer socioeconomic resources, having an increased risk of developing adverse cognitive and health outcomes and social isolation. Therefore, it is of utmost importance to validate interventions that promote healthy aging in this population. Previous studies have shown a positive impact of mindfulness based-stress reduction (MBSR) on outcomes such as cognition and sleep. However, only a few studies verified its potential in older adults, especially with vulnerable populations such as migrants. This article presents the protocol of the MEDITAGING study, which is the first to investigate the MBSR effects in migrants aged ≥55 in comparison to a health promotion program. METHODS: MEDITAGING is a two-arm randomized, double-blinded, controlled study, which will include older Portuguese-speaking migrants (n = 90). Participants are randomized to the MBSR or a health promotion program. Both interventions are conducted in groups over a total of 8 weeks, incorporating weekly meetings, an additional 4-hour class, and extra at-home tasks. The health promotion program has the same structure as the MBSR but comprises different activities related to dementia prevention, healthy habits, cognitive stimulation, sleeping, nutrition, watercolor painting, and physical activity. The assessment of executive functioning, physiological stress measures, self-reported questionnaires, and qualitative interviews are conducted at baseline, after 8 weeks (post-intervention), and at a follow-up session (from one to 3 months thereafter). Analyzes will be conducted using a modified intention-to-treat approach (all participants with at least 3 days of participation in the group-sessions and one post-intervention observation). DISCUSSION: This study will test effects of a mindfulness-based intervention against an active control condition in older adult migrants, which few studies have addressed. TRIAL REGISTRATION: ClinicalTrials.gov NCT05615337 (date of registration: 27 September 2022; date of record verification: 14 November 2022).

Paradoxes in the cultural doula concept for migrant women: Implications for gender-inclusive care versus migrant-friendly maternity care.

OBJECTIVE: Swedish healthcare policies promote gender equality, shared parenting and cultural diversity. In response to the risk of adverse outcomes for migrant women, cultural doulas were introduced as support for migrant women during pregnancy and/or labour. The aim is to investigate potential tensions in the cultural doula concept in relation to policies of gender equality and diversity. DESIGN: An interview study was designed to analyse perceptions of the cultural doula concept among healthcare providers in Swedish sexual and reproductive healthcare. Through the framework of Bacchi's approach 'What Is the Problem Represented to Be?' and Hochschild's concept of 'global care chains', we analyzed whether the introduction of the cultural doula concept is in line with the policies of gender equality and culturally sensitive care by exploring paradoxes, unintended consequences and what was not reflected upon. SETTING AND PARTICIPANTS: Semi-structured interviews (n = 18) with midwives and obstetricians at hospitals in two Swedish counties during 2022. MEASUREMENTS AND FINDINGS: The interviews were analyzed through thematic analysis. Cultural doulas were perceived as multi-tasking resources for facilitating integration and providing healthcare information and psychosocial support. Respondents did not identify doula support as a cultural practice in migrants' origin countries. Despite awareness of cultural differences in gender norms, many respondents stated that doula support included male partners. KEY CONCLUSIONS: The cultural doula concept includes paradoxes in relation to gender equality and diversity. Rather than empowering migrant women, the cultural doula concept is related to gendered patterns of low-educated, underpaid care work. Labour support interventions including migrant women's social network and intensified partner involvement would be more in line with Swedish policies of gender equality, shared parenting and cultural sensitivity when needed. However, doulas may be an imperfect solution for women lacking partners or social networks, for example, newly arrived migrant women, if no support is to be found within the perinatal care system. IMPLICATIONS FOR PRACTICE: Midwives and obstetricians need reflexivity about what the problem is represented to be when it comes to gender equality and cultural sensitivity in their collaboration with cultural doulas, boundaries between roles, how they handle confidentiality, and why cultural doulas are needed in relation to migrant women's integration.

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.

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.

Spiritual practices predict migration behavior.

