Post-migration Phase Research Articles

Repensando a migração brasileira: a agência de mulheres brasileiras altamente qualificadas

Abstract Developing the concept of the “continuum of instability”, we recognise that different phenomena such as agency and resilience are useful to reframe the different dynamics and mechanisms of resettlement and job-education matching in a group of Brazilian women resettled in the Spanish context. This paper contributes to the scientific knowledge of the relationship between strategies of transnational mobility and the reframing of professional identity in the host society. Through the procedure of a qualitative methodology, the data were collected in different Autonomous Communities of Spain during and after the Covid-19 pandemic, between 2021 and 2022. This paper explores the strategies used by highly educated Brazilian women to achieve job-education matches in Spain. To this end, we have analysed the structures of opportunities and constraints that have influenced their career paths in the Spanish socio-occupational context. On the other hand, by considering the micro-analytical level, subjectivity suffers relevant changes based on the negotiation with external factors at macro (structural) and meso (relational) levels, depending on the forms of adaptation and transformation of each woman. In this context, agency and resilience are the nudging factors and become active strategies through the process of deconstruction and reconstruction of the new identity in the post-migration phase.

Alternative Careers toward Job Market Integration: Barriers Faced by International Medical Graduates in Canada.

International Medical Graduates (IMGs), who completed their medical degree and training outside Canada constitute a notable portion of the skilled migrants of the country. However, due to a long and uncertain licensure process and limited opportunities many IMGs look for alternative career pathways where they can utilize their learned skills. Alternative careers in the health and wellness sector may offer such opportunities; however, IMGs' success in these pathways were also less evident despite their high potential. In this study, we investigated the barriers that IMGs stated to face when attempting alternative jobs in Canada. Eight focus groups with 42 IMGs in Canada were conducted. Using a thematic analysis approach, we identified that IMGs encounter these barriers in different stages of their resettlement journey in Canada, including both the pre-migration and post-migration phases. In the pre-migration phase, IMGs were not aware of the success rates of the licensing pathways and did not have sufficient information regarding potential alternative careers. In the post-migration phase, the lack of information continues to affect IMGs where IMGs exhaust their resources pursuing alternative careers without proper guidance and support. Further, IMGs struggle with taking preparation for alternative careers by obtaining further certifications and completing other prerequisites for some barriers, such as financial constraints. While looking for jobs, some IMGs perceived systemic discrimination such as non-recognition of their credentials and experience. Furthermore, the mismatch of expectations and limited growth opportunities offered by potential careers serve to disincentivize IMGs from pursuing an alternative career. Addressing the current employment inequity experienced by IMGs in Canada warrants research collaborations between organizations supporting IMGs and policymakers that target known barriers to the pursuit of alternative careers by IMGs.

A cross-sectional study of health and well-being among newly settled refugee migrants in Sweden-The role of health literacy, social support and self-efficacy.

Structural barriers such as inadequate housing, lack of employment opportunities, and discrimination are known to adversely affect the health of newly settled refugee migrants. However, these barriers remain largely unresolved and unaddressed. Thus, there is a need to better understand how other factors, such as individual-level health resources, may influence health and mitigate ill health in the early post-migration phase. In this study, we aimed to explore the relationship between health outcomes and individual health resources including health literacy, social support, and self-efficacy in newly settled refugee migrants. Survey data was collected from 787 refugee migrants in Sweden. Logistical regression analysis showed that limited health literacy, lack of emotional support, and low self-efficacy were consistently associated with poor health outcomes. Demographic variables such as gender, education, and type of residence permit were not as imperative. Individual-level health resources may play an important role in the general and psychological well-being of newly settled migrants. Promoting health literacy and facilitating the attainment of social support may buffer for structural challenges in the establishment phase and enhance the prospects of later health and social integration.

Predicting PTSD and Complex PTSD among Iraqi and Syrian Refugees.

