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    Item type:Publication,
    International migration, food insecurity, and mental health: A scoping review protocol
    (2024)
    Alice Blukacz
    ;
    ;
    Catalina Huerta
    ;
    Amelia A. Lake
    ;
    Jo Smith
    <jats:p>Introduction Food insecurity is a global priority that has been found to negatively impact mental health, increasing the risk of mental disorders and severe mental illness. International migrants may face food insecurity throughout their migratory cycle due to a range of risk factors, such as poor transit conditions, precarious employment, financial pressure, discrimination, and lack of availability and access to culturally relevant food, among others. Although there are multiple reviews on migration, food insecurity, and health in general, no scoping review has been conducted on food insecurity among international migrants focusing on mental health. Objective To investigate the available evidence on food insecurity and mental health among international migrants. Methods A search of scientific literature in English, Spanish, French, Italian, and Portuguese published since 2013 will be performed in the Web of Science, PubMed, Medline, APA PsycArticles, Cinahl, and ASSIA databases, including grey literature available in Google Scholar. Two authors will independently review titles, abstracts, and full texts before extracting data from publications complying with the eligibility criteria. Extracted data will be descriptively mapped according to emerging thematic categories. Expected results The review will contribute to identifying what is known about international migration, food insecurity, and mental health, gaps in the literature, opportunities for specific research subtopics, and how food insecurity and mental health can be linked in the existing literature.</jats:p>
      6Scopus© Citations 2
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    Item type:Publication,
    Burns: Why give special attention to adolescents in Latin America and the Caribbean from a primary health prevention perspective?
    (2023)
    Alice Blukacz
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    Rodrigo Fuentes
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    ; ;
    Carmina Domic
    <jats:p>The existing evidence on burns in the underage population has focused mainly on children under ten years, leaving behind the age group defined as "adolescents" by the World Health Organization. However, adolescents present their own characteristics that differentiate them from their younger counterparts. These differences are relevant from a primary prevention perspective, focusing on preventing illness or injury. In this context, this article reflects on why adolescents need special attention in the primary prevention of burns in Latin America and the Caribbean. First, burn scenarios in adolescents are often linked to participation in risky activities due to pressure, social desirability, or low perception of the associated risks. Second, it is essential to emphasize that adolescents may experience social vulnerability, which entails a higher risk of suffering an intentional or unintentional burn. Third, the risk of burns in adolescents may be related to mental health and self-harm scenarios. These aspects need to be investigated through both quantitative and qualitative studies to design and implement primary prevention strategies relevant to this population group in the region.</jats:p>
      4Scopus© Citations 1
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    Item type:Publication,
    Feeling prepared to face COVID-19 pandemic among Venezuelans in Chile: findings from an opinion poll
    (2021) ;
    Florencia Darrigrandi
    ;
    Alice Blukacz
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    ;
    Claudia Silva
    <jats:p>Introduction International migration is a social determinant of health. The past decade has seen a large exodus of Venezuelans within Latin America, including Chile. In the past months, the world has been facing the SARS-CoV-2 coronavirus pandemic and its respiratory disease COVID-19. Objective To explore what factors are associated with feeling prepared to face the COVID-19 pandemic among the Venezuelan population residing in Chile. Methods Cross-sectional quantitative study with an opinion poll design. An online self-reported survey in Spanish and Creole was designed and piloted with experts and international migrants. It was disseminated to various international migrant groups through networks of migrant and pro-migrant organizations and the Chilean public health care network across the national territory. An effective sample size for analysis of 1690 participants was reached, of which 1008 (60%) were from Venezuela and included in this analysis. Feeling prepared to face the COVID-19 pandemic (yes/no) among Venezuelan migrants was described, as well as relevant variables like sex, level of education, length of stay, healthcare provision, anxiety or depression due to COVID-19, confinement, and evaluation of the quality of the information provided by the COVID-19 government. Results 65% of the Venezuelan participants reported not feeling prepared for the pandemic. Compared to Venezuelan migrants who feel prepared to face the COVID-19 pandemic, migrants who reported not feeling prepared were in a higher proportion female, with secondary education level, had arrived in Chile in the past year, do not have a job but want to work, and belong to the public healthcare provision. Discussion Receiving good quality information on the pandemic and mental health symptoms are important factors associated with feeling prepared to face COVID-19 in Venezuelan migrants in Chile, suggesting that increased attention towards the physical and mental health of Venezuelan migrants in Chile and the region is needed.</jats:p>
