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Yu L, Li LMW, Tong X. Understanding the link between theory of mind and loneliness among primary school students: A cross-lagged panel model analysis. J Exp Child Psychol 2024; 242:105891. [PMID: 38442684 DOI: 10.1016/j.jecp.2024.105891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/28/2023] [Accepted: 02/03/2024] [Indexed: 03/07/2024]
Abstract
This study aimed to investigate the longitudinal association between theory of mind (ToM) and loneliness as well as the potential moderating effects of parenting style on this association. A total of 689 Chinese third-grade students (341 girls and 348 boys; Mage = 9.23 years, SD = 0.66) were recruited from eight primary schools and were followed from Grade 3 to Grade 5. These students reported their primary caregivers' parenting style in third grade and completed the same ToM task and loneliness questionnaire at each time point from Grade 3 to Grade 5. The study's results indicated a bidirectional relationship between ToM and loneliness, implying that children with less developed ToM abilities tend to feel lonelier and, conversely, that higher levels of loneliness are associated with lower ToM skills. Moreover, the study demonstrated that parenting style influenced the association between ToM and loneliness. Specifically, the impact of ToM at Grade 3 on reducing loneliness at Grade 4 was greater among children who experienced high levels of rejection from their caregivers compared with those with low levels of rejection. In addition, this study found that loneliness at Grade 3 had a greater influence on ToM at Grade 5 for children experiencing low levels of emotional warmth from their caregivers than for those who experienced high levels of emotional warmth. These findings highlight the significance of ToM as both a precursor and consequence of children's loneliness and emphasize the variation in these longitudinal relationships based on the parenting styles of primary caregivers.
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Affiliation(s)
- Liyan Yu
- Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee, FL 32304, USA
| | - Liman Man Wai Li
- Department of Psychology, The Education University of Hong Kong, Tai Po, New Territories, Hong Kong
| | - Xiuhong Tong
- Department of Psychology, The Education University of Hong Kong, Tai Po, New Territories, Hong Kong.
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Linlin F, Chen Y, Fang S, Xu X, Kong W, Liu Z. The impact of left-behind experience on urban identity of new-generation migrant workers. PLoS One 2024; 19:e0300747. [PMID: 38696378 PMCID: PMC11065217 DOI: 10.1371/journal.pone.0300747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/04/2024] [Indexed: 05/04/2024] Open
Abstract
We investigate the impact of left-behind experiences on the urban identity of new-generation migrant workers using data from the 2017 China Migrants Dynamic Survey. The results show the following: (1) The left-behind experience is an important factor undermining the urban identity of new-generation migrant workers, and the conclusion remains consistent after robustness checks, such as propensity score matching. (2) Left-behind experiences of both parents away from home had the most significant negative impact on urban identity. (3) The results of the mechanism tests indicate that the left-behind experience exerts an adverse impact on urban identity through the pathways of poorer physical health, more frequent migration, more challenging job search, and stronger dependence on preexisting social networks. The findings of this study also offer policy suggestions for promoting the urban identity of new-generation migrant workers.
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Affiliation(s)
- Fu Linlin
- Institute of Rural Development, Zhejiang Academy of Agricultural Sciences, Hangzhou, Zhejiang, 310021, China
| | - Yihe Chen
- School of Accounting, Zhejiang Gongshang University, Hangzhou, Zhejiang, 310018, China
| | - Shile Fang
- School of Management, Wenzhou Business College, Wenzhou, Zhejiang, 325035, China
| | - Xinnan Xu
- School of Public Affairs, Zhejiang University, Hangzhou, Zhejiang, 310058, China
| | - Wenli Kong
- Institute of Rural Development, Zhejiang Academy of Agricultural Sciences, Hangzhou, Zhejiang, 310021, China
| | - Ziqi Liu
- Institute of Rural Development, Zhejiang Academy of Agricultural Sciences, Hangzhou, Zhejiang, 310021, China
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Račaitė J, Antia K, Winkler V, Lesinskienė S, Sketerskienė R, Maceinaitė R, Tracevskytė I, Dambrauskaitė E, Šurkienė G. Emotional and behavioural problems of left behind children in Lithuania: a comparative analysis of youth self-reports and parent/caregiver reports using ASEBA. Child Adolesc Psychiatry Ment Health 2024; 18:33. [PMID: 38500119 PMCID: PMC10949819 DOI: 10.1186/s13034-024-00726-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 03/05/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Children being left behind (LBC) in their home countries due to parental emigration is a global issue. Research shows that parents' emigration negatively affects children's mental health and well-being. Despite a high number of LBC, there is a dearth of data from Eastern European countries. The present study aims to collect and analyse self-reported data on LBC emotional and behavioural problems and compare children's reports with those of parents/caregivers. METHODS A cross-sectional study was conducted in 24 Lithuanian schools, involving parents/caregivers and their children aged 12 to 17. We employed self-reported measures, including the Achenbach System of Empirically Based Assessment (ASEBA) tools - Child Behaviour Checklist (CBCL 6/18) and Youth Self Report (YSR 11/18), to evaluate the emotional and behavioural problems of the children. These instruments had been translated, standardised, and validated for the Lithuanian population. Data collection took place between January 2022 and April 2023. In addition to descriptive analysis, multivariate regression was used to adjust for various sociodemographic factors. RESULTS A total of 760 parents/caregivers and 728 of their children participated in the study. LBC exhibited higher total problem scores (57.7; 95% CI 52.0-63.4) compared to non-LBC (47.1; 95% CI 44.7-49.4). These differences were consistent across all YSR 11/18 problem scales. However, no significant differences were observed in CBCL 6/18 scores. Furthermore, LBC self-reported a higher total problem score (57.7; 95% CI 52.0-63.4) compared to their parents/caregivers (24.9; 95% CI 18.9-30.9), and this pattern persisted across all scales. Being female, having school-related problems and having LBC status were associated with higher YSR 11/18 scores in the multivariable regression, while female gender, living in rural areas, school-related problems, and having hobbies were associated with higher CBCL 6/18 scores. CONCLUSION This study highlights that LBC report more emotional and behavioural challenges than their non-LBC peers, while parent/caregiver assessments show lower problem scores for LBC. Gender, living environment, school-related issues, and engagement in hobbies have influenced these outcomes. These findings underscore the multifaceted nature of the experiences of LBC and the importance of considering various contextual factors in understanding and addressing their emotional and behavioural well-being.
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Affiliation(s)
- Justina Račaitė
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, M.K. Čiurlionio 21, Vilnius, LT-03101, Lithuania.
| | - Khatia Antia
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130/3, 69120, Heidelberg, Germany
- School of Health Sciences, The University of Georgia, 77a Kostava Street, Tbilisi, 0175, Georgia
| | - Volker Winkler
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130/3, 69120, Heidelberg, Germany
| | - Sigita Lesinskienė
- Clinic of Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, M. K. Čiurlionio g. 21, Vilnius, LT-03101, Lithuania
| | - Rita Sketerskienė
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, M.K. Čiurlionio 21, Vilnius, LT-03101, Lithuania
| | - Rūta Maceinaitė
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, M.K. Čiurlionio 21, Vilnius, LT-03101, Lithuania
| | - Ingrida Tracevskytė
- Institute of Psychology, Faculty of Philosophy, Vilnius University, Universiteto Str. 9, Vilnius, LT-01513, Lithuania
| | - Elena Dambrauskaitė
- Institute of Psychology, Faculty of Philosophy, Vilnius University, Universiteto Str. 9, Vilnius, LT-01513, Lithuania
| | - Genė Šurkienė
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, M.K. Čiurlionio 21, Vilnius, LT-03101, Lithuania
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Kapilashrami A, John EA, Aziz R, Chan K, Wickramage K. Bridging the gap: Using CHNRI to align migration health research priorities in India with local expertise and global perspectives. J Glob Health 2023; 13:04148. [PMID: 37934961 PMCID: PMC10630695 DOI: 10.7189/jogh.13.04148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023] Open
Abstract
Background Migration and health are increasingly recognised as a global public health priority, but concerns have been raised on the skewed nature of current research and the potential disconnect between health needs and policy and governance responses. The Migration Health South Asia (MiHSA) network led the first systematic research priority-setting exercise for India, aligned with the global call to develop a clearly defined migration health research agenda that will inform research investments and guide migrant-responsive policies by the year 2030. Methods We adapted the Child Health and Nutrition Research Initiative (CHNRI) method for this priority setting exercise for migration health. Guided by advisory groups established at international and country levels, we sought research topics from 51 experts from diverse disciplines and sectors across India. We consolidated 223 responses into 59 research topics across five themes and scored them against five predefined criteria: answerability, effectiveness, feasibility, impact, and effect on equity. We then calculated research priority scores (RPS) and average expert agreement (AEA) each research topic and theme. Results A third of the 59 research topics were on migrants' health and health care access, 12 on social determinants of migrants' health, 10 on policies, law and migration health governance, eight on health systems' responsiveness, and five on migration health discourse. Three of the top five priority topics pertained to migrants' health care access. The policies, law, and governance theme had the highest overall RPS score. Conclusions There is a noticeable gap between research priorities identified by experts at the country-level and the current research focus and priorities set globally. This disconnect between the global and local perspectives in migration health scholarship hinders the development of context-specific and suitable policy agendas for improving migrants' health. Our co-developed agenda emphasises the need to prioritise research on the capacity of existing systems and policies so as to make them more migration-aware and responsive to migrants' health needs.
