An updated scoping review of migrant health research in Ireland.

BACKGROUND: One in five people living in Ireland is a migrant. Understanding the distinctive health needs of this diverse population is essential to provide evidence-based, culturally sensitive primary care services. The aim of this review is to systematically examine changes in migrant health research in Ireland and to inform research, policy and practice in the field. METHODS: To update a 2017 scoping review of migrant health research in Ireland, we used Arksey and O'Malley's framework, updates by Colquhoun and Peters and the PRISMA-ScR from the Joanna Briggs Institute to search 10 databases covering May 2017 - March 2023. Findings were analysed using the World Health Organisation Strategy and Action Plan for Refugee and Migrant Health 2016-2023, which identifies 9 priority strategic areas (SA). Findings were compared with the 2017 review. RESULTS: 62 papers were identified. There has been an increase in studies over time from an average of five per year in the previous review to an average of 10 per year in this review. There is growing interest in research about SA1: Collaborative action on migrant health issues and SA2: Advocacy for the right to health of refugees and migrants - evidenced by an increase of 13% in this review. Similarly to 2017, the majority of papers align with three of the nine WHO Strategic Areas; SA3: Addressing the social determinants of health (24%), SA4: Achieving public health preparedness (29%) and SA5: Strengthening health systems (26%). The volume of research on SA6: Communicable diseases (11%) and SA7: Noncommunicable diseases (19%) remains stable however research on SA8: Health screening and assessment (5%) and SA9: Improving health information and communication (2%) remains low. CONCLUSIONS: The increase in the volume of research on migrant health in Ireland is notable. The analysis over time illuminates changes in the focus of research studies. Gaps in research about screening, assessment and health information warrant particular attention. It is also necessary to continue paying attention to areas of recent growth and stagnation for a balanced and comprehensive evidence base. Mobilising resources to continue this increase is needed for evidence-based policy and practice.

Predicting 2-y outcome in preterm infants using early multimodal physiological monitoring.

BACKGROUND: Preterm infants are at risk of adverse outcome. The aim of this study is to develop a multimodal model, including physiological signals from the first days of life, to predict 2-y outcome in preterm infants. METHODS: Infants <32 wk gestation had simultaneous multi-channel electroencephalography (EEG), peripheral oxygen saturation (SpO2), and heart rate (HR) monitoring. EEG grades were combined with gestational age (GA) and quantitative features of HR and SpO2 in a logistic regression model to predict outcome. Bayley Scales of Infant Development-III assessed 2-y neurodevelopmental outcome. A clinical course score, grading infants at discharge as high or low morbidity risk, was used to compare performance with the model. RESULTS: Forty-three infants were included: 27 had good outcomes, 16 had poor outcomes or died. While performance of the model was similar to the clinical course score graded at discharge, with an area under the receiver operator characteristic (AUC) of 0.83 (95% confidence intervals (CI): 0.69-0.95) vs. 0.79 (0.66-0.90) (P = 0.633), the model was able to predict 2-y outcome days after birth. CONCLUSION: Quantitative analysis of physiological signals, combined with GA and graded EEG, shows potential for predicting mortality or delayed neurodevelopment at 2 y of age.

Comparative analysis of the genome sequences of Bordetella pertussis, Bordetella parapertussis and Bordetella bronchiseptica.

Bordetella pertussis, Bordetella parapertussis and Bordetella bronchiseptica are closely related Gram-negative beta-proteobacteria that colonize the respiratory tracts of mammals. B. pertussis is a strict human pathogen of recent evolutionary origin and is the primary etiologic agent of whooping cough. B. parapertussis can also cause whooping cough, and B. bronchiseptica causes chronic respiratory infections in a wide range of animals. We sequenced the genomes of B. bronchiseptica RB50 (5,338,400 bp; 5,007 predicted genes), B. parapertussis 12822 (4,773,551 bp; 4,404 genes) and B. pertussis Tohama I (4,086,186 bp; 3,816 genes). Our analysis indicates that B. parapertussis and B. pertussis are independent derivatives of B. bronchiseptica-like ancestors. During the evolution of these two host-restricted species there was large-scale gene loss and inactivation; host adaptation seems to be a consequence of loss, not gain, of function, and differences in virulence may be related to loss of regulatory or control functions.