Each year, several thousand migrants from sub-Saharan Africa lose their lives attempting to reach Europe's southern shores. Social scientists and policymakers have puzzled over the question of why so many people are willing to take this extremely high risk of dying. Drawing on panel data from over 10,000 individuals collected over the course of 1 year in The Gambia-a country with one of the highest emigration rates in the world-we show that consulting a local healer for spiritual protection predicts migration outcomes. Furthermore, we find that spiritual practices are strongly associated with a decreased perception of one's own risk of dying on the migration journey. Our findings demonstrate the relevance of ideational factors in explaining risky migration choices, and point to spiritual leaders as important interlocutors for migration policy makers.

Characterization of Latin American migrants at risk for Trypanosoma cruzi infection in a non-endemic setting. Insights into initial evaluation of cardiac and digestive involvement.

BACKGROUND: Trypanosoma cruzi causes Chagas disease (CD), a potentially fatal disease characterized by cardiac disorders and digestive, neurological or mixed alterations. T. cruzi is transmitted to humans by the bite of triatomine vectors; both the parasite and disease are endemic in Latin America and the United States. In the last decades, population migration has changed the classic epidemiology of T. cruzi, contributing to its global spread to traditionally non-endemic countries. Screening is recommended for Latin American populations residing in non-endemic countries. METHODS: The present study analyzes the epidemiological characteristics of 2,820 Latin American individuals who attended the International Health Service (IHS) of the Hospital Clinic de Barcelona between 2002 and 2019. The initial assessment of organ damage among positive cases of T. cruzi infection was analyzed, including the results of electrocardiogram (ECG), echocardiogram, barium enema and esophagogram. RESULTS: Among all the screened individuals attending the clinic, 2,441 (86.6%) were born in Bolivia and 1,993 (70.7%) were female. Of individuals, 1,517 (81.5%) reported previous exposure to the vector, which is a strong risk factor associated with T. cruzi infection; 1,382 individuals were positive for T. cruzi infection. The first evaluation of individuals with confirmed T. cruzi infection, showed 148 (17.1%) individuals with Chagasic cardiomyopathy, the main diagnostic method being an ECG and the right bundle branch block (RBBB) for the most frequent disorder; 16 (10.8%) individuals had a normal ECG and were diagnosed of Chagasic cardiomyopathy by echocardiogram. CONCLUSIONS: We still observe many Latin American individuals who were at risk of T. cruzi infection in highly endemic areas in their countries of origin, and who have not been previously tested for T. cruzi infection. In fact, even in Spain, a country with one of the highest proportion of diagnosis of Latin American populations, T. cruzi infection remains underdiagnosed. The screening of Latin American populations presenting with a similar profile as reported here should be promoted. ECG is considered necessary to assess Chagasic cardiomyopathy in positive individuals, but echocardiograms should also be considered as a diagnostic approach given that it can detect cardiac abnormalities when the ECG is normal.

Travel-Related Diagnoses Among U.S. Nonmigrant Travelers or Migrants Presenting to U.S. GeoSentinel Sites - GeoSentinel Network, 2012-2021.