The present study investigated the cumulative and potential synergistic effect of prolonged adversity from pre-migration to post-migration phases in the prediction of posttraumatic stress [PTSD & Complex PTSD (CPTSD)] among Iraqi and Syrian refugees in the U.S. This study included recent 51 Iraqi and 43 Syrian (n = 94) refugees in Massachusetts. Quantitative data were collected through surveys measuring trauma exposure and posttraumatic stress. Effects were evaluated through a series of hierarchical and multiple regression analyses. Preliminary analyses indicated pre-and post-migration stressors together predict PTSD but not CPTSD. However, only post-migration discrimination predicted CPTSD. Post-migration stress exposure emerged as a significant moderator between pre-migration stress exposure and psychological distress (i.e., PTSD). Findings provided support for the cumulative impact of refugees' exposure to trauma from the pre-to-post-migration process, and shed light on the importance of the post-migration context in the prediction of PTSD.

A qualitative study on newly settled migrants’ perceptions of civic and health orientation in Sweden

Abstract Background Migrants face structural, socio-political barriers in their resettlement processes that affect their health. Migration also impacts resources such as social capital and health literacy that are of importance for health and integration in society. Hence, there is a need for health promotion in the post-migration phase. The aim of the study was to explore participants' perceptions and experiences of civic orientation with added health communication. Methods Six focus group discussions were performed with 32 men and women. Two were held in Arabic, two in Farsi and two in Somali, with native speaking moderators. Participants were recruited from civic orientation classes in the county of Stockholm. An interview guide with semi-structured questions was used. The data were analysed using a method for content analysis of focus group discussions. Results Three main categories were identified: ‘The course gives valuable information but its delivery needs adjustments', which includes that the civic and health orientation is valuable and needed earlier, during asylum phase, and that planning and course content need adjustments. ‘The health communication inspired participants to focus on their health', includes that the health communication was useful and inspired uptake of healthier habits. ‘Participation in the course promoted independence and self-confidence', which includes that the course gave insights into society and values in Sweden and promoted independence and new social contacts. Conclusions This study adds knowledge of the users' perspectives on the potential of civic orientation to promote health and integration of newly settled migrants, describing ways in which civic orientation with added health communication prompted health and empowerment. However, the content and delivery of the course needs adjustment to better fit the migrants' life situations and varying pre-existing knowledge. Key messages The civic and health information is needed early in the resettlement phase. Participation in the course promoted health awareness, independence and self-confidence.

Role of migration in the development of a first episode of psychosis

Introduction Currently, there is scientific evidence supporting the relationship between socio-environmental factors and the onset of a first episode of psychosis (FEP). In this context, the phenomenon of migration, seen as a negative life experience, may become an important risk factor in developing a psychotic disorder (PD). In Europe, the impact of this phenomenon is growing and, therefore, it’s necessary to provide a proper answer to these individual’s mental health problems.ObjectivesIdentify which phases of this migration process are most important in the development of a FEP and what are the more significant socio-environmental factors in each phase.MethodsBibliographic research in Pubmed database using the terms “Migration” and “First Episode Psychosis”.Results Research confirms that migrants have a 2 to 3-fold increased risk of developing a PD. This risk will be even higher in the refugee population. Pre- and post-migration factors demonstrated to be more important than factors related with the migration process itself. In the pre-migration phase highlight factors like the lower parental social class and a previous trauma. In the post-migration phase highlight factors like discrimination, social disadvantage and a mismatch between expectations and reality.Conclusions Literature is unanimous in considering migrant status as an independent risk factor for the development of FEP, possibly due to the outsider’s role in society. Thus, despite the growing interest in Biological Psychiatry, this work demonstrates that socio-environmental factors are very preponderant in the development of these disorders and because of that further investigation is still necessary.DisclosureNo significant relationships.