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Affiliation(s)
- Anuj Kapilashrami
- School of Health & Social Care, University of Essex, UK
- Migration Health South Asia Network (MiHSA)
| | | | - Roomi Aziz
- Migration Health South Asia Network (MiHSA)
| | - Kit Chan
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
| | - Kolitha Wickramage
- Migration Health South Asia Network (MiHSA)
- Migration Health Division, The United Nations Migration Agency (IOM), Switzerland
| | | | | | - India Experts Group for MiHSA Priority Setting Initiative
- School of Health & Social Care, University of Essex, UK
- Migration Health South Asia Network (MiHSA)
- Centre for Global Health, Usher Institute, University of Edinburgh, UK
- Migration Health Division, The United Nations Migration Agency (IOM), Switzerland
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Zhu Z, Wang Y, Pan X. Health problems faced by left-behind children in low/middle-income countries. BMJ Glob Health 2023; 8:e013502. [PMID: 37597874 PMCID: PMC10441040 DOI: 10.1136/bmjgh-2023-013502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 08/08/2023] [Indexed: 08/21/2023] Open
Affiliation(s)
- Zhenggang Zhu
- School of Nursing, Hunan University of Chinese Medicine, Changsha, Hunan, China
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, kelantan, Malaysia
| | - Yanpei Wang
- School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Xiaoyan Pan
- School of Nursing, Hunan University of Chinese Medicine, Changsha, Hunan, China
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Shoib S, Rathnayake L, Badawy MM, Swed S, Saeed F, Chandradasa M. International collaboration to address the inevitable mental health burden in Sri Lanka in the context of the economic crisis. Asian J Psychiatr 2022; 77:103277. [PMID: 36202001 DOI: 10.1016/j.ajp.2022.103277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Sheikh Shoib
- Department of Psychiatry, Jawahar Lal Nehru Memorial Hospital, Srinagar, Kashmir, India.
| | | | - Marwa M Badawy
- Faculty of Medicine, October Sixth University, Giza, Egypt.
| | - Sarya Swed
- Faculty of Medicine, Aleppo University, Aleppo, Syria.
| | - Fahimeh Saeed
- Department of Psychiatry, Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
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Dominguez GB, Hall BJ. The health status and related interventions for children left behind due to parental migration in the Philippines: A scoping review. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 28:100566. [PMID: 35996696 PMCID: PMC9391573 DOI: 10.1016/j.lanwpc.2022.100566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
UNLABELLED Overseas Filipino Workers are hailed as modern-day heroes who enable their families to climb the socioeconomic ladder. Despite their financial contribution, labour migration often separates children from their parents during their most formative years of growth, threatening healthy development. Using the Joanna Briggs Institute's framework, a scoping review was conducted to identify the health outcomes of left behind children in the Philippines and health-related interventions. In total, 4440 records were collected from peer-reviewed articles and grey literature and 50 records were eligible for inclusion. The findings indicated that left behind children experience a vast range of poor physical (general health, hygiene, illness, and nutrition) and mental (behavioural, cognitive, and emotional) health outcomes. A total of 48 interventions were identified in 13 out of 17 geographic regions. Despite this geographic coverage, the evidence-based literature was limited with regard to whether these interventions have been effective. Additional research is needed to better understand children's health, evaluate existing interventions, and develop multisectoral programming. FUNDING This review was supported by the Center for Global Health Equity, NYU Shanghai. No funding agencies were involved in the data collection, data analysis, and writing of this paper.
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Affiliation(s)
- Georgia B. Dominguez
- Faculty of Health Sciences, McMaster University, 1280 Main St. West, MDCL 3500, Hamilton, Ontario L8S 4K1, Canada
- Centre for Global Child Health, The Hospital for Sick Children, 686 Bay Street, 11th Floor, Toronto, ON M5G 0A4, Canada
| | - Brian J. Hall
- Center for Global Health Equity, NYU Shanghai, Room 1201, 1555 Century Avenue, Pudong New District, Shanghai 200122, People's Republic of China
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Zhao F, Tang B, Yang H, Wu J, Chen Q, Zhang L, Liu X. A comparative examination of the health status of earthquake-affected and non-earthquake-affected adolescents in Yushu. Front Public Health 2022; 10:976075. [PMID: 36388266 PMCID: PMC9645053 DOI: 10.3389/fpubh.2022.976075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/03/2022] [Indexed: 01/25/2023] Open
Abstract
Background Yushu, Qinghai Province, which is located in the remote Tibetan Plateau in western China, was struck by a disastrous earthquake in 2010. Methods This study aimed to compare the health status of adolescents who had (Exp-Group) and had not (Non-Group) experienced the Yushu earthquake, 7 years after it occurred; additionally, group-specific predictors of health status were identified. A cross-sectional study was adopted among students from two junior schools in Yushu, whereby two groups were compared. Descriptive statistics, t-tests, Wilcoxon rank-sum tests, Kruskal-Wallis H tests, and stepwise linear regression were used to analyze data. Results Exp-Group scored higher than Non-Group on Physiological Component Summary (PCS) but not on Mental Component Summary (MCS). Among Exp-Group participants, lower PCS scores were predicted for "house damaged," "injured," "family member injured," and "family member or friend dead." Lower MCS scores were predicted by "family member or friend dead." Among Non-Group participants, PCS scores were predicted by "residence" and "family member or friend dead." Lower MCS scores were predicted by "not living with parents." Conclusion Lower PCS and MCS scores of Exp-Group adolescents mainly contributed to earthquake-related injuries, while lower PCS and MCS scores of Non-Group are related to poor living conditions and the fact of the left-behind child.
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Affiliation(s)
- Fangjie Zhao
- Department of Health Service, Second Military Medical University, Shanghai, China
| | - Bihan Tang
- Department of Health Service, Second Military Medical University, Shanghai, China
| | - Hongyang Yang
- Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jing Wu
- School of Nursing, Second Military Medical University, Shanghai, China
| | - Qi Chen
- Department of Health Statistic, Second Military Medical University, Shanghai, China
| | - Lulu Zhang
- Department of Health Service, Second Military Medical University, Shanghai, China,*Correspondence: Xu Liu
| | - Xu Liu
- Department of Health Service, Second Military Medical University, Shanghai, China,Lulu Zhang
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Linking classmate autonomy support with prosocial behavior in Chinese left-behind adolescents: The moderating role of self-esteem and grit. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2022.111679] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Zhang X, Hong H, Hou W, Liu X. A prospective study of peer victimization and depressive symptoms among left-behind children in rural China: the mediating effect of stressful life events. Child Adolesc Psychiatry Ment Health 2022; 16:56. [PMID: 35768872 PMCID: PMC9245339 DOI: 10.1186/s13034-022-00485-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 06/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Ministry of Civil Affairs of the People's Republic of China reported that in 2018, 6.97 million left-behind children (LBC), children who live in rural areas away from their parents, were being cared for by grandparents, relatives, elder siblings, or often living alone. Their parents have migrated to cities for better income opportunities. While a number of studies have detailed elevated depressive symptoms among LBC, relatively little is known about the causes of poorer mental health in LBC. METHODS This study used longitudinal data to examine associations between peer victimization, stressful life events, and depressive symptom severity in LBC from four randomly-selected middle schools in Guizhou Province, China. A total of 862 children aged 11-18 years, with 472 LBC (54.76%) and 390 non-left-behind children (NLBC) (45.24%), were included in the analysis. T-test was used to compare the depressive symptoms, peer victimization, and stressful life events between LBC and NLBC at baseline and follow-up (6 months later). Multivariable linear regression models were used to examine the mediation effect of follow-up stressful life events on the relationship between baseline peer victimization and follow-up depressive symptoms among LBC. RESULTS Results suggested that LBC had higher peer victimization and stressful life events than NLBC (β = 1.28, p = 0.04), and peer victimization and stressful life events at baseline were associated with increased follow-up depressive symptoms among LBC (Peer victimization: β = 0.25, p < 0.0001; Stressful life events: β = 0.15, p < 0.001). Peer victimization affected depressive symptoms partially through stressful life events for female LBC and completely through stressful life events for male LBC, controlling for age, perceived socioeconomic status, and school. CONCLUSIONS This study highlights the vulnerability of LBC exhibiting negative mental health outcomes as they were found to experience more peer victimization and feel more stressed when stressful life events happened, compared with NLBC. Results of this study suggested that protecting LBC from peer victimization experiences can potentially prevent LBC from experiencing an increased impact of other stressful life events, thus decreasing the likelihood of their depressive symptoms. Intervention design should consider the different mediating effects of stressful life events on the relationship between peer victimization and depressive symptoms among female and male LBC.
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Affiliation(s)
- Xiaoqing Zhang
- grid.36425.360000 0001 2216 9681School of Health Professions, Stony Brook University, New York, USA
| | - Houlin Hong
- grid.212340.60000000122985718School of Public Health and Health Policy, City University of New York, New York, USA
| | - Wei Hou
- grid.36425.360000 0001 2216 9681Department of Family, Population, and Preventive Medicine, Stony Brook University, New York, USA
| | - Xia Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China. .,, No. 19 Xinjiekouwai Street, Beijing, 100875, China.
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Openness to Experience Moderates the Association of Warmth Profiles and Subjective Well-Being in Left-Behind and Non-Left-Behind Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074103. [PMID: 35409784 PMCID: PMC8998741 DOI: 10.3390/ijerph19074103] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 12/10/2022]
Abstract
Crouched in the socioecological framework, the present research compared the subjective well-being of left-behind youth with their non-left-behind peers. Furthermore, this research investigated the association of parental warmth and teacher warmth using a person-centered approach with adolescents’ subjective well-being on the whole sample, and examined its conditional processes by ascertaining the moderating role of openness to experience and left-behind status in this association. A total of 246 left-behind youth (53.6% girls; Mage = 15.77; SD = 1.50) and 492 socio-demographically matched, non-left-behind peers (55.1% girls; Mage = 15.91; SD = 1.43) was involved in this study. During school hours, these adolescents were uniformly instructed to complete a set of self-report questionnaires. The results from ANCOVA exhibited no significant differences in subjective well-being between these two groups of youth. Moreover, four warmth profiles were revealed: congruent low, congruent highest, congruent lowest, and incongruent moderate, and youth within the congruent highest profile were more likely than the other three profiles to report higher subjective well-being. Additionally, moderation analyses demonstrated that high openness was one protective factor for subjective well-being, when left-behind youth perceived the lowest levels of parental warmth and teacher warmth congruently. These findings indicate that left-behind youth may not be psychologically disadvantaged in terms of positive psychosocial outcomes, such as subjective well-being, and school activities or social initiatives emphasizing openness to experience would be essential for them to facilitate positive adaptive patterns after parental migration.
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Ma J, Mahat P, Brøndbo PH, Handegård BH, Kvernmo S, Javo AC. Family correlates of emotional and behavioral problems in Nepali school children. PLoS One 2022; 17:e0262690. [PMID: 35041701 PMCID: PMC8765638 DOI: 10.1371/journal.pone.0262690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 01/02/2022] [Indexed: 11/22/2022] Open
Abstract
Background There is a substantial gap in our knowledge about family correlates of child emotional and behavioral problems in low- and middle-income countries (LMIC). The present study contributes to filling this gap by examining such correlates in a larger population study in Nepal. Methods Our study is a cross-sectional, observational study among 3840 Nepali children aged 6–18 years from 64 schools and 16 districts in the three main geographical regions in the country. We used the Nepali version of the Child Behavior Checklist (CBCL)/6-18 to assess children’s internalizing and externalizing problems and an additional background information questionnaire to assess possible family correlates which included parental education, family structure, migrant worker parents, parental mental and physical illness, family conflicts, and child-rearing. The associations between family variables and child internalizing and externalizing problems were analyzed using bivariate correlations and multiple regression. Results Using bivariate analysis, we found that mental and physical illness in parents, conflict in the family, parental disagreement in child-rearing, and physical punishment of child correlated positively with both Internalizing Problems and Externalizing Problems. The same associations were found by using multiple regression analysis. In addition, parental education, family structure, and migrant worker mothers were associated with Externalizing Problems. However, the effect sizes were small. Conclusion The results suggest that in Nepal, child mental problems were associated with several family risk factors. Further, the study points to the need of strengthening prevention- and intervention measures to minimize family risk factors of child mental health disorders.
