Psychosocial Risk Factors Research Articles

Protecting Those Who Protect Us: A Review of Psychosocial Factors and Musculoskeletal Disorders in Police Officers

Introduction: Musculoskeletal Disorders (MSDs) are a common occupational health problem among police officers. This systematic review aimed to estimate the association between psychosocial factors and MSDs in this population. Design: A systematic search was conducted using the Scopus database to identify studies that assessed the psychosocial risk factors for MSDs in police officers. Results: Fourteen studies were included in the review. The findings suggest that exposure to job satisfaction, working type, job demands, shift work, working hours, job control, equipment, organisational structure, job support, work cooperation, workplace inequalities, parenthood, social support, and psychological factors were linked to the presence of pain in the back, neck, shoulder, arm, and legs among police officers. Conclusions: This review highlights the importance of addressing psychosocial risk factors to improve the quality of life of police officers. Specific interventions to reduce these risk factors might include changes in organizational structure, job design, and work schedules, as well as targeted programs to promote stress management, coping skills, and work-life balance. Addressing these factors can help to prevent or reduce the presence of MSDs in this population, promoting healthier and more productive workplaces. Future studies are recommended to investigate this association further by considering the utilization of longitudinal study designs.

An Examination of Bidirectional Associations Between Alcohol Use and Internalizing Symptoms Among Adolescents During the COVID-19 Pandemic

PurposeThis study explores the bidirectional association between internalizing symptoms and alcohol use over three years of the COVID-19 pandemic to examine whether alcohol consumption is associated with higher internalizing symptoms in the next year and vice versa. MethodsWe used linked data from a sample of 2,136 secondary school students who participated in three consecutive waves (2019–2020 [T1], 2020–2021 [T2], and 2021–2022 [T3]) of the Cannabis use, Obesity, Mental health, Physical activity, Alcohol use, Smoking, and Sedentary behaviour study during the pandemic. A random-intercept cross-lagged panel model was used to characterize reciprocal linear relations between internalizing symptoms and alcohol use. ResultsThe findings suggest that students who reported higher levels of alcohol use at T1 experienced increased levels of depression and anxiety in the subsequent year (T2). However, this association was not observed from T2 to T3. Throughout the three-year period, depression and anxiety were not associated with later alcohol use. In males, alcohol use at T1 was a predictor of higher internalizing symptoms at T2 but not from T2 to T3. DiscussionThese results suggest time-sensitive impacts and notable gender differences in the relationship between internalizing symptoms and alcohol use over the pandemic. Given the complexity of impacts, ongoing evaluation of the impact of the pandemic on youth health behaviours is necessary to elucidate these unfolding relationships, especially as the pandemic continues to affect various psychosocial risk factors.

Analyzing complaints of arm, neck, and shoulder pain among academicians in Malaysia: a cross-sectional study on prevalence and contributing factors

OBJECTIVES: Complaints of arm, neck, and shoulder (CANS) have been recognized as an important cause of work disability. Therefore, it is essential to identify those health risk factors for the development of CANS before they escalate into a disabling musculoskeletal condition. This study aims to ascertain the association between individual, physical, and psychosocial risk factors and the occurrence of CANS among academics in Malaysia. METHODS: A cross-sectional study design was adopted, enrolling 296 academic staff working at a private university in Malaysia using a convenient sampling approach. A content-validated questionnaire was distributed among selected academic staff to gather their feedback on the prevalence and contributing factors of CANS, and the survey was conducted for a period of six months. The chi-square test was used to analyze the association between risk factors and CANS, and multiple logistic regression was used to predict the risk factors of CANS. This study links all the health risk factors to CANS in Malaysian academicians. RESULTS: Of the academic staff who participated in this study, 63.5% reported an annual prevalence of CANS. Physical risk factors, including work experience, adopting a static head-down posture, time spent per day in teaching, and the number of hours spent in front of a computer, are associated with CANS (p<0.05). However, the utility of back support (p=0.878) and footrests (p=0.078) does not show any association with the occurrence of CANS (p>0.05). Besides job demand, other psychosocial factors do not show any significant association with CANS. DISCUSSION: The study found that 63.5% of academic staff suffer from arm, shoulder, and neck pain, which is linked to physical risk factors such as work experience, static posture, teaching time and computer use. Back support and footrests had no significant influence on the complaints. Addressing physical risk factors is key to reducing these conditions among academic staff.

