Disparities In Rates Research Articles

Mechanics limits ecological diversity and promotes heterogeneity in confined bacterial communities

Multispecies bacterial populations often inhabit confined and densely packed environments where spatial competition determines the ecological diversity of the community. However, the role of mechanical interactions in shaping the ecology is still poorly understood. Here, we study a model system consisting of two populations of nonmotile Escherichia coli bacteria competing within open, monolayer microchannels. The competitive dynamics is observed to be biphasic: After seeding, either one strain rapidly fixates or both strains orient into spatially stratified, stable communities. We find that mechanical interactions with other cells and local spatial constraints influence the resulting community ecology in unexpected ways, severely limiting the overall diversity of the communities while simultaneously allowing for the establishment of stable, heterogeneous populations of bacteria displaying disparate growth rates. Surprisingly, the populations have a high probability of coexisting even when one strain has a significant growth advantage. A more coccus morphology is shown to provide a selective advantage, but agent-based simulations indicate this is due to hydrodynamic and adhesion effects within the microchannel and not from breaking of the nematic ordering. Our observations are qualitatively reproduced by a simple Pólya urn model, which suggests the generality of our findings for confined population dynamics and highlights the importance of early colonization conditions on the resulting diversity and ecology of bacterial communities. These results provide fundamental insights into the determinants of community diversity in dense confined ecosystems where spatial exclusion is central to competition as in organized biofilms or intestinal crypts.

Effectiveness of hierarchical medical system and economic growth: based on China's urban vs. rural health perspectives.

The hierarchical medical system is an important measure to promote equitable healthcare and sustain economic development. As the population's consumption level rises, the demand for healthcare services also increases. Based on urban and rural perspectives in China, this study aims to investigate the effectiveness of the hierarchical medical system and its relationship with economic development in China. The study analyses panel data collected from Chinese government authorities, covering the period from 2009 to 2022. According to China's regional development policy, China is divided into the following regions: Eastern, Middle, Western, and Northeastern. Urban and rural component factors were downscaled using principal component analysis (PCA). The factor score formula combined with Urban-rural disparity rate (ΔD) were utilized to construct models for evaluating the effectiveness of the hierarchical medical system from an urban-rural perspective. A Vector Autoregression model is then constructed to analyze the dynamic relationship between the effects of the hierarchical medical system and economic growth, and to predict potential future changes. Three principal factors were extracted. The contributions of the three principal factors were 38.132, 27.662, and 23.028%. In 2021, the hierarchical medical systems worked well in Henan (F = 47245.887), Shandong (F = 45999.640), and Guangdong (F = 42856.163). The Northeast (ΔDmax = 18.77%) and Eastern region (ΔDmax = 26.04%) had smaller disparities than the Middle (ΔDmax = 49.25%) and Western region (ΔDmax = 56.70%). Vector autoregression model reveals a long-term cointegration relationship between economic development and the healthcare burden for both urban and rural residents (βurban = 3.09, βrural = 3.66), as well as the number of individuals receiving health education (β = -0.3492). Both the Granger causality test and impulse response analysis validate the existence of a substantial time lag between the impact of the hierarchical medical system and economic growth. Residents in urban areas are more affected by economic factors, while those in rural areas are more influenced by time considerations. The urban rural disparity in the hierarchical medical system is associated with the level of economic development of the region. When formulating policies for economically relevant hierarchical medical systems, it is important to consider the impact of longer lags.

Research on Cross-International Business Operation and Management Strategies of Enterprises

As globalization accelerates, the corporate realm finds itself amidst an unprecedented international business landscape. Conventional marketing paradigms and management strategies falter in such rapidly shifting environments, presenting both challenges and opportunities for multinational operations. This discourse delves into the myriad challenges facing multinational corporations, such as policy risks, legal framework disparities, cultural differentials, economic and monetary policy uncertainties, and disparate rates of technological advancement. Moreover, the article conducts a profound analysis of theories pertaining to international business and multinational management, cultural variance theories, as well as strategic management theories, with the aim of furnishing a robust theoretical foundation for multinational operations and management. Beyond mere theoretical exploration, this article also endeavors to elucidate various successful strategies in multinational operations and management, encompassing market entry strategies, marketing strategies, human resources management strategies, and financial and risk management strategies, in order to furnish enterprises engaging in international markets with reliable guidance and successful paradigms, thus encouraging the realization of both social value and commercial interests in tandem.