Victimización y Problemas de Conducta Externalizante y Antisocial en Menores Extranjeros no Acompañados en Europa: Revisión Sistemática

Previous studies on unaccompanied migrant minors have pointed out the high risk of suffering victimization during the migration process and the important consequences of this, focusing mainly on internalizing problems. This review explores the relationship between victimization and externalizing and antisocial problems in unaccompanied foreign minors settled in Europe, an area less studied. The results of the fourteen studies included in the review point to a high prevalence of victimization, including the post-migration phase, a moderate presence of behavioral problems, which tend to become chronic, and heterogeneous results regarding the global relationship between both aspects. Limitations in the evaluation procedures associated with self-report measures, great diversity of the samples used, and not differentiating between migratory phases may influence such heterogeneity. It is argued that post-migration victimization, in terms of social marginalization, together with deficient care for effective integration in host countries, become risk factors for the development of externalizing problems and antisocial behaviors.

\u201cThis course is like a compass to us\u201d \u2013 a qualitative study on newly settled migrants\u2019 perceptions of civic and health orientation in Sweden

BackgroundMigrants face structural, socio-political barriers in their resettlement processes that negatively affect their health. Migration also adversely impacts resources such as social capital and health literacy that are of importance for health and integration into society. Hence, there is a need for health promotion in the early post-migration phase. In Sweden, newly settled refugee migrants who have received a residence permit are offered an Introduction programme including a civic orientation course. The program is intended to facilitate access to the labour market and promote integration. The aim of the study was to explore participants’ perceptions and experiences of a civic orientation course with added health communication.MethodsWe performed six focus group discussions: two in Arabic, two in Farsi and two in Somali. The discussions were facilitated by native speaking moderators. Participants were 32 men and women recruited from civic orientation classes in the county of Stockholm. We used an interview guide with semi-structured questions. The data were analysed using a method for content analysis for focus group discussions.ResultsThree main categories were identified: (1) ‘The course gives valuable information but needs adjustments’, which includes that the civic and health orientation is needed earlier, during the asylum phase, and that planning and course content need adjustments. (2) ‘The health communication inspired participants to focus on their health’, which includes that the health communication was useful and inspired uptake of healthier habits. (3) ‘Participation in the course promoted independence and self-confidence’, which includes that the course gave insights into society and values in Sweden, and promoted independence and new social contacts.ConclusionThis study adds knowledge about the users’ perspectives on the potential of civic orientation to promote the health and integration of newly settled migrants, describing ways in which civic orientation with added health communication promoted health and empowerment. However, the content and delivery of the course need adjustment to better fit the migrants’ life situations and varying pre-existing knowledge.

International medical graduates: challenges and solutions in psychiatry.

International medical graduates provide a valuable service to the healthcare of their adopted countries. However, there remain a significant number of challenges in their adjustment and acculturation in the post-migration phase. We believe that the cultural capital these doctors bring with them can act as a support as well as a challenge. They are likely to face subtle and not-so-subtle, covert and overt discrimination at a number of levels. In this brief report, we highlight some of the issues faced by them and some potential solutions.

Influencing Factors of Loneliness Among Hmong Older Adults in the Premigration, Displacement, and Postmigration Phases

AbstractMinimal research has simultaneously explored the premigration, displacement, and postmigration experiences of loneliness among older adults with a refugee history. Drawing from a constructivist grounded theory study guided by an intersectionality framework, this study aimed to explore the factors influencing loneliness in these three phases among Hmong older adults with a refugee background. Interviews were conducted with 17 Hmong older adults aged 65 and older residing in Northern California. Findings revealed the influencing factors emerging from systems of oppression grounded within the social, political, and cultural context of each phase. Influencing factors of loneliness were identified as betrayal, familial loss, instability, war violence, loss of social status, isolation, diminishing filial piety, language barrier, declining health, and lack of purpose. This study highlights the need for more research, practice, and policy focused on the context of the refugee experience to gain a greater insight into their loneliness experiences.

Migration history and risk of psychosis: results from the multinational EU-GEI study.

