Identifying Vulnerability Factors Research Articles

Factors affecting hand hygiene practice during the COVID-19 pandemic in the Zimbabwean population: a qualitative study

BackgroundPracticing hand hygiene is recommended as one of the key preventive measures for reducing the transmission of COVID-19 and other infectious agents. However, it is often not practiced frequently enough or correctly by the public. We aimed to identify barriers to and facilitators of hand hygiene in the Zimbabwean population during the COVID-19 pandemic.MethodsA qualitative study was conducted with a purposive sample of health workers, village health workers, church leaders, traditional healers, teachers, youth leaders and the general population selected from ten districts across the country from September to October 2022. Semistructured interviews were conducted with 3 key informant interviews per site. In addition, one homogenous focus group discussion was also conducted per site using a focus group discussion guide. The data were recorded on audiotapes, transcribed verbatim, and translated into English. All the analyses were performed manually using thematic analysis.ResultsTwo themes were identified as facilitators of hand hygiene. These include individual factors (knowledge of hand hygiene practices and how they are performed) and access-related factors (access to hand washing infrastructure, soap, and sanitizers). Among the barriers to hand hygiene, four themes were identified: individual factors (knowledge gaps in proper hand washing, lack of conviction about hand hygiene, and habitual behaviour), access-related factors (lack of access to hand washing infrastructure, soap, and sanitizers), safety concerns (concern about the side effects of sanitizers), and sociocultural and religious factors (social customs, cultural beliefs, values, and religious practices).ConclusionDuring public health emergencies, there is a need for people to access uninterrupted, on-premises water supplies to promote compliance with hand hygiene. The provision of clean water and hand washing facilities is critical for vulnerable communities to afford them the opportunity to improve quality of life and facilitate resilience in the event of future pandemics. Community engagement is important for identifying vulnerability factors to provide appropriate mitigatory measures.

Characterizing the profiles of patients with acute concussion versus prolonged post-concussion symptoms in Ontario

Identifying vulnerability factors for developing persisting concussion symptoms is imperative for determining which patients may require specialized treatment. Using cross-sectional questionnaire data from an Ontario-wide observational concussion study, we compared patients with acute concussion (≤ 14 days) and prolonged post-concussion symptoms (PPCS) (≥ 90 days) on four factors of interest: sex, history of mental health disorders, history of headaches/migraines, and past concussions. Differences in profile between the two groups were also explored. 110 patients with acute concussion and 96 patients with PPCS were included in our study. The groups did not differ on the four factors of interest. Interestingly, both groups had greater proportions of females (acute concussion: 61.1% F; PPCS: 66.3% F). Patient profiles, however, differed wherein patients with PPCS were significantly older, more symptomatic, more likely to have been injured in a transportation-related incident, and more likely to live outside a Metropolitan city. These novel risk factors for persisting concussion symptoms require replication and highlight the need to re-evaluate previously identified risk factors as more and more concussions occur in non-athletes and different risk factors may be at play.

Droughts in forested ecoregions in cold and continental climates: A review of vulnerability concepts and factors in socio‐hydrological systems

AbstractIn a changing climate, drought risk and vulnerability assessments are becoming increasingly important. Following the global call for proactive drought risk management, drought vulnerability assessments are progressively taking their stage in the drought research community. As the manifestation of drought vulnerability is dependent on the social, ecological, and hydroclimatic context in which it occurs, identifying vulnerability factors relevant for specific climatological and ecological regions may improve the quality of vulnerability assessments. Meanwhile, a holistic overview of factors affecting vulnerability in polar and cold climates is currently lacking. These regions are home to large socio‐hydrological systems including urban areas, energy systems, agricultural practices, and the boreal forest. By conducting an interdisciplinary systematic literature review, the manifestation and conceptualization of drought vulnerability were identified for forested ecoregions in the Köppen–Geiger D and E climates. Vulnerability factors, as described by several scientific disciplines, were identified and combined into a conceptual framework for drought vulnerability in the study region. The results demonstrate the wide range of conceptualizations that exist for assessing drought vulnerability, and the thematic differences between sectors such as forestry, water supply, and agriculture. The conceptual framework presented herein adopts a novel approach, categorizing vulnerability factors by their location in a socio‐hydrological system, and their relation to blue or green water sources. This allowed for identification of systemic vulnerability patterns, providing new insights into regional differences in drought vulnerability and a base for stakeholders performing proactive drought risk assessments in the study region.This article is categorized under: Human Water > Methods Science of Water > Water Extremes Water and Life > Conservation, Management, and Awareness Human Water > Water Governance