Problem/Condition: During 2012-2021, the volume of international travel reached record highs and lows. This period also was marked by the emergence or large outbreaks of multiple infectious diseases (e.g., Zika virus, yellow fever, and COVID-19). Over time, the growing ease and increased frequency of travel has resulted in the unprecedented global spread of infectious diseases. Detecting infectious diseases and other diagnoses among travelers can serve as sentinel surveillance for new or emerging pathogens and provide information to improve case identification, clinical management, and public health prevention and response. Reporting Period: 2012-2021. Description of System: Established in 1995, the GeoSentinel Network (GeoSentinel), a collaboration between CDC and the International Society of Travel Medicine, is a global, clinical-care-based surveillance and research network of travel and tropical medicine sites that monitors infectious diseases and other adverse health events that affect international travelers. GeoSentinel comprises 71 sites in 29 countries where clinicians diagnose illnesses and collect demographic, clinical, and travel-related information about diseases and illnesses acquired during travel using a standardized report form. Data are collected electronically via a secure CDC database, and daily reports are generated for assistance in detecting sentinel events (i.e., unusual patterns or clusters of disease). GeoSentinel sites collaborate to report disease or population-specific findings through retrospective database analyses and the collection of supplemental data to fill specific knowledge gaps. GeoSentinel also serves as a communications network by using internal notifications, ProMed alerts, and peer-reviewed publications to alert clinicians and public health professionals about global outbreaks and events that might affect travelers. This report summarizes data from 20 U.S. GeoSentinel sites and reports on the detection of three worldwide events that demonstrate GeoSentinel's notification capability. Results: During 2012-2021, data were collected by all GeoSentinel sites on approximately 200,000 patients who had approximately 244,000 confirmed or probable travel-related diagnoses. Twenty GeoSentinel sites from the United States contributed records during the 10-year surveillance period, submitting data on 18,336 patients, of which 17,389 lived in the United States and were evaluated by a clinician at a U.S. site after travel. Of those patients, 7,530 (43.3%) were recent migrants to the United States, and 9,859 (56.7%) were returning nonmigrant travelers.Among the recent migrants to the United States, the median age was 28.5 years (range = <19 years to 93 years); 47.3% were female, and 6.0% were U.S. citizens. A majority (89.8%) were seen as outpatients, and among 4,672 migrants with information available, 4,148 (88.8%) did not receive pretravel health information. Of 13,986 diagnoses among migrants, the most frequent were vitamin D deficiency (20.2%), Blastocystis (10.9%), and latent tuberculosis (10.3%). Malaria was diagnosed in 54 (<1%) migrants. Of the 26 migrants diagnosed with malaria for whom pretravel information was known, 88.5% did not receive pretravel health information. Before November 16, 2018, patients' reasons for travel, exposure country, and exposure region were not linked to an individual diagnosis. Thus, results of these data from January 1, 2012, to November 15, 2018 (early period), and from November 16, 2018, to December 31, 2021 (later period), are reported separately. During the early and later periods, the most frequent regions of exposure were Sub-Saharan Africa (22.7% and 26.2%, respectively), the Caribbean (21.3% and 8.4%, respectively), Central America (13.4% and 27.6%, respectively), and South East Asia (13.1% and 16.9%, respectively). Migrants with diagnosed malaria were most frequently exposed in Sub-Saharan Africa (89.3% and 100%, respectively).Among nonmigrant travelers returning to the United States, the median age was 37 years (range = <19 years to 96 years); 55.7% were female, 75.3% were born in the United States, and 89.4% were U.S. citizens. A majority (90.6%) were seen as outpatients, and of 8,967 nonmigrant travelers with available information, 5,878 (65.6%) did not receive pretravel health information. Of 11,987 diagnoses, the most frequent were related to the gastrointestinal system (5,173; 43.2%). The most frequent diagnoses among nonmigrant travelers were acute diarrhea (16.9%), viral syndrome (4.9%), and irritable bowel syndrome (4.1%).Malaria was diagnosed in 421 (3.5%) nonmigrant travelers. During the early (January 1, 2012, to November 15, 2018) and later (November 16, 2018, to December 31, 2021) periods, the most frequent reasons for travel among nonmigrant travelers were tourism (44.8% and 53.6%, respectively), travelers visiting friends and relatives (VFRs) (22.0% and 21.4%, respectively), business (13.4% and 12.3%, respectively), and missionary or humanitarian aid (13.1% and 6.2%, respectively). The most frequent regions of exposure for any diagnosis among nonmigrant travelers during the early and later period were Central America (19.2% and 17.3%, respectively), Sub-Saharan Africa (17.7% and 25.5%, respectively), the Caribbean (13.0% and 10.9%, respectively), and South East Asia (10.4% and 11.2%, respectively).Nonmigrant travelers who had malaria diagnosed were most frequently exposed in Sub-Saharan Africa (88.6% and 95.9% during the early and later period, respectively) and VFRs (70.3% and 57.9%, respectively). Among VFRs with malaria, a majority did not receive pretravel health information (70.2% and 83.3%, respectively) or take malaria chemoprophylaxis (88.3% and 100%, respectively). Interpretation: Among ill U.S. travelers evaluated at U.S. GeoSentinel sites after travel, the majority were nonmigrant travelers who most frequently received a gastrointestinal disease diagnosis, implying that persons from the United States traveling internationally might be exposed to contaminated food and water. Migrants most frequently received diagnoses of conditions such as vitamin D deficiency and latent tuberculosis, which might result from adverse circumstances before and during migration (e.g., malnutrition and food insecurity, limited access to adequate sanitation and hygiene, and crowded housing,). Malaria was diagnosed in both migrants and nonmigrant travelers, and only a limited number reported taking malaria chemoprophylaxis, which might be attributed to both barriers to acquiring pretravel health care (especially for VFRs) and lack of prevention practices (e.g., insect repellant use) during travel. The number of ill travelers evaluated by U.S. GeoSentinel sites after travel decreased in 2020 and 2021 compared with previous years because of the COVID-19 pandemic and associated travel restrictions. GeoSentinel detected limited cases of COVID-19 and did not detect any sentinel cases early in the pandemic because of the lack of global diagnostic testing capacity. Public Health Action: The findings in this report describe the scope of health-related conditions that migrants and returning nonmigrant travelers to the United States acquired, illustrating risk for acquiring illnesses during travel. In addition, certain travelers do not seek pretravel health care, even when traveling to areas in which high-risk, preventable diseases are endemic. Health care professionals can aid international travelers by providing evaluations and destination-specific advice.Health care professionals should both foster trust and enhance pretravel prevention messaging for VFRs, a group known to have a higher incidence of serious diseases after travel (e.g., malaria and enteric fever). Health care professionals should continue to advocate for medical care in underserved populations (e.g., VFRs and migrants) to prevent disease progression, reactivation, and potential spread to and within vulnerable populations. Because both travel and infectious diseases evolve, public health professionals should explore ways to enhance the detection of emerging diseases that might not be captured by current surveillance systems that are not site based.