Psychosis rates are higher among some migrant groups. We hypothesized that psychosis in migrants is associated with cumulative social disadvantage during different phases of migration. We used data from the EUropean Network of National Schizophrenia Networks studying Gene-Environment Interactions (EU-GEI) case-control study. We defined a set of three indicators of social disadvantage for each phase: pre-migration, migration and post-migration. We examined whether social disadvantage in the pre- and post-migration phases, migration adversities, and mismatch between achievements and expectations differed between first-generation migrants with first-episode psychosis and healthy first-generation migrants, and tested whether this accounted for differences in odds of psychosis in multivariable logistic regression models. In total, 249 cases and 219 controls were assessed. Pre-migration (OR 1.61, 95% CI 1.06-2.44, p = 0.027) and post-migration social disadvantages (OR 1.89, 95% CI 1.02-3.51, p = 0.044), along with expectations/achievements mismatch (OR 1.14, 95% CI 1.03-1.26, p = 0.014) were all significantly associated with psychosis. Migration adversities (OR 1.18, 95% CI 0.672-2.06, p = 0.568) were not significantly related to the outcome. Finally, we found a dose-response effect between the number of adversities across all phases and odds of psychosis (⩾6: OR 14.09, 95% CI 2.06-96.47, p = 0.007). The cumulative effect of social disadvantages before, during and after migration was associated with increased odds of psychosis in migrants, independently of ethnicity or length of stay in the country of arrival. Public health initiatives that address the social disadvantages that many migrants face during the whole migration process and post-migration psychological support may reduce the excess of psychosis in migrants.

Der Einfluss postmigratorischer Stressoren auf die Pr\xe4valenz depressiver Symptome bei Gefl\xfcchteten in Deutschland. Analyse anhand der IAB-BAMF-SOEP-Befragung 2016

ZusammenfassungEinleitungInternationale Studien belegen eine hohe psychische Krankheitslast bei Geflüchteten. Postmigratorische Stressoren im Zufluchtsland können die psychische Gesundheit beeinträchtigen und zu Depressionen führen.ZielDie Studie untersucht, ob postmigratorische Stressoren mit der Prävalenz depressiver Symptome bei erwachsenen Geflüchteten in Deutschland assoziiert sind.MethodenSekundärdatenanalyse basierend auf für Deutschland repräsentativen Querschnittsdaten der IAB-BAMF-SOEP-Befragung von Geflüchteten 2016 (N = 4465). Depressivität wurde mit dem Patient Health Questionnaire‑2 (PHQ-2) erfasst. Unadjustierte und adjustierte Odds Ratios (OR) und 95 %-Konfidenzintervalle (KI) wurden anhand binär logistischer Regressionsmodelle berechnet, um Zusammenhänge zwischen Depressivität und soziodemografischen, postmigratorischen und psychosozialen Faktoren zu untersuchen.ErgebnisseDepressive Symptome weisen 19,4 % der befragten Geflüchteten auf. Fast alle einbezogenen Postmigrationsstressoren sind nach Adjustierung für soziodemografische und psychosoziale Faktoren statistisch signifikant mit Depressivität assoziiert. Erwerbslosigkeit (aOR = 1,48 [1,04–2,12]), Einsamkeit (aOR = 1,14 [1,10–1,18]) und ein abgelehnter oder noch nicht entschiedener Asylantrag (aOR = 1,34 [1,06–1,70]) erhöhen die Chance für depressive Symptome, während eine stattgefundene Anhörung (aOR = 0,71 [0,56–0,91]) und eine höhere Wohnzufriedenheit (aOR = 0,94 [0,91–0,98]) die Chance für Depressivität verringern.DiskussionPostmigrationsstressoren bei Geflüchteten sind mit dem Vorkommen depressiver Symptome assoziiert. Die Berücksichtigung belastender und protektiver Faktoren der Postmigrationsphase in sozialpolitischen Maßnahmen kann die psychische Krankheitslast in Flüchtlingspopulationen reduzieren.