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Affiliation(s)
- Jasmine Ma
- Regional Centre for Child and Youth Mental Health and Child Welfare -North, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Child & Adolescent Psychiatry Clinic, Kanti Children’s Hospital, Kathmandu, Nepal
- * E-mail:
| | | | - Per Håkan Brøndbo
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bjørn H. Handegård
- Regional Centre for Child and Youth Mental Health and Child Welfare -North, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Siv Kvernmo
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Anne Cecilie Javo
- Regional Centre for Child and Youth Mental Health and Child Welfare -North, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Sami National Competence Center for Mental Health, Sami Klinihkka, Finnmark Hospital Trust, Karasjok, Norway
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Jayatissa R, Wickramage K, Denuwara BH, Herath H, Jayawardana R, Perera AG, De Alwis N. When husband migrate: effects of international migration of husbands on fetal outcomes, body mass index and gestational weight of female spouses that stay behind. BMC Public Health 2022; 22:211. [PMID: 35105324 PMCID: PMC8805333 DOI: 10.1186/s12889-022-12615-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 01/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND International labour migration continues to be an integral component in Sri Lanka's economic development. Previous research indicates an adverse perinatal outcome in association with low maternal pre-pregnancy body mass index (PBMI) and gestational weight gain (GWG). However, evidence of this association is limited in migrant families. This study aims to investigate the associations between PBMI, GWG among lactating mothers (LM), and fetal outcomes in migrant households, where the father is the migrant worker. METHODS A secondary data analysis was done using a nationally representative sample of 7,199 LM. There were 284 LM whose husbands were international migrant workers. Maternal factors were taken as PBMI<18.5 kg/m2 and GWG<7kg. Preterm birth and low birth weight (LBW) were taken as fetal outcomes. Binary logistic regression was performed to assess the associated factors. RESULTS There was significant difference between LM from migrant and non-migrant households with regards to place of residency, ethnicity, household monthly income, household food security, average household members, husband's education and husband's age. Among migrant, PBMI<18.5 kg/m2 was associated with current BMI and mode of delivery. Migrant LM had significantly higher weight gain (≥12 kg) during pregnancy (p=0.005), were multiparous (p=0.008), delivered in private hospital (p=0.000), lesser percentage of underweight (p=0.002) and higher birthweight (p=0.03) than non-migrant LM. Logistic regression model revealed that for each kilogram increment in birthweight and GWG, preterm delivery decreased by 89%(OR=0.11;95%CI:0.04-0.28) and LBW decreased by 12%(OR=0.89;95%CI:0.81-0.97) respectively. Caesarean deliveries were positively associated with low GWG. CONCLUSION Our study showed LM in migrant families had invested remittances to utilize private health facilities for deliveries, to improve weight gain during pregnancy and adequate PBMI to deliver higher birth weight babies. In depth study is needed to understand further utilisation of remittances to improve fetal outcomes by increasing birthweight and GWG in migrant families.
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Affiliation(s)
- Renuka Jayatissa
- Department of Nutrition, Medical Research Institute, P.O. Box 527, Dr. Danister De Silva Mawatha, Colombo 08, 0080, Sri Lanka.
| | - Kolitha Wickramage
- Global Migration Health Research and Epidemiology Unit, Migration Health Division, Paseo De Roxas Makati City, 1226, Manila, Philippines
| | - Buddhini Herath Denuwara
- Department of Nutrition, Medical Research Institute, P.O. Box 527, Dr. Danister De Silva Mawatha, Colombo 08, 0080, Sri Lanka
| | - Himali Herath
- Department of Nutrition, Medical Research Institute, P.O. Box 527, Dr. Danister De Silva Mawatha, Colombo 08, 0080, Sri Lanka
| | - Ranbanda Jayawardana
- Department of Nutrition, Medical Research Institute, P.O. Box 527, Dr. Danister De Silva Mawatha, Colombo 08, 0080, Sri Lanka
| | - Amila Gayan Perera
- Department of Nutrition, Medical Research Institute, P.O. Box 527, Dr. Danister De Silva Mawatha, Colombo 08, 0080, Sri Lanka
| | - Nawamali De Alwis
- Department of Nutrition, Medical Research Institute, P.O. Box 527, Dr. Danister De Silva Mawatha, Colombo 08, 0080, Sri Lanka
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Christodoulou J, Jane Rotheram-Borus M, Hayati Rezvan P, Weiss RE, Tomlinson M. Association of Early Migration with Child Growth, Cognition and Behavior in South Africa. Trop Med Int Health 2022; 27:218-225. [PMID: 34997984 DOI: 10.1111/tmi.13719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Examine the association of migration with child growth, cognition, and behavior in South Africa. METHODS Secondary analysis assessing effects of migration on child outcomes among a population cohort of women and children (n=1,238) recruited in Cape Town, South African townships and repeatedly assessed from birth to age eight. Logistic regression models analyzed sociodemographic predictors of migration and longitudinal models assessed the association of child migration, with or without their mother, on child growth, cognition, and behavioral outcomes. RESULTS By 8 years post-birth, 41% of children born in the townships in Cape Town had migrated to the rural Eastern Cape. Staying in Cape Town, or not migrating, was associated with having an older mother. Children who migrated with their mother were shorter and weighed less than those who did not migrate. Children who migrated had larger vocabularies and those who migrated with their mothers had fewer behavioral problems than children who stayed in Cape Town. CONCLUSION Migration in South Africa between peri-urban Cape Town and rural Eastern Cape areas during a child's early years is common and is associated with both positive and negative child outcomes.
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Affiliation(s)
- Joan Christodoulou
- Department of Psychology, Palo Alto University, Palo Alto, California, USA
| | - Mary Jane Rotheram-Borus
- Department of Psychiatry & Biobehavioral Sciences, Semel Institute, University of California, Los Angeles, USA
| | - Panteha Hayati Rezvan
- Department of Psychiatry & Biobehavioral Sciences, Semel Institute, University of California, Los Angeles, USA
| | - Robert E Weiss
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, USA
| | - Mark Tomlinson
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa.,School of Nursing and Midwifery, Queens University, Belfast, UK
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15
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West HS, Robbins ME, Moucheraud C, Razzaque A, Kuhn R. Effects of spousal migration on access to healthcare for women left behind: A cross-sectional follow-up study. PLoS One 2021; 16:e0260219. [PMID: 34855799 PMCID: PMC8638922 DOI: 10.1371/journal.pone.0260219] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 11/04/2021] [Indexed: 01/29/2023] Open
Abstract
Background Women left behind by migration represent a unique and growing population yet remain understudied as key players in the context of migration and development. Using a unique longitudinal survey of life in Bangladesh, the Matlab Health and Socioeconomic Surveys, we examined the role of spousal migration in healthcare utilization for women. The objective of this study was to assess realized access to care (do women actually get healthcare when it is needed) and consider specific macrostructural, predisposing, and resource barriers to care that are related to migration. Methods and findings In a sample of 3,187 currently married women, we estimated multivariate logistic and multinomial regression models controlling for a wide range of baseline sociodemographic factors measured as far back as 1982. Our analyses also controlled for selection effects and explored two mechanisms through which spousal migration can affect healthcare utilization for women, remittances and frequent contact with spouses. We found that women with migrant spouses were approximately half as likely to lack needed healthcare compared to women whose spouses remained in Bangladesh (predicted probability of not getting needed healthcare 11.7% vs. 21.8%, p<0.001). The improvements in access (logistic regression coefficient for lacking care for left-behind women -0.761 p<0.01) primarily occurred through a reduction in financial barriers to care for women whose spouses were abroad. Conclusions Wives of international migrants showed significantly better access to healthcare even when accounting for selection into a migrant family. While the overall story is one of positive migration effects on healthcare access due to reductions in financial barriers to care, results also showed an increase in family-related barriers such as not being permitted to get care by a family member or travel alone to a facility, indicating that some of the benefits of migration for women left behind may be diluted by gendered family structures.
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Affiliation(s)
- Heidi S. West
- Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, United States of America
- * E-mail:
| | - Mary E. Robbins
- Department of Gender Studies, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Corrina Moucheraud
- Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Abdur Razzaque
- Health and Population Surveillance Division, ICDDR, B, Dhaka, Bangladesh
| | - Randall Kuhn
- Department of Community Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, United States of America
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Sparling TM, Cheng B, Deeney M, Santoso MV, Pfeiffer E, Emerson JA, Amadi FM, Mitu K, Corvalan C, Verdeli H, Araya R, Kadiyala S. Global Mental Health and Nutrition: Moving Toward a Convergent Research Agenda. Front Public Health 2021; 9:722290. [PMID: 34722437 PMCID: PMC8548935 DOI: 10.3389/fpubh.2021.722290] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/09/2021] [Indexed: 01/05/2023] Open
Abstract
Both malnutrition and poor mental health are leading sources of global mortality, disease, and disability. The fields of global food security and nutrition (FSN) and mental health have historically been seen as separate fields of research. Each have undergone substantial transformation, especially from clinical, primary care orientations to wider, sociopolitical approaches to achieve Sustainable Development Goals. In recent years, the trajectories of research on mental health and FSN are further evolving into an intersection of evidence. FSN impacts mental health through various pathways such as food insecurity and nutrients important for neurotransmission. Mental health drives FSN outcomes, for example through loss of motivation and caregiving capacities. They are also linked through a complex and interrelated set of determinants. However, the heterogeneity of the evidence base limits inferences about these important dynamics. Furthermore, interdisciplinary projects and programmes are gaining ground in methodology and impact, but further guidance in integration is much needed. An evidence-driven conceptual framework should inform hypothesis testing and programme implementation. The intersection of mental health and FSN can be an opportunity to invest holistically in advancing thinking in both fields.
