Double Burden Research Articles

Migrant students’ self-reported executive function skills in relation to mental health, postmigration stress, and positive appraisals of self and the social context

ABSTRACT Background: Refugee and non-refugee migrant youths may carry a double burden of past adversities and post-migration stress while trying to continue schooling and adapt to their new social and cultural environment. Executive functioning skills are central to learning and navigating in the new context. Knowledge of how young migrants’ executive functioning is associated with stressful factors and positive or potentially protective factors, could contribute to understanding and possibly finding ways to support these young learners. Objective: To investigate how potentially stressful and positive factors are associated with executive function skills. Method: In a secondary, explorative analysis of questionnaire responses from 1312 migrant students in secondary schools in five European countries, the associations of planning- and initiative executive function skills (PIS-EF) with stressful factors (e.g. emotional and behavioural problems, daily stress, discrimination) and positive factors (e.g. resilience, school belonging, social support) were analysed by linear regression. Furthermore, differences between male/female and refugee/non-refugee migrants were examined. Results: Positive factors accounted for almost one-fifth of the variance in the students’ self-reported PIS-EF and stress factors only one-tenth. Resilience showed the strongest association with students’ PIS-EF, followed by Prosocial behaviour and School belonging. Hyperactivity, and symptoms of anxiety and depression were negatively associated with PIS-EF. Posttraumatic stress symptoms were minimally associated with the investigated aspects of executive functions. Adjusted for other variables, no variables showed significant differences in the association with EF between males and females, and refugee and non-refugee migrant students. Conclusions: Positive factors were more strongly associated with executive functioning than stressful factors and could represent pathways to strengthen executive functioning. To support migrant youths’ functioning, the school, healthcare, and social systems should take a resource-oriented perspective and lay the ground for migrant youth's feeling of belongingness and active use of their personal resources.

Demographic, socioeconomic and dietary factors are associated with double burden of malnutrition among indigenous communities in Sarawak

Introduction: Double burden of malnutrition (DBM), encompassing both overnutrition and undernutrition, is a growing global public health issue. Indigenous people are one of the marginalised populations experiencing DBM at varying severity. This study aimed to identify factors contributing to DBM in indigenous households in Sarawak. Methods: This cross-sectional study utilised multistage random sampling to include 286 indigenous households from six administrative divisions in Sarawak. Mothers aged 20–49 years who had at least one child aged 2–12 years were recruited. Trained interviewers obtained information on demographic and socioeconomic characteristics, food security, and dietary intake via a two-day, 24-hour dietary recall. Height and weight measurements followed World Health Organization protocols. DBM household was identified as having an overnourished (overweight/ obese) mother with an undernourished (underweight/stunting/wasting) child within the same household. Simple and multiple binary logistic regression analyses were performed. Results: Prevalence of DBM among the indigenous communities in Sarawak was 25.2%. Households with an overweight/obese mother and a stunted child was 12.9%, wasted child (11.9%), and underweight child (9.4%). Households with younger mothers, a household size of >4 persons, and higher income per capita (relative to sample population) were significantly more likely to have DBM. Conversely, households with higher monthly non-food expenditure and greater fish and seafood intake scores in children were significantly less likely to have DBM. Conclusion: DBM is prevalent among Sarawak’s indigenous communities, affecting 25.2% of households. Further research and targeted interventions are needed to address socioeconomic and dietary factors in these populations.

Gendered Perceptions and the Costs of Political Toxicity: Experimental Evidence from Politicians and Citizens in Four Democracies

Politicians frequently face toxic behaviors. We argue that these behaviors impose a double burden on women, who may not only face higher exposure to toxicity, but experience attacks that they and others understand to be motivated by prejudice and designed to push them out of office. Using large-scale image-based conjoint experiments in the United States, Denmark, Belgium, and Chile, we demonstrate that both politicians themselves and citizens regard messages targeting women politicians as more toxic than otherwise equivalent messages targeting men. This perception intensifies when messages mention gender or come from perpetrators who are men. A second experiment to investigate the mechanisms shows that hostile behaviors toward women are more frequently understood as driven by prejudice and attempts to remove women from politics. These findings highlight the importance of understanding how perceptions of perpetrators’ motives affect the severity of political toxicity, and provide insights into the gendered effects of political hostility.