Racial Implicit Associations in Child Psychiatry

Racial disparities in diagnosis and treatment are prevalent in child psychiatry, including disparate diagnosis rates of internalizing and externalizing disorders in Black and White children. However, limited research has investigated mechanisms that contribute to these disparities. This study examined child racial implicit associations in psychiatric clinicians and medical students to address this gap. Psychiatrists and trainees completed an online survey including 2 race Implicit Association Tests (IATs) pairing child faces to words with either positive or negative valence, and words related to internalizing or externalizing behavioral problems. Psychiatrists and trainees' demographic predictors of implicit associations were also investigated. Data were analyzed from 235 psychiatrists and trainees (112 child and adolescent psychiatrists and fellows) who met inclusion criteria. Psychiatrists and trainees demonstrated greater moderate-to-strong association between Black child faces and "bad" (ie, negatively valenced) words (44.3%) vs "good" (ie, positively valenced) words (6.4%), and between externalizing words (41.7%) vs internalizing words (7.2%). Psychiatrists and trainees' demographic characteristics including being female (β=-0.12; 95% CI=-0.23 to-0.01; p< .05), Black (β=-0.36; 95% CI=-0.54 to-0.18; p< .001), or an attending physician (β=-0.26; 95% CI=-0.45 to-0.06; p= .01) were significant predictors of decreased association between Black child faces and negative valence words. Being female was a significant predictor of decreased association between Black child faces and externalizing words (β=-0.26; 95% CI=-0.45 to-0.06; p= .01). Participating psychiatrists and trainees demonstrated bias toward associating Black rather than White child faces with negative words and externalizing behavioral problems. Future research should examine the following: racial implicit associations in a more generalizable sample; the relationship between race IATs and provider behavior; and interventions to reduce racial inequities in psychiatry, including individual and systemic solutions. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper received support from a program designed to increase minority representation in science.

Suicidality and Non-Suicidal Self-Injury: A Narrative Review of Measurement, Risk, and Disparities among Minoritized and System-Involved Youth in the USA.

Suicidality and non-suicidal self-injury (NSSI) among youth in the United States continue to be a growing and serious public health concern. With alarming rates of suicide trending in the wrong direction, researchers are committed to bending the curve of suicide and reducing rates by 2025. Understanding the antecedents and conditions, existing measures, and disparate prevalence rates across minoritized groups is imperative for developing effective strategies for meeting this goal. This study presents a narrative review of the operationalization, measurement, risk factors (e.g., firearms and social media), and disparities across race, ethnicity, age, gender identity, ability, sexual orientation, immigration statuses, and system involvement (e.g., foster care and juvenile justice) of suicidality and non-suicidal self-harm across youth in the United States. Implications for research, practice, and policy approaches that incorporate positive youth development, cultural, and youth participation in interventions are discussed.

Gender imbalance in the labor market: causes and features

The article examines current research on labor mobility and gender inequality in the labor market: occupational segregation, unequal pay and the «maternity penalty». The study of the impact of gender stereotypes, social foundations, choice of educational path and professional environment on wage disparities between women and men was conducted. Wage imbalances are widespread around the world and affect the majority of economic sectors and employment types. In Russia data on the gender pay gap varies widely by region, economic sector and occupational group, and where male employment prevails, the rate of disparity is often higher. The recommendations from international organizations on equalizing women and men in labor rights are given.