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Affiliation(s)
- Thalia M Sparling
- Innovative Methods and Metrics for Agriculture, Nutrition and Health Actions (IMMANA), London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Bryan Cheng
- Global Mental Health Lab, Teachers College, Columbia University, New York, NY, United States
| | - Megan Deeney
- Innovative Methods and Metrics for Agriculture, Nutrition and Health Actions (IMMANA), London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Marianne V Santoso
- Department of Anthropology, Northwestern University, Evanston, IL, United States
| | - Erin Pfeiffer
- Independent Consultant, Winston-Salem, NC, United States
| | | | | | - Khadija Mitu
- Department of Anthropology, University of Chittagong, Chittagong, Bangladesh
| | - Camila Corvalan
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Helen Verdeli
- Global Mental Health Lab, Teachers College, Columbia University, New York, NY, United States
| | - Ricardo Araya
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Suneetha Kadiyala
- Innovative Methods and Metrics for Agriculture, Nutrition and Health Actions (IMMANA), London School of Hygiene and Tropical Medicine, London, United Kingdom
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Hou T, Xie Y, Mao X, Liu Y, Zhang J, Wen J, Chen Y, Luo Z, Cai W. The Mediating Role of Loneliness Between Social Support and Depressive Symptoms Among Chinese Rural Adolescents During COVID-19 Outbreak: A Comparative Study Between Left-Behind and Non-left-behind Students. Front Psychiatry 2021; 12:740094. [PMID: 34497549 PMCID: PMC8420998 DOI: 10.3389/fpsyt.2021.740094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 08/02/2021] [Indexed: 02/01/2023] Open
Abstract
Introduction: The COVID-19 pandemic has greatly impacted people's life across the globe. In a public health crisis, rural adolescents are more prone to mental health problems. The current study aimed to investigate the prevalence of depressive symptoms among Chinese rural adolescents during the COVID-19 outbreak, and examine the association between perceived social support and depressive symptoms and its underlying mechanisms. Method: Perceived Social Support Scale, UCLA Loneliness Scale, Patient Health Questionnaire-9 were administrated to 826 rural adolescents from Anhui Province, China, amid the COVID-19 crisis. Mackinnon's four-step procedure was employed to examine the mediating effect, while Hayes PROCESS macro was utilized to test the moderated mediation model. Results: The results showed the rate of depressive symptoms among rural adolescents in China was 77.6% during the outbreak of COVID-19. Female left-behind students and non-left-behind students from disrupted families experienced more depressive symptoms (all P < 0.05). Loneliness mediated the association between perceive social support and depressive symptoms and the indirect effect was stronger in left-behind adolescents in comparison to non-left-behind adolescents during the COVID-19 pandemic. Conclusion: Depressive symptoms are extremely prevalent among Chinese rural adolescents during the COVID-19 outbreak, and perceived social support plays a protective role against depressive symptoms. Chinese rural adolescents, especially left-behind students, could benefit from the interventions aimed at enhancing the perceived social support and reducing loneliness during the COVID-19 pandemic.
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Affiliation(s)
- Tianya Hou
- Faculty of Psychology, Second Military Medical University, Shanghai, China
| | - Yawei Xie
- Faculty of Psychology, Second Military Medical University, Shanghai, China
| | - Xiaofei Mao
- Faculty of Psychology, Second Military Medical University, Shanghai, China
| | - Ying Liu
- Faculty of Psychology, Second Military Medical University, Shanghai, China
| | - Jianguo Zhang
- Faculty of Psychology, Second Military Medical University, Shanghai, China
| | - Jing Wen
- Faculty of Psychology, Second Military Medical University, Shanghai, China
| | - Yan Chen
- Faculty of Psychology, Second Military Medical University, Shanghai, China
| | - Zhechao Luo
- College of Basic Medical Sciences, Second Military Medical University, Shanghai, China
| | - Wenpeng Cai
- Faculty of Psychology, Second Military Medical University, Shanghai, China
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Tang XY, Cheng M, Geater A, Deng QY, Zhong G, Lin YD, Chen N, Lan T, Jiang LY, Zhu MT, Li Q. Multi-level determinants of failure to receive timely and complete measles vaccinations in Southwest China: a mixed methods study. Infect Dis Poverty 2021; 10:102. [PMID: 34294157 PMCID: PMC8296749 DOI: 10.1186/s40249-021-00885-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 07/12/2021] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Measles outbreaks re-emerged in 2013-2014 in Guangxi Zhuang Autonomous Region of China, where measles immunisation coverage is high. The discrepancy between the vaccination coverage and outbreaks indicates that timeliness is crucial, yet there is limited knowledge on the health system barriers to timely vaccination. Using integrated evidence at the household, village clinic, and township hospital levels, this study aimed to identify the determinants of failure in receiving timely measles vaccinations among children in rural Guangxi. METHODS A multi-stage stratified cluster sampling survey with a nested qualitative study was conducted among children aged 18-54 months in Longan, Zhaoping, Wuxuan, and Longlin counties of Guangxi from June to August 2015. The status of timely vaccinations for the first dose of measles-containing vaccine (MCV1) and the second dose of measles-containing vaccine (MCV2) was verified via vaccination certificates. Data on household-level factors were collected using structured questionnaires, whereas data on village and township-level factors were obtained through in-depth interviews and focus group discussions. Determinants of untimely measles vaccinations were identified using multilevel logistic regression models. RESULTS A total of 1216 target children at the household level, 120 villages, and 20 township hospitals were sampled. Children were more likely to have untimely vaccination when their primary guardian had poor vaccination knowledge [MCV1, odds ratio (OR) = 1.72; MCV2, OR = 1.51], had weak confidence in vaccines (MCV1, OR = 1.28-4.58; MCV2, OR = 1.42-3.12), had few practices towards vaccination (MCV1, OR = 12.5; MCV2, OR = 3.70), or had low satisfaction with vaccination service (MCV1, OR = 2.04; MCV2, OR = 2.08). This trend was also observed in children whose village doctor was not involved in routine vaccination service (MCV1, OR = 1.85; MCV2, OR = 2.11) or whose township hospital did not provide vaccination notices (MCV1, OR = 1.64; MCV2, OR = 2.05), vaccination appointment services (MCV1, OR = 2.96; MCV2, OR = 2.74), sufficient and uniformly distributed sessions for routine vaccination (MCV1, OR = 1.28; MCV2, OR = 1.17; MCV1, OR = 2.08), or vaccination service on local market days (MCV1, OR = 2.48). CONCLUSIONS Guardians with poor knowledge, weak beliefs, and little practice towards vaccination; non-involvement of village doctors in routine vaccinations; and inconvenient vaccination services in township hospitals may affect timely measles vaccinations among children in rural China.
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Affiliation(s)
- Xian-Yan Tang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, China. No. 22nd, Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China.
| | - Man Cheng
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, China. No. 22nd, Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China
| | - Alan Geater
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
| | - Qiu-Yun Deng
- Institute of Vaccination, Guangxi Centre for Disease Control and Prevention, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Ge Zhong
- Institute of Vaccination, Guangxi Centre for Disease Control and Prevention, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Yue-Dong Lin
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, China. No. 22nd, Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China
| | - Ning Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, China. No. 22nd, Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China
| | - Tao Lan
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, China. No. 22nd, Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China
| | - Long-Yan Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, China. No. 22nd, Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China
| | - Man-Tong Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, China. No. 22nd, Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China
| | - Qiao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Guangxi Medical University, China. No. 22nd, Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530021, People's Republic of China.
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Left-Behind Children, Parent-Child Communication and Psychological Resilience: A Structural Equation Modeling Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105123. [PMID: 34066012 PMCID: PMC8150701 DOI: 10.3390/ijerph18105123] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/08/2021] [Accepted: 05/09/2021] [Indexed: 11/21/2022]
Abstract
This study aims to examine the role of parental migration status and parent communication in the psychological and related behavioral status of left-behind children and their psychological resilience. A cross-sectional survey was conducted in Anhui Province of China, and a questionnaire survey was conducted with 1992 teens using the Chinese version of the Parent-Adolescent Communication Scale (PACS), Connor-Davidson Resilience Scale (CD-RISC), and Strength and Difficulties Questionnaires (SDQ). Compared with the never left-behind group, left behind children had relatively lower PACS, CD-RISC and SDQ scores. Absence of parents is related with poorer psychological resilience, while good parent communication is related with better psychological resilience. Better psychological resilience is related to fewer psychological problems regardless of parental migration status. Currently left-behind status demonstrated a negative influence on psychological resilience, while never left-behind status had a positive effect. Interventions are needed to enhance psychological resilience of left-behind children to prevent psychological and related behavioral problems.
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20
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Juan J, Weijun L, Guifeng H, Xiaojing G, Zhaoxia C, Li S. Prevalence of unintentional injury among left-behind children in mainland China: Evidence from epidemiological surveys. Child Care Health Dev 2021; 47:387-399. [PMID: 33274506 DOI: 10.1111/cch.12835] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 11/11/2020] [Accepted: 11/26/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Left-behind children have become a particular concern in mainland China, and unintentional injury among these children has attracted increasing attention. This review aims to present the prevalence of unintentional injury among left-behind children and subgroups in mainland China. METHODS A systematic literature search was conducted using four Chinese and two English databases. The included publications were cross-sectional studies in mainland China, of which the population was recruited according to inclusion and exclusion criteria. Information was collected using self-administered questionnaires. The risk of bias was estimated using the Strengthening the Reporting of Observational Studies in Epidemiology, and pooled prevalence was estimated through the DerSimonian-Laird proportion method. RESULTS This review included 34 cross-sectional studies consisting 58,348 left-behind children in mainland China. Results showed that the pooled prevalence of unintentional injury was 38.24% (95% confidence interval (CI): 28.40-48.08) among left-behind children. The prevalence was higher among left-behind children (38.76%) than among non-left-behind children (27.94%), with an odds ratio of 1.65 (95% CI: 1.47-1.85). Furthermore, the prevalence of injury was higher among boys (39.12%) than among girls (28.61%), with an odds ratio of 1.58 (95% CI: 1.41-1.77). Falls had the highest prevalence of 20.79% among the types of unintentional injury. Furthermore, home was the occurrence location with the highest prevalence (16.20%). No significant difference in injury prevalence was observed among left-behind children without accompanying parents and those with single parent accompanying them. CONCLUSIONS This review showed a relatively high injury prevalence among left-behind children in mainland China. Boys had a higher prevalence than girls. Falls had the highest prevalence, and home was the most common occurrence location.
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Affiliation(s)
- Jiang Juan
- Hainan Center for Disease Control and Prevention, Institute for Prevention and Control of Tropical Diseases and Chronic Non-infectious Diseases, Haikou, Hainan, China
| | - Ling Weijun
- School of Public Health, Nanning, Guangxi, China
| | | | - Guo Xiaojing
- School of Public Health, Nanning, Guangxi, China
| | - Chen Zhaoxia
- School of Public Health, Nanning, Guangxi, China
| | - Su Li
- School of Public Health, Nanning, Guangxi, China
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Wu H, Cai Z, Yan Q, Yu Y, Yu NN. The Impact of Childhood Left-Behind Experience on the Mental Health of Late Adolescents: Evidence from Chinese College Freshmen. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052778. [PMID: 33803365 PMCID: PMC7967284 DOI: 10.3390/ijerph18052778] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/27/2021] [Accepted: 03/05/2021] [Indexed: 01/22/2023]
Abstract
A paucity of public service afforded to migrant workers often begets a wide range of social problems. In China, hundreds of millions of migrant worker parents have to leave children behind in their hometowns. This paper investigated the long-term effects of the childhood experience of being left behind on the mental well-being of late adolescents. Mandatory university personality inventory (UPI) surveys (involving psychosomatic problems such as anxiety, depression, and stress) were conducted at a university in Jiangsu, China, during 2014–2017. The study sample consisted of 15,804 first-year college students aged between 15 and 28 years. The PSM method and the OLS regression model were employed. Controlling for the confounding factors (gender, age, single-child status, hometown location, ethnicity, and economic status), our empirical investigation demonstrated that childhood left-behind experience significantly worsened the mental health of the study sample, increasing the measure of mental ill-being by 0.661 standard deviations (p < 0.01). Moreover, the effects were consistently significant in subsamples divided by gender, single-child status, and hometown location; and the effects were greater for females, single-child students, and urban residents.
