Meaning in Life and Suicidal Tendency Among Immigrant (Ethiopian) Youth and Native-Born Israeli Youth

The impact of meaning in life, or lack thereof, on suicidal tendencies among populations at greater risk—youth born to immigrants from developing countries, in this case Ethiopia—in comparison to native-born Israeli youth was examined among 277 adolescents—162 of Israeli origin and 115 of Ethiopian origin—aged 15–18. (1) Overall significant negative correlation between meaning in life and suicidal tendencies was found; (2) no difference was found in meaning in life between immigrant and native-born youth; (3) higher suicidal tendency, anxiety and depression were found among immigrants, with boys displaying more anxiety than girls. No difference in depression was detected between Ethiopian boys and girls. Meaning in life is crucial to minimizing suicidal tendencies among youth, native-born and immigrant alike. Establishment of prevention, intervention and therapy plans in the age range crucial for suicide. Such programs should be based upon finding meaning in life.     

Exploring the Impact of Racism on Black Youth: A Multidimensional Examination of Discriminatory Experiences Across Place and Time

PurposeCommunity violence disproportionally impacts Black youth. Experiences of racism and discrimination may create additional challenges for youth recovering from violence exposure. This study used ecological momentary assessment to elucidate how perceptions of racism and social support influence health and safety outcomes among Black youth following violence exposure.MethodsTwenty-five Black youth (14–19 years old, 60% female) who had witnessed violence within the past three months completed a baseline survey that assessed discrimination experiences, social support, post-traumatic stress symptoms (PTS), and perceived safety. Youth completed ecological momentary assessments three times daily for two weeks about the place they were in, people they were with, their current emotional state, and in-the-moment racism perceptions. Multilevel models estimated the relationship between overall and time-varying perceptions of racism and social support, PTS symptoms, and perceived safety.ResultsOverall, 76% of youth reported at least one discrimination experience at baseline. Prior discrimination was associated with higher PTS (B = 1.86, p = .001) and depressive symptoms (B = 0.13, p = .013) at baseline. Youth who reported higher overall perceptions of racism in-the-moment reported higher PTS (B = 0.50, p = .002) and lower perceived safety (B = ?0.53, p = .001). In-the-moment perceptions of racism were associated with lower perceived safety in that place (B = ?0.09, p < .01). Emotional and instrumental support were associated with lower PTS and higher perceived safety (p < .05).DiscussionExperiences of racism and being in discriminatory places impacted youth’s depressive symptoms, PTS symptoms, and perceived safety. Interventions attuned to in-the-moment experiences of racism, and that leverage social support, are needed to support Black youth exposed to violence and discrimination.     

Health inequalities between male and female immigrants in Spain after the beginning of the economic crisis

The aim of this study was to analyse health inequalities in the immigrant population in Spain in 2014, while differentiating between immigrant and native‐born men and women. We have designed a cross‐sectional study on the population aged over 15 years resident in Spain and the data were obtained from the 2014 European Health Survey in Spain (n = 22,842). Among immigrant men and women, we observed a lower risk of having a Chronic Physical Problem (CPP) or a Mental Health Problem (MHP) and a lower consumption of psychiatric drugs. We also observed a higher risk of lack of medical care in immigrant men compared to native‐born. The country of origin was not significantly related to self‐perception of health or use of Primary Care (PC) and Emergency Care services. In conclusion, we observed that now that the peak of the crisis has passed it seems that the “healthy immigrant” effect is being recovered, although the gender inequalities observed in the general population are transferred to the immigrant population. We need to approach the feminisation of migration from a new perspective and understand how inequalities affect immigrant women.     

Immigrant Status,Mental Health Need,and Mental Health Service Utilization Among High-Risk Hispanic and Asian Pacific Islander Youth

This study examined youth mental health service (MHS) use as a function of family immigrant status and type of mental health need (internalizing vs. externalizing). A sample of Hispanic and Asian/Pacific Islander families (youth ages 11–18; N = 457) involved with public sectors of care provided reports of youth mental health need during an initial interview and MHS use was examined prospectively over 2 years. While externalizing need predicted specialty and school-based MHS use in the overall sample, family immigrant status moderated the association between youth need and specialty MHS use such that immigrant youth were more likely to receive services for externalizing need and less likely to receive services for internalizing need relative to non-immigrant youth.     