Respected but stigmatized: Healthcare workers caring for COVID-19 patients.

BACKGROUND: Healthcare workers (HCWs) caring for Corona Virus Disease 2019 (COVID-19) patients are at increased risk of being stigmatized, which compromises their individual mental well-being and the quality of care they deliver. Stigma-reduction interventions may (partly) prevent this. However, there is a lack of in-depth understanding of the experiences and underlying causes of COVID-19 stigma among HCWs, which is needed to design such interventions. We conducted in-depth semi-structured interviews to assess COVID-19 stigma among COVID-19 HCWs in Ireland, Nigeria, The Netherlands, Pakistan, and The Philippines. METHODS: We used a purposive and snowball sampling to recruit a total of 53 HCWs for online interviews (13 in Ireland; 15 in Nigeria; 6 in The Netherlands; 6 in Pakistan; and 13 in The Philippines (2021). After verbatim transcribing interviews, we used a thematic approach for data analysis. RESULTS: In all countries, stigmatization of COVID-19 HCWs is driven by fear of infection and the perception of HCWs being carriers of the disease amplified by them wearing of scrubs and personal protective equipment. There were differences between countries in the way stigma manifested in self- anticipated and experienced stigma like scolding, discrimination, avoidance, (self-) isolation, and exclusion in public, in the community, at work, and in the household. The stigma resulted in feelings of depression, loneliness, isolation, and the desire to quit one's job. DISCUSSION: COVID-19 HCWs from all countries experienced all forms of stigmatization related to their work as a COVID-19 frontliner. This affected their mental well-being, which in turn affects job performance and quality of care, there is a high need to develop stigma reduction tools for HCWs.

A scoping review of literature exploring factors affecting vaccine uptake within Roma communities across Europe.

INTRODUCTION: Vaccine hesitancy is described by the WHO as one of the top threats to global health. The trajectory of the current COVID-19 pandemic depends upon the vaccination of a global population; therefore, barriers to routine vaccination within marginalized groups considered vaccine hesitant are of critical importance. Consistently, vaccination levels within Roma communities across Europe rate very poorly in comparison with general population coverage, and a number of measles and hepatitis outbreaks over the past 10 years have included Roma communities. This study aims to identify barriers to Roma vaccination in general with a view to informing analysis of potential low levels of vaccination within Roma communities for COVID-19. AREAS COVERED: The research question explores factors and barriers affecting general vaccine (non-COVID-19 vaccine) uptake within Roma communities across Europe. This scoping review was conducted using the Arksey & O'Malley framework, complying with PRISMA-SR for Scoping Review guidelines. EXPERT OPINION: Using Thomson's 5A's Taxonomy, access was identified as the greatest barrier to vaccination within Roma communities. Access factors had the greatest number of references in this scoping review and were considered the most relevant in terms of increasing vaccination uptake. Important access themes identified are health system issues, socioeconomic conditions, and mobility.

Dinnertime and bedtime routines and rituals in families with a young child with an autism spectrum disorder.