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Affiliation(s)
- Huajun Wu
- School of Economics, Nanjing Audit University, Nanjing 211815, China; (H.W.); (Y.Y.)
| | - Zhiyong Cai
- School of Psychology, Nanjing Normal University, Nanjing 210023, China;
- Commission of Student Affairs, Nanjing Audit University, Nanjing 211815, China
| | - Qing Yan
- Wuxi Development and Reform Research Center, Wuxi 214000, China;
| | - Yi Yu
- School of Economics, Nanjing Audit University, Nanjing 211815, China; (H.W.); (Y.Y.)
| | - Ning Neil Yu
- Institute for Social and Economic Research, Nanjing Audit University, Nanjing 211815, China
- Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA 94305, USA
- Correspondence:
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Knipe D, Moran P, Howe LD, Bandara P, Wickramage K, Gunnell D, Rajapakse T. Is being a 'left-behind' child associated with an increased risk of self-poisoning in adulthood? Findings from a case-control study in Sri Lanka. BMJ Glob Health 2021; 6:bmjgh-2020-003734. [PMID: 33648980 PMCID: PMC7925243 DOI: 10.1136/bmjgh-2020-003734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 01/11/2021] [Accepted: 01/14/2021] [Indexed: 12/25/2022] Open
Abstract
PURPOSE The long-term consequences of parental emigration on offspring self-harm risk is unknown. METHODS We investigated the association between experiencing parental emigration in childhood with hospital presentations for self-poisoning in adulthood using a hospital case-control study. Cases were adult self-poisoning patients (≥18 year olds) admitted to the medical toxicology ward Teaching Hospital Peradeniya, Sri Lanka. Sex and age frequency matched controls were recruited from the outpatient department or nearby specialist clinics at the same hospital. Details of parental emigration were collected using a pre-piloted questionnaire. The relationship between parental emigration and self-poisoning in adulthood was estimated using logistic regression models. RESULTS 298 cases, and 500 hospital controls were interviewed for the study. We estimate that one in five adults experienced parental emmigration as children (95% CI 17% to 24%). We find limited evidence that children from households with emigrating parents were more likely to experience adverse childhood experiences than those with non-emigrating parents. We found no statistical evidence of an increased risk of self-poisoning in adulthood in individuals who experienced parental emigration (maternal or paternal) during childhood. There was no statistical evidence that the impact differed by the sex of the participant. CONCLUSION Adults who experienced parental emigration as children were no more likely to self-poison than adults with non-emigrating parents. Further research using longitudinal data are needed to understand whether any adverse outcomes observed in 'left-behind' children are a consequence of parental emigration or due to factors associated but predate the emigration. Prospective data are also important to investigate whether there are any lasting effects on children who experience parental emigration.
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Affiliation(s)
- Duleeka Knipe
- Population Health Sciences, University of Bristol, Bristol, UK,South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Paul Moran
- Population Health Sciences, University of Bristol, Bristol, UK,Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Laura D Howe
- Population Health Sciences, University of Bristol, Bristol, UK,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, Bristol, UK
| | - Piumee Bandara
- Translational Health Research Institute, Western Sydney University, Penrith South, New South Wales, Australia
| | | | - David Gunnell
- Population Health Sciences, University of Bristol, Bristol, UK,National Institute of Health Research Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Thilini Rajapakse
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka,Department of Psychiatry, Facultly of Medicine, University of Peradeniya, Peradeniya, Central, Sri Lanka
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Račaitė J, Lindert J, Antia K, Winkler V, Sketerskienė R, Jakubauskienė M, Wulkau L, Šurkienė G. Parent Emigration, Physical Health and Related Risk and Preventive Factors of Children Left Behind: A Systematic Review of Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031167. [PMID: 33561093 PMCID: PMC7908227 DOI: 10.3390/ijerph18031167] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 01/20/2021] [Accepted: 01/22/2021] [Indexed: 11/16/2022]
Abstract
The aim of our study was to systematically review the literature on physical health and related consequences of internal and international parental migration on left-behind children (LBC). This review followed PRISMA guidelines. We searched the PubMed, Web of Science, Academic Search Complete, PsycINFO, and Cochrane databases and included studies reporting physical health-related outcomes of children affected by parental migration. The quality of the studies was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. We selected 34 publications from a total of 6061 search results. The study found that LBC suffer from poor physical health as compared with non-LBC. Physical health-related risk factors such as underweight, lower weight, stunted growth, unhealthy food preferences, lower physical activity, smoking, alcohol consumption, injuries, and incomplete vaccination tend to be more prevalent among LBC in China. Studies focussing on international migration argue that having migrant parents might be preventive for undernutrition. Overall, our study showed that children affected by internal or international migration tend to have similar physical health outcomes. Moreover, we identified a lack of evidence on international parental migration that may have influenced the overall impacts. Further studies addressing international migration would contribute to better understand the impacts of migration for LBC.
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Affiliation(s)
- Justina Račaitė
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, M.K. Čiurlionio Str. 21, LT-03101 Vilnius, Lithuania; (R.S.); (M.J.); (G.Š.)
- Correspondence: ; Tel.: +370-63158873
| | - Jutta Lindert
- Department of Social Work and Health, University of Applied Sciences Emden/Leer, Constantiaplatz 4, 26723 Emden, Germany; (J.L.); (L.W.)
- WRSC, Brandeis University, Epstein Building, MS 079, 515 South Street, Waltham, MA 02453, USA
| | - Khatia Antia
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130/3, 69120 Heidelberg, Germany; (K.A.); (V.W.)
| | - Volker Winkler
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130/3, 69120 Heidelberg, Germany; (K.A.); (V.W.)
| | - Rita Sketerskienė
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, M.K. Čiurlionio Str. 21, LT-03101 Vilnius, Lithuania; (R.S.); (M.J.); (G.Š.)
| | - Marija Jakubauskienė
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, M.K. Čiurlionio Str. 21, LT-03101 Vilnius, Lithuania; (R.S.); (M.J.); (G.Š.)
| | - Linda Wulkau
- Department of Social Work and Health, University of Applied Sciences Emden/Leer, Constantiaplatz 4, 26723 Emden, Germany; (J.L.); (L.W.)
- Institute for Epidemiology, Social Medicine and Health Systems Research, Hannover Medical School, Carl-Neuberg-Straße 1, 30625 Hannover, Germany
| | - Genė Šurkienė
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, M.K. Čiurlionio Str. 21, LT-03101 Vilnius, Lithuania; (R.S.); (M.J.); (G.Š.)
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Kunwar R, Lamichhane P, Vajdic C, Muscatello DJ. Effect of overseas parental employment migration on healthcare seeking for common childhood illnesses and nutritional status among left-behind young children: A systematic review. J Child Health Care 2020; 24:351-364. [PMID: 30041542 DOI: 10.1177/1367493518787326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We aimed to examine the available evidence on the impact of overseas parental migration on healthcare seeking for common childhood illnesses and the nutritional status of children left-behind under five years of age. A systematic review of English language articles was conducted on PubMed, MEDLINE and EMBASE, supplemented by a manual search of grey literature and reference lists. There were no studies examining the association between overseas parental migration and healthcare seeking for common childhood illnesses. We found three cross-sectional surveys examining the association with an indicator of nutritional status. We observed mixed findings from the available studies. The results indicated that children left-behind may have positive, negative or null effects on their nutritional status. There was insufficient information available to draw conclusions on the magnitude and direction of the association between overseas parental migration and its effect on either healthcare seeking for common childhood illnesses or the nutritional status of left-behind children. The association, if any, may be context or country dependent. Prospective studies are needed to address this important knowledge gap.
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Affiliation(s)
- Ritu Kunwar
- School of Public Health and Community Medicine, University of New South Wales (UNSW), Sydney, New South Wales, Australia
| | - Prabhat Lamichhane
- School of Medicine, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Claire Vajdic
- Centre for Big Data Research in Health, University of New South Wales (UNSW), Sydney, Australia
| | - David J Muscatello
- School of Public Health and Community Medicine, University of New South Wales (UNSW), Sydney, New South Wales, Australia
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Khan F, Eskander N, Limbana T, Salman Z, Siddiqui PA, Hussaini S. Refugee and Migrant Children’s Mental Healthcare: Serving the Voiceless, Invisible, and the Vulnerable Global Citizens. Cureus 2020; 12:e9944. [PMID: 32968603 PMCID: PMC7505673 DOI: 10.7759/cureus.9944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Millions of children are on the run worldwide, with many unaccompanied children and adolescents undertaking risky journeys to flee war, adverse circumstances, and political persecution. The grueling journey and multiple stressors faced by the refugee children, both accompanied and unaccompanied during the pre-migration, migration, and in the country of destination, increase their risk for psychiatric disorders and other medical conditions. Unaccompanied refugee migrant children have higher prevalence of mental health disorders than accompanied refugee peers. Long after reaching the host country, the refugee, migrant, and asylum-seeking juveniles continue to face adversities in the form of acculturation. In assessing medical fitness and healthcare mediations for refugees and migrant children, special consideration should be given to certain areas such as their distinct history, whether they are with their family or separated or unaccompanied, and whether they have been peddled or have been left behind.
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Antia K, Boucsein J, Deckert A, Dambach P, Račaitė J, Šurkienė G, Jaenisch T, Horstick O, Winkler V. Effects of International Labour Migration on the Mental Health and Well-Being of Left-Behind Children: A Systematic Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124335. [PMID: 32560443 PMCID: PMC7345580 DOI: 10.3390/ijerph17124335] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/04/2020] [Accepted: 06/15/2020] [Indexed: 01/23/2023]
Abstract
Labour migration is a challenge for the globalised world due to its long-term effects such as the formation of transnational families. These families, where family members of migrant workers are “left-behind”, are becoming a common phenomenon in many low- and middle-income countries. Our systematic literature review investigated the effects of international parental labour migration on the mental health and well-being of left-behind children. Following the PRISMA guidelines, we performed searches in PubMed, PsychINFO, Web of Science, Cochrane Library and Google Scholar, resulting in 30 finally included studies. We found that mental health and well-being outcomes of left-behind children differed across and sometimes even within regions. However, only studies conducted in the Americas and South Asia observed purely negative effects. Overall, left-behind children show abnormal Strengths and Difficulties Questionnaire scores and report higher levels of depression and loneliness than children who do not live in transnational families. Evidence from the studies suggests that gender of the migrant parent, culture and other transnational family characteristics contribute to the well-being and mental health of left-behind children. Further research utilising longitudinal data is needed to better understand the complex and lasting effects on left-behind children.
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Affiliation(s)
- Khatia Antia
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (J.B.); (A.D.); (P.D.); (T.J.); (O.H.); (V.W.)