Hope and perceptions of parental role among parents assessed as maltreating their children

The present study is anchored in the view that hope is a resource that fosters better coping and parenting. It examines the self‐perceived hope and parental role of parents whom the welfare services in Israel have assessed as maltreating their children. The parents were recruited in 2010 through facilities for maltreated children. The study sample consisted of 262 parents (68.4% response rate), divided into those who had at least one child removed from home and those whose children were all at home. Both groups of parents reported moderately high basic and family hope and sense of pathways and agency, and moderate perceived parental role, with no significant group differences. Differences were found, however, in the role of hope in mediating between parents’ sociodemographic features and their perceived parental role. The mediation was more substantial among the parents whose children were at home and differed in content. Only among parents whose children were at home did religiosity (β = 0.20, P < 0.05) and living with a partner (β = 0.18, P < 0.05) lead to greater hope, which increased the perceived parental role. Moreover, the findings underscore the lack of role of family hope and sense of agency among parents whose children were not at home. In both the groups, higher income led to greater hope (β = 0.18, P < 0.05 for at home; β = 0.16, P < 0.05 for in placement), which increased the self‐perceived parental role but the mediation was effected differently. The findings suggest that professionals working with parents who maltreat their children can use the parents’ hope as a resource to help them improve their parenting, especially where the child was removed from home.     

A matched case–control study comparing the health status of youth village alumni in Israel to the general population

Recent studies have noted that disproportionately adults with histories of childhood out‐of‐home placements, compared to adults without, suffer adulthood psychological and physical problems; however, these findings were based mostly on research investigating adults who were in the US foster care system. Building on this foundation, this study examined adults with histories of living in another type of childhood out‐of‐home placement, called youth villages, a situation in Israeli society reserved for youths who come from impoverished families with the added challenge of being immigrants, from single‐parent families, or having parents who struggle with mental health problems or substance abuse. This study's aim was to examine the longer term adulthood impact of having lived in youth villages on health status, by making comparisons to the general population using a sample matched by age and gender. Youth villages provided lists of alumni, ages 21–55, and telephone questionnaires were administered from November 2014 to December 2015. The adult youth village alumni (n = 152) were compared to a matched sample of the general population (n = 304) drawn from an existing Israeli nationwide data set. Conditional logistic regression was used to compare the health status of the two groups. Youth village alumni were found to have experienced many of the same adverse childhood events as did graduates from the US foster care system; however, after adjusting for confounders, the health status between the two groups did not differ. This dramatically different finding compared to studies on US foster care graduates suggests that the precursors of out‐of‐home placement and out‐of‐home placement itself may not always be devastating experiences with adulthood health repercussions. Future studies are needed to examine the context and process of out‐of‐home placement including: events preceding placement, context of assigning placement, placement itself, stability of placement, placement's fit for the youth's temperament and preparation for exit from the placement.     

Hospitalizations Among Chernobyl-Exposed Immigrants to the Negev of Israel, 1992–2017: A Historical Follow-Up Study

