immigrants

Iran has recently experienced a recent influx of immigrants, mainly from neighboring countries such as Afghanistan and Iraq. We report a case series of immigrant cancer patients who were admitted at Imam Khomeini Hospital Complex in Tehran.

We conducted a retrospective cross-series using the medical records of immigrant patients diagnosed with cancer from March 2013 to March 2023. We performed descriptive analyses of the immigrant patients, including gender, age, country of birth, type of cancer, treatment courses, and metastasis status.

The total number of immigrant cancer patients was 349, with 51.86% being female and 48.14% male. Among these patients, 8 (2.30%) were children (under 14 years old), 42 (12.07%) were young adults (aged 15-24), and 297 (85.59%) were older than 25 years. Most immigrants in the study were from Afghanistan (95.13%), followed by Iraq (4.58%). Additionally, 8.88% of the immigrants were second-generation, born in Iran. The most common cancer types were breast (32.04%), hematological (12.15%), ovarian (11.05%), and colorectal (7.18%) cancers in women and hematological (17.86%), colorectal (10.71%), musculoskeletal (10.12%), and skin (10.12%) cancers in men.

This study is the first description of cancer disparity among immigrants in Iran. The results of this study can be used for cancer surveillance and promoting care among immigrant populations in Iran.

Immigrants who have sustained war-related injuries face unique challenges within the healthcare systems of their new countries. This study aimed to explore the health service experiences of war-injured immigrant populations in Richmond Hill, Ontario, with a focus on identifying the barriers they encounter and the aspects of healthcare that effectively meet their needs. 

This qualitative study utilized semi-structured interviews to collect data from 26 war-injured immigrants with severe physical injury residing in Richmond Hill, Ontario from June to October 2023. Participants were selected to represent a diverse range of ages, genders, and countries of origin. Data were analyzed using thematic analysis to extract patterns and insights related to the healthcare experiences of the participants. The qualitative software NVivo, version 15, was utilized to assist in the organization and analysis of the data.

Four main themes emerged from the data: Access to health services, quality of care, patient-provider relationship, and health outcomes and satisfaction. Subthemes identified included initial contact, navigation challenges, financial barriers, waiting times, professional competence, patient-centered care, communication, trust building, cultural competence, communication quality, continuity of care, patient advocacy, recovery experience, satisfaction with care, and improvement in health status. Participants expressed significant challenges related to navigating the healthcare system, language barriers, financial constraints, and long waiting times. Positive experiences were often linked to high-quality communication, cultural competence of providers, and continuous care. 

This study underscores the need for targeted interventions to improve access and quality of care for this vulnerable population, including enhancing cultural competence and communication strategies among healthcare providers.

Vaccine hesitancy extends beyond simple refusal to receive immunizations, encompassing psychological, cultural, and sociodemographic factors that influence individuals’ perceptions and decision-making regarding vaccines.

This study aimed to determine the prevalence and factors influencing COVID-19 vaccine hesitancy among Brazilian immigrants.

A survey targeting Brazilian immigrants in Portugal was conducted from May to August 2020, involving 598 participants. The study explored the relationship between vaccine hesitancy and non-compliance with social distancing measures using a Poisson regression model with robust variance to calculate prevalence ratios (PRs).

The study identified a vaccine hesitancy rate of 15.1% among Brazilian immigrants. Older individuals (aged 50 and above) exhibited a significantly higher hesitancy, with an adjusted prevalence ratio (aPR) of 10.0 (95% CI: 1.8 - 13.6). Those adhering to a religion were 2.3 times more likely to hesitate (95% CI: 1.4 - 3.4), and a reluctance to follow social distancing measures was associated with a 10.4 times higher hesitancy rate (95% CI: 4.2 - 15.4). Highlighting these correlations is vital for developing strategies to enhance vaccine acceptance and tackle public health challenges.

There is a notable rate of COVID-19 vaccine hesitancy among Brazilian immigrants in Portugal, significantly influenced by age, religious practice, and non-adherence to social distancing measures. Implementing targeted educational and awareness programs is recommended to reduce hesitancy and improve vaccine coverage within this community and in similar settings.