THE INFLUENCE OF FAMILY SOCIO-ECONOMICS AND SOCIAL SUPPORT FROM THE FAMILY SUPPORT TEAM ON STUNTING (Cases in Families at Risk of Stunting in Purwadadi District, Ciamis Regency, 2024)

The problem of stunting which a part of the double burden of malnutrition has a very detrimental impact both in terms of health and economic productivity. The causes of stunting are divided into specific factors and sensitive factors. Sensitive factors that are considered to have an influence on the incidence of stunting are the family's socio-economic and also the social support provided by the family support team who have an important role in efforts to prevent stunting. The socio-economic factors that influence the incidence of stunting in risk of stunting families in Purwadadi District are the level of education from the parents, family income level, participation in family planning programs as a contraception acceptor and the number of children in the family. All forms of social support provided by the family support team in the form of informational, instrumental, emotional, appreciation and friendship/social integration support have an influence on the incidence of stunting in families at risk of stunting in Purwadadi District. The social support from the family support team on stunting that has the most dominant influence on the incidence of stunting in families at risk of stunting in Purwadadi District was informational support and friendship/social integration support.

Cancer care and outreach in South Asian Association for Regional Cooperation (SAARC) countries: from epidemiology and the National Cancer Control Programme to screening, diagnosis, and treatment.

South Asian Association for Regional Collaboration (SAARC) countries, home to 24% of the world's population, are facing the double burden of disease (ie, where a population experiences both an increasing incidence of cancers typically associated with affluence and a sustained or rising burden of cancers linked to infections and poverty) with non-communicable diseases (NCDs) attributing to 47% of the global burden of disease and to about 60% of all deaths. In 2022, cancer in this region accounted for approximately 9·3% of incidence worldwide and 12% of global mortality. Cancer is one of the major NCDs affecting South Asia, accounting for a large proportion of disability-adjusted life-years lost in this region. The most common cancers are lung, head and neck, and gastrointestinal cancers in both sexes, and cervix and breast cancers in females. The cancer burden is high in SAARC countries, although there are differences among countries and within urban and rural regions of each country, depending on the level of available resources, development, and epidemiological shift. Here we discuss various cancer care issues and challenges throughout the cancer care continuum in the SAARC region. We make an urgent call for regional collaboration to develop, modify, and implement a holistic cancer control plan and formulate a systematic approach directed to address the growing burden of cancer in this region. It is crucial to establish strong political will and commitment to take forward the recommended actions outlined in this Series to overcome and address the cancer crisis in the SAARC region, aligning with Sustainable Development Goal 2030 targets.

An Autoethnographic Perspective on Scholarly Impact, Citation Politics, and North–South Power Dynamics

ABSTRACT Citations signal the significance and impact of publication outputs, conferring prestige within an academic prestige economy. The longstanding academic mandate to ‘publish or perish’ has been married with the modern expectation to ‘demonstrate impact or perish,’ reflecting an evolution in scholarly priorities and imposing a ‘double burden’ on scholars, particularly on early-career researchers and marginalised voices. I examine factors influencing citation metrics through an autoethnographic lens, situating them within my subjective experiences and exploring their broader implications. Drawing on my research portfolio from 2016 to 2022, which focuses on Nigerian society, I discuss how research location and other contextual factors shape scholarly impact and citation metrics. Disparities in citation rates between Western and non-Western regions reflect unequal power, resources, and recognition distributions. I assess the interaction between citation metrics and the significance of my research portfolio, which includes five empirical and two conceptual peer-reviewed articles. While I reflect on my delayed recognition of these citation metrics and impact dynamics after earning my doctorate, I advocate for improved education on these factors in social science graduate curricula. Citations are not mere appendages: they are the lifeblood coursing through the veins of academia’s ecosystem.