- Correspondence: ; Tel.: +49-15227857798
| | - Johannes Boucsein
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (J.B.); (A.D.); (P.D.); (T.J.); (O.H.); (V.W.)
| | - Andreas Deckert
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (J.B.); (A.D.); (P.D.); (T.J.); (O.H.); (V.W.)
| | - Peter Dambach
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (J.B.); (A.D.); (P.D.); (T.J.); (O.H.); (V.W.)
| | - Justina Račaitė
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, M. K. Čiurlionio str. 21, LT-03101 Vilnius, Lithuania; (J.R.); (G.Š.)
| | - Genė Šurkienė
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, M. K. Čiurlionio str. 21, LT-03101 Vilnius, Lithuania; (J.R.); (G.Š.)
| | - Thomas Jaenisch
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (J.B.); (A.D.); (P.D.); (T.J.); (O.H.); (V.W.)
| | - Olaf Horstick
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (J.B.); (A.D.); (P.D.); (T.J.); (O.H.); (V.W.)
| | - Volker Winkler
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; (J.B.); (A.D.); (P.D.); (T.J.); (O.H.); (V.W.)
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Zhang L, Yang F. Food insecurity and school performance among the left-behind children in rural China: Depression and educational expectation as mediators. SCHOOL PSYCHOLOGY INTERNATIONAL 2019. [DOI: 10.1177/0143034319869048] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present study aims to explore the associations between food insecurity and school performance, and the serial mediation of depression and educational expectation on the focal association, among Chinese rural left-behind children. This study conducted a cross-sectional survey on 2128 students (Grades 5–9, mean age = 13.21 years) who reported one or both parents had migrated into the urban sector. They responded to questions on school performance, educational expectation, The Food Insecurity Experience Scale, and The Birleson Depression Self-Rating Scale. Serial mediation modelling was used to test the mediating role of depression and educational expectation. It is found that food insecurity was significantly associated with school performance. Moreover, depression and educational expectation functioned as serial mediators and were fully mediating the association between food insecurity and school performance. The findings as with the severity of childhood food insecurity in rural China as well as its association with the negative consequences in children's education provide empirical support for contentions that food insecurity problem should be taken into account in designing and implementing school-based intervention programs for left-behind children. Moreover, schools shall pay special attention to the mental health risks of food insecurity among rural left-behind children.
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Affiliation(s)
- Lufa Zhang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
| | - Fan Yang
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
- China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai, China
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28
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Romano D, Traverso S. The Heterogeneous Impact of International Migration on Left‐behind Households: Evidence from Bangladesh. INTERNATIONAL MIGRATION 2019. [DOI: 10.1111/imig.12620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mordeno IG, Gallemit IMJS, Lantud SSB, Hall BJ. Personal psychological resources mediate parent-child relationship and mental health among left-behind children. Psych J 2019; 8:318-329. [PMID: 31070013 DOI: 10.1002/pchj.288] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 02/03/2019] [Accepted: 03/24/2019] [Indexed: 11/12/2022]
Abstract
Discrepant findings on the impact of parental migration on left-behind children's (LBC) psychological health have been noted in the literature. While several studies have shown the negative effects of parental migration, burgeoning research has demonstrated contradictory findings. The present study aimed to clarify this issue by examining the association between family resources and mental health as mediated by personal psychological resources (PPRs). A sample comprised of 466 LBC (aged 11-17 years) answered a set of questionnaires assessing parent-child relationship, PPRs, and mental health symptoms. The results showed that PPRs, particularly emotional resources, significantly mediated the link between family resources and mental health. This suggests that LBC who have rich family resources (i.e., close parent-child relationship) have lower mental health problems due to higher emotional resources (i.e., satisfaction in life). Conversely, those who reported having poor family resources experienced a lower level of PPRs (i.e., emotional well-being), which in turn, increased their risk of having psychological distress. The "caravanning" of resources from family to personal resources is vital in protecting LBC's mental health.
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Affiliation(s)
- Imelu G Mordeno
- Department of Professional Education, Mindanao State University-Iligan Institute of Technology, Iligan City, Philippines
| | - I Marie Joy S Gallemit
- Department of Psychology, Mindanao State University-Iligan Institute of Technology, Iligan City, Philippines
| | - Sittie Shayuri B Lantud
- Department of Psychology, Mindanao State University-Iligan Institute of Technology, Iligan City, Philippines
| | - Brian J Hall
- Department of Psychology, Faculty of Social Sciences, University of Macau, Avenida da Universidade, Taipa, Macau, China.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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30
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Knipe D, Lambert H, Pearson M, Eddleston M, Jayamanne S, Wickramage K, Hawton K, Konradsen F, Metcalfe C, Gunnell D. Are left-behind families of migrant workers at increased risk of attempted suicide? - a cohort study of 178,000+ individuals in Sri Lanka. BMC Psychiatry 2019; 19:25. [PMID: 30646952 PMCID: PMC6332866 DOI: 10.1186/s12888-018-2000-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 12/26/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There are an estimated 258 million international migrants worldwide. In Asia low-skilled workers often emigrate on a temporary basis (2-3 years) without their families. There is significant concern over the mental health and wellbeing of left-behind families in this region. No previous study has examined whether the risk of suicidal behaviour is elevated in left-behind family members. METHODS Cohort study using baseline data from a large randomised controlled trial in Sri Lanka (n = 178,730 participants; 8% households had a current temporary foreign migrant) and prospective hospital presentations of suicide attempts. Using multilevel Poisson regression models, we compared the risk of attempted suicide in households with left-behind and non-left-behind family members. We also investigated whether the sex of the migrant or the age/sex of the household member left behind altered any associations. RESULTS The risk of an attempted suicide was elevated in female migrant households (IRR 1.60 95% CI 1.38, 1.85), but not male migrant households (IRR 1.01 95% CI 0.76,1.36)) with strong evidence that risk differed for female vs. male migrant households (p-value = 0.005). We found no evidence that the age or sex of the left-behind household member altered the association observed. CONCLUSIONS This analysis suggests that members of households with a temporary female foreign migrant are at an increased risk of attempted suicide, but these findings must be interpreted with caution. The increased risk of suicidal behaviour in these households may be due to factors that were present before the migration and persist post-migration (e.g. household violence, poverty).
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Affiliation(s)
- Duleeka Knipe
- South Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka. .,Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Helen Lambert
- 0000 0004 1936 7603grid.5337.2Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS UK
| | - Melissa Pearson
- 0000 0000 9816 8637grid.11139.3bSouth Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka ,0000 0004 1936 7988grid.4305.2Pharmacology, Toxicology & Therapeutics, University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Michael Eddleston
- 0000 0000 9816 8637grid.11139.3bSouth Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka ,0000 0004 1936 7988grid.4305.2Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, UK
| | - Shaluka Jayamanne
- 0000 0000 9816 8637grid.11139.3bSouth Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka ,Faculty of Medicine, University of Kelanyia, Kelanyia, Sri Lanka
| | - Kolitha Wickramage
- Migration Health Division, International Organization for Migration, UN Migration Agency, Migration Health Centre, Manila, Philippines
| | - Keith Hawton
- 0000 0004 1936 8948grid.4991.5Centre for Suicide Research, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Flemming Konradsen
- 0000 0000 9816 8637grid.11139.3bSouth Asian Clinical Toxicology Research Collaboration (SACTRC), Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka ,0000 0001 0674 042Xgrid.5254.6Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Chris Metcalfe
- 0000 0004 1936 7603grid.5337.2Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS UK
| | - David Gunnell
- 0000 0004 1936 7603grid.5337.2Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS UK ,0000 0004 0380 7336grid.410421.2National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, England
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Fellmeth G, Rose-Clarke K, Zhao C, Busert LK, Zheng Y, Massazza A, Sonmez H, Eder B, Blewitt A, Lertgrai W, Orcutt M, Ricci K, Mohamed-Ahmed O, Burns R, Knipe D, Hargreaves S, Hesketh T, Opondo C, Devakumar D. Health impacts of parental migration on left-behind children and adolescents: a systematic review and meta-analysis. Lancet 2018; 392:2567-2582. [PMID: 30528471 PMCID: PMC6294734 DOI: 10.1016/s0140-6736(18)32558-3] [Citation(s) in RCA: 221] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 09/14/2018] [Accepted: 10/09/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Globally, a growing number of children and adolescents are left behind when parents migrate. We investigated the effect of parental migration on the health of left behind-children and adolescents in low-income and middle-income countries (LMICs). METHODS For this systematic review and meta-analysis we searched MEDLINE, Embase, CINAHL, the Cochrane Library, Web of Science, PsychINFO, Global Index Medicus, Scopus, and Popline from inception to April 27, 2017, without language restrictions, for observational studies investigating the effects of parental migration on nutrition, mental health, unintentional injuries, infectious disease, substance use, unprotected sex, early pregnancy, and abuse in left-behind children (aged 0-19 years) in LMICs. We excluded studies in which less than 50% of participants were aged 0-19 years, the mean or median age of participants was more than 19 years, fewer than 50% of parents had migrated for more than 6 months, or the mean or median duration of migration was less than 6 months. We screened studies using systematic review software and extracted summary estimates from published reports independently. The main outcomes were risk and prevalence of health outcomes, including nutrition (stunting, wasting, underweight, overweight and obesity, low birthweight, and anaemia), mental health (depressive disorder, anxiety disorder, conduct disorders, self-harm, and suicide), unintentional injuries, substance use, abuse, and infectious disease. We calculated pooled risk ratios (RRs) and standardised mean differences (SMDs) using random-effects models. This study is registered with PROSPERO, number CRD42017064871. FINDINGS Our search identified 10 284 records, of which 111 studies were included for analysis, including a total of 264 967 children (n=106 167 left-behind children and adolescents; n=158 800 children and adolescents of non-migrant parents). 91 studies were done in China and focused on effects of internal labour migration. Compared with children of non-migrants, left-behind children had increased risk of depression and higher depression scores (RR 1·52 [95% CI 1·27-1·82]; SMD 0·16 [0·10-0·21]), anxiety (RR 1·85 [1·36-2·53]; SMD 0·18 [0·11-0·26]), suicidal ideation (RR 1·70 [1·28-2·26]), conduct disorder (SMD 0·16 [0·04-0·28]), substance use (RR 1·24 [1·00-1·52]), wasting (RR 1·13 [1·02-1·24]) and stunting (RR 1·12 [1·00-1·26]). No differences were identified between left-behind children and children of non-migrants for other nutrition outcomes, unintentional injury, abuse, or diarrhoea. No studies reported outcomes for other infectious diseases, self-harm, unprotected sex, or early pregnancy. Study quality varied across the included studies, with 43% of studies at high or unclear risk of bias across five or more domains. INTERPRETATION Parental migration is detrimental to the health of left-behind children and adolescents, with no evidence of any benefit. Policy makers and health-care professionals need to take action to improve the health of these young people. FUNDING Wellcome Trust.