767 Racial and Gender Disparities in Traumatic Brain Injury Clinical Trial Enrollment

INTRODUCTION: Despite the increasing number of women and racial/ethnic minorities sustaining Traumatic Brain Injuries (TBI), they are underrepresented in TBI clinical trials. METHODS: The authors conducted a review of TBI clinical trials with reported results registered in ClinicalTrials.gov between 2008 and 2022. The studies were assessed for the proportion of women and racial/ethnic minorities enrolled as well as their reporting of race and gender-specific characteristics such as Gender Ratio (GR) and Racial Diversity Index (RDI). Furthermore, study parameters including year and duration, phase, trial design, type of funding, and trial completion were included. RESULTS: 135 clinical trials met inclusion criteria, of which 65 and 134 reported race and gender, respectively. 25 trials were found to have existing racial disparity (RDI &lt; 1). Comparatively, industry-funded trials had a 26% more likelihood of racial disparities (p = 0.026), whereas federally-funded trials were 30% less likely (p = 0.031). 66 trials had gender disparities (GR &lt; 0.4) present, with federally-funded trials having 37.1% greater rates of gender disparity (p &lt; 0.001, aOR: 5.47, 95% CI: 2.26-14.25). The impact of funding source on race and gender remained significant despite adjusting for other covariates in the multivariate analyses. Racial disparity was negatively correlated with trial completion rate (p &lt; 0.001). Disparities were not found to improve over the 14-year span. CONCLUSIONS: Racial and gender disparities in TBI clinical trial enrollment persist, and the lack of diversity may lead to biased evidence-based medicine. Efforts should be made to increase the representation of women and racial/ethnic minorities in TBI clinical trials to ensure equitable access to effective treatments for all populations.

Abstract 3472: Tailored cancer outreach efforts of a community outreach core working with Native Hawaiian and Pacific Islanders in Hawaiʻi

Abstract Background The Community Outreach Core (COC) of the Pacific Island Partnership for Cancer Health Equity (PIPCHE) aims to improve health equity for historically underserved populations including Native Hawaiians and other Pacific Islanders (NHOPIs), and Filipinos. PIPCHE is a partnership between the University of Hawai’i Cancer Center and the University of Guam whose efforts are focused in Hawaiʻi, Guam and the U.S. Affiliated Pacific Islands (USAPI). The COC directly addresses the disproportionately high rates of health disparities and cancer incidence and mortality found within NHOPIs often due to multiple complex historical, social, cultural, and environmental factors. Cancer is the second leading cause of death in Hawai’i between 2014-2018, as well as the second most common cause of death in nearly all USAPI jurisdictions. The COC uses research-tested, community-engaged approaches to modify determinants of cancer in these groups. Methods Outreach efforts have addressed NHOPI cancer inequities by raising awareness of high cancer burdens experienced by these underserved communities. Efforts include resource sharing and data collection at various venues in Hawaiʻi such as health/wellness fairs, public housing, and Pacific Islander churches. Outreach Advisory Council meetings were held biannually with community health leaders to discuss ongoing and future initiatives/resource sharing. The COC provided health providers and students with cultural competency training on more efficient strategies to work with these unique NHOPI groups. The COC provided presentations and short talks across the U.S, including a Health Providers Symposium on lung cancer across the Pacific. Outreach efforts have included tailored NCI-based Screen to Save (S2S) colorectal cancer education to NHOPIs. Results Forty-seven major outreach events were conducted from 2021 to November 2023. These include: 1 Health Providers’ Cancer Symposium, 5 Outreach Advisory Council meetings, 5 Cultural Competency trainings and class lectures, 11 conference/community and short talk presentations, and 25 community outreach events. There were 1,900 attendees reached during these regional and national outreach activities. The COC works with professional audiences at the national level to inform these groups about cancer and the health burdens of NHOPIs. A total of 97 Pacific Islanders received the S2S education and completed a pre-posttest with positive increases in means found for all 14 questions. Conclusion The PIPCHE COC has been able to reach NHOPIs though community partnerships to deliver culturally tailored cancer prevention education and efforts within Hawaiʻi, as well as shed light nationally of the cancer burdens these populations face. The S2S education has been able to raise awareness of cancer screenings and holds promise as a potential strategy to address cancer burdens of NHOPI communities. Citation Format: Mark Lee Willingham Jr., Kevin D. Cassel, Angela Sy, Munirih Taafaki, Tressa P. Diaz, Antoinette Kleiner, Angelina Mummert. Tailored cancer outreach efforts of a community outreach core working with Native Hawaiian and Pacific Islanders in Hawaiʻi [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3472.

