Background Adolescents, particularly girls, are vulnerable to mental health disorders. Knowledge ... more Background Adolescents, particularly girls, are vulnerable to mental health disorders. Knowledge about young people’s mental health in Eastern European countries is limited. This study is the first to investigate adolescents’ self-reported emotional and behavioural problems in Georgia from a public mental health perspective. Methods This study utilized Achenbach’s Youth Self-Reported syndrome scales among 933 adolescents studying from grades 7–12 in 18 public schools in Georgia. We compared the gender-specific results with each other and with the Achenbach’s Normative Sample using two-sample t-tests. Linear regression was used to assess associations between internalizing and externalizing problems and individual as well as demographic characteristics such as parental migration experience (being ‘left-behind’ or ‘staying behind’). Results The study found that girls obtained higher scores than boys in Youth Self-Reported empirical syndrome scales and the internalizing broadband scale....
Introduction Georgia, like other Eastern European countries, showed a dramatic increase of intern... more Introduction Georgia, like other Eastern European countries, showed a dramatic increase of international labour emigration after becoming independent in 1991. The collapse of the Soviet Union caused economic instability, unemployment and poverty resulting in labour migration. Since then, thousands of children have been left behind in the care of extended family members while their parents work abroad. The aim of this study is to explore schoolteachers’ perceptions on parental migration and left-behind children (LBC) in Georgia as schoolteachers are the main contact persons for LBC and their caregivers. Methods We conducted six focus-group discussions with public school teachers, namely class-tutors and six in-depth interviews with school principals from two migrant sending regions. We applied reflexive thematic analysis to systematically analyse the data and identify main and sub-themes. The contextual model of family stress underpins this study. Results We identified the following...
BackgroundUnderstanding the different types of health interventions that have been conducted for ... more BackgroundUnderstanding the different types of health interventions that have been conducted for migrants and refugees is crucial for the improvement and implementation of future health interventions for these populations. This systematic review aimed to identify and to look at the scope and outcomes of health interventions focused on migrants and refugees in the main host counties in Southeast Asia which are Thailand, Singapore, and Malaysia.MethodsThis study was conducted in line with the PRISMA guidelines and its protocol has been submitted to PROSPERO. The following databases were searched until June 2021: PubMed, Web of Science, Science Direct, Cochrane, and Google Scholar. Studies were excluded if: 1) they were conducted outside Thailand, Singapore, and Malaysia; 2) had only had qualitative results; 3) were non-peer reviewed; 4) not written in English.ResultsThe search yielded 8,266 studies, out of which 33 were included in the review. The majority of the studies (79%) were conducted in Thailand of which most were focused on migrants or refugees from Myanmar (85%). Besides two randomized controlled trials (RCTs) of mental health interventions, most Thai studies were observational (81%) and focused on infectious disease-related interventions (33%) or the evaluation of health-related programs (29%). Six studies were conducted in Malaysia (18%) of which 4 assessed mental health interventions in refugees. Three of these studies were RCTs, whereas 1 was an observational study. Only 1 study was situated in Singapore and was an RCT evaluating treatments for COVID-19 in migrant workers. Even in studies with similar interventions, outcomes were too diverse to conduct a meta-analysis.ConclusionsThe low number of studies highlights the gap in literature on health interventions for migrants and refugees, especially in Malaysia and Singapore. More rigorous and cohesive intervention-related research needs to be conducted in Southeast Asia.Key messages• More intervention-related research for migrant and refugee populations in the main Southeast Asian host countries is needed.• Interventions for migrant and refugee populations in host countries in Southeast Asia often do not follow the gold standard RCT study design, limiting the knowledge on their effectiveness.
Background and Objectives Hypertension is one of the leading cardiovascular risk factors with hig... more Background and Objectives Hypertension is one of the leading cardiovascular risk factors with high numbers of undiagnosed and untreated patients in Sub Saharan Africa (SSA). The health systems and affected people are often overwhelmed by the social and economic burden that comes with the disease. However, the research on the economic burden and consequences of hypertension treatment remains scare in SSA. The objective of our review was to compare different hypertension treatment costs across the continent and identify major cost drivers. Material and Methods Systematic literature searches were conducted in multiple databases (e.g., PubMed, Web of Science, Google Scholar) for peer reviewed articles written in English language with a publication date from inception to Jan. 2022. We included studies assessing direct and indirect costs of hypertension therapy in SSA from a provider or user perspective. The search and a quality assessment were independently executed by two researchers. A...