'Goodbye and good luck' Midwifery care to pregnant undocumented migrants in Norway: A qualitative study.

OBJECTIVE: To explore community midwives' experiences caring for pregnant undocumented migrants seeking prenatal care in Norway. METHOD: Due to the relatively limited previous research and number of pregnant undocumented migrants we used an explorative approach through qualitative method. Ten community midwives were interviewed after snowball sampling in Oslo, the capital of Norway. The main themes emerged through a qualitative analysis of the transcripts, and meaning units were extracted. RESULTS: Midwives with no prior experience with pregnant undocumented migrants expressed uncertainty regarding the women's rights. In contrast, those midwives who had had prior experience with this group, developed their own solutions and enacted certain strategies to help them without any guidelines from their employer. All the midwives found it challenging to provide follow-up care to the undocumented migrants during pregnancy and postpartum. They also expressed concerns regarding increasing challenges creating clinical trusting relationships and restrictions and practices at public hospitals. CONCLUSIONS: To ensure adequate perinatal care, it is needed to reassure pregnant undocumented migrants free and safe care at all stages in the birth giving process. Community midwives need professional support in establishing trusting clinical relationships with pregnant undocumented migrants to reduce maternal stress and facilitate continuity in perinatal care.

Northwest African Neolithic initiated by migrants from Iberia and Levant.