On April 26th, 1986 the nuclear reactor at Chernobyl, Ukraine exploded, causing the worst radiation disaster in history. The aim was to estimate hospitalization rates among exposed civilians who later immigrated to Israel. We conducted a historical follow-up study, among persons exposed to Chernobyl (n?=?1128) using linked hospitalization records from Soroka University Medical Center (SUMC), compared with immigrants from other areas of the Former Soviet Union (FSU) (n?=?11,574), immigrants not from FSU (n?=?11,742) and native-born Israelis (n?=?8351), matched on age and gender (N?=?32,795). Hospitalizations for specific ICD-10 coded diagnostic groups were analyzed by exposure and comparison groups by gender and age at accident. In addition, the rate of hospitalization, and the duration of hospital days and the number of hospitalizations for these selected diagnostic groups was also calculated. Hospitalizations for specific ICD-10 coded diagnostic groups and for any hospitalization in these diagnostic groups in general were analyzed by exposure and comparison groups and by covariates (gender and age at accident). The rate of any hospitalization for the selected diagnostic groups was elevated in the low exposure Chernobyl group (51.1%), which was significantly higher than the immigrant (41.6%) and the Israel-born comparison group (35.1%) (p?<?.01) but did not differ from either the high exposure group (46.9%) or the FSU comparison group (46.4%), according to the post-hoc tests. The total number of hospitalizations in the low exposure Chernobyl group (2.35) differed from the immigrant (1.73) and Israel comparison group (1.26) (p?<?.01) but did not differ from the FSU comparison group (1.73) or the high exposure group (2.10). Low exposure women showed higher rates of circulatory hospitalizations (33.8%) compared to immigrants (22.8%) and Israeli born (16.5%), while high exposure women (27.5%) only differed from Israelis (p?<?.01). Neither exposure group differed from FSU immigrant women on the rate of circulatory hospitalizations. Post-hoc tests showed that among women in the low exposure group, there was a significant difference in rate of hospitalizations for neoplasms (28.6%) compared to the three comparison groups; FSU (18.6%), immigrants (15.7%) and Israel (13.1) (p?<?.01). Those among the low exposure group who were over the age of 20 at the time of the accident showed the higher rates of circulatory (51.2%) and neoplasm hospitalizations (33.3%), compared to the other immigrant groups (p?<?.01). When controlling for both age at accident and gender, hospitalizations for neoplasms were higher among Chernobyl-exposed populations (RR?=?1.65, RR?=?1.77 for high and low-exposure groups, respectively) compared to other FSU immigrants (RR?=?1.31) other immigrants (RR?=?1.11) and Israeli born (RR?=?1.0) after controlling for gender and age at accident. High RRs attributable to Chernobyl exposure were also found for circulatory diseases compared to other immigrants and Israeli born (RRs?=?1.50, 1.47 for high and low exposure compared to 1.11. and 1.0, other immigrants and Israeli born, respectively). Endocrine problems and disorders of the eye also showed elevated RR compared to the immigrant comparison groups. Respiratory and mental disorders did not show any consistent association with Chernobyl exposure. The findings support unique Chernobyl morbidity associations only in some diagnostic groups, particularly for low exposure women. General immigration effects on hospitalizations compared to the Israeli born population were found on all diagnostic groups. There is a need to improve the services and medical follow-up for these Chernobyl exposed groups in specific diagnostic groups.

     

Risk and protective factors among at-risk ultraorthodox Jewish youth in Israel: A contextual model of positive adjustment

This study examined the role of personal (mastery), familial (relationship with parents), and communal (sense of community and sense of belonging to a youth centre) aspects for at-risk youths' adjustment. Specifically, we investigated their role as protective and risk factors for behavioural adjustment (risk behaviour) and psychological adjustment (hope). The study, conducted among Ultraorthodox Jewish males, included 80 participants, ages 14–24 (M = 16.8, SD = 2.33), who attended youth centres designed especially for Ultraorthodox at-risk youth, in five cities with a high percentage of Ultraorthodox population. Findings indicated a significant contribution of mastery to lower levels of risk behaviour and to higher levels of hope. The youth/parent relationship made a significant contribution only to lower levels of risk behaviours, while sense of community made a significant positive contribution only to hope. Surprisingly, the sense of belonging to a youth centre was found to be a risk factor for higher levels of risk behaviours. In contrast, a mediation model revealed an indirect positive contribution of sense of belonging to a youth centre to hope via mastery. The discussion highlights the unique phenomena of at-risk youth in the Ultraorthodox community and suggest carefully and thoroughly checking whether youth centres in this context should actually be discouraged. It also addresses the importance of recognising the unique protective and risk factors for positive adjustment among at-risk Ultraorthodox youth.     

Mild–moderate congenital hearing loss: secular trends in outcomes across four systems of detection

Background

Universal newborn hearing screening (UNHS) targets moderate or greater hearing loss. However, UNHS also frequently detects children with mild loss that results in many receiving early treatment. The benefits of this approach are not yet established. We aimed to (i) compare language and psychosocial outcomes between four hearing loss detection systems for children aged 5–8 years with congenital mild–moderate hearing loss; (ii) determine whether age of detection predicts outcomes; and (iii) compare outcomes between children identified via well‐established UNHS and the general population.