Abstract 7035: Characterization of tissue-resident memory T cells in hepatocellular carcinoma through single-cell multi-omics

Abstract As the fifth leading cause of cancer-related mortality, liver cancer imposes a global burden. Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, with a five-year overall survival rate of less than 20% for advanced-stage cases. Even the most advanced immunotherapy for HCC has disparate response rates in each patient with HCC, which has led to efforts to unravel the underlying factors in the progression of HCC using bioinformatic approaches. In recent decades, numerous studies have explored T-cell subtypes with tissue-specific residency, suggesting their early protective functions and therapeutic potential within tumor microenvironment (TME). This study aimed to understand inter-individual and intercellular TME through single-cell RNA sequencing (scRNA-seq) and single-cell TCR sequencing (scTCR-seq) in five recurrent/non-recurrent HCC patients. We identified tumor-associated tissue-resident memory T (TA-TRM) cells and investigated the heterogeneous characteristics of two TRM clusters (CD69+ and CD103+). Whereas CD69+ TA-TRM showed high expression of genes associated with immunological activation, CD103+ TA-TRM exhibited upregulation of genes related to proliferation capacity. To validate the unique molecular patterns, we analyzed an independent HCC dataset (GSE140228) and observed high concordance of significant core marker genes for TA-TRM clusters between the two datasets. Moreover, we assessed the association of gene expression in TA-TRM cells with overall and recurrence-free survival by conducting survival analysis in two independent large-scale cohorts. The cross-validation approach was applied to estimate risk scores for patients with primary HCC tumors in The Cancer Genome Atlas (TCGA), and the trained model was evaluated using the International Cancer Genome Consortium (ICGC) data. The result of calculating the risk scores clearly indicates that TA-TRM cells are associated with survival in HCC. Therefore, our study characterized two distinct subtypes of TA-TRM cells in HCC, delineated their unique molecular signatures, and established their relevance to survival outcomes. The findings can potentially enhance the understanding of the roles of TA-TRM cells in the context of HCC. Citation Format: Mi-So Park, Hyunbin Cho, Hyeree Kim, Woong-Yang Park, Yong-Han Paik, Yeup Yoon, Wonseok Kang, Hong-Hee Won. Characterization of tissue-resident memory T cells in hepatocellular carcinoma through single-cell multi-omics [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 7035.

Abstract 2137: Racial disparities in triple-negative breast cancer (TNBC) mortality rates in Hampton Roads Virginia and the effects of SIAH expression on prognosis