“Israel is not Switzerland”: The Impact of Political Violence in Israel on Historically Traumatized Argentinian Immigrants

This study explores the long-term impact of childhood political trauma on the lives of adult Jewish-Argentinian immigrants who experienced trauma during the military dictatorship in Argentina (1976–1983), and who subsequently immigrated to Israel. Given the ongoing political instability in Israel, one of the purposes of this study was to determine whether prior political trauma made subjects more vulnerable to negative emotional and behavioral manifestations when living in a similarly violent situation, or whether it instead gave them tools to navigate that situation. The theoretical framework draws from Simich and Beiser’s (2011) paradigm, which includes factors for immigrant mental health across pre- and post-migration phases, which results in an assumed range of possible long-term negative and/or positive outcomes for mental health in adulthood. A narrative approach method was applied when interviewing 15 participants, and thematic textual analysis centered on the behavioral and emotional manifestations of these immigrants’ experiences in their current lives as adults. Findings revealed that participants’ present-day experiences included a variety of both negative and positive long-term emotional and behavioral reactions to ongoing political violence in Israel. These are located between two extremes: at the negative end of the scale, severe emotional and behavioral manifestations, while at the positive end, positive emotional and behavioral manifestations. This study concludes with recommendations for future research on the intersection between prior political trauma and exposure to political violence in the host country, as well as on the experience of this under-researched population.

The Experiences of Mental Health Professionals Supporting Forced Migrants: A Qualitative Systematic Review

Many forced migrants experience trauma in pre-migration, journeying, and post-migration phases of flight. Therefore appropriate mental health provision is required. Whilst previous reviews have explored the experiences of health-care staff in supporting forced migrants, no review was found that focused solely on the experiences of mental health professionals. This qualitative thematic synthesis integrates the findings from ten qualitative studies and identifies analytical constructs that encompass the challenges and facilitators for mental health professionals. Findings will inform how services can be developed to best support staff and enable the provision of high-quality mental health care for this potentially vulnerable population.

The migration journey and mental health: Evidence from Venezuelan forced migration.

•Using migration of Venezuelans to Peru as a case example, we surveyed migrants on mental health and migration factors at the Ecuador-Peru border.•Pre-migration: No factors associated with anxiety; choosing Peru for safety or expected respect for Venezuelans increased odds of depression.•Migration:Walking and education increased odds of anxiety; choosing Peru decreased odds of anxiety; being pregnant increased odds of depression.•Link between migration factors and mental health is concerning, as the associated distress may influence post-migration mental health.•More work is needed to understand the influence of the journey on the mental health outcomes of migrants over time.

Influence of post-migration living difficulties on post-traumatic symptoms in Chinese asylum seekers resettled in Italy.

Little is known about mental health and resettlement difficulties of Chinese asylum seekers fleeing China due to religious persecutions. This study explores main post-migration living difficulties (PMLD) in this population, with a focus on their role in post-traumatic stress disorder (PTSD). A total of 67 patients (95.52% women, mean age 34.75 ± 7.63) were included in the study. The Harvard Trauma Questionnaire (HTQ) was used to assess PTSD, the List of Migration Experiences (LiMEs) was used for pre-migration and post-migration experiences (potentially traumatic events as well as living difficulties). The t-test was used to examine the differences in pre-migration and post-migration mean scores. Logistic regression was used to test the effect of pre-migration traumatic experiences (PMTE) and most frequent PMLD on having a PTSD. A total of 49 patients scored above the HTQ cut-off score for PTSD. As expected, traumatic experiences were concentrated in the pre-migration phase, while living difficulties were present in both phases but more frequently in the post-migration period. PMTE were significantly related to PTSD (OR 1.29, p = .01). However, three PMLD ('Feeling that you do not know where you will lend up tomorrow', 'Loneliness and boredom' and 'Not being able to find work') showed a significant interaction with PMTE, suggesting that their presence in the post-migration phase has a modulation effect by increasing the likelihood of PTSD. This study extends to Chinese asylum seekers the previous evidence that PMLD have a significant role in the likelihood to have a PTSD after landing in the host country.

Vermiform Appendix During the Repackaging Process from Umbilical Herniation to Fixation onto the Right Posterior Abdomen: A Study of Human Fetal Horizontal Sections.

