Needs for Aging in Place:Views of Older Moroccan Adults in the Netherlands

Background and Objectives Due to health and/or financial limitations, older migrants may become especially dependent on their neighborhoods, highlighting the importance of investigating their experiences. We explored older Moroccan adults' views on the relative importance of neighborhood resources for aging in place.Research Design and Methods Thirty Moroccans aged >= 65 years residing in Amsterdam, Rotterdam, The Hague, and Utrecht were interviewed and asked to perform a ranking task developed with the combined quantitative and qualitative Q methodology. They ranked the relative importance of 38 statements representing the World Health Organization's 8 global age-friendly cities domains, with explanation of their reasoning. By-person factor analysis was performed to identify factors representing distinct viewpoints, which were interpreted with reference to the interviewees' comments.Results Four viewpoints were identified: "home sweet home"; "connected, well-informed, and engaged"; "suitable and affordable living"; and "a lively neighborhood." The perceived importance of neighborhood resources for aging in place differed among viewpoints.Discussion and Implications Older Moroccan adults prioritize different neighborhood resources for aging in place. Our findings suggest that their diverse needs can be satisfied by enabling family to live in close proximity, providing diverse, inclusive neighborhoods with affordable, suitable housing, understandable information, social/cultural activities, and care services for vulnerable groups. Future studies may build on our findings to explore older (migrant) adults' views on needs for aging in place in the Netherlands and other western countries

Needs for Aging in Place:Views of Older Moroccan Adults in the Netherlands

BACKGROUND AND OBJECTIVES: Due to health and/or financial limitations, older migrants may become especially dependent on their neighborhoods, highlighting the importance of investigating their experiences. We explored older Moroccan adults' views on the relative importance of neighborhood resources for aging in place.RESEARCH DESIGN AND METHODS: Thirty Moroccans aged ≥ 65 years residing in Amsterdam, Rotterdam, The Hague, and Utrecht were interviewed and asked to perform a ranking task developed with the combined quantitative and qualitative Q methodology. They ranked the relative importance of 38 statements representing the World Health Organization's eight global age-friendly cities domains, with explanation of their reasoning. By-person factor analysis was performed to identify factors representing distinct viewpoints, which were interpreted with reference to the interviewees' comments.RESULTS: Four viewpoints were identified: "home sweet home"; "connected, well-informed, and engaged"; "suitable and affordable living"; and "a lively neighborhood." The perceived importance of neighborhood resources for aging in place differed among viewpoints.DISCUSSION AND IMPLICATIONS: Older Moroccan adults prioritize different neighborhood resources for aging in place. Our findings suggest that their diverse needs can be satisfied by enabling family to live in close proximity, providing diverse, inclusive neighborhoods with affordable, suitable housing, understandable information, social/cultural activities, and care services for vulnerable groups. Future studies may build on our findings to explore older (migrant) adults' views on needs for aging in place in the Netherlands and other western countries.</p

Role of fetal pulmonary artery Doppler in prediction of neonatal respiratory distress in neonates of diabetic mothers

Background: Newborn respiratory complication is one of the most prevalent and life-threatening disorders. The clinical indications of early newborn respiratory distress with consistent radiologic features. The Doppler examination of the primary pulmonary artery in the foetus has been proven to be beneficial. The foetal pulmonary artery At/Et ratio is linked to foetal gestational age and amniotic fluid foetal lung maturity (FLM) tests. The aim of the study was to assess the accuracy of foetal main pulmonary artery (MPA) Doppler indices in prediction of the development of neonatal respiratory distress syndrome (RDS) in diabetic mothers.Methods: This was a prospective observational study carried out on 100 cases of diabetic mothers in obstetrics and gynecology department, Tanta University during one year from the approval of the university counsel. The physician evaluated the foetal heart in a methodical manner after a regular ultrasound assessment that included foetal biometry, anomaly scan, measured foetal weight, and amniotic fluid index. Classic chest radiological features include reticulogranular patterns, air bronchogram and ground glass look, as well as the need for surfactant.Results: PI and RI were significantly higher in newborns with RDS than those without RDS (p=0.025 and 0.036 respectively) PSV and At/Et ratio were significantly reduced in neonates with RDS compared with RDS free ones (p=0.004 and <0.001 respectively). RI was significantly higher in neonates with RDS than those without RDS (P = 0.048) PSV and At/Et ratio were significantly reduced in newborns with RDS compared to RDS free ones (p=0.008 and <0.001 respectively). The ROC curve displayed that the cut off value of ≤0.25 for At/Et ratio was associated with a sensitivity of 76.92%, a specificity of 100.0%, a PPV of 100.0% and a NPV of 96.7% for prediction of neonatal RDS with AUC of 0.925 and p≤0.001.Conclusions: development of neonatal RDS in foetus of diabetic mothers with a cut off value of ≤0.25, a sensitivity of 76.92%, a specificity of 100.0%, a PPV of 100.0%, a NPV of 96.7% and AUC of 0.925 The usage of corticosteroids improved the Doppler indices of main pulmonary artery and is accompanied by less morbimortality related to RDS