Abstract Background: While high-resolution imaging and advancements in therapies have significantly improved breast cancer survival rates, 43,170 breast cancer patients will die in the United States in 2023 alone. Triple-negative breast cancer (TNBC) is the most aggressive breast cancer subtype and disproportionately affects BRCA1 mutation carriers and young black women. Black/African American (AA) patients have the highest mortality and the shortest survival of any racial/ethnic group in the US. Persistent cancer racial disparities remain due to a variety of risk factors. The SEER/CDC data show an 8% lower breast cancer incidence rate and a 41% higher mortality rate in Black/AA patients compared to their white counterparts. Methods: Chart review was conducted using Sentara MD Office/EPIC and VOA iKnowMedicine portals to update tumor relapse, metastasis, and survival in 577 TNBC patients. Supported by strong evidence in developmental, evolutionary, and cancer biology, we hypothesize that persistent EGFR/K-RAS/SIAH pathway activation is a major driving force of TNBC malignancy, racial disparity, early relapse, and high mortality. We propose to integrate SIAH expression to augment the existing clinicopathological parameters to improve patient risk stratification, therapy quantification, and relapse/survival prediction at the 1st-line neoadjuvant settings. Results: We report that cancer disparity and high mortality rates are even more pronounced in our racially-diverse communities in Hampton Roads Virginia. We discovered that SIAH is a tumor-specific, therapy-responsive, and prognostic biomarker in TNBC. High SIAH expression in residual tumors reflects tumor-driving EGFR/K-RAS/SIAH pathway activation (ON) that will predict cancer disparity, treatment resistance, early relapse, and poor survival. Low SIAH expression in residual tumors reflect EGFR/K-RAS/SIAH pathway inactivation (OFF) that will predict tumor remission and prolonged survival. Conclusion: We detect a major racial disparity of TNBC patients at Sentara-EVMS-VOA. Our local Black/AA TNBC patients have a 1.6-fold higher mortality rate than their White counterparts. Encouraged by our preliminary data, we aim to develop a SIAH-centered biomarker panel by measuring the EGFR/K-RAS/SIAH pathway activation (ON)/inactivation (OFF), and use SIAH as a new prognostic biomarker to risk stratify patients, detect cancer racial disparities, forecast tumor relapse, and predict patient survival at 1st-line neoadjuvant settings. By targeting SIAH, individualized treatments can be created to allow for increased survival rates in at risk individuals with more aggressive TNBCs. Citation Format: Claire B. Piatak, Taylor N. Drake, Ashleigh Hannah, Jonathan Baker, Caroline L. Dasom, Emily L. Breeding, Janet S. Winston, Billur Samli, Rick Jansen, Michael Danso, Richard A. Hoefer, Amy H. Tang. Racial disparities in triple-negative breast cancer (TNBC) mortality rates in Hampton Roads Virginia and the effects of SIAH expression on prognosis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2137.

Advancing Equity through Effective Youth Engagement in Public Health to Operationalize Racism as a Public Health Crisis: The Flint Public Health Youth Academy Model

Background: The underrepresentation of BIPOC youth in the fields of public health, medicine, and research may be a factor contributing to the disproportionate rates of health disparities in BIPOC communities. In 2004, the Sullivan Commission on Diversity in the Healthcare Workforce, commissioned by the White House and led by the United States Health and Human Services, recommended efforts to increase the number of minority professionals in the aforementioned fields as necessary for addressing racial and ethnic health disparities. More recently, over 240 municipalities in the United States have declared “racism a public health crisis”. This national declaration links racism directly to public health disparities, thus calling for a public health response. The Flint Public Health Youth Academy (FPHYA) provides an effective model of youth engagement steeped in Equity, Diversity, and Inclusion (EDI). FPHYA was created based on a dissertation study designed to explore the motivators for engagement of African American and other minority students into careers in public health and its six recommendations. Methods: The FPHYA Model described in this article uses a case study of the Flint Water Crisis to assess and explore effective youth engagement models for public health. This model is rooted in the Continuum of Community Engagement and Youth Empowerment Theory and explores FPHYA’s contribution of youth voice in operationalizing racism as a public health crisis.

Perceived nutrition needs of people experiencing disadvantage in utilizing support services: An Australian case study.