Breastfeeding Support for All: Narrowing Inequalities for Nurturing a Future That Is Fair and Sustainable

Early initiation of breastfeeding, duration, and exclusivity are internationally recommended practices to maximize impact in preventing and reducing the double burden of malnutrition, reducing child mortality and other morbidities, improving child development, and reducing health costs. The protection, promotion, and support of breastfeeding are also central to countries' commitments to the 2030 Agenda for Sustainable Development. Global progress in breastfeeding rates has been reported in past years. However, many children are still left behind and are not receiving the numerous benefits of breastfeeding. There are also relevant inequities in breastfeeding rates across global regions and countries and between groups from different socioeconomic statuses and cultural backgrounds within countries. These inequities are also extended to the frequency and availability of comparable standardized indicators worldwide. In 2023, globally, only 39% of the countries provided information on exclusive breastfeeding rates to the age of six months, and 7% assessed their overall breastfeeding support programs in the past five years. The increase in the coverage and frequency of monitoring globally agreed breastfeeding targets and the assessment of the impact of breastfeeding programs are imperative to providing breastfeeding support for all and increasing breastfeeding prevalence equitably. Breastfeeding can be an equalizer in society; no one should be left behind. Only this way can breastfeeding mums be celebrated in all their diversity and journeys, attending the 2024 World Breastfeeding Week call.

Spatial variation, 20-year trends, and determinants of the double burden of wasting and stunting among under-five children in Ethiopia: a geo-spatial and multivariate decomposition analysis (2000–2019)

Despite extensive efforts, malnutrition persists as a critical public health concern, particularly in developing nations like Ethiopia. Concurrent occurrence of wasting and stunting poses severe consequences. Analyzing trends and factors contributing to this double burden is vital for evaluating and enhancing existing nutritional programs. Additionally, understanding the spatial distribution of malnutrition is crucial for targeted resource allocation, expediting progress towards optimal child growth. A 20-year trend and spatial analysis was conducted among 27,138 weighted samples of under-five children using EDHS (2000–2019). The data extraction was conducted between October 1 and November 1, 2023. STATA 18, ArcGIS Pro, and Sat Scan 9.6 were used for analysis. A logit-based multivariate decomposition analysis was used to identify contributing factors for the change in the double burden of wasting and stunting in the past 20 years. The statistical significance was declared at a P-value < 0.05. The double burden of wasting and stunting had shown a decline from 8.42% in 2000 to 3.31% in 2019. There is a clustered distribution of wasting and stunting (Moran’s I = 0.0712, p-value = 0.0290). Significant clustering is detected in the Somali, Afar, and Tigray regions. Among the changes in the effect of the characteristics (coefficient), maternal education level [β = −0.0012, 95% CI −0.0021, −0.0006], wealth level [β = −0.0049, 95% CI −0.0223, −0.0014], family size [β = −0.0014, 95% CI −0.0132, −0.0009] and media access [β = −0.0027, 95% CI −0.0039, −0.0014] were found to be significant contributors to the reduction of the double burden of wasting and stunting over the past 20 years. Despite the significant progress observed in the past 20 years, the problem still requires urgent attention. Thus, improving maternal education and household wealth levels is crucial. Furthermore, enhancing access to and utilization of family planning services and media coverage will help alleviate the burden and end malnutrition. Additionally, deploying additional resources in hotspot areas is also recommended.

Double Burden of Malnutrition Among Pregnant Women in Rural Jharkhand: Evidence From a Cross-Sectional Study

Double Burden of Malnutrition Among Pregnant Women in Rural Jharkhand: Evidence From a Cross-Sectional Study

Who Wants to be a Journalist? Journalists’ Exposure to Violence on the Job

ABSTRACT Research shows that journalists are especially vulnerable to hostile situations that include physical or verbal violence, either online or offline. Digital environments have contributed to an increasing hostility, and women journalists seem to face a double burden. Violence toward journalists may endanger journalism as an institution, and it may add to the already extensive emotional labor experienced by journalists. Yet there seems to be a “normalization” of certain attitudes against journalists. Through semi-structured interviews with Portuguese journalists (N0 = 50), this research shows that most of them have faced violence on the job. Online abuse usually consists of threats and insults, via email, social media, or comments’ sections, and it is often normalized within newsrooms. Offline abuse occurs mostly in the coverage of events such as football matches, protests, political campaigns, or court hearings. Newsrooms are also a setting where journalists are under (psychological) violence, through intimidation or bullying.