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Affiliation(s)
- Gracia Fellmeth
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK
| | - Kelly Rose-Clarke
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - Chenyue Zhao
- Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Laura K Busert
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Yunting Zheng
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Alessandro Massazza
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Hacer Sonmez
- Faculty of Health Sciences, University of Bristol, Bristol, UK
| | - Ben Eder
- Institute for Global Health, University College London, London, UK
| | - Alice Blewitt
- Institute for Global Health, University College London, London, UK
| | - Wachiraya Lertgrai
- Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Miriam Orcutt
- Institute for Global Health, University College London, London, UK
| | - Katharina Ricci
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Munich, Germany
| | | | - Rachel Burns
- Institute for Global Health, University College London, London, UK
| | - Duleeka Knipe
- Department of Population Science, University of Bristol, Bristol, UK
| | - Sally Hargreaves
- Institute for Infection and Immunity, St George's, University of London, London, UK; International Health Unit, Section of Infectious Diseases and Immunity, Imperial College London, London, UK
| | - Therese Hesketh
- Institute for Global Health, University College London, London, UK; Centre for Global Health, School of Medicine, Zhejiang University, Hangzhou, China
| | - Charles Opondo
- National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK; Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Delan Devakumar
- Institute for Global Health, University College London, London, UK.
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Does parental migration have any impact on nutritional disorders among left-behind children in Bangladesh? Public Health Nutr 2018; 22:95-103. [PMID: 30428953 DOI: 10.1017/s1368980018002963] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Rates of migration have increased substantially in recent years and so has the number of left-behind children (LBC). We investigated the impact of parental migration on nutritional disorders of LBC in Bangladesh. DESIGN We analysed data from the nationally representative cross-sectional Multiple Indicator Cluster Survey 2012-2013. Child stunting, wasting and underweight were used as measures of nutritional disorders. Descriptive statistics were used to describe characteristics of the respondents and to compare nutritional outcomes based on status of parental migration. Multivariate logistic regression models were used to examine the associations between parental migration and child nutritional disorders. SETTING Bangladesh.ParticipantsData of 23 402 children (aged <5 years), their parents and households. RESULTS In the unadjusted models, parental migration was found significantly protective for stunting, wasting and underweight - both separately and jointly. After potential confounders were controlled for, no difference was found between LBC and non-LBC in any of these three nutritional outcome measures. Household wealth status and maternal educational status were found to significantly influence the nutritional development of the children. CONCLUSIONS At the population level there is no negative impact of parental migration on stunting, wasting and underweight of LBC in Bangladesh. Remittance from parental migration might enhance affordability of better foods, health care and supplies for a cleaner environment. This affordability is crucial for the poorest section of the society.
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Tan M, Chen M, Li J, He X, Jiang Z, Tan H, Huang X. Depressive symptoms and associated factors among left-behind children in China: a cross-sectional study. BMC Public Health 2018; 18:1059. [PMID: 30139363 PMCID: PMC6108138 DOI: 10.1186/s12889-018-5963-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 08/14/2018] [Indexed: 11/23/2022] Open
Abstract
Background To investigate the prevalence of depressive symptoms among left-behind children (LBC) in junior and senior secondary schools and examine the significant predictors of depressive symptoms, which might provide practical intervention measures for the schools. Methods By using stratified random sampling, 1076 (LBC) in junior and senior secondary schools were investigated in the study. Depressive symptoms were assessed using the depression self-rating scale (SDS). SDS raw scores 40 or higher were categorised as depressive symptoms. Results The total prevalence of depressive symptoms was 54.74% for LBC in junior and senior secondary schools, with 73.08% for grade 12 students. The multivariate logistic regression analysis showed that grades, family income, parental relationship, parent-child relationship and teacher-student relationship were significantly associated with depressive symptoms. Conclusions Depressive symptoms are acommon health problem among LBC in junior and senior secondary schools, and LBC in grade 12 may be at high risk of depressive symptoms. The parents, teachers and schools should pay more attention to LBC, particularly those in grade 12, and provide prevention and early intervention programs such as individual counsel service to prevent depressive symptoms. Electronic supplementary material The online version of this article (10.1186/s12889-018-5963-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Meijuan Tan
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, 410008, China.,Brains Hospital of Hunan Province, Changsha, 410007, China
| | - Mengshi Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, 410008, China
| | - Jing Li
- Department of Cardiology, the First Hospital of Changsha, Changsha, 410000, China
| | - Xinyun He
- Mental Hospital of Anhua County, Yiyang, 413500, China
| | - Zhiyong Jiang
- Mental Hospital of Anhua County, Yiyang, 413500, China
| | - Hongzhuan Tan
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, 410008, China.
| | - Xin Huang
- Department of preventive medicine, School of medicine, Hunan Normal University, Changsha, 410013, China
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Zhao C, Wang F, Zhou X, Jiang M, Hesketh T. Impact of parental migration on psychosocial well-being of children left behind: a qualitative study in rural China. Int J Equity Health 2018; 17:80. [PMID: 29903019 PMCID: PMC6003177 DOI: 10.1186/s12939-018-0795-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 06/04/2018] [Indexed: 11/10/2022] Open
Abstract
Background Tens of millions of rural “left-behind children (LBC)” in China grow up experiencing prolonged separation from their migrant worker parents. This study aimed to explore how children are affected by parental migration, from the perspectives of children, parents, and grandparents, focusing on the experiences of prolonged parent-child separation and relationship dynamics in the extended family. Methods Qualitative in-depth interviews were conducted in a migrant-sending rural area of eastern China. Participants included 25 children (aged 7 to 14), 17 parents, and 13 grandparents, from 30 families, as well as 24 key informants from the communities. Data analysis followed a grounded theory approach. Results The results showed that despite the original purpose of benefiting children, parental migration resulted in challenges in child psychosocial well-being, due to the emotional impacts from prolonged parent-child separation. Parental absence also led to inadequate care and support for left-behind children. The negative effects of parental migration may be exacerbated by other vulnerabilities such as parents’ divorce, poverty and grandparent caregivers’ frailty. Concerns about child well-being made some migrants decide to return home permanently, because of the altered trade-offs of migration. Conclusion Prolonged separation following migration often disrupts parent-child relationships and results in psychosocial difficulties in LBC, especially among those who live with multiple adversities in the family. Community-based interventions may help migrant parents and co-resident caregivers to better engage children and promote their resilience.
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Affiliation(s)
- Chenyue Zhao
- Institute for Global Health, University College London, 30 Guilford St, London, WC1N 1EH, UK.,Department of Child and Adolescent Psychiatry, New York University School of Medicine, 1 Park Ave, New York, NY, 10016, USA
| | - Feng Wang
- Institute of Social Medicine, Zhejiang University, 866 Yuhangtang Rd, Zhejiang, 310000, Hangzhou, China
| | - Xudong Zhou
- Institute of Social Medicine, Zhejiang University, 866 Yuhangtang Rd, Zhejiang, 310000, Hangzhou, China
| | - Minmin Jiang
- Department of Public Policy and Law, Zhejiang Normal University, 668 Yingbin St, Jinhua, Zhejiang, 321004, China
| | - Therese Hesketh
- Institute for Global Health, University College London, 30 Guilford St, London, WC1N 1EH, UK. .,Centre for Global Health, Zhejiang University School of Medicine, 866 Yuhangtang Rd, Zhejiang, 310000, Hangzhou, China.
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Abstract
Sri Lanka's civil war and the tsunami in 2004 had enormous psychological impacts on the country's children. Tackling these issues has been difficult due to the lack of specialists in child and adolescent psychiatry. The end of the war in 2009 opened new avenues for the development of mental health services for children and youth in Sri Lanka. The year 2016 was historic in that the first board-certified child and adolescent psychiatrists assumed services in the country, after training in Australia.
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Liu X, Yang H, Tang B, Liu Y, Zhang L. Health status of adolescents in the Tibetan plateau area of western China: 6 years after the Yushu earthquake. Health Qual Life Outcomes 2017; 15:152. [PMID: 28755656 PMCID: PMC5534242 DOI: 10.1186/s12955-017-0727-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 07/21/2017] [Indexed: 01/19/2023] Open
Abstract
Background An earthquake struck Yushu in Qinghai province of China on April 14, 2010, causing 2698 deaths and 12,135 injuries.The present study aimed to assess the health status, and associated determinants, of child survivors in the epicenter of the Yushu earthquake 6 years after the event. Methods A cross-sectional survey was performed among students from two junior schools in Yushu County. Descriptive statistics, t-tests, ANOVA, Wilcoxon rank sum tests, Kruskal-Wallis H tests and stepwise linear regression analysis were used for data analysis. Results The mean scores onmental component summary (MCS)and physical component summary (PCS) were 42.13 (SD 7.32) and 42.04 (SD 8.07), respectively. Lower PCS in the aftermath of an earthquake was associated with being trapped/in danger, injured to self, receiving no escape training while lowerMCS in the aftermath of an earthquake was associated with a lower grade level, not living with parents, fear during the earthquake, death in the family, and not receiving psychological counseling after the earthquake. Conclusions In conclusion, the results of the present study help to expand our knowledge regarding the health status of child survivors 6 years after the Yushu earthquake. Our study provides evidence-based suggestions for specific long-term health interventions in such vulnerable populations.
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Affiliation(s)
- Xu Liu
- Department of HealthService, Faculty of HealthService, Second Military Medical University, 800Xiangyin Road, Shanghai, 200433, China
| | - Hongyang Yang
- Department of Medical Affairs, The General Hospital of the PLA Rocket Force, Beijing, China
| | - Bihan Tang
- Department of HealthService, Faculty of HealthService, Second Military Medical University, 800Xiangyin Road, Shanghai, 200433, China
| | - Yuan Liu
- Department of HealthService, Faculty of HealthService, Second Military Medical University, 800Xiangyin Road, Shanghai, 200433, China
| | - Lulu Zhang
- Department of HealthService, Faculty of HealthService, Second Military Medical University, 800Xiangyin Road, Shanghai, 200433, China.