Individuals experiencing socio-economic disadvantage face higher rates of food insecurity and health disparities. This study explored the perceptions, attitudes, and knowledge of individuals providing nutrition services, and users of these services, to identify nutrition needs and inform potential strategies for addressing diet-related health inequities. Semi-structured interviews were conducted utilizing a phenomenological approach to explore lived experiences, beliefs, and perceptions influencing nutrition-related health. Key themes were derived by consensus among researchers using inductive thematic analysis. Twenty-two interviews were completed, which identified five themes. "Budgetary Constraints" was found to have a pervasive impact on all nutrition-related services. Secondly, diverse "Individual Clientele" was found to influence three overlapping themes pertaining to opportunities and limitations for "Knowledge and Skills," "Services, Resources and Staff," and the "Systems and Food Environment." Budgets directly impact the availability of services, resources, food provision, sustainability, and educational opportunities for staff, volunteers and service users. A live-in environment offers a platform to implement and evaluate targeted interventions to inform and enhance nutrition-related support services. Future interventions should address individual and systemic influences, prioritizing client-informed, cost-effective, sustainable capacity building for clients and staff. Recommendations for systemic and environmental influences include formalized staff training, peer-mentoring systems, and increasing client autonomy. This has the potential to improve food security for residents following their transition into independent living. Charitable system limitations underscore the need for broader systemic change, informed policymaking, and government intervention to effectively address the root causes of food insecurity and diet-related health inequities.

An analysis of Hawaiian identity and life satisfaction through cultural reclamation: implications for Hawaiian well-being

Today, the Hawaiian community faces high rates of health disparities, as well as loss of land, language, and culture due to colonization. However, Hawaiians continue to keep their culture alive, and cultural reclamation theory argues that Indigenous Peoples are healthier when they have opportunities to engage with their cultural practices. This theory points to culture as a possible intervention. We analyze data from the 2019 Native Hawaiian Survey, which examines Hawaiian identity through a sample of over 1,000 participants across Hawaiʻi who are 18 years or older and have Hawaiian ancestry. Drawing upon what it means to identify as Hawaiian, we expect a positive relationship between activities that increase connection to Hawaiian culture and life satisfaction. We find statistical significance in consideration of sacred spaces, pride in being Hawaiian, and sense of belonging to America and discuss implications for Hawaiian well-being based on these findings.

Incarcerated youth and their siblings: A review of historical and current context, and future directions

AbstractThe 2020 Juvenile Residential Facility Census reports that roughly 25,000 youth in the United States (U.S.) are incarcerated—placing the United States as the leading nation in number of juveniles in correctional facilities worldwide. This paper aims to highlight an overlooked population impacted by this issue: not the incarcerated youth themselves, but their siblings. This paper first grounds historical trends, the effects of racialized sociopolitical systems on disparate rates of incarceration, and the current state of youth incarceration, with a specific focus on impacts on families. This paper reviews the literature on how families are affected by the juvenile justice system in terms of their well‐being, education, and other outcomes—drawing from the small body of research directly on siblings and hypothesizing impacts in need of further study based on families' experiences in the criminal justice system. We present historical and current issues/limitations to understanding and addressing the impacts of youth incarceration on siblings, concluding with areas of future research needed to address the impacts that a youth's incarceration has on their siblings and family.

Black boys unchained: Removing the constraints of racial disparities in discipline at school.

The American Journal of Orthopsychiatry has contributed significantly to scholarly discourse on race and racism especially in its coverage of issues related to the development and well-being of Black boys (BB) and men. Although disparate rates of exclusionary discipline for BB have been widely recognized as a problem, efforts to reduce them have failed. Because exclusion has negative consequences and is ineffective in changing behavior, it should be used rarely or not at all. This article advocates strict limits or outright bans on exclusion up to Grade 6. For BB, the time between pre-K and middle school is a developmentally critical period in which, for a variety of reasons, misconduct is high compared to other groups of children. Instituting bans will require a fundamental change in how school discipline is conceived. Schools will need to reimagine BB and strengthen their social competencies and emotional resilience. This will require a shift in emphasis from punishment to empathy for BB who misbehave. Implementing policies to prohibit exclusion will be difficult in light of opposition from school staff who are reluctant to surrender this tool and disagreements over the role of schools and the responsibility of families for boy's misbehavior. Recommendations for alternative programs and expansion of mental health services have been made in guidance from the federal government and adopted into law by several states. To reduce disparities, schools must establish a culture of caring and support, enact well-reasoned and collaborative regimes of control, and provide BB with interpretive frameworks that convey a sense of purpose and meaning. Together these approaches can free BB from the constraints of harsh and unfair discipline and help them to become the best versions of themselves. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Negative Affect and Drinking among Indigenous Youth: Disaggregating Within- and Between-Person Effects