Racial disparities in stroke incidence in the Women's Health Initiative: Exploring biological, behavioral, psychosocial, and social risk factors

Background– Disparities in incident stroke risk among women by race and ethnicity persist. Few studies report the distribution and association of stroke risk factors by age group among a diverse sample of women. Methods– Data from the Women's Health Initiative (WHI) Observational Study collected between 1993 and 2010 were used to calculate cumulative stroke incidence and incidence rates among non-Hispanic African American (NHAA), non-Hispanic white (NHW), and Hispanic white or African American (HWAA) women by age group in participants aged ≥50 years at baseline (N = 77,247). Hazard ratios (HRs) and 95% CIs for biological, behavioral, psychosocial, and socioeconomic factors overall and by race or ethnicity were estimated using sequential Cox proportional hazard regression models. Results– Average follow-up time was 11.52 (SD, 3.48) years. The incident stroke rate was higher among NHAA (306 per 100,000 person-years) compared to NHW (279/100,000py) and HWAA women (147/100,000py) overall and in each age group. The disparity was largest at ages >75 years. The association between stroke risk factors (e.g., smoking, BMI, physical activity) and incident stroke varied across race and ethnicity groups. Higher social support was significantly associated with decreased stroke risk overall (HR:0.84, 95% CI, 0.76, 0.93); the degree of protection varied across race and ethnicity groups. Socioeconomic factors did not contribute additional stroke risk beyond risk conferred by traditional and psychosocial factors. Conclusions– The distribution and association of stroke risk factors differed between NHAA and NHW women. There is a clear need for stroke prevention strategies that address factors driving racial disparities in stroke risk.

Meta‐analysis of NIH Alzheimer’s Disease‐Related Dementias (ADRD) programs responsive to the National Plan to Address Alzheimer’s Disease (AD)

AbstractBackgroundAD/ADRD diseases currently impact more than 6 million people in the US. Rare forms of AD/ADRD are caused directly and unambiguously by genetic mutations. However, most AD/ADRD burden is complex in etiology and thought to result from an interplay among multiple incompletely understood genetic, biochemical, lifestyle, environmental and psychosocial risk factors. Moreover, risk factors interact with other health factors to impact AD/ADRD outcomes. For example, while the most common dementia diagnosis is AD, research over the past decade revealed most people with a diagnosis of AD have multiple brain pathologies, other comorbidities, and many people diagnosed with clinical AD do not have AD pathology at all. This new knowledge highlights the importance of better understanding dementia syndromes, and the relationships among them, to increase chances of developing effective interventions. The NINDS partners with the NIA, the NIH lead for AD/ADRD, in the NIH response to the National Plan. NINDS leads ADRD including frontotemporal dementia (FTD), Lewy body dementias (LBD), vascular contributions to cognitive impairment and dementia (VCID) and multiple etiology dementias (MED). This project aims to evaluate NIH and the ADRD field’s responsiveness to ADRD research milestones from triennial NINDS ADRD Summits by mapping NIH‐funded research activities to ADRD milestones.MethodThe approach used text‐based analysis/mining of grant titles, abstracts, and specific aims to map awards and activities to ADRD milestones. Mappings were vetted by expert concurrence. The ongoing study includes new or competitively renewed NIH ADRD awards starting from fiscal year 2017. Findings help NIH to better understand the state of the field, identify research gaps and opportunities for future efforts, and enable public communication of research activities with an accurate, accessible, compact, and updatable data visualizations.ResultResults indicate the approach is feasible, and importantly the field and NIH have largely been responsive to the ADRD milestones in the National Plan to Address AD.ConclusionThe analysis points to several cross‐cutting ADRD research areas that may benefit from increased attention going forward, including health equity, the multiple etiology hypothesis of common dementias, emerging risk factors for common dementias (e.g. COVID‐19, TBI, and TDP‐43 proteinopathy), and clinical trials.

Defining the Need for Causal Inference to Understand the Impact of Social Determinants of Health: A Primer on Behalf of the Consortium for the Holistic Assessment of Risk in Transplantation (CHART).

