At-risk Communities Research Articles

A bioassay method validation framework for laboratory and semi-field tests used to evaluate vector control tools

Vector control interventions play a fundamental role in the control and elimination of vector-borne diseases. The evaluation of vector control products relies on bioassays, laboratory and semi-field tests using live insects to assess the product’s effectiveness. Bioassay method development requires a rigorous validation process to ensure that relevant methods are used to capture appropriate entomological endpoints which accurately and precisely describe likely efficacy against disease vectors as well as product characteristics within the manufacturing tolerance ranges for insecticide content specified by the World Health Organization. Currently, there are no standardized guidelines for bioassay method validation in vector control. This report presents a framework for bioassay validation that draws on accepted validation processes from the chemical and healthcare fields and which can be applied for evaluating bioassays and semi-field tests in vector control. The validation process has been categorized into four stages: preliminary development; feasibility experiments; internal validation, and external validation. A properly validated method combined with an appropriate experimental design and data analyses that account for both the variability of the method and the product is needed to generate reliable estimates of product efficacy to ensure that at-risk communities have timely access to safe and reliable vector control products.

The Role of Geospatial Technologies in Disaster Risks Assessments: A Review of Recent Research

Disasters, defined as unpredictable and inevitable natural occurrences, can have detrimental impacts on societal, economic, environmental, and humanitarian domains. Geospatial technologies, encompassing Global Navigation Satellite Systems (GNSS), Geographic Information Systems (GIS), and Remote Sensing (RS), offer powerful instruments in the management of disasters. Urban areas worldwide face a range of significant threats, including droughts, floods, earthquakes, and epidemics. The study aims to comprehend how these technologies can be employed for risk reduction, and identify the obstacles encountered in their implementation. By integrating GIS, GNSS, and RS into disaster management protocols, we can substantially diminish the negative consequences of disasters. Nonetheless, considerable challenges persist in the operational, application, and management aspects of deploying geospatial technology for disaster risk assessments. To harness the immense potential of geospatial technologies for enhancing disaster and emergency management, these obstacles must be confronted and overcome. This necessitates ongoing research, improved system interoperability, and significant capacity-building efforts, especially within at-risk communities

Evaluating the crisis communications campaign during the 2020–21 eruption of La Soufrière, St Vincent

Abstract During the 2020–21 eruption of La Soufrière, St Vincent, the University of the West Indies, Seismic Research Centre played a major role in supporting communication of hazard and risk information to publics and stakeholders across St Vincent. Due to COVID-19 restrictions on in-person education and outreach activities, the communications campaign was heavily reliant on social media platforms, and TV and radio broadcasts. Although the communications approach sought to be inclusive of all members of the affected communities, we consider that more vulnerable residents, such as the elderly, children, and those with low literacy levels and limited digital access were likely excluded from the communication efforts. In order to establish effectiveness of the crisis communications campaign at engaging communities and stakeholders with relevant information, and to identify areas for improvement, a large-scale evaluation campaign was conducted in St Vincent in August 2021. The results demonstrate that radio broadcasts are the most important communication tool for broad community reach, but that person-to-person information sharing was more important in the most exposed communities. Agencies such as the Red Cross and grassroots community disaster preparedness groups were instrumental in amplifying the reach of information to vulnerable members of at-risk communities and for evacuation co-ordination.

Advancing research, awareness, screening, and linkage to care to eliminate HDV in the U.S.