In northwestern Africa, lifestyle transitioned from foraging to food production around 7,400 years ago but what sparked that change remains unclear. Archaeological data support conflicting views: (1) that migrant European Neolithic farmers brought the new way of life to North Africa1-3 or (2) that local hunter-gatherers adopted technological innovations4,5. The latter view is also supported by archaeogenetic data6. Here we fill key chronological and archaeogenetic gaps for the Maghreb, from Epipalaeolithic to Middle Neolithic, by sequencing the genomes of nine individuals (to between 45.8- and 0.2-fold genome coverage). Notably, we trace 8,000 years of population continuity and isolation from the Upper Palaeolithic, via the Epipaleolithic, to some Maghrebi Neolithic farming groups. However, remains from the earliest Neolithic contexts showed mostly European Neolithic ancestry. We suggest that farming was introduced by European migrants and was then rapidly adopted by local groups. During the Middle Neolithic a new ancestry from the Levant appears in the Maghreb, coinciding with the arrival of pastoralism in the region, and all three ancestries blend together during the Late Neolithic. Our results show ancestry shifts in the Neolithization of northwestern Africa that probably mirrored a heterogeneous economic and cultural landscape, in a more multifaceted process than observed in other regions.

Learning from intersectoral initiatives to respond to the needs of refugees, asylum seekers, and migrants without status in the context of COVID-19 in Quebec and Ontario: a qualitative multiple case study protocol.

BACKGROUND: Refugees, asylum seekers, and migrants without status experience precarious living and working conditions that disproportionately expose them to coronavirus disease 2019 (COVID-19). In the two most populous Canadian provinces (Quebec and Ontario), to reduce the vulnerability factors experienced by the most marginalized migrants, the public and community sectors engage in joint coordination efforts called intersectoral collaboration. This collaboration ensures holistic care provisioning, inclusive of psychosocial support, assistance to address food security, and educational and employment assistance. This research project explores how community and public sectors collaborated on intersectoral initiatives during the COVID-19 pandemic to support refugees, asylum seekers, and migrants without status in the cities of Montreal, Sherbrooke, and Toronto, and generates lessons for a sustainable response to the heterogeneous needs of these migrants. METHODS: This theory-informed participatory research is co-created with socioculturally diverse research partners (refugees, asylum seekers and migrants without status, employees of community organizations, and employees of public organizations). We will utilize Mirzoev and Kane's framework on health systems' responsiveness to guide the four phases of a qualitative multiple case study (a case being an intersectoral initiative). These phases will include (1) building an inventory of intersectoral initiatives developed during the pandemic, (2) organizing a deliberative workshop with representatives of the study population, community, and public sector respondents to select and validate the intersectoral initiatives, (3) interviews (n = 80) with community and public sector frontline workers and managers, municipal/regional/provincial policymakers, and employees of philanthropic foundations, and (4) focus groups (n = 80) with refugees, asylum seekers, and migrants without status. Qualitative data will be analyzed using thematic analysis. The findings will be used to develop discussion forums to spur cross-learning among service providers. DISCUSSION: This research will highlight the experiences of community and public organizations in their ability to offer responsive services for refugees, asylum seekers, and migrants without status in the context of a pandemic. We will draw lessons learnt from the promising practices developed in the context of COVID-19, to improve services beyond times of crisis. Lastly, we will reflect upon our participatory approach-particularly in relation to the engagement of refugees and asylum seekers in the governance of our research.

Soins intégrés auprès des personnes LGBTQI+ migrantes : la place des soins psychosociaux.

INTRODUCTION: LGBTQI+ migrants are at greater risk of facing health issues, including mental health issues, especially since the arrival of COVID-19. Furthermore, they face many barriers to accessing care in Quebec. It is in this context that Clinic Mauve was implemented, which aims to remove these barriers by offering medical and psychosocial care in an integrated care setting to LGBTQI+ migrants in Montreal. PURPOSE OF RESEARCH: The purpose of this article is to identify the benefits and challenges of a model like the Clinic Mauve in addressing the psychosocial needs of LGBTQI+ migrant individuals. RESULTS: The analysis shows that the Clinic Mauve model, because of its approaches is able to remove some of the barriers to accessing care for LGBTQI+ migrants and to allow for a certain degree of empowerment of these populations. However, some challenges have been identified, which are mainly due to the lack of resources and organizational constraints. CONCLUSIONS: The article concludes that providing psychosocial care in an integrated care setting addresses some of the barriers to accessing care faced by LGBTQI+ migrants.

Optimizing health and nutrition status of migrant construction workers consuming multiple micronutrient fortified rice in Singapore.

