The goal of this literature review is to provide a critical overview of existing research on the health of immigrant youth within the last decade. Although the review focuses primarily on Canada, the findings have implications for public health planning, policy, and settlement/immigration services in other immigrant-receiving countries. The main objectives are: (i) to locate relevant literature written in the past 10 years (January 1998-January 2008); (ii) to undertake a critical review of retrieved studies; (iii) to highlight gaps in the current state of our knowledge and make recommendations for future research directions. The review focuses on the influence of migration experience on health of youth.

BackgroundCardiovascular disease (CVD) is a leading cause of death among homeless people. This study examines CVD risk factors and 30-year CVD risk in a population of homeless individuals with mental illness.MethodsCVD risks factors were assessed in 352 homeless individuals with mental illness in Toronto, Canada, at the time of their enrollment in the At Home/Chez Soi Project, a randomized trial of a Housing First intervention. The 30-year risk for CVD (coronary death, myocardial infarction, and fatal or nonfatal stroke) was calculated using published formulas and examined for association with need for mental health services, diagnosis of psychotic disorder, sex, ethnicity, access to a family physician and diagnosis of substance dependence.ResultsThe 30-year CVD risk for study participants was 24.5 ± 18.4%, more than double the reference normal of 10.1 ± 7.21% (difference = −13.0% 95% CI −16.5% to −9.48%). Univariate analyses revealed 30-year CVD risk was greater among males (OR 3.99, 95% CI 2.47 to 6.56) and those who were diagnosed with substance dependence at baseline (OR 1.94 95% CI 1.23 to 3.06) and reduced among those who were non-white (OR 0.62 95% CI 0.39 to 0.97). In adjusted analyses, only male sex (OR 4.71 95% CI 2.76 to 8.05) and diagnosis of substance dependence (OR 1.78 95% CI 1.05 to 3.00) remained associated with increased CVD risk.ConclusionsHomeless people with mental illness have highly elevated 30-year CVD risk, particularly among males and those diagnosed with substance dependence. This study adds to the literature by reporting on CVD risk in a particularly vulnerable population of homeless individuals experiencing mental illness, and by using a 30-year CVD risk calculator which provides a longer time-frame during which the effect of modifiable CVD risk factors could be mitigated.Trial registrationCurrent Controlled Trials ISRCTN42520374Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1472-4) contains supplementary material, which is available to authorized users.

Background Inadequate health human resources is a key challenge to advancing child survival in Ghana. Nurses are an essential human resource to target because they represent the largest portion of the health workforce. Building on lessons learned from our pilot pediatric nurse training project and World Health Organization guidelines for transforming and scaling up health professional education, this project aimed to; train 500 pediatric nurse specialists through a one-year training program; develop and integrate a critical mass of pediatric nursing faculty and establish a national standardized pediatric nursing curriculum. This study aimed to evaluate the effectiveness of a national pediatric nurse training program in Ghana at the end of 4 years, including eight cohorts with 330 graduates. Methods This was a mixed-method evaluation with surveys, focus groups and a pre-test/post-test design. Before and after surveys were used to measure knowledge and confidence at baseline and graduation. Objective Structured Clinical Examinations (OSCE) were used to measure clinical skills at baseline, graduation, and 14 months follow-up. At the end of every module, surveys were used to measure students’ satisfaction. Focus groups at graduation qualitatively measured program outcomes. Repeat focus groups and surveys at 14 months after graduation captured the graduates’ career progress, experiences reintegrating into the health system and long-term program outcomes. Results Overall, the graduates completed the program with significantly increased knowledge, confidence, and clinical skills. They also had increased job satisfaction and were able to apply what they learned to their jobs, including leadership skills and gender-sensitive care. Data from 14-month follow-up OSCEs showed that all graduates remained competent in communication, physical assessment, and emergency care, although some obtained a lower mark compared to their performance at graduation. This finding is linked with the observation that the amount of mentorship, support from leadership and equipment that the graduates accessed from their respective facilities varied. Conclusions Mixed-methods evaluations demonstrated significant increases in knowledge confidence and skills by completing the program and maintenance of skills more than 1 year after graduation. Findings have implications for those working on the design, implementation, and evaluation of nursing education interventions in low- and middle-income countries.

This manuscript explores predictors of access to sexual health services among urban immigrant adolescents who live in Toronto, Canada. Surveys (n = 1216) were collected from pre-existing youth groups in community settings. A binary logistic multivariate model was developed to examine associations between access to sexual health services and a series of individual, interpersonal, and structural variables. Sexual activity, age, race, and social resources each had significant partial impact on access to sexual health services. Among young women, those with more social resources had significantly accessed services more often than those with fewer resources, but among men there was no difference as a function of social resources. Although immigration predicted access to sexual health services on its own, it was not statistically significant in this model when other variables were included. Immigration status, in and of itself, was not a predictor of youth's access to sexual health services. The impact of immigration status appears to occur because of its association with other variables, such as race. Implications for practice are discussed.