As a vulnerable group in HIV control programs, immigrants face various obstacles to HIV testing. Despite the effectiveness of peer interventions on health promotion in HIV testing, relatively little is known about how these interventions work. This realist review aims to understand why, how, and under what conditions peer interventions can improve immigrants’ HIV testing uptake.

We followed the steps suggested by Pawson and colleagues for conducting the realist review. To test a initial program theory, we first systematically searched databases of PubMed, Web of Science, Scopus, Embase, and Cochrane, as well as the websites of UNAIDS, World Bank, Global Fund, WHO, and IOM. After data extraction and quality appraisal, data synthesis was conducted to explain the intervention pathways corresponding to context-mechanism-outcome configurations.

Seventeen studies were included in the review. Peer interventions for improving immigrants’ HIV testing uptake worked through four pathways: Following the improvement of communications (as a proximal mechanism): 1) increasing awareness, 2) reduced stigma, 3) improved support, and 4) increased access to services could lead to improved HIV testing uptake among immigrants. The identified mechanisms were influenced by three groups of individual/ interpersonal, service delivery, and structural factors.

Peer interventions with multiple strategies to be designed and implemented considering the barriers to HIV testing and also moving beyond one-size-fits-all approaches can successfully improve the immigrants’ HIV testing uptake. The refined program theory in this study can help the healthcare providers and policy-makers promote the immigrants’ HIV testing uptake and reduce the risk of disease transmission.

 The rising prevalence of mental and psychological issues among immigrants has garnered increased attention due to the significant growth in immigrant populations in recent years. In this context, exploring the connection between psychological health, cognitive flexibility, brain-behavioral systems, and sensory processing in Iranian immigrants in Canada is becoming an essential research goal.

 The aim of this study was to explore the relationships between psychological health, cognitive flexibility, brain-behavioral systems, and sensory processing among Iranian immigrants in Canada.

 A cross-sectional study design was used, gathering data from 400 Iranian students (198 males and 202 females) enrolled at universities in Canada and Iran. We collected participants' demographic details and assessed their psychological health, cognitive flexibility, brain-behavioral systems, and sensory processing through standardized instruments. Psychological health was evaluated using the Beck Anxiety Inventory, cognitive flexibility was measured with the Dennis and Vander Wall Cognitive Flexibility Questionnaire, and sensory processing was appraised via the adolescent/adult sensory profile. The Carver and White behavioral inhibition system (BIS)/behavioral activation system (BAS) scales were utilized to measure brain-behavioral systems. Statistical analyses, including correlation analysis and multivariate regression, were conducted to investigate the relationships among these variables.

 The correlation analysis revealed significant positive associations between anxiety and low registration (r = 0.283, P < 0.001), sensory sensitivity (r = 0.442, P < 0.001), and sensory avoiding (r = 0.307, P < 0.001) in immigrant students. Anxiety also showed nonsignificant negative correlations with the behavioral activation system-drive (r = -0.042, P = 0.551) and behavioral activation system-reward responsiveness (r = -0.090, P = 0.203). The multivariate regression analysis found that low registration (B = 0.177, P = 0.036), sensory sensitivity (B = 0.336, P < 0.001), and cognitive flexibility (B = 0.119, P = 0.025) significantly predicted anxiety levels in immigrant students. An adjusted R-squared value of 0.191 indicated that these variables together explained 19.1% of the variance in anxiety levels.

 This study underscores the significant links between sensory processing patterns, cognitive flexibility, brain-behavioral systems, and anxiety among Iranian immigrant students. These findings highlight the need for interventions focusing on teaching cognitive skills strategies and increasing awareness of sensory needs to help reduce anxiety levels in this population.

This study was done to identify the sanitary and health-oriented and information needs of Afghan immigrant women with breast cancer who are being treated and coping with their disease in health centers and hospitals in Iran.

The present study is a survey and applied in terms of purpose. The study population consisted of 72 Afghan immigrant female patients with breast cancer. A researcher-made questionnaire was used to collect information divided into 6 sections and had 65 questions. Kruskal-Wallis,Mann-Whitney U tests, and SPSS statistical software version 20 were used to analyze the data.

The results showed no significant difference between the health information needs of immigrants based on age, marital status, literacy rate, occupation, treatment stage, manner and place of residence, and other demographic characteristics. "Achieving a healthy life" has been identified as the most critical information need (with a mean of 4.14), and "lack of familiarity with traditional sources related to sanitary and health" has been identified as the most crucial barrier (with a mean of 3.99) in accessing sanitary and health information.