BACKGROUND/AIM: Routines are thought to be critical in laying the foundation for ritual development, and in turn rituals are considered important for forming a strong and healthy family unit. This article provides a description of the experiences of dinnertime and bedtime routines and rituals in Australian families with a young child with an Autism Spectrum Disorder (ASD), as well as common challenges experienced. METHODS: Fourteen Australian mothers with a young child with an ASD between the ages of two and five years were interviewed about their performance of dinnertime and bedtime routines and rituals and their perceptions of both occupations. Descriptive qualitative interviews were audio taped and transcribed. Transcripts were analysed using thematic content analysis. RESULTS: Two overarching themes emerged, including 'centred on ASD' and 'ASD alters meaning'. Mothers' descriptions revealed that families with a young child with an ASD experienced unstructured and chaotic routines at dinnertime. In contrast, bedtime involved the performance of more structured, and at times, non-functional routines. Moreover, dinnertime was bereft of meaningful interactions and rituals, whereas bedtime contained some positive meaningful interactions and rituals. CONCLUSIONS: Occupational therapists need to consider supporting mothers and the child with an ASD in enhancing their participation within all aspects of family life, by encouraging them to develop structured and more predictable dinnertime and bedtime routines inclusive of all family members. In doing so, this action will support mothers to develop a strong and cohesive family unit.

Assistive technology reasoning in rural school-based occupational therapy.

This study explores broad issues associated with assistive technology (AT) service provision in rural school settings. The study was designed to explore the beliefs of practitioners working in rural schools about their role in AT service provision. This article includes an extensive review of the literature and findings from a naturalistic study of AT service provision experience in rural school settings. The study portion of this article involved completion of an open-ended questionnaire followed by semi-structured ethnographic interviews. The participants completing the questionnaires were 22 occupational therapy practitioners and seven individuals from a variety of professional backgrounds recognized as leaders in AT in the state of West Virginia. Data were collected over a 3-year period. Themes identified in the data emphasized concerns about the unclear role of potential AT providers resulting in the use of AT as a last resort, the lack of inclusion of AT in the core curriculum, and the limited collaboration and in-service education opportunities recognized by practitioners. This qualitative study is not generalizable. Findings can be viewed within the context of other research to help enrich the reader's understanding of AT service delivery.

Mothering a child with hidden impairments.

When a mother has a child with a chronic impairment, the occupational demands of mothering extend to address the specialized needs of that child. This research explores how the type of hidden impairment in a child influences family routines and occupations. This qualitative study consisted of interviews with 22 mothers of children with attention deficit hyperactivity disorder (ADHD), a behavioral disorder, and 22 mothers of children with cystic fibrosis, a physical disorder. Open-ended questions were used to explore family demands, resources, time use, routines, concerns, and support. The transcripts of these interviews were analyzed in terms of consistency with existing literature on parenting the child with hidden disability, and for emergent themes. In this analysis the experiences of mothers of children with cystic fibrosis were consistent with research findings on other chronic conditions, with these mothers reporting that family provides them with extensive physical and emotional support. Although mothers of children with cystic fibrosis reported a persistent emotional sorrow, they felt they were able to "normalize" their daily routines. In contrast, mothers of children with ADHD reported little family support, high perception of child-related demands, and less confidence in their success in mothering these children. In describing their daily routines, these mothers often stated that there was no such thing as a "normal" day. They felt constantly "on alert" and did not feel that they had "normal" routines. Based on this study, mothers of children with ADHD felt distress because their child did not easily conform to social standards, and were likely to express exhaustion in their role as "mother." The pattern of responses offered by these participants differs significantly from that of the participants whose children have cystic fibrosis, and from the usual pattern of coping with chronic childhood disability documented in the literature.

Team intervention in food selectivity in a medically complex child in rural appalachia.

"Food selective" is the term used to describe children who eat an unusually limited variety and/or amount of foods and often have serious medical problems that inhibit the normal development of eating. While many urban areas have programs to address these complex eating problems, families in rural areas must rely on sometimes fragmented local resources. This paper describes how a university-based interdisciplinary team of professionals employ a reasoning process during the assessment and intervention with a child with food selectivity in manner supportive of prevailing Appalachian cultural beliefs and values. Issues of this model for occupational therapy is discussed using occupation-based culturally sensitive reasoning and intervention strategies when responding to illustrate the complex interaction of sensory processing and participation in daily occupations modeled in this case report.