HDV, which coinfects individuals living with HBV, is the most aggressive form of viral hepatitis. Compared with hepatitis B monoinfection, hepatitis delta is associated with more rapid progression to cirrhosis and an increased risk of liver cancer and death. Despite being a major contributor to hepatitis B-associated liver disease, hepatitis delta remains largely unknown to the general public, health care providers, and at-risk communities. Given the widespread lack of awareness and underdiagnosis of hepatitis delta in the US, the American Liver Foundation (ALF) and the Hepatitis B Foundation (HBF) convened a virtual Hepatitis Delta Roundtable Meeting on April 21 and 22, 2022. The Roundtable Panel included persons living with hepatitis delta, caregivers, liver disease specialists, primary care providers, state and federal public health professionals, and community-based organizations. The Panel identified several major challenges surrounding hepatitis delta, including a lack of awareness of hepatitis delta among the public and health care providers; complex risk-based testing protocols; a lack of accurate prevalence data; limited data on linkage to care; and inadequate communications among stakeholders. Potential strategies to address these challenges include improving and expanding education for different audiences; advocating for simplified protocols for hepatitis B screening with hepatitis delta reflex testing; expanding surveillance for hepatitis delta; requiring automated reporting and national notification; improving data sharing for research; and enhancing communications around hepatitis delta. The recent CDC recommendations for universal adult screening and vaccination against hepatitis B and the anticipated availability of new therapies for hepatitis delta present a unique opportunity to focus attention on this dangerous virus. The Roundtable Panel calls for urgent action to make significant progress in addressing hepatitis delta among individuals living with hepatitis B.

Impact-Based Flood Early Warning for Rural Livelihoods in Uganda

Abstract Anticipatory actions are increasingly being taken before an extreme flood event to reduce the impacts on lives and livelihoods. Local contextualized information is required to support real-time local decisions on where and when to act and what anticipatory actions to take. This study defines an impact-based, early-warning trigger system that integrates flood forecasts with livelihood information, such as crop calendars, to target anticipatory actions better. We demonstrate the application of this trigger system using a flood case study from the Katakwi District in Uganda. First, we integrate information on the local crop cycles with the flood forecasts to define the impact-based trigger system. Second, we verify the impact-based system using historical flood impact information and then compare it with the existing hazard-based system in the context of humanitarian decisions. Study findings show that the impact-based trigger system has an improved probability of flood detection compared with the hazard-based system. There are fewer missed events in the impact-based system, while the trigger dates are similar in both systems. In a humanitarian context, the two systems trigger anticipatory actions at the same time. However, the impact-based trigger system can be further investigated in a different context (e.g., for livelihood protection) to assess the value of the local information. The impact-based system could also be a valuable tool to validate the existing hazard-based system, which builds more confidence in its use in informing anticipatory actions. The study findings, therefore, should open avenues for further dialogue on what the impact-based trigger system could mean within the broader forecast-based action landscape toward building the resilience of at-risk communities.

Attitudes Toward Plasmodium knowlesi Malaria Prevention Behaviours Among at-risk Communities and Health District Officers’ Efforts and Challenges in Promoting These Behaviours: An Elicitation Study in Peninsular Malaysia

This study explores at-risk communities’ attitudes toward Plasmodium knowlesi (P. knowlesi) malaria prevention behaviours using the Integrated Behavioural Model (IBM) as a guiding framework. This study also presents efforts and challenges faced by district health officers in Peninsular Malaysia in their role as the health authority for mitigating the disease. Seventeen informants were selected from at-risk areas in three states with high cases of P. knowlesi in 2019 (Johor, Pahang, Kelantan) to be interviewed. Semi-structured interview questions were developed guided by the IBM framework. Three district health officers who were involved in malaria prevention efforts in the selected states were also interviewed. Qualitative data analysis using Atlas.ti 8 software was used to facilitate thematic coding. Five prevention behaviours were found to be prevalent among the informants and are hypothesised to be suited for behavioural improvement intervention among at-risk communities. The prevention behaviours identified are: consuming prophylaxis, wearing long sleeves, using bed nets, mosquito coils and insect repellent. Current efforts by health district officers for P. knowlesi malaria prevention include erecting warning signs, community education programmes, and empowering community influencers. Challenges faced by the health district officers include difficulty accessing remote locations, limited facilities, and military-specific issues. This study suggests that future prevention efforts focused on behavioural improvement among at-risk communities in Malaysia should concentrate on the five prevention efforts most prevalent among these communities. Keywords: P. knowlesi malaria, attitude, prevention challenges, prevention efforts, peninsular Malaysia.