Shan Female Sex Workers’ Vulnerabilities and Coping Strategies in Response to COVID-19 in Chiang Mai, Thailand

The Thailand government has marginalized, criminalized, and discriminated against migrant sex workers for decades and the COVID-19 pandemic has only increased the vulnerability of sex workers to hardship. Using a mixed research methodology including interviews, this article outlines the risks Shan sex workers in northern Thailand faced during the COVID-19 pandemic that began in 2020, their vulnerability contexts, and their coping strategies, including how institutional aid and existing assets impacted their livelihoods. Our findings reveal that Shan sex workers in Thailand have suffered primarily from oppressive laws and social stigma. They were excluded from government COVID-19 mitigation measures such as health services, compensation, and economic support. Identifying vulnerability factors highlights the difficulties of both systemic and individual-level responses, leading to suggestions for policymaking to improve the quality of sex workers’ lives. This study reveals that Shan sex workers are still being left behind and discriminated against in Thailand, but they have persevered to speak their minds and struggle to live through the COVID-19 crisis. There is an urgent need for Thailand authorities to decriminalize sex work and restructure the social security system so that it is inclusive for migrants. Keywords: Shan, Sex workers, COVID-19, Vulnerability, Coping strategy, Chiang Mai.

Human Leukocyte Antigen as a Predictor of COVID-19 Severity

Since the spread of the coronavirus disease 2019 (COVID-19) pandemic, many countries have been suffering from the disease, and patients exhibit an extensive spectrum of symptoms from mild to severe, and in some cases, it leads to death. Identifying vulnerability factors may help detect very high-risk subjects to prevent disease mortality. Since people have different human leukocyte antigen (HLA) alleles, and the frequency of the alleles varies between different races and geographic regions, it is inferred that there is an association between HLA and the vulnerability of the population. The present study aimed to find the most frequent HLA alleles that profoundly affect COVID-19 outcomes. To find the relevant articles, medical databases (Medline, PubMed, EMBASE, Cochrane Library, and the like) were searched by the keywords, and the results related to the association between HLA and COVID-19 morbidity were selected and briefly presented. Regarding the extracted information from several studies, HLA alleles with a strong affinity to COVID-19 epitopes such as HLA-A*11:01, HLA-A*02:06, and HLA-B*54:01 could result in mild symptoms, while those with weak affinity such as HLA-B*44:06 and HLA-B*46:01 contributed to severe symptoms and high mortality rate. Further, heterozygosity and frequency of HLA alleles could affect the disease outcome within populations. As a result, the vulnerability of the patients can be predicted through their HLA pattern, and preventive measures can be taken instantly for populations expressing high-risk alleles. HLA can be assumed as a global predictor of COVID-19 disease outcomes. High frequent alleles which affect the outcome of the disease are introduced as susceptibility-determining alleles.

Predictors of stress generation in Turkish young adults: The role of rumination and excessive reassurance seeking.

The stress generation model posits that not only stressful life-events predict depressive symptoms, but also depressive-prone individuals think and behave in ways that make them more vulnerable to experience life-stress. Evidence has supported the bi-directional relationship between stress and depressive symptoms, and there has been an attempt in identifying vulnerability factors for stress generation. Yet, there is a need for studies focusing on multiple risk factors and a replication of findings in non-Western samples. The aim of the present study was to examine the role of rumination and excessive reassurance seeking (ERS) in stress generation in a sample of Turkish young adults. A sample of 318 Turkish college students reported on their rumination, ERS, intensity of stressful life-events and depressive symptoms. A subsample of 162 participants also completed a measure of life-events 5 months later. Cross-sectional results showed that rumination and ERS contribute to life-stress over and above depressive symptoms and gender. Mediational analyses indicated that ERS does not mediate the relationship between rumination and life-stress at 5 months. Rather, rumination fully mediated the relationship between ERS and future life-stress. Results provide evidence for stress generation, and highlight the interconnection between rumination and ERS.