Prevalence and trends of double burden of malnutrition at household-level in South and Southeast Asia

Prevalence and trends of double burden of malnutrition at household-level in South and Southeast Asia

The intersectionality of gender discrimination impact on Beth Harmon’s identity development in The Queen’s Gambit

The Queen's Gambit (2020) addresses gender inequality against women in male-dominated industries like chess. Queen's Gambit displays patriarchal structural and representational judgment of women. Gender discrimination affects women's careers, identities, and development. Thus, the study examines gender discrimination's intersectionality and its effects on Beth Harmon, a white low-class young woman. Pictures and talks from the series are the key data in this qualitative study. Also used are intersectionality theory to analyze gender discrimination statistics and stages of development theory to examine character identity development. Gender, age, ethnicity, class, prejudices, and appearances encountered by Beth Harmon shaped her multifaceted identity. Discrimination hindered Beth's development as a chess player and woman throughout her school years, adolescence, and young adulthood, leading to both dystonic and syntonic effects. Stereotypes and injustice give rise to discrimination; therefore, we must acknowledge various identities and histories to prevent a "double burden" of discrimination that impedes growth.

Design science in public administration: producing both situational interventions and generic knowledge

Abstract Design science is making a comeback in the discipline of public administration: inspired by the growing popularity of design thinking, various scholars have highlighted the value of design science for the public sector. This theoretical and methodological article aims to contribute to the academic value of design science and focuses on the “double burden” of design science: how can it be applied in such a way that it generates both (relevant) situational interventions and contributes to (robust) generic academic knowledge? We identify which types of generic academic knowledge can be generated through design science in public administration: theoretical knowledge, design exemplars, methodological knowledge, and normative knowledge. We use these four types of generic knowledge to develop a new perspective on design science. We also present guidelines for design research that aim to generate both situational interventions and generic knowledge. These guidelines emphasize the need to be more rigorous and systematic in the process of design research as to ensure the validity and reliability of the contributions to generic knowledge for the discipline of public administration.

Intersectoral collaboration and health system resilience during COVID-19: learnings from Ahmedabad, India.

Health system resilience refers to the capacity of a health system to effectively anticipate, assimilate, adjust to and recuperate from unforeseen disruptions and pressures. Evidence indicates that low- and middle-income countries (LMICs) have a double burden of dealing with the existing shortage of health resources in managing both non-emergency care and emergency care during epidemics. Intersectoral collaboration plays a pivotal role in managing crises such as pandemics. The World Health Organization has emphasized that effective intersectoral collaboration is vital for uninterrupted essential services during a pandemic. The study aimed to look at the collaborations entered into at various levels for managing the COVID-19 pandemic, taking as an example the municipal corporation in Ahmedabad, India. We undertook a qualitative study that involved conducting 52 in-depth interviews with officials from the health department, and other departments at the Ahmedabad Municipal Corporation (AMC), including firefighting, estate, engineering and education, as well as private stakeholders. Many diverse observations were documented in this study as collaboration varied across the sectors. A lack of hospital beds and shortage of essential drugs and oxygen posed challenges for healthcare providers and provided an opportunity to collaborate with private stakeholders. Mandatory COVID testing and mobile units such as the Sanjivani van and Vadil ghar seva were examples of some of the initiatives taken by the AMC to manage the pandemic that were instigated and implemented with support from various departments such as education, engineering, tax, estate, animal husbandry and firefighting. Proper communication between public and private entities will result in unfragmented efforts to combat emergencies. Thus, a resilient health system is necessary as well as systematic intersectoral collaboration to ensure the uninterrupted delivery of essential health services during health emergencies.

Double Burden of Working Mothers in Balancing Family and Workplace: A Qualitative Analysis

Women's empowerment has attracted the attention of all people worldwide, which is considered to be one of the main parts of development. Independence, financial solvency, and decision-making power trigger women to join the workforce mostly. People often overlook the unsaid struggles and sacrifices associated with women's empowerment. This primary goal of the study is to draw attention to the little-known tales, difficulties, and barriers that working mothers had to deal with on a daily basis. The study was based on qualitative methodology, and primary data were collected from Dhaka with several case studies. The in-depth interview method was applied to conduct the study to have a better understanding. It was found that the increasing number of working mothers joining the workforce had implications for family, children, and the mental and physical health of women. The study also took into account the possible causes of joining the workforce, with an emphasis on familial, household responsibilities, and child management.