The anatomical position of the vermiform appendix varies among adults, and these variations are responsible for differences in the symptoms of appendicitis. However, to date no study has examined how and when these variations occur during fetal development. The present study examined horizontal sections of 27 midterm fetuses (crown rump length [CRL] 38-97 mm, gestational age approximately 8-15 weeks). There were 10 fetuses (CRL 56 mm or more) in which the cecum and appendix were in a posterosuperior site near the right kidney (postmigration phase), and 12 fetuses (CRL 39-72 mm) in which the ileocecal junction and appendix remained on the visceral surface of the liver in the anterior or anterolateral abdominal cavity (migration phase, after physiological umbilical herniation). Analysis of the 12 fetuses in the migration phase indicated that the appendix extended inferiorly in eight fetuses and superiorly in four fetuses. Likewise, a "preileal" appendix (a morphology in which the distal part of the appendix was in front of the terminal ileum) was present in eight of these fetuses. Extension of the appendix superiorly or inferiorly during the migration phase seems unrelated to the topographical relationship of the appendix with the terminal ileum at the postmigration phase in fetuses and in adults. Conversely, it seems likely that a retroileal appendix leads to a coiled appendix behind the ileocecal junction. "Guidance" by the liver surface seemed to be important for posterior migration, which ended with the ascent of the liver. Clin. Anat., 33:667-677, 2020. © 2019 Wiley Periodicals, Inc.

Migrations Impacts on Diminishing Lingual Heritage

Socialization in the post-migration phase has a key role in shaping the behavior of the people towards a new place, culture and phenomenon. The socialization of children after the migration has potential impacts on the diminishing lingual heritage. Migration has radically exposed the younger generation to this challenge threatening the lingual heritage. They, most probably, lose their mother tongue and get socialized in other languages. This study explores the latent hazards faced by migrants from a rural setting and their impacts on the diminishing languages. The methodology of the study was descriptive. In-depth questionnaires were conducted along with a focused group discussion of sample 95 out-migrant families, living in Rawalpindi and Islamabad through a convenient sampling technique. The results from the cross-comparison of three generations show that the majority of the grandparents and parents proudly speak their native languages whereas their children are rapidly getting alienated from the language of their forefather

Being Hopeful: Exploring the Dynamics of Post-traumatic Growth and Hope in Refugees

AbstractWith more than 60 million people across the world displaced from their homes, the refugee crisis has been in the political limelight and prominent in academic conversations. With a focus on the salutogenic rather than the pathological effects of trauma, this research probed beyond refugees’ distressed psychological wellbeing by exploring contributory factors to refugees’ effective resettlement during the post-migration phase. In this small-scale study, participants were purposively selected. The mixed-methods approach led to the assessment of refugees’ post-traumatic growth and a qualitative investigation of their narrative writings on hope. Adopting a psychological lens, the article critically considers Charles Snyder’s theoretical framework on ‘hope’ and its tenets, namely ‘Goals’, ‘Pathways’, ‘Agency’, ‘Barriers’ and ‘Thoughts & Feelings’, by employing it freshly in a new context and extending the framework in light of refugees’ successful adaptation and integration into society. The research findings endorse the value of developing a hopeful disposition as key to refugees’ acculturation, empowerment and post-traumatic growth.

Brief Report: Subjective Social Mobility and Depressive Symptoms in Syrian Refugees to Germany.

Previous findings indicate that refugees are at increased risk for mental health problems. In addition to stressful pre-migration experiences, post-migration factors may contribute to poor mental health outcomes. Among immigrants to the United States, downward mobility in subjective social status (SSS) was associated with depression, corroborating the potentially detrimental mental health consequences of a decline in one's perceived social position. The present study examined whether downward mobility in SSS among male refugees from Syria to Germany is associated with depression. We found that refugees who experience stronger downward mobility in SSS exhibit more severe depressive symptoms and were more likely to fulfill provisional DSM-IV criteria for a diagnosis of Major Depression. Our findings highlight the importance to consider the 'social pain' of downward social mobility during the post-migration phase.