This study aims to introduce key concepts and methods that inform the design of studies that seek to quantify the causal effect of social determinants of health (SDOH) on access to and outcomes following organ transplant. The causal pathways between SDOH and transplant outcomes are poorly understood. This is partially due to the unstandardized and incomplete capture of the complex interactions between patients, their neighborhood environments, the tertiary care system, and structural factors that impact access and outcomes. Designing studies to quantify the causal impact of these factors on transplant access and outcomes requires an understanding of the fundamental concepts of causal inference. We present an overview of fundamental concepts in causal inference, including the potential outcomes framework and direct acyclic graphs. We discuss how to conceptualize SDOH in a causal framework and provide applied examples to illustrate how bias is introduced. There is a need for direct measures of SDOH, increased measurement of latent and mediating variables, and multi-level frameworks for research that examine health inequities across multiple health systems to generalize results. We illustrate that biases can arise due to socioeconomic status, race/ethnicity, and incongruencies in language between the patient and clinician. Progress towards an equitable transplant system requires establishing causal pathways between psychosocial risk factors, access, and outcomes. This is predicated on accurate and precise quantification of social risk, best facilitated by improved organization of health system data and multicenter efforts to collect and learn from it in ways relevant to specialties and service lines.

A systematic review of psychosocial challenges for MSM living with HIV among diverse and intersecting minorities

Men who have sex with men (MSM) living with HIV have been studied extensively for stigmatization and inequitable factors affecting well-being. Although intersecting factors are acknowledged in some studies, they are rarely discussed in the context of health implications among multiple minority identities. This leaves psychosocial research outputs to focus their efforts among less stigmatized MSM groups, white men, while disregarding specific issues among historically marginalized MSM-related identities (e.g., racialized, Indigenous, and aging populations). As per the 95-95-95 goals set by the Joint United Nations Programme on HIV and AIDS, this systematic review covers psychosocial protective and risk factors experienced by HIV-positive MSM while also considering other intersecting identities. Following a standardized search inquiry, 2,139 records were identified and narrowed down to 24 peer-reviewed articles which were systematically reviewed. Psychological and social protective factors are contextually described. Some risk factors such as co-occurring stigmas, psychological distress, exposure to violence, and trauma among diverse MSM can potentiate greater risk-taking behaviours associated with HIV transmission among HIV-positive men. These findings highlight factors that contribute to resilient pathways among racialized minorities and other intersections among MSM while also examining specific psychological stressors. Tailored interventions and care for minorities with intersecting identities, with a focus on co-occurring stigmas, are crucial to ensure the well-being of diverse HIV-positive MSM and reduce HIV transmission. We propose an adaptation to the minority stress model to refine available tools and provide future studies with more accurate depictions of the lived experiences among diverse MSM.

Loneliness and cognitive function in older adults: Longitudinal analysis in 15 countries.

This study aims to evaluate the directionality of the association between loneliness and cognitive performance in older adults, accounting for confounding factors. Data were from 55,662 adults aged ≥ 50 years who participated in Waves 5-8 of the Survey of Health, Ageing and Retirement in Europe (SHARE). Loneliness was assessed with the Three-Item Loneliness Scale (TILS) and with a one-item direct question. Cognitive performance was assessed with four measures: verbal fluency, numeracy, immediate recall, and delayed recall. Age, sex, geographical area, educational attainment, partnership status, depressive symptoms, and previous chronic diseases at baseline were used as covariates. We analyzed the associations with three-wave random intercept cross-lagged panel models (RI-CLPM) and conducted age-stratified analysis among those younger versus older than 65 years. Full information maximum likelihood estimators were used to handle missing values in Waves 6-8 in the main analyses. We also conducted additional sensitivity analyses stratified by retirement status (retired vs. not) at baseline. At the within-person level, loneliness and cognitive performance were not associated with each other among those aged 50-64 years in the main time-lagged analysis. Among those aged ≥ 65 years, loneliness was associated with lower cognitive performance in the next wave in all four cognitive domains. In addition, lower verbal fluency predicted greater loneliness in the next waves among this age group. Similar patterns were found independently of retirement status at baseline. These results suggest that loneliness is a psychosocial risk factor for cognitive decline among older adults (≥ 65 years). (PsycInfo Database Record (c) 2023 APA, all rights reserved).