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Ang JW, Chia C, Koh CJ, Chua BWB, Narayanaswamy S, Wijaya L, Chan LG, Goh WL, Vasoo S. Healthcare-seeking behaviour, barriers and mental health of non-domestic migrant workers in Singapore. BMJ Glob Health 2017; 2:e000213. [PMID: 28589024 PMCID: PMC5435267 DOI: 10.1136/bmjgh-2016-000213] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 02/02/2017] [Accepted: 02/07/2017] [Indexed: 11/05/2022] Open
Abstract
Background Low-wage migrant workers are vulnerable to healthcare inequities. We sought to identify potential barriers to healthcare and risk factors for mental health issues in non-domestic migrant workers in Singapore, and identify high-risk subgroups. Methods A cross-sectional, interviewer-administered survey of 433 non-domestic migrant workers was conducted at subsidised clinics and a foreign worker dormitory from July to August 2016. Questions assessed healthcare usage patterns, affordability issues, barriers to care and psychological distress using a validated screening scale (Kessler-6). Findings Bangladeshi workers surveyed were more likely to be single, have more financial dependents, a lower level of education and salary and pay higher agent fees (p<0.01). 61.4% of workers reported that they had insurance, but had poor understanding of whether it covered inpatient/outpatient expenses. The majority of workers had not, or were not sure if they had, received information about company-bought insurance (72.4%). Among those who had, most reported that information was not in their native language (67.7%). Non-specific psychological distress was found in 21.9%, as estimated by the Kessler-6 scale. Multivariate analysis found that psychological distress was independently associated with Bangladeshi nationals (OR 2.98, 95% CI 1.58 to 5.62; p=0.001) and previous experience of financial barriers to healthcare (OR 3.86, 95% CI 2.25 to 6.62; p<0.0001). Interpretation We identified gaps in non-domestic migrant workers' knowledge of healthcare coverage, and substantial financial barriers to healthcare. The Bangladeshi population in our study was at higher risk of such barriers and psychological distress. These represent areas for further research and intervention.
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Affiliation(s)
- Jia Wei Ang
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | | | - Calvin J Koh
- Division of Gastroenterology and Hepatology, National University Hospital, National University Health System, Singapore
| | - Brandon W B Chua
- Department of Pharmacy, KK Women's and Children's Hospital, Singapore
| | | | - Limin Wijaya
- Department of Infectious Diseases, Singapore General Hospital, Singapore
| | - Lai Gwen Chan
- Department of Psychiatry, Tan Tock Seng Hospital, Singapore
| | | | - Shawn Vasoo
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- Department of Infectious Diseases, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, Singapore
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Wickramage K, De Silva M, Peiris S. Patterns of abuse amongst Sri Lankan women returning home after working as domestic maids in the Middle East: An exploratory study of medico-legal referrals. J Forensic Leg Med 2016; 45:1-6. [PMID: 27846452 DOI: 10.1016/j.jflm.2016.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 10/21/2016] [Accepted: 11/06/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Migrant worker abuse is well recognised, but poorly characterised within the scientific literature. This study aimed to explore patterns of abuse amongst Sri Lankan women returning home after working as domestic maids. METHODS Sri Lanka has over 2 million of its citizens employed overseas as international labor migrants. A cross-sectional study was conducted on Sri Lankan female domestic maids returning from the Middle East region who were referred for medico-legal opinion. RESULTS A total of 20 women were included in the study. Average length of their employment overseas was 14 months. Complaints of physical violence directed mainly through their employers were made by 60% of women. Upon physical examination, two-thirds had evidence of injuries, with a third being subjected to repetitive/systematic violence. Eighty percent suffered some form of psychological trauma. Personal identity papers and travel documents had been confiscated by the employer in 85% of cases, with two thirds indicating they were prevented and/or restricted from leaving their place of work/residence. CONCLUSIONS Our study demonstrates that female domestic maid abuse manifests through multiple pathways. Violence against such workers span the full spectrum of physical, financial, verbal, emotional abuse and neglect, as defined by the World Health Organization. Findings from this exploratory study cannot be generalized to the large volume of migrant worker outflows. Further research is needed to determine incidence and define patterns in other migrant worker categories such as low-skilled male workers.
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Affiliation(s)
- Kolitha Wickramage
- Migration Health Division, International Organization for Migration (IOM), 17 route des Morillions, CH-1221, Geneva, 19, Switzerland; Rajarata University, Department of Community Medicine, Faculty of Medicine and Allied Sciences, Saliyapura, 50008, Sri Lanka.
| | - Malintha De Silva
- Judicial Medical Office, District General Hospital Negombo, A3 Rd, 11500, Sri Lanka.
| | - Sharika Peiris
- International Organization for Migration (IOM), 62 Ananda Coomaraswamy Rd, Colombo, 003, Sri Lanka.
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Weeraratne B. Protecting the Welfare of Children and its Causal Effect on Limiting Mother's Labour Migration. INTERNATIONAL MIGRATION 2016. [DOI: 10.1111/imig.12263] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hamilton A, Foster C, Richards J, Surenthirakumaran R. Psychosocial wellbeing and physical health among Tamil schoolchildren in northern Sri Lanka. Confl Health 2016; 10:13. [PMID: 27385976 PMCID: PMC4933988 DOI: 10.1186/s13031-016-0081-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 04/26/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental disorders contribute to the global disease burden and have an increased prevalence among children in emergency settings. Good physical health is crucial for mental well-being, although physical health is multifactorial and the nature of this relationship is not fully understood. Using Sri Lanka as a case study, we assessed the baseline levels of, and the association between, mental health and physical health in Tamil school children. METHODS We conducted a cross sectional study of mental and physical health in 10 schools in Kilinochchi town in northern Sri Lanka. All Grade 8 children attending selected schools were eligible to participate in the study. Mental health was assessed using the Sri Lankan Index for Psychosocial Stress - Child Version. Physical health was assessed using Body Mass Index for age, height for age Z scores and the Multi-stage Fitness Test. Association between physical and mental health variables was assessed using scatterplots and correlation was assessed using Pearson's R. RESULTS There were 461 participants included in the study. Girls significantly outperformed boys in the MH testing t (459) = 2.201, p < 0.05. Boys had significantly lower average Body Mass Index for age and height for age Z scores than girls (BMI: t (459) = -4.74, p <0.001; Height: t (459) = -3.54, p < 0.001). When compared to global averages, both sexes underperformed in the Multi-Stage Fitness Test, and had a higher prevalence of thinness and stunting. We identified no meaningful association between the selected variables. CONCLUSIONS Our results do not support the supposition that the selected elements of physical health are related to mental health in post-conflict Sri Lanka. However, we identified a considerable physical health deficit in Tamil school children.
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Affiliation(s)
- Alexander Hamilton
- />British Heart Foundation Centre of Population Approaches to NCD Prevention, University of Oxford, Oxford, UK
| | - Charlie Foster
- />British Heart Foundation Centre of Population Approaches to NCD Prevention, University of Oxford, Oxford, UK
| | - Justin Richards
- />School of Public Health and Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Rajendra Surenthirakumaran
- />Department of Community and Family Medicine, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
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Tang X, Geater A, McNeil E, Zhou H, Deng Q, Dong A, Li Q. Parental migration and children's timely measles vaccination in rural China: a cross-sectional study. Trop Med Int Health 2016; 21:886-94. [DOI: 10.1111/tmi.12719] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Xianyan Tang
- Department of Epidemiology and Biostatistics; School of Public Health; Guangxi Medical University; Guangxi Zhuang Autonomous Region China
- Epidemiology Unit; Faculty of Medicine; Prince of Songkla University; Hat Yai Thailand
| | - Alan Geater
- Epidemiology Unit; Faculty of Medicine; Prince of Songkla University; Hat Yai Thailand
| | - Edward McNeil
- Epidemiology Unit; Faculty of Medicine; Prince of Songkla University; Hat Yai Thailand
| | - Hongxia Zhou
- Department of Epidemiology and Biostatistics; School of Public Health; Guangxi Medical University; Guangxi Zhuang Autonomous Region China
| | - Qiuyun Deng
- Institute of Vaccination; Guangxi Center for Disease Control and Prevention; Guangxi Zhuang Autonomous Region China
| | - Aihu Dong
- Institute of Vaccination; Guangxi Center for Disease Control and Prevention; Guangxi Zhuang Autonomous Region China
| | - Qiao Li
- Department of Epidemiology and Biostatistics; School of Public Health; Guangxi Medical University; Guangxi Zhuang Autonomous Region China
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Siriwardhana C, Wickramage K, Siribaddana S, Vidanapathirana P, Jayasekara B, Weerawarna S, Pannala G, Adikari A, Jayaweera K, Pieris S, Sumathipala A. Common mental disorders among adult members of 'left-behind' international migrant worker families in Sri Lanka. BMC Public Health 2015; 15:299. [PMID: 25884656 PMCID: PMC4381514 DOI: 10.1186/s12889-015-1632-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Accepted: 03/12/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nearly one-in-ten Sri Lankans are employed abroad as International migrant workers (IMW). Very little is known about the mental health of adult members in families left-behind. This study aimed to explore the impact of economic migration on mental health (common mental disorders) of left-behind families in Sri Lanka. METHODS A cross-sectional survey using multistage sampling was conducted in six districts (representing 62% of outbound IMW population) of Sri Lanka. Spouses and non-spouse caregivers (those providing substantial care for children) from families of economic migrants were recruited. Adult mental health was measured using the Patient Health Questionnaire. Demographic, socio-economic, migration-specific and health utilization information were gathered. RESULTS A total of 410 IMW families were recruited (response rate: 95.1%). Both spouse and a non-spouse caregiver were recruited for 55 families with a total of 277 spouses and 188 caregivers included. Poor general health, current diagnosed illness and healthcare visit frequency was higher in the non-spouse caregiver group. Overall prevalence of common mental disorder (CMD; Depression, somatoform disorder, anxiety) was 20.7% (95%CI 16.9-24.3) with 14.4% (95%CI 10.3-18.6) among spouses and 29.8% (95%CI 23.2-36.4) among non-spouse caregivers. Prevalence of depression (25.5%; 95%CI 19.2-31.8) and somatoform disorder 11.7% (95%CI 7.0-16.3) was higher in non-spouse caregiver group. When adjusted for age and gender, non-returning IMW in family, primary education and low in-bound remittance frequency was associated with CMD for spouses while no education, poor general health and increased healthcare visits was significantly associated in the non-spouse caregiver group. CONCLUSIONS To our knowledge, this is one of the first studies to explore specific mental health outcomes among adult left-behind family members of IMW through standardized diagnostic instruments in Sri Lanka and in South Asian region. Negative impact of economic migration is highlighted by the considerably high prevalence of CMD among adults in left-behind families. A policy framework that enables health protection whilst promoting migration for development remains a key challenge for labour-sending nations.
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Affiliation(s)
- Chesmal Siriwardhana
- Faculty of Medical Science, Anglia Ruskin University, Chelmsford, CM1 1SQ, UK. .,Institute for Research & Development, Colombo, Sri Lanka.
| | | | - Sisira Siribaddana
- Institute for Research & Development, Colombo, Sri Lanka. .,Department of Medicine, Faculty of Medicine & Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka.
| | - Puwalani Vidanapathirana
- Institute for Research & Development, Colombo, Sri Lanka. .,Department of cardiothoracic vascular surgery, National University Hospital, Singapore, Singapore.
| | | | | | - Gayani Pannala
- Institute for Research & Development, Colombo, Sri Lanka.
| | | | | | | | - Athula Sumathipala
- Institute for Research & Development, Colombo, Sri Lanka. .,Research Institute for Primary Care and Health Services, School for Primary Care Research, Faculty of Health, Keele University, Newcastle, UK.
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