Common mental disorders among adult members of 'left-behind' international migrant worker families in Sri Lanka

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

Out on a limb: Arboreal camera traps as an emerging methodology for inventorying elusive rainforest mammals

Traditionally, arboreal rainforest mammals have been inventoried using ground-based survey techniques. However, given the success of camera traps in detecting secretive terrestrial rainforest mammals, camera trapping could also be a valuable tool for inventorying arboreal species. Here we assess, for the first time, the effectiveness of arboreal camera traps for inventorying arboreal rainforest mammals and compare the results with those from other methodologies. We do so in one of the world’s most biodiverse conservation areas, the Manu Biosphere Reserve, Peru. We accumulated 1201 records of 24 arboreal mammal species. Eighteen species were detected by arboreal cameras, seven by diurnal line transects, six by nocturnal transects and eighteen through incidental observations. Six species were only detected using arboreal camera traps. Comparing arboreal camera traps with traditional ground-based techniques suggests camera traps are an effective tool for inventorying arboreal rainforest mammal communities. They also detected more cryptic species compared with other methodologies. Daily detection frequency patterns were found to differ between ground-based techniques and arboreal cameras. A cost-effort analysis indicated that despite greater upfront costs in equipment and training for arboreal camera trapping, when accounting for the additional survey hours required to provide similar numbers of records using ground-based methods, overall costs were similar. Our work demonstrates that arboreal camera trapping is likely to be a powerful technique for inventorying canopy mammals. The method has considerable potential for the study of charismatic and threatened arboreal mammal species that may otherwise remain largely unknown and could quietly disappear from the world’s tropical forests. © 2016, Mongaby.com e-journal. All rights reserved

Development and preliminary validation of a questionnaire to measure satisfaction with home care in Greece: an exploratory factor analysis of polychoric correlations

<p>Abstract</p> <p>Background</p> <p>The primary aim of this study was to develop and psychometrically test a Greek-language instrument for measuring satisfaction with home care. The first empirical evidence about the level of satisfaction with these services in Greece is also provided.</p> <p>Methods</p> <p>The questionnaire resulted from literature search, on-site observation and cognitive interviews. It was applied in 2006 to a sample of 201 enrollees of five home care programs in the city of Thessaloniki and contains 31 items that measure satisfaction with individual service attributes and are expressed on a 5-point Likert scale. The latter has been usually considered in practice as an interval scale, although it is in principle ordinal. We thus treated the variable as an ordinal one, but also employed the traditional approach in order to compare the findings. Our analysis was therefore based on ordinal measures such as the polychoric correlation, Kendall's Tau b coefficient and ordinal Cronbach's alpha. Exploratory factor analysis was followed by an assessment of internal consistency reliability, test-retest reliability, construct validity and sensitivity.</p> <p>Results</p> <p>Analyses with ordinal and interval scale measures produced in essence very similar results and identified four multi-item scales. Three of these were found to be reliable and valid: socioeconomic change, staff skills and attitudes and service appropriateness. A fourth dimension -service planning- had lower internal consistency reliability and yet very satisfactory test-retest reliability, construct validity and floor and ceiling effects. The global satisfaction scale created was also quite reliable. Overall, participants were satisfied -yet not very satisfied- with home care services. More room for improvement seems to exist for the socio-economic and planning aspects of care and less for staff skills and attitudes and appropriateness of provided services.</p> <p>Conclusions</p> <p>The methods developed seem to be a promising tool for the measurement of home care satisfaction in Greece.</p

Risk of mental health and nutritional problems for left-behind children of international labor migrants

