Correction: COVID-19 stressors and mental health problems amongst women who arrived as refugees and those born in Australia

[This corrects the article DOI: 10.1371/journal.pgph.0002073.].

Correction: COVID-19 stressors and mental health problems amongst women who arrived as refugees and those born in Australia

[This corrects the article DOI: 10.1371/journal.pgph.0002073.].

COVID-19 stressors and mental health problems amongst women who arrived as refugees and those born in Australia

Women from refugee background residing in high income countries are at greater mental health risk during the COVID-19 pandemic given their higher baseline prevalence of mental disorders, trauma exposures and social adversities. During the COVID-19 pandemic we drew on data from wave-4 of the WATCH cohort study, collected between October 2019 and June 2021. We conducted a cross-sectional analysis to compare the prevalence of common mental disorders (CMDs) from the sample of 650 consecutively recruited women, 339 (52.2%) from the refugee-background who were resettled in Australia and 311 (48.8%) randomly and contemporaneously selected Australian born women. We assessed COVID-19 psychosocial stressors: 1. COVID-related material hardship and 2. COVID-related fear and stress. We examined for associations between scores on these two items and CMDs in each group respectively. Compared to Australian-born woman, women from refugee background recorded a significantly higher prevalence of Major Depressive Disorder (MDD) (19.8% vs 13.5%), PTSD (9.7% vs 5.1%), Separation Anxiety Disorder (SEPAD) (19.8% vs 13.5%) and Persistent Complicated Bereavement Disorder (PCBD) (6.5% vs 2.9%). In refugee women, associations were found between COVID-related material hardship and CMDs [MDD, Relative Risk (RR) = 1.39, 95%CI: 1.02-1.89, p = 0.02] as well as between COVID-related fear and stress and CMDs (MDD, RR = 1.74, 95%CI: 1.04-2.90, p = 0.02 p = 0.02). For Australian-born women, associations were more commonly found between CMDs and material hardship. Our study demonstrates that both women from refugee background and those born in Australia are experiencing significant rates of CMD during the pandemic and that material hardship is an associated factor. We found that women from refugee background are at greater risk for mental health problems and are more likely to report an association of those problems with fear and stress related to COVID_19. All women, and particularly those from refugee background, require urgent and specialised attention to their mental health and psychosocial problems during this pandemic.

Organisational structures and processes for health and well-being: insights from work integration social enterprise

Background

Previous research on employee well-being for those who have experienced social and economic disadvantage and those with previous or existing mental health conditions has focused mainly on programmatic interventions. The purpose of this research was to examine how organisational structures and processes (such as policies and culture) influence well-being of employees from these types of backgrounds.

Methods

A case study ethnographic approach which included in-depth qualitative analysis of 93 semi-structured interviews of employees, staff, and managers, together with participant observation of four social enterprises employing young people.

Results

The data revealed that young people were provided a combination of training, varied work tasks, psychosocial support, and encouragement to cultivate relationships among peers and management staff. This was enabled through the following elements: structure and space; funding, finance and industry orientation; organisational culture; policy and process; and fostering local service networks.. The findings further illustrate how organisational structures at these workplaces promoted an inclusive workplace environment in which participants self-reported a decrease in anxiety and depression, increased self-esteem, increased self-confidence and increased physical activity.

Conclusions

Replicating these types of organisational structures, processes, and culture requires consideration of complex systems perspectives on implementation fidelity which has implications for policy, practice and future research.

Cohort profile: intimate partner violence and mental health among women from refugee background and a comparison group of Australian-born - the WATCH cohort study

PURPOSE

The Women Aware with Their Children study was created because prospective data are required to accurately guide prevention programmes for intimate partner violence (IPV) and to improve the mental health and resettlement trajectories of women from refugee backgrounds in Australia.

PARTICIPANTS

1335 women (685 consecutively enrolled from refugee backgrounds and 650 randomly selected Australian-born) recruited during pregnancy from three public antenatal clinics in Sydney and Melbourne, Australia. The mean age was 29.7 years among women from refugee backgrounds and 29.0 years among women born in the host nation. Main measures include IPV, mood, panic, post-traumatic stress disorder, disability and living difficulties.