Climate change vulnerability and poverty nexus: evidence from coastal communities in central Vietnam

The vulnerability assessment of small-scale households on the central coast of Vietnam has been inadequate despite the apparent impacts of climate change. This knowledge gap presents challenges for identifying at-risk individuals and communities and could impede effective public policy and resource allocation for adaptation efforts. To address this issue, this study employed the Livelihood Vulnerability Index referencing IPCC definitions (LVI-IPCC) framework to examine livelihood vulnerability and its determinants among 455 small-scale households in the coastal areas of Phu Vang district, Thua Thien Hue province, Vietnam. The LVI-IPCC calculation utilized a database of 11 major and 33 sub-indicators collected through a household survey conducted in 2021. The findings revealed that these households exhibit moderate vulnerability to natural disasters and climate shocks, as reflected by their high sensitivity index scores. Additionally, the study identified a persistent cycle of poverty and livelihood vulnerability among coastal communities, wherein poverty and reliance on nature-based income serve as the root cause of the exposure and a gateway to this loop. This study strongly advocates for a pro-poor approach that places poverty alleviation at the forefront of community development planning and climate change agendas. Under this approach, developing value chain models in agriculture and aquaculture and diversifying livelihoods through activities such as community-based tourism is highly recommended.

A cross-sectional study to assess faculty and student knowledge of climate change and health: Readiness for curricular integration.

To examine the perceived knowledge, attitudes and beliefs regarding climate change and health of academic faculty and students in programmes for health professionals and to identify barriers/facilitators to and resources required for curriculum integration. Cross-sectional survey eliciting quantitative and open-ended responses. A 22-question survey to assess climate-health knowledge/attitudes/beliefs was distributed to all students and faculty (n = 224) at one academic institution in the United States. Open-ended questions addressed barriers, facilitators and required resources. Descriptive statistics are reported, and thematic analysis was used to identify themes from open-ended responses. Response rate was 15%. Most respondents (76%) were between 20 and 34 years old. The majority were from nursing (39%), occupational therapy (13%) and communication speech disorders (12.5%). Most respondents perceived climate change as relevant to direct patient care (78%) and believed that it is impacting the health of individuals (86%) and should be integrated into curricula (89%). Yet, most (60%) reported modest to no knowledge about the health impacts. Faculty reported little to no comfort teaching climate change and health concepts (76%). Open-ended responses identified student/faculty receptivity and professional/clinical relevance as important facilitators of successful integration. Barriers included intensity of programmes; time and competing curricular priorities; and a lack of faculty expertise, resources, institutional and professional commitment. Most health professions students and faculty indicated that educating future health professionals about climate change and health is important, but existing barriers must be addressed. This study addressed student and faculty perceptions of integrating climate change and health into health professions curricula. Discipline-specific and interprofessional educational approaches are necessary to optimize future health professionals' efforts to prevent and mitigate climate change impacts for at-risk patients, communities and populations.

Colorectal cancer and digital/live screening navigation: Promoting prevention through personalized recommendations and access.

