The Impacts of Migration on Multidimensional Child Well-Being: Comparative Analysis Between Moldova and Georgia

Using novel household survey data collected between September 2011 and December 2012 on migrant- and non-migrant households in Moldova and Georgia, this paper proposes a method for measuring and comparing multidimensional child well-being in a migration context. While a growing body of literature addresses the effects of migration for children “left behind”, relatively few studies have empirically analysed if and to what extent migration implies different well-being outcomes for children. To compare the outcomes of children in current- and non-migrant households, the present paper defines a multidimensional well-being index comprised of six dimensions of wellness: education, material living standards, protection, physical health, emotional health, and communication access. The results of both bivariate and multivariate analysis suggest that migration bears limited consequences for different domains of well-being. In both Moldova and Georgia children in migrant households were found to have a slightly lower probability of attaining material well-being, but in Georgia migration was linked to higher probabilities of children attaining wellbeing in physical health, communication access, and on total index level. The results suggest that when migration has any statistically significant effect on child well-being, it is generally positive and relatively low in magnitude. The impacts of migration appear to differ widely between Moldova and Georgia, however. While migration was seen to have limited effect on the well-being of children in Moldova, it seemed to bear more consequences for children in Georgia, which likely reflects different migration trajectories, mobility patterns, and levels of maturity of each migration stream

The impact of migration on children left behind in Moldova

This paper empirically evaluates the well-being of children "left behind" by migrant household members in Moldova. Using data derived from a nationally-representative, large-scale household survey conducted between September 2011 and February 2012 among 3,255 households (1,801 of which contained children aged 0-17) across Moldova, different dimensions of child well-being are empirically evaluated. Well-being of children in Moldova is divided into eight different dimensions, each of which is comprised of several indicators. Each indicator is examined individually and then aggregated into an index. Well-being outcomes are then compared by age group, primary caregiver, migration status of the household (current migrant, return migrant, or no migration experience), and by who has migrated within the household. It was found that migration in and of itself is not associated with negative outcomes on children’s well-being in any of the dimensions analysed, nor does it matter who in the household has migrated. Children living in return migrant households, however, attain higher rates of well-being in specific dimensions like emotional health and material well-being. The age of the child and the material living standards experienced by the household are much stronger predictors of well-being than household migration status in a number of different dimensions. The results suggest that migration does not play a significant role in shaping child well-being outcomes, contrary to the scenarios described in much past research. This paper is the first (to the authors’ knowledge) to link migration and multidimensional child poverty

“Children with an Absent Parent: Are They Worse-off?”

While it is taken as a given that the absence of a parent, main caregiver, or other family member can significantly affect many aspects of child well-being, the precise relationship between parental absenteeism through migration and child well-being outcomes is still uncertain. Within the field of migration studies increasing attention has been paid to the “left behind”, individuals who remain in the country of origin following the emigration of a household member. Available evidence on the lives of children left behind is scattered, however, due to the limited scope and depth of previous studies, many of which address the phenomenon through small-scale, qualitative studies. Migration of a household member could have both positive and negative effects on the well-being of children who remain in the country of origin: the transfer of remittances and availability of additional resources could enable the household to make increased investments in the education and health of children while enabling them to meet daily consumption needs without problem. At the same time the absence of a care giver could imply less supervision and greater emotional challenges for children. There are generally no universally positive or negative impacts of migration on well-being outcomes. Kandel and Kao (2001) note that there is a tendency to over-simplify potential positive benefits of migration, and nuance is often lost by failing to balance greater material resources against losses of less-easily measured impacts (such as parental supervision)

Efficacy of intra-articular hyaluronan (Synvisc®) for the treatment of osteoarthritis affecting the first metatarsophalangeal joint of the foot (hallux limitus): study protocol for a randomised placebo controlled trial

<p>Abstract</p> <p>Background</p> <p>Osteoarthritis of the first metatarsophalangeal joint (MPJ) of the foot, termed <it>hallux limitus</it>, is common and painful. Numerous non-surgical interventions have been proposed for this disorder, however there is limited evidence for their efficacy. Intra-articular injections of hyaluronan have shown beneficial effects in case-series and clinical trials for the treatment of osteoarthritis of the first metatarsophalangeal joint. However, no study has evaluated the efficacy of this form of treatment using a randomised placebo controlled trial. This article describes the design of a randomised placebo controlled trial to evaluate the efficacy of intra-articular hyaluronan (Synvisc^®) to reduce pain and improve function in people with hallux limitus.</p> <p>Methods</p> <p>One hundred and fifty community-dwelling men and women aged 18 years and over with hallux limitus (who satisfy inclusion and exclusion criteria) will be recruited.</p> <p>Participants will be randomised, using a computer-generated random number sequence, to receive a single intra-articular injection of up to 1 ml hyaluronan (Synvisc^®) or sterile saline (placebo) into the first MPJ. The injections will be performed by an interventional radiologist using fluoroscopy to ensure accurate deposition of the hyaluronan in the joint. Participants will be given the option of a second and final intra-articular injection (of Synvisc^®or sterile saline according to the treatment group they are in) either 1 or 3 months post-treatment if there is no improvement in pain and the participant has not experienced severe adverse effects after the first injection. The primary outcome measures will be the pain and function subscales of the Foot Health Status Questionnaire. The secondary outcome measures will be pain at the first MPJ (during walking and at rest), stiffness at the first MPJ, passive non-weightbearing dorsiflexion of the first MPJ, plantar flexion strength of the toe-flexors of the hallux, global satisfaction with the treatment, health-related quality of life (assessed using the Short-Form-36 version two questionnaire), magnitude of symptom change, use of pain-relieving medication and changes in dynamic plantar pressure distribution (maximum force and peak pressure) during walking. Data will be collected at baseline, then 1, 3 and 6 months post-treatment. Data will be analysed using the intention to treat principle.</p> <p>Discussion</p> <p>This study is the first randomised placebo controlled trial to evaluate the efficacy of intra-articular hyaluronan (Synvisc^®) for the treatment of osteoarthritis of the first MPJ (hallux limitus). The study has been pragmatically designed to ensure that the study findings can be implemented into clinical practice if this form of treatment is found to be an effective treatment strategy.</p> <p>Trial registration</p> <p>Australian New Zealand Clinical Trials Registry: ACTRN12607000654459</p