P115: Testing the feasibility of a multicomponent neuropsychological intervention for individuals at-risk of dementia: the REMINDER program

Objective:Interventions aimed to optimize cognitive function and functionality in individuals at risk of dementia were scarce in validity studies. While some RCTs have been developed in cognitive training interventions, studies of multicomponent interventions (cognitive, social, and behavioral) integrating intervention targeting psychosocial risk factors (social isolation, depression, low cognitive reserve) is absent. Additionally, few efforts have been made to develop such validity studies with individuals at higher risk of dementia who still do not present objective cognitive decline, despite current recommendations in this regard. We aimed to start the validation of a 20-session multicomponent intervention – REMINDER program - with a feasibility test and a preliminary efficacy testing using a comprehensive outcome assessment protocol.Methods:A feasibility randomized controlled trial (RCT) was conducted, recruiting community-dwelling individuals between 60 to 75 years old with increased risk of dementia (LIBRA dementia risk score). Fifteen participants took part in twice-a-week sessions of the REMINDER program, during twelve weeks. Data on the acceptability, satisfaction and adherence to the REMINDER program was collected, and an association between pre and post intervention motivation and knowledge about dementia risk was examined. For the preliminary efficacy testing we considered as primary outcome a performance-based functionality measure (UPSA) and secondary outcomes will include global cognition, emotional status, and lifestyle habits, tested prior and after the intervention.Results:Rates of satisfaction throughout the REMINDER program sessions were high (75%, mean) as well as the adherences that was superior to the main dementia risk reduction programs referred in literature. (83%). Post-intervention efficacy testing is ongoing, however, levels of knowledge about dementia risk increased 12% compared with pre-intervention (34% pre-intervention, to 46% post intervention; p=.045)Discussion:Preliminary data on feasibility and efficacy of the REMINDER program suggests this program is an engaging and motivating tool for dementia risk reduction, justifying the future implementation of a large-scale RCT. We expect that, with a larger efficacy study we can demonstrate the REMINDER program effects in behavior change and in the adoption of protective lifestyles for dementia prevention, and that the comprehensive outcome assessment proves to be effective and, therefore, replicable in further studies.

Exploring the Relationship between Psychosocial Risk Factors and Sudden Unexplained Infant Death: A Study of Autopsy Cases from a Perspective of Child Welfare

Infants who are born between 24 hours and 1 year of age require extreme caution in their care due to their fragility. However, if there are multiple risk factors associated with the infant, caretaker, household, and surrounding circumstances, providing proper and appropriate care becomes problematic. This difficulty in caring for infants can contribute to abuse, neglect, or even death. This study investigates unexplained infant deaths that occur in the presence of multiple psychosocial risk factors. This study aimed to explore the relationship between various psychosocial risk factors and sudden, unexplained infant deaths. We examined nine cases from the autopsy archive of the National Forensic Service using a statistical approach. Among these cases, three were subject to legal action, while six were closed without further legal process. Although it was difficult to establish a clear relationship between death and abuse or neglect in the six cases, all were found to have experienced a harsh environment that was similar to abuse or neglect. We discuss the implications of our findings for understanding infant deaths and legal outcomes and propose a new framework to understand the deaths of infants.

Génériques et/ou spécifiques ? Quels sont les facteurs de risque permettant d’expliquer la détresse psychologique des cadres de premier niveau ?