For Justice! The Double Burden of Women in Indonesia from the Perspective of The Compilation of Islamic Law

This study investigates the phenomenon of the double burden faced by women in Indonesia through the lens of the Compilation of Islamic Law (Kompilasi Hukum Islam, KHI). The double burden refers to the dual roles that women fulfill, balancing responsibilities within the household and in the public workforce. Utilizing a qualitative approach and document analysis, this research explores how the KHI addresses women’s roles and responsibilities in both spheres. Real-life cases of Indonesian women are examined to assess how interpretations of the KHI impact their experiences. Findings indicate that while the KHI acknowledges women’s participation in multiple facets of life, its implementation is often constrained by patriarchal interpretations that lack gender sensitivity. This has resulted in women bearing disproportionate responsibilities at home and work. The study underscores the need for a more progressive reinterpretation of the KHI to reduce the double burden on women, promoting gender equality and enhancing women’s welfare in Indonesia. These insights are intended to inform strategies for advancing gender equity within the framework of the KHI, contributing to broader social and legal reforms.

Emergency hospital admissions for stress-related presentations among secondary school-aged minoritised young people in England.

Minoritised young people face a double burden of discrimination through increased risk of stress and differential treatment access. However, acute care pathways for minoritised young people with urgent mental health needs are poorly understood. To explore variation in stress-related presentations (SRPs) to acute hospitals across racial-ethnic groups in England. We examined rates, distribution, duration and types of SRPs across racial-ethnic groups in a retrospective cohort of 11- to 15-year-olds with one or more emergency hospital admissions between April 2014 and March 2020. SRPs were defined as emergency admissions for potentially psychosomatic symptoms, self-harm and internalising, externalising and thought disorders. White British (8-38 per 1000 births) and Mixed White-Black (9-42 per 1000 births) young people had highest rates of SRPs, whereas Black African (5-14 per 1000 births), Indian (6-19 per 1000 births) and White other (4-19 per 1000 births) young people had the lowest rates of SRPs. The proportion of readmissions were highest for Pakistani (47.7%), White British (41.4%) and Mixed White-Black (41.3%) groups. Black Other (36.4%) and White Other (35.8%) groups had the lowest proportions of readmissions. The proportion of admission durations ≥3 days was higher for Black Other (16.6%), Bangladeshi (16.3%), Asian Other (15.9%) and Black Caribbean (15.8%) groups than their White British (11.9%) and Indian (11.8%) peers. The type of SRPs varied across racial-ethnic groups. Patterns of SRP admissions systematically differed across racial-ethnic groups, indicative of inequitable triage, assessment and treatment processes. These findings highlight the need for implementation of race equality frameworks to address structural racism in healthcare pathways.

Experimental and numerical investigations of double bracket to CHS column joints

The primary objective of this study is to precisely characterize the behavior of double bracket-to-circular Hollow Section (CHS) column joints due to combined internal forces resulting from double tensile loading in opposite directions. In order to accomplish this goal, an experimental program consisting of eight test specimens has been carried out and numerical finite element modeling has been employed for the same specimens to analyze the stresses and deformations that occur within the vicinity of bracket-to-CHS joints. A total of 15 finite element models were constructed to simulate the initial study, addressing boundary conditions and facilitating verification and results comparison. The study included an investigation of various parameters, including the spacing between brackets in the longitudinal direction, as well as the depth-to-thickness ratio of the CHS columns and adding a T-stiffener to the bracket configuration. The study determined that an increase in the diameter-to-thickness ratio of the CHS columns significantly reduced the overall strength of the joint. Furthermore, findings suggested that increasing the longitudinal spacing between brackets resulted in an increase in single-bracket joint strength and a minor reduction regarding joint strength considering the effect of line loading. Moreover, adding a T-stiffener shape for the brackets enhanced the joint strength and prevented bracket tip fracture. In addition, a distinct behavior arises when considering joints with positive eccentricity, where the forces’ line of action extends beyond the circular cross-section of the CHS. In such cases, a reduction in joint strength is observed. Finally, a modification factor “A” is applied to the X-type branch plate-to-CHS strength equation presented by the AISC360-22 to account for the longitudinal spacing between brackets.