Emigration, remittances, and the subjective well-being of those staying behind

© 2018, The Author(s). We offer the first global perspective on the well-being consequences of emigration for those staying behind using several subjective well-being measures (evaluations of best possible life, positive affect, stress, and depression). Using the Gallup World Poll data for 114 countries during 2009–2011, we find that having family members abroad is associated with greater evaluative well-being and positive affect, and receiving remittances is linked with further increases in evaluative well-being, especially in poorer contexts—both across and within countries. We also document that having household members abroad is linked with increased stress and depression, which are not offset by remittances. The out-migration of family members appears less traumatic in countries where migration is more common, indicating that people in such contexts might be able to cope better with separation. Overall, subjective well-being measures, which reflect both material and non-material aspects of life, furnish additional insights and a well-rounded picture of the consequences of emigration on migrant family members staying behind relative to standard outcomes employed in the literature, such as the left-behind’s consumption, income, or labor market outcomes

Prevalence of hallux valgus in the general population: a systematic review and meta-analysis

BACKGROUND: Hallux valgus (HV) is a foot deformity commonly seen in medical practice, often accompanied by significant functional disability and foot pain. Despite frequent mention in a diverse body of literature, a precise estimate of the prevalence of HV is difficult to ascertain. The purpose of this systematic review was to investigate prevalence of HV in the overall population and evaluate the influence of age and gender. METHODS: Electronic databases (Medline, Embase, and CINAHL) and reference lists of included papers were searched to June 2009 for papers on HV prevalence without language restriction. MeSH terms and keywords were used relating to HV or bunions, prevalence and various synonyms. Included studies were surveys reporting original data for prevalence of HV or bunions in healthy populations of any age group. Surveys reporting prevalence data grouped with other foot deformities and in specific disease groups (e.g. rheumatoid arthritis, diabetes) were excluded. Two independent investigators quality rated all included papers on the Epidemiological Appraisal Instrument. Data on raw prevalence, population studied and methodology were extracted. Prevalence proportions and the standard error were calculated, and meta-analysis was performed using a random effects model. RESULTS: A total of 78 papers reporting results of 76 surveys (total 496,957 participants) were included and grouped by study population for meta-analysis. Pooled prevalence estimates for HV were 23% in adults aged 18-65 years (CI: 16.3 to 29.6) and 35.7% in elderly people aged over 65 years (CI: 29.5 to 42.0). Prevalence increased with age and was higher in females [30% (CI: 22 to 38)] compared to males [13% (CI: 9 to 17)]. Potential sources of bias were sampling method, study quality and method of HV diagnosis. CONCLUSIONS: Notwithstanding the wide variation in estimates, it is evident that HV is prevalent; more so in females and with increasing age. Methodological quality issues need to be addressed in interpreting reports in the literature and in future research

Corneal ulcerative disease in dogs under primary veterinary care in England: epidemiology and clinical management

Abstract Background Corneal ulcerative disease (CUD) has the potential to adversely affect animal welfare by interfering with vision and causing pain. The study aimed to investigate for the first time the prevalence, breed-based risk factors and clinical management of CUD in the general population of dogs under primary veterinary care in England. Results Of 104,233 dogs attending 110 clinics participating within the VetCompass Programme from January 1st to December 31st 2013, there were 834 confirmed CUD cases (prevalence: 0.80%, 95% confidence interval (CI) 0.75–0.86). Breeds with the highest prevalence included Pug (5.42% of the breed affected), Boxer (4.98%), Shih Tzu (3.45%), Cavalier King Charles Spaniel (2.49%) and Bulldog (2.41%). Purebred dogs had 2.23 times the odds (95% CI 1.84–2.87, P < 0.001) of CUD compared with crossbreds. Brachycephalic types had 11.18 (95% CI 8.72–14.32, P < 0.001) and spaniel types had 3.13 (95% CI 2.38–4.12, P < 0.001) times the odds for CUD compared with crossbreds. Pain was recorded in 385 (46.2%) cases and analgesia was used in 455 (54.6%) of dogs. Overall, 62 (7.4%) cases were referred for advanced management and CUD contributed to the euthanasia decision for 10 dogs. Conclusions Breeds such as the Pug and Boxer, and conformational types such as brachycephalic and spaniels, demonstrated predisposition to CUD in the general canine population. These results suggest that breeding focus on periocular conformation in predisposed breeds should be considered in order to reduce corneal disease

Adult Child Migration and Elderly Multidimensional Well-Being: Comparative Analysis Between Moldova and Georgia

Despite growing concern over the potential consequences of migration for the “left behind,” few systematic attempts have been made to document the relationship between the migration of an adult child and the well-being of his or her elderly parent(s) remaining in the country of origin. This article proposes a multidimensional elderly well-being index that enables the identification and comparison of outcomes between elderly individuals with and without adult migrant children in Moldova and Georgia, two former Soviet states that are both experiencing demographic and mobility transitions. The outcomes of elderly individuals with and without children living abroad are compared to illustrate in what domains child absence through migration corresponds to differing well-being outcomes. The findings suggest that the migration of an adult child is not as significant a factor in shaping well-being outcomes as would be expected based on past literature; other factors may play much stronger roles in shaping of well-being