10566 Background: This project evaluates the effectiveness of an advocacy organization-led digital and live navigation framework aimed at colorectal cancer (CRC) screening completion. The Colorectal Cancer Alliance’s screening quiz guides patients to a clinically valid, personalized CRC screening recommendation with a handoff to live navigation for those at risk. The framework utilizes digital innovation, targeted awareness, and financial support to support populations experiencing the greatest disparities and increase screening intention, behavior, and further health equity in colorectal cancer. This simple intervention is critical due to existing research consistently indicating on-time screening for CRC leads to favorable outcomes. Methods: In July 2022, the Alliance launched an enhanced quiz to improve the CRC screening navigation experience and increase engagement. The new survey instrument was restructured to streamline time to completion while preserving clinically accurate risk stratification. The follow-up navigation protocol was reordered from digital-first to live-first to leverage high-touch strategies earlier in the screening journey and dynamic content was added to the recommendation page to create a more personalized resource. The Alliance also deployed social media and influencer campaigns to increase outreach to at-risk communities. Results: The enhanced quiz delivered over 8,300 CRC screening recommendations and improved the average monthly completion rate (33%) and contact capture rate (14.4%) compared to the previous quiz in 2022 (24%; 8%). The median age of respondents was 55, and 37.2% of the respondents were between the ages of 45 and 64. Of the respondents, 26.7% were male and 73.3% were female. The majority were White (77.1%), 7.3% identified as Black/African American, 5.5% were Hispanic or Latino, and 3% were Asian. Most respondents were symptomatic (67.8%) but 8.1% were asymptomatic high-risk. Respondents (1,078) were triaged to live Alliance patient navigation. Conclusions: This digital and live navigation framework may serve as a strong solution in driving colorectal cancer screening and supporting shared-decision making conversations compared to other available interventions. The framework provides users with robust access to live navigation, educational resources, and support services for CRC screening and diagnosis. The Alliance is uniquely positioned to utilize its communications channels, social media and influencer campaigns to reach at-risk communities with credibility. Data attributed to specific campaigns are still being analyzed, and the Alliance will continue to optimize its navigation protocol and awareness efforts as quality improvement processes allow for a deeper understanding of more inclusive and impactful navigation experiences to close screening gaps among at-risk populations.

Seeing malaria through the eyes of affected communities: using photovoice to document local knowledge on zoonotic malaria causation and prevention practices among rural communities exposed to Plasmodium knowlesi malaria in Northern Borneo Island

BackgroundMany rural communities in Malaysian Borneo and Southeast Asia are at risk of Plasmodium knowlesi malaria. Multiple factors contribute to infection, however, a deep understanding of illness causation and prevention practices among at-risk communities remains limited. This study aims to document local knowledge on malaria causation and preventive practices of rural communities in Sabah, Malaysia, using photovoice—a participatory research method.MethodsFrom January to June 2022, a photovoice study was conducted with rural communities in Matunggong subdistrict, Malaysia, to explore their experiences with and local knowledge of non-human primate malaria and prevention practices. The study included (1) an introductory phase in which participants were introduced to the photovoice method; (2) a documentation phase in which participants captured and narrated photos from their communities; (3) a discussion phase in which participants discussed photos and relevant topics through a series of three focus group discussions (FGDs) per village; and (4) a dissemination phase where selected photos were shared with key stakeholders through a photo exhibition. A purposively selected sample of 26 participants (adults > 18 years old, male, and female) from four villages participated in all phases of the study. The study activities were conducted in Sabah Malay dialect. Participants and the research team contributed to data review and analyses.ResultsRural communities in Sabah, Malaysia possess local knowledge that attributes non-human primate malaria to natural factors related to the presence of mosquitoes that bite humans and which carry “kuman-malaria” or malaria parasite. Participants revealed various preventive practises ranging from traditional practises, including burning dried leaves and using plants that produce foul odours, to non-traditional approaches such as aerosols and mosquito repellents. By engaging with researchers and policymakers, the participants or termed as co-researchers in this study, showcased their ability to learn and appreciate new knowledge and perspectives and valued the opportunity to share their voices with policymakers. The study successfully fostered a balance of power dynamics between the co-researchers, research team members and policymakers.ConclusionThere were no misconceptions about malaria causation among study participants. The insights from study participants are relevant because of their living experience with the non-human malaria. It is critical to incorporate rural community perspectives in designing locally effective and feasible malaria interventions in rural Sabah, Malaysia. Future research can consider adapting the photovoice methodology for further research with the community toward building locally tailored-malaria strategies.

Harnessing the Power of Collaboration to Expand the Coverage and Equity of COVID-19 Vaccinations in India: A Community Collaboration Model.