    Scopus© Citations 6  2
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    Item type:Publication,
    Relationship between job satisfaction, burnout syndrome and depressive symptoms in physicians: a cross-sectional study based on the employment demand–control model using structural equation modelling
    (2022)
    David Villarreal-Zegarra
    ;
    Wilder Iván Lázaro-Illatopa
    ;
    Ronald Castillo-Blanco
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    ;
    Alice Blukacz
    <jats:sec><jats:title>Objective</jats:title><jats:p>To evaluate the relationship between job satisfaction, burnout syndrome (BS) and depressive symptoms (DS) based on the job demand–control framework model on a nationally representative sample of physicians working in the Peruvian Health System.</jats:p></jats:sec><jats:sec><jats:title>Setting</jats:title><jats:p>We carried out a secondary data analysis of the National Survey of Satisfaction of Users in Health 2016 in Peru.</jats:p></jats:sec><jats:sec><jats:title>Primary and secondary outcome measures</jats:title><jats:p>Our study assessed the development of the predictive model and had two parts: (1) to evaluate the association among the variables based on the job demand–control framework, and (2) to assess the proposed model acceptability using the structural equation modelling approach to estimate goodness-of-fit indices (GOFIs).</jats:p></jats:sec><jats:sec><jats:title>Participants</jats:title><jats:p>We excluded physicians older than 65 years, who did not report income levels or who had missing data related to the workplace. Thus, we analysed 2100 participants.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The prevalence of DS was 3.3%. Physicians’ work-related illnesses had more probability to result in DS (prevalence ratio=2.23). DS was moderately related to BS dimensions (r&gt;0.50); nevertheless, the relationships between DS and the three job satisfaction scales were weak (r&lt;0.30). The first predictive model based on the variables, DS, BS and job satisfaction, had low GOFIs (comparative fit index (CFI)=0.883; root mean square error of approximation (RMSEA)=0.125). In a second evaluation, we used models with correlated errors obtaining optimal GOFIs (CFI=0.974; RMSEA=0.060).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Our study identified a stable model to explain the relationship between job satisfaction, BS and DS among physicians. The results are consistent with the job demand–control framework. They could be applied to decision-making in occupational contexts in Latin American low/middle-income countries.</jats:p></jats:sec>
    Scopus© Citations 14  3
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    Item type:Publication,
    Perceptions of Health Needs among Venezuelan Women Crossing the Border in Northern Chile during the COVID-19 Pandemic
    <jats:p>In parallel to the COVID-19 pandemic, Chile has experienced a significant influx of international migrants, many of whom are Venezuelan women who have entered the country through unauthorized crossing points. In this context, gender and migration intersect as the social determinants of health, leading to their experiencing a range of adverse events. This poses important challenges in terms of short- and long-term health outcomes, the social determinants of health, and access to healthcare. This study aims at describing Venezuelan women’s perceptions of their health needs as they migrate to Chile via an unauthorized crossing point, with a focus on adverse events throughout the migration cycle, self-reported health needs, and responses. A qualitative case study was carried out with 22 participants in the Antofagasta region of Chile, including Venezuelan migrant women, healthcare professionals, and social workers from the public healthcare system, stakeholders from non-governmental and international organizations, and local government officials. The semi-structured, individual interviews were analyzed thematically. The results show that Venezuelan women face a range of adverse events throughout the migration cycle. The perceived health needs that are reported are sometimes linked to these adverse events or existed prior to migration and were exacerbated throughout the migratory cycle. Addressing these physical and mental health needs is essential for short- and long-term individual and public health; however, despite substantial efforts to ameliorate the situation, persisting gaps in access to care are reported.</jats:p>
      16Scopus© Citations 11
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    Item type:Publication,
    “If I get sick here, I will never see my children again”: The mental health of international migrants during the COVID-19 pandemic in Chile
    (2022)
    Alice Blukacz
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    ;
    Kate E. Pickett
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    ;
    Paula Madrid