Paying attention to the information needs of cancer patients, especially immigrants and refugees with cultural differences and many social gaps with the host community (Iran), seems inevitable. As a result of being aware of the health information needs of these people in different stages of treatment and providing appropriate information by health professionals, informants, doctors, nurses, and medical staff, the situation will provide for better and more effective treatment of these patients in addition to reducing mental anxiety and psychological security in patients.

Breast cancer is the most prevalent cancer and a major cause of mortality among women. Breast self‑examination (BSE) is a key technique for early diagnosis of breast cancer, which, along with lifestyle changes, can alleviate the risk of mortality. This study aimed to examine the effect of self‑care training programs on lifestyle change and BSE of immigrant Afghan women residing in Iran.

In this quasi‑experimental study, 140 immigrant Afghan women visiting health‑care centers in Shiraz (Iran) were selected via convenience sampling during 2019–2020. The data were collected using a lifestyle questionnaire, a demographic information checklist, and a BSE checklist. Following the pretest, the experimental group received three sessions of self‑care training and took the posttest 2 months after the intervention. The control group did not receive any intervention, but took the same posttest 2 months after the pretest. Data analysis was performed using paired and independent t‑test and Chi‑squared test in Statistical Package for the Social Sciences (SPSS) 22.

The post‑intervention level of knowledge and performance of the experimental group significantly increased in terms of a healthy lifestyle (P < 0.001) and performance of BSE (P < 0.001) compared to the control group. The intervention also had a significant positive effect (P < 0.000) on all dimensions of lifestyle.

Self‑care training for lifestyle and BSE can promote the prevention and early diagnosis of breast cancer in immigrant Afghan women who have limited access to health care.

Educational attainment is one of the main social determinants of health, however, based on a literature from the US, high educational attainment is associated with fewer health advantages for marginalized groups such as immigrants. A recent study has shown diminished returns of education on health. In the current study, built on the Marginalization-related Diminished Returns (MDRs) theory, the differential association between educational attainment and happiness in Europe by nativity status is tested. For this cross-sectional study, we borrowed data from European Social Survey 2020 (ESS 2020). Participants included 9560 individuals who identified as either native-born (n = 9052) or immigrant (n = 508) individuals who had worked in the past week and were residing in one of these ten countries: Bulgaria, Czechia, Estonia, Finland, France, Croatia, Hungary, Lithuania, Slovenia, and Slovakia. Age, sex, and self-rate health were control variables, while educational attainment was the independent variable. Happiness was the outcome. Linear regression was used for data analysis. Poisson regression was used for sensitivity analysis. Overall, high educational attainment was associated with higher levels of happiness. We documented a statistical interaction between nativity status and education on happiness, indicating a weaker inverse association between educational attainment and happiness for immigrant than native-born individuals. The results remained similar using linear or Poisson regression models. Similar to the US, the link between educational attainment and happiness also depends on nativity in Europe. Countries of host undervalue the educational attainment of immigrants. Future research should explore the role of labor market discrimination and other racialization and xenophobia on reducing the return of education for immigrants. Given the existing MDRs, and because diminished returns are a mechanism behind disparities, policymakers should go beyond equal SDOH and equalize the return of SDOHs. Policies such as equal pay and additional enforcement of antidiscrimination may help. The results are important given the anti-immigrant sentiment and nationalist movements in Europe and around the world.

University reform was carried out in Turkiye in 1933. Many people of Jewish heritage, opposition doctors, and others who had fled Nazi persecution in Europe sought safety in Turkiye between 1933 and the end of World War II. Having examined the relevant official state archive documents, we, as our main objective, aimed to share the information obtained about immigrant physicians and scientists who worked at Istanbul University, contributing to establishing the Faculty of Medicine from 1933 until the end of World War II.The study was designed as a qualitative-multiple document analysis. Documents found by scanning the catalog of the Turkish Presidency State Archives Republic Archive Catalog were examined. In addition, other publications on the subject have been read. Seventeen original archival documents on physicians and other scientists who fled Nazi Germany and took refuge in Turkiye are examined. The names of 16 physicians and scientists are mentioned in the documents. They worked at the institute, clinic, School of Dentistry, and School of Pharmacists incorporated in the Faculty of Medicine. In addition to the advantages Turkiye provided for the scientists who took refuge, the country made it simple for their relatives to move and live there. Some of these scientists even acquired Turkish citizenship.It is found that immigrant physicians and scientists who took refuge in Turkiye have made a significant contribution to the development of Turkish medical education and medicine.