Methods

Linear regression adjusted for potential confounding factors was used throughout. Via a quasi‐experimental design, language and psychosocial outcomes were compared across four population‐based Australian systems of hearing loss detection: opportunistic detection, born 1991–1993, n = 50; universal risk factor referral, born 2003–2005, n = 34; newly established UNHS, born 2003–2005, n = 41; and well‐established UNHS, born 2007–2010, n = 21. In pooled analyses, we examined whether age of detection predicted outcomes. Outcomes were similarly compared between the current well‐established UNHS system and typically developing children in the Early Language in Victoria Study, born 2003, n = 1217.

Results

Age at diagnosis and hearing aid fitting fell steadily across the four systems. For moderate losses, mean expressive language (P for trend .05) and receptive vocabulary (P for trend .06) improved across the four systems, but benefit was not obvious for mild losses. In pooled analyses, diagnosis before age six months predicted better language outcomes for moderate losses. Children with mild–moderate losses exposed to well‐established UNHS continue to experience expressive language scores well below children in the general population (adjusted mean difference ?8.9 points, 95% CI ?14.7 to ?3.1).

Conclusions

Treatment arising from UNHS appears to be clearly benefitting children with moderate hearing losses. However, rigorous trials are needed to quantify benefits, versus costs and potential harms, of early aiding of children with mild losses.     

Substance use,generation and time in the United States: The modifying role of gender for immigrant urban adolescents

Although immigrant youth have lower rates of substance use than US born youth, whether substance use varies by generation and time in the US is unclear. This study examines adolescent alcohol, tobacco and marijuana use by generation/time in US (i.e., first generation, in US ≤4 years; first generation, in US >4 years; second generation; and third generation or higher). Data come from a 2008 survey of Boston, Massachusetts public high school students (n = 1485). Multivariable logistic regression models were used to examine the association between generation/time in the US and risk of past 30-day substance use, adjusting for age and race/ethnicity. To determine whether the associations differed by gender, we fit gender stratified regression models. The prevalence of substance use was lowest among immigrants who had been in the US ≤4 years. Among girls, generation/time in US was not related to alcohol use or to tobacco use. For boys, being an immigrant regardless of number of years in the US, as well as second generation was associated with a significantly lower risk of tobacco use, compared to third generation youth. Additionally, immigrant boys who had been in the US ≤4 years had a significantly lower risk of alcohol use. Among both boys and girls, all first and second generation youth were significantly less likely to report marijuana use compared to third generation youth. Immigrant youth have a lower risk of alcohol, tobacco and marijuana use relative to US born youth; however the protective effect of foreign nativity on alcohol was eroded much more quickly than for tobacco or marijuana. The effects of generation and time in US on substance use differ by gender and the particular substance.     

Evaluation of a community based dental clinic for youth experiencing homelessness in Brisbane

The relationship between homelessness and ill health is complex, and many risk factors for homelessness such as unemployment, low income, and substance abuse are also risk factors for poor oral health. In order to overcome barriers to access dental care, previous studies have recommended integrating dental care, referral pathways, and information within the overall care provided by support services available to people at risk of homelessness. This study aimed to evaluate a dental service developed and implemented to improve access to oral health care of disadvantaged youth in Brisbane. A mobile dental clinic run by volunteer dental professionals was implemented into a community organisation for disadvantaged youth. Participants were clients of Brisbane Youth Services who were disadvantaged youth, ≤25 years and attended the dental clinic in a 1 year period. A questionnaire collected demographic information, a self‐assessment of oral health and an evaluation of their experiences with the dental clinic. Clinical data including DMFT, appointment attendance and items of service provided were collected. One hundred and twelve clients participated in the four dental clinic weeks and its evaluation. Cost was the greatest reported barrier to accessing dental care among participants. More than half (57%) of participants who pre‐booked an appointment failed to attend. A total of 640 services were delivered, with an estimated value of $48,000. The majority (69%, n = 444) of the services provided were preventative services. Almost all of the clients felt the service they received was suitable for them (97%, n = 98) and would use the service again (98%, n = 99). This dental clinic model is feasible and sustainable due to its integration into an existing homeless youth service, low running costs, acceptability to clients and an interest by dental practitioners to volunteer. It provides a useful model which could be scaled up and implemented in other regions.     