Negative affect (depression/anxiety) and alcohol use among Indigenous youth in Canada remain a concern for many communities. Disparate rates of these struggles are understood to be a potential outcome of colonization and subsequent intergenerational trauma experienced by individuals, families, and communities. Using a longitudinal design, we examined change in alcohol use and negative affect, and reciprocal associations, among a group of Indigenous adolescents. Indigenous youth (N = 117; 50% male; Mage=12.46–16.28; grades 6–10) from a remote First Nation in northern Quebec completed annual self-reported assessments on negative affect (depression/anxiety) and alcohol use. A Latent Curve Model with Structured Residuals (LCM-SR) was used to distinguish between- and within-person associations of negative affect and alcohol use. Growth models did not support change in depression/anxiety, but reports of drinking increased linearly. At the between-person level, girls reported higher initial levels of depression/anxiety and drinking; depression/anxiety were not associated with drinking. At the within-person level, drinking prospectively predicted increases in depression/anxiety but depression/anxiety did not prospectively predict drinking. When Indigenous adolescents reported drinking more alcohol than usual at one wave of assessment, they reported higher levels of negative affect than expected (given their average levels of depression/anxiety) at the following assessment. Our findings suggest that when Indigenous youth present for treatment reporting alcohol use, they should also be screened for negative affect (depression/anxiety). Conversely, if an Indigenous adolescent presents for treatment reporting negative affect, they should also be screened for alcohol use.

Geographical distance predicts psychiatric treatment retention for Hispanic women with comorbid major depression and breast cancer.

Depression is among the most common comorbid psychiatric disorders of patients with breast cancer. Depression decreases patient quality of life and, if untreated, can adversely affect cancer treatment. We sought to identify treatment barriers for women with breast cancer receiving psychotherapy for depression. Findings may help policy makers and researchers determine funding and design of future studies involving this population, especially in communities with high rates of health disparities. We used data from a randomized trial for women with breast cancer and current DSM-IV non-psychotic unipolar major depressive disorder (MDD). Patients were randomly assigned to 12weeks of one of three psychotherapies and attrition was assessed by whether subjects completed 12 weekly treatment sessions. We used descriptive analyses and logistic regression to identify treatment barriers. R shiny was used to determine study patient residences. Of 134 randomized patients, 84 (62.7%) were Hispanic. Fifty-nine patients (44%) either did not start or dropped out of treatment, 49 (83.1%) of them being Hispanic. Being a Hispanic woman, less educated, and geographically distant from treatment significantly predicted attrition. Single Hispanic mothers had significantly higher attrition risk than married and/or childless women. Identifying barriers to treatment is important to improve treatment adherence for patients with concurrent diagnoses of breast cancer and MDD, especially for traditionally underserved minorities. Additional support such as affordable tele-medicine, multi-language assistance, financial aid for transportation and child-care, and allocation of more funds to address some identified barriers deserve consideration to improve treatment adherence and outcomes.

Comparing the photodegradation of typical antibiotics in ice and in water: Degradation kinetics, mechanisms, and effects of dissolved substances