A successful response to the risk of human immunodefficiency virus (HIV) infection among immigrants requires improved access to HIV prevention, diagnosis, and treatment services. However, most immigrants face significant challenges in accessing HIV/AIDS services. The aim of this study was to explore the aspects influencing access to HIV/AIDS services among Afghan immigrants in Iran. This was a qualitative study using conventional content analysis that was conducted from June 2018 to April 2020 in Tehran, Iran. Purposeful sampling method was performed. We conducted 25 semi-structured interviews with three groups of stakeholders including Afghan immigrants infected with or at risk of HIV (n=8), service providers (n=8), and policymakers/managers/experts (n=9). Inductive qualitative content analysis was applied according to the Granheim and Lundman method. Data were analyzed using Open Code software version 4.03. Aspects influencing access to HIV/AIDS health services were categorized into 3 themes (that were extracted from 9 categories): 1. Cultural aspects (cultural similarities and differences, values and beliefs); 2. Psychosocial aspects (social support, stigma and discrimination); and 3. Service delivery related aspects (awareness, health services coverage and integrity, health services financing, accessibility, and continuity of care). The findings suggest that efforts to improve Afghan immigrants’ access to HIV/AIDS health services in Iran need to consider the cultural aspects, increasing HIV awareness, providing support, reducing stigma and discrimination, and improving health services coverage, integrity, financing, and continuity of accessible services.

Higher personal mastery is associated with better physical functioning, wellbeing, and longevity among older populations. However, few studies have focused on whether personal mastery is protective against mortality among older adults living with diabetes over time. 

A total of 1,779 participants were identified from an off-year survey of the Health and Retirement Study. Proportional Hazard Models were used to evaluate the significance of selected variables in predicting the survival of participants over a 13-year period.

A substantial proportion (46.7%) of the diabetic patients had survived by the end of 2016. Adults with lower mastery scores were more likely to die (Hazard Ratio = .94, p < .001). Gender differences in the association patterns between personal mastery and survival were identified. Personal mastery had an independent health-protective effect on the survival of diabetes patients over the study period. With lower educational attainment, the foreign-born female diabetics scored higher in personal mastery measure when compared to their male counterparts. In the face of more severe diabetes comorbidity, foreign-born female diabetics also  outlived their male counterparts over the study period.

As a crucial psychological resource and a modifiable factor, personal mastery holds a potential for improving the health status among lower SES groups of older adults. Further investigations into the identified gender difference could be applied to break the cycle of poor health among lower Socio-Economic Status groups of older adults.

This study was designed to detect, if there are asymptomatic malaria infections amongst native and immigrant population from Afghanistan and Pakistan countries in Sistan & Baluchistan Province of Iran, where is under the national malaria elimination program.

This cross-sectional study was performed among native individuals and resident immigrants in the southeastern province of Sistan & Baluchistan from May 2016 to Jul 2017. A total of 271 individuals were considered in this cross- sectional study based on microscopical method, Rapid Diagnostic Tests (RDTs) and PCR techniques. Out of 271 native and immigrant participants 140 (52%) and 131 (48%) were male and female, respectively.

None of the prepared samples was diagnosed as malaria positive case when was considered via above mentioned three techniques.

Neither native nor immigrant individuals had asymptomatic malaria, hinting that national malaria elimination program is performed according to planned schedule in the studied areas

Given the high prevalence of physical inactivity among Asian immigrants and its potential negative effects on health, more attention should be paid to identifying factors that might affect their participation in leisure time physician activity (LTPA). This study examined how perceived environmental characteristics are related to self-efficacy and LTPA among Asian immigrants in the United States.

This cross-sectional study collected data from an on-line survey administered through Qualtrics, a web-based survey software company. In the data analysis, 512 Asian immigrants were included. As independent variables, we assessed perceived environmental characteristics with regard to the perceived accessibility of LTPA-related sites and neighborhood quality. As mediating and outcome variables, we measured self-efficacy and LTPA, respectively. Using AMOS version 22, a path analysis was conducted to measure model fit.