Facing recovery: Emotional bias in working memory, rumination, relapse, and recurrence of major depression; an experimental paradigm conducted five years after first episode of major depression

Identifying vulnerability factors for relapse of depression is essential in planning preventive interventions. Emotional face processing in major depression (MDD) shows promise as a potential cognitive marker for depression. The current study investigates how working memory (WM) load in face processing relates to rumination and new episodes of MDD in a novel explorative paradigm. It was expected that history of MDD is associated with reduction of the ability to process sad stimuli in high WM load conditions and reduction of the ability to process happy stimuli in low WM conditions. It was further predicted that these relations are associated with rumination and risk for relapse. The experiment was included as a cross sectional part in a follow-up study of a population that previously experienced first episode (FE) depression. The FE (N = 23) and a healthy control group (N = 22) completed a WM face processing task. In the task, three happy or sad faces were presented, processed in either a high or low WM taxing manner, followed by a target stimulus consisting of one of the previous pictures. Response time and accuracy were dependent variables. Rumination and number of relapses or recurrences were measured. The FE group recalled the placement of significantly fewer happy faces in the low WM load condition, and significantly fewer sad faces in the high WM load condition compared to controls. Significantly different scores between groups predicted trait rumination. Poor accuracy in the sad high WM load condition correlated with high degree of rumination. Relapse or recurrence was predicted by rumination. The present study supports an emotional WM deficit in remitted MDD. This suggests that deficits in manipulation of sad faces could represent a trait bias related to rumination and depression.

Risk and protective factors associated with being a victim of aggression in the health sector. Research protocol

Background: aggression against healthcare workers is an alarming issue worldwide. However, there is lack of data on psychologicalvulnerability factors (such as personality traits, attachment style) which can constitute a risk or a protective factor for being a victimof an episode of violence in the health sector.Methods/design: the present protocol is a cross-sectional study on prevalence and characteristics of violent episodes experienced bynursing students in the clinical setting. Its aim is to identify risk and protective factors for becoming a victim of verbal and/or physicalaggression among healthcare workers. Participants will undergo an intensive battery of psychometric tests, dealing with episodes ofaggression in the previous year, attachment style, personality traits, perceived stress, health related quality of life and job strain.Conclusions: the findings derived from this study may be of value in identifying vulnerability factors in experiencing an episode ofaggression in the health sector. In this respect, it is a step towards the development of valid training and support focused on healthworkers, aimed at teaching them how to modulate and manage their vulnerability factors in an efficient way.

Prediction of individual differences in fear response by novelty seeking, and disruption of contextual fear memory reconsolidation by ketamine

Only a portion of the population exposed to trauma will develop persistent emotional alterations characteristic of posttraumatic stress disorder (PTSD), which illustrates the necessity for identifying vulnerability factors and novel pharmacotherapeutic alternatives. Interestingly, clinical evidence suggests that novelty seeking is a good predictor for vulnerability to the development of excessive and persistent fear. Here, we first tested this hypothesis by analyzing contextual and cued fear responses of rats selected for their high (high responders, HR) or low (low responders, LR) exploration of a novel environment, indicator of novelty seeking. While HR and LR rats exhibited similar sensitivity to the shock and cued fear memory retention, fewer extinction sessions were required in HR than LR animals to reach extinction, indicating faster contextual and cued memory extinction. In a second part, we found an effective disruption of contextual fear reconsolidation by the N-methyl-d-aspartate receptor antagonist ketamine, associated with a down-regulation of early growth response 1 (Egr1) in the hippocampal CA1 area, and up-regulation of brain-derived neurotrophic factor (Bdnf) mRNA levels in the prelimbic and infralimbic cortices. Altogether, these data demonstrate a link between novelty seeking and conditioned fear extinction, and highlight a promising novel role of ketamine in affecting established fear memory.

Mouse Social Interaction Test (MoST): a quantitative computer automated analysis of behavior.