    <jats:sec id="sec001"> <jats:title>Background</jats:title> <jats:p>The COVID-19 pandemic has had an impact on the mental health of international migrants globally. Chile has managed its response to the pandemic in an ongoing context of social unrest and combined regional migratory and humanitarian crisis. The country’s population presents a high prevalence of common mental disorders and a high suicide rate, with limited access to mental healthcare. International migrants in Chile represent 8% of the total population, and although a socioeconomically heterogenous group, they face social vulnerability, a range of mental health stressors and additional barriers to access mental healthcare. This study describes the mental health outcomes, stressors, response, and coping strategies perceived by international migrants during the COVID-19 pandemic in Chile.</jats:p> </jats:sec> <jats:sec id="sec002"> <jats:title>Methods and findings</jats:title> <jats:p>A qualitative case study was carried out through individual online interviews to 30 international migrants living in Chile during the pandemic and 10 experts of the social and health care sectors. An inductive content analysis was carried out, a process during which the researchers sought to identify patterns and themes derived from the data. Participants experienced mainly negative mental health outcomes, including anxiety and depression symptomatology. Stressors included the virus itself, work, living and socioeconomic conditions, discrimination, fear for their family and distance caring. Institutional responses to address the mental health of international migrants during the pandemic in Chile were limited and participants relied mainly on individual coping strategies.</jats:p> </jats:sec> <jats:sec id="sec003"> <jats:title>Conclusions</jats:title> <jats:p>The pandemic can represent an important opportunity to strengthen mental health systems for the general population as well as for population groups experiencing social vulnerability, if the issues identified and the lessons learned are translated into action at national, regional, and international level. Promoting the mental health of international migrants means recognising migration as a social determinant of mental health and adopting a cross-cultural as well as a Human Rights approach.</jats:p> </jats:sec>
    Scopus© Citations 4  5
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    Item type:Publication,
    “Nadie está preparado para escuchar lo que vi”: atención de salud mental de refugiados y solicitantes de asilo en Chile
    <jats:p>El presente artículo analiza las necesidades de atención de salud mental de refugiados y solicitantes de asilo de origen latinoamericano en Chile, por medio de un estudio cualitativo descriptivo, realizado en 2018, desde la voz de las personas solicitantes de refugio y asilo (n=8), profesionales de salud que los atienden (n=4), y miembros de organismos e instituciones dedicados en la temática (n=2). Los hallazgos evidencian que las obligaciones asumidas por Chile, a través de la adhesión a tratados internacionales, no han logrado garantizar el ejercicio del derecho a la salud mental, entendida como parte del derecho universal de acceso a la salud. En lo particular, el artículo documenta la presencia tanto de barreras de acceso a la salud mental en migrantes solicitantes de refugio y asilo, como de factores de estrés posmigratorios que pueden acentuar el riesgo de estos grupos a sufrir trastornos emotivos. También se reporta la insuficiente instalación de capacidades de atención en los equipos de salud mental para abordar las consecuencias psíquicas de los episodios de violencia y persecución que están a la base de la migración forzada. Finalmente, el artículo discute la necesidad de estrechar la vinculación entre la salud mental –como derecho humano fundamental– y el derecho a la protección internacional.</jats:p>
      8Scopus© Citations 10
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    Inequities in mental health and mental healthcare between international immigrants and locals in Chile: a narrative review
    <jats:title>Abstract</jats:title> <jats:p>Mental health in a context of international migration is a particularly pressing issue, as migration is recognised as a social determinant of physical and mental health. As Chile is increasingly becoming a receiving country of South-South migration, immigrants face mental health inequities, with regards to outcomes and access to care.</jats:p> <jats:p>In order to identify and synthetize mental healthcare inequities faced by international migrants with regards to locals in Chile, a narrative review of the literature on national mental healthcare policies in Chile and a narrative review of the literature on migrants’ mental healthcare in Chile were conducted, with a focus on describing mental health outcomes, policy environment and persisting gaps and barriers for both topics. The existing literature on mental healthcare in Chile, both for the general population and for international migrants, following the social determinant of health framework and categorised in terms of i) Inequities in mental health outcomes; ii) Description of the mental health policy environment and iii) Identification of the main barriers to access mental healthcare.</jats:p> <jats:p>Despite incremental policy efforts to improve the reach of mental healthcare in Chile, persisting inequities are identified for both locals and international migrants: lack of funding and low prioritisation, exacerbation of social vulnerability in the context of a mixed health insurance system, and inadequacy of mental healthcare services. International migrants may experience specific layers of vulnerability linked to migration as a social determinant of health, nested in a system that exacerbates social vulnerability.</jats:p> <jats:p>Based on the findings, the article discusses how mental health is a privilege for migrant populations as well as locals experiencing layers of social vulnerability in the Chilean context. International migrants’ access to comprehensive and culturally relevant mental healthcare in Chile and other countries is an urgent need in order to contribute to reducing social vulnerability and fostering mechanisms of social inclusion.</jats:p> <jats:p>International migration, social determinants of mental health, mental health inequities, social vulnerability, review.</jats:p>
    Scopus© Citations 21  9