HIV Knowledge Among Canadian-Born and Sub-Saharan African-Born Patients Living with HIV

Research has revealed differences on scales measuring HIV knowledge between individuals from various ethnic backgrounds and cultures. Few studies have examined this knowledge with immigrant populations and persons living with HIV. This study examined HIV knowledge among persons living with HIV who were either born in Canada or in sub-Saharan Africa and, for comparison, in a sample of college students. All participants were residing in Canada. Participants completed questionnaires measuring demographic variables, sexual health behaviour, and HIV status, treatment, and knowledge. Canadian-born patients living with HIV were more likely to be older and male than the other groups. On average, patients living with HIV were diagnosed 6.4 years ago, and 80% reported having current or previous experience taking HIV medications. After adjusting for age and gender, significant differences were found between the groups on the Brief HIV Knowledge Questionnaire. Canadian-born persons living with HIV (n = 110) scored higher than sub-Saharan African-born patients (n = 23) and college students (n = 81); mean percentage correct was 86, 70, and 62%, respectively (P < .01). These results suggested that ongoing HIV education is needed for all groups, and that additional tailored and targeted educational interventions are needed to address important gaps in knowledge among persons living with HIV patients originating from Africa and among college students.     

Perceived Discrimination Among Three Groups of Refugees Resettled in the USA: Associations With Language, Time in the USA, and Continent of Origin

The objectives of this study were to assess the prevalence and predictors of discrimination among a community-based sample of refugees resettled in the USA. We sought to test whether language, gender, time in the USA and country of origin were associated with the experience of discrimination among individuals resettled in the USA as part of the refugee resettlement program. Perceived discrimination was assessed among individuals from East Africa (n = 92), West Africa (n = 74), and from Eastern Europe (n = 112) using a multi-item measure of discrimination. Bivariate associations revealed statistically significant associations between experiences of discrimination and time in the USA, language ability, and sending country. A logistic regression model revealed that refugees from African sending countries were more likely than Eastern European individuals to experience discrimination, even after controlling for potentially confounding factors. We interpret this finding as evidence of racism and discuss the implications for population health and resettlement practice.     

Partner Selection among Latino Immigrant Men Who Have Sex with Men

This qualitative study explored partner selection in a sample of immigrant Latino men who have sex with men (MSM). In-depth interviews were conducted with men living in the greater New York metropolitan area who had been born in Brazil (n = 10), Colombia (n = 14), or the Dominican Republic (n = 9). One focus group was conducted with MSM from each of the three countries (9 Brazilian, 11 Colombian, and 5 Dominican participants). A grounded theory approach revealed three main themes relating to partner selection. The first concerned stereotypes of how Latino and Anglo-American men tend to behave in their sexual encounters and relationships. The participants perceived Latinos to be more affectionate and passionate, whereas they saw Anglo-American men as more independent and practical. These cultural discrepancies sometimes resulted in a preference for Latino partners. A second theme concerned stereotypes of the national groups, including expectations that Brazilians would be sexy and sensual and that Dominicans would have large penises. As found in other research on MSM of color, ethnic and national stereotypes were associated with experiences of sexual objectification. The third theme addressed the importance of masculine characteristics in sexual attraction and partner selection. Negative feelings towards effeminate men who did not conform to normative male physical or behavioral presentation reflect a stigma found inside and outside of the gay community. These findings suggest that gender and ethnic stereotypes play an important role in shaping partner choice and have implications for sexual risk and relationship formation.     