La littérature scientifique visant à identifier les déterminants de la détresse psychologique au travail se concentre essentiellement sur des facteurs de risque psychosociaux largement répandus dans divers types d’emplois, comme les caractéristiques des tâches (Karasek, 1979). Il s’agit de facteurs pouvant être associés à bon nombre d’occupations puisque leur conceptualisation est générique (p. ex. la charge de travail quantitative). Or les études qui s’intéressent aux facteurs spécifiques à la nature même des emplois étudiés sont encore minoritaires dans la littérature portant sur la détresse psychologique. Dans notre étude, nous investiguons les facteurs de stress associés au rôle des cadres de premier niveau, lequel est reconnu pour sa nature dite « paradoxale » (Hales, 2005). Notre objectif de recherche consiste à identifier les facteurs de stress associés à leur rôle, puis à vérifier l’influence de ceux-ci sur leur niveau de détresse psychologique. Nous optons pour une méthodologie mixte en déployant un devis de type séquentiel exploratoire (Creswell, 2009). Ce type de devis débute par une approche inductive qui permet la collecte de données qualitatives (N=14) propices à la découverte de facteurs de stress spécifiques. Le volet quantitatif subséquent permet de vérifier l’effet de ces facteurs de stress sur le niveau de détresse psychologique à l’aide de données collectées auprès d’un plus vaste échantillon (N= 243). Notre recherche mixte permet d’abord de mettre en lumière les facteurs de risque spécifiques au rôle des cadres de premier niveau, soit le conflit imputabilité/contrôle ainsi que le conflit de rôle associé à la position paradoxale qu’ils occupent. Ensuite, l’étude hypothético-déductive montre que ces facteurs spécifiques contribuent à influencer leur niveau de détresse psychologique, tout comme les facteurs de risque génériques (c.-à-d. la charge de travail quantitative). Nos résultats permettent de mieux comprendre comment les tâches et les responsabilités contribuent à engendrer de la détresse psychologique en plus de positionner les facteurs de risque spécifiques au rôle des cadres de premier niveau comme une avenue de recherche pertinente pour mieux comprendre le phénomène de la détresse psychologique au travail.

Assessing Psychosocial Readiness for Gene Therapy in Sickle Cell Disease: A Consensus Statement

Introduction: Scientific evidence regarding the efficacy and safety of gene therapy for sickle cell disease (SCD) is growing and clinical trials are increasingly available to patients. As a result, clinical trial teams are now challenged with considering the ways in which psychosocial factors may affect patient decisions about pursuing gene therapy and how pre-gene therapy psychosocial functioning may influence long-term patient outcomes. Although data specific to gene therapy for SCD are currently limited, research in other chronic illness populations undergoing major medical procedures (e.g., solid organ and stem cell transplants) suggest that premorbid psychosocial functioning affects decision-making and post-procedure outcomes. Clinical observations support the relevance of considering psychosocial readiness for curative therapies in patients with SCD but there is a lack of guidance regarding how to carry out such evaluations. Therefore, the NHLBI's Cure Sickle Cell Initiative (CureSCi) formed the Patient Readiness and Resilience Working Group to develop consensus recommendations regarding the assessment of psychosocial readiness in the context of gene therapy for SCD. Methods: The NHLBI CureSCi Patient Readiness and Resilience Working Group was formed in September 2020 and consisted of 10 members including mental health clinicians, researchers, and patients and caregivers. The working group met from 2020-2022 to develop best practice recommendations for the assessment of patient readiness and resilience prior to gene therapy for SCD. Recommendations were developed based on available scientific evidence, expert clinical guidance, review of strategic planning documents, and consultation with CureSCi subcommittees and working groups representative of patient, advocate, clinician, and researcher perspectives. A draft of the consensus recommendations was released for public comment in 2022 and final revisions were completed in early 2023. Results: The CureSCi Patient Readiness and Resilience Working Group reached consensus regarding recommended practices for conducting pre-gene therapy assessments of patient readiness in SCD. The working group developed a recommended workflow for assessing patient readiness, including an institutional self-assessment of readiness to support patients' mental health and address psychosocial barriers to care, brief screening of cognitive functioning and health literacy, patient education about clinical trials and gene therapy, assessment of patient readiness and resilience followed by interventions to address areas of concern, and informed consent. Detailed guidance was developed across four primary domains: 1) Effective education delivery; 2) Evaluation of knowledge and understanding; 3) Evaluation of interest and motivation; and 4) Evaluation of psychosocial risk and resilience factors. The working group created a guide to support implementation of pre-gene therapy assessments, which outlines evidence-based strategies for effective patient education, recommended assessment tools, and sample clinical interview questions. Conclusions: As gene therapy for SCD becomes increasingly available to patients, there is a growing need to be prepared to consider readiness and resilience factors that could affect patient well-being before, during, and after treatment. This CureSCi working group developed a set of consensus recommendations regarding the assessment of psychosocial factors in the context of gene therapy for SCD. A thorough guide was developed to aid in implementation of pre-gene therapy assessments across a range of institutional settings. The presentation will review consensus recommendations, describe practical strategies for conducting assessments, and discuss areas for future research.