FINDINGS TO DATE

Prevalence of IPV at all three time points is significantly higher for refugee-background women. The trend data showed that reported IPV rates among Australian-born women increased from 25.8% at time 1 to 30.1% at time 3, while for refugee-background women this rate declined from 44.4% at time 1 to 42.6% at time 3. Prevalence of major depressive disorder (MDD) at all three time points is higher for refugee-background women. MDD among Australian-born women significantly declined from 14.5% at time 1 to 9.9% at time 3, while for refugee-background women it fluctuated from 25.1% at time 1 to 17.3% at time 2 and to 19.1% at time 3.

FUTURE PLANS

We are currently examining trajectories of IPV and mental disorder across four time points. Time 4 occurred during the COVID-19 pandemic, enabling a unique opportunity to examine the impacts of the pandemic over time. Time 5 started in August 2021 and time 6 will begin approximately 12 months later. The children at time 5 are in the early school years, providing the capacity to examine behaviour, development and well-being of the index child.

Attitudes towards gender roles and prevalence of intimate partner violence perpetrated against pregnant and postnatal women: Differences between women immigrants from conflict-affected countries and women born in Australia

BACKGROUND

The aim was to compare, for the first time in a large systematic study, women born in conflict-affected countries who immigrated to Australia with women born in Australia for attitudes towards gender roles and men's use of IPV and the actual prevalence of IPV. The study also examined if any associations remained across the two timepoints of pregnancy and postpartum.

METHODS

Women were interviewed during their first visit to one of three Australian public hospital antenatal clinics and re-interviewed at home six months after giving birth. A total of 1111 women completed both interviews, 583 were born in conflict-affected countries and 528 born in Australia. Associations between attitudes towards gender roles and men's use of IPV, socio-demographic characteristics and reported actual experiences of IPV were examined using bivariate and multiple logistic regression analyses.

RESULTS

Attitudes toward inequitable gender roles including those that condone men's use of IPV, and prevalence of IPV, were significantly higher (p<0.001) among women born in conflict-affected countries compared to Australia-born women. Women born in conflict-affected countries with the strongest held attitudes towards gender roles and men's use of IPV had an adjusted odds ratio (aOR) of 3.18 for IPV at baseline (95% CI 1.85-5.47) and an aOR of 1.83 for IPV at follow-up (95% CI 1.11-3.01). Women born in Australia with the strongest held attitudes towards gender roles and IPV had an aOR of 7.12 for IPV at baseline (95% CI 2.12-23.92) and an aOR of 10.59 for IPV at follow-up (95% CI 2.21-50.75).

CONCLUSIONS

Our results underscore the need for IPV prevention strategies sensitively targeted to communities from conflict-affected countries, and for awareness among clinicians of gender role attitudes that may condone men's use of IPV, and the associated risk of IPV. The study supports the need for culturally informed national strategies to promote gender equality and to challenge practices and attitudes that condone men's violence in spousal relationships.

The health and well-being impacts of a work integration social enterprise from a systems perspective

Recent research has drawn upon the social determinants of health (SDH) framework to attempt to systematize the relationship between social enterprise and health. In this article, we adopt a realist evaluation approach to conceptualize social enterprises, and work integration social enterprises in particular, as 'complex interventions' that necessarily produce differential health outcomes for their beneficiaries, communities and staff. Drawing upon the findings from four social enterprises involving a range of methods including 93 semi-structured interviews with employees, managers and enterprise partners, together with participant observation, we demonstrate that these health outcomes are influenced by a limitless mix of complex and dynamic interactions between systems, settings, spaces, relationships and organizational and personal factors that cannot be distilled by questions of causality and attribution found in controlled trial designs. Given the increased policy focus on the potential of social enterprises to affect the SDH, this article seeks to respond to evidence gaps about the mechanisms and contexts through which social enterprises promote or constrain health outcomes, and thereby provide greater clarity about how research evidence can be used to support the social enterprise sector and policy development more broadly.

Prevalence, predictors and associations of complex post-traumatic stress disorder with common mental disorders in refugees and forcibly displaced populations: a systematic review