Early in 2021, India embarked on the uphill journey of the COVID-19 vaccination of the largest population group in the world in a prioritized manner and in the shortest possible time. Considering the endless variety of geography and diverse socio-economic demographic, religious, and community contexts, there was a high likelihood of certain population subgroups with known vulnerabilities facing inequities, which were anticipated to be further accentuated by a digital divide. This necessitated devising solutions for such communities in a localized manner to aid the local government in breaking the service access and uptake barriers with an inclusive approach. To bridge this vital gap, the Momentum Routine Immunization Transformation and Equity project implemented a three-tiered collaboration, viz., government, non-governmental organizations (NGOs), and a wide range of vulnerable and at-risk communities, utilizing knowledge exchange and use of data. The project implemented localization strategies through the NGOs for community engagement in conjunction with government vaccination teams to universalize COVID-19 vaccination uptake up to the last mile. The collaboration resulted in reaching close to 50 million beneficiaries through messaging and facilitated the administration of more than 14 million vaccine doses, including 6.1 million doses for vulnerable and marginalized communities in 18 States and Union territories in India, along with suggesting implications for public health practice and research.

Investigating Gravitational Slope Deformations with COSMO-SkyMed-Based Differential Interferometry: A Case Study of San Marco dei Cavoti

Landslides pose significant risks to towns and villages in Southern Italy, including the San Marco dei Cavoti hamlet (Benevento, Campania), where settlements have expanded into areas threatened by landslides, leading to property damage, disruption to the social fabric and loss of life. This study aims to investigate the surface deformations in the area using Differential Interferometry SAR (DInSAR) analysis on COSMO-SkyMed radar imagery and to assess the potential implications for landslide activity. The DInSAR analysis methodology allowed us to obtain high-precision results presented as time series diagrams and maps of cumulative displacement for the study area. Furthermore, the displacement rates derived from the DInSAR analysis were decomposed into vertical and horizontal components to provide better insights into the slope processes and their potential impacts on the San Marco dei Cavoti hamlet. Our significant findings revealed active slope movements and the uphill enlargement of previously inventoried landslides threatening the San Marco dei Cavoti hamlet. These insights contribute to a better understanding of the landslide dynamics in the region and highlight the areas that may require further investigation or intervention measures. In conclusion, this study demonstrates the effectiveness of DInSAR analysis in providing valuable insights into landslide dynamics and informing potential mitigation measures for at-risk communities. This technique could be applied to other landslide-prone regions to support informed decision-making and enhance the safety and resilience of affected communities.

Pandemi Covid-19 Dalam Risiko Masyarakat Kontemporer

The Covid - 19 pandemic is a disaster that occurs quickly and thoroughly. This pandemic affects not only health, but also the economic, cultural, social and political education fields. The existence of the Covid - 19 pandemic makes people live in conditions of risk. Society will face terrible threats such as the spread of viruses and other threats. The consequences of the emergence of the Covid - 19 virus have caused social anxiety in society. This raises serious concern because this virus is increasingly spreading, including in areas where there are few positive confirmed cases of Covid - 19 itself. There are so many threats of Covid 19 that great attention is needed for the perception of own risk in decision making. The current situation shows that society has become a risky society. Where people are at risk themselves are vulnerable people. Community life will be colored by risks that can affect society. This article tries to analyze the context of the covid - 19 pandemic in at-risk communities by using a sociological perspective of at-risk communities, especially in the covid - 19 pandemic. This Covid - 19 pandemic also shows that society is not ready to face the Covid 19 disaster which occurred as a whole and not a single country that can avoid the impact of Covid - 19. In addition, this article shows that the pandemic affects all classes in society and affects people from young to old