Adolescents’ dietary patterns, their drivers and association with double burden of malnutrition in adolescents: a cross-sectional study in Kenya’s urban slums

BackgroundThe double burden of malnutrition (DBM) during adolescence is associated with growth and developmental impairment and risk of non-communicable diseases. There is limited evidence on adolescent’s dietary patterns (DPs), and how they contribute to DBM in urban low income contexts in sub Saharan Africa. This study assessed DPs of adolescents, their drivers and association with DBM in Kenya’s urban slums.MethodsAnthropometric, socio-demographic and dietary-intake data were collected through a cross-sectional survey of 621 adolescents from three major urban slums in Nairobi, Kenya. DPs were derived using principal component analysis. Multinomial-logistic-regression was used to assess the association between the DPs, individual and environmental factors and DBM.ResultsTwo DPs were identified: traditional DP (whole grains/cereals, rice, fruits, legumes/nuts, and water) and transitioning DP (refined cereals (maize/wheat), vegetables, meat, tea/coffee, sweet ultra-processed/deep fried snacks). Adolescents from Mathare (the largest slum) were more likely to adhere to the traditional DP (RRR = 3.43; 95% CI 1.85–6.37). Cultural background (Luo) had a positive association (RRR = 4.28; 95% CI 1.97–9.32), while longer residency in the slum (> 10 years) had a negative association (RRR = 0.47; 95% CI 0.25–0.90) with transitioning DP. The transitioning DP had a positive (non-linear) association with overweight/obesity in girls (RRR = 2.79; 95% CI 1.16–6.71). The DPs were not associated with thinness or stunting.ConclusionThe DPs indicate various stages of nutrition transition of adolescent diets, which are influenced by cultural background, neighbourhood and duration of stay in the slum. Transitioning DP may expose adolescents to the risks of overweight/obesity in the long-term.

Logistic Regression Model on Nutritional Status Based on Body Mass Index (BMI) in Women of Reproductive Age (WRA) in Indonesia

The aggregate analysis of Riskesdas data in Indonesia revealed that nearly all provinces face a serious double burden of malnutrition. Both undernutrition and overnutrition negatively affect the quality of human resources, especially when they occur in adolescent girls, Women of Reproductive Age (WRA), and pregnant and breastfeeding women, as this can lead to intergenerational nutritional problems. Body Mass Index (BMI) is a nutritional status measurement technique recommended by WHO. Nutritional problems occur when BMI is abnormal or not ideal, categorized as underweight (&lt;18.5 kg/m²), pre-obesity (25-29.9 kg/m²), obesity class I (30-34.9 kg/m²), obesity class II (35-39.9 kg/m²), and obesity class III (&gt;40 kg/m²). Data from laboratory results completed up to 2017, based on selected samples from the 2013 Basic Health Research (Riskesdas), were used to assess the nutritional status of the Indonesian population. This study used 9,418 respondent data samples from 33 provinces in Indonesia. Logistic regression analysis was applied because the response variable in this study is binary, representing ideal BMI (1) and non-ideal BMI (0). The independent variables used in this study include Hemoglobin level, Ferritin level, CRP level, age group, physical activity, living location, marital status, education, and risky food consumption patterns. All independent variables are categorical. The study found that the factors influencing nutritional status based on BMI in WRA are Hemoglobin level, Ferritin level, CRP level, age, and location. The resulting logit model is logit (π)=0.27695-0.1491 (Non-anemic Hemoglobin level)-0.1721 (Normal Ferritin level)+0.741 (Non-infectious CRP level)-0.2933 (Adult age group)-0.0976 (rural location). logit (π)=0.27695-0.1491 (Non-anemic Hemoglobin level)-0.1721 (Normal Ferritin level)+0.741 (Non-infectious CRP level)-0.2933 (Adult age group)-0.0976 (rural location). The largest odds ratio The largest odds ratio was produced by the CRP level variable, indicating that CRP level is the most influential factor affecting nutritional status based on BMI in WRA, where non infectious CRP compared to infectious CRP increases the likelihood of WRA having an ideal BMI.