Background: The inclusion of complex post-traumatic stress disorder (CPTSD) in ICD-11 represents a turning point for the field of traumatic stress, with accumulative evidence of this disorder in refugees and displaced populations. Objective: The objectives of this systematic review are to examine, in refugee and displaced populations: 1) the prevalence of CPTSD; 2) factors contributing to CPTSD; and 3) and associations between CPTSD and other common mental disorders including: PTSD, depression, anxiety and somatisation. Method: We followed the Joanna Briggs Institute Methodology for Systematic Reviews. Papers published in English language were included, with date of publication between 1987 and June 2019. We searched six relevant databases: MEDLINE, PsycINFO, Embase, Scopus, CINAHL, and PILOTS, and the grey literature. We included observational studies with prevalence data on CPTSD. Results: 19 articles met all inclusion criteria. Quality assessment was performed on each included study using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. Based on this, 13 moderate and high-quality studies were included in our narrative synthesis. The included studies reported prevalence of CPTSD in refugees and displaced populations ranging from 2% to 86%. Conclusions: Reasons for the wide variation in prevalence may include contextual and geographical differences, the influence of post-migration difficulties, and sample population characteristics such as treatment seeking versus general population. We found higher prevalence rates (range: 16-82%) in more studies with treatment seeking samples, followed by convenience and snowball samples (40-51%), and lower rates in more studies utilising random sampling techniques (2-86%). Consistent with the broader literature, the studies in our review supported an association for complex post-traumatic stress disorder with prolonged, repeated trauma, and post-migration living difficulties, with the latter association being specific to refugee and displaced populations. Further research on this construct in this population group, including effective treatments, is required.

Prevalence and antibiotic resistance profiles of Staphylococcus sp. isolated from food, food contact surfaces and food handlers in a Moroccan hospital kitchen

Food poisoning risk related to the consumption of contaminated food with known foodborne pathogens or antibiotic-resistant bacteria is currently a serious threat for public health. Thus, pathogenic methicillin-resistant Staphylococcus strains are considered as one of the major cause of foodborne diseases in hospitals. The present study aims to determine the prevalence and the antibiotic resistance patterns of Staphylococcus in various types of hospital food samples, work surfaces and its carriage by food handlers. A total of 608 collected samples including 300 food samples, 238 food contact surfaces and 70 nasal and hand samples were tested. The identified Staphylococcus and their antibiotic resistance patterns were analysed using the agar disk-diffusion and PCR method was used for mecA resistance gene amplification. The prevalence of S. aureus and the coagulase-negative staphylococci were 17·33 and 23·33%, respectively. The antibiotic resistance reached 100% towards oxacillin and Penicillin G for both S. aureus and CoNs. The mecA gene was detected in 5·71% (4/70) and 7·69% (4/52) of S. aureus and CoNs strains, respectively. The outcome of this study enlightens isolation of MRSA strains and resistant CoNs from food, food contact surfaces and food handlers. The presence of this resistant species in this critical setting, where products were intended to vulnerable and immunocompromised patients, represents a serious threat to this community. It can be a source of nosocomial infection and more precautions must be taken to prevent staphylococci food contamination mainly in hospitals. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first study describing the antibiotic resistance patterns of Staphylococcus aureus and coagulase-negative Staphylococcus isolated from hospital food, food contact surfaces and food handlers samples in a Moroccan hospital kitchen. High levels of multi-resistance were reported. The alarming outcome of this study emphasizes the crucial need of implementing an approach to fight multidrug-resistant staphylococci mainly in healthcare settings, where the community have already compromised health issues.

Believe #metoo: sexual violence and interpersonal disclosure experiences among women attending a sexual assault service in Australia: a mixed-methods study

OBJECTIVES

Sexual abuse is a strong predictor of future psychiatric problems. A more nuanced qualitative understanding of mental health outcomes, in the context of interpersonal responses from family members towards survivors after sexual abuse, may help to better inform prevention and interventions.

DESIGN

A mixed-methods approach included a qualitative timeline method to map and identify contextual factors and mediating emotional responses associated with mental disorder following sexual abuse.

SETTING

Participants were adult survivors of sexual abuse, seeking support from the Sexual Assault Counselling Service, Sydney Local Health District, Australia.

PARTICIPANTS

Thirty women 18 years and older with current or past mental disorder or symptoms were interviewed between August 2015 and May 2016.

OUTCOME MEASURES

A qualitative timeline interview and the Mini-International Neuropsychiatric Interview (MINI, 5.5.0) were applied.

RESULTS

The MINI prevalence of current post-traumatic stress disorder was 96.6% (n=28) and of major depressive disorder was 82.8% (n=24). More than half (53%) reported suicidal ideation at some time in their lives. Women exposed to childhood sexual abuse reported being ignored, not believed, or threatened with retribution on disclosing the abuse to others, usually adult family members, at or close to the time of the violation(s). Participants described experiences of self-blame, betrayal, and psychosocial vulnerability as being the responses that connected negative disclosure experiences with mental disorder. Participant accounts suggest that these reactions created the foundations for both immediate and long-term adverse psychological outcomes.