Rodents are the most commonly used preclinical model of human disease assessing the mechanism(s) involved as well as the role of genetics, epigenetics, and pharmacotherapy on this disease as well as identifying vulnerability factors and risk assessment for disease critical in the development of improved treatment strategies. Unfortunately, the majority of rodent preclinical studies utilize single housed approaches where animals are either entirely housed and tested in solitary environments or group housed but tested in solitary environments. This approach, however, ignores the important contribution of social interaction and social behavior. Social interaction in rodents is found to be a major criterion for the ethological validity of rodent species-specific behavioral characteristics (Zurn et al. 2007; Analysis 2011). It is also well established that there is significant and growing number of reports, which illustrates the important role of social environment and social interaction in all diseases, with particularly significance in all neuropsychiatric diseases. Thus, it is imperative that research studies be able to add large-scale evaluations of social interaction and behavior in mice and benefit from automated tracking of behaviors and measurements by removing user bias and by quantifying aspects of behaviors that cannot be assessed by a human observer. Single mouse setups have been used routinely, but cannot be easily extended to multiple-animal studies where social behavior is key, e.g., autism, depression, anxiety, substance and non-substance addictive disorders, aggression, sexual behavior, or parenting. While recent efforts are focusing on multiple-animal tracking alone, a significant limitation remains the lack of insightful measures of social interactions. We present a novel, non-invasive single camera-based automated tracking method described as Mouse Social Test (MoST) and set of measures designed for estimating the interactions of multiple mice at the same time in the same environment interacting freely. Our results show measurement of social interactions and designed to be adaptable and applicable to most existing home cage systems used in research, and provide a greater level of detailed analysis of social behavior than previously possible. The present study describes social behaviors assessed in a home cage environment setup containing six mice that interact freely over long periods of time, and we illustrate how these measures can be interpreted and combined to classify rodent social behaviors. In addition, we illustrate how these measures can be interpreted and combined to classify and analyze comprehensively rodent behaviors involved in several neuropsychiatric diseases as well as provide opportunity for the basic research of rodent behavior previously not possible.

Rumination and Interpersonal Functioning in Perinatal Depression

Identifying vulnerability factors for antenatal depression is an important step in reducing depression rates. To date, research has focused on demographic and interpersonal risk factors for antenatal depression rather than cognitive factors. This study investigated the moderating role of social functioning on rumination and silencing the self in predicting prospective increases in depressive mood in a sample of pregnant women. Pregnant women at high risk for depression (n = 110) were assessed at baseline for symptoms of depressive mood, rumination, functioning aspects of perceived social support, and silencing the self. Depressive mood was measured again three months later. Social functioning moderated the effects of rumination and silencing the self on depression. For women low in social functioning, rumination was related to increases in depression while silencing the self was unrelated to rumination and depressive mood. High social functioning buffered the impact of rumination on prospective depressive...

In Situ Mitochondrial Ca2+ Buffering Differences of Intact Neurons and Astrocytes from Cortex and Striatum

The striatum is particularly vulnerable to neurological disorders, such as Huntington disease. Previous studies, with nonsynaptic mitochondria isolated from cortical and striatal homogenates, suggest that striatal mitochondria are highly vulnerable to Ca(2+) loads, possibly influencing striatal vulnerability. However, whether and how neuronal and glial mitochondria from cortex and striatum differ in Ca(2+) vulnerability remains unknown. We test this hypothesis using a novel strategy allowing comparisons of mitochondrial Ca(2+) buffering capacity in cortical and striatal neuron-astrocyte co-cultures. We provide original evidence that mitochondria not only in neurons but also in astrocytes from striatal origin exhibit a decreased Ca(2+) buffering capacity when compared with cortical counterparts. The decreased mitochondrial Ca(2+) buffering capacity in striatal versus cortical astrocytes does not stem from variation in mitochondrial concentration or in the rate of intracellular Ca(2+) elevation, being mechanistically linked to an increased propensity to undergo cyclosporin A (CsA)-sensitive permeability transition. Indeed, 1 microm CsA selectively increased the mitochondrial Ca(2+) buffering capacity of striatal astrocytes, without modifying that of neurons or cortical astrocytes. Neither thapsigargin nor FK506 modified mitochondrial Ca(2+) buffering differences between cell types, excluding a predominant contribution of endoplasmic reticulum or calcineurin. These results provide additional insight into the mechanisms of striatal vulnerability, showing that the increased Ca(2+) vulnerability of striatal versus cortical mitochondria resides in both intact neurons and astrocytes, thus positioning the striatum at greater risk for disturbed neuron-astrocyte interactions. Also, the selective effect of CsA over striatal astrocytes suggests that in vivo neuronal sheltering with this compound may indirectly result from astrocytic protection.

Multivariate Statistics. IV. Statistical Issues in Identifying Vulnerability and Protective Factors Log-Linear Analysis

This is the last of four papers considering the application of multivariate statistics in psychiatric research. The relevance of log-linear analysis with multiway contingency table data is described. The problems of identifying vulnerability factors in life-event research are discussed. The conclusion is reached that non-hierarchical models need to be tested to provide a sensible operational definition of vulnerability with such data. An illustration of a non-hierarchical log-linear analysis is provided.