INTRODUCTION: A well-nourished workforce is instrumental in eradicating hunger, alleviating poverty, and spurring economic growth. A fifth of the total workforce in high-income countries are migrant workers. Despite the accessibility of nutritious foods in high-income countries, migrant workers often rely on nutrient-poor diets largely consisting of empty calories, which in turn leads to vitamin and mineral deficiency, also called hidden hunger, and resultant productivity loss. Here, we study the magnitude of hidden hunger in male migrant construction workers in Singapore and investigate the impact of consuming fortified rice for 6 consecutive months on the nutrition and health status of these workers. METHODS: 140 male migrant workers aged 20-51 years of either Bangladeshi or Indian ethnicity from a single dormitory in Singapore volunteered to participate in the study. In total, 133 blood samples were taken at the start of the study and were used to assess vitamin B12, hemoglobin, ferritin, folate, and zinc levels; a sub-sample underwent for homocysteine testing. Anthropometric measurements and vital signs, such as blood pressure, were recorded before and after the intervention. RESULTS: The results show that vitamin and mineral deficiency was present, especially folate (59% of workers deficient) and vitamin B12 (7% deficient, 31% marginally deficient). The consumption of fortified rice significantly improved the vitamin, iron and zinc level in the workers and significantly reduced the systolic blood pressure amongst the Bangladeshi migrant workers, specifically. CONCLUSION: Our study demonstrates that fortified rice may have a positive impact on male migrant construction worker health and nutrition status at the workplace.

Health outcomes, health services utilization, and costs consequences of medicare uninsurance among migrants in Canada: a systematic review.

BACKGROUND: Medically uninsured groups, many of them migrants, reportedly delay using healthcare services due to costs and often face preventable health consequences. This systematic review sought to assess quantitative evidence on health outcomes, health services use, and health care costs among uninsured migrant populations in Canada. METHODS: OVID MEDLINE, Embase, Global Health, EconLit, and grey literature were searched to identify relevant literature published up until March 2021. The Cochrane Risk of Bias in Non-randomized Studies - of Interventions (ROBINS-I) tool was used to assess the quality of studies. RESULTS: Ten studies were included. Data showed that there are differences among insured and uninsured groups in reported health outcomes and health services use. No quantitative studies on economic costs were captured. CONCLUSIONS: Our findings indicate a need to review policies regarding accessible and affordable health care for migrants. Increasing funding to community health centers may improve service utilization and health outcomes among this population.

Does migrant workers' subjective social status affect their mental health? Job satisfaction as a longitudinal mediator.

BACKGROUND: Prior studies on migrant workers have explored the effect of their subjective social status and job satisfaction on their mental health, respectively or combined, as well as how their subjective social status affects their job satisfaction. Nonetheless, few have accounted straightforwardly and holistically for the mechanism of interaction between subjective social status, job satisfaction and mental health amongst migrant workers. AIMS: Taking migrant workers in China as the object of study, we intended to probe the longitudinal links between their subjective social status, job satisfaction and mental health, in particular, their job satisfaction as a longitudinal mediator therein. METHOD: Using the three-wave data from the 2014, 2016 and 2018 China Labour-force Dynamics Survey, we defined migrant workers as labourers aged 15 to 64 with agricultural hukou and engaged in non-agricultural work in urban areas. The final valid sample comprised 2,035 individuals. Latent growth models (LGMs) were applied to test the hypothesised relationships. RESULTS: The LGMs based on bootstrapping showed that amongst migrant workers the subjective social status, job satisfaction and mental health tended overall to grow linearly and that the job satisfaction longitudinally mediated between the subjective social status and mental health. CONCLUSIONS: The findings may enlighten policymaking to elevate migrant workers mentally and inform future studies on theoretical and practical fronts.

Food Insecurity among International Migrants during the COVID-19 Pandemic: A Scoping Review.