CONCLUSION

A more in-depth understanding of the type and emotional impact of negative responses to disclosure by parents and other family members, and the barriers to adequate support, validation and trust, may inform strategies to avert much of the longer-term emotional difficulties and risks that survivors encounter following childhood abuse experiences. These issues should receive closer attention in research, policy, and practice.

Prevalence and Risk Factors of Major Depressive Disorder Among Women at Public Antenatal Clinics From Refugee, Conflict-Affected, and Australian-Born Backgrounds

IMPORTANCE

Pregnancy may increase the risk of depression among women who self-identify as refugees and have resettled in high-income countries. To our knowledge, no large systematic studies among women with refugee backgrounds in the antenatal period have been conducted.

OBJECTIVES

To compare the prevalence of major depressive disorder (MDD), trauma exposure, and other psychosocial risk factors among women who identify as refugees, women from the same conflict-affected countries, and women from the host nation and to test whether self-identification as a refugee indicates greater likelihood of prevalence and risk.

DESIGN, SETTING, AND PARTICIPANTS

This cross-sectional study was undertaken in 3 public antenatal clinics in Sydney and Melbourne, Australia, between January 2015 and December 2016. Overall, 1335 women (685 consecutively enrolled from conflict-affected backgrounds and 650 randomly selected from the host nation) participated. Data analysis was undertaken between June and September 2018.

EXPOSURES

One-hour interviews covering mental health, intimate partner violence, and other social measures.

MAIN OUTCOME AND MEASURES

World Health Organization measure for intimate partner violence and the Mini-International Neuropsychiatric Interview from the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) for MDD. To make a diagnosis, 1 of 2 items relating to being consistently depressed for 2 weeks and 3 further symptoms that cause personal distress or psychosocial dysfunction were endorsed.

RESULTS

Overall, 1335 women (84.8% overall response rate), comprising 685 (51.3%) from conflict-affected countries (women self-identifying as refugees: 289 [42.2%]) and 650 (48.7%) from the host nation, participated. The mean (SD) age was 29.7 (5.4) years among women from conflict-affected backgrounds and 29.0 (5.5) years among women born in the host nation. Conflict-affected countries included Iraq (260 [38.0%]), Lebanon (125 [18.2%]), Sri Lanka (71 [10.4%]), and Sudan (66 [9.6%]). Women who identified as refugees reported higher exposure to 2 to 3 (67 [23.2%]) and 4 or more (19 [6.6%]) general traumatic events compared with women from the host nation (103 [15.8%] and 21 [3.2%], respectively). Women who identified as refugees also reported higher exposure to 1 (147 [50.9%]) and 2 or more (97 [33.6%]) refugee-related traumatic events compared with women from the host nation (86 [13.2%] and 20 [3.1%], respectively). Women who identified as refugees reported higher rates of psychological intimate partner violence than women born in the host nation (124 [42.9%] vs 133 [20.5%]; P < .001). Women who identified as refugees were less likely to identify 5 or more supportive family or friends compared with women born in the host nation (36 [12.5%] vs 297 [45.7%]; P < .001). A greater proportion of women who identified as refugees reported experiencing 3 or more financial stressors compared with women born in the host nation (65 [22.5%] vs 41 [6.3%]; P < .001). Women who identified as refugees had the highest prevalence of MDD (94 [32.5%]), followed by women from other conflict-affected backgrounds (78 [19.7%]), and women born in the host nation (94 [14.5%]).

CONCLUSION AND RELEVANCE

Women identifying as refugees reported a higher prevalence of MDD and all the indicators of adversity related to that disorder. Even after risk factors were accounted for, refugee status was associated with risk of MDD. Assessing whether women attending an antenatal clinic self-identify as refugees may offer an important indicator of risk of MDD and a range of associated psychosocial adversities.

[Calibrated sleeve gastrectomy or sleeve gastrectomy: experiences in Abidjan]

INTRODUCTION

The aim of this study was to evaluate and analyze the first 29 cases of sleeve gastrectomy in Abidjan.

PATIENTS AND METHODS

We analyzed the records of patients operated for morbid obesity in 3 private clinics in Abidjan by the team of Professor Alexandre N'Guessan from 2009 to 2014. This study included all patients who underwent laparoscopic sleeve gastrectomy for morbid obesity.