Birth Outcomes,Postpartum Health and Primary Care Contacts of Immigrant Mothers in an Australian Nulliparous Pregnancy Cohort Study

To investigate differences and similarities in birth outcomes, postpartum health and primary care contacts of mothers born overseas of non-English speaking background (NESB) compared with Australian-born mothers. Nulliparous women were recruited in early pregnancy (≤24 weeks gestation) to a prospective pregnancy cohort study from six metropolitan public hospitals in Victoria, Australia. Analyses are based on questionnaires completed in pregnancy and at 3 months postpartum. Of the 1,507 women recruited in the study, 1,431 women (95%) were followed up at 3 months postpartum. Immigrant mothers of NESB (n = 212) and Australian born mothers (n = 1,074) had similar obstetric outcomes and postpartum physical health outcomes. Immigrant women were more likely to say they had been depressed for 2 weeks or longer since the birth (Adj OR = 1.92, 95% CI 1.3–2.8); to report relationship problems (Adj OR = 1.39, 95% CI 0.9–2.1) and to report lower emotional satisfaction with their relationship with the partner (Adj OR = 1.69, 95% CI 1.1–2.6) after adjusting for age, education status, income, method of birth and genital tract trauma. Immigrant mothers were less likely to be asked about feeling low or depressed by general practitioners (OR = 0.79, 95% CI 0.5–0.9) and about relationship problems by maternal and child health nurses (OR = 0.68, 95% CI 0.5–0.9). Immigrant women of NESB reported greater psychological distress, less emotional satisfaction with their partner and more relationship problems in the first 3 months postpartum than Australian born women. Although immigrant mothers had an equivalent level of contact with primary care practitioners in the first 3 months postpartum, they were less likely to be asked about their emotional well-being or about relationship problems by health professionals.     

The Utility of Clinicians Ratings of Anxiety Using the Pediatric Anxiety Rating Scale (PARS)

Clinician ratings of anxiety hold the promise of clarifying discrepancies often found between child and parent reports of anxiety. The Pediatric Anxiety Rating Scale (PARS) is a clinician-administered instrument that assesses the frequency, severity, and impairment of common pediatric anxiety disorders and has been used as a primary outcome measure in several landmark treatment trials. However, no data on nonanxious youth have been published. The purpose of this study was to address this gap by examining clinician’s ratings of anxiety on the PARS in a volunteer sample of youth without anxiety disorders (n = 84; ages 7–12; 51% female, 75% Caucasian). The nonanxious sample was comprised of youth with (At-risk; n = 36) and without (Healthy; n = 48) anxious parents. Data were also used to evaluate the reliability (i.e., internal consistency), convergent, and divergent validity of the clinician-rated PARS. In addition, a receiver operating curve analysis was used to determine optimum cut off scores indicative of clinical levels of anxiety by comparing PARS scores between these nonanxious youth and a clinically anxious sample (n = 77) randomized in the Research Units of Pediatric Psychopharmacology (RUPP) anxiety study (RUPP 2001). Results indicated that anxious and nonanxious youth were significantly different on all PARS severity items. Optimum cutoff scores of 11.5 (5-item total score) and 17.5 (7-item total score) discriminated youth with and without anxiety disorders. Cronbach alphas for the Healthy and At-risk sample were .90 and .91 and .75 and .81 for the 5- and 7-item total PARS scores respectively, supporting the measure’s internal consistency among nonanxious youth. PARS total scores were positively correlated with other measures of anxiety (i.e., the Screen for Child Anxiety Related Emotional Disorders) for the At-risk but not Healthy subsample. PARS scores were not significantly correlated with depressive symptoms (i.e., Children’s Depression Inventory). Overall, findings support the utility of clinician’s assessments of anxiety symptoms for nonanxious youth. Using the PARS can help facilitate determining whether a child’s anxiety level is more similar to those with or without an anxiety disorder.     

Influence of Maternal Education on Child Immunization and Stunting in Kenya

In 2003, the child mortality rate in Kenya was 115/1000 children compared to 88/1000 average for Sub-Saharan African countries. This study sought to determine the effect of maternal education on immunization (n = 2,169) and nutritional status (n = 5,949) on child’s health. Cross-sectional data, Kenya Demographic Health Survey (KDHS)-2003 were used for data analyses. 80% of children were stunted and 49% were immunized. After controlling for confounding, overall, children born to mothers with only a primary education were 2.17 times more likely to be fully immunized compared to those whose mothers lacked any formal education, P < 0.001. For nutrition, unadjusted results, children born to mothers with primary education were at 94% lower odds of having stunted growth compared to mothers with no primary education, P < 0.01. Policy implications for child health in Kenya should focus on increasing health knowledge among women for better child health outcomes.