The SARS-CoV-2 coronavirus and the measures imposed to control it have impacted food security globally, particularly among vulnerable populations. Food insecurity, in turn, has repercussions on health, exacerbating pre-existing inequalities. This scoping review maps the literature describing associations between the COVID-19 pandemic and food insecurity among migrants, with a particular view toward health. A total of 909 papers were extracted through four electronic databases, and 46 studies were included. The migrant populations described originated mainly from Latin America (11/46) and were located in North America (21/46). Most studies included refugees and asylum seekers (20/46). The main challenges described were financial hardship (28/46), the effect of migrants' documentation status on using public food aid (13/46), and the suspension of or reduction in humanitarian assistance due to the economic recession (7/46). The impact of food insecurity on migrants' mental and physical health was described in 26 of the 46 studies. Authorities in all destination countries should focus their attention and efforts into ensuring nutrition security for migrants in a holistic way, including their economic and legal integration, to be better prepared for health crises in the future.

Relevance and Feasibility of Group Traumatic Episode Protocol Delivered to Migrants: A Pilot Field Study.

INTRODUCTION: Post-Traumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD) are commonly observed in migrants. Although Eye Movement Desensitization and Reprocessing (EMDR) can be helpful to treat these diseases, it remains difficult to propose EMDR as an individual intervention in help-seeking migrants. Group EMDR, like Group Traumatic Episode Protocol (G-TEP), which was built around the 8 phases of the original EMDR protocol, could offer an effective treatment to a large number of people. It may also be more resource-efficient to provide psychiatric care to migrants. METHODS: In this open-label trial, the feasibility and the effectiveness of a 6-session G-TEP intervention was investigated in a group of 10 migrants. RESULTS: The intervention was well tolerated by participants. The final attrition rate was 10%. After the intervention, there was a 28.2% significant decrease in PTSD and complex PTSD symptoms, as measured by the International Trauma Questionnaires (total_ITQ) scores (p = 0.013) and a trend towards a significant decrease in MDD symptoms, as measured with the Patient Health Questionnaire (PHQ-9) (p = 0.057). CONCLUSIONS: G-TEP may be effective in decreasing PTSD symptoms in migrants. The accessibility, low-cost, and very structured features of G-TEP may make its implementation sustainable in the field of psychiatric care for migrants.

African Hut model of health: a framework for improving African migrant health in Aotearoa/New Zealand.

There is renewed international effort to improve the health and well-being of migrants. For African migrants, theoretical frameworks designed to account for and guide interventions to address the underlying mechanisms that interact to influence health and well-being remain largely underdeveloped. The aim of this study was to address this gap by providing a unique socio-ecological framework with specific entry points for targeted health promotion action aimed at improving the health and well-being of African migrants living in Aotearoa New Zealand. The African Hut model of health was developed through an inductive iterative approach informed by a review of the evidence and semi-structured interviews with key informants. The interviews were conducted in person using one-on-one format and employed to refine initial themes from the literature. A hybrid thematic analysis, involving both inductive and deductive approaches was used to analyse the interview data. The health and well-being of African migrant communities are the outcome of complex interplay of individual, economic, social and structural factors. To protect and promote the health of African communities in Aotearoa requires tailored interventions that centre culture and deliver holistically.

"We All Have a Job to Do in This World, It's up to Us": Farmworker and Farmer Mental Health in a Rural US-Mexico Border Region.

Improving mental health outcomes for agricultural populations is dependent on understanding the unique farming related stressors in context of the local culture and community. This study was designed to assess the prevalence of stressors and mental health risks among farmers and farmworkers in a rural, medically underserved US-Mexico border region. Of 135 study respondents, 55.6% (n = 18) farmers had clinical depression symptomatology based on the Center for Epidemiologic Studies depression screening scale (CES-D) and 40.2% (n = 117) farmworkers had stress levels that pose significant mental health risks based on the Migrant Farmworker Stress Inventory. Farmworker females were 2.3 times more likely to have a score of clinical concern. Results provide an understanding of the distinct sources of stress for both farmers and farmworkers and the mental health challenges across the industry. With an understanding that suicide is the third leading cause of injury death in Imperial County and depression associated with an increased risk of suicidality, the agricultural workforce in Imperial County is particularly vulnerable. Local farm organizations, employers, and community organizations can help increase mental health access, acceptability, and availability to achieve greater safety and health in the region's largest workforce.