The perceived accessibility of the LTPA-related sites (b=0.10, P=0.04) and self-efficacy (b=0.26, P=0.001) were positively related to LTPA. Perceived neighborhood quality (b=0.11, P=0.012 was positively associated with self-efficacy, yet not directly associated with LTPA. Selfefficacy mediated the relationship between the perceived accessibility of LTPA-related sites and LTPA (estimate=0.036, 95% CI=0.015–0.067, P=0.003).

This study suggests that perceiving easy access to LTPA-related sites and living in quality neighborhoods can encourage people to participate in LTPA more often by increasing their self-efficacy toward LTPA. These findings highlight a need for public infrastructural investments to improve accessibility to LTPA-related resources and neighborhood quality, which can potentially increase self-efficacy and promote LTPA among Asian immigrants.

Although education is among the major socioeconomic status (SES) resources that influence populations’ and individuals’ health, social marginalization may reduce the health gain that follows access to SES indicators such as education, a pattern called marginalization-related diminished return (MDR). The literature on MDRs, however, has been mainly derived from studies that have defined marginalization based on race, ethnicity, and sexual orientation. Thus, more research is needed on MDRs that may follow as a result of immigration. To extend what is known on immigration status related MDRs, this study compared a national sample of immigrants and non-immigrants for the effect of education on the poor self-rated health (SRH) of adults in the United States. With a cross-sectional design, this study employed data from the 2015 National Health Interview Survey (NHIS), a survey that had enrolled 33,654 adults who were either immigrants (n = 6225; 18.5%) or non-immigrants (n = 27 429; 81.5%). The independent variable was education level, treated as a categorical variable. The dependent variable was poor SRH treated as a dichotomous variable. Race, ethnicity, age, gender, marital status, and region were the confounders. Immigration (nativity) was the moderator. Logistic regression was used for data analysis. Higher education credentials were associated with better SRH in the pooled sample; however, immigration showed a significant statistical interaction with education level (college graduation) on the outcome. This interaction was indicative of a smaller protective effect of college graduation on poor SRH among immigrants than non-immigrant adults. In line with the MDRs framework, the effect of education on SRH is weaker for immigrants than for non-immigrant adults. There is a need to help highly educated immigrants to mobilize their human capital to secure their best health outcomes, similar to non-immigrants. Such strategies may require bold and innovative policy solutions to reduce discrimination against immigrants, so they can more effectively translate their education and human capital into tangible outcomes such as health.

Tuberculosis (TB) affects vulnerable populations. Immigrants have contributed to the increased incidence of TB. In this population, TB has some common characteristics that can lead to increased resistance to anti-TB drugs and undesired outcomes. In Cartagena de Indias, Colombia, an increase in TB cases has been observed in immigrants. Our objective is to describe the clinical and microbiological characteristics of Mycobacterium tuberculosis in the immigrant population of Cartagena de Indias, Colombia. A descriptive study of 101 patients with a clinical and microbiological diagnosis of TB was carried out in the city of Cartagena de Indias, Colombia from December 2017 to December 2018. The clinical spectrum and sensitivity profile of M. tuberculosis to first-line anti-TB drugs were characterized by phenotypic tests and molecular markers of resistance. Confidence intervals were calculated for the estimates. Statistical significance was considered at P≤0.05. A total of 101 patients were analyzed. 8.91% (95% CI: 4.16-16.24%) of the study population were immigrants. Extrapulmonary tuberculosis (EPTB) occurred more frequently among immigrants than in the native population (44.44%; 95% CI 13.70-78.80% vs. 4.49%; 95% CI 1.24-11.11%; P=0.002). The immigrants also had a higher frequency of cases with resistance (15.22 vs. 44.44%; P=0.051) and undesired outcomes, such as therapeutic failure (8.70% vs. 33.33%; P=0.001) and death (4.35% vs. 44.44%; P=0.001). Immigrant TB patients were more likely to present particular clinical characteristics, such as HIV coinfection, malnutrition, constitutional manifestations, extrapulmonary spread, the presence of caverns, and undesired outcomes.