Background The aim of our study was to systematically review the literature on physical health an... more Background 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). Methods This study followed the PRISMA guidelines. We searched relevant databases for studies published up to 15 May 2020. The quality of the studies was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Results We included 34 studies out of 6061 in the final analysis. Results from internal migration shows that compared with children of non-migrant parents, LBC were more susceptible to illness and had a higher prevalence of acute and chronic diseases, have a higher risk of getting injured, were more likely to engage risky behaviours such as unhealthy diet, physical inactivity, sedentary lifestyle, smoking, and drinking. Studies included in this review found a lower coverage of vaccination among LBC. Results from international migration foun...
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Background Already, Dengue affects 400 million individuals every year. Its main drivers, urbaniza... more Background Already, Dengue affects 400 million individuals every year. Its main drivers, urbanization, globalization, and climate change, however, will spread the disease even further and potentially threaten billions. In Dengue, bleeding occurs frequently. Severe bleeding strongly increases mortality and immediate medical response is crucial for survival. Predicting the occurrence and course of bleeding in advance would improve clinical outcome, reduce unnecessary hospitalization, and improve economic efficiency. Methods Following the PRISMA-guidelines, we conducted a systematic review of the literature to identify predictors of bleeding in acute confirmed Dengue. We searched Pubmed, Web of Science, IRIS, LILACS, and the Cochrane Archives and included all prospective longitudinal studies restricting neither language nor study sample characteristics. Results We included 19 studies but found that most data suffered from high risk of bias because of poor reporting and not accounting f...
Background A number of refugees and asylum seekers have increased dramatically in recent years. M... more Background A number of refugees and asylum seekers have increased dramatically in recent years. More than 250 million people worldwide are considered as refugees (United Nations High Commission for Refugees, 2018), among whom more than 50% are children. General health and especially psychological health of the refugee and asylum seeking children are an emerging, however, not well explored issues. In this study, we aimed to review the literature on the psychological health of refugee children. Methods We performed a literature search and descriptive analysis of studies published until July 2019, through MEDLINE and Science Direct databases. We identified literature on psychological health state of refugee and asylum seeking children. We analysed results of 16 studies. Results The study found that refugee children are facing severe psychological health issues, such as Post-traumatic stress disorder (PTSD), depression, anxiety, sleep disorders, behavioural problems. We identified 3 pha...
Background Left behind children (LBC) are children living with caregivers, while their parents wo... more Background Left behind children (LBC) are children living with caregivers, while their parents work abroad. In recent decades Lithuania had lost ¼ of its population due to emigration, but the prevalence of LBC and their health needs are not sufficiently studied. The aim of study was to evaluate the association between self-reported health, emotional and behavioural difficulties between LBC and non-LBC. Methods The cross-sectional study was approved by the Biomedical Research Ethics Committee, No. 2021/11-1378-861. In March 2022, this pilot study collected data from adolescents aged 12-17 years at three randomly selected schools from the migration affected regions. Parents and children provided informed consent to participate in pilot study. Self-reported measures collected from the participants: Strengths, and Difficulties Questionnaire (Goodman, 2005) and a questionnaire on demographics and on the health situation. Chi2 tests and logistic regression were calculated by using Stata (...
Little is known about the impact of school-based nutrition interventions on parents and other fam... more Little is known about the impact of school-based nutrition interventions on parents and other family members. This systematic review aims to explore the impact of school-based nutrition interventions on different parental/family outcomes, mainly dietary intake, nutrition knowledge, and health outcomes. PubMed, Web of Science, PsycINFO, EconLit, Cochrane Reviews, and Google Scholar were systematically searched for controlled trials or natural experiments measuring the impact of school-based nutrition interventions, with or without parental involvement, on parents/families of school children. Twenty-two studies met the inclusion criteria. Of which, 15 studies assessed the impact of school-based nutrition interventions on parental/family dietary intake, 10 on parental/family nutrition knowledge, and 2 on parental/family health outcomes. Inconsistent results were found for parental dietary intake with six studies reporting favorable effects. Most studies found improved parental nutritio...
Background Labor migration is a challenge for the globalised world due to its long-term effects s... more Background Labor migration is a challenge for the globalised world due to its long-term effects such as the formation of transnational families with the particularly vulnerable groups of left-behind children (LBC). These families, where family members of migrant workers are 'left-behind' are becoming common practice in many developing countries. In this systematic literature review, we aimed to investigate the impacts of parental labor migration on the mental health and well-being of their LBC. Methods Following the PRISMA guidelines, we performed a systematic literature search in English using PubMed, PsychINFO, Web of Science, Cochrane Library and Google Scholar for studies, investigating mental health and well-being among LBC who live in transnational families. Case-reports, qualitative studies as well as opinion papers were excluded. We summarized the evidence and additionally compared quantitative results. Results 25 studies were selected for the final analysis. We foun...