New antibiotic contaminants have been detected in both surface waters and natural ice across cold regions. However, few studies have revealed distinctions between their ice and aqueous photochemistry. In this study, the photodegradation and effects of the main dissolved substances on the photolytic kinetics were investigated for sulfonamides (SAs) and fluoroquinolones (FQs) in ice/water under simulated sunlight. The results showed that the photolysis of sulfamethizole (SMT), sulfachloropyridazine (SCP), enrofloxacin (ENR) and difloxacin (DIF) in ice/water followed the pseudo-first-order kinetics with their quantum yields ranging from 4.93 × 10−3 to 11.15 × 10−2. The individual antibiotics experienced disparate photodegradation rates in ice and in water. This divergence was attributed to the concentration-enhancing effect and the solvent cage effect that occurred in the freezing process. Moreover, the main constituents (Cl−, HASS, NO3− and Fe(III)) exhibited varying degrees of promotion or inhibition on the photodegradation of SAs and FQs in the two phases (p < 0.05), and these effects were dependent on the individual antibiotics and the matrix. Extrapolation of the laboratory data to the field conditions provided a reasonable estimate of environmental photolytic half-lives (t1/2,E) during midsummer and midwinter in cold regions. The estimated t1/2,E values ranged from 0.02 h for ENR to 14 h for SCP, which depended on the reaction phases, latitudes and seasons. These results revealed the similarities and differences between the ice and aqueous photochemistry of antibiotics, which is important for the accurate assessment of the fate and risk of these new pollutants in cold environments.

The next generation of developmental psychopathology research: Including broader perspectives and becoming more precise.

The current Special Issue marks a major milestone in the history of developmental psychopathology; as the final issue edited by Cicchetti, we have an opportunity to reflect on the remarkable progress of the discipline across the last four decades, as well as challenges and future directions for the field. With contemporary issues in mind, including rising rates of psychopathology, health disparities, and international conflict, as well as rapid growth and accessibility of digital and mobile technologies, the discipline of developmental psychopathology is poised to advance multidisciplinary, developmentally- and contextually- informed research, and to make substantial progress in supporting the healthy development of individuals around the world. We highlight key future directions and challenges for the next generation of developmental psychopathology research including further investigation of culture at multiple levels of analysis, incorporation of macro-level influences into developmental psychopathology research, methods advances to address heterogeneity in translational research, precision mental health, and the extension of developmental psychopathology research across the lifespan.

Describing skin health and disease in urban-living Aboriginal children: co-design, development and feasibility testing of the Koolungar Moorditj Healthy Skin pilot project

BackgroundIndigenous children in colonised nations experience high rates of health disparities linked to historical trauma resulting from displacement and dispossession, as well as ongoing systemic racism. Skin infections and their complications are one such health inequity, with the highest global burden described in remote-living Australian Aboriginal and/or Torres Strait Islander (hereafter respectfully referred to as Aboriginal) children. Yet despite increasing urbanisation, little is known about the skin infection burden for urban-living Aboriginal children. More knowledge is needed to inform service provision, treatment guidelines and community-wide healthy skin strategies. In this pilot study, we aimed to test the feasibility and design of larger multi-site observational studies, provide initial descriptions of skin disease frequency and generate preliminary hypotheses of association.MethodsThis project has been co-designed with local (Noongar) Elders to provide an Australian-first description of skin health and disease in urban-living Aboriginal children. In collaboration with an urban Aboriginal Community Controlled Health Organisation (Derbarl Yerrigan Health Service), we conducted a week-long cross-sectional observational cohort study of Aboriginal children (0–18 years) recruited from the waiting room. Participants completed a questionnaire, skin examination, clinical photos, and swabs and received appropriate treatment. We assessed the feasibility and impact of the pilot study.ResultsFrom 4 to 8 October 2021, we recruited 84 Aboriginal children of whom 80 (95%) were urban-living. With a trusted Aboriginal Health Practitioner leading recruitment, most parents (or caregivers) who were approached consented to participate. Among urban-living children, over half (45/80, 56%) of parents described a current concern with their child’s skin, hair and/or nails; and one-third (26/80, 33%) reported current itchy skin. Using a research-service model, 27% (21/79) of examined urban-living participants received opportunistic same-day treatment and 18% (14/79) were referred for later review.ConclusionsThis co-designed pilot study to understand skin health in urban-living Aboriginal children was feasible and acceptable, with high study participation and subsequent engagement in clinical care observed. Co-design and the strong involvement of Aboriginal people to lead and deliver the project was crucial. The successful pilot has informed larger, multi-site observational studies to more accurately answer questions of disease burden and inform the development of healthy skin messages for urban-living Aboriginal children.