Impact of Neighborhood Opportunity on Missed Clinic Visits and Acute Care Utilization in Individuals with Sickle Cell Disease

Background: Sickle cell disease (SCD) is a complex inherited blood disorder associated with high acute healthcare utilization, further complicated by psychosocial and socioeconomic factors. Social determinants of health (SDOH) have a known impact on healthcare access and health outcomes, particularly in minoritized communities. The Area Deprivation Index (ADI) is a composite measure of neighborhood socioeconomic disadvantage. The Childhood Opportunity Index (COI) is a validated approach for estimating multi-dimensional SDOH leading to inequitable distribution of opportunity across neighborhoods. Both have been associated with acute care utilization in pediatric populations other than SCD. We hypothesize that ADI and COI will be associated with acute care utilization and care access in SCD, as well. Methods: Data were collected retrospectively from the electronic medical record between September 2021 and July 2023 for patients followed at a Midwestern Pediatric SCD Clinic who completed a Psychosocial Assessment Tool (PAT) at an annual comprehensive visit. The PAT is a validated quantitative caregiver survey used to screen for psychosocial risk factors and resiliency, with subcategories such as social support, child problems, structure/resources, and family beliefs. Number of emergency department (ED) visits, hospitalizations, and missed clinic visits were collected from the time the PAT was completed up to 1 year after (or the end of the data collection period). The area deprivation index (ADI) and childhood opportunity index (COI) were determined utilizing census block data for the patient at the time the PAT was completed. Descriptive statistics were performed on all data above, as well as t-tests and chi square tests for univariate analyses. Results: One hundred seventy-four unique patients completed a PAT during the study period. The median age of the child with SCD was 11.5 years (range 4-22 years), with the majority having Hb SS disease (61%). Eighty-nine percent had a primary care provider documented and 75% had public insurance. The median state ADI (6) and COI (2) for the cohort demonstrated significant neighborhood disadvantage/SDOH for all patients (See Figure). Ninety-two unique patients had 239 ED encounters. Fifty-eight unique patients accounted for 149 hospitalizations. Forty-seven percent of those hospitalized had a PAT in the Targeted or Clinical range (i.e. increased psychosocial stressors) compared to 30% of those who had not been hospitalized ( p=0.04). There was no statistically significant difference between ADI or COI and number of ED encounters or hospitalizations. However, patients who missed 1 or more SCD visits (n=79) had a higher median state ADI than those who did not miss a visit (8 vs 6, p=0.009). Median state COI was also lower in this group than those who did not miss a visit (1 vs 2, p=0.008). Forty-eight percent of those who missed 1 or more SCD visit had a PAT in the Targeted or Clinical category versus 27% of those who did not miss any ( p=0.009). Conclusion: While those with significant SDOH and neighborhood disadvantage did not have higher rates of acute care utilization in this cohort, there was a significant contribution to missed preventative SCD care visits, further emphasizing the need for psychosocial support and resources as essential elements to SCD programs, as well as alternative forms of care delivery, such as telemedicine, to improve access to SCD specialists. Further studies are needed to understand the impact comprehensive resources such as these may have on care burden, as well as disease outcomes.

The importance, consequences and treatment of psychosocial risk factors in heart disease: less conversation, more action!

Psychosocial factors play asignificant role in the incidence and prognosis of cardiovascular disease with arapidly increasing body of knowledge, as acknowledged by their inclusion in the European Society of Cardiology cardiovascular prevention guideline since 2012. Nevertheless, psychosocial risk is not consistently assessed, acknowledged and treated in daily clinical practice. Therefore, adopting amultidimensional approach that encompasses biological, psychological, and social factors is crucial for understanding the dynamic nature of cardiovascular health and disease, delivering patient-centred care, and developing effective interventions to ultimately enhance health and satisfaction with contemporary medicine and care. The current review summarises the state-of-the-art evidence for screening and treating psychological risk factors in coronary heart disease, heart failure, and atrial fibrillation in the context of cardiac rehabilitation, along with accompanying recommendations. The limited adoption of routine screening, despite longstanding recommendations, highlights the importance of prioritising the implementation and expansion of routine screening in primary and secondary prevention. To advance psychosocial treatment, astandardised and personalised approach including comprehensive education, physical exercise, and psychosocial support with afocus on patient-reported outcomes is crucial. Treating heart and mind together has the potential to decrease psychosocial risk while enhancing the prognosis and quality of life, therefore delivering true patient-centred care.