The COVID-19 pandemic and its impacts on mass shootings in six major US cities

BackgroundThe COVID-19 pandemic has significant impacts on the US socioeconomic structure. Gun violence is a major public health issue and the effects on this area have not been well-elucidated. The objective of this study was to determine the impacts of the pandemic on mass shootings in six major United States cities with historically high rates of gun violence. MethodsMass shooting data were extracted from an open-source database, Gun Violence Archive. Mass shooting was defined as four or more people shot at a single event. Data from six cities with the highest incidence of mass shootings were analyzed in 2019 versus 2020 (Baltimore, Chicago, Detroit, New Orleans, Philadelphia, and St. Louis). Geographic data were examined to assess changes in each city's mass shooting geographic distribution over time. Quantitative changes were assessed using the Area Deprivation Index (ADI), and qualitative data were assessed using ArcGIS. ResultsIn 2020, the overall percentage of mass shootings increased by 46.7% though there was no change in the distribution of these events when assessed quantitatively (no change in average ADI) nor qualitatively (using ArcGIS). In the six cities analyzed, the total proportion of mass shooting events was unchanged during the pandemic (21.8% vs 20.6%, p = 0.64). Chicago, the US city with the highest incidence of mass shootings, did not experience a significant change in 2020 (n = 34/91, 37.3% vs. n = 53/126, 42.1%, p = 0.57). Baltimore had a significant decrease in mass shooting events (n = 18/91, 19.8% vs. 10/126, 7.9%, p = 0.01). The other four cities had no significant change in the number of mass shootings (p>0.05). ConclusionThis study is the first to use ArcGIS technology to describe the patterns of mass shooting in six major US cities during the COVID-19 pandemic. The number of mass shootings in six US cities remained largely unchanged which suggests that changes in mass shootings is likely occurring in smaller cities. Future studies should focus on the changing patterns of homicides in at-risk communities and other possible social influences.

Early Warning for Natural and Manmade Disaster

Abstract: Emergency and disaster are on the rise in the world. One of the most important components of disaster risk management is the early warning system. Studies have shown divergent models of warning systems with different structures. However, since no systematic review of early warning systems in disasters has been conducted so far, a systematic review of the models, components, and structures of these systems is essential. This protocol is a systematic review study, which aims to evaluate the existing warning systems and their structure. An Early Warning System (EWS) represents the set of capacities needed to generate and disseminate timely and meaningful warning information that enables at-risk individuals, communities and organizations to prepare and act appropriately and in sufficient time to reduce harm or loss. On one hand, the gathering, processing and presentation of information in a consistent and meaningful manner to allow the generation of alert messages and, on the other hand, the generation and transmission of alert messages to the citizens at risk means of warning communication. An EWS allows harm and loss reduction with getting and disseminating warning information about hazards and vulnerabilities in a group of people who are considered at risk. Each word has an important meaning, for example, community involves a network of social interaction, early refers to prevention of any disaster or reduction of the potential harm or damage, warning means a message that announces danger and system put all together.

Central Gulf Coast CDF Freedom Schools’ approach to poverty and learning loss

The Central Gulf Coast Children’s Defense Fund summer program has provided a solution to the issues related to learning loss and poverty over the last three years. Elementary students were strategically selected from low-income, at-risk, and minority communities to participate in the Freedom Schools program. This study describes the benefits to the students, their families, and the community, as well as the Servant Leader Interns who provided the culturally relevant curriculum. The history, structure, and essential components of Freedom Schools are described for the national model and Central Gulf Coast’s approach. The benefits of the program are also shared, as well as the practical implications for the participants in this study.

Detecting, Monitoring and Foreseeing Wildland Fire Requires Similar Multiscale Viewpoints as Meteorology and Climatology

Achieving sustainable coexistence with wildfires in the Anthropocene requires skilful integrated fire observations, fire behaviour predictions, forecasts of fire risk, and projections of change to fire climates. The diverse and multiscale approaches used by the atmospheric sciences, to understand geographic patterns, temporal trends and likely trajectories of weather and climate, provide a role model for how multiscale assessments of fire danger can be formulated and delivered to fire managers, emergency responders and at-risk communities. Adaptation to escalating risk of fire disasters requires specialised national agencies, like weather services, that provide to provide a diverse range of products to enable detection and near and longer-range prediction of landscape fire activity.