Health promotion strategies toward improved healthcare access for migrants and refugees in Europe: MyHealth recommendations.

MyHealth European project (2017-2020) was committed to elaborate on models to engage vulnerable migrants and refugees (VMR) in their health through community involvement. Low healthcare access and poor quality of healthcare services for VMR is a common reality in many European countries. The purpose of the present study, as part of MyHealth project, was the development of an agenda for actions and consequent recommendations to tackle the issue. A qualitative research design was applied at four study sites in Barcelona, Spain; Berlin, Germany; Brno, Czech Republic and Athens, Greece. The Metaplan® group discussions allowed the collection, organization and process of ideas and opinions elaborated in the collaborative groups. In total, 14 sessions took place: 4 with health and social professionals (n = 41) and 10 with VMR (n = 77). A participatory thematic analysis was performed at every session and overall for all sessions a thematic analysis synthesized the findings. The suggested actions were divided into two levels of recommendations: (i) local authorities at destination country-related, such as the investment in health professionals' cultural competences, and (ii) VMR-related, such as adaptation of help-seeking behavior patterns. Special attention was proposed to women survivors of violence and homeless minors. The study concluded to an agenda for action in Europe. We advocate for a public health paradigm shift where, while holding a bottom-up approach, VMR as well as professionals working with them are actively and meaningfully engaged in the decision-making process of access-enhancing and health promotion strategies in a given socio-cultural context.

Low healthcare access and poor quality of healthcare services for vulnerable migrants and refugees (VMR) is a common reality in many European countries. As part of MyHealth project (2017­2020), a qualitative methodology was used to engage VMR and professionals in the decision-making of proposed actions and corresponding recommendations to address the issue.

Access to Health Services Among Forced Migrants in Tanzania: A Cluster Randomized Cross Sectional Study of 3560 Congolese and Burundian Refugees.

Despite significant advances in the understanding of the global burden of surgical disease, limited research focuses on access to health and surgical services among refugees, especially in east Africa. The goal of this study was to describe patterns of access to transportation to health services among Congolese and Burundian refugees in Tanzania. We utilized cluster random sampling to perform a large, cross-sectional study in Nyarugusu refugee camp, Tanzania using an adapted version of the Surgeon Overseas Assessment Tool (SOSAS). We randomly selected 132 clusters out of 1472 clusters, randomly selected two people from all households in those clusters. Data analysis was performed in STATA (Stata Version 16, College Station, TX). A total of 3560 participants were included in the study including 1863 Congolese refugees and 1697 Burundian refugees. The majority of refugees reported they were generally healthy (n = 2792, 79.3%). The most common period of waiting to be seen at the health center was between three and 5 h (n = 1502, 45.8%), and over half of all refugees waited between 3 and 12 h to be seen. There was heterogeneity in other intra-camp referral networks (e.g. to and from traditional healer and hospital). Finally, a low percentage (3%) of participants reported leaving the refugee camp to seek health care elsewhere, and Congolese refugees were more likely to pursue self-referral in this manner. To our knowledge, this is the largest study focused on access to transportation among refugees in Tanzania and sub-Saharan Africa. Most participants reported financial difficulty always affording transportation costs with significant wait times occurring once arrived at the hospital. Our study does suggest that some independent health care seeking did occur outside of the camp-based services. Future research may focus more specifically on barriers to timely servicing of patients and patterns of self-referral.Please confirm if the author names are presented accurately and in the correct sequence (given name, middle name/initial, family name). Author 1 Given name: [Zachary Obinna] Last Name [Enumah] and Author 2 Given name: [Mohamed Yunus] Last Name [Rafiq]. Also, kindly confirm the details in the metadata are correct.Confirmed.