BACKGROUND: One-in-ten Sri Lankans are employed abroad as International Labor Migrants (ILM), mainly as domestic maids or low-skilled laborers. Little is known about the impact their migration has on the health status of the children they 'leave behind'. This national study explored associations between the health status of 'left-behind' children of ILM's with those from comparative non-migrant families. METHODS: A cross-sectional study design with multi-stage random sampling was used to survey a total of 820 children matched for both age and sex. Socio-demographic and health status data were derived using standardized pre-validated instruments. Univariate and multivariate analyses were used to estimate the differences in mental health outcomes between children of migrant vs. non-migrant families. RESULTS: Two in every five left-behind children were shown to have mental disorders [95%CI: 37.4-49.2, p < 0.05], suggesting that socio-emotional maladjustment and behavioural problems may occur in absence of a parent in left-behind children. Male left-behind children were more vulnerable to psychopathology. In the adjusted analyses, significant associations between child psychopathological outcomes, child gender and parent's mental health status were observed. Over a quarter (30%) of the left-behind children aged 6-59 months were 'underweight or severely underweight' compared to 17.7% of non-migrant children. CONCLUSIONS: Findings provide evidence on health consequences for children of migrant worker families in a country experiencing heavy out-migration of labour, where remittances from ILM's remain as the single highest contributor to the economy. These findings may be relevant for other labour 'sending countries' in Asia relying on contractual labor migration for economic gain. Further studies are needed to assess longitudinal health impacts on the children left-behind

Hybrid Navigation Decision Control Mechanism for Intelligent Wheel-Chair

The continuous rising of the elderly/disabled population has created a requirement for assistive robotics devices to counter the lack of trustworthy servants. Intelligent Wheelchairs are developed for that particular purpose. Intelligent Wheelchairs differ depending on the interactive modality and most commonly found modalities are speech-controlled. Since these are assistive devices that need to act as human companions, it is necessary to have a dialogue between the device and the user. Even though the wheelchair is fully automated, the user should have control over it at some point. However, this exchange of control should be intelligent and transitions need to be executed in order to safeguard the user. Therefore the purpose of this paper is to propose an intelligent system that would navigate an intelligent voice-controlled wheelchair facilitating the intelligent exchange of control between the user and the wheelchair. This control is not simultaneous and one can override the other only when navigation could lead to collisions. In the proposed method, users can control the wheelchair using fixed vocal commands, and execution of those commands will be performed using the spatial and control parameters. Control of the wheelchair will be exchanged between the user and the wheelchair itself considering specific parameters such as obstacle distance, collision time, the velocity of the wheelchair among others. User control mode has 5 definite vocal commands with classifiers to identify any navigation command into the command model and considers uncertain terms such as &#x2018;little&#x2019; and &#x2018;hard&#x2019; for &#x2018;Turn&#x2019; commands. Command classification had produced a Cohen&#x2019;s Kappa value of 0.9462 and the classifier for the uncertain terms had produced a Cohen&#x2019;s Kappa value of 0.7325. Both were acceptable values for those particular classifications. As per the experiment results, the proposed system reduced the vocal command frequency and risk of collisions through proper control of the velocity levels and intelligent exchange of control at given locations

Metals and Metallothionein Expression in Relation to Progression of Chronic Kidney Disease of Unknown Etiology (CKDu) in Sri Lanka

Chronic kidney disease of unknown etiology was investigated for metal relations in an endemic area by a cross-sectional study with CKD stages G1, G2, G3a, G3b, G4, G5 (ESRD), and endemic and nonendemic controls (EC and NEC) as groups. Subjects with the medical diagnosis were classified into groups by eGFR (SCr, CKD-EPI) and UACR of the study. It determined 24 metals/metalloids in plasma (ICPMS) and metallothionein (MT) mRNA in blood (RT-PCR). MT1A at G3b and MT2A throughout G2&ndash;G5 showed increased transcription compared to NEC (ANOVA, p &lt; 0.01). Both MT1A and MT2A remained metal-responsive as associations emerged between MT2A and human MT inducer Cr (in EC: r = 0.54, p &lt; 0.05, n = 14), and between MT1A and MT2A (in EC pooled with G1&ndash;G5: r = 0.58, p &lt; 0.001, n = 110). Human MT (hMT)-inducers, namely Zn, Cu, As, Pb, and Ni; &Sigma; hMT-inducers; 14 more non-inducer metals; and &Sigma; MT-binding metals remained higher (p &lt; 0.05) in EC as compared to NEC. Declining eGFR or CKD progression increased the burden of Be, Mg, Al, V, Co, Ni, Rb, Cs, Ba, Mn, Zn, Sr, &Sigma; hMT-inducers, and &Sigma; MT-binding metals in plasma, suggesting an MT role in the disease. MT1A/2A mRNA followed UACR (PCA, Dendrogram: similarity, 57.7%). The study provides evidence that proteinuric chronic renal failure may increase plasma metal levels where blood MT2A could be a marker