Background Georgia, a major migrant sending country, with about 39% of children living with their... more Background Georgia, a major migrant sending country, with about 39% of children living with their caregivers while at least one of the parents migrated (left-behind children, LBC) has been severely affected by the COVID-19 pandemic. The main aim of this study was to qualitatively explore LBC’s perception and experience during the pandemic. Methods Between December 2021 and January 2022, we conducted 39 (29 LBC, 10 non-LBC) individual in-depth interviews with schoolchildren aged 12-18 in a public school from a migrant sending region. We conducted life history narrative interviews and used a thematic analysis approach. Results Preliminary findings show four salient themes: (1) Family members’ first reactions to the pandemic influence children’s emotional health irrespective of parents’ working arrangements. Children express less stress and anxiety when families show emotional stability and are not overwhelmed by the pandemic; (2) All interviewed children find COVID-19 and home-schooli...
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Health outcomes of in utero Ramadan exposure have been reported in a systematic literature review... more Health outcomes of in utero Ramadan exposure have been reported in a systematic literature review; however, the available literature on long-term effects were not fully covered. Our study aims to specifically review the long-term outcomes of in utero Ramadan exposure. We searched for original research articles analyzing any long-term outcome of in utero Ramadan exposure, excluding maternal and perinatal outcomes. Sixteen studies from 8304 non-duplicate search results were included. Most studies suggest negative consequences from in utero Ramadan exposure on health, as well as on economic outcomes later in adulthood. Higher under-five mortality rate, higher mortality under three months, and under one year, shorter stature, lower body mass index, increased incidence of vision, hearing and learning disabilities, lower mathematics, writing and reading scores, as well as a lower probability to own a home were associated with Ramadan exposure during conception or the first trimester of pr...
International Journal of Environmental Research and Public Health, 2020
Labour migration is a challenge for the globalised world due to its long-term effects such as the... more 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 chi...
Background Georgia, like other Eastern European countries, showed a dramatic increase of internat... more Background Georgia, like other Eastern European countries, showed a dramatic increase of international labour emigration after becoming independent in 1991. Since then, thousands of children are left-behind (LBC) in the care of extended family members while their parents work abroad. School teachers are frequently in contact with LBC and their caregivers. The main aim of this study is to explore school teachers' perceptions on parental migration and LBC in rural Georgia. Methods In this qualitative study, we conducted six focus-group discussions with public school teachers and six in-depth interviews with school principals from two migrant sending regions. We applied a reflexive thematic analysis approach, systematically analysed data and identified main themes and sub-themes from the collected data. The theoretical framework of the socio-ecological model of human development underpins this study. Results We identified the following themes expressed by both teachers and school p...
International Journal of Environmental Research and Public Health
The aim of our study was to systematically review the literature on physical health and related c... more 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 internati...
International Journal of Environmental Research and Public Health
Oral health is one of the most neglected aspects of refugee health. The study aimed to systematic... more Oral health is one of the most neglected aspects of refugee health. The study aimed to systematically review evidence on prevalence of dental caries and dental care services provided to refugees in Europe. Following PRISMA guidelines, we searched PubMed, Cochrane, WHOLIS, Web of Science, Medline Ovid, and Google Scholar identifying studies on dental caries among refugees in Europe after the 2015 refugee crisis. From 3160 records, fourteen studies were included in the analysis. Eight studies on oral health showed caries prevalence of between 50% and 100%, while it ranged from 3% to 65% in six general health studies. Caries prevalence was proportional to age and inversely associated with education, whereas gender and country of origin showed no significant association. Nowhere is oral health part of general health assessment on arrival and is complaint based. Primary focus on resettlement, language, cultural, and economic barriers emerged as explanatory models for limited access. Our ...
Background: Alzheimer’s disease (AD) is a chronic neurodegenerative disease that accounts for mor... more Background: Alzheimer’s disease (AD) is a chronic neurodegenerative disease that accounts for more than 50% of all dementia cases worldwide. There is wide consensus on the risk factors of AD; however, a clear etiology remains unknown. Evidence suggests that the inflammatory-mediated disease model, such as that found with periodontal disease due to Porphyromonas gingivalis (P. gingivalis), plays a role in AD progression. Objective: This study aims to systematically review the literature on the association between P. gingivalis to AD, and to identify the homogeneity of the methods used across studies to measure P. gingivalis involvement in AD. Methods: We systematically searched studies on Cochrane library, Ovid Medline, PubMed, Web of Science, WHOLIS, Google Scholar databases, and reference lists of identified studies. Results: 6 studies out of 636 identified records fulfilled all eligibility criteria. Results showed no clear pathophysiology of AD due to P. gingivalis and its various...
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