RESULTS

A total of 29 patients were operated; 28 women and 1 man with a mean age of 34 years. Their body mass index (BMI) ranged between 35 and 49 kg/m² with comorbidities. The laparoscopic procedure was possible in all cases without conversion. The average operative time was 3 hours. Patients were exeat in 70% of cases in the second postoperative day after methylene blue checks were conducted. Only 4 complications (1 phrenic abscess, 1 small bowel obstruction, 1 gastric stenosis and 1 digestive fistula) required surgical recovery. The operative mortality was 6.89%. Around 92.85% of patients had a loss of excess weight greater than 50% over 4 years, with an improvement of comorbidities.

CONCLUSION

The sleeve gastrectomy is a feasible technique with our current working conditions. It requires a good patient selection, and a multidisciplinary team.

Effect of a Cable Rupture on Tensegrity Systems

A numerical investigation of the effect of a sudden rupture of a cable component in a Tensegrity assemblage is performed using nonlinear dynamic time history analysis to determine element axial forces and nodal displacements responses of the system. Details of the modeling of the Tensegrity elements as well as the numerical scheme used to integrate the equations of motion are discussed. The investigation is carried on a continuous struts Tensegrity system. The system is constituted by an assemblage of five expanded-octahedron basic modules. The simulation of the sudden rupture of a single cable is realized by replacing this element by its tension, applied as an external force to the extremities of the struts to which this element is attached. This force is then removed instantaneously provoking a load imbalance in the system. This imbalance acts as a triggering mechanism sending an impulsive shock to the damaged structure resulting in a damped vibration motion and large magnitude element axial forces.

[Evaluation of a four-year experience with laparoscopic surgery in Abidjan, Ivory Coast]

Laparoscopic surgery is now a widely accepted modality for gastrointestinal surgery. In this report the authors evaluate their four-year experience with laparoscopic surgery in a total of 494 patients in Abidjan, Ivory Coast. Cholecystectomy and appendectomy were the main indications in this series. However laparoscopic surgery has a wide range of applications in Black Africa not only for elective indications such as evaluation of chronic abdominal pain and digestive cancer but also emergency indications such as peritonitis and abdominal trauma.

[Video-assisted left colectomy for severe constipation. Description of two cases]

The purpose of this report is to describe two cases involving a 43-year-old man and a 41-year-old woman who underwent laparoscopic surgery for dolichocolon causing severe constipation. In both cases the procedure consisted of left colectomy with colorectal anastomosis. There was no operative mortality or morbidity. The outcome on constipation was good. This study demonstrates the utility of laparoscopy for treatment of dolichocolon in carefully selected patents.

[Not Available]

Objective : The aim of this study was to analyse the coelioscopic surgery in appenditis. Method : We done a retrocpective study concerning 150 coelioscopic surgery in appenditis during 42 months. Result : In the study period we done more than three times coelioscopic sergery. In our study we includ 86 femals (57,3%) and 64 males (42,7%). The mean reason of surgery was tipical clinical appenditis in 124 cases (82,6%), chronic abdominal ack in 10 cases and other reasons for the last 16 cases. The appendice was take of by the "external method" in 76 cases (50,6%) "internal method" in 9 cases (6%) and the two methods in 61 cases (40,6%). In 33 cases (21,3%) the surgery of appendice was associeted with other surgery. In term of morbidity we notice three cases of parietal abces (2%). Any mortality was notice in our serial. Conclusion : Ceolioscopic sergery is a good and pratical method in appenditis tratment it allows the minimizing of hospitalisation stay.

[Crohn's disease: first report in Côte-d'Ivoire]

The authors report the first case of Crohn's disease in Côte-d'Ivoire. A 20-year-old Ivorian man presented chronic diarrhea and weight loss over six years. Ulcerated lesions were found throughout the colon extending to the terminal ilieum but not involving the rectum. Diagnosis of Crohn's disease was established on radiological and histological findings. Treatment consisted of total colectomy with ileorectal anastomosis. This case is of special interest because of the extremely low incidence of Crohn's disease in black Africa.

Cretaceous sauropods from the sahara and the uneven rate of skeletal evolution among dinosaurs

Lower Cretaceous fossils from central Niger document the succession of sauropod dinosaurs on Africa as it drifted into geographic isolation. A new broad-toothed genus of Neocomian age ( approximately 135 million years ago) shows few of the specializations of other Cretaceous sauropods. A new small-bodied sauropod of Aptian-Albian age ( approximately 110 million years ago), in contrast, reveals the highly modified cranial form of rebbachisaurid diplodocoids. Rates of skeletal change in sauropods and other major groups of dinosaurs are estimated quantitatively and shown to be highly variable.