Hate Raids on Twitch: Echoes of the Past, New Modalities, and Implications for Platform Governance

In the summer of 2021, users on the livestreaming platform Twitch were targeted by a wave of "hate raids," a form of attack that overwhelms a streamer's chatroom with hateful messages, often through the use of bots and automation. Using a mixed-methods approach, we combine a quantitative measurement of attacks across the platform with interviews of streamers and third-party bot developers. We present evidence that confirms that some hate raids were highly-targeted, hate-driven attacks, but we also observe another mode of hate raid similar to networked harassment and specific forms of subcultural trolling. We show that the streamers who self-identify as LGBTQ+ and/or Black were disproportionately targeted and that hate raid messages were most commonly rooted in anti-Black racism and antisemitism. We also document how these attacks elicited rapid community responses in both bolstering reactive moderation and developing proactive mitigations for future attacks. We conclude by discussing how platforms can better prepare for attacks and protect at-risk communities while considering the division of labor between community moderators, tool-builders, and platforms.

Sociodemographic circumstances, health, and life experience shape posttraumatic distress trajectories among individuals exposed to smoke during a large-scale coal mine fire.

The 2014 Hazelwood coal mine fire in the Latrobe Valley, Australia, distributed toxic smoke into surrounding communities over 45 days. This study investigated risk and protective factors associated with four trajectories of posttraumatic distress (resilient, recovery, delayed-onset, chronic) among exposed adults. Participants (N = 709) completed surveys in 2016-2017 and 2019-2020 assessing mine fire-related particulate matter (PM2.5 ) exposure; sociodemographic, physical, and mental health variables; and exposure to other traumatic and recent stressful events. Mine fire-related posttraumatic distress was measured using the IES-R; trajectories were determined according to established clinical significance thresholds. Relative risk ratios (RRRs) were generated from multivariate multinomial regressions. The resilient trajectory was most common (77.0%). The chronic trajectory (8.5%) was associated with loneliness, RRR = 2.59, 95% CI [1.30, 5.16], and physical health diagnoses, RRR = 2.31, 95% CI [1.32, 4.02]. The delayed-onset trajectory (9.1%) was associated with multiple recent stressful events, RRR = 2.51, 95% CI [1.37, 4.59]; mental health diagnoses, RRR = 2.30, 95% CI [1.25, 4.24]; loneliness, RRR = 2.05, 95% CI [1.09, 3.88]; and male gender, RRR = 2.01, 95% CI [1.18, 3.44]. Socioeconomic advantage protected against chronic, RRR = 0.68, 95% CI [0.53, 0.86], and delayed-onset trajectory membership, RRR = 0.68, 95% CI [0.50, 0.94]; social support protected against chronic trajectory membership, RRR = 0.67, 95% CI [0.49, 0.92]. PM2.5 exposure did not determine trajectory. These findings enhance understanding of longer-term posttraumatic responses to large-scale smoke events and can inform mental health initiatives within at-risk communities.

Quantifying uncertainty in the temporal disposition of groundwater inundation under sea level rise projections

Over the next century, coastal regions are under threat from projected rising sea levels and the potential emergence of groundwater at the land surface (groundwater inundation). The potential economic and social damages of this largely unseen, and often poorly characterised natural hazard are substantial. To support risk-based decision making in response to this emerging hazard, we present a Bayesian modelling framework (or workflow), which maps the spatial distribution of groundwater level uncertainty and inundation under Intergovernmental Panel on Climate Change (IPCC) projections of Sea Level Rise (SLR). Such probabilistic mapping assessments, which explicitly acknowledge the spatial uncertainty of groundwater flow model predictions, and the deep uncertainty of the IPCC-SLR projections themselves, remains challenging for coastal groundwater systems. Our study, therefore, presents a generalisable workflow to support decision makers, that we demonstrate for a case study of a low-lying coastal region in Aotearoa New Zealand. Our results provide posterior predictive distributions of groundwater levels to map susceptibility to the groundwater inundation hazard, according to exceedance of specified model top elevations. We also explore the value of history matching (model calibration) in the context of reducing predictive uncertainty, and the benefits of predicting changes (rather than absolute values) in relation to a decision threshold. The latter may have profound implications for the many at-risk coastal communities and ecosystems, which are typically data poor. We conclude that history matching can indeed increase the spatial confidence of posterior groundwater inundation predictions for the 2030-2050 timeframe.