Risk factors for household food insecurity in the Eastern Caribbean Health Outcomes Research Network cohort study.

Globally, 1.3 billion people were considered food insecure as of 2022. In the Caribbean region, the prevalence of moderate or severe food insecurity was 71.3% as of 2020, the highest of all subregions in Latin America. Experienced based measurement scales, like the Latin American and Caribbean Food Security Scale, are efficient measurement tools of food insecurity used globally. The Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study is a population-based longitudinal cohort study in the two Caribbean U.S. territories of Puerto Rico and the U.S. Virgin Islands, as well as in Barbados and Trinidad & Tobago. The purpose of this research was to examine the demographic, psychosocial, behavioral, and environmental risk factors associated with household food insecurity (HFI) among adults ≥40 years of age in the ECHORN cohort. A cross-sectional analysis of baseline ECHORN cohort study data was conducted. The primary outcome was household food insecurity (none, mild, moderate/severe). A total of 16 known and potential risk factors were examined for their association with HFI. The ANOVA and chi-square statistics were used in bivariate analysis. Ordinal logistic regression was used for the multivariable and sex stratified analyses. More than one-quarter of the sample (27.3%) experienced HFI. In bivariate analyses, all risk factors examined except for sex, were significantly associated with HFI status. In the multivariable analysis, all variables except sex, education, marital status, smoking status, and residing in Puerto Rico were significant predictors of HFI in the adjusted model. In sex stratified analysis, depression, food availability, self-rated physical health, and island site were significantly associated with increased odds of worsening HFI for women, but not for men. Source of potable water was an important risk factor for both men and women. The prevalence of HFI in the ECHORN cohort study is comparable to other studies conducted in the region. While women did not have an increased risk of HFI compared to men, a different set of risk factors affected their vulnerability to HFI. More research is needed to understand how water and food security are interrelated in the ECHORN cohort.

Psychosocial and environmental risk factors of obesity and hypertension in children and adolescents-a literature overview.

Childhood obesity has become a worldwide epidemic in the 21st century. Its treatment is challenging and often ineffective, among others due to complex, often not obvious causes. Awareness of the existence and meaning of psychosocial and environmental risk factors seems to be an essential element in the prevention and treatment of obesity and its complications, especially arterial hypertension. In this review, we will discuss the role of that risk factors linking obesity and increased cardiovascular disorders including the role of nutritional factors (including the role of unhealthy diet, inadequate hydration), unhealthy behaviors (e.g. smoking, alcohol and drugs, sedentary behavior, low physical activity, disrupted circadian rhythms, sleep disorders, screen exposure), unfavorable social factors (such as dysfunctional family, bullying, chronic stress, mood disorders, depression, urbanization, noise, and environmental pollution), and finally differences in cardiovascular risk in girls and boys.

Dual Diagnosis in a Forensic Patient Sample: A Preliminary Tripartite Investigation to Inform Group Treatment Delivery for Substance Use

ABSTRACT The etiology of forensic dual diagnosis and the efficacy of psychosocial substance use interventions remain poorly understood. This multi-study: (1) Examined what is empirically known about forensic psychosocial substance use interventions; (2) Empirically quantified from forensic inpatient’s perspectives (n 12) psychosocial risk factors relevant to substance using behaviors (Study 1); and (3) Evaluated from forensic service users ( 12) and service providers ( 9) standpoint the acceptability and feasibility of a novel substance use intervention (Study 2). Findings showed that (1) Existing interventions are of limited effectiveness; and (2) Eleven etiological psychosocial risk factors and two bifurcative pathways are arguably implicated in substance using behaviors.

THE ASSOCIATION BETWEEN INDIVIDUAL, PHYSICAL, AND PSYCHOSOCIAL RISK FACTORS AND OCCUPATIONAL FATIGUE AMONG COMMUTER LINE TRAIN WORKERS