‘You understand me, right?’.:Health research among the Moroccan community in the Netherlands

Based on a secondary analysis of three qualitative studies, we describe three tensions that arose when conducting health research within the Moroccan community in the Netherlands. Namely, the tension between (1) the need for an informal recruitment approach and preventing participation as a social obligation, (2) building a relationship of trust and breaking taboos and (3) immersing into respondents’ life world and keeping a distant perspective. The current scientific practice provides limited space to align with ethnic minority’s experience that professional and formal institutes have little attention for their perspectives and needs. Research teams, consisting of researchers from different backgrounds, who take time to continuously reflect collectively on the research process are necessary to recognize such tensions and find ways to deal with these tensions

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Vi är helt enkelt för olika : En kritisk diskursanalys av flashbackskribenters syn på koranbränningen i Malmö 2020

The request for permission to complete a Quran burning in Malmö sparked strong emotions, particularly among muslims. Some people have used physical means to express their emotions, resulting in demonstrations. Using a critical discourse method, this study critically analyzed 259 comments on how forum writers on Flashback valued Quran burning. This study takes a perspective that focuses on developing knowledge that can help people who are disadvantaged. Social constructivism and intersectionality are the theories that have been adopted. The study reveals themes that almost entirely center on muslims reactions to the event rather than the event itself. Many themes are pro-Quran burning, and some of those who are against it are not motivated by anti-discrimination concerns. It turns out that forum writers place more value on the burning of the Quran and less on muslims and their faith

Burning Hijabs and Breaking Frames : A qualitative content analysis on Swedish daily newspapers framing of the Iranian protest

For studies of social movements, media is the most crucial aspect when it comes to understanding the movement. And for a civil society choosing to protest under an authoritarian regime, the media is more than crucial, it is key. Based on the social media attention the protests in Iran after Mahsa Aminis death received, this study intends to see how the Swedish daily newspapers SvD and DN framed the protest, focusing on message, political actors and local voices- the key aspects to include when framing a protest. The empirical data for this study consists of articles published between September 16, 2022 and November 16, 2022, making it up to 124 articles to examine. By using a coding scheme for the content analysis, it is based on previous studies regarding the protest paradigm, which is a theory applied to understand the focus on spectacle in media's portrayal of protests. This study developed two coding schemes where the first one is for the aim of identifying the overall portrayal and the second intends to identify frames that further contribute to the constructions of the political actors. Along with the content analysis, framing theory and the protest paradigm, the study adopts the social constructivist view of language to be able to understand the role of news in shaping public perceptions. Analyzing news coverage through this perspective allowed this study to gain a deeper understanding of how knowledge is constructed and how it shapes our understanding of the world. Lastly, by applying discourse analysis the study was able to examine the language within the frames and how it was used to construct reality and political actors in different ways. It was helpful in finding out the influence of the articles in creating as well as changing political and societal discourse around the issue. The study revealed a result that challenged the protest paradigm as well as confirming some results in previous research. Violence frames were in previous literature the main frames, which it was in this study too, however, in this study the violence frames did not get interpreted as in the protest paradigm theory since protest under authoritarian regimes needed another analytical eye focusing more on the context and the way in which the violence was directed towards

Vi är helt enkelt för olika : En kritisk diskursanalys av flashbackskribenters syn på koranbränningen i Malmö 2020

The request for permission to complete a Quran burning in Malmö sparked strong emotions, particularly among muslims. Some people have used physical means to express their emotions, resulting in demonstrations. Using a critical discourse method, this study critically analyzed 259 comments on how forum writers on Flashback valued Quran burning. This study takes a perspective that focuses on developing knowledge that can help people who are disadvantaged. Social constructivism and intersectionality are the theories that have been adopted. The study reveals themes that almost entirely center on muslims reactions to the event rather than the event itself. Many themes are pro-Quran burning, and some of those who are against it are not motivated by anti-discrimination concerns. It turns out that forum writers place more value on the burning of the Quran and less on muslims and their faith