Introduction: Occupational fatigue affects workers in various industries including transportation. Commuter train drivers and office workers are subjected to high levels of physical and psychosocial stress, which can lead to occupational fatigue. Aims: to examine the relationship between individual, physical, and psychosocial risk factors and occupational fatigue in commuter train workers in Jakarta, Bogor, Tangerang, and Bekasi. Methods: Individual (i.e., age, gender, marital status, type of work, duration of work, and smoking status), psychosocial (i.e., effort, reward, overcommitment, monotonous work, social support, job satisfaction, and work stress) factors, and occupational fatigue were investigated in 78 commuter line train workers (both drivers and officers). Observing workers' activities yielded physical factors (awkward posture, repetitive work, prolonged work, and material manual handling activities). The association between each risk factor and occupational fatigue was investigated using a logistic regression model. Results: Commuter line officers (OR 4.96, 95% CI 1.77 – 13.85), those with high overcommitment (OR 3.16, 95% CI 1.25 – 8.00), and those with high work stress (OR 1.54, 95% CI 1.19 – 2.00) were more likely to report occupational fatigue than train drivers, who reported low overcommitment and low work stress, respectively. When compared to those who reported low job satisfaction, those who reported high job satisfaction were less likely to report occupational fatigue (OR 0.19, 95% CI 0.07 – 0.52). Conclusion: Job position, overcommitment, and work stress were associated with occupational fatigue.

"There just isn't any other option-so we just have to put up with it": mental health in women's cycling and the necessity of structural change.

Historically, bicycle riding connoted freedom, independence, and enhanced mental and physical wellbeing for women. Persevering through criticism and moral panic, female cyclists have been competitive since the late 19th century-many earning substantial prize money and prestige. Unfortunately, this progress was not linear in its trajectory and contemporary professional women's cycling continues to be pervaded by structural and cultural challenges, which can have deleterious effects on athlete mental health. Notably, socioeconomic pressures endure, like unstable employment terms, limited team support, and role conflicts. Furthermore, sexual harassment, body shaming, and manipulation may characterize women's experiences with their coaches and teams. Sizable investment gaps between men's and women's teams and competitions often underpin these scenarios of disadvantage. Alongside hindering the development of women's cycling, these adverse circumstances may induce psychosocial risk factors. Within this context, by highlighting sport-specific and sex-specific considerations, the emerging subdiscipline of sports psychiatry can be valuable for protecting and promoting athlete welfare in women's cycling. Raising awareness about extant symptoms, vulnerabilities, contributing behaviours, and systemic issues, can bolster efforts to develop better conditions and care equivalence. To that end, this perspective article draws upon anecdotal and scholarly evidence to provide an overview of psychiatric concerns in women's professional cycling. This informs recommended strategies to improve mental health and advance equality within the sport, which should involve actions from several stakeholders, such as athletes, teams, and governing bodies.

Impact of central sensitization on pain, disability and psychological distress in patients with knee osteoarthritis and chronic low back pain

BackgroundCentral sensitization (CS) is becoming increasingly recognized as a significant factor in many chronic pain conditions, including knee osteoarthritis (KOA) and chronic low back pain (CLBP). Yet it presently remains unclear how strong is the involvement of CS in KOA and CLBP and which factors are involved in CS in these two chronic disabling diseases.MethodsThis is a cross-sectional study in which included a total of 178 patients with KOA and 118 patients with CLBP. Inclusion criteria for eligible participants for the KOA group were a confirmed diagnosis of KOA according to the American College of Rheumatology criteria, and for the CLBP group a chronic low back pain for more than 3 months. Subjects were excluded if they presented with a diagnosed psychiatric disorder or if they lacked the capacity to provide informed consent, understand study questionnaires or perform physical performance tests. In each group, were assessed; CS-related symptoms using the Central Sentization Inventory (CSI); demographic and clinical characteristics such as disease duration, pain intensity on a visual analog scale, self-reported function using the Lequesne index for KOA patients and the Oswestry Disability index for CLBP patients, and physical performance with the 6 minutes’ walk test; as well as psychosocial risk factors using the Patient Health Questionnaire for depression (PHQ-9), the Generalized Anxiety Disorder (GAD-7) and the Pain Catastrophizing Scale (PCS).ResultsCSI scores significantly correlated with pain intensity and disability in KOA and CLBP patients, and were highly correlated with self-reported symptoms of depression, anxiety and pain catastrophizing. Depression significantly predicted the CSI score in both groups.ConclusionThese findings provide further evidence for the impact of CS on pain, function and physical performance in KOA and CLBP patients. Psychosocial symptoms such as pain catastrophizing, anxiety and depression should also be considered as they are also associated with CS.